The Namibian Association of Medical Aid Funds (NAMAF) is formulating interventions to secure the sustainability of medical aid funds.
In November 2023, the association announced that it was faced with significant challenges.
The N$5 billion industry was under immense financial pressure, primarily due to high utilisation rates from medical aid claims.
The Chief Executive Director of NAMAF, Stephen Tjiuoro, said that to address this issue, the industry came together in a workshop to devise interventions aimed at ensuring the sustainability of medical aid funds.
“During its meeting on the 18th day of October 2023, the NAMAF Management Committee approved a strategic roadmap for 2024–2026. This roadmap focused on swiftly executing interventions to stabilise the industry. One crucial aspect of the strategy involved analysing the claims pie chart, which highlighted the top three disciplines driving healthcare costs. Namaf decided to concentrate its efforts on these disciplines to maximise impact.”
Tjiuoro added that to tackle the issue of high costs at private hospitals, NAMAF took a two-pronged approach.
Firstly, they collaborated with stakeholders to standardise the interpretation of terms related to healthcare services.
“This included defining terms like “minor and major cases,” “unattached operating theatres,” and others to reduce ambiguity and improve efficiency.”
Secondly, they worked on formalising relationships between private hospitals, healthcare facilities, and medical aid funds through contracts.
This is to enhance the effectiveness of healthcare services and reduce resource waste.
Another significant expense was the cost of medicines.
“NAMAF implemented the Namibian NAPPI Product and Price File to establish benchmark fees for medicines, providing a comprehensive coding structure for healthcare episodes.”.
Overall, NAMAF emphasised collaboration with stakeholders to ensure the sustainability of the medical aid funding industry.
By protecting the interests of members, healthcare service providers, and the industry as a whole, NAMAF aims to create solutions beneficial to all parties involved.
