The Effects of Delays in Reimbursement of Claims by National Health Insurance Authority on Financial Management of Health Care Facilities in Brong Ahafo Region of Ghana

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DOI: 10.21522/TIJMG.2015.SE.19.02.Art012

Authors : Nestor Naabulee Nasage, Joseph Kwasi Agyemang, Michael Adusei Boadu


Financing health care system is of a major concern to countries all over the world. The Act of Parliament (Act 650) passed in 2003 health care financing and being implemented and supervised by the National Health Insurance Authority (NHIA). National Health Insurance Authority aimed to assure equitable and universal access for all residents of Ghana to an acceptable quality package of essential health care services without payment being required at the point of use. The efficiency and sustainability of the health care facilities depend on funding and timely disbursement of claims. It has been observed that, whilst health care facilities do comply with section 37 (7) of L.1 1809, the scheme has not been able to comply with section 38(1) of the L.1 1809. This leads to undue delays in reimbursement of funds to accredited institutions. This delays of reimbursement of claims by National Health Insurance Authority therefore has adverse effects on the financial management of health care facilities. It is therefore recommended that, Government should speed up on releasing funds to National Health Insurance Authority for payment of claims. Further research needs to be done to verify the findings among other groups of facilities, and explore comparative studies involving facilities from different industries. Future researchers should also develop measures of additional dimensions to find out if the premium charged on scheme members of NHIS is fair enough to pay claims and also suggest whether premium charged should be increased or maintained.

Keywords: National Health Insurance Authority, Reimbursement, Financial Management, Accredited Health Facilities


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