Private Health Facilities Warn of Retrenchments as NHIMA Arrears Mount
The Health Care Federation of Zambia (HFZ) has sounded the alarm that the country’s private health sector is on the verge of collapse due to prolonged non-payment of bills by the National Health Insurance Management Authority (NHIMA).
Speaking at a media briefing this morning, HFZ revealed that its members have continued providing services to hundreds of thousands of citizens under the National Health Insurance Scheme (NHIS), despite not receiving payments for claims submitted since mid to late 2024.
“We are exhausted and financially strained from continuing to provide NHIMA services without receiving payment from NHIMA,” HFZ stated.
The federation accused NHIMA of breaching contractual obligations by failing to adhere to the legal requirement of settling claims within 45 days. Instead, it alleged, the authority has created an “unwritten rule” that prioritises payments to public health facilities, leaving private providers struggling to stay afloat.
HFZ also condemned NHIMA’s unilateral revision of tariffs in January 2025, describing the structure as unrealistic and unsustainable. Under the new framework, an outpatient visit remains capped at K600 but is divided into K150 for drugs, K150 for laboratory tests, K50 for registration, K50 for consumables, and K200 for consultation. Chronic patients are further restricted to one visit every three months, capped at K1,200 for all treatment.
“These amounts fall far short of covering the actual cost of quality care,” HFZ argued. “Public facilities are cushioned by government funding, but private facilities must shoulder salaries, equipment, consumables, and taxes from the same inadequate tariffs. It is unfair and unsustainable.”
The federation cautioned that unless arrears are urgently cleared, many private health facilities will be forced to retrench staff or close entirely, worsening unemployment and reducing access to essential health services. It further noted that NHIMA’s dominance is squeezing private insurance firms out of the market, with several already exiting the industry.
HFZ has appealed directly to President Hakainde Hichilema to intervene, stressing that the private sector is a vital partner in delivering health services and a key driver of economic growth.
“We do not want NHIS to collapse. It is a game changer for Zambian citizens. But unless NHIMA clears arrears and creates a fair playing field, the private health sector cannot survive,” the federation warned.
Despite the crisis, HFZ reaffirmed its commitment to supporting government in achieving universal health coverage, but underscored that sustainability can only be achieved through fair treatment, timely payments, and genuine consultation.
