The Chief Executive Officer (CEO) of the National Health Insurance Authority (NHIA), Dr. Victor Asare Bampoe, has reiterated his commitment to ending illegal charges or out-of-pocket payments under the National Health Insurance Scheme (NHIS).
Often referred to as co-payment, he said the phenomenon, which has become pervasive, reduces public confidence in the Scheme despite its critical role in achieving Universal Health Coverage.
“We have just returned from Tamale and Bolgatanga, where we visited the Bolgatanga Regional Hospital. Impromptu interviews with patients highlighted that their major concern with the NHIS is the out-of-pocket payments they are required to make. This is worrisome as it reduces confidence in the scheme,” Dr. Bampoe observed.
Speaking to the Ghana Chamber of Private Medical Groups, who called on him in Accra on Thursday, March 20, 2025, Dr. Bampoe stated that the problem had been attributed to low tariffs and the rapidity of payment and assured that the Authority is working on addressing this issue.
“There are opportunities for people to correct this. We need to devise ways to clamp down on this,” he said.
Interventions
Dr. Bampoe outlined several interventions that the NHIA was pursuing to address the illegality.
The interventions included regular claim reimbursement and collaboration with stakeholders to ensure realistic tariffs.
This whole issue of co-payment is extremely important to us, and I am aware that a significant amount of work has been done on it, with more ongoing to ensure this issue is addressed. A group that would actually spearhead the work from our point of view has been instituted.
We’re working on a mechanism that will provide funding more regularly, allowing you to be reimbursed as well. There’s some good news on the horizon. If that mechanism that we are thinking about is put in place, it will revolutionise this payment system because it will ensure that payments come more regularly,” Dr. Bampoe stated.
He further highlighted the Finance Minister’s commitment to ensuring timely funding to the National Health Insurance Fund.
According to Dr. Bampoe, the Minister’s eagerness stems from the expectation that funds will be primarily used for claims payment rather than other expenses.
Touching on a key issue, Dr. Bampoe noted that the uncapping of the National Health Insurance Levy (NHIL) will also enhance reimbursement processes.
The Vision for Universal Health Coverage
Dr. Bampoe emphasized that all interventions being implemented, along with two other deputy chief executives, are aimed at operationalizing the President’s vision of achieving universal health coverage through the NHIS, Mahama Cares, and free primary healthcare policies.
“Internally, the key objective of the vision is to strengthen internal controls around financial management and claims payment, ensuring financial integrity while making payments more efficient and rapid.
“The backbone for all this is how we use technology to ensure the integrity of the process,” he said.
He also emphasized the importance of human resource development, stating that staff must be well-resourced and motivated to execute their responsibilities effectively.
President Mahama’s Vision: Free Primary Healthcare
Dr. Bampoe linked these ongoing efforts to the larger goal of achieving universal access to free primary healthcare and Mahama Cares.
“Imagine a Ghana where you just have a Ghana Card, and with that, you can access a basic package of free healthcare services. That is the ultimate vision. But for this to work, we must first tighten the system to prevent abuses,” he explained.
He emphasised that ensuring financial discipline and motivating healthcare workers would be crucial in realising this goal.
Mahama Cares
Additionally, Dr. Bampoe reiterated the importance of the Mahama Cares initiative, which the President is keenly monitoring.
“My colleagues know how passionate the President is about this. The urgency of the initiative is clear. He is keeping an eye on it. In 120 days, we have to make a move on this.
So, the Health Ministry has set up a seven-member taskforce to oversee the implementation of Mahama Cares. The program is expected to play a significant role in addressing the growing burden of non-communicable diseases in the country.
Addressing Non-Communicable Diseases
Dr. Bampoe noted that the NHIS currently covers some cancers, including the four childhood cancers, breast cancer, and cervical cancer, and under Mahama Cares, efforts are being made to establish a sustainable system for covering hemodialysis for end-stage renal failure, cardiovascular diseases, and other cancers such as prostate cancer.
However, he acknowledged that full implementation would take time.
“We cannot roll this out nationwide all at once. We need to strengthen provider capacity while educating beneficiaries. A public-private partnership (PPP) approach will be essential in achieving this,” he noted.
Dr. Bampoe reiterated that significant work remains to be done to achieve these ambitious healthcare reforms.
However, with the right financial controls, technological improvements, and policy direction, Ghana is on the path to a stronger, more accessible healthcare system.
Delegation
The delegation from the Ghana Chamber of Private Medical Groups was led by Dr Andre Kwasi-Kumah of the Society of Private Medical and Dental Practitioners (SPMDP).
While expressing their commitment to collaborating with the NHIA to enhance the Scheme, they proposed several interventions to make the NHIS environment more conducive for the private sector to thrive.
They called for expedited work on the ongoing tariff review and a prompt payment regime, as well as government support to enhance their operations and the quality of care they deliver.
Dr. Senanu Kwesi Djokoto, Deputy Chief Executive, Operations, and various directors present at the meeting provided diverse input into the discussions and renewed their commitment to supporting the Chamber and the sector as a whole.
The directors included Mr. Francis Oti Frempong, Director, Membership and Regional Operations; Dr. Abigail Nyarko-Codjoe Derkyi-Kwarteng, Ag. Director, Claims; Mr. Oswald Essuah-Mensah, Ag. Director, Corporate Affairs, and Mrs. Annette Obenewaa Adutwum, Director, Legal.
The others are Dr. Yaw Opoku-Boateng, Director, Quality Assurance, and Mr. Magnus Owusu-Agyemang, Director, Actuarial.
