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Since the establishment of Ghana’s NHIS in 2003, the country has made substantial progress towards its goal of universal health care. As of 2014, the NHIS covered 10.5 million people which is 40% of Ghana’s population. The total number of inpatient and outpatient visits to health facilities rose from just under 0.5 per capita in 2005 to almost 3 per capita in 2014. Despite the progress made in coverage, ensuring the NHIS’s financial sustainability continues to pose a serious challenge and remains authorities’ priority.  The goal of this study therefore,  was  to inform policy makers on improving financial sustainability of the NHIS based on quantitative evidence from claim expenditure patterns.  Findings from the study showed that three principal factors determine the amount  and affected the efficiency of claims expenditures in Ghana and these include;  coverage expansion, behavior of service providers and NHIS members, and the internal management of the national health insurance authority.
 
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