One of the objetives of the health transformation plan (HTP) in Iran is to reduce out-of-pocket (OOP) payments for inpatient services and eradicate informal payments. The HTP has three phases: the first phase is focused on reducing OOP payments for inpatient services; the second phase is focused on primary healthcare (PHC) and the third phase utilizes an updated relative value units for health services and is focused on the elimination of informal payments. This aim of this study was to determine the OOP payments and the frecuency on informal cash payments to physicians for inpatient services before and after the HTP in Kurdistan province, Iran.