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Ministry, NHIF in fresh talks on taming rising healthcare cost, fraud

Friday, December 2nd, 2022 10:00 | By
Evacuation plan rescues thousands of accident victims, says NHIF boss
National Hospital Insurance Fund headquarters on Ngong Road, Nairobi. Photo/PD/FILE

National Hospital Insurance Fund (NHIF) is in talks with the Ministry of Health on regulating the pricing of medical services in a bid to tame high healthcare cost and medical fraud.

The engagements are part of a roadmap to help insurance companies take part in the implementation of Universal Health Coverage (UHC) which is still trailing due to its costly nature.

However, this means that there will be need for an amendment of the current NHIF Act to end the market-determined cost of medical services. Wambungu Kariuki, Head of Beneficiaries Management at NHIF said there are constant engagements between NHIF and MoH and it is possible to start price regulation (of medical services).

“The amended Act stipulates that the development of a benefits package will be done between NHIF and MoH and it is at the point of developing a benefits package that issues of pricing come in,” he told the Business Hub. Lack of price caps in the health sector has allowed medical providers to inflate costs and later seek reimbursement from the insurance companies, burdening them with costly compensation costs. The cost of healthcare has risen drastically since Covid-19 struck. Data from the Kenya National Bureau of Statistics (KNBS) shows that healthcare inflation has increased by 7.08 per cent since November 2020.

Insurance companies have always been quick to revise upwards their health coverage premiums whenever the cost of health rise. While this is an attempt of protect their capital, it always put insurance cover out of reach of many households.

“Kenyans need to sit down with the government, which we are part of, to actually regulate the cost of healthcare in the country so that even insurers can still be able to maintain their premiums at an affordable rate that will allow many Kenyans to enroll for health insurance with either NHIF or private sector,” added  Kariuki.

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