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Controversy over National Health Insurance capitation deepens in Ashanti Region

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The controversy over the pilot implementation of the National Health Insurance Capitation System in the Ashanti Region appears to be worsening with the private facility operators vowing to have nothing to do with it.

The National Health Insurance Authority (NHIA) and the Society of Private Medical and Dental Practitioners (SPMDP) have taken entrenched positions and a crunch meeting to find common ground ended in confusion in Kumasi on Thursday.

The SPMDP said it is opting out of the National Health Insurance Scheme (NHIS) capitation with immediate effect and NHIA signalled its determination to go ahead, abrogating all contracts with members of the SPMDP.

The meeting had been called at the instance of the NHIA to bring stakeholders together to brainstorm on the way forward for successful take off of the new payment system.

The first week of the implementation of the capitation had brought to the fore some serious challenges, a development that had led to a call for its suspension by the former Regional Manager of the Scheme and Municipal Chief Executive for Ejisu-Juaben, Mr Kwaku Afrifa Yamoah Ponko.

Tension run high at the meeting, co-chaired by Dr Kwaku Agyeman Mensah, Regional Minister and Mr Sylvester Mensah, Chief Executive of NHIA, with heated debate and exchanges among the key stakeholders made up of leaders of the SPMDP, Christian Health Association of Ghana, Ghana Health Service, Pharmaceutical Council, Registered Midwives Association, management and staff of NHIA.

Dr Emmanuel Harry Tawiah, Regional Chairman of SPMDP, said their members could not be part of the implementation of the capitation in its present form.

He said the amount of GH¢1.75 being paid by NHIA as service charge per person per visit, would collapse their facilities.

Dr Tawiah, however, said members would continue to serve patients who come to their facilities with their NHIS cards.

Mr Sylvester Mensah, Chief Executive of NHIA, insisted the implementation would continue and urged service providers who could not afford the conditions to opt out.

He said private providers who do not go along with the new system would not be permitted to run the NHIS.

Asked why a large geographical area like Ashanti Region was chosen for the pilot capitation instead of a district, Mr Mensah said the decision was influenced by the region’s central location and the range of health care providers.

He said NHIA was convinced that starting with the region would help the authority to identify properly challenges that might come with the nationwide implementation.

Dr Agyeman Mensah appealed to the stakeholders to soften their positions and work together to find a way out to make the pilot system work.

Source: GNA

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