NHIS to extend capitation to 2 more regions
Enoch Darfah Frimpong
Health
The National Health Insurance Scheme (NHIS) capitation payment mechanism will be extended to two more regions by April, this year. It forms part of a gradual nationwide implementation programme, which would see all the regions implementing the system by the end of the year.
The Ashanti Region began piloting the capitation payment system last year.
A statement issued by the National Health Insurance Authority (NHIA) in Accra Monday said the Chief Executive of the NHIA, Mr Sylvester A. Mensah, made this known during a two-day capitation review meeting with various provider groups in Kumasi.
It said three other regions would be enrolled onto the system by end of the second quarter and extended to remaining regions by the end of the year.
The NHIA has had separate engagements with medical superintendents of government facilities in the regions, the Christian Health Association of Ghana (CHAG) and private providers.
The statement said Mr Mensah explained that the engagements were necessary to receive critical feedback and suggestions from the groups on the way forward for the policy.
According to the statement, Mr Mensah indicated that the NHIA was about to embark on a massive exercise across the country where all members of the NHIS would select their preferred health facility, which would be responsible for their primary healthcare needs.
The selection of primary providers, it said, was the first step towards the nation-wide capitation implementation.
It said Mr Mensah told the leadership of CHAG and heads of private healthcare facilities in the Ashanti Region that the NHIA had learnt useful lessons from the pilot scheme in the Ashanti Region.
It said Mr Mensah, therefore, gave the assurance that many of the challenges encountered during the piloting phase had been addressed.
It said the various groups suggested that a percentage of the revenue the country made from the oil sector be allocated to the NHIS to help finance the healthcare cost of citizens.
The statement said the stakeholders were of the view that doing that would ensure that every Ghanaian benefited directly from the oil resource.
Others, it said, also suggested that some revenue from the minerals mining industry be set aside for supporting the healthcare needs of the country through the NHIS.
The private healthcare providers called for the transfer of the 2.5 per cent of the National Health Insurance Levy to be made directly into the National Health Insurance Fund and not through the consolidated fund which was the practice currently, the statement said.
The statement said the stakeholders were also of the view that such an approach would help reduce the length of time it took for funds to reach the NHIS for disbursement to its service providers.
While making a case for the prompt release of funds from the government to the NHIA, the providers also called for additional sources of financing for the scheme to enable it to meet demands of its rising subscriber base, the statement said.
The capitation programme is a government policy intended to complement other provider payment methods currently being used by the NHIA.
In the view of the Ministry of Health, by rolling out such payment method for general outpatient care, the NHIA is likely to make the scheme more efficient and prevent abuse of the health insurance system.
The ministry further reckons that the system will also make providers take better care of their clients or subscribers.
Capitation is a provider payment mechanism in which providers in the payment system are paid, typically in advance, a pre-determined fixed rate to provide a defined set of services for each individual enrolled with the provider for a fixed period of time.
The amount paid to the provider is irrespective of whether that person would seek care or not during the designated period.
Graphic.com.gh
