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.

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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.

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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.

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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.

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Value - based care approach can reorient health systems

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Globally there is a growing consensus around aligning measurement, delivery and payment to deliver better human-centered outcomes. Yet, in practice, they haven’t been connected at scale. When we measure value, we don’t necessarily pay for it. Even paying for value may be ineffective if  we do not give providers enough flexibility to optimize care. 

At leapfrog to value our goal is to catalyze an ecosystem in LMICs to drive higher value. Our work focuses on integrating value–based measurement, delivery, and payment innovations to bring a human-centered health system to life.

 
 
 

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, Kenya and beyond.

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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.

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Knowledge

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

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Advocacy

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

Work

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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.

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“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.

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“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 MaruExecutive Director and Founder

Chintan Maru

Executive Director and Founder

Chintan believes that health systems should promote not only physical wellbeing, but also human flourishing. In addition to leading Leapfrog to Value, he is a Director at the Global Development Incubator where he has built a portfolio of initiatives focused on improving the value of health systems.

Prior to founding Leapfrog to Value, he was a consultant in McKinsey & Co’s health systems practice, where he led value-based care reforms for payers, providers, and state governments in the United States; and advised on public sector delivery transformations in Africa. He also co-wrote a report for WHO/PAHO on financing primary care in Latin America. Chintan is a graduate of Johns Hopkins School of Medicine and majored in political science at Duke University. He was a Public Policy and International Affairs Fellow at Princeton University and a Fulbright Scholar to Jamaica. When he isn’t geeking out on health systems, he plays Capoeira Angola.

 
Balkrishna Korgaonkar (BK)Innovation Director

Balkrishna Korgaonkar (BK)

Innovation Director

Balkrishna believes that compassionate design, delivery and culture can go a long way in creating healthier and sustainable communities. Before L2V, he worked at Roche Pharma India, where he led their value-based healthcare effort and designed access solutions for cancer and rare diseases. Prior to that he was a consultant for life-sciences industry and developed pricing, market access and country entry strategies for many global pharma, medical devices, and hospital organizations. Being a physician and an MBA from IIM Ahmedabad, he is passionate about looking at public health issues through a management lens. When not at work he enjoys helping his clients resolve their issues using hypnosis.

 
Sameera AliInnovation Manager

Sameera Ali

Innovation Manager

Sameera is a passionate doctor and holds an MBA from the Indian School of Business. Prior to L2V, she worked as a healthcare practitioner and in advocacy efforts related to oral cancer and tobacco cessation. Her expertise includes building and scaling telehealth and clinician decision-support solutions. Sameera is also co-founder of the NGO Hamara Footpath that serves the holistic needs of children living on the street in Mumbai. She is motivated to solve for inequity in both healthcare and education. When not working on health system change, she enjoys spending her time reading. Amitav Ghosh and Murakami are among her favorite authors.

 
Joanne Ke EdelmanAdvisor, Digital Health

Joanne Ke Edelman

Advisor, Digital Health

Joanne is a firm believer that every person should have an equal opportunity to build a better future for themselves and their families. This passion motivates Joanne’s work as Senior Manager at GDI, where she helps design, build, and launch social impact startups to change traditional practices of global development. In the digital health space, Joanne helped set up the Global Digital Health Index, working extensively with stakeholders at the global and national levels. She is also the co-author of the “State of Digital Health 2019.”

 
Whitney AdamsAdvisor, Innovative Finance

Whitney Adams

Advisor, Innovative Finance

Whitney works at the intersection of innovation and global health. As a senior advisor to the Global Development Incubator’s health portfolio, Whitney is collaborating with donors and investors to unleash private capital to achieve the health SDGs. With 17 years’ experience in the development sector, Whitney was the founding Director of CARE’s Scale X Design Accelerator, a first-of-its-kind NGO program supporting promising pilots to achieve scale. She supported the launch of CARE’s first Innovation Department, including CARE’s external consulting practice, impact investment fund, and domestic innovation hub. She has a degree in Nutrition Science from the University of Georgia and a Master’s in Public Health from Emory University.

 
Andrew SternAdvisor, Strategy

Andrew Stern

Advisor, Strategy

Andrew is the Founder and CEO of the Global Development Incubator. He shapes new opportunities for GDI to drive the global development sector forward and provides strategic guidance to select incubated initiatives. Andrew has played many roles within GDI initiatives, including Interim CEO of Convergence and of Emerging Public Leaders, and currently serves on the Boards of Aceli Africa, citiesRISE, the Institute for Transformative Technologies, and the Refugee Investment Network.

Prior to founding GDI, Andrew was a Global Operating Partner at Dalberg Global Advisors. During that time, he helped design and launch ANDE and served as the founding chairman of mothers2mothers. Andrew holds a joint MBA/MPP from Harvard Business School and Harvard Kennedy School and a BA in Economics from Princeton University. When he isn’t urging nonprofits toward their “endgames,” Andrew can be found pruning cedar groves in his backyard.

