Queen Máxima of the Netherlands has engaged three patients living with chronic diseases at Manna Mission Hospital in Accra to understand how PharmAccess Ghana’s NkwaPlus digital healthcare platform is improving access to medical care and helping them manage their health alongside their financial responsibilities.

The Queen, who visited the hospital in her capacity as the United Nations Secretary-General’s Special Advocate for Financial Health, was particularly interested in why patients were willing to pay for digital healthcare services despite being covered by the National Health Insurance Scheme (NHIS).

The engagement brought together three patients, Margaret, Dorinda and Famos, who are receiving treatment at the hospital under a Value-Based Care initiative jointly designed by PharmAccess, the National Health Insurance Authority (NHIA) and the Christian Health Association of Ghana (CHAG).

Country Director of PharmAccess Foundation, Dr. Maxwell Antwi, who moderated the engagement, explained that the initiative allows patients to receive medical attention beyond the hospital through NkwaPlus.

"They are three patients who are receiving care in this hospital. They are also all covered by the National Health Insurance Scheme, which is our social health insurance scheme," he explained.

"But they are also being seen on the app, so that from their market, home and offices, they can take their blood pressure and send it to the doctors, and then the medical team can take care of them. And when need be, they come in for care."

Queen questions patients on paying for NkwaPlus

Leading the conversation, Queen Máxima sought to understand the patients' motivation for enrolling on NkwaPlus when the digital monitoring service was not yet covered by the NHIS.

The dialogue was designed to explore the experiences of patients receiving care through NkwaPlus, particularly how remote monitoring affects their ability to work, earn an income and meet their household responsibilities.

It also examined the financial burden of chronic disease management, including the out-of-pocket costs of digital healthcare services and the choices families face when medical expenses compete with other essential needs.

How NkwaPlus supports chronic disease management

The NkwaPlus platform forms part of the Value-Based Care initiative, which combines periodic hospital consultations with digital monitoring between visits.

Through the platform, patients living with conditions such as hypertension and diabetes can check their blood pressure at home or work and share the readings with medical professionals for review.

This enables healthcare teams to monitor patients between hospital appointments and determine when they need further medical attention.

While the NHIS covers periodic hospital consultations under the initiative, patients currently pay out of pocket for the digital monitoring service.

The arrangement has brought attention to the need for a financing model that makes digital healthcare more accessible to people living with chronic diseases.

Value-Based Care pilot records improved patient outcomes

The implementation of the Value-Based Care initiative, which incorporates NkwaPlus, has recorded improvements in hypertension management, with the proportion of participating patients whose blood pressure was under control increasing from 50 per cent to 57.1 per cent after 12 months.

More than 90 per cent of patients participating in the pilot also indicated that they would recommend the service.

The initiative seeks to improve patient outcomes while addressing the growing cost of managing chronic diseases, particularly hypertension and diabetes.

PharmAccess, the NHIA and CHAG are working towards a financing approach that would place greater emphasis on improved patient outcomes rather than the number of healthcare services provided.

Although outcome-based payments have not yet begun, the pilot has introduced non-financial incentives for healthcare providers, including early reimbursement of claims and early re-credentialing.

One of the proposed next steps is for the NHIA to develop a reimbursement tariff for digital healthcare services such as NkwaPlus, which patients currently finance themselves.

The Queen's interaction with the patients formed part of her broader visit to Ghana, which focuses on improving financial health and protecting households against unexpected expenses, including the cost of medical care.

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Queen Máxima engages patients on how PharmAccess’ NkwaPlus is changing chronic disease care

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