KATH demands upward review of insurance tariffs
8/14/2012 8:45:12 PM -
Kumasi, Aug 14, GNA - The Management of the Komfo Anokye Teaching Hospital (KATH), has demanded upward adjustment of tariffs paid by the National Health Insurance Authority (NHIA).
Professor Ohene Adjei, Chief Executive of the Hospital, said 'this is urgently needed to save the facility from its current operational challenges and mounting debts.'
He said the low tariffs received for services rendered to insured patients, had become a major headache and affecting their performance.
The chief Executrive said about 85 percent of the hospital's clients were insured patients and the inability to recoup the cost incurred in their treatment gave cause for worry.
Addressing a mid-year performance review meeting at the Yegola Hotel in Kumasi, Prof Ohene Adjei noted that the health insurance tariffs had remained unchanged despite the huge rise in the cost of medical consumables and medicines.
He said for example that whilst it currently costs the facility GH¢ 492.33 to treat 'bone marrow hypoplasia' in children under 12 years, it is reimbursed GH¢ 237.60 by the NHIA.
Again, he said, the facility was paid GH¢269.30 for gynecological laparotomy although it costs GH¢ 423.24 to render the service.
In case of laparotomy for gastric surgery, he said, they had been receiving GH¢ 343.70 instead of GH¢ 1,372.75, while neonatal respiratory disorders with ventilation treatment attracts GH¢ 242.00 instead of GH¢ 1,014.96.
These tariffs were fixed in year 2008 and marginally adjusted by 20 percent last year.
Prof Ohene Adjei said the huge disparity between the current cost of medical consumables and equipment on one hand and the rate of re-imbursements from health insurance on the other hand was not the best.
He said it was disturbing that while the hospital buys consumables at the current market prices, it was reimbursed at rates set years back.
The Chief Executive acknowledged that the first half of the year had been challenging with most of the service targets for the period missed.
The only exception was radiotherapy that saw services jumped to 3,785 as against a target of 3,050.
Prof Ohene Adjei also raised concern about the ballooning in the facility's maintenance cost. This rose from GH¢ 476,158.00 in 2009 to GH¢ 1,103,091.00 in 2010, and then shot up to GH¢ 2,212,162.16, last year.
It was expected to further go up, this year, he said, adding that the facility would have to fund such huge expenditures from its internally generated funds (IGF).
He encouraged all the directorates and units at the hospital to identify new services that were not covered by the national health insurance and render services 'purely on fees for service basis.'
That, he said, could help generate additional income to tackle some of its pressing needs.