The Lagos State Health Management Agency (LASHMA) in its commitment to ensure better service delivery to ILERA EKO Enrollees and foster a good working relationship with the providers under the Lagos State Health Scheme (LSHS), has increased the tariff paid to the providers.
The Board Chairman, Lagos State Health Management Agency (LASHMA), Dr. Adebayo Adedewe, who disclosed this during the Providers’ Engagement Forum with both the private and public facilities under ILERA EKO, held at LCCI, CBD, Alausa, Ikeja, recently, said that LASHMA would commence the payment of the new tariff with effect from 1st September, 2024.
Dr. Adedewe said that the review of the tariff became imperative considering the current economic situation in the country and the increase in the prices of healthcare services including drugs. He added that the new tariff, no doubt, will boost the revenue of the providers.
The Board Chairman disclosed that LASHMA has 857 healthcare providers under the Scheme and these, according to him, comprise of the primary care providers, specialty providers including eye and dental clinics, private healthcare providers, general hospitals and community pharmacies.
Dr. Adedewe added that the growth, is a clear indication of the Agency’s commitment towards expanding access to quality healthcare across the State.
He said that the Agency has made significant strides in supporting healthcare facilities by providing technical support to ensure the smooth implementation of ILERA EKO Health Insurance Plan, organise clinical and non-clinical capacity building for healthcare provider’s staff, supply medications and consumables, and uphold quality assurance standards with the latest being the deployment of Clinify Electronic Medical Record (EMR) to 53 Healthcare Providers to enhance their efficiency.
The Permanent Secretary, Lagos State Health Management Agency (LASHMA), Dr. Emmanuella Zamba, in her welcome address,
commended Governor Babajide Sanwo-Olu, for making the Equity Fund meant for the enrolment of the vulnerable in the State under the Health Insurance Scheme, a first line charge and for also providing free health insurance coverage for one-year to the Lagos State Government pensioners.
Dr. Zamba announced that the Agency has developed a new providers’ flexible payment system and that henceforth, healthcare providers under ILERA EKO, will be categorised based on the quality of service and the scope of services provided as well as the number of enrollees under providers’ care. These categorisations, she noted, will directly influence provider remuneration, capitation and fee-for-service (FFS) payments.
The Permanent Secretary disclosed that at LASHMA, enrollee’s satisfaction and providers happiness are critical. She said that in order to ensure quality service from the providers, the Agency has increased the capitation to be paid to the providers based on the number of enrollees under their care and the type of service rendered either as primary care provider or both primary and secondary care.
She also mentioned that LASHMA has also increased Fee-For- Service tariff across board with some being as high as 200 per cent.
Similarly, Dr. Zamba disclosed that the Agency has actuarially determined the break even number of enrollees for providers and to support providers with less enrollees, she said that capitation paid to such category of providers, will be higher than those paid to providers with large number of enrollees.
The Permanent Secretary reminded the providers that with the Executive Order, the opportunity has opened for them to become enrolment centres and also expand their hospitals either in their existing locations or outside their existing locations to increase their revenue.
A former Board Member, LASHMA, Mr. Olufemi Akingbade commended the Lagos State Government for taking the lead in the health insurance space above all other States in the country. He said, “Lagos State is the first State to champion most of all the giant strides that we are witnessing now in the health insurance space”.
These, he said, included the inclusion of the informal sector in the health scheme, making the equity fund a first line charge, organising healthcare summits, expanding drug access, having bouquet of health insurance plans with the latest, being the launch of the Standard Jaara Health Insurance Plan which has telemedicine service embedded in it, commissioning of ILERA EKO Virtual Booths and the domestication of the NHIA Act.
Mr. Akingbade appealed to the providers not to relent in their efforts to support and cooperate with the Lagos State Government in the journey of achieving Universal Health Coverage (UHC) in the State. “Health Insurance is the way forward for health financing as out-of- pocket payment for medical bills is not sustainable”, he added.
