A Study into the Financial Sustainability of Offinso Mutual Health Insurance Scheme

Abstract

It is widely recognized that a strong financial base is a prerequisite for an effective health care delivery system. Currently, Governments in sub-Saharan Africa are facing serious financial constraints in their attempts to provide basic health services to their people (Abekah-Nkrumah, et.al 2009). The purpose of this research was to determine: the adequacy of funding of Offinso Health insurance scheme; the relationship between revenue trends and claims management from 2006 to 2011; and measures put in place to ensure the financial sustainability of the scheme. In doing so the funding adequacy, revenue trend and claims payment from 2006 to 2011, and financial sustainability strategies of Offinso health insurance scheme was examined. The research was both descriptive and causal. The research strategy was survey and single case holistic. The research philosophy was both positivism and interpretivism. The research also used both deductive and inductive approach. Data was analysed using quantitative techniques like mean, frequency, correlation, standard deviation, and others. The unit of analysis was staff of Offinso Health Insurance Scheme. The total population size of 20 was used. In addition extract from the financial records of the scheme was also used. No specific sampling technique was used since data was collected from the entire population. It was found out that the scheme is not adequately funded; there is a highly positive relationship between revenue and claims payment and that claims payment consumes substantial portion of total revenue; the scheme has adequate defensive strategies; there is poor prudent fund management; and inadequate sourcing strategies. Generally the scheme may be facing financial sustainability problems in the long run as evidenced in the research findings.

Keywords: Adequacy of funding, Financial sustainability, Mutual health insurance, Offinso.