Nairobi Hospital in talks with insurers over tariffs concerns

The Nairobi Hospital Saturday confirmed that it is holding consultative meetings with medical insurance companies to address recent concerns over tariff adjustments.

The hospital said in a statement the discussions are aimed at finding a mutually agreeable solution that safeguards patient care and ensures continued access to quality healthcare.

According to the hospital, representatives from all affected insurers have been invited to a consultative forum in the following week.

“The Nairobi Hospital wishes to inform its patients, partners, and the general public that it is currently engaging insurance companies in constructive discussions following concerns over recent tariff adjustments,” the statement read.

“We have invited representatives of all affected insurers to a consultative forum scheduled for Monday, August 11, 2025, with the aim of reaching a mutually agreeable solution that safeguards patient care and sustains access to quality medical services.”

The meeting is expected to focus on reconciling the hospital’s revised rates with insurers’ concerns while maintaining high service standards.

Chief Executive Officer Felix Osano noted that while the hospital values its partnership with insurers, the tariff adjustments are necessary to sustain the quality of healthcare offered to patients.

He explained that independent comparisons show the hospital’s revised rates remain competitive and fair when measured against peer institutions providing similar levels of care and expertise.

“We recognise the concerns raised by our insurance partners, but reiterate that the adjustments are essential to maintain the high standards of healthcare our patients deserve,” Osano said.

The CEO expressed confidence that dialogue and goodwill would lead to an amicable resolution in the best interests of the parties, including patients, insurers, and the wider healthcare ecosystem.

Osano reaffirmed the hospital’s commitment to delivering accessible and sustainable healthcare, emphasising that this remains the facility’s priority.

Several insurance companies announced plans to suspend services at the facility, citing a substantial increase in treatment charges.

They described the steep hike as unsustainable, warning that it could prompt a collective withdrawal of coverage and potentially affect clients who depend on insurance for access to medical care.

This came as eight major insurance companies suspended their insurance services from the Nairobi Hospital, citing a spike in the cost of treatment announced by the hospital recently.

This is after the hospital increased the cost of services by as high as 61 per cent on key services such as scans, ultrasounds and bed charges.

The eight companies include Madison Insurance, ⁠First Assurance, ⁠Minet, ⁠Old Mutual, ⁠Britam, ⁠AAR, ⁠CIC and ⁠Pacis Insurance.

For instance, AAR Insurance noted that the hike in the recent cost raises concerns about long-term affordability for its members.

“With our customers’ best interests at heart, we engaged The Nairobi Hospital in open and constructive discussions, aiming to agree on a more sustainable, volume-based model that would safeguard both quality and affordability,” the statement read in part.

“Despite a sincere effort from both parties, we were unable to reach mutually acceptable terms this as a result, AAR Insurance member access to The Nairobi Hospital will be temporarily suspended effective Monday, 11 August 2025.”

CIC Group, on the other hand, wrote to its staff members saying it will suspend the services from Tuesday, August 12.

“We have been engaging The Nairobi Hospital on the cost of care at their facility. As you may be aware, and may have picked from the reports (specifically average cost report) that we share with you, the provider has significantly revised their prices,” the statement read in part.

“We consider their rates not only unsustainable, but those that cannot be remedied, not even with a premium revision. As our intention is to safeguard the sustainability of the policies we administer and the operations of our organization, we have been engaging the provider on the revision but have regrettably not been able to reach a mutually agreeable position.”