National Health Insurance Scheme (NHIS)
Mr James Zuuga Tiigah, Upper East Regional Minister has called on stakeholders of the National Health Insurance Scheme (NHIS), to work hard to sustain the scheme to facilitate quality healthcare delivery to the poor and the vulnerable.
Mr Tiigah said government’s commitment to deliver its mandate on universal coverage of healthcare in the country was the reason for the innovative measures, such as the biometric system put in place to enhance quality data for the scheme.
He said capitation and electronic claim processing to ensure effective claim management and sustainable health delivery system is also on course.
The Regional Minister made the call in Bolgatanga when he addressed staff of the NHIS during the mid-year performance review for 2015.
He said physical access through establishment of CHPS facilities in every community would was complement efforts to ensure physical accessibility to health facilities.
Mr Tiigah said in spite of difficulties such as delay in payment of claims, efforts are in place to nib the challenge in the bud.
He observed that some clients continue to abuse the scheme by going from one care provider to the other without completing earlier medication, making it cumbersome for the NHIS to correlate the services.
Mr Sebastian Alagpulinsa, Regional Director of the National Health Insurance Authority (NHIA), said the scheme has achieved 63 per cent of membership target of 338,882 with Bawku Municipality and Talensi and Nabdam satellite offices obtaining over 70 per cent of their targets.
To inject financial efficiency and sustainability into the scheme, the Regional Director said the NHIS has reviewed and monitored 145 provider sites in all eight districts where claims submission are verified to enforce compliance with the tariff regime and application of medicines.
Mr Alagpulinsa said, through stakeholder engagements, a total of 50,790 subscribers across all districts have chosen their preferred primary healthcare providers to enhance capitation, as an alternative provider payment method to be implemented in the region.
He noted that challenges such as transport and accommodation are problems confronting some district offices.
He assured the scheme managers that the NHIA has taken measures to resolve the problems as soon as practicable.
Dr Koku Awoonor- Williams, Regional Director of Ghana Health Services called for stronger gate keeping system for proper harmonisation of claims.
He advised the scheme to apply effective communication strategies in the payment of claims.
