State reimburses Sh13.3b to medical institutions from NHIF deductions
The government paid State and private hospitals Sh13.3 billion between October and December last year as National Health Insurance Fund (NHIF) refunds, Health Cabinet Secretary Susan Nakhumicha (pictured) has said.
The Sh13.3 billion for 103,636 patients falls short by Sh1.6 billion of Sh14.9 billion approved for payments.
A document tabled before the National Assembly’ Health committee shows of the Sh13.3 billion paid out, Sh2.39 billion went to government hospitals though this is a shortfall of Sh894.4 million as the initial approved pay was Sh3.3billion.
Faith-based institutions were paid Sh2.2 billion out of an approved sum of Sh2.198 billion while private hospitals were paid Sh8.7 billion out of an approval of Sh9.4 billion.
Nakhumicha told the MPs the reimbursement is based on the availability of funds received from statutory deductions from the informal sector, government remittances for sponsored programmes and enhanced schemes premiums.
“Reimbursement of claims to hospitals is fully dependent on the availability of funds. Nevertheless, NHIF has continued to ensure a good balance in payouts to healthcare providers,” she said, adding that while the government providers account for 66.7 per cent of the total service providers and 22.03 per cent of total number of transactions, 17.95 per cent of the total payouts made in the first and second quarter of the financial year 2023/24, were made to government related facilities.
Capitation
She said in the third quarter of the 2023/24 financial year, Sh1.88 billion, Sh653 million and Sh360.7 million was paid to National, County government, and faith-based facilities, respectively, for capitation.
In addition, in the month of February this year, Sh238.8 million was paid out to National and County Government facilities out of a total of Sh321.2 million for the Linda Mama programme, she stated.
In the 2023/24 financial year, the total amount paid to all Nairobi county facilities stands at Sh3.3 billion.
Out of this, Sh2.986 billion was paid three national referral hospitals in Nairobi county, including Kenya National Hospital, Kenyatta University Teaching, Referral and Research Hospital (KUTRRH)) and Mathari Mental Hospital while Nairobi county facilities received a total of Sh326.4 million in the current financial year.
