Sanigest provides expert technical and administrative analysis for the development and implementation of national health systems
- Oral health is crucial to overall health. So why is dental insurance separate from health insurance?
- Push for Sustainable Financing of Universal Health Coverage
- Florida health system donors redirect funds amid admissions policy controversy
Provider network reconfiguration is one of the most complex services Sanigest provides to its clients. Sanigest is more than adept in actively assisting clients to systematically reform health care networks in order to curb the immediate problem of growing arrears and ensure long-term sustainability.
Sanigest has extensive experience with situations where there is need to redefine and properly structure the network/chain of primary care/ambulatory services with inpatient care. No reform of the hospital sector will be successful without a functional primary health care system with a broad scope of work, capable of handling most situations and publicizing to hospitals what is needed in terms of specialization and more complex care. Usually the general objective of reforming any provider network involves enhancing overall efficiency, effectiveness, quality, and equity in the health sector, to ultimately improve the health status of the population. We provide our clients with a comprehensive set of measures to address these issues, and attain the following goals:
- Achieve equal conditions between public and private providers
- Establish an economic relationship between the health care provider and the patient
- Diversify the sources of financing in the different entities
- Reinforce the interdependence of health and economic management
- Improve curative and preventive care and its material and technical basis
- Renew the positive attitude of citizens toward their own health
- Improve the social status of health professionals through the introduction of a performance-based reward system
- Strengthen the control process in the delivery of health care services
- Standardize the processes of diagnoses and treatment
Moreover, provider network reconfiguration is a sensitive topic significantly influenced by legislation. Sanigest can also assist its client in this field by providing the following services, all in need of proper legislative and regulatory development:
- Define health care providers, types of providers, licensing, certification, and accreditation
- Provide sound networking and management
- Assist with price setting and contracting
- Control and supervise licensing, certification, and accreditation
- Define the role and status of chambers or associations of health care professionals
- Offer support with accounting, reporting, auditing, and governance
- Provide clinical and managerial information and support with data gathering
- Define professional and ethical standards
For example, in Slovakia, an ambitious health reform program was launched which included, among other efforts, restructuring and changing the ownership status of hospitals, strengthening the health insurance companies, and introducing complementary private insurance. Sanigest held a fundamental role in assisting the Slovak government to systematically reform the health care financing and delivery system.
Sanigest engaged in a project to assist the Government of Moldova develop a comprehensive restructuring plan for the municipality of Chisinau. The overall goal entailed creating a plan to allow for the most cost-effective allocation of the limited amount of budgetary resources available, while at the same time improve the population’s health standards. Based on this objective, the team reviewed the existing feasibility report and any other information held by the MOH relating to the buildings and facilities, including details of existing water supply systems and sanitation. Next, Sanigest reviewed local contractors’ capabilities to carry out the work effectively, and made appropriate recommendations on procurement to the MOHMI. In addition, the team compiled bid documents for the agreed bid packages, comprising instructions to bidders, conditions of contract, drawings, specifications, schedules, and detailed cost estimates. Likewise, Sanigest helped the Moldovan government disseminate this plan, so as to gain the necessary political and popular support for its implementation.