Healthcare
Sanigest provides expert technical and administrative analysis for the development and implementation of national health systems
Relevant Areas
Sanigest excels at assisting our clients’ search for improved value-for-money by developing and deploying cutting-edge information systems for payers and providers. Our fully integrated, paperless health insurance and provider activity system, Health Planner and RAA, provide organizations with a turnkey solution to improve the management of insurance organizations. Over the past ten years, we have worked in more than ten countries to improve health insurance management, claims reimbursement, handling of membership, premium collection, more effective utilization of health service resources, medical audit and public relations through the deployment of our IT solutions.
Sanigest capabilities related to Health Insurance include:
- Definition of the catalogue of services for included and excluded from the benefit package
- Revision of the cost for each category of services
- Development of payment systems, business rules, and schedules for health services
- Specification of terms and mechanisms for contracting health providers in public and private sectors
- Creation of an integrated management information system
- Design of a full M&E system as a managerial tool to monitor the newly established health system
- Research and impact assessments of the health insurance systems
- Development of policy frameworks and action plans to support the implementation of health insurances
- Writing of reports and documents about any area of health insurance systems
Some projects in this area include:
Dominican Republic: Technical assistance, revision of the Health Services Plan Catalog
Bahamas: National Health Insurance Plan for The Bahamas
Belize: Strengthening and Rolling Out National Health Insurance
Bahamas: Catalogue for Health Services Providers
Costa Rica: Case Studies in the Governance of Mandatory Health Insurance
Sanigest was assigned to elaborate a case study on mandatory health insurance in Costa Rica as part of the World Bank commissioned paper “Mandatory Health Insurance in Developing Countries: Overview, Framework, and Research Program”, aimed to provide guidance on the most promising and appropriate institutional designs and governance mechanisms for member countries aspiring to reform or establish mandatory health insurance.
Project DetailsHonduras: Technical Proposal and Implementation of UHI
Preparation of a Technical Proposal and Implementation of a Universal Health Insurance Model in the Department of Gracias a Dios, which includes the Health Care, Management, and Financing Model
Sanigest was assigned by UNDP to design and implement a health insurance model in the Gracias a Dios Department in Honduras. The team implemented a health care model based on a quality improvement program and access to health services of the most socially vulnerable population, as well as synchronize the assistance activities of the health units with the rest of the area service network. Sanigest also designed and implemented a financial-economic management model which allowed the establishment of a common fund for financing health service in the Gracias a Dios Department community.
Project Details