The National Health Insurance Authority (NHIA) has announced plans to implement new economic tariffs aimed at significantly increasing payments to healthcare providers.

This was disclosed by the Deputy Chief Executive for Operations, Dr. Senanu Kwesi Djokoto, during a conference in Ho organised by the NHIA’s Quality Assurance Directorate to disseminate the clinical and audit findings for the last quarter of 2024.

“We have gathered a group of experts from all fields—private, public, all over—and we had a consensus on what will be economic tariffs. So very soon, you are going to see an appreciable increase in tariffs that you receive,” he said.

He noted that while the NHIA is responsible for ensuring financial access to healthcare, providers must ensure geographical accessibility of services.

“We depend on each other. You, the providers, must ensure the sustainability of service delivery, while we ensure the sustainability of the Scheme,” he said.

In a bid to fast-track reimbursement, he encouraged providers to submit claims within 30 days rather than wait until the statutory 90-day deadline.

“If you can submit within 30 days and there is adequate liquidity, we can begin to pay you before the 90 days. We do all this so that there will be quality healthcare delivery,” he said.

Dr. Djokoto also called on providers to join the NHIA in the fight against illegal payments. “Dr. Victor Bampoe has a vision to ensure that when we say financial access, we mean true financial access. With the variety of payments and economic tariffs, we believe that illegal payment should now be a thing of the past,” he said.

The Director for Quality Assurance, Lydia Anaab Bisi, emphasised the need for collective action toward delivering quality care.

“We are partners in the provision of healthcare services. Our common goal is to ensure that every person living in Ghana, especially those registered with NHIA, will receive quality care without paying out-of-pocket. But that goal, we have not yet achieved,” she said.

A representative from the Ghana Health Service Director-General’s office stressed the importance of listening to feedback from service providers. “We hold in high esteem our role as gatekeepers to always protect the Scheme so that we can reach out to the population. We have structures in place that will help us implement some of the feedback you have shared,” he said.

Deputy Director for Quality Assurance, Mr. William Omane-Adjekum, made available findings from a regional audit of healthcare facilities across the Volta and Oti regions.

The findings were presented by a Manager at Quality Assurance, Eugene Ernest Kofie, on behalf of Mr. Omane-Adjekum.

“We came to the Volta Region sometime last year and selected facilities across all levels of care, except the teaching hospital. There will be an audit specifically for the teaching hospital,” Mr. Omane-Adjekum said.

The audit results showed non-compliance with malaria treatment protocols. Some of the facilities treated malaria with no evidence of testing in the records. In some cases, malaria tests came out negative, yet treatment was still administered. The audit also established that public confidence in the Scheme was declining.

“Members are losing trust due to illegal payments and are increasingly choosing not to renew their NHIS membership,” Mr. Kofie said.

To address these issues, he announced upcoming training initiatives. “We have identified a knowledge gap regarding the NHIS benefit package. More training will be conducted to bridge this gap,” he said.