It is our pleasure to introduce the Health Plans of KGMD Healthcare Limited to you. Our Health Plans have evolved to fill the gap that exists in the Managed Healthcare market to deliver great quality healthcare that meet the customers’ expectation. Our ability to provide quality care rests mainly in our unique model of Health Maintenance Organization called an IPA or Independent Providers Association. We are the first to implement the IPA model of HMO in Nigeria.

Managed Healthcare is not altogether new in Nigeria. It is a means of providing comprehensive healthcare to defined groups of individuals, families, and employees under a fixed payment arrangement over a period of time. The payment is an insurance premium paid per head per annum and covers the provision of defined healthcare needs (otherwise called Benefit Package). It provides real value to the healthcare consumer (and payer) since it combines lowered costs with high quality, two often desired attributes that has traditionally moved in opposite directions. In addition, the pre-paid nature allows for better healthcare budgeting unlike the fee-for-service system where the budget is more difficult to determine because of its open-ended nature. Our Health Plan provides the best incentives for the healthcare providers to render the best possible care to the enrolled population because of shared ownership.

One of the greatest challenges of Managed Care in Nigeria, which negatively impact the quality of care received, is the lack of proper alignment of the needs and expectations of the provider network (i.e. hospitals and clinics through which the HMO provide care) with that of the Health Maintenance Organization thus creating a dichotomy for which the enrollees and the payers pay dearly for in poor quality service and the attendant danger to lives.

The IPA on the other hand creates a seamless flow of service from the HMO to the network of providers. This is made possible essentially because of the shared ownership of the network and the HMO.

In Managed Healthcare, real value is created for the enrollees and the payers through:

• Bulk purchase, synergies and elimination of redundancies, thus creating efficiencies.

Through bulk purchase and negotiation with suppliers of healthcare inputs, resource planning, removal of unnecessary steps in the healthcare delivery process and improvement of the delivery system, healthcare costs are brought down in real terms.

• Active quality management through Case Management or Care Coordination, Utilization Management, Peer Review mechanism, Benchmarking and other systems of setting standards and monitoring standards
• Use of Health Promotion and Disease Prevention methods to reduce the cost of illness by intervening before and during the early phases of disease and ill health causation.