Private hospitals across the country will now require cash payments from patients covered by the Social Health Authority (SHA), following a directive by the Rural & Urban Private Hospitals Association of Kenya (RUPHA).
In a notice issued on Sunday, RUPHA said the move, effective Monday, September 22, was prompted by delayed and unsettled payments from SHA, which it said had made it unsustainable for hospitals to continue offering services on credit.
“Effective today, all healthcare services (unless otherwise stated) at this facility for Social Health Authority (SHA) beneficiaries will be provided on a cash basis,” the notice stated.
The association, which represents private hospitals nationwide, explained that the decision was necessary to ensure facilities remain open, essential supplies are available, and staff can continue serving patients.
The association further emphasized that while the move may inconvenience many patients, it was a step taken in the interest of sustainability.
“We regret the inconvenience this may cause and assure you that this action is driven by our commitment to ensure that hospitals remain open, essential supplies and equipment are available, and our staff can continue to serve you with the highest standards of care,” the notice added.
Delays in processing hospital claims have been a major concern among healthcare providers since the SHA began operations in October 2024, replacing the National Health Insurance Fund (NHIF).
Private hospitals argue that despite serving thousands of patients under SHA, payments have been slow and sometimes incomplete, making it difficult for them to meet their daily operational needs.
Hospitals rely on timely payments to purchase drugs, pay staff salaries, and maintain essential equipment, and when these funds are delayed, the burden falls back on the facilities.
The replacement of NHIF with SHA had been expected to streamline healthcare financing in the country. However, complaints from providers suggest that challenges have only grown in recent months. Many hospitals say they have been forced to run into debt or cut down on services due to the accumulation of unpaid claims.
This situation, according to RUPHA, is what pushed them to take the drastic step of demanding cash payments from SHA beneficiaries until the matter is resolved.
The decision is expected to affect thousands of patients who depend on private hospitals for treatment. Many Kenyans prefer private facilities due to shorter waiting times and wider access to specialized services.
With the new directive, patients covered under SHA will now need to pay out of pocket and later seek reimbursement, a process that may discourage some from seeking care when needed.
RUPHA has called on SHA to act urgently and address the backlog of claims so that hospitals can continue working with them without disruption. The association maintained that private hospitals remain committed to serving patients but cannot do so effectively if financial challenges persist.
Until then, hospitals will only serve SHA patients on a cash basis to protect their ability to keep doors open and ensure quality healthcare is not compromised.
