Fri, 31/08/2018 - 05:15
Current Issue 69
Redefining Medical Scheme Healthcare
Tanya Bell reveals how Selfmed Medical Scheme is powering development in South Africa’s private healthcare market
Writer: Jonathan Dyble
Project Manager: Callam Waller
Private healthcare has continued to make significant strides within the South African market.
National statistics show that approximately nine percent of the country’s GDP is attributed to healthcare each year, on par with the likes of Spain and Malta, largely driven by the private sector.
With more than 200 private hospitals across South Africa, private medical schemes serve roughly 18 percent of the South African population, compared to 81 percent opting for public medical treatment.
However, with investment across both sectors being relatively even, private medical schemes indisputably offer the best quality services to patients across the country, reflected by a study from Statistics South Africa showing that 97.3 percent of households were satisfied with their private healthcare service.
There is, however, still room for improvement and great potential within the market – potential that is driving Selfmed Medical Scheme, one of South Africa’s most successful medical schemes, to continually pursue excellence.
“We proudly boast over 50 years of providing our members access to the highest quality healthcare, and this combined with excellent personalised service, makes Selfmed one of the most experienced in the industry,” says Tanya Bell, Head of Marketing at the Scheme.
Selfmed takes an innovative and forward-thinking approach to the betterment of its operations, most readily reflected by its emphasis on the implementation and use of new and advanced technologies.
One of the biggest challenges facing the industry is rising healthcare costs, an issue that is increasingly placing pressures on medical schemes to find sustainable ways of coping with rising financial difficulties.
In addressing this, Selfmed is tactically increasing its research and development activities in the aim of proactively introducing new mechanisms to help better control its finances.
One such technology that the Scheme has looked to as a result of this is machine learning, an intelligent solution that has the potential to help cut costs, improve member-scheme relationships and enhance the Schemes services, as Bell explains.
“The Scheme is currently applying machine learning to the claims database, enabling us to draw a more accurate picture of any of our members’ specific healthcare needs,” she says. “The implementation of machine learning is a big step and the aim is to mature the technology to such a stage that we can give members individual health information that will help them to lead a better life.
“We hope to change the interaction between the medical aid provider and the customer so that a partnership is developed, rather than the current system where the medical aid is acting more like a payment facilitator than a long-term partner in healthcare.”
An expanded portfolio
This disruptive outlook and willingness to adapt and evolve has resulted in Selfmed launching two new key offerings to its portfolio in recent times: SelfNET and SelfNET Essential.
Bell reveals: “In line with our strategy to progressively offer innovative, more affordable benefits to our members, the SelfNET and SelfNET Essential benefit options were added in 2015 and 2016 respectively.
“Due to the Scheme being in a process of monitoring market trends, coupled with the challenging operational climate and a competitive market, an immense amount of market research is continually required in order to stay on top of our game, identify trends, and develop new and innovative strategies to complement our service offerings.
“When we analysed the product range of the Scheme we realised that there were segments of the market that were not being serviced by our products. The need for a more affordable product with benefits that provides cover for one-off events instead of continual and recurrent care was identified – and so, the SelfNET and SelfNET Essential options were borne.”
Combined with the Schemes Selfmed 80%, Med Elite, Selfsure and Med XXI products, each of which has been specifically designed to cater to a different life stage, Selfmed ensures that it is able to provide a more personalised service and experience to all of its members.
“This, ultimately, is what we are focused on,” Bell states.
Breaking the mould
Whilst the launch of both SelfNET and SelfNET Essential were specifically aimed at increasing Selfmed’s overall scope within the South African healthcare market, the Schemes motivations are also driven by its member retention strategies and improving its existing offerings.
“We have found our approach has proved that in the times that we are living in, it is no longer simply about product, but just as importantly about nurturing the member-relationship experience,” adds Bell. “Our unconventional open-door policy, whereby a member can contact any member of the team, is something that we hold very dear to our service offering.
“The well-known adage that prevention is better than cure holds very true in the context of our business. To this end our managed healthcare programmes play a vital part in not only bolstering the sustainability of the entire Scheme from a cost perspective, but also ensuring that our members are guided towards the best possible medical outcomes through our quality care and wellness initiatives.”
It is these key philosophies that have placed Selfmed on the renowned footing that it stands upon today, and it is this ethos that the Scheme will continue to abide by religiously to further establish itself as a fundamental player in driving forward South Africa’s healthcare progression.
Bell Concludes: “We regard ourselves as a dedicated team that hold the best interests of Selfmed and its members in high esteem.
“To this end, moving in to the future we will continue to be proactive in introducing new and innovative strategies that will continue to drive us forward whilst ensuring that our members enjoy best value in respect of their healthcare needs.”