Nairobi — The Social Health Authority (SHA) paid Sh12.74 billion to healthcare providers in its May claims cycle, with the Social Health Insurance Fund (SHIF) accounting for Sh7.25 billion of the total disbursement.
The payments come as healthcare facilities continue to rely on reimbursements from the government's health financing schemes to fund operations, procure medicines and settle supplier obligations.
Data released by SHA shows that SHIF received the largest allocation at Sh7.25 billion, followed by the Primary Care Network and Older Persons and Severe Disabilities Medical Scheme Fund (POMSF) at Sh3.03 billion. The Primary Health Care (PHC) fund accounted for Sh2.02 billion, while the Emergency, Chronic and Critical Illness Fund (ECCIF) received Sh433 million.
"SHA has paid KES 12.741 billion to healthcare providers in this month's claims payment cycle."
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"SHIF KES 7.25 billion, POMSF KES 3.03 billion, PHC KES 2.02 billion and ECCIF KES 433 million."
The SHIF allocation represented about 57 percent of the total claims settled during the payment cycle, highlighting the fund's growing share in financing healthcare services under Kenya's new health insurance framework.
The latest payout comes amid continued scrutiny of Kenya's transition from the defunct NHIF to the Social Health Authority (SHA), with hospitals closely monitoring reimbursement timelines and claim settlements under the new system.
In March, SHA disbursed Sh11.1 billion to healthcare providers to clear approved claims under the SHIF.
The health financing system has also been handling growing claim volumes, particularly for chronic and critical illnesses.
Government figures indicate that more than 29 million Kenyans have enrolled under SHA, while over 10,000 public, private and faith-based health facilities are currently transacting under the scheme.
The transition, however, has faced challenges, including concerns from some healthcare providers over reimbursement delays, claims verification processes and the financial sustainability of the new health insurance framework.
The government has maintained that claims undergo clinical reviews, forensic audits and verification before payments are approved.
SHA has also intensified scrutiny of claims after authorities reported that billions of shillings in suspected fraudulent claims had been flagged and blocked through its digital claims management system.
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