Researchers from University of California – San Francisco Provide Details of New Studies and Findings in the Area of Health Insurance (Private…

Researchers from University of California - San Francisco Provide Details of New Studies and Findings in the Area of Health Insurance (Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative ...)

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Researchers detail new data in Health Insurance. According to news originating from San Francisco, California, by NewsRx correspondents, research stated, "Incorporating private healthcare providers into social health insurance schemes is an important means towards achieving universal health coverage in low and middle income countries. However, little research has been conducted about why private providers choose to participate in social health insurance systems in such contexts, or their experiences with these systems."

Financial support for this research came from Bill and Melinda Gates Foundation (see also Health Insurance).

Our news journalists obtained a quote from the research from the University of California - San Francisco, "We explored private providers' perceptions of and experiences with participation in two different social health insurance schemes in Sub-Saharan Africa-the National Health Insurance Scheme (NHIS) in Ghana and the National Hospital Insurance Fund (NHIF) in Kenya. In-depth interviews were held with providers working at 79 facilities of varying sizes in three regions of Kenya (N=52) and three regions of Ghana (N=27). Most providers were members of a social franchise network. Interviews covered providers' reasons for (non) enrollment in the health insurance system, their experiences with the accreditation process, and benefits and challenges with the system. Interviews were coded in Atlas.ti using an open coding approach and analyzed thematically. Most providers in Ghana were NHIS-accredited and perceived accreditation to be essential to their businesses, despite challenges they encountered due to long delays in claims reimbursement. In Kenya, fewer than half of providers were NHIF-accredited and several said that their clientele were not NHIF enrolled. Understanding of how the NHIF functioned was generally low. The lengthy and cumbersome accreditation process also emerged as a major barrier to providers' participation in the NHIF in Kenya, but the NHIS accreditation process was not a major concern for providers in Ghana. In expanding social health insurance, coordinated efforts are needed to increase coverage rates among underserved populations while also accrediting the private providers who serve those populations. Market pressure was a key force driving providers to gain and maintain accreditation in both countries."

According to the news editors, the research concluded: "Developing mechanisms to engage private providers as stakeholders in social health insurance schemes is important to incentivizing their participation and addressing their concerns."

For more information on this research see: Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya. Plos One, 2018;13(2):e0192973. (Public Library of Science - www.plos.org; Plos One - www.plosone.org)

The news correspondents report that additional information may be obtained from M. Sieverding, Global Health Sciences, University of California San Francisco, San Francisco, California, United States. Additional authors for this research include C. Onyango and L. Suchman.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1371/journal.pone.0192973. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Keywords for this news article include: California, San Francisco, United States, Health Insurance, Health and Medicine, North and Central America.

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