How nations can adopt value-based care on the path to universal health coverage
 

Human-centered health systems

We all want and need health systems that are human-centered. At Leapfrog to Value we believe that such systems can produce better health and societal outcomes at a better cost.

How do we build human-centered health systems? 

  • Take a holistic view of human flourishing, addressing the social, behavioral, environmental, and spiritual aspects of wellness, in addition to the biomedical

  • Invest in compassionate and high-quality care that emphasizes prevention in the community, reducing the need for costly drugs and procedures

  • Prioritize health over healthcare. Buying more healthcare doesn’t produce better health; research shows that only ~10% of of outcomes can be attributed to medical interventions.

 
 

Value-based care is a strategy for building human-centered health systems

Value-based care puts forth best practices in how we measure, deliver, and pay for care.

While value-based care has been embraced by the public and private sectors globally (World Health Organization, G20, World Economic Forum), low and middle-income countries(LMICs) have been left out of the dialogue.

We seek to change that. We believe that value-based care can help LMICs bolster the quality of healthcare systems, by making care more patient-centered and thereby improving demand, and by systematically steering more resources to address social, environmental, and behavioral determinants of health. Value-based care models can also optimize costs by rewarding providers for being stewards of resources.

 

Measure

What a health system chooses to measure is its North Star. It guides how it learns, improves, and innovates. It is the basis for how success is defined and how resources flow.

If the goal is to maximize value, measuring value is imperative.

Value = outcomes that matter most to patients/costs to achieve those outcomes

The numerator in the value equation is human-centered outcomes. For a mother and her newborn, this is not only a delivery at term without complications. It’s also a fulfilling birth experience and success with feeding.

The denominator is the costs required to achieve those outcomes. For the same mom and newborn, these are the combined costs of antenatal services, delivery, and post-natal care. This comprehensive view reveals to us when investments in healthy pregnancies are offset by the lower likelihood of complications.


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Deliver

Value-based delivery is built around human-centered care pathways. For each pathway, providers routinely review value-based data and use those insights to continuously improve care.

This focus leads systems to emphasize preventive care in community and primary care settings when possible, providing access to hospital-based treatment when necessary.

What might this look like for diabetes?

  • Proactively reaching out to patients who are at high risk

  • Supporting people in lifestyle changes, drawing on behavioral science and the wisdom of frontline providers

  • Investing in innovative at-home technology that “pays for itself” by improving outcomes and reducing the long-term costs of uncontrolled diabetes


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Pay

The flow of resources in a system can act as the invisible hand that shapes how and where care is delivered, how the health sector recruits talent, and which facilities and infrastructure attract investment.

Given these far-reaching implications, it is important that payment design reflects a health system’s priorities.

This means aligning budgets and payment schemes with the highest-value interventions.

For cancer care, this may mean dissociating a doctor’s income from the decision to prescribe diagnostics, drugs, and procedures. In addition, it can mean rewarding providers for delivering high-quality, compassionate care.

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Why embrace a value-based approach now?

Window of  opportunity: Historically, health systems in low- and middle-income countries have taken a volume-based approach to health rather than a value-based one. The public sector has focused on coverage rates or access, and the private sector profits when it drives quantity of expensive, hospital-based care. Adhering to this path will create long-lasting structural flaws that increase costs without delivering desired results, similar to what we see in many developed economies. We at Leapfrog to Value believe that LMICs have a window of opportunity to leapfrog to a value-based approach.

Care after Covid The global pandemic has generated tailwinds for bold change in the health sector. It has elevated health system strengthening as a priority, accelerated the uptake of innovation, and underscored a need to restore trust in our health systems. Leapfrog to Value and its partners are harnessing these tailwinds.

 

Work

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We partner with global and local institutions to unlock the value of human-centered health systems for patients, providers, and payers in India, South Africa, Ghana, Kenya and beyond.

