KEY POINTS
- NHIA increases capitation fees by 93 percent and fee-for-service by 378 percent.
- The elevated rates serve as an instrument to enhance healthcare budgeting alongside improved delivery of services.
- NHIA enforces all rules with strictness to prevent additional charges against members.
The National Health Insurance Authority (NHIA) updated fee-for-service payments by 378 percent and raised capitation payments by 93 percent in its most extensive payment adjustment since the last decade.
The rates received approval from Professor Muhammad Ali Pate as Minister for Health and Social Welfare before they became active starting April 2025.
The NHIA Director General Dr. Kelechi Ohiri presented the update at a stakeholder meeting in Abuja by revealing that the enhanced fee-repayments stem from a recent actuarial assessment which seeks to stabilize medical services and counter increasing healthcare expenditures.
The administration has introduced revisions which will both provide adequate compensation to service providers and bolster clinical services as well as patient healthcare quality.
Reform plan to enhance health insurance operations
The new organizational structure establishes an incentive program which supports Nigerian Universal Health Coverage by motivating healthcare providers to provide superior services.
Enrollees will have access to all healthcare services without extra charges because the NHIA strengthened its inspection procedures.
The NHIA received praise from Health Management Organizations (HMOs), healthcare provider associations and federal hospital representatives who agreed to support national initiatives for expanded quality healthcare access.
