🌟Delighted to share that I recently attended an engaging webinar on “The Purchaser-Provider Split and the Public Sector”, organized by The Lakshmi Mittal and Family South Asia Institute, Harvard University🌟
Moderated by Nachiket Mor Sir (Visiting Faculty, ISB), the session featured an esteemed panel of speakers:
1️⃣ Inke Mathauer Ma’am (Senior Health Financing Specialist, WHO)
2️⃣ Rifat Atun Sir (Professor of Global Health Systems, Harvard T.H. Chan School of Public Health)
3️⃣ Kheya Melo Furtado Ma’am (Associate Professor, Healthcare Management, GIM)
4️⃣ Jack Langenbrunner Sir (Senior Associate, Aceso Global)
✨ Key Takeaways:
🔸The session began by highlighting pivotal role of India’s vast public sector in delivering healthcare services. One of the key challenges lies in the performance of the public sector, particularly in ensuring the efficient allocation of resources. While the current expenditures and financing by state governments may be adequate, optimizing their impact remains crucial. They discussed on how an IDS (Integrated Delivery System), introducing a PPS (Purchaser-Provider split) model can address these challenges.
🔸Expected benefits of PPS model include: Split makes it easy to move away from rigid payment methods, makes purchasing more strategic, contributes to Universal health coverage, provides for a contractual relation b/w purchaser & provider, improves responsiveness & accountability of service providers to patients, creates a healthy competition b/w providers.
🔸Strategies for building the PPS: differentiating b/w financing schemes of govt, making institutional arrangements to setup a purchase agency, integrated national health insurance schemes, introducing some form of empanelment of patients, providing a clearly defined benefits package. The question of including Private sector into the PPS is something to be thought upon as well (if it is needed).
🔸What needs to be defined to setup a PPS? One has to have a regulatory framework to define the nature of the insurance entities, considering governance, accountability, service agreement factors. One has to define the extent of competition, “currency” of contract, packages, understanding both under & over performance, benchmark costs & outcomes, understand huge variations in costs of health procedures across different regions and develop “REFORMED” payment methods.
🔸A model they have proposed & tested was discussed: 3 types of payment methods include: A.) For out-patient care- risk adjusted global budgets B.) For In-patient care- Case based payments C.) For indirect services. They’ve observed the impact of blended payment models on already existing district models, & introduced concept of “Output based costing”. It’s been inferred that this method doesn’t increase the national payout to the district hospitals & can redistribute healthcare funds efficiently, suggesting an implementable framework, which contributes to the “CAPACITY-BUILDING” of the public sector.