 
Caroline PecquetAdvisor, Communications

Caroline Pecquet

Advisor, Communications

Caroline is a multi-faceted international communications professional with more than fifteen years of experience in the biotechnology and pharmaceutical sectors in corporate, commercial, and technical functions, as well as prior agency experience working with corporate and government clients. She has an undergraduate degree from Georgetown University in Washington DC, and an MBA from New York University’s Stern School of Business.

In her role with a major pharmaceutical company leading communications for the region of Eastern Europe, the Middle East, and Africa, Caroline was inspired by her partnership with internal and external stakeholders to help build a meaningful policy that expands access to medicines and improves health outcomes in emerging markets.  She brings that experience to her current work with L2V. In her free time, Caroline loves exploring hiking trails in the mountains and woods of her current home of Switzerland, as well as biking, cooking, and yoga.

 
Elizabeth VanDerWoudeFinance Director

Elizabeth VanDerWoude

Finance Director

Elizabeth enjoys seeing creative ideas and organizations come to life. She is the Director of Finance for both Global Development Incubator and Leapfrog to Value. In addition to leading finance and general operations across GDI, she also supports GDI’s 20+ initiatives, in building the systems and policies required to scale. Before joining GDI, she served as Senior Director of Finance and Accounting at NASTAD and as Vice President of Finance and Administration at Education for Employment.

 

Partners

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Innovation Partners

We know we can’t achieve systems change alone. We collaborate with global and local institutions who share our values and mission.

Shivani RanchodCEO, Percept; Co-founder Alignd

Shivani Ranchod

CEO, Percept; Co-founder Alignd

Shivani is a healthcare actuary and part-time academic. She sees her work life as an extension of her meditation and yoga practice: an imperfect (but always evolving) attempt to bring careful attention to bear on socially-meaningful problems.

The healthcare system is the primary object of her intellectual affection. When she isn’t working (or reading something healthcare-related) you’ll find her hanging out with Dave, her son Shivam and Zadie & Bruno, the dachshunds. She spends an inordinate amount of time thinking about food. She also loves big cities, reading fiction & writing.

 
Anja SmithDevelopment Economist, Percept

Anja Smith

Development Economist, Percept

Anja is a development economist and part-time academic. She helped found Cenfri, a financial service think tank, in 2008. After spending eight years of her career consulting in the area of access to financial services and financial inclusion, she pursued a PhD in economics focusing on various South African health system questions. Through the PhD, she immersed herself in health sector research. She remains deeply interested and committed to broader societal development and the social delivery systems that support this.

Anja works for Percept as an economist and is also a part-time researcher for Research on Socio-Economic Policy (ReSEP) at Stellenbosch University’s Economics Department.

 
Rose Tuyeni PeterHealth Economist, PerceptAdvisor, Innovative Finance

Rose Tuyeni Peter

Health Economist, PerceptAdvisor, Innovative Finance

Rose is an economist with a deep interest in researching health systems and how they can be improved to deliver better and more equitable health outcomes. Rose joined Percept after previously working in financial inclusion and financial sector development. She holds an MSc in Health Economics and Decision Science from University College London and an MComm in Applied Economics from University of Cape Town.

 
Sirisha PapineniProgam Analyst in Monitoring and Evaluation, World Health Partners

Sirisha Papineni

Progam Analyst in Monitoring and Evaluation, World Health Partners

Sirisha works as the Head of Research & Evaluation at World Health Partners, India. Her experience focuses on interdisciplinary approaches to improve the quality of Tuberculosis care including medical epidemiology, operational research, technology design, ethnography, and policy development.

Prior to World Health Partners, she worked at the Poverty Action Lab, United Nations High Commissioner for Refugees, and the Clinton Foundation. Her portfolio has included agricultural development, post-conflict refugee settings, and infectious diseases. She has worked in Uganda, Kenya, Zambia, and India. Sirisha is a graduate of Harvard Medical School and Northwestern University and has served as an Infectious Disease Research Fellow.

 
Yogesh PatelProject Director, World Health Partners

Yogesh Patel

Project Director, World Health Partners

Dr. Yogesh believes that patients deserve improvements in mental and social health in addition to clinical improvement. He works as project director in WHP for the USAID project ‘Closing the Gaps in TB Care Cascade’. Before joining WHP, he worked as a consultant with World Health Organization(WHO) at the state and central level. He facilitated the development and implementation of various initiatives for managing Drug-Resistant TB, including introduction of a shorter regimen and newer drugs under the National TB Elimination Program (NTEP). He also contributed to expansion of Nikshay MIS platform, development of NTEP guidelines for private sector engagement and active case finding and development of e-training content. He assisted in the engagement of private sector/NGOs/other sectors for TB management in two states. He has an MD in Community Medicine and MBA (HRM). When not at work, he loves cycling and playing cricket.

