HMOs Have Capacity to Boost Healthcare Delivery, Says Hygeia CEO

Kuni Tyessi in Abuja

For improved and affordable healthcare services to Nigeria’s teeming population, especially in assisting healthcare facilities in getting paid for services rendered and in ensuring less burden to beneficiaries of the services, Health Management Organisations (HMO) are said to be key.

The Chief Executive Officer of Hygeia, Mr. Obinnia Abajue, stated this when he held its Providers’ Conference in company of some of its partners in Abuja. The conference was steered towards creating an open platform for feedback from its stakeholders and healthcare service providers.

He emphasised that most beneficiaries of healthcare services cannot afford to pay the cost in its entirety, hence the need for HMOs to work with hospitals‎ and find ways to balance the needs of the providers and that of the enrollees.

While stating that healthcare services must be paid for, as they are certainly not free and are commodities that are expensive everywhere in the world, Abajue lamented that several Nigerians do not know and understand the significance of HMOs and what they stand for, as well as what they stand to benefit.

He explained that HMOs are private establishments that have been set up to act as intermediaries between individuals and the providers. He added that they aggregate demand to be able to channel them to providers in a way that they sustain it more.

He said: “Healthcare is not cheap. It is expensive everywhere in the world. Someone has to pay for it because it is certainly not free. If you try to pass the cost ultimately to the beneficiaries, most people can’t afford it and we have to work for hospitals who are themselves businesses trying to stay profitable and alive and see a way that balances the needs of the providers and enrollees who pay for the services ultimately.

“What we do is to work with them based on the amount that they charge and find ways to make their businesses easier. We find out how they process their activities, how they get financing for supplies that they need and what else they can do to provide the capacity of the provider without necessarily raising the cost to everybody.

“‎The key challenge is that many people don’t really understand what the HMO is supposed to do. If someone goes to a hospital and asks for a deposit of however much, just to be able to access care, with a HMO backing him, he doesn’t need that deposit because the hospital knows the HMO will pay. The process of managing that is really about growing the size of the book. The cost of one person going to the hospital is effectively the same with the cost of two people which gives you a cost times two.

“The point is HMOs help to be able to work up the large base so that hospitals can get services, get paid for the services‎ they render each time people go, and people don’t have to pay the full cost themselves,” he added.

‎The Providers’ Conference is an annual stakeholder summit held across Nigeria, aimed at fostering the relationship with Hygeia medical partners and aligning strategies to deliver the best in class medical care.