In line with NHIF Strategic Plan 2018-22, the Fund has continued to review benefit packages to members. In 2016, new packages were introduced after the review of monthly contribution rates. The current benefit packages are: Outpatient; Inpatient; Maternity Package; Renal Dialysis; Kidney Transplant; Radiology Package( MRI&CT Scan); Oncology Package (Cancer treatment – chemotherapy & Radiotherapy); Rehabilitation, Drug and Substance Abuse Package; Foreign Treatment package; Chronic Diseases (diabetes & Hypertension); Specialized Lab Tests; and Surgical Package (Minor, Major & Specialist).
Declaration and Contracting of new Healthcare Providers.
In an effort to speed up the declaration and contracting process of new healthcare providers (hcp) into the NHIF system, the Board (in 2016) suspended pre-assessment audits and accreditation fees. The healthcare providers applying for declaration now only need to fill an application form, attach their hospital registration papers and licenses from relevant government bodies authorizing their operations.
Internal Restructuring for improved service delivery
Towards embracing a competitive business culture and practices, the Board put in place, in 2015, new organization structure comprising four directorates, two heads of department and six regional offices to ensure proper coordination of all NHIF service points spread across all the 47 counties. The reorganization has seen creation of divisions of Communications & Public Education, and Marketing and Customer Service to address the issues of corporate communications, customer service, the Fund’s corporate image and continuous public education on NHIF programmes.
Computerization and Decentralization
NHIF operations have been computerized and decentralized, enhancing efficiency in settling claims and effective management of membership database. The Fund also increased its service accessibility through the current networked 63 fully-fledged branches, 35 satellite offices and service points at most district hospitals countrywide. The branches function independently to offer services similar to any other office across the country.
The Fund operates a zero-based budget allowing A-I-E Holders to spend within the planned budget. This has enabled administrative costs to be reduced and enhanced line A-I-E Holders accountability.
The Fund has about 6.3 million principal members/ contributors as at December 2016. This translates to a coverage of about 25 Million beneficiaries taking an average family size of four people.
Expansion of NHIF service points to 98 and 45 Huduma Centres across the country has ensured service delivery closer to the people. The Fund has developed a policy to guide this important exercise into the future.