This paper highlights the process for developing this learning community and some of the key learnings on how to successfully implement PCNs. Furthermore, it provides key recommendations for country policymakers, practitioners, and development partners based on lessons from the PHCPI COP.
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.
Nigeria’s implementation of the Strategic Communications Practical Guide and Strategic Communications Planning Tool to address underlying facilitators and barriers to the BHCPF led to the first appropriation for the fund and an increase in interest in BHCPF services. The communication plan is thought to have improved the targeting and perception of the rollout communication processes. […]
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 […]
Kenya’s use of the Costing of Health Services for Provider Payment toolkit produced findings that were used to change county-level reimbursement models to lower costs, increase efficiency and improve financial sustainabilty. This case study profiles the use of Costing of Health Services for Provider Payment in Kenya. In Makueni County, the government has the mandate […]