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The government has given an assurance that it will settle the Sh30 billion owed to hospitals by the defunct National Health Insurance Fund (NHIF) as part of the ongoing transition to the Social Health Insurance Fund (SHIF).
Medical Services Principal Secretary, Mr Harry Kimtai said already Sh4.5 billion had been released to health facilities last week adding that a further Sh4.5 billion would be disbursed by Friday.
While announcing that the government has committed to pay the health care facilities Sh9 billion by the end of next month Mr Kimtai said the State had directed County Commissioners and County Executive Committee Members (CECMS) in charge of Health Services to ensure that paid up members of Social Health Insurance Fund (SHIF) are not denied services.
Speaking in Nakuru after meeting County Commissioners and CECMs from the 14 Counties in Rift Valley, the Principal Secretary advised Kenyans who have registered with SHIF to upload the names of their dependants on the fund’s portal so that they may benefit whenever need arises.
Mr Kimtai stated that the move to settle the Sh30 billion is a crucial step to maintain the health facilities’ trust and cooperation under SHIF. He pledged that the remaining payments will be made progressively, based on the availability of funds. Hospitals and other healthcare providers were hesitant to shift to SHA due to the financial strain caused by unpaid claims.
The Principal Secretary indicated that a national steering committee that brings on board all stakeholders in the health sector had been put in place to help smoothen transition from NHIF to SHIF. “We acknowledge there have been glitches in the course of transition to the new SHIF but we want to assure Kenyans that we are ironing out the challenges and soon operations at the new fund will run seamlessly. The government is committed to ensuring that every Kenyan gets quality and affordable health care,” the Principal Secretary pointed out.
According to the management of some of the hospitals, the outstanding amounts have created operational challenges, with some facilities forced to delay services or find alternative means to stay afloat. As part of the transition, Mr Kimtai reassured stakeholders that it will address this outstanding financial obligation.
He stated that the concerns of most hospitals regarding the transition and debts were legitimate and would be addressed in due course. “We will take on the assets and liabilities of NHIF. Our estimated outstanding debt is approximately Sh30 billion,” he said.
The Health ministry, he said, has formed a transition committee that has been taking stock of NHIF’s assets and liabilities.
“We have also formed a committee that will oversee claims payment and disbursement of funds. We will not favour any hospital as far as payment is concerned,” he said. “Whatever amount we have at the Ministry, we will just use a percentage and declare that out of the amount that we have, we will pay hospitals a flat rate so that we clear the debts to assure them that there will be no debts carried forward with the transition,” Mr Kimtai added.
The Principal Secretary said that moving forward with the transition, payment of claims would not be delayed since the current system can monitor claims as they come in, with the system as of Tuesday capturing Sh100 million to be paid to hospitals.
“We have given a directive to SHA (Social Health Authority) that they need to pay the claims within 90 days of being lodged. This will bring confidence and satisfaction to everyone. We want sanity to ensure that those who are investing in the business are sure of their returns so that they can grow,” he said.
The Principal Secretary defended the Social Health Insurance Fund (SHIF) that has caused radical changes in the health sector saying the inadequacies being experienced are due to teething problems. He emphasized that the new Social Health Insurance Fund (SHIF), despite its shaky rollout, is set to transform healthcare access.
“I know we have had challenges because we are transitioning from what it was to the new model. In every transition there will be challenges, which we are managing. Last week we disbursed money for hospitals and dispensaries and next week will do the same until transition is complete,” he said.
On October 1, the government discontinued the National Health Insurance Fund (NHIF) and directed all healthcare providers and patients to shift to SHIF. However, initial glitches in the SHIF system left many patients unable to access medical services, causing widespread confusion and distress across the country.
He affirmed that the Kenya Kwanza government is committed to upholding the Constitution by ensuring that disadvantaged households have equitable access to healthcare services. “We want to ensure that anyone regardless of their financial capacity or not can seek medical services without being turned back because they don’t have money. That’s the essence of the transition from the old model for delivery of health and the current model,” the Principal Secretary affirmed.
So far over three million Kenyans have registered afresh with Mr Kimtai saying the new registration will ensure that no Kenyan is left out from accessing benefits rolled out under the retooled public healthcare system anchored on the Universal healthcare pillar.
“We must use the benefit of using data and that’s the reason why we are asking every citizen to register so that we can be able to plan our health as a nation and know what the disease load in which area and we are able to plan,” he added. For salaried employees, the monthly contribution rate is 2.75 percent of gross salary with a minimum contribution of Sh300 per month and no maximum contribution. Employers must make this remittance by the ninth day of the subsequent month.
For non-salaried persons, the household will make an annual contribution set at a rate of 2.75 percent of the household income with a minimum contribution of Sh300 per month (and no maximum amount payable annually) within 14 days before the lapse of the annual contribution.
The Regulations further stipulate that data will be collected on non-salaried households to determine and estimate the household’s ability to pay SHIF contributions based on housing characteristics, accessibility to basic services and household composition and characteristics.