SHA eases hospital cash strain with two-phase claims payment
The development follows persistent complaints from a section of health providers about payment delays, which they say have disrupted service delivery and led to operational setbacks, particularly among low-tier hospitals.
The Social Health Authority has outlined a two-stage payment plan for verified claims under Kenya’s new health insurance framework, offering reprieve to over 9,000 healthcare facilities that have endured mounting financial pressure due to delayed reimbursements.
In a statement issued on Monday, SHA Chief Executive Officer Mercy Mwangangi confirmed that payments for validated claims under the Primary Health Care Fund (PHCF) and the Social Health Insurance Fund (SHIF) would be disbursed in two phases on July 14 and July 21.
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“We wish to inform contracted Health Care Providers that reviewed and verified claims payments under Primary Health Care (PHC) and the Social Health Insurance Fund (SHIF) will be processed and disbursed on 14th and 21st July 2025,” Mwangangi stated.
The development follows persistent complaints from a section of health providers about payment delays, which they say have disrupted service delivery and led to operational setbacks, particularly among low-tier hospitals.
A recent survey conducted by the Rural and Urban Private Hospitals Association of Kenya (RUPHA) exposed the severity of the crisis.
According to the report, only 20 per cent of facilities under SHA’s PHC model had received their full monthly reimbursements.
It further revealed that 36 per cent had turned to borrowing to sustain operations, while 30 per cent faced possible loan defaults.
An additional 13 per cent were at risk of auction, 9 per cent were battling court cases from suppliers, and 1 per cent had already shut down.
The report also highlighted inconsistencies in payment timelines and transparency, with level 2 hospitals suffering the most delays and level 3 facilities expressing uncertainty over when payments would arrive.
Appearing before Parliament last week, Health Cabinet Secretary Aden Duale said that 9,365 healthcare facilities had so far been contracted under the SHA scheme.
These include 5,219 public hospitals, 3,650 private facilities, and 496 run by faith-based organisations.
Duale noted that these hospitals serve more than 6.2 million Kenyans under the PHCF and SHIF models.
The PHCF allows patients to access basic outpatient services for free, while SHIF covers more complex care such as imaging, cancer treatment, dialysis, and maternal services.
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