The Green Path Model [GPM] for Healthcare Financing

Africa and the world at large currently experience a huge healthcare financing gap. GPM consists of a six-staged path that involves identification of health financing gaps at a given country, issuing of a Social Impact Bond to social investors, a conceptual shift to the Circular Economy,  and refocusing on repayment of the social investors. All the final products that go through the Circular Economy's 3Rs - reusing, recycling and reduction initiatives are meant to have ecolabels which attract premiums, i.e., a recycled plastic bottle will bear an ecolabel which attracts a premium.

Ecolabels are seals of approval given to products that are deemed to have fewer impacts on the environment than functionally or competitively similar products. The premiums collected for all products that undergo the 3Rs process are channeled to the Green Fund – pool of funds in a Green Bank thus filling up the health financing deficits.

The Green Path Model - GPM is built entirely with the sole purpose of bridging healthcare financing gaps globally. According to GBCHealth which serves as a hub for business engagement on the world’s most pressing health challenges, Africa alone has a huge financing gap of approximately US $66 billion per year.

World Bank's Health overview report as of January 31, 2019 alludes to the fact that in many countries there are still large coverage gaps, in particular for poor and marginalized communities. Half the world's population cannot access needed health services, while 100 million people are pushed into extreme poverty each year because of health expenses, shows WBG/ World Health Organization (WHO) research from 2017.

In addition, 800 million people spend at least 10 percent or more of  their household budget on healthcare expenses, often forcing them to  choose between their health and other needed expenses for their family.  Even if health services are available, countries at all incomes levels  often struggle to ensure quality in health services.

It is for these pressing challenges and reasons that GPM was developed in a bid to address this global challenge is a more sustainable way that is in line with sustainable social impact investing.

I started developing the Green Path Model (GPM) as part of  my research at Strathmore University, Nairobi, Kenya. The study involved modeling healthcare financing in Kenya.

The population whose lives am working to directly and meaningfully improve are those in the informal settlements, mostly in rural areas and marginalized communities. Previously, I had a chance to work as an Assurance Intern at Ernst & Young Audit Firm in Western Kenya for close to three months (January - March 2016). During that period, I visited level II & III donor-funded health facilities in five counties, i.e., Kisumu, Kakamega, Vihiga, Bungoma & Siaya.

Most patients lacked access to health insurance and there was heavy reliance on out-of-pocket settlement of healthcare bills.This is what led me to start developing GPM in a bid to address this issue after having a one-on-one encounter with these people.

Therefore, GPM exists to help address the healthcare financing deficits by providing a framework that champions for cheap and inexpensive means to raise funds in a more sustainable approach that will address the most pressing healthcare needs of base of the pyramid populations in rural areas globally.

An ideal and properly constituted health financing system is characterized by the following: its objectives and actions revolve around raising sufficient funds for health; improvement of financial risk protection and coverage of the vulnerable; improvement in the efficiency of resource utilization and improved financial transparency and management at operational level. However, according to my previous study, case in point Kenya, it failed to meet the 2001 Abuja Declaration of allocating at least 15% of its FY 2016/17 Programme Based Budget to Health at national level and also, it could not meet the minimum universal $60 health per capita target as per the analysis. A similar case was revealed from the study’s analysis at the county level.

Therefore, Kenya and other countries facing health financing gaps need to reconsider relying on innovative healthcare financing means to scale up their internal healthcare financing through innovative models such as the Green Path Model – GPM. There is need to refocus the Circular Economy lens to innovative healthcare financing too.

To recap my proposed solution, the Green Path Model  is tested and proven healthcare financing model that has been developed to address the healthcare financing challenge. GPM consists of a six-staged path that involves identification of health financing gaps at a given country, issuing of a Social Impact Bond to social investors, a conceptual shift to the Circular Economy, and refocusing on repayment of the social investors. At the final stage, the surplus amount generated from the Circular Economy’s green initiatives is channeled to the Green Fund – pool of funds in a Green Bank thus filling up the health financing deficits in a sustainable manner.

The Green Path Model- GPM is innovative in the sense that that it brings a totally new, creative yet simple approach towards raising high impact funds in the Healthcare financing industry. GPM offers an innovative solution that has a huge transformational impact in terms of unlocking funds from sustainable 3Rs - reusing, recycling and reduction of wastes through tapping into the power of the continuous loop of the Circular Economy.

The six stages that characterize GPM's path are unique in the sense that their interconnections are all geared towards one central goal - raising funds in a cheap and inexpensive approach. That is, the process of identification of health financing deficits dictates the amounts that would be raised from social investors. Next is refocusing the lens towards the Circular Economy framework in order to raise funds meant to repay the social investors.

All the final products are meant to have ecolabels which attract premiums. Ecolabels are seals of approval given to products that are deemed to have fewer impacts on the environment than functionally or competitively similar products.

The surplus amount generated from the Circular Economy’s green initiatives for all products that undergo the 3Rs process is channeled to the Green Fund – pool of funds in a Green Bank thus filling up the health financing deficits.

