Value-based Care to be piloted in 60 hospitals – PharmAccess Country Director

The Country Director of the PharmAccess Foundation in Ghana has revealed that the Value-Based Care (VBC) system will be piloted in 60 healthcare facilities.

All the hospitals that will benefit from this initiative will be members of the Christian Health Association of Ghana (CHAG).

According to Dr. Maxwell Antwi, 120 healthcare providers, including doctors, nurses, and pharmacists, will be trained in delivering the VBC system of healthcare.

He made these comments at the end of a 5-day workshop in Accra organized by the PharmAccess Foundation in Ghana in partnership with the National Health Insurance Authority (NHIA), Leapfrog to Value and CHAG.

“The Christian Health Association of Ghana and the National Health Insurance Authority have come together to get this started. 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. We have indicated why we are starting with hypertension: one out of four Ghanaians has it, out of which only 30% are aware, only 22% are on treatment, and only 6% are controlled. So that is really a huge burden; that is why we want to start with hypertension.” he said.

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

The piloting of the Value-Based Care will form 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 the Country Director for PharmAccess in Ghana, is a drain on the public purse.

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

Dr. Maxwell Antwi further indicated that hypertension prevalence in Ghana has been on the rise; a phenomenon that is putting stress on the healthcare system as well as the economy.

He added: “If you suffer from a complication of hypertension, which is usually a kidney disease, stroke, heart disease, or eye disease, you are going to live with that for a very long time because it mainly affects the middle-aged group. 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. Patients will be mobilized so that they are also self-aware of their adherence to treatment and compliance with medication, as well as mobilizing the whole health ecosystem. From now onward, 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 said.

The public health expert also stated that they are working together with the University of Ghana Economics Department on the costing and incentive models for the Value-Based Care system.

“CHAG and the NHIA are looking at rolling out the VBC system within a year, after which the results will be measured. This will then inform the decision as to whether to maintain the status quo or implement the VBC system in the entire country”.

The digital health expert underscored the importance of data analytics in the delivery of quality healthcare. He said that data analytics using technology will enable NHIA to gain insights into the disease patterns of subscribers and the cost of care for these 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.

Three years of NHIA 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.

PharmAccess presented seven high-spec laptops to the newly set-up Data Analytics Unit of the NHIA to facilitate their work.