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Premium Health Insurance Programme

Background:

Like most low and middle income countries, Nigeria is making efforts toward achieving universal access to affordable and quality healthcare services in the country. However, most of the health programmes and strategies target the vulnerable segments of the population and do not provide comprehensive care and abroad treatments that appeal to Nigeria’s wealthy. If health insurance is expected to be universal in Nigeria, all segments of the population must be covered.

Vesta Healthcare was appointed to design and develop a premium health programme for a leading Nigerian Health Insurance Provider looking to introduce a new health insurance product targeted at the wealthy of Nigeria. The programme is to cover and address chronic health conditions, overseas treatment and any other type of healthcare required by the enrollees. The premium for this comprehensive health insurance programme is to be pooled as part of the health insurance fund to produce risk equalisation.

Approach

Vesta Healthcare provided technical advisory on the design, development and deployment of the new comprehensive healthcare insurance package. The package was aimed at the population segment who prefer a broader range of services and were prepared to pay the premium for such a product. An assessment of the target market and market opportunity was carried out to determine the inclusion of the package.

Vesta Healthcare researched and studied success stories of countries like the UK that has a similar programme. Vesta Healthcare also arranged a study tour of the UK NHS for the Nigerian Health Insurance Provider’s senior management to understand the operations of the NHS, its arm-bodies and partner organisations. The study tour highlighted deficiencies in the client operations, and provided useful insight into improving their quality standards and data management central to the efficiency of their operations.

In addition, Vesta Healthcare led a Visioning, Design and Strategy Workshop in Abuja attended by the management committee and accredited HMOs in Nigeria. The workshop provided input into the blueprint and marketing plan for the new health insurance package. Vesta Healthcare continues to work with the Nigerian Health Insurance Provider in the development of the blueprint document for the new healthcare insurance package, and have arranged to provide programme monitoring and evaluation services.
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Health Insurance Management Agency

Background

Accessibility to quality and affordable healthcare services in Nigeria remains a major problem. Many Nigerians struggle to access quality care and/or struggle to pay for the medical bills. The National Health Insurance Scheme (NHIS) was established to provide easy access to affordable healthcare services for all Nigerians through various prepayment systems. However, since its implementation in 2005, the NHIS provides coverage to less than five percent of the population. Several states in Nigeria have implemented their own health insurance scheme aimed to ensure that its residents have access to quality healthcare services, without suffering financial catastrophe.

Following the introduction of their health insurance scheme, one of Nigeria’s largest states enlisted Vesta Healthcare to support the State Government in drafting the legislation of the Health Insurance Management Agency responsible for the promotion, operation and regulation of the new health insurance scheme in the State.

Approach

Learning from the implementation of NHIS, Vesta Healthcare collaborated with key stakeholders and ensured that the roles of all relevant healthcare practitioners were specified in the operational guidelines for the Health Insurance Management Agency. The Health Insurance Management Agency will regulate, supervise and ensure the effective administration of the new scheme.

Vesta Healthcare worked closely with the State Ministry of Health, State House of Assembly, International Development Institutions, and other relevant stakeholders in drafting the legislation and developing a detailed implementation plan.

As part of the advisory committee, Vesta Healthcare provided support on technical issues to the Minister of Health on the development of the policy and legislation for the successful implementation of the health insurance scheme. This included introducing an equitable health financing system, where enrolees paid according to their ability to pay and received benefits based on their health status. Vesta Healthcare played a leading role in the development of the health funding strategy by creating the Health Fund and designing the financial flows within the new scheme.

The final draft Bill was reviewed intensively to ensure the rigorous and continuous monitoring of the implementation of the scheme. Vest Healthcare provided recommendation for improvements that would ensure it produced an efficient operational structure to promote and regulate health insurance in the State.

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Network of Diagnostic Centres across Nigeria

Diagnostic testing is an essential element of the healthcare system, integral to many clinical decisions, providing physicians, nurses and other healthcare providers with pivotal information for the prevention, diagnosis, treatment and management of diseases. Over the last few decades, public-sector diagnostic facilities in Nigeria have deteriorated and there is now an unmet demand for quality laboratory services.

