Healthcare providers’ satisfaction with participation in private Health Insurance scheme in a city in the Southern Nigeria

Abstract

Background: Health insurance coverage in Nigeria is still very low as over 70% of health care expenditure is financed by out-of-pocket  payment. Health care providers are critical participants in the private health insurance scheme, therefore, their perception and  satisfaction with the scheme is fundamental in ensuring sustainability. This study assessed health providers’ satisfaction with private  health insurance scheme in Port Harcourt Rivers State.

Method: A descriptive cross-sectional study which engaged a two-stage sampling method to recruit 60 participating health facilities and  180 responding health personnel by simple random sampling at each stage. A structured, pretested interviewer-administered  questionnaire was used to collect data on the levels of satisfaction with the four major domains of satisfaction viz; billing rate, payment  models, HMO administrative processes and claims management. Data was analysed using of SPSS, version 26. Characteristics of the  responding facilities were tabulated and compared. Level of satisfaction was deduced by Likert Scale according to the domains of  satisfaction. Regression analysis with p-value was set at less than or equal to 0.05 was used to determine the predictors of satisfaction  with participation in health insurance. The level of satisfaction with negotiated billing rates, payment models, HMO administrative  processes and claims management were analysed descriptively, and results were presented as means, standard deviation, frequencies  and percentages, in tables, pie and bar charts.

Results: 68.3% of the respondents were females and 31.7% males. 37.8% were satisfied  with billing rates, 76.1% preferred fee-for-service method of payment. 55.6% were satisfied with HMO administrative processes and 41.5%  were satisfied with claims administration. Facilities that have been in operations for more than 10years were 1.5 times more likely  to be satisfied with their participation in private health insurance scheme [OR = 1.52; 95% CI = 0.07-0.65] p value = 0.01

Conclusion:  Health care providers’ satisfaction with participation in private health insurance scheme is barely above average. The HCWs were poorly  satisfied with billing rates and claims administration by HMOs. There is a need to actively involve providers in the processes and  operations of the health insurance scheme in Nigeria.