KEPSA hosted a follow up meeting after the Private Sector’s engagement with the Panel of Experts leading on the National Hospital Insurance Fund (NHIF) Transformation and Reform process on the 7th May 2019 at the KEPSA offices.
The purpose of the meeting was to harmonize the issues raised by Private Sector members who had met with the Panel independently to galvanize support for the propositions given.
It is hoped that as a result of the reform process, NHIF will transition into a strategic purchaser towards the attainments of Universal Health Coverage (UHC). The Panel was expected to come up with clear recommendations and action plan for implementation on proposed reforms including the review of past strategic recommendations.
Among the key issues that the private sector expected would be addressed to enable realization of UHC include:
- Multiple fees and charges which increase the cost of doing business and high operationalization cost which in turn affect the quality and affordability of healthcare raise sufficient revenue to finance the health systems;
- Regulatory burden due to conflicting legislation, bureaucracy, inconsistent charges;
- Limited health financing: health is generally under funded with 63% of total healthcare financing being donor funded;
- Counterfeits and irregular imports leading to unfair competition and negatively affects the quality of healthcare since the products are never inspected for quality;
- Fragmented data and poor sharing of health sector information sharing: This causes interoperability of data and research which would promote innovation and ease of providing healthcare services;
- Delayed accreditation and reimbursements by NHIF affecting delivery health care services;
- Exclusion of the poor in health insurance schemes- only 36% of Kenyans are insured making health them unable to afford healthcare; and
- Inefficiencies in revenue utilization.
These issues are directly linked to emerging issues that the Panel of Experts hope to address which include;
- How to purchase defined health services more efficiently and effectively;
- Improve accessibility and link purchasing to provision of quality services;
- How best to align proposed reforms and county priorities and functions in order to attain UHC; and
- The need to anchor reforms in law and strengthening the regulatory framework.
Based on the discussions held at the meeting, KEPSA members will be putting together a harmonized position paper to be presented to the Panel of Experts on 13th May 2019.