Former presidential aspirant and Medical Director of Sckyé Hospitals Limited, Akure, Dr. Thomas-Wilson Ikubese, has criticised the Delta State Contributory Health Commission (DSCHC) over its monthly capitation payments to healthcare providers, describing the rates as inadequate for quality healthcare delivery.
Dr. Ikubese made the remarks during a panel session at the maiden National Summit of State Social Health Insurance Agencies (SSHIAs), held in Akure, Ondo State.
The two-day summit focused on the theme, “Economic Realities and the Universal Healthcare Dream: Mobilizing States for a Scalable Health Insurance.”
He faulted the Commission’s payment of ₦500 monthly capitation for public health facilities and ₦520 for private healthcare providers, noting that the National Health Insurance Authority (NHIA), following a nationwide actuarial study conducted in 2025, fixed the capitation rate at ₦1,450 per enrollee.
According to him, it is disturbing that a state health insurance agency is paying barely one-third of the NHIA-approved rate in 2026.
Dr. Ikubese stressed that the quality of healthcare services available to enrollees is directly linked to the level of capitation paid to healthcare providers. He argued that healthcare facilities cannot be expected to deliver quality services when they are paid what he described as “peanuts.”
He noted that healthcare providers under both the NHIA and state health insurance schemes source drugs from the same pharmaceutical companies at similar costs, making significant disparities in capitation rates unjustifiable.
The medical practitioner maintained that no state health insurance scheme should pay a capitation rate lower than that of the NHIA, since both operate within the same healthcare market.
Responding to claims by the Director-General of DSCHC, Dr. Isaac Akpoveta, that Delta State’s ₦520 capitation is among the highest in the country, Ikubese pointed out that Ondo State currently pays ₦750, although healthcare providers still consider the amount insufficient.
The Convener of the YesWeFit Revolutionary Movement also advocated greater transparency in the operations of state health insurance agencies nationwide. He proposed the creation of dedicated websites where healthcare providers can upload monthly claims, while Third Party Administrators (TPAs) vet submissions and provide clear explanations for any deductions or adjustments.
He added that capitation payments and claims settlements should be publicly reflected on the platforms to enhance accountability and ease reconciliation processes.
Dr. Ikubese expressed confidence that such reforms would strengthen trust among stakeholders and improve the effectiveness of health insurance schemes across the country.
Earlier, Governor of Ondo State, Dr. Lucky Orimisan Aiyedatiwa, welcomed participants from across the federation and reaffirmed his administration’s commitment to expanding health insurance coverage.
He announced that all retired Ondo State civil servants would be enrolled free of charge into the Orange Health Insurance Scheme, with funding provided by the state government.
The announcement received widespread applause from participants at the summit.
