Healthcare needs fewer firefighters and more strategists
One thing you learn working in health insurance is that a medical crisis rarely begins when a patient walks into a hospital. In many cases, the warning signs have been there for days, weeks or years. They show up in routine check-ups, in conditions that go undiagnosed and in illnesses that are not properly managed […] The post Healthcare needs fewer firefighters and more strategists appeared…
Healthcare in Kenya is facing rising costs, with medical claims increasing from Sh26.69 billion in 2021 to Sh52.61 billion in 2025, according to the Insurance Regulatory Authority (IRA). Medical insurance now accounts for 41% of the general insurance market, and a 2026 Global Medical Trend Rates Report projects a 13.5% increase in Kenya's medical costs this year. Employers are already facing higher bills, with NCBA and Co-operative Bank reporting significant increases in staff medical expenses.
The issue goes beyond just treatment costs, as many conditions are not detected and managed early enough, leading to more complicated and expensive care. For example, hypertension affects 28.6% of Kenyan adults aged 18 to 69, but only 9.4% of women and 3% of men aged 15 to 49 reported being told they had hypertension. Similarly, 53.4% of diabetes cases in Kenya were undiagnosed in the 2015 STEPS data.
The article argues that employers and insurers should focus more on prevention than just treating illnesses. This means paying closer attention to what happens before a medical claim is filed. Are employees undergoing regular screenings? Are people with chronic conditions receiving appropriate follow-up care? Are they taking prescribed medication and managing their conditions effectively? These questions should be part of the annual review of every corporate medical scheme, alongside the claims ratio.
Preventive care is crucial, especially as people age. For senior leaders, regular screening becomes increasingly important due to the higher risk of health issues. However, preventive care should extend to all employees, not just executives. Employers need to understand what each private medical insurance covers, identify gaps, and ensure employees can access care without unnecessary duplication.
The article concludes by posing a direct question to employers and insurers: What are we doing today to prevent tomorrow's claim?
Written by urgent.news from KBC's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
