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Mediclinic News : SCHEME ADDS BENEFITS FOR 2019

Title

SCHEME ADDS BENEFITS FOR 2019

Date

2018-10-04

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News Description

BUSINESS DAY Bonitas announced a weighted increase of 8.9% for 2019 despite a challenging year for the healthcare industry, against a backdrop of uncertainty around the NHI, the recent Health Market Inquiry and current tough economic conditions faced by consumers, according to Gerhard Van Emmenis, principal officer. He says the past 12 months have been extremely trying, with a number of uncertainties and changes anticipated. In addition, consumers have been heavily impacted by the increase in VAT and escalating prices which resulted from this. In July Bonitas announced its financial results for 2017, the best in its 35 year history, with a solid surplus of R730.20m, having recouped a deficit of R16.9m from 2016. "This turnaround was due to several key cost saving strategies," says Van Emmenis. "It bolstered our reserves from R3.1bn to R4bn, which means that we are able to invest back into the scheme and offer our members access to healthcare of the highest quality.” The fund has announced a number of additional benefits for its members for 2019. "We know it's not only the monthly premiums that affect consumers' pockets but the value they get out of their medical aid plan. "Some of the benefits have been tweaked, others increased, one plan has been discontinued and two new options have been introduced, all aimed at helping members take control of their health and lead better lifestyles. "We continue to seek partnerships with healthcare providers to ensure we are part of the same value chain, rather than being part of the supply and demand of the healthcare economy," says Van Emmenis. "In addition, we are focused on educating role players to balance affordability, quality and cost efficiencies. We are developing an incentive model to motivate service providers to eliminate activities that do not add value to members.” Over the past few years, Bonitas has taken a multipronged approach to cost saving, focusing on: • Hospital claims account for half of Bonitas' annual claims, about R6bn a year. For this reason the scheme negotiated a pricing structure with the main hospital groups to deliver a savings of R242m last year and projects this saving will increase to about R550m over the next two years. • Bonitas places great emphasis on managed care initiatives to help members with chronic conditions manage their health better. It takes into account the best clinical and treatment protocols while containing costs. Bonitas' back and neck, oncology, hip and knee and HIV AIDS programmes continue to offer members emotional, clinical and financial support. • The Council for Medical Schemes CMS cites chronic conditions with diabetes in particular as one of the key contributors to a rising disease burden in SA and escalating healthcare costs. Eighty percent of the scheme's diabetic patients have associated chronic conditions such as high blood pressure and cholesterol, heart disease and depression which need to be managed. Through the scheme's diabetes programme, hospital admissions related to diabetic patients having reduced by 11.6% year on year. • Bonitas has a keen focus on preventative care as early detection is a critical factor in ensuring members get the support they need to manage serious conditions timeously. • Last year, the scheme kept a firm focus on women's health, introducing cover for pap smears on all its plans. Since cervical and breast cancer continue to be most prevalent, Bonitas has continued its efforts towards early detection by ensuring mammograms for women over 40 will be covered once every two years on all plans from 2019. • The scheme has also placed the spotlight on men's health, especially in light of a prevalence of prostate cancer, by adding the prostate screening antigen test to all options for men aged between 45 and 69. • Bonitas has SA's largest GP network which ensures that members get value for and stretch their benefits. The scheme's online provider locator tool has been enhanced so members can find network hospitals, doctors and specialists in their area quickly. • Bonitas' ongoing efforts to reduce fraud, waste and abuse have been successful, with a number of convictions and sentencings. This significant focus delivered recoveries of R31.2m with a potential preventative savings of R75m. The scheme will continue to ensure that all outstanding money is successfully recovered and repaid to the fund, so that it can be put to better use to benefit members. Van Emmenis says digital remains a key driver for member and broker communication with a newly introduced corporate zone available on the website. The online application has been revamped with the introduction of an electronic membership and a live chat function has been added to assist current and potential members with any questions they may have. "Besides enhancing the Member Zone as from January 1 2019 members will have access to the Bonitas App a revolutionary cellphone application that will offer the full benefits of the member zone, making it easier for members to view their benefits and claims as well as submit claims, obtain authorisation, find a network provider, resolve queries and so much more while on the go. "As a value add for members, Bonitas has aligned with strategic partners to offer a comprehensive, holistic solution to help members take care of their financial health and wellness, without paying extra, This is not another loyalty programme, but real added value aligned to member needs, with no fee or points scoring."
Created at 2018/10/23 03:24 PM by Mediclinic
Last modified at 2018/10/23 03:24 PM by Mediclinic