Spotlight On: Improving Access to High-Quality Healthcare Through Strategic Purchasing
Helping country health systems change how they pay for health care to improve quality, efficiency, patient outcomes, and patient satisfaction.
Abt clients around the globe pay for health care on behalf of millions of consumers, and they look to us to design, implement and evaluate new provider payment methods such as value-based purchasing, capitation, and diagnostic-related groups. That’s because Abt has more than 50 years of experience helping governments strengthen their health systems to better serve their people.
In the U.S., Abt oversees multiple initiatives to help consumers choose high-quality care. We work with health care providers to transform medical research into clinical practice. We have a 25-year track record as the U.S. government’s trusted partner in assessing the impact of Medicare and Medicaid reforms.
Internationally, Abt builds the capacity of ministries of health and public insurance agencies in more than 50 countries to direct their limited funds to needy populations and the most cost-effective health interventions. For example, new purchasing methods in Central Asia helped reduce maternal mortality rates, with reductions ranging from 7 percent in Turkmenistan to 71 percent in Kazakhstan.
Methods
Designing Innovative Models for Better Payment Decisions
Strategic provider payment methods can make the difference between a healthy population—and healthcare system—and one that’s performing poorly. Abt develops and supports the implementation of new payment methods, addressing institutional structures, the technical capacities of the payer and providers, and the economic issues that affect political acceptability. We’ve seen that, by containing costs and encouraging providers to proactively manage their resources, governments can improve.
Relevant Experience
Evaluation of Hospital-Setting Health Care Innovation Awards
Client: Centers for Medicare & Medicaid Services
CMS’s Health Care Innovation Awards funded up to $1 billion in awards to U.S. organizations that implemented the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and Children's Health Insurance Program.
Abt evaluated the 10 winners of the Hospital-Setting Health Care Innovation Awards to identify opportunities to improve the quality of hospital-based healthcare. All 10 awards focused on improving care for high-acuity patients. The initiatives ranged from improving critical care (intensive care unit (ICU) or ED care) to screening for emerging acute conditions in nursing home patients, to team-based inpatient and outpatient services for high-risk patients. Abt developed a tailored evaluation design for each initiative. We used mixed qualitative and quantitative methods to analyze care improvement/redesign processes, use of IT, workforce development, and other elements of each initiative, with the goal of informing future health care programs.
Health Finance & Governance Project – Ukraine TB Hospitals
Client: USAID/Ukraine
In the Ukraine, over-hospitalization is the norm for TB care, wasting limited funds and exposing patients who should be treated as outpatients to the risk of multi-drug resistant TB. Abt helped the government build comprehensive and accurate facility-level cost accounting and discharge data systems in more than 100 hospitals in Poltava, Lviv, and Odessa oblasts and Kyiv City. Abt also developed the Provider Payment System analytical model that enables authorities to assess and merge cost and clinical data to develop and implement a new payment system based on diagnosis-related groups (DRGs). These systems are being fully institutionalized within the Ministry of Health and National Health National Health Service and rolled out nationally.
