Subsidise medical aid funds – NAMAF
Statistics in the 2011 annual report of Namibia Financial Institutions Supervisory Authority (NAMFISA) shows that in 2010, aproximately 152,328 citizens, which includes 64,399 primary members, were covered in the nine private medical aid funds that are members of NAMAF. This figure however excludes those covered in the Public Service Employee Medical Aid Scheme (PSEMAS). Medical aid funds under NAMAF consist of five closed funds and four open funds, which Mbapaha says makes up more than 80% of the total members.
On an annual basis, NAMAF engages with healthcare service providers that are tasked with motivating to the body to arrive at an acceptable tariff regime against which medical aid funds will benchmark the reimbursement of health services rendered to medical aid fund members. South African based actuarial company, Towers Watson, conducts the annual actuarial reviews of NAMAF by collecting data from the funds to arrive at acceptable tariffs. “I am pleased to say that over 90% of our members adhere to this requests,” Mbapaha said.
NAMAF collaborates with the Board of Healthcare Funders of Southern Africa (BHF) to allocate practice numbers using the Practice Code Numbering System (PCNS), which is a unique database of registered healthcare professionals and institutions used by both private and public healthcare entities. The allocation of practice numbers allows claims to be accurately identified. Each healthcare service provider is provided with a unique number for reimbursement. Mbapaha says that for sake of transparency, financial statements of the medical funds are reviewed by NAMFISA.
NAMAF was established in terms of the Medical Aid Funds Act, 1995 (Act 23 of 1995) to control, promote and co-ordinate the establishment and functioning of medical aid funds in Namibia. The body plays the function of protecting members of medical aid funds against abuse from both medical aid funds and providers of healthcare services and serves as an advocate between medical aid funds and their members. Mbapaha says through associations like Namibia Medical Society, the healthy relationship between NAMAF, health care providers and medical aid funds is maintained.