The restructuring of the National Hospital Insurance Fund is likely to start in June this year after a panel of experts appointed to lead the reforms presents its report.
It is expected that the NHIF reforms will be completed by the end of the year when the Universal Health Coverage will be rolled out nationally.
The experts have collected views for 45 days. They will present an action plan to transform and reposition the fund to lead the UHC.
Last year, the national health insurer raised Sh48 billion, mainly from premiums. It will handle more than Sh200 billion annually when the UHC is rolled out.
"We want to increase the institution's capacity to prevent current flaws as we move into UHC," James Wambugu, an insurance expert who chairs the panel, told journalists in Nairobi yesterday.
Wambugu said they will hold public participation forums across the country before June.
He said the small contributors (Sh500 monthly) will also be represented in the NHIF board.
The panel will also address the inequalities in the payout. Currently, private hospitals receive the bulk of NHIF payout compared to public facilities.
"We want to ensure there is equitable distribution and quality," Wambugu said.
Last year, the fund paid hospitals Sh12.3 billion for 637,066 in-patient claims. This was the largest payout, followed by Sh5.7 billion for 59,313 claims for major surgeries. Normal deliveries followed at Sh1.9 billion payout for 304,599 claims.
Panel member Edwine Barasa said NHIF covers only 20 per cent of Kenya's population because the majority cannot afford the premiums.
"If you want poor people to make contributions monthly they will never be able to benefit from UHC," Barasa said.
