Government Introduces New Payment Model for Primary Health Care
The Ministry of Health has introduced a new Primary Health Care (PHC) financing model to improve healthcare service delivery. Under this system, payments to health facilities will now be determined by the actual number of patients treated rather than insurance coverage. This ensures that funds are distributed based on healthcare needs, rather than a patient’s ability to pay for insurance.
In a statement released on Wednesday, March 5, the Ministry of Health described this shift as a significant milestone in the journey toward achieving Universal Health Coverage (UHC). The new model aims to remove financial barriers that have long prevented many Kenyans from accessing healthcare services.
How the New Model Differs from NHIF
Previously, under the National Health Insurance Fund (NHIF), payments to health facilities depended on whether a patient had an active insurance cover. This meant that only individuals who had paid their insurance premiums in advance could access medical services. As a result, many Kenyans who could not afford insurance coverage were left without essential healthcare.
In contrast, the new PHC model ensures that healthcare funding reaches the right places by prioritizing patient needs over insurance status. This means that every patient will receive medical care, and healthcare facilities will be reimbursed based on verified data showing the actual number of patients they have served.
Faster Payments and Dedicated Funding
To improve efficiency and ensure that healthcare facilities receive their funds on time, the government has significantly reduced the claims processing time from 90 days to just 30 days. This will allow hospitals and clinics to receive payments faster, ensuring they have the necessary resources to continue providing quality care.
Additionally, all PHC payments will now be deposited directly into accounts specifically designated for primary healthcare funding. This guarantees that the money will be used exclusively for essential health services, improving transparency and accountability in financial management.
Strengthening Financial Oversight
The Ministry of Health has also called on county governments to strengthen Facility Improvement Fund (FIF) committees. These committees will play a crucial role in managing healthcare funds effectively and ensuring that services are delivered efficiently. By enhancing financial oversight, the government aims to prevent mismanagement and ensure that resources benefit patients directly.
Primary Healthcare to Be Fully Tax-Funded
One of the most significant changes under this new model is that all primary healthcare services will now be fully funded by the government through tax revenue. This means that Kenyans will no longer have to pay out of pocket for basic healthcare services, making healthcare more accessible to everyone, regardless of their financial situation.
“With primary healthcare now fully tax-funded, no Kenyan will be denied access to essential medical services,” Health Cabinet Secretary Deborah Barasa announced on Wednesday.
A Move to Improve the Healthcare Sector
These changes come at a time when the Ministry of Health is working to reform and improve the healthcare sector. Many Kenyans have raised concerns about the quality of services in public hospitals, with some feeling that the system is failing them.
By shifting to a needs-based financing model, the government hopes to enhance service delivery, ensure fairness, and move closer to the goal of universal healthcare for all citizens.
Join Gen z and millennials TaskForce official 2025 WhatsApp Channel To Stay Updated On time the ongoing situation https://whatsapp.com/channel/0029VaWT5gSGufImU8R0DO30
