Table 5.
NHIF Annual Cash Flow Outlook for a Hypothetical Population of One Million Informal Sector Principal Members (in KES)a
| Scenario 1 | Scenario 2 | |
|---|---|---|
| Number of principal members | 1,000,000 | 1,000,000 |
| Dependency ratio | 2 | 4 |
| Number of dependents | 2,000,000 | 4,000,000 |
| Total membership | 3,000,000 | 5,000,000 |
| Monthly premium contribution | 500 KES | 500 KES |
| Annual premium contribution | 6,000 KES | 6,000 KES |
| Total annual premium contribution | 6,000,000,000 KES | 6,000,000,000 KES |
| Annual outpatient capitation rate | 1,200 KES | 1,200 KES |
| Total annual capitation paid | 3,600,000,000 KES | 6,000,000 KES |
| Annual inpatient claim | 1,475 KES | 1,475 KES |
| Total annual inpatient claim | 4,425,000,000 KES | 7,375,000,000 KES |
| Percentage of administrative cost | 7.5% | 22% |
| Total annual administrative cost | 450,000,000 KES | 1,320,000,000 KES |
| Total payout | 8,475,000,000 KES | 14,695,000,000 KES |
| Net annual cash flows | 2,475,000,000 KES | 8,695,000,000 KES |
| % Deficit | 29% | 59% |
a
Assumes current level of administative costs and the NHIF assumption for dependency ratio.