NHIA Increases Payments To Service Providers

The National Health Insurance Authority (NHIA) has increased the payment for the services of its health providers as a way of motivating them to provide quality and prompt services to their clientele.

Consequently, the NHIA, yesterday, published the new and reviewed NHIS tariffs and medicines list in some selected media outlets to enable its customers and service providers alike to have access to them.

The publication would also help the customers and service providers to know and identify the 517 different formulations of medicines, which cover every single condition named in the NHIS benefit package.

Speaking at a press conference in Accra on Friday, Nathaniel Otoo, Chief Executive of the Authority, said the 2016 medicines list has 517 different formulations and medicines, which cover every single condition named in the NHIS benefit package.

He explained that the NHIS benefit package covers about 95% of all reported disease conditions in Ghana, adding, “There are medicines for each condition.” Explaining further, Mr. Otoo noted: “Considering the vastness of the NHIS medicines list, reports that the NHIS covers only paracetamol is obviously inaccurate. There are 517 medicines healthcare providers can prescribe for NHIS members at various levels.”

“In all” he noted, “88% of the medicines on the 2016 list saw an upward adjustment of their prices, and the rest had their prices maintained or reduced.”  The NHIA boss continued that every year his outfit carries out a review of its medicines list, to ensure that the prices it pays for medicines and services actually reflect current economic and market realities, taking into account the economies of scale the NHIS, as a bulk purchaser of services, brings on-board.

“Averagely, the review gives medicines an upward price adjustment of 24%. This is just an average, but in reality, some medicines saw over 100% price adjustments”, while “Service tariffs under the NHIA also have seen an average increase of 27.5% over the 2014 figures,” he averred.

Continuing, Mr. Otoo said this year’s review process, which was a Ministry of Health directive, “took particular interest in safe motherhood, by allowing the administration of oxytocin and egometrine at the lowest levels of care. “These two medications are lifesaving before, during, and after labour, by preventing postpartum haemorrhage (bleeding after delivery),” he posited.

Mr. Otoo, however, elucidated that the general upward tariff review will not be an extra cost to the subscriber, saying, “It simply means that the NHIA is going to pay its providers more for their services and medicines, so subscribers can be better attended to when they visit the health facilities.” He noted that the NHIA would bear all the cost of covered services and medicines, not the subscribers.

What the review means
The review of tariffs and medicines list means that healthcare providers, hospitals, clinics, pharmacies, chemical stores, etc, will be paid realistic prices for the services and medicines they dispense to NHIS members. Reviews are done yearly.

It also means that our healthcare providers will be happier providing service to NHIS members, because they will be reimbursed at the right price.  For our members, it means that the charging of unauthorised fees by healthcare providers when they go to seek healthcare would cease.

By Richard Kofi Attenkah

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