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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