Ultimate Health HMO Drives Digital Healthcare Expansion for Informal Sector

Ultimate Health HMO is stepping up its initiatives to extend health insurance benefits to Nigeria's vast informal economy. This strategic move, announced during its 14th Annual General Meeting, held after its 39th board session, aligns with the Federal Government's renewed commitment to increasing health insurance penetration, especially since the passage of the National Health Insurance Authority Act of 2022. The company is actively deploying digital technologies and innovative solutions to propel universal health coverage forward.

Speaking at the AGM, Mr. Lekan Ewenla, the Managing Director and Chief Executive Officer, highlighted the company's focus on the informal sector, noting its significant underserved status by existing health insurance providers. He emphasized the necessity for Health Maintenance Organisations (HMOs) to broaden their reach, citing National Bureau of Statistics (NBS) figures. Ewenla stated, "Looking at the data released by the National Bureau of Statistics, we found that only about 15 per cent of Nigerians work in the organised private sector. The bulk of Nigerians are in the informal sector."

Ewenla further revealed that Ultimate Health HMO has uniquely extended the comprehensive benefit package typically enjoyed by federal civil servants to include artisans, traders, and proprietors of small businesses. He elaborated, "What Ultimate HMO has done differently and innovatively is to adopt the benefit package currently provided for federal civil servants as our basic plan and introduce it to the informal sector and small and medium-scale business owners. That is what we are doing differently, and we are driving it vigorously because health insurance was designed for the mass market."

The Ultimate Health HMO chief expressed support for the Federal Government's recent enforcement actions, which mandate employers and businesses to enrol their staff in health insurance schemes and obtain compliance certificates from the National Health Insurance Authority (NHIA). Industry experts anticipate that this policy will substantially boost health insurance enrollment, particularly among employees in the private sector and small enterprises. Ewenla commented, "As a patriotic organisation, whatever policy the government introduces to improve the economy and the well-being of Nigerians is welcome to us. We were part of the decision-making process on how to enforce compliance after the law was passed. A circular issued by the Office of the Secretary to the Government of the Federation now requires companies to enrol their staff in health insurance schemes and obtain certificates of compliance from the NHIA."

He added that Ultimate Health HMO is actively engaging with various informal sector groups, such as transport unions and market associations, to expand enrollment. Ewenla detailed the company's introduction of flexible healthcare access options, enabling enrollees to register at two different hospitals—one conveniently located near their homes and another close to their workplaces or markets. He explained, "We know that many traders and market women spend most of their day in the markets. So, we allow them to choose a hospital close to the market where they operate and another near their residence. In addition, we provide both physical and digital identity cards. The ID card is available on your phone, so you can simply present it at the hospital and access care immediately."

Regarding specialized healthcare services like reproductive health treatments, including In-Vitro Fertilization (IVF) and fibroid surgeries, Ewenla confirmed that the company’s benefit package comprehensively covers a broad spectrum of medical conditions. He remarked, "You will be surprised that the basic NHIA plan covers a majority of these benefit packages, including cancer treatment. That is one of the reasons we adopted the package because of how robust and affordable it is."

The MD/CEO underscored that the company's objectives extend beyond mere profitability. He stated, "It is not only about the premium; it is about changing the narrative of our poor health indices as a country. What drives growth across the world is patriotism. We are patriotic about this country, and it is Nigerians who will drive the development of Nigeria."

In his remarks, Abulaziz Abdullahi, the Chairman of Ultimate Health HMO, noted the company's substantial growth in enrollment and its deliberate strategy to diversify its client base beyond the public sector. He asserted, "Ultimate has been a pacesetter in the HMO sector in the country. The level of our enrolment has been growing tremendously, and ever since I joined the board in 2022, I have encouraged the management and fellow board members to focus more on the private sector and not rely solely on the public sector."

Abdullahi also pointed out that the NHIA Act has opened up new avenues for expanding healthcare access nationwide. He expressed optimism, "The coverage should not just be limited to the formal sector. We are leading the way and, hopefully, by next year, our performance will be even more impressive."

The chairman further emphasized the company's embrace of technology as a crucial growth catalyst, predicting a greater role for digital healthcare and artificial intelligence in its future operations. He shared, "If you do your research, you will find that Ultimate has been a pacesetter in digital medicine. Most of our operations are driven by technology, and our call centre operates 24 hours a day, seven days a week. Just two days ago, I was discussing with the management the need to explore the use of Artificial Intelligence in our operations. This shows that we are not taking chances."

Nigeria continues to face one of Africa's lowest health insurance coverage rates, with a significant portion of its populace still relying on direct out-of-pocket payments for healthcare. The National Health Insurance Authority Act, enacted in 2022, legally mandated health insurance for all Nigerian citizens and legal residents, thereby superseding the previous National Health Insurance Scheme framework and reinforcing the government's drive towards universal health coverage. Despite these policy reforms, stakeholders acknowledge that enrollment figures remain modest, particularly within the informal sector, which constitutes the majority of Nigeria's workforce. This ongoing challenge has spurred health insurance providers to develop specific products tailored for artisans, traders, transport workers, and small business owners.