Abstract:

The National Health Insurance Scheme (NHIS) is a major social intervention program ever initiated, implemented and championed by the Government of Ghana in its quest to achieving universal health coverage for all the citizenry. Although a beautiful and highly acclaimed and acceptable scheme by many, the implementation of its payment regime of reimbursable claims to service providers is fraught with several challenges of which delayed reimbursement of submitted claims to health service providers is a major one. It is assumed that this anomaly disrupts the supply chain management of service providers with some consequential results in general service output of the latter viz; availability of prescribed medicines, surgical and medical consumables, patient waiting time and medical and surgical equipment. Employing descriptive and inferential statistics in a cross-sectional study with the problem statement, variable assessment, instrument development, method of data collection (primary and secondary), data analysis and report writing well captured, the researcher concludes that there is some amount of truth that truly delayed reimbursement by the NHIS has some consequential results on the general service output of healthcare providers and therefore recommends prompt payment of submitted claims by the NHIS.

References:

[1].   Albert Ahenkan & John Azaare, 2018, Managerial Implications of Delayed Reimbursement of National Health Insurance Claims: The Case of two Hospitals in Northern Ghana, available at https://www.ajol.info/index.php/ajmr/article/view/176344 and retrieved on 07/04/2020.

[2].   Campbell, D. J., Organizations and the Business Environment, Butterworth-Heinemann, 1997.

[3]. City Population Ghana available at 

https://www.statsghana.gov.gh/gssmain/storage/img/marqueeupdater/Census2010_Summary_report_of_final_results.pdf and retrieved on 08/04/2020.

[4].   Ghana population and housing census, 2010, available at

https://www.statsghana.gov.gh/gssmain/storage/img/marqueeupdater/Census2010_Summary_report_of_final_results.pdf and retrieved on 11/04/2020.

[5]. GHS background, available at http://www.ghanahealthservice.org/ghs-category.php?cid=2 and retrieved on 08/04/2020.

[6].   Health Communication Capacity Collaborative, (2014). Theory of planned Behavior; an HC3 researcher primer.

http://www.healthcommcapacity.org/wp-context/uploads/2004/03/theory-of-planned.behavior.pdf.

[7]. Jan Dirk Herbermann (2010), available at 

(http://www.who.int/bulletin/volumes/88/4/10-030410/en/), and retrieved on 08/04/2020.

[8].   Jones, G. R. (2013). Organizational theory, design, and change (7^th Ed.). Upper Saddle, NJ: Pearson Prentice Hall.

[9].   Krajewski L. J, et al (2013). Operations management – processes and supply changes (10^th Ed.) Upper Saddle NJ: Pearson Prentice Hall.

[10].  Leiyu, S. & Douglas, A. S. (2012), Delivering healthcare in America: a systems approach (5^th Ed.) Burlington, MA: Jones & Bartlett Learning.

[11].  Nestor Naabulee Nasage & co, 2019, 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 available on

https://www.academia.edu/41529067/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 and retrieved on 10/04/2020.

[12].  NHIA mission statement, available at http://www.nhis.gov.gh/nhia.aspx and retrieved on 09/04/2020.

[13].  SDH Annual Performance Review (2029), available at www.stdominichospitalakwatia.org and retrieved on 10/04/2020.

[14].  The New York Times (NYT), Tuesday, June 23, 2015. p. A3.

[15].  Weiss, N. A (Neil A) 2012, Introductory Statistics. Pearson Education, Inc. Boston.

[16].  Worthington and Chris Britton: The Business Environment, Pearson 2006.