NHIF Bills Dropped By 7 Billion Shillings Over COVID-19

The National Hospital Insurance Fund said that Kenyans spent less on medical bills in the financial year 2020 compared to a similar period in 2019, as patients avoided hospitals over the fear of contracting COVID-19.

According to the NHIF, the decline was a result of the “impact of COVID-19, as job losses may have seen a reduction on premiums contribution”, following the inability to raise funds by Kenyans due to limited income.

The NHIF also added that government restrictions like a ban on international flights were also of great effect since it disorganized the surgical and oncology procedures patients had been accustomed to mostly in India.

“On the utilization of the benefits, there was a definite decline for all benefits in March and April. This however started correcting in June when most providers resumed services fully. Overseas treatment had a definite drop due to restricted travels,” NHIF said

The agency also notes that the COVID-19 pandemic slowed down admissions in the last quarter of the financial year (March-June), since hospitals were overwhelmed by COVID-19 patients which affected admission of patients with other illnesses.

Data indicated that the National Hospital Insurance Fund spent Sh13 billion on bills compared to Sh20 billion last year, a 35 percent drop, as maternity services and surgeries topped payments.

Between March and June, Kenyans seeking CT Scan and ultrasound services, cesarean delivery, chemotherapy, and radiotherapy dropped by 38 percent, according to the NHIF

The data also showed that only 13.42 billion cases were treated through NHIF payments in the three months compared to 21.72 billion in the first three months of the year.

NHIF Spending During The COVID-19 Period

Minor surgeries

On surgeries, NHIF paid out Sh6.82 billion to hospitals, compared to Sh5.6 billion in 2018.

About Sh5.22 billion was spent on major surgeries, with specialized procedures costing Sh957.80 million. Minor surgeries cost the public insurer 548.8 million. Maternity services took about Sh3.52 billion, compared to Sh2.78 billion in 2018.

Cesarean section saw its biggest growth by 37 percent to Sh1.52 billion from Sh1.15 billion, while Sh2.02 billion was pumped in normal deliveries, up from Sh1.67 billion in 2018.

Chemotherapy

NHIF spent Sh331.9 million on specialized diagnostic tests, which included MRI, CT scan, and ultrasound, while renal hemodialysis took Sh1.81 billion, a 28 percent increase from Sh1.41 billion. The insurer pumped Sh41.5 million into kidney transplants, up from Sh38.5 million in 2018.

On cancer, the insurer spent Sh827 million on oncology, which included chemotherapy and radiotherapy, up from Sh577 million.

Chemotherapy complex was the highest-paid tab under this segment, increasing by 44 percent, with Sh525.09 million paid out to hospitals, up from Sh364.08 million.

Normal chemotherapy costs also shot up by 41 percent to Sh210.83 million, up from Sh149.75 million, while radiotherapy rose by 42 percent to 92.06 million, from Sh64.9 million.

Optical and dental services accounted for Sh1.7 million and Sh3.8 million respectively.