Private hospitals in Kenya want the government to prioritize settling outstanding NHIF arrears before processing Social Health Authority (SHA) claims. The Departmental Committee on Health of the National Assembly recently received a report detailing this preference from the Rural and Urban Private Hospitals Association of Kenya (RUPHA) and the Kenya Association of Private Hospitals (KAPH).
According to the report, which collected data from over 500 private healthcare providers, 55% of facilities want NHIF arrears addressed first. In comparison, 26% prefer simultaneous payment of both NHIF and SHA claims, and only 19% support prioritizing SHA claim payments while deferring NHIF arrears.
The report also revealed that 61% of private facilities overwhelmingly prefer NHIF arrears settlement, compared to 51% for faith-based hospitals and 49% for public facilities. Additionally, 56% of facilities have completed NHIF claims reconciliation, although primary care facilities at Levels 2 and 3 continue to face challenges due to a lack of awareness and portal access restrictions.
Unpaid facilities have been asked to resubmit banking details, with 52% reporting this request, indicating inefficiencies in the claims settlement process. RUPHA and KAPH emphasized that NHIF arrears remain a critical concern, severely impacting healthcare providers' ability to sustain operations and forcing many to take on high-interest commercial loans to stay afloat.
Despite the noble intentions behind the establishment of SHA, which aimed to enhance healthcare access, ensure timely provider reimbursements, and foster a more efficient health financing model, the transition from NHIF to SHA has left private healthcare providers in financial distress. RUPHA and KAPH, representing over 1,000 private healthcare facilities in Kenya, will provide detailed evidence to Parliament to support their advocacy for a more predictable, transparent, and equitable health financing model that allows hospitals to continue providing quality services to Kenyans.
According to the report, which collected data from over 500 private healthcare providers, 55% of facilities want NHIF arrears addressed first. In comparison, 26% prefer simultaneous payment of both NHIF and SHA claims, and only 19% support prioritizing SHA claim payments while deferring NHIF arrears.
The report also revealed that 61% of private facilities overwhelmingly prefer NHIF arrears settlement, compared to 51% for faith-based hospitals and 49% for public facilities. Additionally, 56% of facilities have completed NHIF claims reconciliation, although primary care facilities at Levels 2 and 3 continue to face challenges due to a lack of awareness and portal access restrictions.
Unpaid facilities have been asked to resubmit banking details, with 52% reporting this request, indicating inefficiencies in the claims settlement process. RUPHA and KAPH emphasized that NHIF arrears remain a critical concern, severely impacting healthcare providers' ability to sustain operations and forcing many to take on high-interest commercial loans to stay afloat.
Despite the noble intentions behind the establishment of SHA, which aimed to enhance healthcare access, ensure timely provider reimbursements, and foster a more efficient health financing model, the transition from NHIF to SHA has left private healthcare providers in financial distress. RUPHA and KAPH, representing over 1,000 private healthcare facilities in Kenya, will provide detailed evidence to Parliament to support their advocacy for a more predictable, transparent, and equitable health financing model that allows hospitals to continue providing quality services to Kenyans.
