Health Sector Economics and Health Finance

Improving health services through sustainable delivery, financing and management mechanisms.

Raising standards for patients worldwide

The scope of available medicines and medical treatments continues to expand exponentially, where-as healthcare budgets don’t. Because that predicament is universal, a number international consultancies have programmed standard sector models. To us, that is as ill-conceived as giving all patients the same off-the-shelf treatment. National, cultural, biological and economic differences demand radically different operations.

Our role in healthcare is not clinical. It is to provide sound economic analysis and high-level expertise to policy and decision makers to help improve the allocation and mobilisation of healthcare resources and to develop appropriate ways to fund healthcare.

Our expertise in health economics has been applied to the development of innovative and sustainable models of health care.   Our people have established a reputation for initiating innovative programmes and for putting them into practice. Their successes have ranged widely over health sector policy, planning, strategy and reform projects around the world.

Implementing health reform programmes.

Much of our work has been undertaken in the context of health reform programmes. We have worked on national strategies and restructuring programmes; improved the supply and sustainability of pharmaceuticals; improve decentralisation and outreach of healthcare; and designed healthcare systems at all levels, from government structures to local community-based facilities,

Some projects have involved the detailed assessment of health sector needs and the preparation of strategies to ensure these needs are met more efficiently and equitably. Other projects have been more narrowly focused, involving the financial and economic evaluation of individual health projects and investments. We have evaluated alternative healthcare delivery structures and introduced options for greater private provision, decentralisation and trade-offs between cost efficiency and equity.

In all cases our first tasks have been to thoroughly understand our client’s aspirations and goals, the context in which the work is to be conducted and the resources and timeframes available. This enables us to design recommendations tailored specifically to fit the needs of the client and then marry with the context in which they will be applied and not merely repeat off the shelf solutions.

Innovative health care financing

Our close working relationships with governments, the private sector and international donors, has allowed us to develop unparalleled expertise in health sector financing. Financing mechanisms – the sources and structure of funding- directly impact on both the efficiency and equity of healthcare provision.

We apply detailed economic analysis and implement best-practice solutions to support the development of sustainable social health insurance schemes, user charging systems, Public Private Partnerships and wide scale financial reform.

We are acutely aware that there is no right or wrong answer to such questions as: How should health pricing be implemented? What are the most appropriate funding methods? If cost sharing schemes are feasible how do payment systems work? Can competition between providers in developing countries increase efficiency and value for money? Can internal markets in health provision increase efficiency without decreasing equity? We rely on original analysis and past experience to determine the best answer for each case.

Strengthening healthcare organisations

We help strengthen local capacity in both the public and the private health sectors through improving the institutional structure and processes in the provision of healthcare, as well as increasing the capacity of individual organisations – ministries, health authorities, private companies, grassroots organisations and NGOs, worldwide.

We achieve this through a broad range of innovative training courses for health managers and general health professionals. These include short courses, workshops and seminars as well as degree level programmes with some of the world’s premier health training and research institutes.

We are also managing national and local education programs on the prevention of, HIV and lifestyle afflictions. And we help health systems prepare for the impact of climate change on public health.

Successful operations worldwide

In Bosnia and Herzegovina, our framework for health resource accounting and financial planning resulted in substantial savings. It included a detailed inventory of services provided by the state, by NGOs and by private sectors.

On the business side, a major Croatian pharmaceutical producer with a substantial business in the Former Soviet Union (FSU) and Eastern Europe used our expertise to substantially strengthen its position in the Russian market.

In Romania, a wide-ranging project saw a new law passed to allow the reform of the healthcare financing system and introduction of a new health insurance scheme.

In Bolivia, our comprehensive review of health sector financing rigorously assessed the financing mechanisms provided through the Ministry of Health and the national insurance system as well as the private sector and NGOs.

Back in Bosnia and Herzegovina, we based our major pharmaceutical restructuring project on an in-depth review of domestic production and distribution. It focused on privatisation and the import of foreign pharmaceuticals.

A Russian project, designed to assess the supply and demand of medicines, led directly to a strategic programme that improved both healthcare provision and the development of the pharmaceutical industry.

The Kazakhstan, Ministry of Health and the Compulsory Medical Insurance Fund looked to us for vital technical assistance in designing and implementing sweeping health reforms. They got it.

Another Kazakhstan, project saw the provision of mother-and-child health services put under the microscope. That one resulted in substantial improvements to the quality of care.

In Jamaica, we were instrumental in developing the highly successful National Health Insurance Plan. Our focus was on the components and cost of services. That included inpatient services, pharmaceuticals and diagnostic procedures, costs proposed and reimbursement rates.

In Nassau, we developed and implemented an in-house quality assurance and risk management strategy for the main general hospital, two tertiary centres, and outlying primary care facilities.

In Indonesia, our proposals for developing insurance-based managed care for the poor included: assessing costs allowing for the plunge of the Rupiah; assisting project design and implementation; and identifying public financing issues given of the national economic situation.

In Vietnam, a study which examined the scope for domestic production disposable medical products proved highly profitable.

In Bangladesh, we set up and ran a Health Economics Unit in the Ministry of Health and Family Welfare. The aim was to establish a national health economics capacity that used research, policy advice and training to dramatically improve health care efficiency. It worked.

In Cameroon, we undertook an economic, technical and financial study to determine the feasibility of opening a factory to supply rubber gloves and condoms to both domestic and regional export markets.