Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana
Loading...
Date
2019-08-26
Authors
Asante, F.A.
Andoh-Adjei, F-X.
Nsiah-BoatengID, E.
van der Velden, K.
SpaanI, E.
Journal Title
Journal ISSN
Volume Title
Publisher
Plos One
Abstract
Background
Ghana introduced capitation payment method in 2012 but was faced with resistance from
provider groups and civil society organizations for its perceived negative effects on quality
care delivery. This study seeks to explore the views of providers to understand their preferred
payment method for the various types of services they provide in order to inform the
discussion and negotiations during this period of reform. Findings will not only aid the
National Health Insurance Authority (NHIA) to improve the implementation arrangements
but also provide useful inputs for other low and middle-income countries (LMICs) in their
quest to reform their provider payment systems.
Materials and methods
We conducted a cross-sectional survey of 200 credentialed health care providers’ in the
three regions of Ghana on providers’ preference for payment method. We administered
closed-ended questionnaires employing 5-point Likert scales for measurement of payment
method preference. Descriptive and regression analysis were performed to examine healthcare
providers’ background characteristics and their association with preferred payment
method for primary care.
Results
In general, health care providers prefer the Ghana-Diagnosis-Related Grouping (G-DRG)
payment method to fee-for-service and capitation payment methods. Result of bivariate
analyses showed that healthcare providers’ preference for payment method for primary outpatient
services differed significantly by their region of residence (p<0.001). The multinomial
logic model showed that being a female (p = 0.013) or healthcare provider in the Volta region(p = 0.008) was significantly associated with health provider preference for G-DRG payment
method relative to fee-for-service. Similarly, being a healthcare provider in the Volta region
(p = 0.026) or Medical Assistant (p = 0.032) was significantly associated with capitation relative
to fee-for-service payment method.
Conclusion
We conclude that the most preferred payment method across all regions is the G-DRG. However,
whereas providers in the Volta region are not willing to accept capitation as payment
method, this was not the case in Ashanti and Central regions. Capitation payment method as an
option for primary care services in Ghana should, therefore, not be ruled out of the discussion.
Description
Research Article
Keywords
civil society organizations, Ghana, National Health Insurance Authority (NHIA), low and middle-income countries (LMICs)
Citation
Andoh-Adjei F-X, Nsiah-Boateng E, Asante FA, Velden Kvd, Spaan E (2019) Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana. PLoS ONE 14(8): e0221195. https://doi. org/10.1371/journal.pone.0221195