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We are the first to implement the IPA model of HMO in Nigeria. Managed Healthcare is not altogether new in Nigeria. It is a means of providing comprehensive healthcare to defined groups of individuals, families, and employees under a fixed payment arrangement over a period of time.
The payment is an insurance premium paid per head per annum and covers the provision of defined healthcare needs (otherwise called Benefit Package). It provides real value to the healthcare consumer (and payer) since it combines lowered costs with high quality, two often desired attributes that has traditionally moved in opposite directions. In addition, the pre-paid nature allows for better healthcare budgeting unlike the fee-for-service system where the budget is more difficult to determine because of its open-ended nature. Our Health Plan provides the best incentives for the healthcare providers to render the best possible care to the enrolled population because of shared ownership.
One of the greatest challenges of Managed Care in Nigeria, which negatively impact the quality of care received, is the lack of proper alignment of the needs and expectations of the provider network (i.e. hospitals and clinics through which the HMO provide care) with that of the Health Maintenance Organization thus creating a dichotomy for which the enrollees and the payers pay dearly for in poor quality service and the attendant danger to lives.
The IPA on the other hand creates a seamless flow of service from the HMO to the network of providers. This is made possible essentially because of the shared ownership of the network and the HMO.