Health Policy

health-insurance-policy

The Health Policy Area (HP) is one of the most consolidated areas of the Firm. Projects carried out in this area relate to reform in resource management, financing, service delivery, and sector stewardship.

Recent reforms implemented in health systems have been oriented towards improving the health of targeted groups by attending to a population’s needs while at the same time augmenting the efficiency of the institutions and organizations involved. For instance, Sanigest has supported key institutions in implementing sanitary reforms in countries around the world.

Traditionally, the Firm has rigorously linked the technical approaches to the socioeconomic and political context of the country where reforms are carried out. Likewise, when assisting organizations in putting reforms into practice, Sanigest strives to transfer practical knowledge, ensuring local key actors are empowered and actively participate in the processes they are involved with.

Moreover, this practice area also encompasses the research and publication of specialized articles and reports developed by the interdisciplinary network of our in-house and associate consultants. These efforts guarantee that the approaches presented to our clients are continually updated and innovative, and keep the firm at the forefront of the latest trends in health system reform.

Some Projects within this area include:

Bahamas: National Health Insurance Plan for The Bahamas

Sanigest was contracted to provide operational details on four critical aspects of the NHI: (1) defining the health benefits package; (2) costing the benefits package; (3) designing the provider payments system; and (4) financing recommendations for the Plan to ensure sustainability. Two main paths are under consideration for the NHI: (1) A comprehensive universal roll-out or (2) A phased implementation process with either some populations being targeted initially, and/ or certain benefits being targeted. Sanigest is working on both options.
Project Details

Bulgaria: Advising on Options for Improving GP Referral and Hospital Admissions Practices

Sanigest analyzed the referral and hospital admissions practices in Bulgaria and developed specific recommendations and supporting regulations for improving the incentives (positive as well negative) and the control mechanisms to ensure that health care is provided at the most appropriate level. In order to achieve this goal, Sanigest supported the analysis of GP/outpatient specialist referral and hospital admissions practices, including the review of legislation and regulatory framework, and assisted in the development of both incentives and regulatory / control mechanisms to encourage more effective and appropriate (for the patient and public purchaser) provider behavior.
Project Details

Bahamas: Catalogue for Health Services Providers

At the request of the Bahamas Ministry of Health and National Insurance Board, Sanigest provided expert technical and administrative analysis for the implementation of the National Health Insurance (NHI), in an effort to ensure that health care for all is guaranteed, protected, and free from financial burden at the time of use.
Project Details

Costa Rica: The Costs of Illness in Costa Rica: A Study

The study involved an appraisal of the epidemiological and demographic situation, as well as the health care service capabilities in the country. Likewise, the study entailed a review of institutional information and health policies, an analysis of information sources relating to practical applications, and the definition of adaptations required to facilitate effective measures. Moreover, Sanigest professionals estimated the costs of infirmity in years of lessened lifespan and years of disablement, as well as adapted an automation mechanism to estimate life curtailment and disability factors.
Project Details

Hounduras: 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

Area Expert

Michal Pothuis
Consultat

Etoile Pinder
Consultant, Survey Expert

Request for proposal

Request for a proposal