Wednesday, May 29, 2024
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Healthcare providers accuse HMOs of high indebtedness, impunity

By Angela Onwuzoo 

…List way forward for NHIS

To  realise the objective of the National Health Insurance Scheme  in  making quaulity health care available to Nigerians at an affordable cost, healthcare providers  in the country, under the aegis of Health Care Providers Association of Nigeria, have  listed grey areas  requiring urgent  government attention  for the scheme to move  forward .

The healthcare providers decried  the irregularities in the operations of  some Health Maintenance Organisations in the health insurnace industry, while accusing them of impunity and failure to pay providers their capitation fees,  which they said were running into millions of naira.

Speaking at a press briefing in Lagos recently, President of HCPAN, Dr. Arigbabuwo Adeyeye, blamed the poor performance of the NHIS on weak and politicised leadership of  the scheme, which he said was responsible for low uptake and  less  than five per cent coverage  since the  establishment of the scheme over 12 years ago.

Following recent alleged corruption charges  rocking the leadership of the scheme, the Federal Government ordered its  Executive Secretary, Prof. Usman Yusuf, to proceed on an administrative leave pending the outcome of  a seven-man panel set up  to investigate the allegations levelled against him by the scheme’s Governing

Adeyeye also  Identified absence of enrollees in most facilities, skyrocketing out of pocket payment, high morbidity and mortality rate in Nigeria, poor funding, low NHIS awareness in the communities, lack of information technology infrastructure at health facilities as well as  poor distribution of enrollees as some of the factors that have hindered the growth of the  Nigerian health insurance scheme.

Besides, he noted that the failure of the Federal Government to make health insurance compulsory for every Nigerian  also contributed to the slow pace of success in the scheme.

Giving insight into activities of some  of the HMOs, which he said were totally unacceptable to HCPAN, Adeyeye said, “The instability and impunity of some HMOs, with most of them owing providers for several months,  is a affecting the health sector.

“We are now experiencing a deliberate insolvency by some HMOs and bailing out with providers’ funds running into several millions of naira, for instance, THEBE,KBL, Premium Health, et cetera.”

He also frowned at the attitude of  the teaching hospitals, saying they have taken over the bulk of the enrollees and primary cases , thereby making them unable to adequately attend to referral cases, training and research for which they were established.

The HCPAN President is also not happy that the state-supported health insurance is emphasising more on primary care while neglecting secondary care provision/ accreditation by
providers .

On the way forward, Adeyeye called on the Federal Government  to make  the scheme compulsory  in order for everyone to come on board, adding that when everybody enrolls into  the scheme, it will promote efficiency  and  proper utilisation of the health facilities and ultimately better health care delivery system in the country.

The NHIS was established by the Federal Government in 2005 to enable Nigerians enjoy easy access to health care services.

Stressing  the need for the NHIS Act to be amended accordingly, the HCPAN leader  also asked  the government to stop tertiary institutions from  attending to primary cases and receiving capitation.

He further said : “Tariff must be reviewed and done regularly to reflect the economic realities in the country. HMOs must be made to pay providers as and when due. There should be equity in the distribution of

Providers must be given a minimum of enrollees necessary to break even. Providers should improve on their IT infrastructure because it will serve to improve keeping of data. There should be public enlightenment in the various communities  to improve awareness of NHIS by all stakeholders.”



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