Health News of Tuesday, 11 March 2014

Source: NHIA

We will help to make capitation succeed in Volta – Afotey-Agbo

Outgoing Volta regional minister, Nii Laryea Afotey-Agbo, has pledged his administration’s support for the implementation of the capitation payment method in the region. The Minister made the comment when a team from the National Health Insurance Authority called on him at his office to brief him on preparations towards rolling-out the payment method in the Volta region.

He assured the team that his administration will give the needed support to ensure that the implementation of the system is successful. According to the Minister, “we will also let people on the ground know what it [capitation] means and what it stands for.”

In declaring the region’s preparedness to embrace the program, the Minister advised the NHIA to ensure that it engages various stakeholders adequately and consults widely before starting the roll-out. According to him, the NHIS is a national asset and efforts to ensure its sustainability must be supported.

Also, present at the meeting was the deputy regional minister, Hon Francis Ganyaglo, who said the regional coordinating Council would work with the various District Chief Executives to ensure that the program succeeds. He further urged the NHIA to involve community leaders, DCEs and assembly members in the education and implementation process so the miscommunication and other challenges experienced in the pilot phase in Ashanti will not recur.

“Make sure you go to the ground to the people, listen to them so that fallouts from Ashanti will not be repeated,” he urged.

The Ministry of Health through its implementing agency, the NHIA, has introduced an additional provider payment method, capitation, to take care of primary-care cases. Capitation is a provider payment method in which providers in the payment system are paid typically in advance a pre-determined fixed rate to provide a defined set of services for the individual enrolled for a fixed period of time.

The payment method was introduced in Ashanti region in 2012 as a pilot subsequent to its nation-wide roll-out. According to the NHIA, the system will improve quality of care, enhance a healthy provider-patient relationship and help healthcare facilities under the NHIS address issues of forecasting and budgeting, mainly because monies to take care of their patients would be advanced to them at the beginning of each month.

NHIS subscribers under the system will be made to choose a health care provider of their choice where they will receive medical care for primary healthcare cases. The chosen health facility becomes the subscriber’s Preferred Primary-care Provider [PPP].

Deputy Chief Executive of the NHIA in-charge of operations, Nathaniel Otoo, who led the NHIA team, told the minister the visit was a routine one to assess the operations of the Scheme in the region and to engage with stakeholders on the introduction of instant NHIS identification cards based on biometric data and capitation as a provider payment method.

Anthony Gingong, who is the Project Coordinator of the Nation-wide Capitation Roll-out Program, reiterated the need for the introduction of the capitation system. He stated that as the country works towards attaining Universal Health Coverage, it is important to introduce systems, which will make the NHIS, run more efficiently. “We all have a responsibility to ensure that the NHIS program we are running is sustainable,” he said.

Mr Gingong mentioned that capitation will cover 22% of all services paid for under the NHIS while emergency and serious cases will be paid for under the existing Diagnosis Related Groupings [DRG] method.

The six-member team from the Authority from the NHIA last week was made up of Nathaniel Otoo, Deputy Chief Executive, Operations, NHIA, Anthony Gingong, Project Director of the Nation-wide Capitation Roll-out Program, Ben Kusi, Director, Membership, Provider Relations and Regional Operations, OB Acheampong, Director, Research and Development, Eric Ametor-Quarmyne, Consultant and Selorm Adonoo, communications Manager. Director of Institution Care at the Ghana Health Service also joined the team.