Innovation

Through rigorous experimentation, we test our core hypothesis that human-centered health systems produce better outcomes at a better cost.
We do this with partners who are prepared to scale what works.

Knowledge

We develop trainings, tools, and case studies that enable other health system leaders to integrate value-based care best practices with their work.

Advocacy

We make the case for health system transformation to leaders in the public and private sectors.

 

Platform for innovation

Our platform facilitates collaboration between provides, payers, and donors, We support these partners in the design of human-centered health innovations. Through rigorous experimentation, we test our core hypothesis that human-centered health systems produce better outcomes at a better cost

 

Patients

Patient advocacy groups shaping human-centered health care.

Providers

Public and private.Selected for innovation and commitment to human-centered care.

Payers

Governments, public & private health insurance schemes.

Donors

Committed to scalling human-centered models alongside major payers.

 
 

Innovation

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All innovation is focused on tangible impact at the human level. There are many potential entry points for value-based innovation, from local to global.

Local

In the Western Cape of South Africa, we are partnering with the local consultancy Percept to integrate value-based care principles into the Primary Healthcare Innovation (PRIMI) project of Western Cape Government Health.

“Western Cape Government Health has a track record of embracing innovation”
- Chintan

National

In India, we are integrating value-based care into the TB care pathway in four districts in the states of Gujarat and Jharkhand. The work is funded by USAID and implemented in partnership with World Health Partners, Harvard School of Public Health, Indian Institute of Public Health, and Everwell.

“USAID India Mission has championed the importance of value”
– Balkrishna

Global

In partnership with USAID's Center for Innovation and Impact, USAID's Office of HIV/AIDS, and the PEPFAR-supported, USAID-managed Data.FI global HIV/AIDS project, we are developing metrics to advance a value-based care approach to HIV.

“DataFI is at the cutting edge of using data to improve care”
– Sameera

 

Team

Our work requires an entrepreneurial team that is professionally multilingual—conversant in public health, medicine, design, economics, management, and technology.

Chintan Maru
CEO and Founder
Balkrishna Korgaonkar
COO
Sameera Ali
Senior Manager, Strategy and Design
Joanne Ke Edelman
Advisor, Digital Health
 
Whitney Adams
Advisor, Innovative Finance
Andrew Stern
Advisor, Strategy
Caroline Pecquet
Advisor, Communications
Elizabeth VanDerWoude
Finance Director
 

Affiliates

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We partner with leading advisory firms that have expertise in quality improvement, health economics, health policy, and actuarial science. Leveraging their deep market knowledge and networks, we work together to build human-centered health systems that deliver better outcomes at a better cost. Through these partnerships, we (1) design and launch demonstration projects grounded in the principles of value-based care, (2) develop and disseminate knowledge products that enable value-based care, and (3) identify actions that local public and private sector leaders can take to facilitate a transformation toward value.

Our Affiliated Organizations are:

About Percept

Percept is a South African trans-disciplinary consultancy driven by heart and curiosity, forging enduring relationships with clients who are also working towards a healthier, more financially resilient world.Founded by Shivani Ranchod and Dave Strugnell, both of whom are actuaries with an academic background. The leap from academia to Percept is surprisingly small: deep curiosity, an endless supply of problems worth solving and questions worth answering, an appreciation of intellectual rigor and the desire to create a learning environment in which people can thrive. Percept’s team boasts of skills across healthcare policy, public sector budgeting and financial governance, analytical leadership, value based care and measurement of quality of healthcare and robust quantitative modeling. 

 
Shivani Ranchod
CEO, Percept; Co-founder Alignd
 
Ursula Torr
Director, Consulting Actuary
 
Jodi Wishinia
Public Health Consultant
 
Rose Tuyeni Peter
Health Economist, Percept Advisor, Innovative Finance
 
Emma Finestone
Consultant
 
 

About Access Health International

Access Health is a leading think tank, advisory group and implementation partner. They work closely with the government, donor organizations, and national and international researchers to address issues at the systems level and improve and strengthen the overall healthcare system in India. Access Health work is organized around five core elements within a health system: Health Systems Governance, Health Finance, Healthcare Provision, Digital Health, and Community Health.

