Benefit package

The accreditation criteria and rebates to hospitals have been addressed in the current strategic plan. In the past, we've has seen health care providers automatically raising their charges once the NHIF rebates are adjusted upwards. To address this, the NHIF has been strengthening mechanisms to facilitate quality services to beneficiaries at the accredited providers. The accredited providers are being reassessed and contracted on a continuous basis for purposes of NHIF benefits.

Internal restructuring

Towards embracing a competitive business culture and practices, new divisions of Public Relations and Marketing were introduced in the 1990s to address the issues of corporate communications, customer care and the Fund’s corporate image. The quality assurance function was introduced in 2002, giving the Fund the necessary capacity to conduct clinical audits on presented claims and facilitate quality services by all the accredited facilities. A prosecution unit has also been established to address employers defaulting on remittance of member’s contributions.

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 23 fully-fledged branches, 7 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.

Cost Containment

The Fund has introduced the concept of cost center accounting and zero-based budgeting allowing managers to spend within the planned budget. This has enabled administrative costs to be reduced and enhanced line manager’s accountability.

Member database

It is estimated that the Fund has about 1.5 million contributors with about 6 million dependants. The Fund is in the process of converting these into individual account holders and issue them with photo cards. The photo cards will enhance service provision and help curb fraud. In addition, the database is updated using electronic downloading of payroll information on a monthly basis.

Corporate Image

The Fund inherits a history of being perceived as an inefficient organization, which has necessitated corporate reengineering process to bolster its past image. Customer service and corporate social responsibility are some of the programmes developed and actualized to this end.

Service Accessibility

Expansion of branch network remains a priority and a challenge as a way of getting services closer to the people.

Performance Management

The Fund has been put into performance management mode as required by the ongoing government reforms.