Kenya is facing a significant increase in healthcare costs, with medical claims rising from Sh26.69 billion in 2021 to Sh52.61 billion in 2025, according to the Insurance Regulatory Authority (IRA). This represents a substantial increase in healthcare expenditure, with medical insurance now accounting for 41 per cent of the general insurance market. The pressure is unlikely to ease soon, with Aon's 2026 Global Medical Trend Rates Report projecting a 13.5 per cent increase in Kenya's medical costs this year.
Employers in Kenya are already feeling the strain of rising healthcare costs, with many facing higher bills for staff medical expenses. NCBA's staff medical expenses rose from Sh632.36 million to Sh727.76 million in the latest reporting period, while the Co-operative Bank's expenses increased from Sh849.92 million to Sh962.12 million. These substantial sums are forcing businesses to make difficult decisions about how to manage their medical benefits budgets.
The rising healthcare costs are not just a financial burden, but also have a significant impact on the quality of life for individuals and families. Unmanaged chronic conditions, such as hypertension and diabetes, can lead to serious health complications and increased healthcare costs. Kenya's 2015 STEPS survey found that 28.6 per cent of adults aged 18 to 69 had raised blood pressure, while an analysis of the same data found that 53.4 per cent of diabetes cases in Kenya were undiagnosed.
To address the rising healthcare costs, there is a growing need for a shift towards preventive care in Kenya. This includes increasing access to screening and early treatment for chronic conditions, as well as promoting healthy lifestyles and behaviors. Employers and insurers can play a critical role in promoting preventive care by providing access to screening and follow-up services for employees and policyholders.
Aly Maherali, CEO of Executive Healthcare Solutions, believes that Kenya needs to consider a new approach to healthcare spending, one that prioritizes prevention over treatment. He argues that claims data tells us what we have paid for, but not necessarily whether we could have prevented the illness in the first place. By focusing on preventive care, employers and insurers can help reduce healthcare costs and improve health outcomes for individuals and families.
To implement this new approach, employers and insurers need to work together to develop effective healthcare strategies that prioritize prevention. This includes providing access to screening and follow-up services, promoting healthy lifestyles and behaviors, and encouraging employees and policyholders to take an active role in managing their health. By working together, Kenya can reduce its healthcare costs and improve health outcomes for its citizens.
The Kenyan government also has a critical role to play in promoting preventive care and reducing healthcare costs. This includes investing in public health programs and initiatives that promote healthy lifestyles and behaviors, as well as providing access to screening and early treatment for chronic conditions. By prioritizing preventive care, Kenya can reduce its healthcare costs and improve health outcomes for its citizens.
Key points
- Medical claims in Kenya increased from Sh26.69 billion in 2021 to Sh52.61 billion in 2025.
- Employers are facing higher bills for staff medical expenses, with NCBA's expenses rising from Sh632.36 million to Sh727.76 million.
- A shift towards preventive care is needed to address the rising healthcare costs in Kenya.
