Under a Provider-Purchaser Split Model, the financing and provision of public health services are divided, with the financing agency contracting for services from service providers. To introduce a Provider–Purchaser Split Model in the public health sector, Project 2000 developed a decentralized hospital management improvement model in three Peruvian regional hospitals.
The main issue was that the objectives of hospital management and the Ministry of Health (MOH) differed. While the MOH sought to guarantee access to health services for the poor, hospital management tended to exclude those unable to pay for services. To align these different objectives, incentives were developed to make the interests of hospital management and the MOH coincide.
Indicators of coverage, quality, and cost were negotiated between the hospital and MOH and formalized in a Management Agreement. These indicators were developed through a planning process that established and prioritized strategic objectives. The indicators and their goals reflect these strategic objectives.
Once the Management Agreement was agreed upon, the MOH began periodically monitoring the achievement of the goals for each indicator. This system replaced the traditional budget control system. However, in order for hospital management to move towards the proposed goals regarding improvements in coverage, quality, and costs, management flexibility was needed in key areas: hospital organization, financial management, and personnel management.
The purpose of this pilot experience is to evaluate the capabilities of hospital managment to function under these new rules and assess the impact this new relationship between the hospital and the MOH has on efficiency and quality.
Learning Objectives: 1. Describe the Decentralized Management Improvement Model. 2. Explain the importance of establishing and monitoring a Management Agreement
Keywords: Management and Sustainability, Quality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.