As part of a move toward service expansion, the Salvadoran Social Security Institute has initiated a program of contracting for some services with external providers. Most recently, they are in the process of contracting for the management of two facilities-a small elective surgery facility and a general hospital providing basic secondary care services including maternal and child care. As part of the decision to contract the operations, the Institute anticipates both a competitive solicitation and a payment schedule based not on costs but on a fixed price per procedure. The objective is to create conditions for more efficient production and greater client satisfaction.
The design of the contracting procedures to implement this objective has presented a number of challenging problems. As an example, the contracts must be written in ways that encourage effective management, yet the competitive pressure must not compromise the sustainability of the operator's commitment. Central to design is the issue of how these characteristics are to be assessed. What criteria should be specified in the solicitation to ensure viable sustainable proposals? How are proposals to be assessed, compared, and evaluated? The presenters have been working with the Institute in the design and implementation of these contracts and recognize that the experience holds many general lessons. This presentation will explore the implications of this experience for those using contract strategies to assure a sustainable supply of quality services.
Learning Objectives: At the end of the presentation, participants will: · Have a better understanding of the complex of issues which need to be addressed in the contracting process · Be familiar with the evolving experience in El Salvador · Recognize the relevance of this experience to similar domestic efforts
Keywords: Management and Sustainability, Contracting
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Management Sciences for Health, Salvadoran Social Security Institute
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment with MSH