National Health Insurance Authority to actively engage stakeholders on capitation

The National Health Insurance Authority (NHIA) has pledged to actively engage stakeholders, particularly service providers, to remove all glitches to ensure the successful implementation of the insurance capitation.

Mr Sylvester Mensah, the Chief Executive of the Authority, said the new payment system, which is being run on pilot basis would help to address the difficulties with forecasting and budgeting, simplify claims processing and improve cost containment.

There was the need to share financial risk between the health insurance scheme, service providers and subscribers to allow for a more efficient healthcare delivery.

Interacting with a section of the Media in Kumasi, he said, the capitation has necessitated some structural reforms which would help to increase the responsiveness of the health system.

There is a built-in monitoring and evaluation for continuous quality improvement, accountability in the financial systems, strengthening of routine management information systems data, analysis and use.

Mr Mensah said closer monitoring of quality of care was essential under the capitation to make sure that the NHIS in general remained fair for the package of services covered.

He spoke of plans to roll out the capitation across the entire nation by January 2013.

In line with this, they had stepped up efforts at strengthening the Regional Capitation Implementation Committees.

The Chief-Executive said through clinical audit, the NHIA had within the last year recovered a total of GH¢21 million that was either overpaid or claimed through fraudulent deals.

The Authority was also setting up Call Centres where subscribers could make complaints about quality of services.

Source: GNA