An international public health financing expert has said capitation as a provider payment method is likely to inject the needed efficiency into the claims payment regime of the National Health Insurance Authority (NHIA) and deepen cost containment measures currently being undertaken by the NHIA.
Health economist, Dr. Cheryl Cashin, said “capitation can play an important part in cost containment for the NHIS” and called on stakeholders in Ghana’s health service delivery system “to make it work.”
Dr. Cashin made the remark at the recently held NHIS stakeholders’ meeting under the theme, “sustaining the NHIS – our collective responsibility.”
The ministry of health, through its implementing agency, the NHIA, is spearheading the introduction of an additional provider payment method, capitation, to take care of primary-care cases.
Capitation is a provider payment method in which providers in the payment system are paid typically in advance a pre-determined fixed rate to provide a defined set of services for the individual enrolled for a fixed period of time.
The payment method was introduced in Ashanti region in 2012 as a pilot and is currently in the process of scaling it up across the country.
The NHIA asserts that the system will improve quality of care, enhance a healthy provider-patient relationship and help healthcare facilities under the NHIS address issues of forecasting and budgeting, mainly because monies to take care of their patients would be advanced to them at the beginning of each month.
NHIS subscribers under the system will be requested to enroll with a health care provider of their choice where they will receive medical care for primary healthcare cases. The chosen health facility becomes the subscriber’s Preferred Primary-care Provider (PPP).
Earlier, Health Minister, Madam Sherry Ayittey, and NHIA Chief Executive, Sylvester Mensah, in separate submissions both underscored the importance of the additional payment method.
Dr. Cashin who has more than 20 years of experience in the design, implementation and evaluation of health financing policy told the stakeholders that considering the expansive coverage of the NHIS and the Scheme’s objective to attain Universal Health Coverage, capitation is the best payment model to ensure sustainability whiles ensuring that quality of care is also guaranteed.
Dr. Cashin is a Senior Fellow at Results for Development Institute and is currently serving as the Lead for the Provider Payment Mechanisms technical track of the Joint Learning Network for Universal Health Coverage.
She is a co-author of the World Bank’s “Designing and implementing health care provider payment systems: a how-to manual.” She previously served as an advisor to the Government of Albania on health sector monitoring and evaluation, as the director of a health financing policy program in the Republic of Georgia, and as the deputy director and health financing specialist for a health reform program in the Central Asian Republics.
The one-day event held at the Ghana Institute of Management and Public Administration [GIMPA] was attended by health sector practitioners, politicians, academics and NHIS subscribers. Notable among the attendees were Dr Ebenezer Appiah Denkyira, Director-General of the Ghana Health Service, Dr. Gilbert Buckle, Executive Director of CHAG, Dr Richard Anane, a former Health Minister, Dr. Matthew Opoku Prempeh, MP and Member of the Parliamentary Sub-committee on Health, Hon. Joseph Yieleh Chireh, a former Health Minister, Prof. Agyeman Badu Akosa, and a host of others.