Description of Session
Performance-based Financing (PBF) has been implemented many developing countries to strengthen the health system and improve health service provision and quality. PBF provides financial incentives to health providers based on the delivery of specified priority outputs, upon verification that the results have actually been delivered. The verification process is the cornerstone of PBF as it ensures that the health services being claimed have actually been provided. However, verification is extremely costly (20-30% of the total program costs) and time consuming, contributing to payment delays to health providers. In recent years blockchain (BC) has gained prominence in the healthcare sector with use cases focusing on privacy, security, tracking, and access to patient health records. If BC networks can automate manual processes of verification, it would speed up processing times and dramatically cut operating costs. It would also allow the purchaser of health services to create an immutable ledger that will serve as a permanent record of all transactions conducted at each consultation, in all health facilities under a performance contract. Patients (or their designated representative) would be asked to verify via SMS that a service has actually been delivered, with the response being stored on the BC for payment or further follow-up. The same approach could be used to reduce leakages in supply chain for pharmaceutical goods, while improving the assurance that drugs are actually being used by/delivered to patients. The World Bank’s Health Nutrition and Population Global Practice, in cooperation with its Technology and Innovation Lab, has developed a working prototype of this system, called “Real-Time-Results-Based Financing Verification”, which is being piloted in Cote D’Ivoire as the next step in beta-testing this system. This presentation highlights the results of this piloting process and provides conclusions on potential scale-up costs and benefits.
