The Center for Health Market Innovations categorizes programs according to how they work to improve quality, affordability, and accessibility of healthcare for the poor. See below for the categories and their definitions. Learn more about the CHMI health market framework here.
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Organizing Delivery: Programs that reduce fragmentation and informality of health care delivery and that may enable financing, regulation, training and new business models. |
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A group of providers that operates under the same brand, but where outlets are operator-owned and services are standardized by a central franchisor. |
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Social franchising is an approach to organizing private providers into networks that deliver specific health services under a common brand, with a promise of quality assurance. |
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A group of health outlets that operate under the same brand and where outlets are owned and operated by a single parent organization. |
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A group of providers that are loosely joined to deliver services to specific population groups. Each provider is a separate entity and retains its own branding. Membership in the network may entitle the provider to payments, patient volume, central services, or training. |
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An organization that seeks to further a particular healthcare profession, the interests of individuals engaged in that profession, and the public interest. Often entrusted with maintaining control or oversight of the legitimate practice of the profession. |
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Financing Care: Programs that mobilize funds for health care and align provider incentives to increase access for targeted groups of patients or to support select health interventions. |
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A government entity selects and pays one or several private sector providers to deliver specific health services to specific populations. These programs sometimes replace government-provided services. This most often takes the form of a Public Private Partnership (PPP). |
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Programs that charge full-fees for services to patients that are able to afford them and use the profits to subsidize services for the poor. |
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A national or sub-national health insurance scheme that is sponsored by the government and pools funding, spreads risk across the population, and offers protection against specific health needs |
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A savings account that allows individuals to pay for current health expenses and save for future qualified medical expenses. |
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Community or micro-insurance are types of private health insurance that specifically targets low-income people. They offer protection to low-income people against specific perils in exchange for regular premium payments, proportional to the likelihood and cost of the risk involved. |
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Subsidized coupons distributed to a target population that may be used to purchase specific health goods and/or services from approved providers. |
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Regulating Perfomance: Programs that set standards and enforce or incentivize higher quality care or increased access for target populations. |
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Government policies that create incentives or requirements for private organizations or professionals to serve underserved populations or provide high-value services (e.g., tax breaks for facilities in rural areas, requirements that a certain portion of clients fall below the poverty line, requirement that facilities must treat patients with medical emergencies regardless of ability to pay). |
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Programs and policies that give credentials to select providers that meet certain quality, structural, and managerial standards. Also, any program that requires clinical practice guidelines, and/or monitors providers over time to ensure quality. |
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An established set of standards describing the expected level of care that comes from the best available evidence. |
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Programs or policies that incentivize quality by rewarding providers financially for meeting pre-established targets for the delivery of health care services. |
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Programs and policies that incentivize quality and provide consumer protection by standardizing medical and institutional practices, regulating insurance packages and coverage, placing limitations on marketing, etc. |
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Changing Behaviors: Programs designed to change the behavior of individuals involved in health care transactions by educating patients about what kind of care to seek or providers about how to deliver higher-quality services. |
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Cash payments provided to poor households or individuals contingent upon the completion of certain behaviors (e.g. school attendance, vaccination) or achievement of pre-specified outcomes (e.g. nutritional outcomes, STI status). |
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Organizations that act in the interest of consumers to promote quality, safety, fairness, and responsiveness. |
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Programs that create social awareness and educate the public about specific health topics such as disease prevention and treatment, healthy behaviors, correct use of pharmaceuticals, etc. |
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Programs that seek to improve the quality and/or efficiency of services by training health care workers and/or building the internal capacity of organizations. |
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Programs that aim to change consumer care-seeking behaviors through marketing/advertising techniques. These are often used to encourage patients to seek and purchase particular products or to promote quality networks or franchises. |
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Enhancing Processes: Processes, technologies, or products that facilitate increased efficiency, lower costs, higher quality, and/or improved access. |
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Programs that improve quality, reduce costs, or enhance efficiency of services through new business or care processes (e.g., high-volume/low-cost operational models, process standardization, shifting of tasks to less-trained personnel). |
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| Information Communications Technology | Programs that utilize technology to enable remotely delivered care, communication, and exchange of medical information (e.g., telemedicine, call center, cell phone technology, biometric system, etc.). |
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Programs that perform diagnostic or laboratory tests to help detect disease or illness. |
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Programs that utilize various models of transportation to deliver services to rural and remote populations. (e.g., ambulance services, health worker transport, traveling clinics/products, etc.)
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Programs that design, manufacture, and sell new products such as rapid testing kits, nutritional supplements, or other medical supplies, that reduce costs, improve quality, or enable remote care. |
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Programs that reduce costs and improve the efficiency of supply chains that move medical products from manufacturer to retailer. |
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