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Value-Based Care to be piloted in 60 hospitals

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Dr Maxwell Antwi, the Country Director of the PharmAccess Foundation, Ghana, has announced plans to pilot the Value-Based Care (VBC) system in 60 healthcare facilities across the country.

For now, the hospitals that will benefit from the initiative will be members of the Christian Health Association of Ghana (CHAG).

Successful implementation of the VBC system will ensure every citizen has access to quality and equitable basic healthcare services.

About 120 healthcare providers, including medical doctors, nurses, and pharmacists will be trained to offer the VBC system in the beneficiary health facilities.

Dr Antwi announced this at the end of a five-day workshop for service providers in Accra, organised by the PharmAccess Foundation, Ghana, in partnership with the National Health Insurance Authority, Leapfrog to Value and the CHAG.

“The Christian Health Association of Ghana and the National Health Insurance Authority have come together to get this started.

“And so we’re going to start with 60 hospitals from CHAG and train about 120 healthcare providers, including doctors, nurses, midwives, and pharmacists, to focus first on hypertension,” Dr Antwi stated.

“We have indicated why we are starting with hypertension because one out of every four Ghanaian has it. And out of which only 30 per cent are aware, only 22 per cent are on treatment, and only six per cent are controlled,” he added.

The NHIA, in recent years, has deployed digital technologies to enhance the provision of healthcare in Ghana.
Among these technologies are the mobile NHIS renewal system, which helps subscribers to renew and pay their insurance premiums conveniently, and the digital claims submission application ( CLAIM-IT), which helps service providers to submit their claims without hassle.

The piloting of the VBC system forms part of initiatives by the NHIA to address some of the challenges in healthcare delivery in Ghana.

The VBC model is centered on patients, and it guarantees efficient use and allocation of resources, ensures quality, and improves health outcomes.

The current National Health Insurance Scheme (NHIS) rewards healthcare providers based on the volume of patients who visit their facilities rather than the outcomes of the services provided.
This system, according to Dr Antwi, is a drain on the public purse.

He believed that the VBC system, when successfully implemented, will provide all citizens with quality and equitable access to basic healthcare.

Dr. Antwi further indicated that the prevalence of hypertension cases in the country had been rising; a phenomenon that was putting pressure on the healthcare system as well as on the Ghanaian economy.
“If you suffer from a complication of hypertension, which is usually a kidney disease, stroke, heart disease, or eye disease, you’re going to live with that for a very long time because it mainly affects the middle-aged group,” Dr Antwi explained.

“We are going to train healthcare workers on how to deliver care based on value, beyond volumes, and a scheme is being designed to incentivize those who will do that,” he said.

“Some patients will be mobilized so that they are self-aware and ensure adherence to treatment and compliance with medication, as well as mobilising the whole health ecosystem,” Dr Antwi said.

“From now onwards, if someone is hypertensive or somebody has diabetes, the doctor will be paid based on the blood pressure or sugar control, rather than the number of times the patient turned up at the hospital,” Dr. Antwi added.

The public health expert indicated that they were working collaboratively with the University of Ghana Economics Department on the costing and incentive models for the VBC system.

The CHAG and the NHIA are looking at rolling out the VBC system within a year, after which the results will be measured, he stated.

This will then inform the decision as to whether to maintain the status quo or implement the VBC system in the entire country.

He underscored the importance of data analytics in the delivery of quality healthcare and believed that using technology would enable NHIA to gain insights into the disease patterns of subscribers and the cost of care for those diseases over time.

PharmAccess is providing technical assistance, including capacity building, advice, and data analytics, to make the NHIA a data-driven insurer and knowledge institute that capitalizes on the disruptive potential of technology to create value out of its own data.

The NHIA’s three-year membership data (2017–2019) have already been analyzed and the key insights shared with NHIA management and the board, as well as key stakeholders including the Ministry of Health, the Ministry of Finance, and health sector development partners for management decision-making and policy development, Dr Antwi stated.

The PharmAccess Foundation, Ghana, presented seven high-spec laptops to the newly set-up Data Analytics Unit of the NHIA to facilitate its work.

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