Top private hospitals missing from NHIF provider list
Patients wait to be attended to at the Nyeri General Hospital. The NHIF has released a list of 1,128 hospitals to serve its members. PHOTO | FILE
What you need to know:
The NHIF list does not include the country’s top hospitals like Nairobi, Aga Khan, Mater, MP Shah and Gertrude’s.
The NHIF appears to have yielded to pressure from the top hospitals who accused the public health insurer of including them in a list of service providers in May 19, before concluding negotiations.
Top private hospitals are missing from the list of providers that the National Hospital Insurance Fund (NHIF) published on Monday for its outpatient services, a pointer that they have failed to strike a deal with the public health insurer.
The NHIF published a list of more than 1,128, private and faith-based health service providers in a section of the press designating them as the “accredited facilities that have the capacity to serve beneficiaries on the enhanced cover.”
The list does not include the country’s top hospitals like Nairobi, Aga Khan, Mater, MP Shah and Gertrude’s.
The fund had hoped to entice its members, whose monthly contribution were increased from Sh320 up to Sh1,700, with the promise of enhanced benefits in premium facilities.
The NHIF appears to have yielded to pressure from the top hospitals who accused the public health insurer of including them in a list of service providers in May 19, before concluding negotiations. The May 19 list had more than 1,500 hospitals.
The introduction of outpatient services will start on July 1, despite the fund having started collecting the higher contributions in April.
John Nyaumah, the chairman of the Kenya Association of Private Hospitals (Kaph), on Monday maintained that the latest NHIF list was still tentative.
Mr Nyaumah said NHIF has not concluded negotiations with the bulk of its members for provision of outpatient services under the new scheme.
“I am reliably informed that no conclusive agreement has been reached hence my assessment that the newly-published list is simply meant to calm the public down and show that something is happening,” said Mr Nyaumah.
“The technical committee which we are part of has met a couple of times. Another meeting is scheduled for some time next week.”
The Business Daily was unable to reach NHIF chairman Mohamud Ali and chief executive Simeon ole Kirgotty for comment.
NHIF members earning between Sh50,000 and Sh59,999 in April started remitting Sh1,200 to the enhanced benefits scheme while the self-employed are paying Sh500 up from Sh160 a month.
Workers earning Sh5,999 and below now pay Sh150 to the fund while those paid Sh100,000 and above remit the highest amount of Sh1,700, a 431 per cent increment.
The NHIF has since said it had collected Sh1.5 billion against a target of Sh2.3 billion in May and that the money is being accumulated before it is given to hospitals chosen by contributors.
The high and low-end private hospitals, which most Kenyans prefer because they are better equipped, need to negotiate a co-payment or bill sharing structure with the NHIF.
The new outpatient cover is expected to offer services like general consultation, treatment of sexually transmitted diseases, renal dialysis, x-rays and minor surgical procedures.
The NHIF has until now been providing inpatient cover to workers and is using the new outpatient services to fend off opposition to the higher monthly contributions.
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