By Joyce Ekeh
Healthcare providers in Lagos State have called for a review of reimbursement rates, prompt settlement of claims and greater professional inclusiveness in the implementation of the state’s health insurance programme, warning that providers must operate under fair and sustainable conditions for Universal Health Coverage (UHC) to succeed.
The Healthcare Providers Association of Nigeria (HCPAN), Lagos State, made the demands during a courtesy visit by its newly elected executive members to the Permanent Secretary of the Lagos State Health Management Agency (LASHMA), Dr Emmanuella Zamba, at the agency’s office last Wednesday.
The association, led by its newly elected Chairman, Mr Adekoya Abimbola Julius, said improved collaboration between healthcare providers and LASHMA was essential to strengthening the ILERA EKO Health Insurance Programme and expanding access to quality healthcare across the state.
At the meeting, Adekoya identified the prevailing reimbursement rates and tariffs, delays in claims processing and payment, cumbersome enrolment procedures and inadequate professional representation as major concerns requiring urgent attention.
He argued that the success of health insurance depended not merely on enrolling residents but also on ensuring that participating healthcare facilities could sustainably deliver quality services.
“The success of health insurance depends not only on citizens’ enrolment but also on the ability of healthcare providers to deliver quality services under fair, sustainable and clearly defined operating conditions,” he said.
The HCPAN chairman also called for the recognition and inclusion of all professional groups affiliated with the association in the implementation framework, stressing that the contributions of different healthcare professionals were critical to delivering comprehensive and accessible healthcare.
He further advocated simplified enrolment procedures, more effective engagement with providers and efficient claims management to address operational bottlenecks confronting participating facilities.
Responding, Zamba acknowledged the concerns raised by the association and expressed the agency’s readiness to strengthen its relationship with healthcare providers.
She described the engagement as a “family meeting,” acknowledging HCPAN as a critical stakeholder in the actualisation of Universal Health Coverage in Lagos State.
The Permanent Secretary said the meeting was organised to promote a common understanding between LASHMA and healthcare providers on the state government’s health insurance implementation agenda.
On the demand for improved reimbursement rates, Zamba acknowledged the need to review existing tariffs but explained that the amounts payable to healthcare providers were also influenced by the premiums affordable to enrollees.
She disclosed that the existing tariff was due for review after the stipulated two-year period and expressed optimism that the process could accommodate an adjustment in 2027.
She, however, urged healthcare providers to understand and comply with the necessary administrative procedures involved in the review.
Zamba also assured the delegation that LASHMA would work towards improving claims processing and payment mechanisms, recognising their importance to the financial sustainability of healthcare facilities participating in the scheme.
The agency’s Permanent Secretary further expressed willingness to participate in HCPAN Lagos’ proposed retreat and regular webinar series as additional platforms for professional engagement, stakeholder education and resolution of emerging challenges.
Earlier, officials of LASHMA briefed the visiting delegation on the agency’s operational framework and progress in implementing the state’s health insurance policy.
The presentations covered the Lagos State Executive Order EO/BOS/01 of 2024, the onboarding of healthcare providers into the ILERA EKO programme, Provider-Led Enrolment, LASHMA-AID and the agency’s quality assurance framework.
“The success of health insurance depends not only on citizens’ enrolment but also on the ability of healthcare providers to deliver quality services under fair, sustainable and clearly defined operating conditions.”
Also speaking, the immediate past President of HCPAN Nigeria, Dr Jimmy Adeyeye Arigbabuwo, emphasised the need for sustained capacity-building programmes to educate healthcare providers and other stakeholders on their respective responsibilities in achieving Universal Health Coverage.
He said continuous stakeholder education would improve understanding of the health insurance system, strengthen service delivery and minimise operational challenges.
Similarly, the immediate past Chairman of HCPAN Lagos, Pharmacist Biola Paul-Ozieh, commended Zamba for her efforts in advancing the agency’s activities, urging both parties to sustain dialogue and cooperation.
She maintained that the success of ILERA EKO would depend on the willingness of LASHMA and healthcare providers to identify implementation challenges and jointly develop practical solutions.
The HCPAN delegation included the Deputy Chairman, Dr Deji Akinlade; General Secretary, Pharmacist Ajalo Abraham; and Publicity Secretary, Mr Jimoh Ayuba.
The meeting marks a renewed engagement between the association and LASHMA as Lagos State intensifies efforts to expand health insurance coverage and advance Universal Health Coverage.
For healthcare providers, however, stakeholders say the sustainability of the scheme will depend significantly on whether tariff reviews, timely payments, professional inclusiveness and efficient administrative processes translate into concrete improvements in their operating environment.
