Surge in kidney ailments increases NHIF payment for renal dialysis

KENYA- Cost for covering renal dialysis has more than tripled over the last four years, as NHIF paid a whooping Ksh. 3.8 billion to cover dialysis expenses, indicating the growth in kidney disease burden among Kenyan citizens.

The national social health insurer remitted 3.844 billion shillings 295,563 claims for patients who underwent renal dialysis procedures between June 2017 and June 2021 as soaring cases of chronic kidney diseases continue to burden the fund.

This represented a 208 percent increase from the Ksh. 1.247 billion the NHIF paid for hemodialysis in the same period in 2017.

The NHIF collected Ksh. 61.5 billion in the year ended June and paid out Ksh54.6 billion (88.7%) as claims to hospitals. NHIF health insurance has over 10 million principal contributors and covers a total of 25 million Kenyans.

The fund’s financial pool is also running low since it disclosed that 5.7 million members (54%) of 10.6 million principal contributors had stopped remitting their premiums at the end of last month after they had benefited from its services that attracted huge bills.

Chronic kidney disease is a pathological condition that hinders a person’s kidney such that it cannot purify the blood. This can lead to high blood pressure and severe infections.

An increase in morbid conditions linked to non-communicable diseases such as obesity and high blood pressure is attributed to relaxed vigilance on lifestyle habits, as seen in the consumption of large quantities of junk and refined sugary foodstuff.

On average, typical kidney dialysis in Kenya costs between 5,000 Ksh – 9,000 Ksh per session, depending on the type of dialysis you are going for.

NHIF members are eligible for two hemodialysis sessions per week at a cost of Ksh. 9,500, translating into an annual payment per patient covered to Ksh. 960,000.

Official MOH data show that 4 million Kenyans have chronic kidney ailments, with a significant proportion of this population progressing to kidney failure.

The Ministry of Health has set up 51 dialysis centres countrywide to ensure Kenyans receive dialysis services without traveling long distances to seek dialysis services.

This has increased the number of patients currently on hemodialysis by more than 10-fold.

NHIF chief executive officer Peter Kamunyo said that most patients with kidney ailments join the scheme after falling ill.

The annual average payment per principal contributor under this insurance coverage amounts to Ksh. 6,000, buy they receive benefits close to Ksh. 1 million per year as payment for their dialysis sessions. This poses a great burden to the NHIF scheme.

Unfortunately, a significant proportion of voluntary contributors have chronic ailments that drain the fund’s kitty owing to huge monthly claims.

The number of voluntary contributors has risen exponentially in recent years following nationwide mass recruitment drive.

Renal dialysis gobbled up much of NHIF’s medical bills expenditure (Ksh.3.8 billion), coming in third after inpatient services and major surgeries at Ksh. 7.43 billion and Ksh. 5.08 billion respectively.

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