Costing of Health Services for Provider Payment in Kenya

Kenya’s use of the Costing of Health Services for Provider Payment toolkit produced findings that were used to change county-level reimbursement models to lower costs, increase efficiency and improve financial sustainabilty. This case study profiles the use of Costing of Health Services for Provider Payment in Kenya. In Makueni County, the government has the mandate to organize and implement health programs for their constituents. As part of Makueni County’s Vision 2025, leaders established “MakueniCare,” to provide an affordable health insurance scheme for households. Unfortunately, despite the new insurance scheme, out-of-pocket expenses remained high for many people, sometimes catastrophically high, and posed a significant barrier to accessing health services. Like many local health systems, Makueni County was under pressure to contain costs while also improving the quality of health services. To help inform decision-making, the JLN Country Core Group worked with members in the Makueni County Department of Health to adapt and implement the JLN knowledge product called the Costing of Health Services for Provider Payment: A Practical Manual in the county to better understand what factors were driving high costs and how to improve the fee-for-service model being used.