DAR ES SALAAM: AFTER one year of stakeholder consultation, the National Health Insurance Fund (NHIF) will begin implementing an improved package, including new prices for services offered by health facilities, starting from January 1st of next year.
The move is envisaged to enhance the provision of health services to NHIF members, ensure the sustainability of the scheme, and increase access to affordable healthcare for more citizens.
The NHIF announced this development on Monday in Dar es Salaam, stating that the changes have taken into account market price trends and technological advancements.
During a meeting with editors from various media houses, the Director General of NHIF, Bernard Konga, revealed that the fund has made improvements to the benefits package for various purposes, including enhancing services to citizens and strengthening control measures to prevent fraud.
"The purpose of the improvement is to align the benefits package with the National Essential Medicines List (NEMLIT) and the Standard Treatment Guidelines (STG)," he said.
He stressed that the improvements have been made in accordance with Article No. 39 of Chapter 395 of the NHIF Act, which requires an assessment of the fund's lifespan and sustainability.
Konga added that the improvements have undergone various stages, involving the participation of stakeholders such as the Association of Private Health Facilities of Tanzania (APHFTA), the Medical Association of Tanzania (MAT), government health facilities, the Christian Social Services Commission (CSSC), and the National Muslim Council (BAKWATA).
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
Regarding the changes, Konga highlighted that the price for haemodialysis, a treatment required by patients with kidney disease, will be reduced to 200,000/- from the current 240,000/-.
Additionally, the NHIF has included a total of 124 medicines and 309 alternative medicines in the new package to align with the NEMLIT.
The new package for surgical services takes into account input costs, actual market prices, and expands the scope of superspecialist surgical services. It is worth noting that the current package has not been updated since 2016.
"Since the implementation of the Fund's responsibility in 2001, seven package assessments have been conducted in 2003, 2006, 2009, 2012, 2013, 2016, and 2021," Konga stated.
To strengthen the payment system for service providers, Konga mentioned that the Fund is in the process of implementing mixed-payment mechanisms, including fee for service, capitation, result-based financing (RBF), case-based payments, and Diagnostic Related Group (DRG).