Leapfrog to value and Access health will work together to design and implement innovative pilots that test the core hypothesis: “Human-centered health systems deliver better outcomes at a better cost.” It is expected that these pilots will provide useful lessons to public and private insurance schemes as India advances toward Universal Health Coverage. Together, we will build capabilities within the health ecosystem, enabling providers, payers, and policymakers to apply contextual value-based care to their own work. Finally, the Partnership will make the case for embracing value-based care to public and private sector leaders in India.

 
 
Dr. Krishina Reddy
Country Director at ACCESS Health International
 
Girish Bommakanti
Director Operations & Strategic Growth - South Asia, Middle East and Africa
 
Maulik Chokshi
Deputy Country Director (Technical)
 
Dr. Anju Aggarwal
Lead - Health Insurance and Financing
 
Kavita Jha
Technical Specialist - Healthcare Operations
Kaleem Mohammad
Consultant - Healthcare Practice
Anudeep Kathuroju
Technical Consultant - Healthcare Practise
Himani Sethi
Lead - Health Systems Capacity Building
 

About PharmAccess Foundation

PharmAccess believes in doing healthcare better. With a focus on sub-Saharan Africa, they are an international organization that works on improving healthcare markets so that they can deliver for everyone.

With headquarters in Amsterdam and most of its staff based in four country offices across Africa, the PharmAccess Group is an organization with a history of reimagining what is possible. They challenge the notion that exclusion from healthcare is an inevitable consequence of living in poorer countries and identify the opportunities and partners - both private and public, needed to bring about transformation.

Through public-private partnerships, PharmAccess focuses on promoting basic health insurance plans and other innovative demand-side financing options to protect people from financial hardship; introducing quality standards and improvement methodologies for health care providers to increase transparency and stimulate efficiencies; facilitating and stimulating loans, business support, and investments for private health care providers; and innovating value-based health care solutions and financing, using data to empower health care consumers, patients, doctors and financiers alike.

 
Nicole Speiker
CEO - PharmAccess group
 
Kwasi Boahene
Director Health Systems at PharmAccess
 
Maxwell Antwi
Country Director - Ghana
 
Alex Israel Yao Attachey
Innovations Manager at PharmAccess
 

Partners

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The International Consortium of Health Outcome Measurement (ICHOM) unlocks the potential of value-based healthcare by defining global Standard Sets of health outcomes that matter most to patients ( 39 sets so far).

They are also driving adoption and reporting of these measures worldwide. ICHOM was co-founded by Prof. Michael Porter, BCG and Karolinska Institute and is building on the value-based care framework developed by Prof. Porter and Elizabeth Teisberg.

Leapfrog to value has partnered with ICHOM to build, connect and elevate a VBC "community of practice" in low- and mid-income countries(LMICs) to advance the use of outcome measures.


USAID Center for Innovation and Impact(CII) applies business-minded approaches to pressing global health challenges. CII is part of USAID’s Global Health Bureau and focuses on innovation, market access, and digital health.


CII is a founding partner of Leapfrog to Value and provides financial and technical support

  • Co-developed Leapfrog to Value’s landmark report

  • Developed strategy for value-based TB and HIV care

  • Developing a global platform for value-based care in LMICs

USAID India Mission’s Partnerships for Health focus on improving the health of women and children, addressing HIV and TB, responding to COVID-19, and combating other infectious diseases.


