NAIROBI, Kenya– Private hospitals have given the government two weeks to clear mounting arrears totaling Sh76 billion, warning that delayed reimbursements from the defunct National Hospital Insurance Fund (NHIF) and its successor, the Social Health Authority (SHA), have placed the sector on the brink of collapse.
The Rural Private Hospitals Association of Kenya (RUPHA) says providers are in “severe financial distress” as claims continue to pile up against shrinking disbursements.
“As of end of August 2025, healthcare providers had submitted Sh96.2 billion in claims. SHA has only paid Sh53 billion, leaving an outstanding obligation of Sh43 billion,” RUPHA noted.
The shortfall has particularly hit lower-level facilities, where reimbursement ratios for inpatient and surgical cases have dropped to between 10 and 20 percent.
Primary healthcare payments have also stalled in several counties despite rising outpatient visits.
RUPHA argues that SHA’s funding model is unsustainable, citing a financing gap of up to Sh3.5 billion every month.
The association faulted the rollout of mass registration campaigns without adequate contributions, saying hospitals are now “flooded by patients while facilities lack medicines, staff, and operating cash flow.”
Legacy debts from NHIF, estimated at Sh33 billion, have further strained operations.
The biggest unpaid claims are owed to Kenyatta National Hospital (Sh1.58 billion), Moi Teaching and Referral Hospital (Sh1.23 billion), and Kenyatta University Teaching, Referral and Research Hospital (Sh540 million).
The group also accused SHA of routinely rejecting valid claims without following contractual timelines, calling for a tribunal to handle disputes and an end to arbitrary suspension and downgrading of facilities.
Unless at least half of SHA’s Sh43 billion liability is cleared within the 14-day window, RUPHA says hospitals will be forced to scale down services, disrupting patient care across the country.
