MANAGED HEALTHCARE

MAKING A DIFFERENCE IN AFRICA

a better & intuitive system

What is Managed Healthcare?

A health delivery and financing system where an enrolled population pays a fixed annual fee (capitation) to a medical provider for access to health services as needed.

BGiL Klinika is dedicated to increasing affordable access to quality health care in Sub-Saharan Africa, in the pursuit of this objective, we contribute not only to healthier populations but also in social and economic development.

Financing Health Care - The Managed Care Model

There are many models for finance and delivery of medical services, among which are self- financing (out of pocket as need arises) and various forms of risk pooling. The high cost of medical care, particularly in case of hospitalization, makes self financing out of reach for all but the wealthiest members of society. Thus risk pooling - where a large number of people contribute a small amount each year, or the benefit of the relatively few who actually become ill - has gained a significantly greater role in a lot of settings in Africa.

The Challenge of Affordable, Accessible Care

In most developing countries in Sub-Saharan Africa with limited resources, the challenge is to ensure that resources available are put to their most efficient use, and it is therefore important for the private sector to offer creative alternatives to government health care provision. BGiL Klinika offers affordable high quality medical services in the market based on the principals of Provider-based Managed Healthcare. This form of risk pooling eliminates the need for costly middle men, such as insurance companies, by making the medical provider itself a repository for the pooled funds.

The provider, instead of investing in the stock market, or interest bearing bonds, uses member funds to build hospitals, clinics, invest in medical equipment and facilities to be used for patients as need arises. This direct link from patient to provider offers the most efficient solution in reducing costs while providing a regular and predictable source of income for the provider.

Incentives in Managed Care

  • Because services are prepaid, providers have incentives to reduce costs.
  • Providers have incentives to keep members healthy, not just treat illness.
  • Prevention is better and cheaper than cure.
  • In a competitive environment, providers have incentives to give high quality, effective care.

Objectives in Managed Care

  • Provide high quality medical care.
  • Provide care efficiently.
  • Reduce costs to patients.

What Managed Care Does?

  • Brings all aspects of health care under one umbrella, giving patients easy access to the care they need.
  • Manages and directs caregivers to ensure comprehensive, efficient and effective treatments.
  • Has a vested interest in ensuring its members remain as healthy as possible.
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Why Africa?