CHALLENGES AND STRIVES OF THE NATIONAL HEALTH INSURANCE SCHEME (NHIS)

By Lawrence Manu-Gyan 

The National Health Insurance Authority (NHIA) is encouraging its clients to promptly report any unauthorized fee requested by healthcare providers to the Authority for the necessary intervention. The issue dominated discussions during a media engagement as part of activities marking the 20th-anniversary celebration of the NHIS in Sunyani which brought together journalists from the Bono Region.

 The Bono Regional Director of NHIA, Joseph disclosed that most clients who fall victim to such illegality fail to report to the Authority making it difficult to deal with it. To this end, he stressed that victims who have fallen victim to the practice to file official complaints at any office of the NHIA for remedial action.

Touching on the steps the Authority is taking to further improve the payment of claims, Mr Mensah indicated it is dependent on how fast and accurate the service providers are in submitting claims to the NHIA. To this end, he urged service providers to do due diligence when submitting their claims to the Authority for processing.

The National Health Insurance Scheme was created in 2004 to replace the cash and carry system and address the challenges associated with it.  In its twenty years of existence, the NHIS has helped in the promotion of affordable healthcare delivery in the country to much acclaim from stakeholders in the healthcare sector and beneficiaries alike. Despite the successes chalked by the scheme, it is faced with several challenges notable among them is the issue of co-payment or illegal charges by providers, which has been a big challenge in the last decade. 

Despite these challenges the NHIS continues to make strives in the Bono Region. For instance, the Region in addition to leading in membership enrolment of over 80 per cent for four consecutive years starting from 2018, is also the first Region to annually attain the World Health Organization's Universal Health Coverage target since 2020. As of October 2023, the region boasts of an active membership of eighty-three per cent, surpassing its annual target with 1,151,648 people registered, exceeding the target of 956,389.