The Green Path Model relies on healthcare financing data with focus being directed towards the model outputs at each stage. For instance, the model heavily relies on health budget allocations data versus the National budget of a given country so as to arrive at a certain national healthcare financing deficit. Later on, this deficit informs what needs to be raised from social impact investors.

The social impact investments are channeled to the Circular Economy unit where funds for repayments of impact investors are raised and generated through an innovative 'premium-based' business model.

Across all stages, data plays a critical role in informing successive decisions across the model. Thus, the core technology utilized by GPM is Big Data and the goal is unlocking insights and trends on how healthcare deficits can be met through innovative means of raising funds in a continuous loop and sustainable way.

According to Vera Songwe, Executive Secretary, United Nations Economic Commission for Africa, total spending on healthcare in Africa has  remained within a narrow band of five to six percent of GDP in 2000 to 2015, on average, though in per capita terms it has almost doubled from US $150 to US $292 (in constant PPP dollars). Scarce public resources and unpredictable donor aid have resulted in high private out-of-pocket expenditure that have pushed many people into poverty. Therefore, health spending in Africa remains largely inadequate to meet the growing  health financing needs and the rising healthcare demands creating a huge financing gap of US $66 billion per year.

Funds need to be mobilized in a way that is inclusive rather than exclusive so as to encourage more pooling of funds from different stakeholders. GPM is built on the premise of the 3Rs - reusing, recycling and reducing wastes with a goal of extracting value (financing) out of these circular economy initiatives. Participants in this fundraising model not only advance environmental conservation but also help address a socioeconomic issue that directly affects everyone - access to affordable healthcare services.

Affordable healthcare service delivery requires proper funding and sustainable means such as GPM's approach. The core of the model is its ability to champion for a healthy world through enabling countries that will adopt this model to raise funds in a cheap, inexpensive and more sustainable approach. A healthy world will ultimately be a wealthy world!

At the moment, GPM is built within the health financing realms of Kenya and possible replication within Africa. I have already presented this model to the Kenya National Health Insurance Fund - NHIF for testing and deployment and we are still in discussions.

Also, the main inputs of the model are extracted from health financing data from the 47 counties in Kenya and the Ministry of Health budget allocations. The goal is to reach out to different County Health Executives & Commissioners with the ultimate goal of deploying this model at scale to all the 47 counties in Kenya within one year.

Once the model has been refined from the feedback and realities within Kenya, the next phase will involve deploying it in all the East African Countries and select African Countries in the next five years based on the replicability principle. During this period, the goal will be to establish what works and refine the model to meet all the international healthcare financing standards before deploying it globally in countries where it will be fit and suitable for its purpose.

My goal in the next five years is to see the Green Path Model adopted by different Ministries of Health across Africa and the World at large as a health financing policy tool.

Also, I'll be glad to see this model adopted in health budgeting conversations across health councils of International organizations such us the World Health Organization, World Bank Group and the United Nations because it captures the following Sustainable Development Goals:

• SDG 1: No Poverty - GPM will help in providing a solution aimed at ending poverty in all forms by addressing health financing deficits for the poor and vulnerable;
  
• SDG 3: Good Health and well-being - GPM will ensure healthy lives and promote well-being for all at all ages through its collective involvement approach under its proposed circular economy sustainable initiatives;
  
• SDG 10: Reduced Inequalities - GPM aims at reducing health financing inequalities within and among countries;
  
• SDG 12: Responsible consumption and Production - GPM will ensure sustainable consumption and production patterns of all the ecolabelled units;
  
• SDG 13: Climate Action - GPM will take urgent action to combat climate change and its impacts by turning wastes into valuable resources that address urgent human needs - health;
  
• SDG 17: Partnerships for the goals - GPM will strengthen the means of implementation and revitalize the global partnership for sustainable development in the healthcare financing world together with redefining industry synergies and sustainable CSR initiatives.

The barriers I currently face mostly center around status quo and sticking to conservative health financing means. Most health financing policymakers tend to be skeptical about new and innovative approaches that can be utilized to raise more funds. A lot of emphasis is on volume of funds raised with little to no energy and focus being directed to sustainable means that capture mix and reliability besides volume of funds raised. Mostly, emphasis is on what works and little energy is directed to answer the question as to whether its sustainable.

Also, I would be glad to see this model embedded within learning  institutions' curricula and other centers of excellence such as research centers, health financing organizations among others but the great challenge is bureaucracies that exist and standard protocols that one has to adhere to if such a group was to be pursued.

Ultimately, all the aforementioned challenges hinder collaborations, potential partnerships and lock out new insights and contributions that could help refine GPM.

Tackling the status quo challenge and skepticism of health policy makers towards implementing new financing mechanisms will require a lot of round table meetings to first walk them through GPM, explaining to them its purpose, the innovation it brings on board and possibly strike collaborations and Partnerships with them in a bid to give it room for implementation.

The challenge of institutions' bureaucracies can only be addressed by signing binding contracts with them on a win-win basis more so having a tripartite  agreement between the institutions, GPM team and health service providers so as to fully exploit the scale and applicability of GPM under such controlled environments.

Not Applicable

At the moment am just alone but I am happy to partner with experts in this field in future.

