Nearly all private hospitals (93.8 percent) are struggling to cover their operational costs such as rent, electricity, and housekeeping due to delayed payments by the Social Health Authority (SHA), that runs the new Social Health Insurance Fund (SHIF), the latest survey has shown.
A report by the Rural and Urban Private Hospitals Association of Kenya (Rupha) on payments made by SHA to healthcare providers between October 28 and 31, also shows that 89.6 percent of facilities struggled with payroll and supplier payments while 75 percent faced shortages in essential supplies, impacting patient care.
“The survey findings reveal severe financial distress among healthcare facilities in Kenya, primarily driven by delayed or insufficient payments from the SHA. Nearly all facilities reported substantial difficulties, particularly in covering operational and payroll expenses, maintaining supplies, and servicing debt obligations” the survey report said.
“The delayed SHA payments, along with minimal coverage of outstanding claims, are contributing to an unsustainable financial situation for many healthcare providers” it added.
According to information on SHA portal, by the end of October, over 2,598 health facilities had submitted claims totalling more than Sh1.6 billion.
The portal also reveals that private hospitals lodged the highest claim values at Sh773 million, public hospitals at Sh674 million, faith-based hospitals at Sh204 million, and community hospitals at Sh17,000.
The survey was conducted by Rupha between October 28 and 31, to assess payments to healthcare facilities by the SHA and the financial status of these facilities.
The survey was disseminated through various social media platforms, targeting private and faith-based healthcare facilities across Kenya.
A total of 146 responses from 52 SHA branches countrywide were received, providing insights into five key metrics related to SHA payments and the financial conditions of healthcare facilities.
A massive 99 percent of private hospitals (144 facilities) indicated they were facing financial distress, with only two facilities reporting no distress.
“The high level of distress is indicative of broader financial challenges across the healthcare sector, compounded by delayed and insufficient SHA payments,” the survey said.
The majority of hospitals, 68.9 percent, received payments that covered less than 10 percent of their outstanding claims, highlighting significant gaps in reimbursement.
Nearly 90 percent of facilities also faced shortages of essential supplies, directly affecting patient care.
Only about 1.5 percent of facilities reported receiving payments that covered more than 60 percent of their outstanding claims, demonstrating that most payments are insufficient to meet accumulated financial obligations.
The data also shows that 50.8 percent of facilities received less than Sh100,000, which is often insufficient to cover even basic operating and salary costs.
Brian Lishenga, chairperson of Rupha, said the findings reveal severe financial distress among health facilities in Kenya, mainly due to late or insufficient payments from the SHA.
“Addressing these issues is essential to ensure the continuity of quality healthcare services in the country,” the official said.
Under the SHIF plan, Kenyan workers in the formal sector from October 1, 2024 part with 2.75 percent of their monthly gross pay while households in the informal sector will cede a similar percentage from the gross income.
Kenyans, with no source of income, are also compelled to pay at least sh300 every month to SHIF as the State targets a vast funding pool to finance universal healthcare.