 
Liz NeradDirector, Data.Fi, Palladium

Liz Nerad

Director, Data.Fi, Palladium

Liz is Director of Digital Solutions within Palladium’s Data Informatics and Analytical Solutions (DIAS) Practice, working on several Data.FI activities. Liz specializes in the development and implementation of digital strategies and products to solve pressing development challenges. She bridges realms of technology, data, and health systems by effectively communicating and engaging with stakeholders from diverse backgrounds to align incentives and enable digital transformation. She has experience working for and with many different stakeholders, including community-based non-governmental organizations, consulting firms, United Nations organizations, and government ministries in Africa, Asia, and Latin America. Liz holds an MBA and MPH from Boston University.

 
Nena Do NascimentoSenior Manager, Data.Fi, Palladium

Nena Do Nascimento

Senior Manager, Data.Fi, Palladium

Nena is a is a learning and evaluation professional with 12+ years of experience leading research design and program implementation, developing and strengthening strategies and their monitoring, evaluation and refinement, and promoting ongoing learning across the technology, healthcare and social services sectors. She is currently a senior manager with Palladium, where she has worked since 2012. In this position, Nena leads the Data.FI project measurement strategy and promotes learning across the project’s 25+ activities. She holds an MPP from University of Maryland’s School of Public Policy and a BA from McGill University. Nena speaks English, Portuguese, and French.

 
 
 
 

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 .


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.


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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.


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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

 

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


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

Click Here


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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


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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


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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


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

 

Innovation

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As a field catalyst, we are creating health system transformations through global and local collaborations. This gives us a vantage seat to enable , empower and amplify change

 
 
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Enable

  • We empower providers with the right skills and resources to deliver value based, human centered care, via training and tools

  • We help design data architecture blueprints to integrate action - oriented systems

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Empower

  • Pilots - We support payers and providers in designing , launching and evaluating pilots. We ensure each pilot includes a “scale partner” who has the mandate to scale what “works”

  • Leapfrog Labs - We support portfolios of value- based experimentation through our collaborative platform

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amplify

We create compelling narratives and build on advocacy efforts

  • We inform policy briefs

  • We organize investor round tables

About

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For decades, low- and middle-income countries (LMICs) viewed improving access to healthcare as a top priority, and for good reason. With that priority, health systems have been designed to maximize the quantity of services delivered.  The public sector has thus focused on the number of people who have access and the private sector on bed occupancy and revenue per bed.

We are at a critical point now where these volume-based systems pose the greatest threat to public health as they have created mistrust and unsustainable financial costs. Yet it seems that LMICs are rapidly establishing the volume-based systems that high-income countries have been trying to dismantle.

We have learned the hard way that access accounts for only two out of every five avertable deaths in LMICs. While quality accounts for the other three. We know the current trajectory is taking us to increasing spending without equivalent gains in the required results.

FOR LMICS TO CHART A BETTER TRAJECTORY THEY MUST LEAPFROG TO A VALUE-BASED HEALTH SYSTEM.

THIS REQUIRES A SHIFT FROM - 

HOSPITAL-CENTRIC TO PRIMARY-CARE-CENTRIC

VOLUME-DRIVEN TO VALUE-DRIVEN, HUMAN-CENTERED HEALTH SYSTEMS

PROVIDING HEALTHCARE TO CREATING HEALTH

“Under performance of health systems for people in low-and middle-income countries is a source of lost lives (nearly 9 million per year), lost trust, and lost investment. neither the volume- and profit-based approach pursued by private providers nor the access-first strategy embraced by the public sector responds to the health needs of patients nor maximizes population health. This is a huge waste of public and family funds”

- Margaret E. Kruk; Chair, Lancet Global Health Commission on High Quality Health Systems in the SDG Era; Associate Professor of Global Health, Harvard T.H. Chan School of Public Health

 

What is a human-centered health system?

Puts people and communities, not diseases, at the center of health systems, and empowers people to take charge of their own health rather than being passive recipients of services. Evidence shows that health systems oriented around the needs of people and communities are more effective, cost less, improve health literacy and patient engagement, and are better prepared to respond to health crises. 1

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Why is a human-centered health system needed?

Traditionally health care has been volume driven and focused on coverage in public sector and on revenue generated in the private sector. While globally lifespans are increasing, so are the healthcare challenges. WHO states that only 1 in 3 patients have treatment risks explained to them, 1 in 5 have at least one unnecessary test and there is almost 40% wasted health expenditure due to inefficiencies. Such a system does not foster human flourishing and fails to comprehensively address human suffering. Further an individual’s health extends beyond the time spent in a health facility and extends to their daily life.

