Alternative Payment Arrangements and Service Delivery Models for Oncology Care

Oncology treatment is often costly and occurs over a number of months or years.  Restructuring delivery to improve quality and control costs can be achieved through redesigned delivery arrangements and shifts in payment systems. Incentives driven by payment mechanisms allow a shift away from reliance on fee-for-service and case-based payments such as DRGs that reward volume of care, to more mixed arrangements grounded in bundled payments that allow for flexibility but incentivize continuity of care and quality outcomes. This presentation was delivered by Aceso Global CEO, Maureen Lewis, to the Agência Nacional de Saúde Suplementar (ANS), the National Regulatory Agency for Private Health Insurance and Plans in Brazil, in February 2017.


Innovations for Sustainable Healthcare in Brazil: Value-based Care

This presentation explores the challenges facing the Brazilian healthcare sector in terms of quality, efficiency and outcomes. It draws from the US experience with value-based care to highlight possible directions for innovation in Brazil, with a focus on integrated care, alternative payment mechanisms and new roles for information technology. Aceso Global CEO Maureen Lewis delivered this presentation at the seminary Dasa/Valor Econômico in São Paulo, Brazil, in November 2018.


Innovations in Brazil’s Private Health Sector

This presentation discusses innovations in the Brazilian private healthcare sector. It covers private health insurance and providers, as well as some of the major innovators operating in Brazil’s private healthcare market today. More specifically, the presentation dives into innovative delivery models championed by the private sector, while also exploring challenges, such as issues of poor quality and performance of unaccredited private providers. It concludes with recommendations for raising quality and efficiency. Aceso Global CEO Maureen Lewis gave this presentation at the HSR Conference in Liverpool, UK, in November 2018.


Public Hospital Autonomy: Global Experience

This presentation introduces hospital governance and management concepts related to autonomy. It covers the rationale for hospital autonomy, presents a framework for understanding different autonomy models, global cases involving autonomy reform and lessons learned. Some of the main lessons learned include: autonomy is often a prerequisite to improving management; autonomy requires strong accountability mechanisms; and managers must be empowered to respond to incentives set in autonomy agreements. Aceso Global CTO Gerard La Forgia delivered this presentation at the Hospital CEO forum in Manila, Philippines, organized by the Asian Development Bank, in July 2018.


Value-based Payment Systems to Incentivize Healthcare Delivery

This presentation explores the concept of value-based payments, and how those payments can be used to influence the quality and efficiency of healthcare service delivery. More specifically, the presentation discusses the implications of payment arrangements such as bundled payments and fee for service, and innovative financing and delivery models, such as accountable care organizations. Aceso Global CEO Maureen Lewis delivered this presentation in February 2018.


Preparing for Transition from Donor Funding: Developing a Stakeholder Engagement Tool for the Global Fund in LAC

This presentation introduces Aceso Global’s work for The Global Fund to Fight AIDS, Tuberculosis and Malaria, conducting Transition Readiness Assessments in Latin America to help middle-income countries transition away from reliance on donor funding for these diseases. The work, as outlined in the presentation, includes the development and testing of a transition tool comprised of specific modules that will help assess whether countries are ready – financially, managerially, and politically – to shoulder a greater share of disease funding and program oversight. The findings will inform analytical reports and country-specific recommendations on this topic.  

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Government-Sponsored Health Insurance in India: Building Blocks for Achieving UHC or Trojan Horse

This presentation explores the role of state and central government health insurance schemes in achieving universal health coverage in India. It provides an overview of the main features and impacts thus far of multiple new state-sponsored insurance programs, as well as challenges. Finally, it takes a forward-looking approach and considers the role of these health insurance schemes in the broader public and private health care landscape in India. 

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Pay for Performance and Hospital Quality Within the Affordable Care Act

This presentation examines the new generation of Pay for Performance initiatives included in the U.S. Affordable Care Act (ACA) and provides lessons for countries considering similar health care payment reforms. It lists measures and outcomes used to gauge performance under the ACA, and the payment schemes employed to link pay to these measures. While highlighting various improvements arising from the adoption of Pay for Performance, such as lower costs and reduced readmission rates, the presentation also discusses emerging challenges.

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Patient Flow Analysis: Innovation for OECD & Emerging Market Hospitals

This presentation provides a basic introduction to Patient Flow Analysis (PFA) and its applications and relevance to hospitals in emerging markets. Specific international examples highlight the benefits of PFA for hospitals, including increased patient and staff satisfaction, greater patient throughput, reduced costs, and less chaotic hospital environments. The presentation concludes with an overview of Aceso Global’s ongoing work in Mexico on this topic, including specific metrics and measures used to perform PFA, and potential challenges that can arise when attempting to implement patient flow management changes. 

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Holistic Approaches to People-Centered Care: New Models for Service Delivery Built on Strong Primary Health Care

This product examines current challenges in health care service delivery and introduces a new delivery approach: People Centered Integrated Care (PCIC). Emerging evidence suggests that this new approach generates better patient compliance, patient satisfaction, access, quality, and efficiency, with fewer unnecessary hospitalizations and admissions. The product showcases a World Bank study on PCIC initiatives and highlights lessons learned from implementation across the globe.


Qualihosp: 2015: Desempenho em Sistemas de Saúde

This product provides an overview of global trends in hospital policy. The OECD faces a growing burden of chronic and multi-diagnosis illnesses, resulting in new challenges with strong implications for health care and hospital care provision. In the wake of these epidemiological shifts and changing demographics, policymakers are working to improve efficiency and contain costs in order to improve hospital quality and financial sustainability. The product outlines policies and strategies for addressing these challenges. 

Note: Available in Portuguese. 

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Hospitals in Low- and Middle-Income Countries: What Do We Know?

The product reviews hospital research in emerging markets and developing countries, discusses how health care delivery and hospital care are changing, examines ways to capture efficiency and quality of care, including using the World Management Survey, and evaluates implications for the future of health in emerging markets and developing countries.

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Hospitals and Public Health Priorities: Role of Policy

This product examines the shifting landscape of health care in developing countries, discusses evolving public and private sector roles, places them in the context of Foreign Direct Investment (FDI), evaluates how government roles are shifting away, and discusses the future for hospitals and hospital networks.

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Pay for Performance: The Latest Trend in US Health Care

This product examines US pay for performance (P4P) trends in the context of the 2010 Affordable Care Act (ACA). It introduces the twin issues of cost and quality driving P4P trends, lists the broad package of measures currently used to evaluate P4P schemes, evaluates P4P efforts at the federal level, introduces select private and nonprofit experiments and innovations, and discusses common challenges facing P4P initiatives.   

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Financing Global Health

This product examines health financing in developing countries since 2000. It traces overseas development assistance trends and priorities, examines total global Foreign Direct Investment flows, underlines the implications of a shift in the disease burden, and discusses the rise and types of FDI, the impact of remittances on health spending, and projects future developments in global health financing.  

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