Kenya’s private health providers have issued a dire warning over what they describe as unprecedented financial distress linked to unpaid claims by the Social Health Authority (SHA). The situation, they caution, threatens to cripple access to healthcare nationwide if not urgently addressed.
According to internal communications within the sector, the network of private and faith-based hospitals responsible for nearly 60 percent of medical care in the countrys on the brink of collapse due to ballooning debts inherited from the defunct National Health Insurance Fund (NHIF). The debts have continued to accumulate despite a presidential directive earlier this year that all NHIF arrears below Sh10 million be cleared.
Health providers report that the failure to honor these payments has left many facilities grappling with severe financial strain. Some have already resorted to closures, staff layoffs, and auctions of assets, while others are struggling to meet contractual obligations. Industry leaders warn that unless immediate action is taken, the quality of healthcare will deteriorate sharply, forcing millions of Kenyans into catastrophic out-of-pocket expenses.
The providers also point to growing hostility within the sector, citing unexplained rejection of claims and blanket accusations of fraud. This, they argue, has undermined trust and weakened investor confidence in Kenya’s healthcare system.
To mitigate the crisis, the federation of providers has proposed a set of measures. These include issuing default notices to patients whose insurance funds are not performing, requiring patients to sign liability undertakings, and intensifying engagement with lawmakers to demand accountability. They are also pushing for greater transparency from SHA on claim payments, collections, and the performance of its administered schemes. Additionally, they want the establishment of a clear appeals process for rejected claims to ensure fairness and efficiency.
In their statement, the providers emphasized that if SHA or any other health payer fails to settle claims, hospitals may have no option but to revert patients to cash payments before receiving treatment. Such a shift, they caution, would severely undermine universal health coverage and expose ordinary Kenyans to overwhelming financial risk.
Despite the challenges, private and faith-based hospitals affirmed their continued commitment to delivering essential healthcare, describing their role as “irreplaceable and indispensable” in the national health system. However, they stressed that without urgent government intervention, the entire sector faces the risk of collapse.
