As out-of-pocket payment continue to dominate Nigeria’s healthcare sector and less than 5 percent of Nigerians covered by health insurance, an indicator which shows huge market for health insurance by Health Maintenance Organisation (HMOs), industry players have called for improved partnership between hospitals and HMO in a bid to ensure that enrolees under the scheme receive quality healthcare without bottlenecks.
Speaking during the first edition of Avon HMO’s Providers Quality Forum in Lagos, Adesimbo Ukiri, MD/CEO, Avon Healthcare Limited, said that hospitals have a critical role to play if the country is to take health insurance to the heights everyone expects.
While HMOs can make all the promises in the world to enrolees, Ukiri, pointed out that it is through the hospitals that they (enrolees) will experience the needed services.
“You can say that the hospitals are the taste of the pudding for enrolees. But we also understand that historically, HMOs have not partnered with hospitals the way they are supposed to. At Avon HMO, our hospitals are our partners, and that is why we are taking the lead in forging a mutually beneficial partnership with our care providers through this event,” Ukiri stated.
Banjo Oni, head, providers services unit, Avon HMO noted that the forum was the first in a series of engagements intended to improve the quality of the service delivery that Avon enrolees enjoy from hospitals under the HMO’s network.
Encouraged by the outcome of the first Provider Quality Forum, Oni revealed that more than 200 representatives from partner hospitals across the country were in attendance, a forum that gave room for exchange of ideas between partner hospitals and Avon.
According to Oni “We intend to do this every quarter and then go round the country with it. The ultimate aim is to work closely with our hospitals to improve the quality of service delivery, as well as understand the challenges that they face in the course of their work.
“At the end of the day, we want to step up the level of education, skills, capabilities and competencies in these hospitals, both with the clinical staff and their administrative staff, in order to improve service delivery.
“Currently, we are looking at getting over 10 million subscribers into Avon HMO. But, in order for us to get to that level, we have to make health insurance attractive to those who are currently using it. If we can do that, then they will become advocates of the entire system, and that will help attract new subscribers.”
Until now, the health insurance coverage in the country has been less than 7 percent (both private and public sectors). The challenge of dearth of awareness and investment in marketing activities to point out the benefits of health insurance still confronts the emerging health insurance business.
In addition to the challenges include misconception among healthcare providers, Health Maintenance Organisation (HMO) and patient, lack of innovative products to capture the informal sector, and other encumbrances that have prevented Nigerians from taking up health insurance.
At the event, special prize presentations were given to three hospitals under the Avon HMO network that were adjudged to have performed well in service delivery and prompt filling of enrolees’ claims. These hospitals are Blue Cross, Afrimed Specialist and Bee Hees Hospitals.
By: Alexander Chiejina
