Business News of Sunday, 16 July 2017
The government has decided to abolish the National Health Insurance Scheme (NHIS) capitation policy which was first piloted in the Ashanti region in 2012.
The Senior Minister, Mr Yaw Osafo Maafo made this known at the Ashanti Regional New Patriotic Party (NPP) delegates conference in Kumasi on Sunday, Graphic Online’s Kwadwo Baffoe Donkor reports.
Capitation, which is one of the most effective and efficient healthcare provider payment systems, was implemented on a pilot basis in 2012 in the Ashanti Region. The scheme initially faced stiff opposition and challenges from healthcare providers in the region.
The opposition faced, was due to lack of adequate education and sensitisation to the project in the region, a challenge that made the National Health Insurance Authority (NHIA) to learn lessons from the pilot programme.
After the pilot, real implementation began in the Ashanti Region and the extension of the programme to the Volta, Upper East and Upper West regions brought to four, the number of regions implementing the new provider payment method.
Under capitation, service providers are paid in advance, a pre-determined fixed rate to provide a defined set of services for each individual enrolled with the provider for a fixed period of time.
The amount paid to the provider is irrespective of whether that person will seek care or not during the designated period and it covers only primary health care for out-patient attendance.
One advantage of capitation, is that it guaranteed the service provider a certain amount of money at the start of every month depending on the number of subscribers enrolled in that facility.
The pre-payment of claims under capitation, according to the NHIA, was, therefore, an incentive which made it easier for service providers to forecast and plan their activities without worrying about delays in claims reimbursement from the NHIA.