The National Health Insurance Fund (NHIF) has opened a search for a new provider for road accident evacuation services amid concerns about low uptake with the current contractor.
The state-owned insurer currently holds an evacuation contract with Emergency Plus Medical Services (E-Plus) that runs until September 30.
The deal earns the provider over Sh1 billion in capitation annually, regardless of the number of evacuations it undertakes.
An actuarial study found the Kenya Red Cross Society-linked firm handled 2,971 road evacuations in the financial year to June 2022, pointing to low utilisation of the service among active NHIF members.
“The service provider should have access to ambulances equipped with trauma equipment, advanced life supports medical supplies and drugs to allow professional ICU patient transport,” said NHIF in a notice calling for interested providers to submit their applications by June 14.
The road ambulance services are one of the 10 benefits offered under the Universal Health Coverage (UHC) Supa Cover and enhanced medical schemes and are accessible to all NHIF – part of the emergency road evacuation benefit package.
The benefit was initially available only to civil servants and members of the disciplined forces through the comprehensive medical scheme in the financial year 2013/2014.
It has since been extended to all other schemes including secondary school medical cover dubbed Edu Afya and the National Health Scheme.
Under the deal, the NHIF deducts Sh16.5 per month from its active members and remits to E-Plus, translating to Sh198 per member per year.
The actuaries in the Road Evacuation Utilisation Report found that the low uptake of emergency road evacuation service was due to a lack of awareness of its existence among NHIF members.
Contract with E-Plus was renewed for the third time on 30 December 2022, amid revelations that the Funds Board had directed the Directorate Beneficiary and Provider Management to explore other options available.
NHIF renewed the contract for a further one year to 30 September 2023 with a membership varied capitation of 6.99 million principal members translating to a contractual obligation amounting to Sh1 billion.
