Delivering on the NHIS Promise

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NATIONAL HEALTH INSURANCE AUTHORITY

PRESENTATION AT THE DONOR FORUM ON WORLD BANK GROUP PARTERNSHIP, PROGRAMS AND TRUST FUNDS

PARIS, FRANCE

MAY 20-21, 2008

BY

RAS A. BOATENG

(CHIEF EXECUTIVE)

Delivering on the NHIS Promise

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Outline Of Presentation

• Overview of Health Insurance Act

• Private Sector Participation

• Status of Implementation

• Challenges

• Strategies to address challenges

Delivering on the NHIS Promise

Overview Of Health Insurance Act

Subsidize Cost to DMHISReinsure DMHIS against cost fluctuationsFund Indigent Healthcare costProvide access to health service

ACT 650ACT 650

NATIONAL NATIONAL HEALTH HEALTH

INSURANCE INSURANCE COUNCILCOUNCIL

TYPES OF TYPES OF HEALTH HEALTH

INSURANCE INSURANCE SCHEMESSCHEMES

NATIONAL NATIONAL HEALTH HEALTH

INSURANCE INSURANCE FUNDFUND

Education Programs

Implement NHI Policy

Register, license & Regulate HISGrant accreditation to Healthcare Providers

Manage NHI Fund

Determine Premiums

Promote Health Education

Establishment of District Mutual Health InsuranceEstablishment of Private Commercial Health InsuranceEstablishment of Private Mutual Health Insurance

Delivering on the NHIS PromisePrivate Sector Contribution to the growth of Health Insurance in Ghana

• 1993: Nationwide Mutual Medical Insurance Scheme (by the Private Medical Practitioners Association; reached subscriber base of 20,000 people in 2 years, corporate subscribers paid premia annually, half yearly or quarterly and was based on the benefits level)

• 1997: Metropolitan Health Insurance Plan (by Metropolitan Insurance company Ltd., As at September 2001, 15,000 subscribers were on full cover, 25,000 on partial cover. Over 100 companies had subscribed. Had designed a package for the educational sector workers and was working with Defence to design one for the Civilian workers/dependants of the Military)

• 1999: The Ghana Healthcare Company (by SSNIT but still at gestation period)

• The Nkoranza Community based Mutual Health Scheme

Delivering on the NHIS PromisePrivate Sector Participation in NHIS Implementation (Financing side)

• Gemini Life Insurance Company

• Vanguard Assurance

• Momentum Health Insurance

Delivering on the NHIS Promise

Category of Providers Number Accredited

Hospitals/Clinics 301

Dental Clinics 7

Maternity Homes 201

Pharmacies 301

Chemical Shops 229

Diagnostic Centres 96

Total Accredited 1135

Private Sector Participation in NHIS Implementation (Provider side)

Delivering on the NHIS PromisePercentage Market Share of Health Service Provision

Service Provider Number of Facilities

Percentage Percentage HR

Ghana Health Service and Teaching Hospitals

1,110 49 67

Faith Based Providers 231 10 15

Private Hospitals and Clinics & Maternity Homes

878 39 10

Quasi 48 2 8

Delivering on the NHIS Promise

Status of Implementation

Schemes in Operation 145

Total Registered 11,279,678 55%

Members eligible for ID Cards 9,773,100 48%

Informal Adult 2,456,012 25%

70 years and above 405,474 4%

Under 18 years 5,985,152 61%

SSNIT Contributors 625,783 6.5%

Pensioners 52,300 1%

Indigents 248,379 2.5%

ID Card Bearers 8,291,666 42%

Delivering on the NHIS Promise

YEARYEAR Hospital/Clinic Hospital/Clinic Attendance Attendance

Active MembersActive Members

2005 552,000 1,388,662

2006 3,213,450 3,955,203

2007 6,835,104 8,291,666

Status of Implementation (Cont’d)

Delivering on the NHIS PromiseChallenges of the Private Sector in Health

Private Health Insurance side:

• initial capitalisation, e.g. the security deposit

Private Provider side:

• disincentive in locating at hard to reach areas

• Initial capitalisation

• Technical Personnel

Delivering on the NHIS Promise

• Incentivise private providers to operate in hard to reach areas.

• Use of accreditation of existing private providers to redistribute health facilities to improve geographical access

• Encouraging Ghanaian doctors/Nurses in Diaspora to relocate and establish modern health facilities in the country through the franchise idea

Proposed strategies to address challenges

Delivering on the NHIS Promise

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END OF PRESENTATIONEND OF PRESENTATION

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