NHIF in fresh accreditation for health providers

 

Clinix Medicare Limited was one of the private healthcare providers that won a contract to offer NHIF outpatient services to public servants. Photo/FILE  NATION MEDIA GROUP

By MUTHOKI MUMO

The national medical insurer has adopted new quality assurance standards for health providers as it seeks to simplify evaluation process.

The National Hospital Insurance Fund (NHIF) on Tuesday said that it had domesticated the SafeCare set of international standards to which health providers, who want to receive rebates for serving its members, will have to comply.

NHIF’s accreditation process came into question last year following revelations that it had accredited some providers who did not have the required infrastructure or equipment.

“Aligning the NHIF’s accreditation system with SafeCare methodology will create a transparent evaluation system,” said NHIF chief executive, Mr Simeon Ole Kirgotty.

NHIF will implement the new standards through a Sh85 million ($1 million) partnership with the International Finance Corporation.

The standards will touch on a number of areas ranging from human resource management to infrastructure and equipment.

Mr Kirgotty said that the NHIF is targeting to transition all health providers in Kenya to the new system within three years.

“We are trying to encourage competition in the healthcare system so that everyone strives to achieve high standards. We will simply end partnerships with hospitals that do not meet these standards,” he said.

Last year, it came to light that NHIF had illegally accredited 77 health facilities that were not licensed by the Medical Practitioners and Dentist Board (MPDB).

Two facilities, Clinix and Meridian, were awarded the lion’s share of NHIF funds irregularly.

Mr Kirgotty noted that it will be difficult for many health facilities, especially those in the public sector, to meet the standards due lack of drugs and equipment.

Ministry of Health cabinet secretary, Mr James Macharia, said that the government was pursuing a plan to refurbish public health facilities across the country with an eye to bring them up to standard.

“We will carry an audit across the country to confirm which facilities require rehabilitation. Provisions for this initiative will most likely be included in the 2014/2015 budget,” said Mr Macharia.

In tightening its accreditation processes, NHIF is implementing recommendations of an independent report published by Deloitte in 2011.

The audit firm noted that NHIF needed to overhaul its accreditation and communication processes. Deloitte also made recommendations to change the procedure of appointing NHIF board members