Browsing by Author "Nkya, Zamda Haroun"

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    Factors influencing the effectiveness of timely benefit claim payment to sevice providers: the case of NHIF in Tanzania
    (University of Dar es Salaam, 2019) Nkya, Zamda Haroun
    This study assessed the effectiveness of timely benefit claims payment. Data was collected on number .of days claims were reimbursed, contribution of members, claims processed, number of members and number of accredited health facilities at NHIF. The study was a quantitative experimental approach on factors influencing the effectiveness of timely benefit claim payment. This study took into account there imbursement days required by the strategic plan and actual days taken to reimburse claims. The difference obtained was named strategic day lag, which presents the dependent variable. Furthermore, the four independent variables tested were contribution of members, claims processed, number of members and number of accredited health facilities. The SPSS version 25regression model was used on the data for five financial years from 2013/2014 to 2017/2018. The selected regression model of four independent variables was significant. Furthermore, in relation to the Goal setting theory and Contingency theory, the findings showed that there is a need to increase the level of contributions of members so that enough funds will be available to settle the benefit claims on time. Moreover, increasing the number of health facilities so that NHIF members will be optimally spread hence reducing the risk of reimbursing illegitimate claims. This study, further recommends that controls should be placed on an optimal number of members who would receive services to each accredited health facilities. However, more studies should be conducted to determine factors influencing the increase in amount of claims processed. Moreover, studies should be conducted to determine factors affecting the effectiveness of members' recruitment, contribution collection and accreditation of health facilities.