The National Health Insurance Authority (NHIA) has increased capitation, a fixed annual payments to health care providers per enrolled patients by 93% and fee for service by 378% .
This adjustment which aims to incentivise healthcare providers and improve service delivery follows an initial increase made six months ago, a 60% increase in capitation fees and 40% increase in the fee-for-service payments.
The Authority explained that new tarrif was introduced as a temporary measure to stabilise the industry and manage rising costs while awaiting a full actuarial review to establish sustainable rates.
The newly rates which are approved by Muhammad Ali Pate, Coordinating minister for Health and Social Welfare, are based on the findings of the completed actuarial review, and will be implemented from April 2025.
Kelechi Ohiri, director General of the NHIA, announced the development at a stakeholders meeting with HMO’s and Healthcare Providers in Abuja.
According to the Authority, these adjustments not only aim to address outdated rates but also to align compensation with the reality of rising medical costs, and incentive quality care.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.
Read also: NHIA raises capitation by 60% to pacify health providers
“These updates also strengthen consumer protection measures, ensuring patients receive better and more reliable care”, the Authority said.
Commenting on the development, the NHIA DG, emphasised that the primary goal was to incentivise healthcare providers to deliver higher-quality services to enrollees.
He asserted that that the increases reflected 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 enrollees will be improved and sustained. Providers are expected to deliver good quality care at no additional cost to enrollees, and NHIA will ensure strict enforcement,” he stated.
The Authority stressed that 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, it added.
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 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 enrollees experience the impact of these changes.
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