Hospitals Face Financial Strain as Health Insurance Board Delays Payments

Kathmandu – Hospitals across the country are grappling with serious financial and managerial challenges due to the Health Insurance Board’s failure to release payments on time. More than half of the hospitals under the program are now facing operational difficulties, with some warning of potential service disruptions if the issue persists.

The problem, which first drew national attention last year after hospitals openly protested against the delays, has intensified in recent months. Officials say the board is more focused on calculating outstanding dues than ensuring timely disbursements to hospitals for the services already delivered to insured patients.

At Bharatpur Hospital, one of the country’s busiest government hospitals, the crisis has reached a critical point. The hospital has over Rs 1 billion in unpaid claims, with no payment released since Shrawan of the last fiscal year. According to hospital officials, the backlog includes Rs 900 million from the previous fiscal year and Rs 100 million for the month of Shrawan alone.

“The salary for Shrawan has barely been paid, but it will not be possible to pay salaries for Bhadra,” said the hospital’s Medical Superintendent, Prof. Dr. Krishna Prasad Poudel. He added that even day-to-day operations have been hampered, while the construction of the hospital’s trauma center has been halted due to a lack of funds.

The scale of the problem is evident from the hospital’s data. In the last fiscal year alone, Bharatpur Hospital submitted 441,308 claim files, with nearly 70 percent of its patients insured under the government’s health insurance program. The hospital received Rs 555.14 million in payments carried over from the previous fiscal year, but current dues remain unpaid.

Patients at Bharatpur Hospital have also begun reporting changes in the way they are treated, attributing it to the financial pressure hospitals face due to the delays. Hospital officials warn that unless the Health Insurance Board acts urgently, both service delivery and staff morale will continue to deteriorate.