Clinical experts meet to review the Ghana-Diagnostic Related Groupings of the NHIA


The National Health Insurance Authority has organised a three-day hands-on event for a specialist group of clinical experts for a comprehensive review of the Ghana Diagnostic Related Groupings (G-DRG) payment method of the National Health Insurance Scheme (NHIS).

The clinical experts, according to a statement from the NHIA, were drawn from all specialty areas on the Benefit Package of the Scheme.

They were from the Ghana Health Service (GHS), Korle Bu Teaching Hospital, Komfo Anokye Teaching Hospital, Greater Accra Regional Hospital, Upper East Regional Hospital, Police Hospital, Ho Regional Hospital, Bank Hospital, Ghana Infectious Disease Centre, and Society of Private Medical and Dental Practitioners.

The rest were from the Accra Medical Centre, University of Cape Coast Hospital, Accra Psychiatric Hospital, Private Health Facilities Association of Ghana, Medicas Hospital, National Blood Service, Shai-Osudoku District Hospital, Fresh Luk Eye Centre and St. Joseph Hospital.

Dr Isaac Charles Noble Morriso
n, a member of the NHIA Governing Board, who chaired the opening ceremony, called for a collective responsibility to ensure an all-inclusive NHIS.

He said the ongoing meetings were a statutory requirement in line with the NHIA Act 2012, (Act 852) section 34 subsection 1, which mandates the Authority to review the NHIS service list and service tariff in collaboration with healthcare providers.

Dr Ruby Aileen Mensah Annan, the Convener and Acting Director, Strategic Health Purchasing Directorate, NHIA giving an overview of the Scheme’s operations and the development and use of G-DRGs as the payment method for services, said the NHIA remained committed to achieving the objective of providing financial risk protection against the cost of quality healthcare services for its members.

She emphasised the need for the expert team to capture all the needed input for care to ensure the development of accurate reimbursable tariffs.

Dr Francis Asenso-Boadi, Chairman of the NHIA National Copayments Committee, decried t
he recurrent problem of illegal charges (copayments) by some credentialed healthcare providers.

Professor Adukwei Hesse, the NHIS service tariff review consultant, who highlighted the guidelines for the specialty group work, review templates, and reference materials, urged the participants to provide solutions to concerns raised to inform the final decision of policy makers regarding the 2024 NHIS service tariff review.

Source: Ghana News Agency