Private hospitals received more than half of payments disbursed from the Social Health Insurance Fund (Shif) in March 2025, signalling attempts by the State to mend fences with this category of healthcare providers after months of funding feuds.
Bank statements reviewed by the Business Daily show that a total of Sh4.57 billion was disbursed for 5,123 claims, which included faith-based, government, and private hospitals.
According to the March 24 statements, private hospitals received Sh2.6 billion, accounting for 57 percent of the total payments, reflecting the increasing reliance on private health facilities for medical services.
Government hospitals received Sh1.43 billion for 2,021 claims, while faith-based hospitals received the least with only Sh532.5 million for 405 claims.
The disparity in payments suggests that more patients are seeking treatment at private hospitals, which often offer faster services and specialised care.
However, the higher costs associated with private facilities raise concerns about affordability and access to healthcare for low-income patients.
The significant allocation to public hospitals indicates their continued importance in serving a large proportion of the population, particularly those who rely on public health services.
On the other hand, the lower disbursement to faith-based hospitals may reflect their smaller network or fewer claims processed during this period. Faith-based organisations are crucial to Kenya's health system, accounting for over 40 percent of health services nationwide.
Archbishop Philip Anyolo of the Diocese of Nairobi announced on Tuesday that all faith-based hospitals in the country may close due to unpaid debts to the Social Health Authority (SHA), saying that non-payment of outstanding bills is crippling hospitals and they can't continue to operate normally.
"It's clear that if they don't pay, there will be a shutdown. The church has a significant percentage of medical services that help the government and the people of Kenya," said Anyolo.
Last month, SHIF disbursed Sh5.1 billion, bringing the total disbursements to Sh18.29 billion since the scheme was launched in October 2024.
However, SHA, which oversees SHIF, has faced financial challenges due to low contribution rates. Of the 19 million Kenyans enrolled in the scheme, only about 3.3 million are actively contributing, leading to a cash shortfall.
As a result, some healthcare providers, particularly private hospitals, have reported delays and lower-than-expected payments, with many receiving less than Sh100,000 - an amount insufficient to cover operating costs and salaries.
From the statements, Kenyatta National Hospital (KNH) received the highest share of Sh72.25 million, followed closely by Kenyatta University Teaching and Research Hospital, which received Sh69.34 million, and Moi Teaching and Referral Hospital, which received Sh62.58 million.
Notable private and faith-based facilities that received significant funding include Lifecare Hospital-Eldoret Limited with Sh32.68 million and Tenwek Hospital Bomet with Sh34.89 million, although the majority of hospitals received less than Sh100,000.
The Rural and Urban Private Hospitals Association of Kenya (Rupha), which represents private and faith-based hospitals, has raised serious concerns about SHA payments.
In February, Rupha announced an indefinite suspension of services under the SHA, citing unpaid claims and an unsustainable reimbursement model.
The association stressed that the government's failure to clear Sh22 billion in arrears and address operational issues has jeopardised patient care and the sustainability of hospitals.
"Hospitals have lost staff, defaulted on loans, and faced shortages of drugs due to delayed payments. We will be closely monitoring the government's actions to ensure full implementation of its commitments," said Dr Brian Lishenga, Rupha chairperson.
Three weeks ago, the government announced that it would begin paying all historical claims, starting with those under Sh10 million, which cover about 91 percent of facilities. However, this agreement has yet to materialise. Facilities with claims above Sh10 million are now waiting about 70 days to receive their payments, as promised by the state.
Meanwhile, the Ministry of Health has introduced new accreditation guidelines, a standardised claims submission process, and a digital tracking system to streamline payments and improve the efficiency and transparency of SHIF payments.
