Private hospitals across Kenya have announced that they will now require cash payments from patients under the Social Health Authority (SHA) due to delayed reimbursements that have left facilities struggling to operate.
The directive, issued by the Rural & Urban Private Hospitals Association of Kenya (RUPHA), came into effect on Monday, September 22. Patients with SHA coverage will be expected to pay upfront for healthcare services unless otherwise stated.
“Effective today, all healthcare services for SHA beneficiaries will be provided on a cash basis,” RUPHA stated, apologizing for the inconvenience while stressing the move is necessary to keep hospitals open and ensure availability of essential supplies.
Brian Lishenga, RUPHA chairperson, warned that private hospitals could collapse unless the government clears pending bills. He explained that the sector faces Ksh 76 billion in unpaid claims, with Ksh 33 billion owed by NHIF and Ksh 43 billion by SHA.
Lishenga added that failure to settle the debts could force hospitals to operate entirely on a cash basis by December, putting millions of Kenyans who rely on private healthcare at risk.
The dispute comes less than a year after SHA replaced the defunct NHIF in October 2024 as part of reforms to improve universal health coverage. Delayed claim processing and mounting arrears have, however, drawn criticism from healthcare providers.
Private hospitals argue that without timely payments, they cannot pay staff, restock essential drugs, or maintain equipment, jeopardizing patient care.
The Ministry of Health has not responded to the RUPHA directive, raising concerns about the program’s sustainability and public confidence in SHA.
Patients holding valid SHA cards may now be required to pay cash, signaling a growing crisis in Kenya’s healthcare financing system.
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