With comprehensive and competitive healthcare strategies that are leading South Africa’s medical aid industry, Bestmed Medical Scheme is a titan in preventative care. Principal Officer and CEO, Leo Dlamini tells us more.
A CULTURE OF CARE
The medical scheme industry is a vital part of South Africa’s functioning healthcare system.
Yet, the sector has experienced recent challenges and remained stagnant due to prevailing economic circumstances that have restricted short to medium-term growth.
The medical scheme industry has become highly regulated, with organisations in the sector consistently reviewing their procedures and processes.
To compound this, both public and private medical schemes are acutely aware of the developments related to the South African government’s implementation of National Health Insurance (NHI). As such, the funding for NHI and the overall future of medical schemes is still unclear.
On the contrary, Bestmed Medical Scheme (Bestmed) is optimistic about the future, as the organisation is a proactive part of the industry through its participation on the Board of Healthcare Funders, which monitors and contributes to the development and representation of the South African private healthcare industry in the face of the new NHI bill.
“We believe that medical schemes have the opportunity to make a difference in people’s lives,” opens Leo Dlamini, Principal Officer and CEO of Bestmed.
“We have reassured our members that Bestmed will do everything in its power to protect the rights of the Scheme and its members to ensure that access to quality healthcare is not compromised,” he explains.
This tenacity and drive stems from Bestmed’s flourishing history, providing medical aid for nearly six decades. With in excess of 240,000 lives under its care, Bestmed is the largest self-administrated scheme and the fourth-largest open medical scheme in South Africa.
To cater to its vast base of members, the organisation has approximately 18,000 competent healthcare providers and ancillaries nationwide, making it one of the country’s most extensive healthcare networks.
Bestmed offers its members 14 structured plans, which include competitive preventative care benefits such as flu vaccines, female contraceptives, and baby growth and development assessments. The organisation also offers managed healthcare interventions to ensure efficient, cost-effective, and high-quality healthcare services including oncology, HIV/AIDS, dialysis, and maternity care.
Significantly, the preventative care and managed healthcare interventions not only help minimise the risk of prolonged illness and impairment, but save members the associated treatment costs in the long-term.
One of the organisation’s fundamental focuses is to ensure accessibility to as many members as possible. Bestmed prides itself on having an incredibly accessible member administration contact base, with walk-in centres in Pretoria, Cape Town, Durban, Port Elizabeth, Nelspruit, and Polokwane, where members can make appointments, obtain membership cards, and change contact details and dependants.
“The Scheme’s promise of being ‘Personally Yours’ has become synonymous with Bestmed, distinguishing our people, our culture, our partners, and how we deliver exceptional service to our members every day in every interaction,” Dlamini tells us.
A key part of the organisation’s value proposition is its wellness programme, Tempo, which comes at no additional cost.
“The Tempo wellness programme includes Nutritional Health, Fitness (Get Active), and Emotional Wellbeing Journeys to promote a healthy, balanced lifestyle,” he adds.
Members can complete a health assessment to access two consultations each with a Tempo partner biokineticist and dietician, both playing a vital role in the patient’s Fitness and Nutritional Health Journeys. The consultations with a biokineticist include a fitness assessment and personalised exercise plan, alongside a nutritional assessment and the development of a tailored eating plan with a dietician.
In 2023, the Tempo wellness programme was expanded to include a Get Active Journey, to incorporate physical activity into the wellness plan. Furthermore, all journeys are available on the Bestmed App and online member portal.
“The Get Active Journey allows all members to set personal goals and sync their fitness devices for exercise tracking. Members also have access to challenges in which they participate, including on-demand Tempo exercise classes, with a library of health and wellness topics,” highlights Dlamini.
In a competitive environment, it is an important focus for Bestmed to differentiate itself from competitors. To achieve this, it has two payment runs every week, whilst members pay child-dependant rates for children up to 24 years old and registered students are covered as child dependants up to 26 years old, inter alia.
From a financial perspective, the CMS requires all medical schemes in South Africa to have a minimum solvency ratio of 25 percent to ensure financial sustainability in the event of an unexpected increase in claims.
Bestmed has a solvency ratio of 41.7 percent as of December 2022, maintaining a strong financial position, and forecasts a promising growth trajectory.
Regarding the wider industry, the realm of virtual consultations is shaping the delivery of benefits and services for medical scheme members. As an industry leader in this area, Bestmed was the first medical scheme to partner with Intermedix in 2020 to create the innovative iCanRefer™ digital referral programme.
This has been instrumental in enabling general practitioners (GPs) to find cost-effective and Scheme-approved specialists near a patient’s home, through the use of an e-scripting web application that allows healthcare professionals to generate a digital prescription to track and record their patients’ medical history.
The application also makes cost-effective medicine included in the Scheme’s medicine formularies available, issues a digital prescription, and lets GPs send the digital prescription and digital script to the retailer or courier pharmacy via an advanced electronic signature.
“Through this process, the iCanRefer™ programme creates a digital footprint that ensures greater compliance and adherence by health professionals and patients. It also guarantees, through data analytics, a better overall health outcome for the individual,” Dlamini elaborates.
Elsewhere, to strengthen the organisation’s position and remain competitive in the industry, Bestmed has strategically invested in improving its ICT infrastructure and systems to benefit the end user and enhance the efficiency of the organisation’s operations.
In line with the organisation’s strategic objectives and need for agility, it refreshed the Scheme’s binary digit (BIT) administration hardware last year not only to remain relevant in the industry, but to enhance projects and add value to the member experience.
“Businesses need to be agile, flexible, and willing to embrace new ideas and new technologies. We will continue to enhance our infrastructure throughout 2023 and into next year with the aim of providing an even better service for our members and other stakeholders.”
EMPOWERING LOCAL OPPORTUNITIES
Alongside its strategic investment in digital infrastructure, the Scheme has an equally well-defined corporate social investment (CSI) framework. Bestmed’s main intent is to benefit previously disadvantaged members of society in a sustainable manner and engage as a good corporate citizen.
In addition to the CSI budget, Bestmed also implements initiatives that require its employees to contribute to society and nurture an organisational culture of caring.
“Bestmed’s achievements of winning the Titanium Award for Excellence in Creating Access to Quality Healthcare, presented by the Board of Healthcare Funders (BHF), for three consecutive years is testament to our commitment to making a difference in South African communities.”
The award seeks to honour organisations from across the healthcare industry who are driving programmes, initiatives, and campaigns that create access to quality healthcare for underserved communities.
Alongside its corporate social responsibility (CSR), Bestmed also hopes to continue to enhance its brand and value proposition into next year. This will span several different areas, including increasing its service provider network, growing its brand awareness, and remaining the preferred choice for members and healthcare providers.
“We will actively continue to reposition Bestmed as a next-generation healthcare business that can achieve high growth and exceptional service whilst maintaining sustainable financial performance.
“Caring for our employees also remains critical. We will support and build resilience in the ranks through various health and well-being initiatives that continue to provide a stellar member experience,” Dlamini closes.