Fri, 25/05/2018 - 05:50
Current Issue 71
Healthcare to live your Best Life
Bonitas Medical Fund is demonstrating its stability in a difficult market, providing a range of plans and joining forces with other market leaders in pursuit of the best possible service and benefits for its members
Writer: Phoebe Calver
Project Manager: Josh Mann
The vast majority of businesses in South Africa are required to be extremely agile when it comes to adapting to a changing environment, and the healthcare industry is no exception to this rule.
Having just entered its 36th year in the healthcare industry, Bonitas Medical Fund is a great success story. The Scheme has evolved over the years from an initial membership base that was comprised exclusively of black civil servants, to the open medical scheme it is today.
“The important change to an open-scheme occurred in 1995 and since that point we have gone from strength-to-strength,” explains Gerhard van Emmenis, Principal Officer at Bonitas Medical Fund. “We are currently the second largest open scheme in South Africa and cover more than 700,000 lives.
“Although our Scheme has grown in terms of numbers, we have also developed to progressively offer innovative benefits to our members to ensure that healthcare is both more affordable and accessible for all.”
Perhaps the biggest challenge facing the private healthcare sector at present is the rising costs surrounding it, and subsequently medical schemes need to be proactive in curtailing those fees.
“Healthcare inflation continues to outpace general inflation by approximately five percent, which we recognise is reaching a point that will endanger medical aid by making it prohibitively expensive for the public,” continues Van Emmenis. “We cannot simply say that this is not our fault or our problem, instead we need to constantly be looking for different methods in order to contain the costs as much as possible.”
“The healthcare industry is an increasingly complex entity, while also being increasingly competitive. We have witnessed negative growth for the industry in recent years primarily due to healthcare inflation escalations. This has subsequently created a cutthroat environment in which we are all fighting to produce the best possible product at the lowest-rate.”
At present the core focus for Bonitas is to ensure it offers members medical aid that best suits their lifestyles and finances; to that end there is a wide selection of options available including traditional options, savings options, income-based options and hospital plans. Unlike the rest of the financial services industry, Bonitas prides itself on offering plans that are simple to use, easy to understand and designed specifically for the South African market.
“At Bonitas we have 12 plans available, each designed to perfectly meet the needs and budgets of South Africans from all walks of life,” adds van Emmenis. “These plans are covered under the umbrella of management of healthcare for our members, with two particular focus areas that specifically include cost containment and preventative care.”
As previously mentioned, with thanks to the inflation costs currently being experienced by the industry, cost containment has become a major point of interest.
Van Emmenis continues: “During the 2016 financial year, the Scheme experienced an increase in the utilisation of healthcare services, particularly hospital admissions and related benefits. Towards the end of the year we embarked on a hospital negotiations strategy, resulting in savings of R242 million the following year and all without compromising members’ access to quality healthcare.
“We will continue to negotiate robustly in this manner, containing costs wherever possible and negotiating the best possible rates for members.
“This year we will be carrying out a secondary initiative in order to identify hospitals on our network that are not cost-effective and work towards improving their efficiency. During the next few years ahead, we will likely seek to identify other options that will ensure we grow and retain our existing membership base, this will include the possibility of amalgamations as well as the development of new distribution models and channels.”
The Scheme’s managed care programmes also play a vital role in both the development of Bonitas and in ensuring that it can compete in the market.
“With the increase in prevalence of lifestyle diseases and the rising cost of treatment, there has been a trend towards prevention and managed-care protocols,” affirms van Emmenis. “At Bonitas we cover a range of areas including cancer, diabetes, mental health and HIV/AIDS through specialised managed care programmes.
“These programmes include vital tools that will enable our members to achieve the best possible clinical outcomes through quality care and ongoing wellness support. They offer access to clinical support as well as educational material to empower members to take control of their health.”
In 2017, Bonitas was bolstered by the introduction of the Bonitas Diabetes Management Programme, the success of which was underpinned by the Scheme’s ability to identify potential diabetic patients and enrol them on the programme while also actively managing them through support, testing and education.
Van Emmenis continues: “This year we have introduced a managed care programme that focuses on mental health, while also exploring the available options to introduce alternative reimbursement models for procedures such as knee and hip surgery.
“Connecting with our customers still remains a key focus area, as we seek to improve upon our digital capabilities in the hope that it will better our members’ experience while also communicating effectively and keeping them informed and engaged.”
The Scheme aims to use best technology available in order to make things more simple and effective for the customer.
“We have also implemented an Electronic Health Record which enables our members to track their health-status, while also making proactive changes to improve their general health and quality of life,” states the Principal Officer. “It will also help us monitor chronic conditions in order to stop them from developing or worsening.”
For organisations such as Bonitas, technology and enhanced infrastructure is an area that needs to be closely studied in order to make the required regular improvements.
“Finding meaningful ways to connect with our members, while also empowering them to take care of their health is a critical factor in our services,” continues van Emmenis. “In addition, there is currently an increased prevalence of chronic illnesses such as diabetes, hypertension and mental health and we are closely studying ways to improve the disease burden and clinical outcomes for each individual with these conditions.”
In order to keep carrying out this research and improving its service, new members are a critical factor to the sustainability of any medical scheme. In October, 2016 Bonitas amalgamated with LMS Medical Scheme (formerly Liberty Medical Scheme) concluding the largest transaction of its kind in the industry, with an excellent migration rate.
“We are delighted that during the amalgamation more than 90 percent of the LMS members utilised one of the 12 plans that we offer, providing us with a much higher retention rate than anticipated,” explains van Emmenis. “The amalgamation of Bonitas and LMS followed an increasing trend within the healthcare industry to create stronger and more sustainable medical schemes, with the hope that they would provide enhanced cover and benefits for members.”
Since it came to fruition, Bonitas has received numerous awards for its service expertise and excellence, most recently demonstrated when it received the Ask Afrika Orange Index, Kasi Star Brand Award and the Icon Brands Survey award in the same year.
“Our members are aware that when things get tough, we are more than capable of handling the smaller details to ensure they receive the best care in the business,” concludes van Emmenis. “We continue to explore and implement solutions that will help to curtail costs and allow our members to derive real value for mo