Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana

• Published in: PloS one 2019-08, Vol.14 (8), p.e0221195
• Main Authors: Andoh-Adjei, Francis-Xavier, Nsiah-Boateng, Eric, Asante, Felix Ankomah, Velden, Koos van der, Spaan, Ernst
• Format: Article
• Language: English
• Subjects: Adult; Ambulatory care facilities; Analysis; Balances (scales); Bivariate analysis; Delivery of Health Care - economics; Economic aspects; Efficiency; Female; Ghana - epidemiology; Health care; Health care industry; Health care policy; Health facilities; Health insurance; Health insurance industry; Health Personnel - economics; Health services; Humans; Insurance; Insurance, Health - economics; Male; Managed competition; Medical care quality; Medicine and Health Sciences; Methods; Middle Aged; National health insurance; National Health Programs - economics; National Health Programs - standards; Negotiations; Organizations; Outpatients; Payment systems; Payments; People and Places; Policy; Polls & surveys; Poverty - economics; Primary care; Primary Health Care - economics; Quality of Health Care - economics; Reforms; Regression analysis; Social Sciences; Sociodemographics; Studies; Surveys
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0221195

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. 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. 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