CHPS Compounds could be rich under Capitation

Prospects for Community Based Health Planning and Service (CHPS) Compounds to become rich under the capitation system of the National Health Insurance Scheme are high.

This is because those Compounds are crucial gate-keepers in the referral system in which they are to be the preferred primary provider of health in every community.

But those Compounds also risk becoming ‘white elephants’ if clients ignore them as the preferred primary health providers at community level and go ahead for facilities at the higher levels of health delivery under capitation.

Mr Charles Agbeve, Ho Municipal Manager of the National Health Insurance Authority (NHIA) made these points at the 2015 Annual Performance Review Meeting of the Ho Municipal Directorate of the Ghana Health Service on Thursday.

Other levels of health delivery above the CHPS Compounds are Clinics, Health Centres, Poly Clinics, District and Municipal Hospitals and Regional Hospitals.

Mr Agbeve said clients of the NHIS needed to be made to conform to the hierarchy in the referral system under capitation.

He advised managers of the CHPS Compounds not to stray into areas outside their prescribed scope, otherwise they risked losing claims for services they were not required to provide.

For example those Compounds do not have the capacity to prescribe hypertension drugs.

Such clients should be referred to the appropriate health facilities after providing the services their Compounds were allowed to give those clients.

Mr Agbeve hinted that a new medicines list and tariffs were in the offing.

He said the June and July 2015 claims by the health facilities would be paid soon and called for timely submission of properly vetted claims to avoid undue delays in claims payment.

Mr Agbeve said the Authority was facing some challenges and called for forbearance from to its partners.

Dr Atsu Seake-Kwawu, Ho Municipal Director of Health in his report, lamented huge deductions from the claims made by health facilities at the lower levels of health delivery.

The cuts resulted in those facilities losing huge sums of money and rendered them unattractive as preferred primary providers under the NHIS capitation scheme, he said.