For the first time in over a decade, the National Health Insurance Authority (NHIA) has significantly increased two key payment mechanisms for healthcare providers: capitation and fee-for-service payments.
The NHIA announced that this landmark decision aims to improve the quality and sustainability of healthcare services.
Director-general of NHIA, Dr. Kelechi Ohiri made the announcement on Monday in Abuja during the NHIA-Health Maintenance Organisations (HMOs) Standing Committee Meeting.
Ohiri revealed that capitation payments have been increased by 93 per cent, while fee-for-service payments have risen by an astounding 378 per cent compared to the rates in December 2023.
He explained that the revised rates, which have been approved by the Minister of Health and Social Welfare, Prof. Muhammad Pate will take effect in April 2025.
These adjustments are the result of a comprehensive actuarial review designed to stabilise the industry, address outdated tariffs, and encourage healthcare providers to deliver better services without imposing additional costs on enrollees.
Ohiri emphasized that the primary goal of the new payment structure is to incentivise quality healthcare delivery while ensuring financial sustainability.
“With the increase in premiums, we expect improvements in the quality of care for enrollees. Providers are required to offer high-quality services at no additional cost and the NHIA will ensure strict compliance,” he stated.
He assured stakeholders that the revised tariffs would guarantee fair compensation for providers, encourage top-tier medical services, and cushion the impact of rising medical costs.
Additionally, he mentioned that consumer protection measures would be strengthened to ensure that enrollees experience tangible improvements in care quality.
Science Nigeria reports that key stakeholders, including heads of HMOs, representatives of healthcare provider associations and the Committee of Chief Medical Directors (CMDs) of Federal Tertiary Hospitals, have commended the NHIA for this bold initiative.
They pledged their commitment to ensuring that health insurance enrollees feel the positive impact of these changes.
