Health Cabinet Secretary Susan Nakhumicha has revealed that between October and December last year, the government disbursed KES 13.3 billion to both state and private hospitals as refunds from the National Health Insurance Fund (NHIF).
However, this amount, intended for 103,636 patients, falls short of the approved payment of KES 14.9 billion by KES 1.6 billion.
A document tabled before the National Assembly’ Health committee shows of the KES 13.3 billion paid out, KES 2.39 billion went to government hospitals though this is a shortfall of KES 894.4 million as the initial approved pay was KES 3.3billion.
Faith-based institutions were paid KES 2.2 billion out of an approved sum of KES 2.198 billion while private hospitals were paid KES 8.7 billion out of an approval of KES 9.4 billion.
Nakhumicha informed the Members of Parliament that the reimbursement is contingent upon the funds obtained from statutory deductions from the informal sector, government contributions for sponsored programs, and increased scheme premiums.
“Reimbursement of claims to hospitals is fully dependent on the availability of funds. Nevertheless, NHIF has continued to ensure a good balance in pay-outs to healthcare providers,” she said, adding that while the government providers account for 66.7 per cent of the total service providers and 22.03 per cent of total number of transactions, 17.95 per cent of the total pay outs made in the first and second quarter of the financial year 2023/24, were made to government related facilities.
During the third quarter of the 2023/24 financial year, Nakhumicha disclosed that Sh1.88 billion, Sh653 million, and Sh360.7 million were disbursed to National, County government, and faith-based facilities, respectively, for capitation.
Furthermore, she mentioned that in February of the current year, Sh238.8 million was distributed to National and County Government facilities as part of the total Sh321.2 million allocated for the Linda Mama program.
For the 2023/24 financial year, the cumulative payment to all facilities in Nairobi county amounts to KES 3.3 billion.
Among this, KES 2.986 billion was directed to three national referral hospitals in Nairobi county, which include Kenya National Hospital, Kenyatta University Teaching, Referral and Research Hospital (KUTRRH), and Mathari Mental Hospital. Meanwhile, Nairobi county facilities received a total of KES 326.4 million in the ongoing financial year.
