Actuarial Models for Management of Sickle Cell Under the National Health Insurance Scheme

The paper examined actuarial models for managing sickle cell care disease under the national health insurance scheme in Lagos State, Nigeria. The objective was to determine the effectiveness of existing actuarial models in predicting and managing the costs associated with Sickle Cell Disease (SCD) care under the NHIS in Lagos State. A descriptive survey was conducted with 216 underwriters from 27 insurance companies, focusing on patients registered under the scheme, including those diagnosed with sickle cell disease regardless of age. Descriptive statistics of mean and standard deviation was used to answer the research questions. The study found that underwriters in Lagos State agreed on the effectiveness of actuarial models in predicting and managing costs associated with Sickle Cell Disease (SCD) care, as well as their impact on accessibility and quality of care. However, they acknowledged the challenges and limitations in applying actuarial models effectively within the National Health Insurance Scheme (NHIS). The study recommends that underwriters advocate for policy reforms that support the integration of effective actuarial models into the NHIS framework, creating an environment conducive to improved SCD care accessibility and quality.