This archive report was first published on 22 September 2021.
Sh3.8bn Dialysis Bill: A Growing Concern for NHIF ¶
Wednesday, September 22, 2021
The National Hospital Insurance Fund (NHIF) has seen a significant increase in payments for renal dialysis over the past four years, with the fund paying Sh3.844 billion for 295,563 claims in the year to June.
This represents a 208 percent jump from Sh1.247 billion the NHIF paid for dialysis in the year to June 2017.
According to NHIF chief executive Peter Kamunyo, a significant number of kidney patients joined the fund after falling ill, leading to a scenario known as adverse selection in insurance terms.
Adverse selection refers to situations where an insurance company extends coverage to an applicant whose actual risk is substantially higher than the risk known by the insurance company.
The NHIF collected Sh61.5 billion in the year ended June and paid out Sh54.6 billion or 88.7 percent as claims to hospitals.
Mr Kamunyo said a significant number of active voluntary contributors are suffering from chronic diseases, leaving the fund with huge monthly claims.
Voluntary contributors — usually drawn from the informal sector — pay Sh500 a month to the NHIF while those in the formal sector contribute between Sh150 and Sh1,700 every month, depending on salary scale.
The government-backed NHIF (Amendment) Bill seeks to make it compulsory for every Kenyan above 18 years to contribute and be a member of the fund.
The proposed law, which is currently before Parliament, targets more than 16 million adult Kenyans who are not covered by the NHIF.
