NAIROBI, Kenya, Sep 28-The National Hospital Insurance Fund (NHIF) has said that it expects employers to remit the increased contribution rates beginning this month as earlier scheduled.
NHIF Corporate Strategy and Planning Manager Chacha Marwa said on Tuesday that they were already in the process of engaging over 3,100 private, mission and public health facilities that had applied to offer outpatient services.
He told Capital News in an interview that another 538 hospitals including private had applied to offer inpatient services using the new NHIF scheme.
“We shall now go and do the technical evaluations so that we can see which ones have the capacity to give our members the kind of services we want our members to get,” Mr Marwa said.
“For the outpatient, we are going to ask the facilities we contract to give unlimited medical services to our members without necessarily charging them more,” he added.
The requirement comes a day after the Industrial Court threw out a case challenging the legality of the new rates.
The Central Organisation for Trade Union (COTU) and Federation of Kenya Employers (FKE) had sought to block the new contributions.
He said that this would help NHIF cut down on the administrative costs to have less claims from the hospitals adding that this model has worked in other countries like the Philippines and United Kingdom.
“We will be allocating money to the health facilities based on the number of members who choose that particular facility each month,” he explained.
“But we will be monitoring to ensure that our members get value for money through patient satisfaction surveys.”
Mr Marwa said members would now choose which hospitals they would want to use on a monthly basis after a full list of the service providers is compiled.
“If you thought that the facility you went to the previous month was not satisfactory, you have the choice of changing to another facility within the scheme which means we redirect the money you have been using to the facility you have chosen,” he said.
“In terms of mobility we are working on how we can address that aspect of mobility where families live in different towns but in the initial stages we will have to restrict you to a particular hospital of your choice so long as it is within our list,” Mr Marwa added.
He said that members could choose the facility they wanted on the web, through Short text messages, swiping the card at the health facilities or any NHIF office.
At the same time, Mr Marwa said that employers were set to benefit from the new scheme that is to provide both inpatient and outpatient services.
He said that employers who had been finding it difficult to pay medical bills for their staff especially on chronic ailments for outpatient would benefit the most in the long term.
“Already there are a number of companies who have talked to us. One company was saying that they spend about Sh78 million annually on medical for their employees and they have calculated that with this new scheme they will be spending about Sh11 million and if they can bring the Sh11 million, they would rather give us that Sh11 million and we take care of their people than spend the Sh78 million.”
He however said that in future employers would be required to match the employees’ contribution and discussions were in process at the board level.
“Actually this is in the vision 2030 that Kenya is going to have a National Social Health Insurance Scheme where the employers and employees are paying. We would want to see it sooner because the sooner it comes, the more benefits members will get but then we will also have to be realistic and say that discussions sometimes take long,” Mr Marwa said in the interview.
Under the new rules, The NHIF has moved away from the Sh320 maximum contribution to a progressive rate of up to Sh2, 000.
The lowest contributor would now pay Sh150 which applies to those earning less than Sh6, 000, while the highest contributor will fork out Sh2,000 for those earning more than Sh100,000.
About The Author
