NHIA Issues One-Hour Deadline for Patient Care Under Health Insurance
Health Maintenance Organisations (HMOs) in Nigeria have been issued a stern directive: patients on health insurance must not wait more than one hour before receiving medical attention at their designated healthcare facilities.
This mandate was revealed by Otunba Lekan Ewenla, Managing Director and CEO of Ultimate Health Management Services, during the company’s 14th Annual General Meeting held in Abuja on Thursday.
NHIA Moves to End Long Wait Times at Hospitals
Ewenla, a former governing council member of the National Health Insurance Scheme (NHIS), disclosed that the directive came from the National Health Insurance Authority (NHIA) following rising complaints from enrollees about prolonged delays and neglect at hospitals.
“Too often, patients spend the entire day at hospitals before being seen. This is unacceptable. The NHIA has now directed that the maximum waiting time for any patient under the health insurance scheme must not exceed one hour,” Ewenla said.
He likened the NHIA’s role in healthcare to CBN’s role in banking and PENCOM’s in pensions, emphasizing its function as a regulatory body protecting patient rights and enforcing standards.
Ultimate HMO Surpasses NHIA Benchmark
Reacting swiftly to the NHIA directive, Ewenla said Ultimate Health Management Services has not only complied but significantly outperformed the directive.
“Today, our average waiting time is just 10 minutes, and we are working to reduce it further to five minutes,” he stated.
Deployment of Smart Systems to Improve Patient Flow
Ewenla attributed this efficiency to a robust health management software and a new pre-booking system that alerts hospitals in advance of patient visits.
“We even place reminder calls to the hospital on the morning of the patient’s visit. This is in line with global best practices. Healthcare should not be approached casually,” he added.
He reaffirmed that quality healthcare is a fundamental right, and health insurance is the gateway to accessing that right effectively.
New Diaspora Healthcare Plan Launched
As part of its innovation strategy, Ultimate HMO has launched a health plan targeting Nigerians in the diaspora, especially those who financially support elderly relatives back home.
“Many Nigerians abroad send money back home for healthcare, but this one-off approach often fails due to lack of follow-up care,” Ewenla explained.
Pilot Programme Begins in the United States
According to Ewenla, a pilot of this plan has already launched in the United States, where he recently engaged the Nigerian Consulate in Atlanta, Georgia.
The outreach effort also includes Nigerian churches, mosques, and community grocery stores abroad.
“We’re seeing growing interest from the diaspora, and we are pushing for regulatory backing to ensure wider enrollment and compliance,” he said.
Cultural Attitudes Must Shift for Reform to Succeed
Ewenla emphasized that Nigerians must change their attitudes toward systems and public services for reforms to take root.
“We all see how Nigerians disregard simple traffic laws. The same attitude reflects in how we treat healthcare systems. That’s why we’re working closely with government and regulators to change this narrative,” he added.
Board Chair Urges Industry-Wide Innovation
Speaking at the AGM, Mrs. Angela Ajala, Chairman of the Board of Ultimate Health Management Services, echoed the call for patient-centric reforms and warned HMOs against delayed settlement of medical claims.
“We take the health and satisfaction of our enrollees very seriously. At Ultimate HMO, we ensure prompt settlement of claims because that’s the backbone of our service delivery,” she said.
Call to Embrace Mental Health, Telemedicine, and Special Needs Care
Ajala also challenged healthcare stakeholders to embrace innovation and respond to new healthcare trends, including the rise in mental health cases, telemedicine, and care for children with special needs.
“We must be proactive. The expectations of patients are evolving, and we must think ahead to remain relevant,” she concluded.
