Delay in Health Care Service Funds Disbursement by Premier Medical Aid Society, Zimbabwe

Abstract

Premier Medical Aid Society, by June, 2020, had not settled health service providers’ claims on time. They owed health service providers hundreds of millions of United States Dollars. The aim of the study was to examine how delays in the settlement of claims by Premier Medical Aid Society affected health service providers. The objectives of the study were, to identify the causes of delayed payments to health service providers by Premier Service Medical Aid Society (PSMAS), assess the legislation available in the disbursements of funds to health service providers, measure the real impact of these payment delays on the general welfare of health service providers and suggest possible solutions to the delays in payment to health service providers. The study used descriptive research design to summarise and organize data in an effective and meaningful way. Mixed research approach was used. The study targeted the private health service providers located in Gweru. For the purpose of this study, 55 participants (from selected health service providers) were purposely selected to answer the questionnaire. Seven (7) top executives from service providers with the highest amounts owed to them were selected and three (3) PSMAS managers as key informants to participate in the interview. Statistical Package for Social Science (SPSS) version 21 software was used to analyse the data. Pie charts, graphs and tables were used to present data. The major findings of the study were that health service providers’ claims were not settled within the stipulated time of 60 days. The majority of health service providers indicated that non settlement of claims affected their daily operations and hence forcing them to ask their clients for cash upfront before serving them in order to stay in business. One of the recommendations was that medical aid societies and health services providers should work together to eliminate delays in the settlement of claims.