Hospitals facing financial distress have been handed a Christmas lifeline, as the Social Health Authority (SHA) announced it will settle validated claims from providers by Wednesday, December 24, 2025. The move comes after a period of intense pressure on medical facilities, many of which have been teetering on the brink of collapse due to delayed reimbursements.

The payments target healthcare providers who were affected by "facility-level mismatches." This issue arose after a verification process where the SHA cross-checked facility licensing records with the Kenya Medical Practitioners and Dentists Council (KMPDC) and confirmed their designated service level under the Kenya Essential Package for Health (KEPH). Facilities were required to amend their contracts to align with their verified status, and those who completed the process have now been cleared for payment.

A System Under Strain

This payout promise arrives against a backdrop of severe financial strain for many hospitals. Associations representing private healthcare providers have repeatedly warned of a looming crisis, citing billions of shillings in unpaid bills that have crippled their operations. The Rural and Urban Private Hospitals Association (RUPHA) has been particularly vocal, stating that many of its members struggle to pay salaries, rent, and suppliers, forcing them to take on debt to stay afloat.

The delays are not a new phenomenon. Surveys conducted earlier in the year and in late 2024 painted a grim picture:

• A RUPHA survey in late 2024 revealed that 58% of contracted facilities had received no payment for their claims in the final quarter.
• The same study found nearly 96% of surveyed hospitals reported severe financial distress, with many unable to meet operational costs or pay staff.
• Another report noted that by August 2025, SHA's debt to hospitals stood at a staggering KES 43 billion (approx. $330 million), with billions more under review.

The core of the problem, according to some analysts and providers, is a fundamental funding mismatch within the new health scheme. Contributions from citizens, particularly from the informal sector, have not been sufficient to cover the costs, leaving a significant financing gap that strains the entire system.

The Path to Payment

In a public notice, SHA Chief Executive Officer Mercy Mwangangi confirmed that the first batch of contractual and facility record reviews had been completed, paving the way for the holiday payments. The authority emphasized that this is part of an ongoing effort to streamline contracts and ensure the accuracy of the claim process under the new Social Health Insurance framework.

For facilities still navigating the system, the SHA has provided clear channels for assistance. Providers can check the status of their clearance or seek help via email, their county office manager, or a toll-free line. This structured communication is a crucial step in resolving the administrative errors that have plagued the system, such as the sudden re-categorization of some facilities by the KMPDC, which led to contract mismatches and payment blockages.

While the promised funds offer immediate relief, the long-term stability of Kenya's healthcare financing remains a critical concern. The success of Universal Health Coverage hinges on the SHA's ability to create a reliable and transparent payment system that keeps hospital doors open and ensures Kenyans can access the care they are paying for.