Joint Learning Fund
Supporting Countries’ Learning for UHC Reforms
The Joint Learning Fund (JLF) is a flexible pool of resources to support cross-country learning activities to strengthen health systems. The JLF is uniquely responsive to country needs and can be mobilized by practitioners on short notice. This allows practitioners to act quickly, leveraging political momentum to promote policy change.
The Joint Learning Fund (JLF) is a critical resource for JLN member countries. The JLF gives countries the opportunity to complement their work under JLN’s technical initiatives with joint learning activities in other areas. The focus on activities outside technical initiatives allows members to identify and nurture new priorities for the network.
Member countries use the JLF to conduct study tours and participate in international meetings, workshops and trainings, with the goal of strengthening their practical knowledge around UHC-oriented reforms. The fund is also used to support long-term collaboration among countries working together to solve specific challenges.
Launching a New Learning Collaborative: Medical Audits
The development of medical audit systems is an increasingly common and exceedingly important quality-enhancing strategy for national health systems. Many practitioners and policymakers across the JLN have expressed interest in establishing or strengthening their medical audit systems. The Joint Learning Fund, administered by JLN partner ACCESS Health International, responded to these requests by establishing a new Medical Audits collaborative and funding its learning activities. The collaborative is hosted by South Korea, JLN’s newest member.
Over the course of three in-person meetings in 2016, participants from Colombia, Ghana, India, Indonesia, Kenya, Malaysia, Nigeria and the Philippines gathered in Seoul to share common challenges and experiences. South Korea offered members first-hand exposure to its medical audit system, and they observed South Korea’s Health Insurance Review and Assessment Service (HIRA) in action. The in-person meetings helped JLN members learn from each other as they worked on their respective audit systems. The collaborative members developed a public toolkit that any country can now use when establishing a new medical audit system or strengthening an existing one. Inspired by HIRA, Nigeria – a JLF beneficiary country – is planning a systematic review of present systems and processes within its own National Health Insurance Scheme. The goal is to use the knowledge gained through the collaborative to re-establish Nigeria’s medical audit system with a more robust IT system and improved linkages between claims review and payment. Similarly, the Philippine Health Insurance Corporation is applying the learnings to its newly established health care provider performance assessment system, incorporating an emphasis on the importance of data quality, the need for standardization and use of indices, and using thresholds for triggers for fraud identification.
The toolkit produced from the Medical Audits collaborative is set for launch at the end of 2017. The toolkit will offer step-by-step guidance on technical questions that surface when designing and enhancing medical audit systems and share examples of best practices.
A Study Tour to India on Claims Management Systems
When JLN member countries identified the establishment and strengthening of claims management systems as one of the highest emerging technical priorities, the JLF organized a learning exchange and study tour to India hosted by India’s state-sponsored health insurance programs. A delegation of 15 participants from Bangladesh, Kenya, Malaysia and the Philippines visited the states of Gujarat, Telangana and Delhi to learn how their claims management systems operate.
Following this first learning exchange, each country submitted an action plan for next steps and jointly identified priority learning areas, such as structure and policy; workflow process; and information technology. In Malaysia, the JLN team is now drafting a claims process based on what they learned from the visit. Without the visit, the Malaysia team would not have been able to visualize the entire work flow from notification and processing to evaluation. The countries are now working together to narrow down common priorities and start creating a jointly developed product on claims management.
“At the Ministry of Health in Vietnam, we have used what we learned through JLF-funded study visits to make better decisions about our own health reforms.”
Trong Khoa Nguyen
Deputy Director of Medical Services Administration, Vietnam
To date, more than 400 practitioners from 16 JLN member countries have benefitted from the Joint Learning Fund.
“We would not have been able to set up a claims-management process if our delegation had not taken part in the JLF-funded study visit to India with other member countries. The visit helped Malaysia to visualize the entire work flow from notification and processing to evaluation.”
Siti Nadiah Binti Rusli
Principal Assistant Director of the National Health Financing Unit, Planning Division, Ministry of Health, Malaysia