Thinking Globally: NQF’s recent work with the Singapore Ministry of Health

One of my NQF colleagues and I spent a week in Singapore recently, meeting with dozens of leaders from the Singaporean Ministry of Health (MOH), as well as health system leaders, clinicians, and staff from each of the country’s three regional healthcare groups, or "clusters." While Singapore has among the best health and lowest healthcare spending in the world, trends in population health and healthcare spending are fueling growing concern there. In response, MOH has undertaken sweeping reforms with the twin goals of improving population health and controlling costs. They are implementing a model that uses a combination of global population-based budgets, performance-based payments, and a robust portfolio of quality measures. Their approach is similar to the Blue Cross Blue Shield of Massachusetts Alternative Quality Contract (AQC) model that I helped develop and lead.

My experience with the design and execution of the AQC combined with NQF’s performance measurement expertise put us in position to offer uniquely relevant insight and recommendations for success. We just completed a first phase of work with MOH, advising them in areas like how to constitute a measure set and incentive model to be the basis for performance-based payments, how to improve global budgets and benchmarking, how to support providers to improve outcomes, patient experience, and spending, and how to monitor progress and maintain public support. In all of this, there are tremendous parallels and relevance to success factors for value-based payment in the U.S. Last week, we had the honor of presenting our findings and recommendations to the Minster of Health and engaging with him and senior officials as they consider the next phases of implementing the reforms.

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