FUNDING GAP for the National Health Insurance Scheme (NHIS) is expected to be in excess of GH�299 million in 2014 due to financial imbalances with a projected increase from GH�347 million in 2015 to a projected gap of GH�803 million in 2018.
The estimates, according to the Minister of Health, Dr. Kwaku Agyeman Mensah, �are based on very moderate increase in NHIS membership of not more than one percentage point per annum with respect to the national population.�
Dr. Mensah said this yesterday on the floor of Parliament when he presented a statement on the status of the NHIS and noted that allocation for the scheme approved by government over the last three years continue to fall short of expenditure requirement of the scheme.
The minister explained that active membership of the scheme has increased substantially since its inception in 2005, from 1.35 million to 10.14 million as at December 2013, representing a growth of over 650 percent.
According to him, outpatient utilization of health care services in respect of NHIS subscribers has also increased significantly from 597,859 in 2005 to 9,339,296 by December 2008 and 27,350,847 by end of 2013 and added that impatient cases also increased from 28,906 in 2005 to 1,610,622 by December 2013.
He said in 2005, a total amount of GH�7.60 million was paid as claims to healthcare service providers but increased in 2013 to GH�785.64 million.
The Health Minister explained that the increasing growth in membership and utilization is growing faster than the annual financial resource allocation to the scheme thereby placing the �scheme under severe financial pressure.�
He, however, stated that a total amount of GH�929.66 million has so far been received into the NHI Fund as at August 2014 out of which GH�332.21 million was in respect of arrears for 2013 and GH�597.45 million for 2014 excluding September and October of GH�151.8 million.
Dr. Mensah said �total claims paid in 2014 to date is GH�761.25 million. This represents 81.8 per cent of total NHIL receipts for the year to date. Claims for the months of June to October 2014 estimated at GH�425 million remains outstanding.�
He further noted that the authority has however initiated a number of strategies to reduce abuse of the system and embarked on a number of efficiency measures to address the critical financial situation confronting the scheme to ensure financial efficiency and sustainability.
He credited the Ministry of Finance for releasing over 80 per cent of reported collections to the NHIF, �the highest recorded over the last couple of year.�
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