Poor quality of care is now a larger driver of mortality than poor access to care in many low- and middle income countries (LMICs). In part, this is due to volume-based health systems that focus on the quantity of services provided and not quality or outcomes. A compelling alternative is value-based care, which measures outcomes that matter to patients and optimizes delivery and payment models to achieve those outcomes. The United States Agency for International Development's (USAID) Center for Innovation and Impact (CII), in partnership with the Bill and Melinda Gates Foundation and the Rockefeller Foundation, supported the Global Development Incubator to launch the Leapfrog to Value (external link) report in 2020 on the potential for value-based care in LMICs.

Since then, Leapfrog to Value has led a movement to generate and consolidate evidence on value-based care in LMICs. In partnership with USAID, Leapfrog to Value has:

  • Developed and implemented people-centered metrics and cost drivers for TB care in India with implementing partner and USAID India mission in 2021-22. Read about the learnings here.
  • Developed people-centered metrics for HIV, working with Office of HIV/AIDS in 2022
  • Published a design playbook in 2023. To know how to co-design VBC projects read the Playbook for designing human-centered health systems
  • Currently working with USAID Uganda mission to put the people-centered HIV metrics in practice for children living with HIV and not virally suppressed
  • USAID continues to examine the potential for value-based care in HIV service delivery, notably in Mozambique.