HEALTHCARE providers under the aegis of Health Care Providers Association of Nigeria (HCPAN) have decried the astronomic rising costs of health goods and services abysmally matching low reimbursement by the Health Management Organizations (HMOs) in private health insurance scheme and called for upward review of their tariffs.
HCPAN’s president, Dr Adeyeye Arigbabuwo, speaking in a media briefing in Lagos, said health care providers under Nigeria’s private health insurance scheme now bear close to 100 per cent of the risks in ensuring enrollees in the private health insurance scheme access quality health care services.
Dr Arigbabuwo said the current pricing tools for health care services are faulty and acceptable because current premiums were arbitrarily determined while some HMOs have taken the option of undercutting their peers in a desperate bid to get some accounts to work with.
He stated that far back in 2018, health care providers protested the poor tariffs that were more than two decades old and asked HMOs to review and restructure them because they were highly unrealistic and they had enough reasons to appeal to their corporate clients for upward review.
He added, “The covid-19 saga has made it more imperative that even preparation to see and examine the patient will have drained capitation (if ever any HMOs still pay this) or it will make the issue of tariffs reimbursement grossly affected as inadequate.
“In all other sectors, the cost of virtually all goods and services have gone up in several folds in the last 15 years, but worse still, in the last three years, and indeed unbearable in the last quarter of 2021, no one has thought it normal or fair to review the reimbursement mechanism and valuation for the Private Health Sector.”
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The HCPAN decried many outfits sold by HMOs to fresh undertakers that were not aware of assets and liabilities they acquired now having challenges breaking even and meeting the settlement and reimbursement of the services rendered by providers monthly.
He, therefore, called for the immediate adjustment of all existing Tariffs/ Contracts of Private Health Insurance business with immediate effect from February 1, 2022, and ensuring that the tariffs released by HCPAN recently remain the minimum across the country.
According to him, a periodic review of the tariffs subject to increasing costs of goods and services of health care in the country is also needed and where the tariffs are not translating into premiums, the HMOs should have dialogues and renegotiations with their immediate clients.
Dr Arigbabuwo, however, urged HCPAN members to report infamous conducts such as undercutting of Service Tariffs by colleagues or unjust demobilization of enrollees to their professional regulatory bodies and asked owing HMOs to pay up its health providers.
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