New Payment System To Address NHIS Shortcomings
As part of measures to address shortcomings of the current provider payment under the National Health Insurance Scheme, a capitation payment system is to be piloted in the Ashanti Region. It involves advance payments to primary care service providers of a calculated and agreed amount of money per client for a particular period.Mr Reuben Bedzrah, Ahafo-Ano South District Director of Health Service, said all health insurance accredited facilities in the region would be included in the trial phase, effective April, this year. He was speaking at an annual health review meeting of the district held at Mankranso.He said the new system would exclusively cover non- specialist out-patient’s services.Specialist referral and in-patient care would continue to be paid for through the already existing Ghana Diagnostic Related Groups (G-DRG) with the fee for service and medicines payment method. Mr Bedzrah said the capitation payment would among other things control cost escalation by sharing financial risk between schemes, providers and subscribers, introduce managed competition for providers and simplify claims processing.It would be evaluated after six months, and he said and expressed confidence that it would be replicated in all health facilities across the country. This would end the situation where the facilities sometimes found it difficult to operate due to lack of funds.Mr Patrick Fiagbe, District Parent of the Mankranso Health Management Team, appealed to health personnel to be innovative and stick to professional ethics. He called on district assemblies to sponsor the education of more students in health training schools to ensure that there were adequate health personnel especially in the rural communities.