USAID India provides financial and technical support to Leapfrog to Value

  • Co-developed strategy for value-based TB care and value-based primary care in India

  • Funded a 3-year value-based TB care pilot in Gujarat and Jharkhand, implemented by a consortium led by World Health Partners

  • Amplifying value-based care in forums such as NATHEALTH


USAID Office of HIV/AIDS, As a key implementer of PEPFAR, USAID’s Office of HIV/AIDS provides global leadership to maximize the impact of the Agency’s overall response to combat the epidemic. USAID supports country-led efforts to combat the complex challenges of HIV/AIDS in over 50 countries around the world.

USAID’s Office of HIV/AIDS provides technical leadership to Leapfrog to Value in the development of metrics to advance a value-based care approach to HIV. This work is conducted in partnership with the PEPFAR-supported, USAID-managed Data.FI global HIV/AIDS project.


Bill & Melinda Gates Foundation’s Maternal, Newborn & Child Health program envisions a world in which healthy mothers deliver healthy babies and receive quality care from skilled and well-equipped health care workers.

BMGF’s MNCH program provided financial and technical support to Leapfrog to Value’s flagship report.

BMGF’s Global Delivery programs improve the delivery of health products and services and promote health system innovations so countries can significantly reduce maternal and child mortality, improve disease control, and advance health equity.

BMGF’s Global Delivery team provided financial and technical support to Leapfrog to Value’s flagship report. They also fund the Primary Healthcare Innovation (PRIMI) project in South Africa .


Merck for Mothers works across 60 global sites strengthening healthy systems to sustain delivery of high-quality maternity care services that benefit women and their communities.

Merck for Mothers is currently supporting Leapfrog to Value in building a collaborative platform that catalyzes the movement toward value-based care across LMICs.


UBS Optimus Foundation believes in impactful philanthropy to drive breakthrough solutions across pressing social, health and environmental issues. UBS is currently supporting Leapfrog to Value in building a collaborative platform that catalyzes the movement toward value-based care across LMICs.


Rockefeller Foundation works to advance the fields of public health and medical science to improve outcomes for all people, everywhere.

Rockefeller provided financial and technical support to Leapfrog to Value’s flagship report.


Mulago Foundation finds and funds high-performance organizations that tackle the basic needs of the very poor.

Leapfrog to Value participated in the Mulago Foundation’s 2020 Design Group.


Global Development Incubator (GDI) is an incubator for transformational development ventures, working to build and scale the next generation of social impact solutions.

GDI is Leapfrog to Value’s incubation partner, providing support on strategy; finance & operations; brand, marketing, and communications; talent.


Data for Implementation (Data.FI) brings together leaders across the digital health and analytics landscape to harness the power of data to end the HIV epidemic. It is a five-year cooperative agreement funded by the U.S. President’s Emergency Plan for AIDS Relief through the U.S. Agency for International Development. It is implemented by Palladium, in partnership with JSI Research & Training Institute (JSI), Johns Hopkins University (JHU) Department of Epidemiology, Right to Care (RTC), Cooper/Smith, IMC Worldwide, Jembi Health Systems and Macro-Eyes, and supported by expert local resource partners.Data.FI funded by PEPFAR through USAID, is providing expert input and helping Leapfrog to Value navigate the ecosystem of stakeholders in the HIV space.


World Health Partners (WHP) provides health and reproductive health services at scale to rural and underserved communities by enhancing the efficiency and efficacy of currently available resources. WHP harnesses the latest advances in communication, diagnostic and medical technology to establish sustainable service delivery networks that have an unwavering focus on holistic primary health.
WHP leads a consortium of partners implementing the value-based TB care program in India, drawing on its technical and management experience. The consortium includes the Indian Institute of Public Health, Harvard School of Public Health, Everwell, and Leapfrog to Value

 

Partner With Us

Leapfrog to Value brings together patients, providers, and payers to design value-based care models, support experimentation, and develop strategies for scale.​

We collaborate with providers, payers, patients, and donors. We support our partners in the design of human-centered health innovations. Through rigorous experimentation, we test our core hypothesis that human-centered health systems produce better outcomes at a better cost

  • Our approach is tailored to fit our partners’ needs. We facilitate the design process through collaborative workshops and iterative blueprinting.