One of Nigeria’s leading providers of pathology services wishes to expand and grow their business by partnering with existing diagnostic facilities across Nigeria to provide quality, reliable and accessible medical laboratory services. This partnership will address the infrastructure and equipment deficit faced by many public-sector tertiary care institutions. The Diagnostic Centres will provide state of the art equipment and personnel training all of which would drive up standards. As the Business Growth Adviser to the leading pathology provider, Vesta Healthcare led the process of the establishment of Diagnostic Centres as Public Private Partnerships (PPPs) across Nigeria.

Approach

Vesta Healthcare worked to provide a collaborative risk-sharing Public-Private Partnership (PPP) venture framework, involving the pathology provider, State Ministries of Health, Tertiary Care Facilities as well as other key stakeholders. Preliminary discussions were made with the prospective tertiary healthcare institutions with the objective of making their institution home of the leading diagnostic services provider in their location. Following detailed research and extensive consultations, Vesta Healthcare developed a Concept Paper to take on a road show.

Vesta Healthcare will develop an Outline Business Case backed by a robust, cost recovery Financial Model to determine the required framework essential for making such Diagnostic Centres fully operational and financially viable. As part of the PPP Advisory Services, Vesta Healthcare will assist in developing an Implementation Plan for the Diagnostic Centres and gaining approval with the relevant regulatory bodies.
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Upgrade of Two Public Specialist Hospitals

Nigeria’s public health system is faced with recurring
challenges such as poor infrastructure and outdated technologies, resulting in Nigerians seeking treatment from the private sector and overseas providers. Technology has been a major tool in bringing improvement to the delivery of health services. The effective use of technology can help healthcare facilities deliver high quality care and improve patient outcomes.

Most specialist hospitals in Nigeria are in need of an upgrade devoted to improving the standard of care by procuring critical modern medical equipment. Vesta Healthcare was engaged by a State Ministry of Health to identify and supply medical equipment for the upgrade of two public-sector specialist hospitals with the view of improving its capacity and patient health outcomes.

Approach

Vesta Healthcare provided technical advisory on specialist hospital equipment capacity and functionality improvement. Starting with a comprehensive audit of existing equipment in both hospitals, Vesta Healthcare conducted a functionality and capability assessment of the human resources for health. Vesta Healthcare undertook all aspects of Medical Equipment Planning from developing Bill of Quantities, procuring the equipment and supervising the installation process.

Working closely with the State Ministry of Health, Vesta Healthcare developed a Bill of Quantity (BoQ) listing the equipment requirement and technical specifications based on international best practice and standards. After extensive consultations, the content of the final BoQ was then used to source and procure the best equipment from manufacturers globally. The delivery, installation, commissioning and after sales support was all provided. Vesta Healthcare recognised that the specialist hospitals also needed the skilled manpower to utilise the required equipment and technology in their organisation capacity analysis and ensured that staff training and equipment maintenance following installation was included in the package.
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Growth Capital for a Private Hospital

A private hospital based in Lagos State offering quality healthcare services, experienced significant growth over 10 years while maintaining an outstanding reputation throughout Nigeria. The hospital aimed to secure its leading position in the market as well as increase its clientele base by increasing their facilities and services.

The private hospital wished to build on their success and needed additional capital to secure its future by expanding the scope and range of its clinical services. With rapid growth potential predicted for the coming years, the private hospital chose to utilise Vesta Healthcare as Transaction Advisor to assist in raising growth capital for the expansion of their core clinical services. The capital was to be deployed to fund the development of new premises as well as the procurement of state-of-the-art equipment.

Approach

The engagement commenced with a comprehensive Vesta Healthcare Due Diligence Assessment of the entire business including clinical and non-clinical service offering, operations, management, patient needs, workforce and financial accounts. In evaluating its strategic options, Vesta Healthcare conducted an analysis of the industry, key market metric, value chain, business models, competition, profitability and trends. The information gathered was used to develop a Growth Strategy, Financial Model, Risk Register and Risk Mitigation Strategy. Vesta Healthcare produced a prospectus document, the Investment Memorandum (IM) to be presented to selected offshore investors for the purpose of securing growth capital.

Vesta Healthcare identified a number of credible prospective private investors and continues to provide strategic advice and counsel to the private hospital in executing their growth strategy.
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