Ghana's National Health Insurance Authority (NHIA) is expanding  advanced digital interventions to plug financial leakages in its operations, especially in the area of membership enrollment, illegal charges at healthcare facilities and electronic Claims management.

The interventions include introduction of Artificial Intelligence (AI) and Machine Learning (ML) algorithms into NHIS membership verifications and electronic Claims processing,  deployment of Biometric Membership Authentication System (BMAS) to all credentialled NHIA Health Provider sites, implementation of NHIA Integrated Electronic Payment System (NIEPS), GIFMIS integration for all NHIA Regional and District offices,  NHIS and Ghana cards linkage, introduction of Bulk payment programs, among others.

A Deputy Director, in charge of Business Systems, of the NHIA Management Information Systems (MIS) Directorate, Mr. Joe Annor-Darkwah made this known in a presentation at the NHIA Membership and Regional Operations (MRO) Directorate 2024 mid-year  performance review meeting on September 4, 2024, in the Ashanti Regional capital, Kumasi.

The meeting's primary objective was to review the regional management teams performance in comparison to the targets set at the beginning of the year.

Mr. Joe Annor-Darkwah posited that the deployment of Artificial Intelligence (AI) will enhance the detection  and prevention of fraud associated with membership health facility attendance verifications and claims management.

This, according to him, will strengthen the NHIA Executive Management to do due diligence on Electronic Claims management and make rapid payments to deserving credentialed healthcare providers.

He reiterated the NHIA's use of digital interventions to improve its operations and reduce wastage of resources.

He lauded the NHIA's paradigm shift from curative care to Preventive and Promotive healthcare delivery as well as Wellness programs. He therefore entreated the regional and district management teams to spread the interventions in their catchment areas.  

Opening ceremony

  During the opening remarks, Louisa Atta-Agyemang (Mrs.) who chaired the meeting motivated the staff to strive for excellence to surpass the targets set for the year, in relation to NHIS membership mobilization and revenue collection through digitalization and effective management strategies.

"Technology has also played a pivotal role in our progress. The digital transformation agenda that we embarked on is now bearing fruit. The introduction of the MyNHIS App has revolutionized our operations, making the registration process more seamless and improving data management. This technological advancement is not just about modernizing our systems; it is about ensuring that every Ghanaian, regardless of their location, has access to the quality healthcare services they deserve."

"Our continuous efforts to increase membership enrollment is yielding positive results, with a notable increase in active membership compared to the same period last year. This upward trend in enrollment reflects our commitment to extending healthcare coverage to more Ghanaians, bringing us closer to realizing the goal of Universal Health Coverage (UHC)."

Touching on some of the related issues and expectations for the rest of the year, the Ag. Director Membership and Regional Operations Directorate (MRO), Mr. Oti Frempong urged the stakeholders to augment their efforts to achieve the set annual targets.

There were presentations on the regional performances and the way forward that necessitated discussions and brainstorming, resulting in decisions expected to further enhance the NHIS active membership increment.    

Exceptional performance

The Bono and Bono East Regions received special praise for their outstanding performance during the period under review.

Challenges

The meeting shed light on some operational challenges, including inadequate operational vehicles and insufficient staff in some districts.    

Source: ABDUL KARIM NAATOGMAH