The Rwanda Private Medical Facilities Association (RPMFA) is appealing for an inclusive review of current health service tariffs to save them from losses and ensure sustainability of quality healthcare to patients, The New Times has learnt.

The Executive Secretary of RPMFA, Christian Ntakirutimana, told The New Times that the tariffs in question were set in 2017 (for all private health facilities) and they were subject to be reviewed after one year — in 2018, which has not been done since then.

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"Rwanda Private Medical Facilities Association started following-up with different concerned organs towards reviewing such medical tariffs, given the high inflation rate and remarkable price increase at national and international markets,” he said, citing the Covid-19 pandemic among factors for the remarkable increase in prices of medical products, including specialised medical machines and reagents.

He gave an example of a type of biochemistry analyser — medical equipment used to analyse some components of the blood with intention to diagnose different medical conditions — that cost Rwf11 million in 2017, but its price rose to Rwf14.5 million in 2023

"Yet, the price of a test carried out using that machine [biochemistry analyser] did not increase,” he said, adding that inflation and the appreciation of the US dollar against the Rwandan franc is also one of the factors to consider.

Again, Ntakirutimana said that salaries of staff in private medical facilities increased – in some cases doubling since 2017, for the facilities to be able to retain qualified medical personnel.

Lack of adjustments of medical tariffs to reflect those changes make health facilities incur losses, he pointed out.

Parliament wants heath service tariffs review expedited

On February 14, the Lower House requested the Ministry of Health to present to it a roadmap to expedite the review of health service tariffs for all health facilities by taking their categories into account, to reflect price increase in medical products.

It made the resolution after RPMFA told lawmakers on the Social Affairs committee— during an oversight of private health facility performance — that lack of tariff revision was negatively affecting their operations.

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The Chairperson of the Committee on Social Affairs, Odette Uwamariya, said that Committee on Social Affairs evaluated the operations of private health facilities and visited some of them that operate in the City of Kigali to understand their performance, the issues they face, and strategies that can be devised to enable them to continue offering healthcare to residents.

It also visited two public teaching hospitals in line with comparing medical tariffs which the Ministry of Health had earlier said they had started to review – starting from teaching hospitals and those providing special healthcare, she added.

To carry out the assessment, she said that the Committee, among other activities, held sessions with representatives of RPMFA – an umbrella organisation gathering around 200 private health facilities (including private hospitals, polyclinics, specialised clinics, and general clinics operating in Rwanda), which represents 59 per cent of all 337 health facilities counted countrywide.

By analysing the issues identified in private health facilities, visiting some of them, and holding talks with concerned entities, the Committee observed that lack of revision of healthcare tariffs was a hindrance in their operations, making them incur losses as prices of medical products and equipment went up, Uwamariya said.

She pointed out that the Ministry of Health told the Committee that a review of health service tariffs was discussed in several meetings that convened various entities including private health facilities, and that prices were still being adjusted at each health facility level.

"The Committee realises that the issue of health service tariffs is valid, both for the case of private and that of public health facilities because since their establishment in 2017, prices of the medical tools they use gradually increased,” she said.

Health service ‘tariffs revised for 11 facilities’ only

Meanwhile, she pointed out that the committee later learnt that the Ministry of Health revised tariff of health services [for some health facilities] as indicated in a letter of the Minister of Health dated January 23, 2024, which he wrote to the top management of the Rwanda Social Security Board (RSSB), the Military Medical Insurance, and all insurance firms.

"The Committee made an assessment and found that the tariffs were revised for only 11 private health facilities, yet there are 200 health facilities under RPMFA in the country,” she said.

Also, the Committee received a letter of RPMFA dated January 28, 2024, which it wrote to the Ministry of Health suggesting that the application of the prices be put on hold because they were revised for few health facilities, yet they did not know the factors based on for that, Uwamariya said.

Ntakirutimana observed that the association found that the Ministry of Health’s decision to review medical tariffs for only 11 private health facilities was not an effective way to address the problem.

He said the association wrote to the Ministry of Health requesting that the implementation of the decision be put on hold so that the review be applied to all private health facilities, and all concerned health services.

"We realised that telling 11 health facilities out of 200 facilities to use [the revised] tariffs could cause conflicts among health facility owners,” he said, pointing out that they thought there was no ground to increase tariffs for 11 health facilities.

He indicated that the health facilities for which the tariffs were revised upwards are in the categories of hospitals, polyclinics, and specialised clinics, and that there was no general clinics among them.

Another concern he expressed is that the increase did not apply to medical laboratory services, yet this is one of the areas which needed review the most as health facilities spend more on such services.

Meanwhile, he said that after the new tariffs were issued for the 11 health facilities, the association met with the Ministry of Health, and it promised them that it was going to bring together the concerned entities to address the identified issues urgently – within two months.