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Mediclinic News : Consumers look for rich benefits, impeccable service and lower-than-average contribution rates


Consumers look for rich benefits, impeccable service and lower-than-average contribution rates




News Description

BUSINESS REPORT As the South African private healthcare funding landscape continues to come under threat due to high costs and limited value, healthcare consumers increasingly seek high value benefits and lower-than average contribution rate increases. They also want impeccable service and a scheme with solid financial standing. So says Dr Johan Pretorius, CEO of healthcare management company, Universal Healthcare. He adds, "Given the fact that demand often fuels costs, medical schemes and corporates are hard pressed to find lasting value when it comes to the delivery of affordable healthcare, particularly in the current financial climate." "Furthermore, many healthcare administrators make the mistake of underestimating the importance of sound working partnerships with the medical schemes un-der their administration. Some even neglect their relationships with healthcare providers altogether” He assures that Universal Healthcare is not only conscious of the importance of affordability and accessibility, it also seeks to facilitate the delivery of excellence in healthcare. One way is through active case management and disease management. Another is sound treatment protocols that follow internationally accepted conventions. "Everyone is looking for cost-efficient options that are affordable and sustainable. We have delivered on this need, and the success of this approach is particularly evident when looking at the outcomes." This was recently demonstrated when the annual GTC (formerly Grant Thornton Capital) medical aid survey, which assesses the financial health of medical schemes, rated Comp-Care Wellness Medical Scheme as the healthiest open medical scheme in South Africa. CompCare, which is administered by Universal Healthcare Administrators, attained a 100 percent score for financial sustainability It was, says Pretorius, affirmation of a member advocacy approach, which has seen the scheme posting contribution rate increases that are, on average, 1,7 per-cent below the industry average, over the past five years. Through increasing member benefits year after year, it proved that a medical scheme can still maintain robust financial health while offering unparalleled value for money. "A good healthcare administrator can truly set the medical schemes under its administration apart. "We have always ensured that members of schemes under our management receive additional benefits and added value year-after-year with very competitive increases in contributions, all the while safe-guarding the financial health of the schemes under our aegis," he adds. "The health of the schemes under our management remains central to our ability to offer members appreciable value. At Universal, our approach embraces the health of members and their medical schemes as complimentary priorities." Through its fully accredited managed healthcare arm, Universal Care, the company provides a comprehensive range of managed care services ranging from hospital pre-authorisation to disease management, chronic medicine management and provider networks. The latter has enabled contracted medical schemes to offer low income, afford-able options as part of their benefit plans and the ability to negotiate innovative alternative reimbursement models with healthcare providers, selected hospital groups and centres of excellence, resulting in reduced member contributions. He adds, "We have one of the largest individually contracted provider networks in South Africa which means that we have the total buy-in of all our healthcare providers. "Their treatment of patients is at all times guided by evidenced-based protocols and with strict adherence to our medicines formulary. "By paying closer attention to all of the different aspects of the healthcare delivery system, we are able to create a situation that is win-win for everyone: medical schemes, employer groups, medical scheme members and providers."
Created at 2016/07/06 10:26 AM by Mediclinic
Last modified at 2016/07/06 10:26 AM by Mediclinic