The Social Health Authority (SHA) has started preparations for a new contracting cycle for healthcare providers and facilities, with the new arrangements expected to take effect on October 1, 2026.
The new contracts will remain in force until June 30, 2029, and will set out the terms under which hospitals, clinics and other healthcare providers will offer services under the government’s health insurance programme.
SHA has developed four separate contracts covering the Primary Health Care Fund (PHCF), Social Health Insurance Fund (SHIF), Emergency, Chronic and Critical Illness Fund (ECCIF), and the Public Officers Medical Scheme Fund (POMSF).
The PHCF agreement will outline the responsibilities of facilities providing primary healthcare services under the fund.
The SHIF contract will cover providers offering services under the Social Health Insurance Fund, while the ECCIF agreement will apply to facilities handling emergency, chronic and critical illness services.
The fourth contract will govern the participation of healthcare providers in the Public Officers Medical Scheme Fund, which serves public officers.
Providers given time to give views
SHA has invited healthcare providers and other stakeholders to review the proposed agreements and submit their views before the new contracting cycle begins.
Stakeholders have until Thursday, September 10, at 11:59 p.m. to submit their feedback through an online form provided by the Authority.
The process is being carried out under the Social Health Insurance Act, which requires SHA to empanel and contract healthcare providers after they have been inspected, licensed and certified by the relevant authorities.
SHA said the new arrangements are part of efforts to streamline how healthcare facilities participate in the national health insurance system.
The Authority is also holding virtual sensitisation sessions in all 47 counties to take providers through the changes.
The sessions are focused on the new electronic contracting process, contract requirements and the responsibilities of participating facilities. Providers will also have an opportunity to raise questions and seek clarification from SHA officials.
Facilities have been grouped according to their levels for the sessions.
Level 5 and 6 facilities are scheduled for September 9 from 9 a.m. to noon, followed by Level 4 facilities from 2 p.m. to 4 p.m.
On September 10, Level 3 facilities will attend the morning session from 9 a.m. to noon, while Level 2 facilities are scheduled for the afternoon session from 2 p.m. to 4 p.m.
SHA said the meeting links will be distributed through its county offices.
CHP integration
The contracting changes come as the government continues to expand the role of community-based healthcare workers within the country’s digital health system.
President William Ruto has directed that more than 107,000 Community Health Promoters (CHPs) be incorporated into the SHA programme.
The government has also indicated that the stipend arrangements for the CHPs will be reviewed by December 2026.
Health Cabinet Secretary Aden Duale said during the Health Summit held in August that the process of integrating the CHPs into the digital health system would begin after their verification.
“All the CHP workers have been included in the Digital Health Agency,” Duale said.
The latest contracting process is expected to determine which healthcare providers will participate in the SHA system for the next three years, as the government continues with its efforts to implement the new health financing model.
