Health insurance providers dissociate from capitation demo

The Health Insurance Service Providers Association of Ghana (HISPAG) has dissociated itself from street protestations against the implementation of the health capitation in the Ashanti region.

Some interest groups are planning series of street demonstrations to register their displeasure in the capitation system.

According to the groups, the piloting of capitation in the region is no longer acceptable, demanding that the National Health Insurance Authority (NHIA) review the rate of payment to providers and roll out nationwide.

The National Executive Council of the HISPAG however believes demonstrating against the NHIA may jeopardize strides made in negotiations with the Authority in the review of the capitation policy.

The HISPAG has been holding series of meetings with the NHIA demanding an immediate increment of the capitation rate from Gh₵2.27 to Gh₵12.00.

 

“The Authority had admitted that the capitation rate is on the lower side and had agreed to adjust it upward but demanded some data and justification of Gh₵12 proposed by the leadership of HISPAG,” said a statement by Frank Richard Torblu, Chief Executive Officer of the Association.

HISPAG is also informed the NHIA and the Ministry of Health would go ahead with the nationwide roll-out of the Preferred Primary Provider (PPP) system and has demanded a comprehensive roadmap on implementation.

Council Chairman of HISPAG, Dr. Edward Tagoe, tells Luv News there should be room for dialogue with the government to address challenges affecting the health insurance scheme.

“What we need to do is not the streets but we sit down the roundtable and come to a compromise… I’m not saying demonstration is not the answer but not now whilst we are still at the table,” he stated.

The leadership of HISPAG is scheduled to meet with the NHIA on its proposals on February 4, 2014.

Story by Kofi Adu Domfeh

Matters arising in health insurance implementation in Ashanti

The National Health Insurance Authority (NHIA) has activated a Claims Processing Centre (CPC) in the Ashanti region to ease delays in vetting claims for re-imbursement submitted by health service providers.

The Authority has also introduced the e-claims service, an electronic payment system, to reduce the length of time for receipt of payment by providers.

Some health service providers in the region have not been enthused with the delayed payment of claims. Administrator of the Brodekwamo Methodist Clinic, Kwasi Odame, says delayed payment and mounting arrears in health insurance claims is one of the major challenges hampering service delivery.

“It is an institution that gets support from the government, so at the end of the day we request for funds and if the funds do not come in early, it will delay the payment,” acknowledged Bawa Nurudeen, Ashanti Regional Manager of the NHIA.

He is however optimistic the claims processing centre will be one of the interventions to address the challenge in vetting of claims.

“With effect from 1^st December 2013, all providers who are under the sub-metro schemes – Asokwa, Subin, Manhyia, Bantama and Ejisu – are supposed to submit claims to the CPC. It will speed up the turnaround time with which we use to process claims and also ensure prompt payment,” stated Mr. Nurudeen.

He has also debunked assertions that the implementation of the health capitation is responsible for increase in maternal and infant mortality in the region.

“Everything about maternal services is not part of capitation, and so if a pregnant woman goes to a facility and the facility fails to provide certain medication – remember the medication is also paid for by the health insurance – capitation has nothing to do with drugs and so if drugs are not dispensed, we should not blame capitation,” he stressed.

There are presently over 400 health facilities under the health capitation in Ashanti. Some of these facilities and other interest groups have expressed disapproval in the pilot implementation of the scheme in Ashanti since it was introduced in January 2012.

Meanwhile, the Health Insurance Providers Association of Ghana (HISPAG) has opined that delinking the National Health Insurance Authority from government control would improve efficiency in service delivery.

Frank Richard Togblo, Chief Executive of HISPAG believes such autonomy would protect the health scheme from political manipulation “so that it will not be an issue that tomorrow when another government comes, he changes the direction and focus of the NHIA.”  

“Once it is established by law, there is nothing that can change it, unless they have to go back to parliament to scrap it off. Just as we have SSNIT and Ghana Revenue Authority, which are completely delinked from the government, so it should be as far as the NHIA is concerned,” he asserted.

Story by Kofi Adu Domfeh