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Need for uniform reimbursement
mechanism to sustain NHIS - Boateng
Accra, July 27, Ghanadot - Mr Ras Boateng, Chief Executive
Officer of National Health Insurance Council, addressing the
opening session of a two-day Stakeholders Meeting on the New
NHIS Provider Tariff Structure and the Medicine List in
Accra, has called for uniform reimbursement mechanism to
sustain the National Health Insurance Scheme.
He said the mechanism should be acceptable to the council,
and various and major providers of the scheme - Christian
Health Association of Ghana, quasi-government and private
practitioners, and Ghana Health Service which runs about 70
per cent of all healthcare facilities in the country.
He pointed out that driving every health insurance system
were the networks of provider systems, strong and
cost-effective tariff structure and drug formulary.
Mr Boateng said to address these issues; the council used an
accreditation process to contract with providers, tariff
structure to reimburse providers and medicine list to avail
NHIS members to both prescribed over-the-counter medicines.
He said without streamlining the existing tariffs into a
single NHIC-produced tariff would threaten the
sustainability of the NHIS, adding; "acceptable rates would
increase provider participation, thus reducing congestion at
current NHIC accredited facilities."
Mr Boateng said surgical procedures, should be classified
using the principles similar to those used in the designing
of the diagnosis related groups.
He explained that the meeting was not for negotiations, but
policy formulation for stakeholders to come out with a
common framework to be used as the basis to develop other
reimbursement mechanisms.
"This will help us to continue to provide affordable quality
healthcare to the people of Ghana while containing cost," Mr
Boateng added.
Source GNA
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