Currently I work as a Risk and Investment Analyst at Sunfunder. SunFunder is a solar energy finance business with a mission to provide  financing for solar assets in emerging economies, including inventory, working capital, construction, and structured finance loans. SunFunder  is a well-positioned financial intermediary that has been operating  since 2012.

Working with SunFunder’s Risk and Lending team has given me a chance to  vet and analyze borrowers' operations, particularly finances, and applying SunFunder's due diligence criteria in assisting management to structure loans for qualified financial and cash flow analysis. Also, I developed SunFunder’s Excel version of the Structured Asset Finance Instruments (SAFI) Financial Model & cash flow templates that helped in analysis of SAFI deals with minimum ticket sizes of $2M. I have actively been participating in solar financing deal origination, deal structuring and term sheet review, carrying out due diligence processes, site visits, and actively participating in Portfolio monitoring processes.

All these skills have allowed me to refine the Green Path Model more so in areas around social impact investments. That is, understanding fund economics, innovative financing models and the the future of sustainable impact investments.

At the moment am not in any partnership with any organization.

• Business : Green Financial Services Advisory Group
  
• Value Proposition: establishing a sustainable and innovative health financing solution whose goal is to minimize gaps and deficits
• Type of intervention: providing a solution to the ever increasing health financing deficits and gaps in a bid to increase health delivery and access by under-served, poor, marginalized and economically impoverished people
• Products & Services: The Green Path Model - GPM (Main Product); Health Financing Data Analysis and Management Services; Health Financing Advisory & Consultancy Services.
• Partners + Key Stakeholders: Governments; Ministries of Health; Global Health Financing Institutions such as The Global Fund; Health Financing Development Finance Institutions (DFIs) & Microfinance Institutions (MFIs), Research Labs among other health financing stakeholders
• Customers: Health Financing institutions; Governments & ministries of health
• Key Activities: development of innovative and sustainable health financing solutions such as GPM; Health Financing Data Analytics & Management; offering Health Financing Advisory & Consultancy services
• Cost Structure: hiring of staff; model development, testing & deployment costs; Research & Development costs
• Revenue: services fees from model subscription; licenses, advocacy & consultancy fees
• Impact measures: 100% universal health coverage; 100% health delivery; number of empowered health practitioners 

Initial Stages: the plan is to raise initial investment funds through my initial equity injection, sustained grants and donations and funds raised from participating in cash awards from competitions such as Solve.

Development & Expansion stages: invest the profits in expansion of the services offered by Green Financial Services such as consultancy & advisory roles; data analytics & management services.

I would like Solve to help me deploy the Green Path Model as a health financing tool across different countries without facing the common barriers to entry by health financing policy makers who are keen on maintaining status quo. Innovative solutions are always regarded as risky without being given a chance to prove themselves, their viability and role in shaping decisions. If given some breathing space, such solutions like GPM could be the next big things in redefining sustainable health financing models.

I would be glad if Solve can help me gain access to Technical Assistance Funding -TAF, resources, mentorship and new connections (networks). My Goal is to start the Green Financial Services Advisory Group that will have GPM as the pioneer licensed product. In future, this organization will focus more on helping health financing policymakers address issues such as: sustainable fundraising initiatives, risk management, proper health fund management, sensitivity analysis and scenario testing of different unseen financial circumstances and establishing proper health financing Key Performance Indicators (KPIs).

Not Applicable

I would like to partner with United Nations - UN simply because GPM captures the following Sustainable Development Goals (SDGs):

• SDG 1: No Poverty - GPM will help in providing a solution aimed at ending poverty in all forms by addressing health financing deficits for the poor and vulnerable;
• SDG 3: Good Health and well-being - GPM will ensure healthy lives and promote well-being for all at all ages through its collective involvement approach under its proposed circular economy sustainable initiatives;
• SDG 10: Reduced Inequalities - GPM aims at reducing health financing inequalities within and among countries;
• SDG 12: Responsible consumption and Production - GPM will ensure sustainable consumption and production patterns of all the ecolabelled units;
• SDG 13: Climate Action - GPM will take urgent action to combat climate change and its impacts by turning wastes into valuable resources that address urgent human needs - health;
• SDG 17: Partnerships for the goals - GPM will strengthen the means of implementation and revitalize the global partnership for sustainable development in the healthcare financing world together with redefining industry synergies and sustainable CSR initiatives.

Also, a partnership with World Health Organization - WHO is welcomed on grounds of sharing crucial health financing data and adopting GPM at scale in health financing initiatives across different multicultural environments globally by different health policymakers.

The GPM team would appreciate receiving the AI Innovations Prize in its advanced computing techniques used for identification of health financing gaps across different countries. This task requires precise and well structured data analysis techniques so as to capture reliable information of tons of data stored in different data-banks and databases across the world.

Also, the ultimate goal is to set up the Green Financial Services Group that would have a data analytics center that is intended to have the power to carry out SMART (Specific, Measurable, Attainable, Realistic, and Timely) Big Data Analytics and Real-time health financing monitoring and evaluations so as to generate time series data for our clients that is useful in arriving at resource allocation decisions. Such initiatives require properly structured machine learning algorithms and APIs that can be funded by this AI Innovations Prize.