India drew on its participation in the JLN’s Medical Audits Collaborative and adaptation of the Medical Audit Toolkit to implement a medical audit system that could be decentralized and scaled by India’s states to review claims, identify fraud, and ensure the quality of health services being provided to patients.
Mongolia’s use of the Empanelment Assessment Tool enabled a shift to a person-centered approach for PHC. Linking empanelment to a mobile technology initiative providing team-based PHC home visits has contributed to a national empanelment approach and shifts in health care seeking behavior. This case study profiles the use of the Empanelment Assessment Tool in Mongolia. […]
Malaysia’s use of the Toolkit to Develop and Strengthen Medical Audit Systems shaped the operations for a new Medical Audit Section responsible for auditing PeKa B40 claims. The SOPs for the unit support identifying and deterring fraud and review of provider perfomance resulting in improved quality of health care screenings. This case study profiles the […]
Malaysia’s use of the JLN UHC PHC Self-Assessment produced findings that were used to improve public private partnerships to increase PHC coverage. This case study profiles the use of the Universal Health Coverage Primary Health Care Self-Assessment Tool in Malaysia. Malaysia piloted this self-assessment tool as a cross-sectional study collecting both qualitative and quantitative data […]
The tool, referred to as the “UHC-PHC Self-Assessment Tool,” is a multi-stakeholder survey that helps accomplish the following: Document and assess how health insurance or financial coverage institutions interact with other PHC actors and programs; Identify key areas of improvement and opportunities to align the health financing agency (HFA) or other health financing policymakers with […]