CarePay: Transforming healthcare in Kenya

Illness-related expenses push an estimated 1.5 million Kenyans into poverty each year, and two out of every five people who need care don’t seek treatment at medical facilities because they can’t afford it.

Nearly 50% of all healthcare expenditures in Kenya are paid out of pocket. Yet demand for health financing solutions such as insurance remains low, despite considerable growth in the health insurance sector over the last few years. Moreover, while donors are responsible for about 30% of all health payments in Kenya, they’re often unable to track how disbursed funds are used. On the supply side, healthcare availability and quality fall short of need.

CarePay is transforming how Kenyans pay for healthcare. Its M-TIBA platform is a cloud-based healthcare finance solution that can be accessed on any GSM cellular phone (the mobile network standard in Africa). M-TIBA empowers users to make decisions about how to finance healthcare for themselves and/or for their relatives, friends or employees through a mobile-based wallet” that can accommodate multiple sources of funding, including individual savings, family remittances, health insurance and NGO donations for specific (vulnerable) populations.

CarePay has grown into a solution provider for all type of payers – insurers, public bodies, donors, corporations and individuals – as well as for healthcare providers and patients. It can administer, automate and manage any type of healthcare scheme or programme to ensure that funds earmarked for healthcare are spent by the right person, for the right care, at the right place, at the right time and at a very low transaction cost.

Winning the 2019 Entrepreneurs for Resilience Award enabled CarePay to roll out its digital healthcare finance platform for a pilot of Kenya’s Universal Health Coverage (UHC) programme in two counties. Although 70 healthcare providers and 122 000 individuals from 44 000 low-income households were swiftly enrolled, the planned scale-up the UHC programme was hindered by the government’s diversion of resources to managing the COVID-19 pandemic and national elections in 2022. In response, CarePay reallocated part of the Swiss Re Foundation funding to drive the roll-out of low-cost insurance to address and reach the population segments in need. In 2023, CarePay launched Kinga Afya, a 24-hour travel accident and emergency evacuation insurance product, in collaboration with one of Kenya's largest public service transport company, 2NK Sacco. The premiums for this insurance were seamlessly integrated into the bus ticket for every passenger, offering emergency and accident coverage for the specific journey. Subsequently, two additional saccos have adopted the product and by end of 2023 a total of 45 316 passengers enrolled on Kinga Afya on a commercial basis and 311 954 passengers were enrolled on the subsidized pilots.

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