The National Hospital Insurance Fund (NHIF) is set to collect Sh3 billion monthly from June amid complaints that leading hospitals turn away private sector workers seeking outpatient medical services.
The projections by the national insurer are pegged on the growth in membership following the introduction of a new package which includes outpatient cover and a stand-alone cover for patients with chronic diseases such as cancer and kidney failure.
The NHIF will now pay Sh25,000 per session for chemotherapy, Sh18,000 for radiology and Sh500,000 for a kidney transplant.
NHIF chief executive Simeon ole Kirgotty Thursday told the National Assembly Committee on Health that the medical scheme has registered 5.9 million members.
“This translates to 23.4 million Kenyans if we include dependants. We therefore project to collect Sh3 billion in June,” he said.
Mr Kirgotty was briefing the MPs on the progress made so far following a review of monthly contributions to the medical scheme introduced last year.
He said Kenyans prefer accessing medical care at private hospitals than government and mission hospitals.
“A survey carried out in December 2015 indicated that 67 per cent of Kenyans opted for services at private NHIF accredited facilities, 16 per cent at government hospitals and 17 per cent mission hospitals,” said Mr Kirgotty.
He said there was a significant growth in outpatient numbers and a decline in inpatient numbers.
To date, major private hospitals such as Aga Khan, Nairobi and Mater have rejected the NHIF medical scheme, maintaining that capitation levels are too low.
St Marys Mission Hospital, in Nairobi, Thursday defended its decision to reject the scheme saying it does not make business sense.
“Given that we are a self-sustained institution, we cannot afford to have post pay capitation arrangements,” said Bryann Nyangeri, the managing director.