Health schemes parley for better delivery

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Gloria Essien

The National Health Insurance Scheme, NHIS in continuation of its strategic stakeholder’s engagement, has met with Health Management Organisations, HMOs.

The meeting held in Abuja was to look at the bulk of the complaints received from Enrollees in most hospitals and to address them.

Nigerian Ministry of Health, Dr. Osagie Ehanire while addressing the forum, said the review process was most appropriate and timely, considering that NHIS had been in the eye of the storm in recent years, with grave consequences on the sustenance of corporate focus and the quality of service delivery.

Engagement for Healthcare
“It is on the strength of this that I hereby call on all stakeholders to take full advantage of the reforms in NHIS, to engage in frank conversations around the issues that have clogged the wheels of NHIS in the past.

To underscore the strategic importance of these reforms, and the political will and commitment for its success, I was personally here in the company of the Honourable Minister of State for Health, about two weeks ago, to address a similar engagement for Healthcare Providers,” he said.

 “I wish to repeat myself by saying that all stakeholders of the National Health Insurance Scheme are expected to take advantage of the reform mood of the regulatory body, to critically examine themselves and their operations. This is the only way to remain relevant and reputable in the new NHIS we are building,” the Minister said.

He also called on operators of the Health Maintenance Organisations (HMOs), to use the opportunity to review their operations and business processes.

“Reports reaching me indicate that an overwhelming percentage of enrollees and health care providers have expressed grave concerns over the performance of HMOs, with areas of the concerns including, but not limited to, non-remittance of payments to healthcare providers, poor customer service delivery and inaccessibility to enrollees at critical moments of need.

The collective results of these and many other cases of service failure in the industry are poor service delivery, poor quality of care and a worrisome reputation damage for the Scheme,” Ehanire said.

Patriotic obligations
He said they must ensure their economic interests do not submerge the patriotic obligations in dealing with clients as part of the collective effort to build a nation of healthy and prosperous people.

The Executive Secretary of NHIS, Professor Muhammed Nasir Sambo said on resumption of office, he was confronted with various complaints about difficulties encountered by enrollees who were the end users of insurance services.

He said for Nigeria to attain Universal Health Coverage, there was the need to identify, address and proffer solutions to the challenges in the scheme.

“In the cause of this engagement, we must address the issues that have cast the scary shadow on the scheme. We must unmask the faces to enable us look straight in the mirror to see what we can do to redeem ourselves from the public, especially the enrollees and health care providers. We are waiting for the outcome of this engagement,” Professor Sambo said.

He urged the HMOs to work with renewed commitment and vigour to achieve results for the sake of posterity.

Health Management Organisations at forum described it as a good idea.

Strategic forum
Speaking on behalf of the HMOs, Dr. Kunle Ladele, assured that they would support the new Executive Secretary to succeed.

He appreciated the organisation of the strategic forum and promised to be frank and honest with the scheme.

Dr. Kayode Obende, said that the meeting would chat a way forward for the future.

He also said that a lot of HMOs have deviated from the original idea of the scheme explaining that the meeting would address such.

Also speaking, the Natural President of the Association of Health Insurance Practitions of Nigeria, Dr. Benedict Okpala, said the association was aware that the success of the scheme and the attainment of Universal Health Coverage was of utmost importance to all Nigerians.

“We understand how important it is to endure enrollee satisfaction through quality healthcare services, provider cooperation by way of prompt and adequate settlement of claims for services rendered, and sustainability of the scheme by abusing by the operational guidelines, as they are the factors that will ensure the achievement of the objectives of the scheme, and universal health coverage within record time,” Dr Okpala said.

There were paper presentations on ‘Changing the landscape of NHIS and group work Challenges of Health Maintenance Organisation in NHIS.’

 

Lateefah Ibrahim