The National Health Insurance Scheme (NHIS) has announced a major reform in its payment model, replacing the long-standing bulk payment system with a new system based on individual patient receipts. The move is part of ongoing efforts to increase transparency, accountability, and efficiency in the administration of healthcare claims.
Under the previous system, healthcare providers received lump-sum payments from the NHIS for services rendered over a period, often leading to delays in reimbursement and concerns over inflated or unverifiable claims. The new model will require healthcare facilities to submit itemized receipts for each patient covered by the scheme, which will then be used to process payments directly.
Speaking at a press briefing in Accra, NHIS Chief Executive Officer Dr. Victor Asare Bampoe said the change would streamline the claims process and curb financial leakages.
“This new system ensures that every service rendered is accurately documented and verifiable,” Dr. Victor stated. “We are confident that it will reduce the incidence of fraudulent claims and significantly cut down on payment delays.”
Healthcare providers will be required to adapt their record-keeping and billing systems to align with the new model. Training and technical support will be provided to ease the transition, the NHIS assured.
Reactions from stakeholders have been mixed. While some healthcare providers have welcomed the increased clarity and fairness, others have expressed concerns over the additional administrative workload and the readiness of facilities in remote areas to comply.
Dr. Ama Boadu, a medical superintendent at a district hospital, said, “In principle, it’s a good move. But smaller facilities with limited staff and digital infrastructure will need serious support to make it work.”
The NHIS says the policy will be rolled out in phases, starting with select facilities in urban centers before expanding nationwide by the end of the year.
The change comes amid broader reforms aimed at strengthening Ghana’s health insurance system, which provides coverage for millions of citizens.
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