EDITORIAL: Pending NHIF claims risk rural healthcare services

Rural private hospital operators have run out patience in their push to have the National Hospital Insurance Fund (NHIF) pay up Sh5.7 billion in accumulated claims.

According to the Rural Private Hospitals Association of Kenya, they submitted their bills a year ago through the insurer’s e-claims system, which collapsed in August last year.

Rural-based hospitals play a critical role in the provision of healthcare to the masses. We urge the NHIF to review the claims and pay without undue delay.

The hospitals cited cash flow hitches in their operations due to the delayed payments. This comes at a very critical moment when Kenya is grappling with Covid-19 pandemic.

Medical facilities, both public and private, are stretched and are operating on limited resources.

The issue becomes critical, especially in places without public facilities. The facilities play a complementary role to ensure Kenyans access to quality healthcare. However, the institutions are starved of cash that is necessary for them to buy essential medical supplies and meet other operational expenses as well as pay health workers’ salaries.

The NHIF payout would be critical to ensure the survival of the facilities. In a worst-case scenario, their collapse would not bode well for health service delivery.

According to official data, member contributions to NHIF grew 22.0 per cent to Sh58.0 billion while payouts to hospitals rose by 36.8 per cent to Sh53.4 billion.

Some members, especially the voluntary contributor, have defaulted on premiums amid layoffs and unpaid leave.

Understandably, the NHIF may also have a crisis of its own, but it should vet and validate the claims and settle genuine ones to enable the hospitals to operate optimally. Besides, the failure to pay the bills as well as compromised service delivery might further hurt not only the hospitals but also make members lose confidence in the insurers and make a bad situation worse.