Private hospitals struggle to cover costs due to SHA cash delays

Almost all private hospitals (93.8 percent) are struggling to cover their operating costs, such as rent, electricity and housekeeping, due to payment delays by the Social Health Authority (SHA), which administers the new Social Health Insurance Fund (SHIF), the latest survey showed.

A report by the Kenya Rural and Urban Private Hospitals Association (Rupha) on payments made by the SHA to healthcare providers between October 28 and 31 also shows that 89.6 percent of facilities experienced difficulty in paying salaries and payments to providers, while 75 percent faced with shortages of basic necessities. , influencing patient care.

“The findings of the study show serious financial difficulties among health facilities in Kenya, primarily caused by delayed or insufficient payments from the SHA. Almost all businesses reported significant difficulties, particularly in meeting operating and payroll costs, maintaining supplies, and servicing debt obligations,” the survey report said.

“The delay in SHA payments, along with minimal coverage of outstanding claims, contributes to the precarious financial position of many health care providers,” it added.

According to the SHA portal, by the end of October, more than 2,598 health facilities had filed claims totaling more than Sh1.6 billion.

The portal also reports that private hospitals filed the highest amount of claims at Sh773 million, public hospitals at Sh674 million, religious hospitals at Sh204 million and community hospitals at Sh17,000.

The survey was conducted by Rupha between October 28 and October 31 to assess PPA payments to health care institutions and the financial health of these institutions.

The survey was distributed through various social media platforms, reaching private and religious health facilities across Kenya.

A total of 146 responses were received from 52 PHA offices across the country, providing insight into five key indicators related to ACC payments and the financial health of health care providers.

A whopping 99 percent of private hospitals (144 institutions) indicated that they were facing financial difficulties, with only two institutions reporting no problems.

“The high level of crisis is indicative of broader financial problems in the health sector, exacerbated by delayed and insufficient SHA payments,” the study said.

The majority of hospitals (68.9 percent) received payments that covered less than 10 percent of their outstanding claims, highlighting significant gaps in reimbursement.

Nearly 90 percent of facilities also experienced shortages of essential supplies, which directly impacted patient care.

Only about 1.5 percent of institutions reported receiving payments covering more than 60 percent of their outstanding claims, indicating that most payments are insufficient to meet accumulated financial obligations.

The data also shows that 50.8 percent of establishments received less than Sh100,000, which is often not enough to cover even basic operating and salary costs.

Brian Lishenga, chairman of Rupha, said the results show severe financial difficulties among health facilities in Kenya, mainly due to late or insufficient payments from the SHA.

“Resolving these issues is essential to ensure continuity of quality healthcare services in the country,” the official said.

Under the SHIF plan, Kenyan formal sector workers will receive 2.75 percent of their monthly gross wages from October 1, 2024, while households in the informal sector will relinquish a similar percentage of gross income.

Kenyans without a source of income are also forced to pay at least Sh300 every month to SHIF as the government aims to create a huge pool of funds to fund universal healthcare.