NHIA USAID Accelerator to conduct research on Out Of Pocket Payments associated with NHIS | 3/7/2023

The National Health Insurance Authority (NHIA) in collaboration with the United States Agency for International Development (USAID) Accelerator has established a fifteen (15) member Technical Working Group (TWG) to provide technical support to a team investigating the incessant financial pressure known as (Out-Of-Pocket-Payments OOP) associated with the operationalization of Ghana's National Health Insurance Scheme (NHIS).  

The TWG has representation from the Ministry of Health (MoH), NHIA, USAID, Ghana Health Service (GHS), Results for Development (R4D)/Accelerator, Christian Health Association of Ghana (CHAG), Private Health Facilities Association of Ghana and a consultant from the University of Ghana, Economics Department.

The TWG members held their inception meeting on Thursday, March 2,  2023, in Accra. The research, which will be fully funded by the USAID, is to examine the magnitude and factors that contribute to the charging of Out-Of-Pocket-Payments such that NHIS members are compelled to pay for services covered by the Scheme, hence undermining people's trust in the Scheme.   

The Principal Investigator is Dr. Francis Asenso-Boadi, Director Research, Policy and Monitoring and Evaluation of the NHIA and the Research Consultant is Professor Edward Nketiah-Amponsah of the Economics Department, University of Ghana, with DataPlas providing data collection and management services.

The Technical Working Group has six (6) months to support the research team to conduct a comprehensive study with a nationally representative sample into the phenomenon which remains a major obstacle to healthcare financing in Ghana. 

In a presentation, the Research Consultant, Professor Edward Nketiah-Amponsah, gave an overview of the research Aim, Objectives, and Methodology. 

 The Out-Of-Pocket Studies Activity Lead at the R4D/Accelerator, Marian Opoku-Agyeman, made a presentation on the Governance Structure for the study. 

 By means of comments, questions and suggestions, the participants contributed meaningfully to the presentations including the need to include a representative from other faith-based health institutions in the Technical Working group, and for the research team to use NHIA classification of health facilities for the stratification of population sample.  

Copayments Committee Creation

 Copayments refer to the direct out-of-pocket-payments for healthcare services and medications covered by the NHIS, adversely affecting affordability and equality in accessing healthcare. 

The NHIA had earlier set up a nine-member committee to investigate the menace which is widespread at various health facilities across the country.  

The committee’s mandate includes engaging with the Authority’s credentialed healthcare service providers and NHIS members who are sometimes compelled to pay extra monies for services covered by the Scheme.

This is to strengthen the NHIS mandate of providing financial risk protection and improved access to healthcare for the Scheme’s members. 

Okoe Boye decries Copayments 

The NHIA Chief Executive, Dr. Bernard Okoe-Boye has repeatedly served notice of management’s non-negotiable decision to revoke the license of credentialed healthcare providers charging illegal fees. 

He said the NHIA reimbursed one and a half billion cedis annually to healthcare providers for claims submitted to the Authority, for which reason it was unreasonable demanding extra money from NHIS members at the point of need.