Private hospitals warm up to NHIF civil servants deal

More reputable private hospitals have warmed up to providing medical cover under the NHIF outpatient civil servants scheme, despite being offered a lower capitation.

The Kenya Association of Private Hospitals (KAPH) on Thursday said that more than 200 of its members had agreed to offer treatment at the rate of Sh2,850 per patient.

READ: NHIF's medical scheme for civil servants returns profit

“KAPH has decided to go ahead with the lower figure of Sh2,850 even as we continue with discussions on the possibility of increasing this fee,” said KAPH’s national coordinator John Nyaumah.

KAPH had earlier this year cried foul over tendering for participation in the scheme and the capitation amounts offered. The Association had demanded Sh6,000 per patient.

KAPH members on the recently published list of about 600 hospitals include Nairobi’s Karen Hospital, Maria Nursing, and Metropolitan Hospital. Others are Makupa Hospital in Mombasa, and Elgon View Hospital in Eldoret.

Last month, KAPH vice chairman Kanyange Gakombe said that the capitation model preferred by NHIF instead of the fee for service model would cause wastage of funds and poor services.

On Thursday, however, the body said it fully supported the outpatient scheme as “the best answer to health provision in Kenya.”

The national medical scheme has been in the limelight over alleged fraud through payments to clinics that were either non-existent, had incompetent staff, or were poorly equipped.

Weeks of wrangles pitting the NHIF management, acting head of Civil Service Francis Kimemia, and Medical Services minister Anyang’ Nyong’o led President Kibaki to suspend the insurer’s board.

A caretaker committee, under Mr Adan A Adan, was appointed to run the fund for three months.

This was done as investigations into allegations of corruption over the Sh4.2 billion roll-out of the outpatient medical scheme for the 261,000 civil servants were initiated.

A parliamentary committee that investigated the scheme found that some outlets of Meridian and Clinix hospitals had either unregistered medical staff or that the clinics were altogether non-existent.

Capitation fees

NHIF is said to have paid Sh634.7 million to public and private health services providers who were identified to offer services in the first quarter of this year.