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Dr. Anthony Nsiah Asare (center), Director General of the Ghana Health Service, in interaction with Dr. Samuel Yaw Annor, while Dr. Eli Atikpui (2nd from left), Registrar, Board of Dental and Medical Medicine; Major Richard Boateng (left), NHIS Liaison Officer, Armed Forces Health Services, and Mr. Peter Yeboah (right), Executive Director of the Ghana Christian Health Association, observe. Image: NII MARTEY M. BOTCHWAY
The National Health Insurance Scheme (NHIS) this year proposed a 20% tariff increase for service providers, after three years of no increase.
Dr. Samuel Annor, chief executive of the National Health Insurance Authority (NHIA), told the Daily Graphic that the proposal was subject to negotiations with service providers and subsequent approval by the Ministry of Health.
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Currently, more than 4,300 service providers are on the NHIS list, of which community-based health planning (CHPS) has 2,320 facilities.
"We think that 20% is achievable within the limits of our budget. But we need to get the necessary approval from them (service providers), "said Dr. Annor.
He added that the revision should take place every year. "If that does not happen, the burden of proof is not solely on the NHIS; Health providers can call us on this because we all work for the benefit of patients. If we all stay quiet, it means we are all happy.
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Event
Dr. Annor said this after a stakeholder meeting with service providers in Accra yesterday.
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The meeting was to address relevant issues that affected the efficiency and sustainability of the NHIS.
The rate represents the fees paid to service providers per visit to an NHIS accredited facility.
The exam is performed annually to reflect the price changes in the market.
Chronology
Mr Annor said that once the discussions ended, the tariff increase would come into effect from January this year.
When asked if he expected a higher percentage increase from service providers, given that there had been no increase in the last three years, he responded "That's why we're here to negotiate. But we will negotiate within the limits of our budget. "
According to some service providers, they were looking for a 25-50% increase to reflect the realities of the market.
They said that an achievement of this increase would be a major relief because of the rising cost of health care in the country.
Results
Dr. Lydia Dsane-Selby, Deputy General Manager of Operations, said during an audit of her facility last year, revealed anomalies in some facilities, including poor record keeping, documentation incorrect, insufficient professional staff and unqualified staff as prescribers in the facilities, incorrect diagnoses to make patients sicker, and malaria treatment without evidence of testing.
She added that many cases of service providers deliberately encouraged patients to come multiple times, with irrational prescription drugs, lab requests and incorrect diagnoses, solely to attract higher rates.
Dr. Dsane-Selby also described as worrying a trend that 99% of requests received by the authorities were nine months older, accompanied by accompanying letters explaining the delays as well.
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