The General Manager, Lagos zonal office of National Health Insurance Authority, NHIA, Olufemi Akingbade has revealed that about 10 Health Management Organizations, HMOs, who erred in rendering quality service were de-accredited by the authority in the last one year and six other HMOs are also being scrutinized.
Akingbade made the disclosure during the second quarterly stakeholders furum for errollees of national health insurance held in Lagos on Tuesday.
He said : “With what we have in the new law as an Authority, we can sanction providers, HMOs. If you look at our records, you will notice that last year alone, we de-accredited ten HMOs from our list. I know that, even this year some are going to go because we are already at the point of compiling those that have erred, those that are owing, and those that are not behaving well”. “We are giving them an opportunity because we have done another review this year, whereby we gave some HMOs three months, some six months to be able to correct anomalies that we saw. However, if after six months, those anomalies are still there, we don’t have a choice than to de-accredit them. The same thing with service providers. We have the right to also de-accredit them. “.
Explaining the reason for the forum, the zonal General Manager said the authority has different stakeholders,. “We have the enrollees, the healthcare service providers, the HMOs. We have different levels of stakeholders. What we trying to do is to engage each of these stakeholders to know their grievances and to be able to pass message back to them on what they are doing right or doing wrong to be able to improve the system”.
” For today, we have the enrollees, most of the people here are enrollees and you know they are the king. They are the reason why we are existing. And one of the the things we try to do is to feel their pulse . To know how they are being treated when they go to the hospitals both by the healthcare providers and also the HMOs.”.
He added that Health Insurance is for everybody. “let those who have registered, let us know how we are treating them so that we can improve the conditions. Now that health insurance has been made mandatory with the new law, we are expecting more people to come on board. Those that are already here should spread the message about the benefits they are getting from the health insurance.”
”A lot of them are not having to pay out of pocket. You find out that a lot of Nigerians are paying out of pocket at the point of care. And that is one of the things that the health insurance is trying to eradicate. You prepare for it, so that when you need care, you don’t need to bring everything again out of your pocket.”
Also speaking at the forum, Dr Bethuel-Kasimu Abraham, the Deputy General Manager and State Coordinator, Ikeja State office of the NHIA in Lagos, said the stakeholders are more enlightened about the insurance scheme now.
He also said there has been improvements from the health service providers in the state after the last stakeholders gathering.
Dr Abraham said : ”There has been an improvement in the sense that the number of complaints have shot up by a margin. When you have a fora like this where you empower people with knowledge, one thing you notice is that your complaints will rise because people now know what they didn’t know before the encounter with that inclusion of knowledge”.
” And so they can now report. They see things differently which they see previously as normal. That is the feedback we got from the previous session with service providers and HMOs. This one is specifically for the enrollees.”
When asked about the negative perceptions about the health insurance and the lots of complaints, the State Coordinator said : “For those that have not yet enrolled, that has this perception about health insurance and the agencies managing health insurance, I want to assure them of one thing. A complaint is not necessarily a negative thing. A complaint means that there is hope that there can be correction.” .
“It means there is somebody that can make that correction. It also means that there is going to be feedback. Perception can be part of peoples experience. And when they have such experience, it can be easily generalised.. But that may not be the case.
“We now have a streamlined process for having complaints and we follow it to the latter. However, we are now more transparent and we encourage those who have not enrolled to do so. Should they experience any negative thing, they should be willing to provide their details while making complaints,” Abraham advised.