Private health facilities want the government to first settle NHIF arrears before Social Health Authority (SHA) claims, Departmental Committee on Health of the National Assembly has learnt.
Rural and Urban Private Hospitals Association of Kenya (RUPHA) and Kenya Association of Private Hospitals (KAPH) said 55 per cent of the facilities want NHIF arrears to be considered first.
In a report to the committee, RUPHA and KAPH said data from health service providers show 26 per cent of private facilities prefer simultaneous payment of both NHIF and SHA claims.
They said 19 per cent support prioritising SHA claim payments while deferring NHIF arrears.
“Private facilities overwhelmingly prefer NHIF arrears settlement (61 per cent), compared to 51 per cent for faith-based hospitals and 49 per cent for public facilities,” the report said.
The report said 56 per cent of facilities have completed NHIF claims reconciliation, “though primary care facilities (Levels 2 and 3) continue to struggle due to lack of awareness and portal access restrictions.”
It further said 52 per cent of unpaid facilities have been asked to resubmit banking details, signaling inefficiencies in the claims settlement process.
“NHIF arrears remain a critical concern, with the outstanding amount severely impacting healthcare providers’ ability to sustain operations. Many facilities have had to take on commercial loans at high interest rates to remain afloat while waiting for funds owed by the government,” RUPHA and KAPH said.
RUPHA and KAPH jointly represent over 1,000 private healthcare facilities in Kenya
SHA was established with the noble intention of enhancing healthcare access, ensuring timely provider reimbursements, and fostering a more efficient health financing model.
RUPHA and KAPH, however, said the transition from the National Health Insurance Fund (NHIF) to SHA has left private healthcare providers in financial distress.
The two said that data was collected from over 500 private healthcare providers, outlining key challenges, financial implications, and urgent recommendations for corrective measures.
“As Parliament is the House of Records, we will provide detailed evidence to support our advocacy for a more predictable, transparent, and equitable health financing model that allows hospitals to continue providing quality services to Kenyans,” they said.
