#PHC4UHC: Why we’ll not engage HMOs for health insurance – Niger Govt.

The Niger State Government says it will not engage Health Management Organisations (HMOs) in its newly established State Contributory Health Scheme (NGSCHS).

The Permanent Secretary of Niger State Ministry of Health, Makusidi M.M, said the measure became necessary because of the failure of HMOs to deliver services at the national level.

The official was addressing some senior executives of the National Institute for Policy and Strategic Studies, (NIPSS) study tour team course 41 in Minna, the state capital. They arrived at the state on Monday for a study tour of the health sector, especially the primary health system.

“Everything is going digital and electronic. All we need to do is to send money directly to the accounts of the service providers. If we use HMOs, they will demand commission, that is why we are removing them in the public sector but engaging them in another way,” Mr Makusidi said.

“We don’t want to allow them (HMOs) become so powerful that you cannot even talk to them just like it’s happening in the National Health Insurance Scheme (NHIS).”

Many have linked poor coverage and service delivery of the NHIS to the operations of the HMOs.

HMOs serve as the link between the scheme and the service providers.

The scheme disburses cash to HMOs, every three months, who in turn pay service providers monthly for health services of participants.

However, HMOs have allegedly not kept to that arrangement as service providers’ are unable to deliver adequate care.

Since inception, HMOs have received over N350 billion from the health insurance scheme.

“NiCare”

Leadership newspaper reported three months ago that the bill establishing the Niger State Contributory Health Agency and the Scheme was passed into law last December and was signed by the governor, Abubakar Bello, with a takeoff fund of N100 million.

Named NiCare, the scheme is managed by the contributory agency which oversees disbursement to the formal sector. In the informal sector, there will be a Third Party Agent (TPA) in charge of disbursement.

To be enrolled in the scheme, each enrollee would pay N600 per head monthly, which will amount to N7,200 annually for the informal sector. In the formal sector, 2.5 per cent of the monthly salary, to be matched with the same amount by the employer, will be deducted at source.

Mohammed Usman, the Executive Secretary of the agency, said the scheme is mandatory for all indigenes of the state.

“The purpose of putting the agency is to ensure that all the people of Niger have access to quality healthcare services. They should not suffer any financial hardship,” he told PREMIUM TIMES immediately after a meeting with the NIPPS delegation, Monday afternoon.

“We have not yet started implementing, but right now, what we are doing is that we are accrediting the facilities and the TPAs we are going to use. By next month, we will go into enrollment and in July, we will start providing services.”

New NHIS Act, Mandatory Insurance

The proposed bill to repeal the NHIS Act has passed third reading in the Senate and awaits presidential assent.

While the bill, which comprises of nine parts and 80 sections, makes health insurance mandatory for all Nigeria, it also makes the engagement of HMOs optional.

It also provided a clear-cut guideline on how state insurance schemes should be run.

PREMIUM TIMES reported how health experts agreed that health insurance should be made compulsory for Nigeria to achieve Universal Health Coverage (UHC) during the first phase of the NIPSS study tour in Abuja.

In continuation of the tour, NIPSS, in collaboration with the Development Research and Project Centre (DRPC) on Monday commenced routine visits around the health sectors of four states, starting with Niger and Taraba.

Nasirdeen Usman, the Secretary-General of the Alumni association of NIPSS, is the team leader of the tour. The project is aimed at bridging the gap between policymakers and the end recipients of government policies.

NIPSS is Nigeria’s policy formation centre for bureaucrats, private sector leaders, army officers, medium-rank and senior civil servants. It was founded in 1979.