The federal government is set to review the capitation fees paid to healthcare providers under the national health insurance programme, addressing long-standing concerns from hospital proprietors involved in the scheme. Capitation fees are payments determined by the number of patients served.
Dr. Kelechi Ohiri, Director-General of the National Health Insurance Authority (NHIA), disclosed that these fees have not been reviewed for many years, emphasizing the necessity of addressing this issue for the betterment of the healthcare sector.
“It’s been a while since tariffs were reviewed. We initiated actuarial reviews in February to have a solid foundation for adjusting these tariffs,” Dr. Ohiri stated.
Additionally, the definition of vulnerability now includes women at risk of death during childbirth, predominantly found in rural areas. The NHIA is also enhancing partnerships with state government-run health insurance programmes to boost enrolment nationwide. Dr. Ohiri commended state governments for their efforts to expand health insurance.
“Every state in Nigeria now has a state health insurance scheme, with Rivers State being the latest to join. Many states are also setting up Equity Funds to complement federal efforts,” he noted.
Despite these efforts, only about 16 million Nigerians, or 7 percent of the population, are currently covered by health insurance. The new NHIA Act aims to increase this coverage. “With the act making insurance mandatory, we now have a pathway to universal coverage. We aim to increase the coverage significantly from the current 7 percent,” said Dr. Ohiri.
Dr. Ohiri stressed the collective responsibility of improving health insurance coverage, involving both public and private sectors.
“We have a mixed insurance space with NHIA, state health insurance schemes, private health insurance agencies, HMOs, and administrators. Achieving universal healthcare coverage requires joint efforts from the federal and state governments, private sector, and civil society organizations,” he concluded.
The review and initiatives by the NHIA are expected to strengthen Nigeria’s healthcare system and make health insurance more accessible to all citizens, particularly the most vulnerable groups.
