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The National Health Insurance Authority (NHIA) in Ghana was established to achieve universal health insurance coverage under the National Health Insurance Scheme (NHIS). The NHIA’s responsibilities include registering, licensing, and regulating health insurance schemes, assessing healthcare providers, managing the National Health Insurance Fund, and ensuring care for the indigent. This report presents annual results for the 2018 review, highlighting increases in active membership, credentialed healthcare facilities, and healthcare service utilization. The Authority’s revenue surpassed expenditures, resulting in a surplus. Key initiatives like e-renewal and electronic claims processing were introduced to improve efficiency and enrollment.