CBHI Membership Management System in Rwanda

SHEMA, Joseph, Health Financing Unit/MoH)

NDIZEYE, Cedric, Management Sciences for Health

CBHI in Rwanda (Informal sector)

Policy Law

New Policy

Pilot

CBHI in RWANDA

• Premiums collections:– Based on socio-stratification category

• Benefit package– Same package (MPA, CPA & Tertiary package)

– Ambulances

– Patient roaming

• Co payment– Flat for MPA

– 10% rest

• Reimbursement: Fee for service

Health Insurance Governance Structure

Structure of Rwanda Health InsuranceRegulation

Finance

Payment

Advisor Rwanda Health Insurance

Council

Private Health Insurance

Ministry of Finance

Ministry of Health

Rwanda Social Security Board

+ MMI

District

Sector

District Hospital

Health Centre

National Risk Pool

Referral Hospital

District CBHI Risk Pool

CBHI Section

Population

Stratification (Ubudehe)

• “Ubudehe” : Collectiveaction to solve problems of localpeople by local people with the support from local government

• Starting point: “Ubudehe map” at village level harmonized after the pilot phase

Main objective: Poverty reduction

CBHI categoriesUBUDEHE Categories CBHI Categories Amount per capita (USD)

1&2(Those living in abject poverty & the Very poor)

1 Around 3 USD(To be paid by Government)

3 &4(Poor & Resourceful poor)

2 Around 5 USD/ capita/ year

5 &6((Food rich &Money rich)

3 Around 11 USD/ capita/year

Stratification

National Income Categorization Database (NICD): NICD enables the local government authority to collect data on income categories of Rwandans by household. Contains more than 10 million records!

Results from National categorization

Access to information

• Web Interface

Managing members

• Register Households

• View Households

• View Indigents

• Register Indigents

Payment

• Import list of Indigents

Viewing details of a user (member)

The Details page has three sections with the following information:

• Section 1 which contains the profile of a member

• Section 2 which contains Additional Menus: – View Dependents

– Update Dependents

– Calculate Payments

– View invoices

Calculate payments

• This menu display the following feature:

• Selection of a medical insurance (Civil servant, private: CORAR, MEDIPLAN etc.)

• Allow to calculate the total amount to pay for medical insurance premium.

• The system prints the invoice with the option for printing

Register Household

• Page with Head ID number field and two command buttons:– Clear

– Lookup info.

• LOOKUP INFO button to pull information from the UBUDEHE Database

Register Indigents Payment/Import list of indigents

Reporting• Membership Report

– list of members based on the start/end dates

– type of the member

• Member Statistics – Member type and percentage

• Payments Report – Method of payment

– Bank/Funder

– Expected and paid contribution/ Balance

• Payments Statistics

• Export report:– Excel – Word – Pdf– Html

Mobile phone interface• Uses USSD on any phone

to display menu of options

• Important option to support patient roaming in case the internet is not available.

• A separate module is being designed to enable members to make mobile money payments using a mobile service aggregator (PivotAccess)

Next steps/ Challenges

• Roll out of mobile application

• Transfer of CBHI systems to Rwanda Social Security Board

• Big challenge of completeness and update of the National Income Categorization Database

Thanks