The Chief Executive of the National Health Insurance Authority NHIA, Mr. Sylvester Mensah has said the Authority is committed to building a scheme that stands out as a model in Africa and beyond.
In this regard, he said, the Authority would continue to superintend and facilitate the provision of affordable, accessible and quality health care delivery services to the people.
He said Ghana’s Health Insurance model enjoys international recognition and acclaim and the Authority would spare no effort in maintaining such standard.
Mr. Mensah stated this at the third annual NHIA management retreat at Akosombo in the Eastern Region.
It attracted members of the National Health Insurance Scheme Council, the management teams of the NHIA and the National Health Insurance Scheme and external resource persons to deliberate on issues aimed at enhancing the smooth operations of the scheme.
Mr. Mensah said working towards the growth in membership coverage, active membership, registration of the poor and greater stakeholder engagement would remain a top-most priority of the Authority.
He said plans were far advanced to introduce an Enterprise Risk Management Framework “that identifies and mitigates the natural propensity for institutional leakages, neglect and abuse” as well as monitor and evaluate performance management systems.
Touching on achievements and key programmes of the Authority, Mr. Mensah said it had established a call centre to address issues, enquiries and complaints of NHIS subscribers and other stakeholders expeditiously.
He said the authority had reviewed the medicines list and tariffs respectively in line with changing trends.
Mr. Mensah said a Medium Term Strategic Plan had been developed with stakeholder collaboration to guide the operations of the Scheme and Authority.
The Chief Executive mentioned the institution and fine-tuning of clinical auditing to promote quality of care and reduce abuse and malpractice at health care facilities as a major achievement.
He said there had also been improvement in claims administration with the establishment of a consolidated claims processing centre to take care of claims from the teaching, regional and some selected district hospitals.
That, he explained, had improved the claims processing turnaround time which currently stood at 21 days for the claims processing centre and 60 days for the schemes, barring interruptions to the timely flow of funds.
Mr. Mensah said reforms in the provider payment system with the piloting of capitation in Ashanti Region which, despite initial difficulties, is providing useful lessons and informed plans for a possible country-wide scaling up in 2013.
He said the Authority had introduced a consolidated premium account to collect payments made at the scheme level into one composite account to ensure greater accountability and to improve efficiency in the financial operations of the scheme.
Mr. Mensah said the Authority had completed the necessary processes for electronic linking of treatment to diagnosis which would be incorporated into the new claims module to facilitate electronic claims processing and inject speed and efficiency into the NHIS claims management and payment system.
He said the design and successful piloting of a new prescription form to minimise abuses in the prescription and dispensing of medicines had been initiated.