The Government through the National Hospital Insurance Fund (NHIF) has launched a Benefit Package for the 2022/2024 contracting cycle, which seeks to enhance the NHIF’s capacity to effectively deliver on its mandate on the national rollout of the Universal Health Coverage (UHC).
This is after the Ministry of Health commissioned Health Financing Reforms Expert Panel (HEFREP) to transform and position NHIF as a Strategic Purchaser of Health Services to attain UHC.
NHIF implemented several reforms to improve operational efficiencies such as the element of access of services, the amendment of the NHIF Act to accommodate the changing healthcare ecosystems dynamics and lobby for the push of the contracting cycle to 1st July 2022 to allow Stakeholder engagement, which include the change of its name from National Hospital Insurance Fund to National Health Insurance Fund.
Speaking on Thursday evening during the launch at the NHIF building headquarters in Nairobi, Health Cabinet Secretary Mutahi Kagwe said that to improve strategic purchasing, NHIF is required to identify the interventions or services to be purchased, considering the needs of Kenyans, national health priorities and cost-effectiveness.
Kagwe noted that the new contracts accommodate the concerns of Kenyans and accredited hospitals for standardization of reimbursement rates across all Healthcare Proxies (HCPs), as per the Kenya Essential Package for Health (KEPH) Levels of care.
“The strategic standardization of hospital contracts is critical to increase quality of care, efficiency and productivity, which is critical for the implementation of UHC in our country,” he said.
The CS stated that contracts will be either comprehensive, where the members will walk in and walk out without paying or non-comprehensive, where if a member chooses to go to a facility, then they would top up.
Kagwe added that initial government and faith-based hospitals have comprehensive contracts, while the private hospitals have a non-comprehensive contract.
“Members will access services in more than 7,600 healthcare facilities spread across the country of which 80 per cent are comprehensively contracted,” the CS emphasized.
He disclosed that the other expanded scope in this contract include Medical Outpatient cover, Oncology Benefit which has been expanded to include bone scans and radionuclide therapy, Surgical Benefit package that has been doubled and also the enhancement of Mental and Behavioral Health benefits package.
Kagwe added that Dialysis is covered comprehensively in over 50 healthcare providers countrywide and that radiology/medical imaging benefit has been enhanced to include access to mammography, fluoroscopy, ECHOs, EEGs and specialized ultrasound imaging for all beneficiaries, which will support the Government and public health intervention towards early diagnosis and early optimized management.
“The Ministry of Health, NHIF and hospitals have since then held extensive stakeholder engagements on strategic purchasing to ensure Kenyans access healthcare without suffering financial hardships,” the CS maintained.
To implement the new benefit package, Kagwe revealed that all NHIF empaneled healthcare providers will be issued with fresh contracts commencing on 1st July 2022 on a 2-year contracting cycle.
He thanked all health industry stakeholders who continue working together in promoting sustainable healthcare to keep Kenyans healthy.
By Sammy Macharia