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National Health Insurance Scheme


NHIA Steps up efforts to achieve Universal Coverage|11/27/2019

The National Health Insurance Authority (NHIA) has stepped up efforts to achieve 100 percent coverage of all Ghanaian residents in tandem with attainment of the Universal Health Coverage (UHC).   To this end, the authority is collaborating with the National Identification Authority (NIA) to allow registered members to use the Ghana Card to access healthcare services under the National Health Insurance Scheme (NHIS).   This move is to increase active membership on the health insurance scheme and also to reinforce the NHIS mandatory status by partnering with other state institutions. The Chief Executive Officer of the NHIA Dr. Lydia Dsane-Selby brought this to the fore in an exclusive interview on her NHIS journey so far.   According to the NHIA Boss, the Authority’s major concern is to increase its membership to reposition Ghana in line with the attainment of Universal Health Coverage (UHC). ‘‘The main thing we all want is Universal Health Coverage for Ghanaians which means we need to increase the membership coverage and also match the benefit package with the health needs of the citizens of Ghana. This is to say that the scheme must be financially sustainable to achieve financial risk protection for the people of Ghana.” She further said…“We are looking at ways of partnering with various agencies, organizations to make the requirement of having NHIS active membership almost mandatory across the country that will get us the 100 percent coverage we are looking for.”   “We have a lot of innovations going on and during our tenure I think we will be able to show that the Health Insurance is alive and kicking, very vibrant and more importantly responsive to the needs of the people of Ghana.”   She maintained that the Authority would continue to work with Civil Society Organizations and other development partners to achieve the UHC goal.   FINANCIAL SUSTAINABILITY                     Dr. Dsane-Selby commended government for boosting the NHIS budgetary allocation as captured in the 2020 Financial Statement presented by the Finance Minister, Ken Ofori Atta, lately.   “Because we are being prudent in our management, the Ministry of Finance is making sure our allocation is guaranteed within the budget and the 2020 budget has given us a bigger boost.”   MOBILE RENEWAL SERVICE   Describing the Mobile Renewal Service as an absolute game changer, Dr. Dsane-Selby explained that feedback from the public on the NHIS operation informed the decision to invent the much touted project.   “In 2015/2016, the NHIA realized that membership of the Scheme was stagnating and the challenge was in the renewal of membership. Having a biometric card meant that our members had to go back to our district offices to renew. And the decision was what we can do differently around the renewal process.”   “ILO came forward to partner with the NHIA to really work out if there was a way to change the enrolment process. The project started in May 2017 using design thinking methodology where you come out with some ideas throw it to the users, get feedback, redefine until you come out with a system that is suitable for all.”   She recounted, “Within a few months, it was clear that the best way was using mobile technology and once we decided on that I think within six months we were already piloting at a couple of districts and the feedback from the members was great, after which the project.”   “What started as just Mobile Renewal project has ended up spooning several other options which have all been so beneficial to us. The uptake has been very fast just because the product is so good. Within three months of launching the authentication, 96 percent of providers were in compliance without enforcing anything which again told us it was very good and the methodology is very simple’’ just dial *929#.   CLAIMS MANAGEMENT Dr. Dsane-Selby reaffirmed the Authority’s determination to pay approved claims on time. “Right now we have the infrastructure to allow a hundred percent of digital claims and therefore we have designed applications to allow hospitals submit their claims electronically. We just built a new actuarial model to avoid increasing claims payment exponentially. We are ensuring that there is no co-payment at the point of need.” She commended the staff of the NHIS for their steadfastness and urged them to continue on that tangent to meet the health needs of all active members.   She further thanked her predecessors for contributing to the NHIS achievements since its inception in 2004.   EXPECTATION She said the NHIA would deepen its partnership with the Providers to satisfy the needs of the members and thereby underscored the need for all Ghanaian residents to own the Scheme by joining the active membership.   Source: ABDUL KARIM NAATOGMAH      

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