    1.Identify “tip-of-the-spear” opportunities for experimentation. This may be a patient segment and/or geographic area. If we focus on a disease vertical, we do this diagonally: building toward an integrated model.

    2. Understand value drivers. Through data analysis, secondary research, and expert consultation, we discover what drives value and identify opportunities to improve.

    3. Develop a value-based care model

    1. Measure: Define metrics that are feasible to track and actionable.

    2. Deliver: Design the patient journey employing human-centered design methods.

    3. Pay: Define payment and financing models that are linked to value metrics, integrating financial and non-financial incentives for frontline providers.

    4. Develop plan for evidence generation, ensuring evidence can inform policy and/or business decisions. This includes setting performance baseline and targets.

    5. Develop an implementation plan, including people, processes, technologies, and budget.

    6. Define the partnership structure between patients, providers, and payers.

    7. Mobilize funding for experimentation from philanthropic, private, and/or public sectors.

  • We recognize that great design is nothing without excellent follow-through. After the design phase, Leapfrog to Value tailors strategic, technical, and implementation support \ to complement the needs of our partners. We provide these services through our core team and affiliates. Read more about our team and affiliates  

At , Leapfrog to Value works with payers and providers in both public and private sectors. These organizations are looking to test and scale value-based care models in their operating context.

Please reach out to us if you are, for example:

  1. An innovative healthcare provider that wants to demonstrate the value of your model to public and/or private payers who can scale your work

  2. A government health insurance scheme that wants to introduce value-based purchasing models that align provider payments with quality and outcomes.

  3. A health insurance company that wants to develop affordable products that promote health and wellness.

  4. A state or national health ministry that wants to create visibility and accountability for value generated for patients.

  5. A donor that wants to scale innovative delivery models through public and private payers, or that wants to integrate value-based care into outcomes-based financing programs.

 

Leapfrog to Value Resources

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Leapfrog to Value launched its flagship report in February 2020. The report offers a human and economic case for value-based healthcare and a strategy for LMICs to leapfrog to value-based care.

Click Here


Watch the launch event of Leapfrog to Value’s flagship report at the Center for Global Development

Click Here


The World Health Organization published a policy brief in November 2020: From value for money to value-based health services: a twenty-first century shift

Click Here


The World Economic Forum established in 2020 the Global Coalition for Value in Healthcare, public-private collaboration to accelerate the transition to value-based healthcare.

Click Here


Following their facilitation of G20 Health Working Group, the Center for Improving Value in Health published a landscape of value-based care organizations globally.

Click Here


A Playbook for designing human-centered health systems

Fresh off the press in April 2023, this playbook is Leapfrog to Value’s follow-up to the landmark report published in 2020. It provides guidance for patients, providers, and payers to collaboratively DESIGN human-centered health systems.

Click here


Resources for value-based HIV care:

Leapfrog to Value in partnership with Data.Fi and USAID developed a set of human-centered Indicators for HIV and Practical Considerations for Implementation.

Routine measurement of people-centered outcomes has the potential to shape the trajectory of HIV care by revealing what clients prioritize and by designing HIV care services, performance improvement loops, and incentives to deliver superior outcomes, ultimately, helping to overcome persistent challenges in retention in care, adherence to treatment, and sustained viral suppression.

Click Here

 

Leapfrog to Value in partnership with Data.Fi and USAID developed an advocacy tool for PLHIV spokespersons and HIV experts to advocate for a fourth goal beyond the three 95s: elevating people-centered outcomes, specifically health-related quality of life.

VBC builds on existing measurement and quality improvement efforts by bringing quality of life and the care experience to the forefront as core indicators.

Click Here

 

Leapfrog to Value in partnership with Data.Fi and USAID has developed an overview that shares approaches for country programs to put people-centered HIV metrics into action.

Click Here

 

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