The National Health Insurance Authority (NHIA) has announced a significant increase in the mechanisms for the payment and service rate to improve the provision of services and motivate medical care providers.
This adjustment, he said, follows an initial increase made six months ago as a 60% increase in capitation rates and a 40% increase in service rate payments.
This was introduced as a temporary measure to stabilize the industry and manage the increase in costs while waiting for a complete actuarial review to establish sustainable rates.
The new rates approved by the Minister of Health and Social Welfare, the Prof Muhammad Ali Pate, are based on the findings of the complete actuarial review and will be implemented from April 2025.
The general director of the NHIA, Dr. Kelechi Ohiri, announced the development at the NHIA Permanent Committee meeting -HMO in Abuja, on February 3, 2025.
According to the revised structure, the capitation: the fixed annual payments to the medical care suppliers by registered patients have increased by 93% compared to the rate in December 2023. Mandating, while the fee payments for service, which reimburse Specific medical procedures and services, 378% have increased compared to 2023 rates.
Specifically, these adjustments are not only aimed at addressing obsolete rates but also aligning compensation with the reality of the increase in medical costs and the quality of incentives.
Backed by actuarial analysis, revised rates are designed to guarantee equity, sustainability and the best provision of health services. These updates also strengthen consumer protection measures, ensuring that patients receive better and more reliable care.
When commenting on development, the NHIA DG, emphasized that the main objective is to encourage medical care providers to provide higher quality services to affiliates.
He affirmed that the increases reflect the commitment of the NHIA and other partners to advance in the federal government vision of an improved health system, a healthier population and significantly improved national health results.
“With the increase in premiums, we hope that the quality of care for affiliates will improve and maintain. Suppliers are expected to provide good quality attention at no additional cost for affiliates, and NHIA will guarantee a strict application, ”he said.
Revised tariffs are aimed at guaranteeing fair compensation, encouraging suppliers to provide high quality services and mitigate the growing medical costs.
In general, adjustments are adapted to provide better financial support for medical care providers, which leads to better patient care and industry standards.
The interested parties in the meeting, including the bosses and representatives of the HMO, the associations of medical care providers and the CMD committee of the federal tertiary hospitals, praised the NHIA by the bold step to stabilize Nigeria's effort towards the coverage of universal health and the significant reforms that are implemented.
They expressed their commitment to do everything possible to ensure that health insurance members experience the impact of these changes.
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