by Niyi Jacobs
The sustainability of private Health Maintenance Organisations (HMOs) in Nigeria is under serious threat as the rising cost of healthcare continues to outpace static insurance premiums, the Group CEO of Consolidated Hallmark Holdings Plc and Chairman of Hallmark HMO, Mr. Eddie Efekoha, has warned.
Speaking at the 4th edition of the Hallmark HMO Stakeholders’ Engagement held in Abuja, Efekoha said private HMOs are being squeezed financially, with growing operational costs placing pressure on shareholder funds and threatening future investments in the sector.
“The cost of providing quality healthcare is rising sharply, thereby threatening shareholders’ funds of many private businesses without any clear mechanisms for cost recovery,” he stated.
While stressing the importance of universal health coverage, Efekoha cautioned against policies that place the entire burden on private providers. He said that unless a sustainable balance is struck between healthcare accessibility and financial viability, private investments in the health insurance space could decline.
“Private HMOs are key players in the healthcare system and must be supported, not weakened, in the drive to achieve national health goals,” he noted.
Efekoha also pointed to regulatory overlaps as a growing concern. According to him, the lack of clear role definitions among private HMOs, state-backed health schemes, and the National Health Insurance Authority (NHIA) has led to policy confusion and inefficiencies in healthcare delivery.
He called for increased collaboration among industry stakeholders and urged that complaints and disputes be resolved swiftly to ensure better service delivery.
Managing Director/CEO of Hallmark HMO, Mrs. Oladotun Adeogun, disclosed that the firm has partnerships with over 1,500 hospitals across Nigeria. She said this was the first time the engagement was being hosted in northern Nigeria, with the aim of deepening relationships with local clients and regulators.
Adeogun added that Hallmark HMO has focused on delivering quality service since its establishment in 2018, helping it stay competitive despite a saturated and highly price-sensitive market.
In his goodwill message, the Emir of Zazzau, His Highness Ahmed Nuhu Bamalli, represented by Dr. Mohammed Aliyu Bamalli, expressed concern over unsustainable pricing in the industry. He said HMOs were engaging in unhealthy price wars, leading to low tariffs and the dispensing of substandard or fake medication.
“More and more companies are moving away from managed care back to retainership, and that’s a dangerous trend,” he warned.
He advocated innovation in health insurance design — including co-payments, deductibles, and pharmacy benefits — as well as a review of tariffs to ensure that SMEs can continue to provide coverage for their employees.
Dr. Olumide Okunola of the World Bank, who served as guest speaker, described Nigeria’s health financing as inadequate, noting that 75 percent of health expenses are paid out-of-pocket by citizens — one of the highest rates in the world.
He urged the government to reduce its emphasis on expensive health infrastructure and instead focus on expanding health insurance coverage to attract private investments and reduce mortality, especially among vulnerable groups such as children and pregnant women.
