Mohamud Ali, the National Hospital Insurance Fund chairman. PHOTO | FILE
What you need to know:
The National Hospital Insurance Fund will direct a portion of contributors’ monthly deductions to the fund to meet their medical costs.
NHIF chairman Mohamud Ali said the board will meet this month to decide how much the fund will hold and the facilities to provide services in the 47 counties.
This will come as a big relief for contributors who cannot access treatment for chronic diseases under the health insurer’s enhanced medical scheme.
The National Hospital Insurance Fund (NHIF) plans a new fund to finance outpatient treatment for chronic diseases like cancer, diabetes, kidney failure and hypertension in public and private hospitals.
NHIF chairman Mohamud Ali said the agency will direct a portion of contributors’ monthly deductions to the fund to meet their medical costs.
This will come as a big relief for millions of contributors who cannot access treatment for chronic diseases under the health insurer’s enhanced medical scheme.
“NHIF should provide Kenyans with the cover for chronic diseases by year end,” Mr Ali told the Business Daily.
He said the board will meet this month to decide how much the fund will hold and the facilities to provide services in the 47 counties.
Workers’ monthly contributions to the NHIF in April increased from Sh320 up to a maximum of Sh1,700 based on their pay. This enabled the health insurer to introduce outpatient services on top of in-patient care which was already running.
But the medical cover has been limited to basic ailments like malaria, cuts and burns, pneumonia and typhoid while excluding chronic diseases.
This exclusion is against the government’s promise to cover every disease at both public and private facilities, which was part of the reason for the steep increase in monthly contributions. Mr Mohamud said the fund collects about Sh1.9 billion per month.
Private hospitals have, however, rejected the Sh1,200 cash allocation that the NHIF has offered to pay as annual fee (capitation) for every beneficiary, saying it is too little.
This has confined contributors to medical care in public hospitals since the rollout of the enhanced scheme on July 1.
Under the scheme, NHIF pays Sh1,200 annually to a facility that the contributor and his family have chosen and where they are given access to services without cost limits.
This removal of cost limits favours low-income households who are often hard-pressed to raise cash for emergency treatment.
Kenya Association of Private Hospitals (Kaph) officials — representing over 400 small and mid-sized private hospitals, did not respond to our calls as well as the Kenya Associations of Hospitals officials representing top tier hospitals like Nairobi Hospital, Aga Khan, Mater and MP Shah.
Most households prefer medical care at the better equipped private hospitals, but most cannot afford the high charges in a country beset with rampant poverty and unemployment.
Kenyan poor homes are often hard-pressed to raise cash for treatment of chronic diseases at private hospitals, with many crowding the few cheaper public facilities.
In March, for instance, more than 1,000 cancer patients were on the waiting list at Kenyatta National Hospital (KNH) in Nairobi for radiotherapy treatment with some booked up to 2017.
KNH, the country’s foremost public referral facility, charges Sh500 per session of radiotherapy while private hospitals like MP Shah, Aga Khan and Nairobi hospitals charge about Sh10,000.
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