Communique Issued at the End of a One Day Strategic Stakeholders Engagement for Health Care Providers (HCPs) Under the National Health Insurance Scheme (NHIS)

On 18/Sep/2019 / In Press Publications

COMMUNIQUE ISSUED AT THE END OF A ONE DAY STRATEGIC STAKEHOLDERS ENGAGEMENT FOR HEALTH CARE PROVIDERS (HCPs) UNDER THE NATIONAL HEALTH INSURANCE SCHEME (NHIS) HELD AT CHIDA HOTELS, UTAKO, ABUJA ON SEPTEMBER 5, 2019.

INTRODUCTION

In the pursuit of its rebranding agenda, the National Health Insurance Scheme (NHIS) organized a one-day National Strategic Stakeholders Engagement for Healthcare Providers (HCPs). The main objectives include unveiling the reforms of the new-result oriented NHIS, reviewing the roles and responsibilities of the HCPs, identifying challenges and proposing solutions in the implementation of the Health Insurance Programmes with respect to Providers. The event, which was the first official engagement of the Honourable Minister of Health, Dr. Osagie Emmanuel Ehanire, with any of the Departments and Agencies under the Ministry, was supported by the Honourable Minister of State, Dr. Adeleke Olorunnimbe Mamora. The meeting was attended by 285 representatives of healthcare Providers across the nation. The Chairman, Committee of Chief Medical Directors, the President of Healthcare Providers Association of Nigeria (HCPAN), and a representative of the Guild of Medical Directors, gave goodwill messages. The Honourable Minister of State, in his remarks advocated frankness in the discussions and the need to promote synergy and collaboration. In declaring the workshop open, the Honourable Minister recognized that we are in global competition which makes the Government committed to strengthening the Scheme towards provision of Universal Health Coverage (UHC). He stated that the success of the Scheme will be measured by the scope of coverage and quality of care to enrollees who should be treated with dignity and respect. He also enjoined stakeholders of the Scheme to take advantage of the current reform process to improve Health Insurance and guarantee appropriate redress mechanism.

National Health Insurance Scheme

TECHNICAL SESSIONS

The stakeholders' engagement had a technical session which received presentations on NHIS-changing Landscape and Healthcare Providers as Catalyst to Successful Implementation of the NHIS. The Group work focused on the challenges of HCPs in their relationships with Enrollees, HMOs, HCPs and NHIS and proposed solutions.

CHALLENGES

The stakeholders identified some challenges affecting the implementation of the Social Health Insurance Programme. The challenges include; delayed payments (capitation, fee-for-service), old tariff rates. lack of appropriate interface among stakeholders, delayed issuance of authorization code, payment without advice, rejection and reduction of bills without explanation, lack of effective communication among stakeholders, lack of capacity for quality assurance, lack of monitoring of private health plans, lack of standard billing process, referral issues among providers, inequitable distribution of enrollees to HCPs, payment into wrong account in TSA, improper attitude of enrollees,

RECOMMENDATIONS

  1. The NHS should embark on programmes to expand coverage of critical segments of the population in order to achieve U HC in the shortest possible time.
  2. Efforts should be made to clear the arrears of debts to HCPs and appropriate systems put in place to ensure prompt settlement of d aims especially fee-for-service.
  3. Urgent review of tariffs and drug list in view of economic realities.
  4. The deployment of Information and Communications Technology (ICT) infrastructure that allows for effective interface between all stakeholders.
  5. Stakeholders should comply with the Operational Guidelines, play their roles accordingly and sanctions should be given whenever there is a breach.
  6. There should be biometric registration of enrollees.  
  7. Establishing necessary linkages between stand-alone facilities and primary providers.
  8. Sensitization and capacity building of all stakeholders on a regular basis.
  9. Review of NHIS Operational Guidelines to conform to current realities.
  10. Engagement of stakeholders, including regulatory bodies, in the process of accreditation and reaccreditation.

CONCLUSION

The National stakeholders' engagement participants commended the Management of NHIS for embarking on a rebranding agenda which focuses on value system reorientation, transparency and accountability and accelerating the drive towards the achievement of Universal Health Coverage by 2030.

Signed for the COMMUNIQUE COMMITTEE:

Dr. Bukar A. Grema

Aminu Kano Teaching Hospital, Kano

Mr. Olufemi Akingbade

General Manager/Zonal Coordinator, Lagos Zone, NHIS

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