Heath Minister, Dr Agyemang Mensah has praised the management and staff of the National Health Insurance Authority (NHIA) stating that “you are doing a good job.”
The newly appointed health minister who paid his maiden working visit to the NHIA mentioned that the work of the NHIA in running the health insurance scheme is important in providing financial risk protection against the cost of basic quality health care for residents in the country.
On the basis of what he described as the “importance of your (NHIA) mandate,” he made the point that though a lot was obviously being done, there always exists “room for improvement.” He challenged the NHIA to intensify its public education outreach programs since in his view the NHIS has seen significant growth and progress in the last few years.
He therefore suggested that the Authority should consider engaging some of the retired clinicians around the country to help in its public education campaigns. He was optimistic that the challenges the scheme is facing will be addressed soon.
The Health Minister told the Chief Executive, Sylvester Mensah and his management team that the “people of Ghana are looking to the NHIS for access to healthcare” therefore the performance of the scheme is not negotiable.
He pledged his support to the success of the scheme and remarked that “my doors are always opened to you 24 hours. It is my job to ensure that you perform and I am committed to that cause.”
The minister made the comments after he was taken through a presentation on the status of the NHIS by Chief Executive, Sylvester Mensah.
Mr Mensah said the Scheme has seen tremendous growth in the last few years. According to him, “all key performance indicators are positive and a lot more is being done to enhance the subscriber experience.” He explained that the fact that more people now use the NHIS means a higher financial burden on the NHIS. He however said the Authority has set in motion a raft of measures to maximize the use of the resources available to it and ensure greater efficiency.
He mentioned that Capitation for example, has been introduced as an additional payment method to complement the existing fee-for-service and the Ghana Diagnosis Related Groupings (GDRG) systems. The capitation package makes up 22% of NHIS services. This provider payment method is widely acclaimed as one of the most efficient payment methods all around the world, especially for countries working towards reaching Universal Health Coverage and is currently operational in Ashanti while three other regions, according to Mr Mensah, are being added in an incremental roll-out fashion.
Mr Mensah named the instant issuance of ID cards as an efficiency gain strategy to ensure proper ID card management, which he said is bringing relief to subscribers, “as they do not have to return at later dates for their cards. The instant ID card system based on biometric data is currently operational in the Greater Accra, Central, Eastern and Ashanti.”
The Chief Executive remarked that in 2010, a Claims Processing Centre (CPC) was established in Accra as a pilot to take over the claims management of big hospitals. In 2013, he said the CPC model was rolled out to Tamale, Cape Coast and Kumasi.
The centre in Accra, according to him, takes care of claims from Greater Accra, Volta and Eastern Regions, whilst CPC Tamale manages claims from the Northern, Upper East and Upper West Regions. CPC Kumasi processes claims from Ashanti and Brong Ahafo Regions, and CPC Cape Coast takes care of Central and Western Regions.
The roll out plan for the year 2014 is to cover the claims of 65% of providers nationwide. This percentage includes most hospitals and major providers representing approximately 80% of total claims in terms of volume.
Mr Mensah also said in a bid to enrich the NHIS subscriber experience, the Authority established the NHIS Call Centre [054 444 6447] to give voice and ear to the subscriber by providing an avenue for them to lodge complaints and make enquiries.
According to him, the Call Centre which runs 18 hours every day, operates in six languages and that hundreds of subscriber issues have been resolved over the phone with the Call Centre.
The minister was accompanied by the Chief Director of the ministry, Madam Salamata Abdulsalam, Director of Policy Planning, Monitoring and Evaluation at the Ministry, Dr Afisah Zakariah, the Public Relations Officer, Tony Goodman and a host of others from the ministry.
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