Utilization of healthcare services and renewal of health insurance membership: evidence of adverse selection in Ghana

by Stephen Kwasi Opoku Duku, Francis Asenso-Boadi, Edward Nketiah-Amponsah et al.
Health Economics Review,2016 6:43 – Published: 13 September 2016

12 pp. 621 kB

Utilization of healthcare in Ghana’s novel National Health Insurance Scheme (NHIS) has been increasing since inception with associated high claims bill which threatens the scheme’s financial sustainability. This paper investigates the presence of adverse selection by assessing the effect of healthcare utilization and frequency of use on NHIS renewal. The authors conclude that the NHIS claims bill is high because high risk individuals who self-select into the scheme makes more health facility visits and creates financial sustainability problems. Policy makers should adopt pragmatic ways of enforcing mandatory enrolment so that low risk individuals remain enrolled; and sustainable ways of increasing revenue whiles ensuring that the societal objectives of the scheme are not compromised.

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