Kenya’s Social Health Authority Launches Provider Payment Reforms to Curb Fraud

The Social Health Authority (SHA) has implemented new capitation and performance-based payment models for hospitals and clinics to curb fraud and improve quality. Under the system, facilities receive fixed monthly payments per enrolled patient plus bonuses for meeting maternal and child health targets. Over 3,500 facilities are now on the system, with real-time claims verification via NHIF’s digital platform. Early results show a 40% drop in duplicate billing and 25% faster reimbursements. The SHA says the reforms ensure sustainability while expanding universal coverage to 20 million Kenyans by mid-2024.