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Mediclinic News : Healthcare providers must publish clinical data – former Discovery health executive

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Healthcare providers must publish clinical data – former Discovery health executive

Date

2016-05-18

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MEDICAL BRIEF Patients using private healthcare have no idea whether they are getting value for money as publicly available data reflects only price and not quality, former Discovery Health executive Brian Ruff told the Competition Commission’s Health Market Inquiry. Business Day reports that Ruff, who now runs health management company PPO Serve, said it should be a legal requirement for all health-care providers to collect and publish standardised data on their clinical outcomes. “There is a crisis of access and affordability. The current narrative ignores the poor performance of the health-care system – it produces unnecessarily high costs and, therefore, high (medical scheme) premiums,” he said. The report says Ruff, who is a specialist in internal medicine, was asked by the inquiry to make a submission, as he has extensive experience in both the public and private sector. He worked for Discovery Health, South Africa’s biggest medical scheme administrator, for more than 15 years and before that, worked for the Gauteng Health Department. Ruff said negotiations between medical schemes and healthcare providers such as hospitals were entirely focused on price, with no consideration given of the clinical outcomes achieved. Medical schemes competed for patients on the basis of the benefits they offered and their premiums, rather than their capacity to negotiate value from providers, he said. The state should revoke hospital licences if facilities failed repeatedly, he said. Ruff urged the state to play a more strategic role in how it licensed private hospitals beds, and use the requirements of regional populations to determine how many beds were allowed. Excess capacity and fragmentation of care led to over-servicing and supplier-induced demand, which pushed up costs, he said. According to the report, Ruff said the Medical Schemes Act should be amended to allow regional medical schemes, as the requirement that they offer national coverage blocked new entrants and hampered competition. Doctors should be encouraged to work in teams rather than in isolated practices, as this would improve the quality of care. Private hospital group Netcare says, meanwhile, it remains optimistic about the scope for providing services to state patients in South Africa, despite the hostility expressed by Health Minister Aaron Motsoaledi earlier on at the inquiry. Business Day report that the minister criticised Netcare’s public-private partnership with the Lesotho government when he made his submission to the inquiry, saying these kinds of contracts had never benefited the governments concerned. Yet the government’s National Health Insurance White Paper proposes that the state contract with private-sector health services. “We think (National Health Insurance) is a real opportunity to partner with government in improving access and quality of care,” Netcare CEO Richard Friedland is quoted in the report as saying. “We have a decade-and-a-half of experience with working with the British government in a variety of initiatives – be it (shortening) waiting lists, building facilities and running five-year contracts, or the provision of services,” he said. “The advantage (for the government) of partnering with the private sector is you don’t have to build additional capacity and employ staff: you use the capacity in the private sector, provided you agree on the tariff and quality regime that governs it.” The report says Netcare has more than 50 hospitals in South Africa, with 9,996 beds, and owns the UK’s biggest private hospital network, BMI Healthcare, which has 59 sites and 2,797 beds. It also has a public-private partnership with the Lesotho government for the 425-bed Queen Mamohato Memorial Hospital in Maseru.
Created at 2016/05/23 05:46 PM by Mediclinic
Last modified at 2016/05/23 05:46 PM by Mediclinic