Reprieve for patients as hospitals and NHIF ink deal

Friday, July 1st, 2022 08:40 | By
NHIF faces more change towards universal health coverage gain
National Hospital Insurance Fund headquarters on Ngong Road, Nairobi. Photo/PD/FILE

National Hospital Insurance Fund (NHIF) yesterday renewed its reimbursement contracts with private and faith-based hospitals after months of push-and-pull giving the Universal Health Coverage (UHC) a new lease of life.

To accelerate the national rollout of the UHC, the government is depending on a balanced working relationship between the country’s health insurers and hospitals; both public and private. The signing of new contracts presided over by Health Cabinet Secretary, Mutahi Kagwe at the NHIF boardroom will commence today, and will be in effect for 2 years.

“Thus, the contracts will be either comprehensive — where the members will walk in and out without paying — or non-comprehensive whereby if a member chooses to go to a facility, then they would top up,” the CS said, noting that the new contracts will accommodate the concerns of Kenyans and accredited hospitals through three core benefit packages and affiliated aspects.

Initially, the government and faith-based hospitals had comprehensive contracts, while the private hospitals have non-comprehensive contracts.

One of the key features of the contracts is a standardised reimbursement rate across all healthcare providers as per the Kenya Essential Package for Health levels of care.

In the new move which the CS described as a win-win for both the hospitals and the patients, the medical outpatient has been enhanced to cover seven categories of essential basic lab tests, payment model risk-adjusted for the five most common non-communicable diseases.

“I urge Kenyans to register for NHIF so as to access health services in 7,600 accredited facilities countrywide,” NHIF Board chair, Lewis Nguyai said.

Kenya Association of Private Hospitals chairman Abdi Mohamed welcomed the move by NHIF to comprehensively cover dialysis services without co-payment from patients.

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