Partnering with people to create agency and co-ownership of their health, treating them with respect and compassion and supporting them both inside and outside the facility is needed. Such human – centered approach nurtures trust, reduces inefficiencies and produces outcomes that matter most to patients. For providers it gives flexibility to furnish better service quality and job satisfaction.

A human-centered health system

Bridges inequity and access and quality.

Is inclusive and compassionate.

Delivers better outcomes at better costs.

Prioritizes the creation of health over the production of healthcare


Value based care requires the integration of measurement delivery and payment…

 
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DElivery

The health systems must keep evolving. That is only possible with experimentation, for which providers must be empowered to address the most important drivers of health. We include drivers beyond the traditional domain of healthcare and include social, behavioral, and environmental factors. In the process, the providers become stewards of the resources they manage.

Health systems should be designed to maximize the value they deliver. This should guide policy makers, payers and providers

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measurement

Is the guiding star. It guides how human-centered health systems can learn, improve, and innovate.  It is the basis for how success should be defined and how resources should flow.

  • The numerator of value is the human-centered outcomes. This is not only mortality and morbidity. But also, patient experience of care and being able to lead high-quality life..

  • The denominator of value is the costs required to achieve those outcomes. These are not insurance claims, but the resources we invest over the whole course of a patient journey—prevention and treatment.

    “We cannot manage what we do not measure”

    - Peter Drucker -

 
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Payment

Human-centered health systems pay for value to incentivize continued improvement. Doing so can influence when, where and how care is delivered. Additional incentives for caring for the most vulnerable must also be provided

Payment is the invisible hand that directs resources throughout the system. If we care about value, we should pay for value.

 
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Measurement

Is the guiding star. It guides how human-centered health systems can learn, improve, and innovate.  It is the basis for how success should be defined and how resources should flow.

  • The numerator of value is the human-centered outcomes. This is not only mortality and morbidity. But also, patient experience of care and being able to lead high-quality life..

  • The denominator of value is the costs required to achieve those outcomes. These are not insurance claims, but the resources we invest over the whole course of a patient journey—prevention and treatment.

    “We cannot manage what we do not measure”

    - Peter Drucker -

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Delivery

The health systems must keep evolving. That is only possible with experimentation, for which providers must be empowered to address the most important drivers of health. We include drivers beyond the traditional domain of healthcare and include social, behavioral, and environmental factors. In the process, the providers become stewards of the resources they manage.

Health systems should be designed to maximize the value they deliver. This should guide policy makers, payers and providers

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Payment

Human-centered health systems pay for value to incentivize continued improvement. Doing so can influence when, where and how care is delivered. Additional incentives for caring for the most vulnerable must also be provided

Payment is the invisible hand that directs resources throughout the system. If we care about value, we should pay for value.

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Integrating the three

Globally there is a growing consensus around aligning measurement, delivery and payment to deliver better human-centered outcomes. Yet, in practice, they haven’t been connected at scale. When we measure value, we don’t necessarily pay for it. Even paying for value may be ineffective if  we do not give providers enough flexibility to optimize care. 

At leapfrog to value our goal is to catalyze an ecosystem in LMICs to drive higher value. Our work focuses on integrating value–based measurement, delivery, and payment innovations to bring a human-centered health system to life.


Reception

“When governments seek to insure their populations, to meet ever expanding health needs, and to do it all without breaking the bank, the moment is ripe for a focus on value-based care. The report makes a strong case that compels innovation and action.”

- Foreword by Margaret E. Kruk, Harvard T.H. Chan School of Public Health, Chair of Lancet Global Health Commission on High-Quality Health Systems

The report was presented at the G20 in Riyadh, the World Bank Health Financing Forum in Washington DC, and the International Society for Quality in Health Care in Cape Town, and featured by Harvard’s Institute for Strategy and Competitiveness.

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Steering Committee

  • Amy Lin, Acting Director, Center for Innovation and Impact, United States Agency for International Development

  • Amy Pollack, Director, Maternal, Neonatal, and Child Health, Bill & Melinda Gates Foundation

  • Andrew Stern, Founder and CEO, Global Development Incubator

  • Chintan Maru, Founder and Executive Director, Leapfrog to Value

  • Jean Kagubare, Deputy Director, Integrated Delivery, Bill & Melinda Gates Foundation

  • Jeff Walker, Co-Chair, Community Health Acceleration Partnership, Hosted by WHO Ambassador for Global Strategy

  • Naveen Rao, Managing Director, Health, Rockefeller Foundation

Acknowledgements

The following individuals made significant contributions to the development of this report

  • Danielle Dobos, Former Consultant, Dalberg

  • David Milestone, Former Director, CII, USAID

  • Monisha Ashok, Market Access Advisor, CII, USAID

 Contributors

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