By Muhammad Amaan
The National Health Insurance Authority (NHIA) said it has increased two key payment mechanisms for healthcare providers- capitation and fee-for-service payments.
The adjustment, according to the agency, followed an initial increase made six months ago, 60 percent increase in capitation fees and 40 percent increase in the fee-for-service payments.
NHIA on Monday explained that the new initiative, the first of its kind in decades, “was introduced as a temporary measure to stabilize the industry and manage rising costs while awaiting a full actuarial review to establish sustainable rates.”
Th Director General of the NHIA, Dr Kelechi Ohiri, announced the development at a stakeholders’ meeting with Health Management Organisations (HMOs) and healthcare providers in Abuja.
He said, “The newly rates which are approved by the Minister for Health and Social Welfare, Professor Muhammad Ali Pate, are based on the findings of the completed actuarial review, and will be implemented from April 2025.”
Under the revised structure, capitation, fixed annual payments to health care providers per enrolled patients has increased by 93 percent compared to the rate in December 2023.
Meanwhile, fee-for-service payments, which reimburse specific medical procedures and services, have risen by 378 percent compared to the 2023 rates.
“Specifically, these adjustments not only aim to address outdated rates but also to align compensation with the reality of rising medical costs, and incentive quality care.
“Backed by actuarial analysis, the revised rates are designed to ensure fairness, sustainability, and improved healthcare service delivery.
“These updates also strengthen consumer protection measures, ensuring patients receive better and more reliable care,” he said.
The NHIA DG, emphasized that the primary goal is to incentivize healthcare providers to deliver higher-quality services to enrolees.
He asserted that that the increases reflect the commitment of the NHIA, and other partners, to advance the Federal Government’s vision of an enhanced healthcare system, a healthier population and significantly improved national health outcomes.
“With the increase in premiums, we expect that the quality of care for enrolees will be improved and sustained. Providers are expected to deliver good quality care at no additional cost to enrolees, and NHIA will ensure strict enforcement,” he stated.
The revised tariffs aim to guarantee fair compensation, encourage providers to deliver top-quality services, and mitigate rising medical costs.
Overall, the adjustments are tailored to provide better financial support for healthcare providers, leading to improved patient care and industry standards.
Stakeholders at the meeting, including heads and representatives of HMOs, Healthcare Provider Associations, and Committee of CMDs of Federal Tertiary Hospitals, commended the NHIA for the bold step to stabilise Nigeria’s effort towards Universal Health Coverage and the significant reforms being implemented.
They expressed their commitment to doing all they can to ensure that health insurance enrolees experience the impact of these changes.
