Could cost sharing sustain the Ghana National Health Insurance Scheme?

ABSTRACT

This paper estimates the effect of cost sharing on the sustainability of the Ghana National Health Insurance Scheme (NHIS) from the point of view of enrollment, utilization, and financing. We use data from a nationwide survey to estimate the retention of subscribers and propensity to utilize the scheme's benefit package under a cost sharing policy. The estimates from the survey are used together with data on the Ghana NHIS, to estimate the patronage, and financial status of the Ghana NHIS had cost sharing been introduced. The result indicates that a 5% cost sharing rate would have kept the scheme in surplus between 2007 and 2015. In addition, the 5% cost sharing rate would have led to virtually no change in enrollment and would have reduced utilization rate by about 15%. It is also found that women have higher enrollment and utilization of health insurance than men under cost sharing.

KEYWORDS:

• National Health Insurance
• financing healthcare
• health policy
• retention rate
• utilization rate
• cost sharing

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Anthony Afful-Dadzie

Anthony Afful-Dadzie is a senior lecturer at the Operations and Management Information Systems department at the University of Ghana Business School. He employs operations research and decision analysis techniques in various research areas including healthcare, energy planning, renewable energy technology adoption analysis, multi-criteria decision-making, and information systems.

Eric Afful-Dadzie

Eric Afful-Dadzie (PhD, Informatics) is a faculty member in the department of Operations & Management Information Systems at the University of Ghana Business School. His research spans the multidisciplinary areas of data mining, open data technologies, health informatics, decision aiding methodologies, social media analytics, and business process modelling.

Seth Mensah

Seth Mensah is an MPhil student at the Operations and Management Information Systems department of the University of Ghana Business School. He is interested in applying operations research techniques to the analysis of healthcare management.