HealthGroup - News

By: Healthgroup  11-11-2011

Financial Results released for 2009

Discovery Health experienced another year of excellent overall performance with several multi-year strategies continuing to yield positive results. The Scheme generated a surplus of R791 million for the current year taking the Scheme’s statutory solvency level to 25.45%, R111 million higher than the 25% statutory solvency required by the Medical Schemes Act 131 of 1998, as amended. The Scheme continued to exhibit strong membership growth in 2009 and now covers over 2 million lives. Importantly, while members joined the Scheme at a significant rate of 10.17%, the rate of members leaving the Scheme was only 3.76%. On average the Scheme processed 151,203 claims per day equating to over 3,1 million claims per month with an error rate of only 0.75% and the claims being paid within 3.97 days from date received.

New Registrar of Medical Schemes appointed
The Minister of Health has appointed Dr Monwabisi Gantsho to the position of Registrar of Medical Schemes and Chief Executive of the Council for Medical Schemes (CMS) with effect from 1 June 2010.

Dr Gantsho is a medical doctor whose academic achievements include a Masters Degree in political science and economics. He is a Fellow at the Centres for Leadership and Public Values from the Graduate School of Business at the University of Cape Town and the Terry Sanford Institute of Public Policy at Duke University in the United States. He has occupied a senior management position at the South African Medical Association (SAMA) for the past five years. He is a member of the Institute of Directors (IoD) and the World Medical Association (WMA).

Private health care changes tune on price controls

The government is again busy with a plan to set up a structure that will determine the prices that should be charged by service providers in the private health care sector.

It is reported that Health Minister Aaron Motsoaledi wants to establish an independent commission that will look at pricing in the sector with the aim of regulating charges. Motsoaledi is said to have told the Board of Healthcare Funders that he was asking the Competition Commission to consider exempting medical schemes from the Competition Act until such a commission was in place.

Life Healthcare in record JSE IPO of R8 billion

South African private health care company Life Healthcare said it will raise up to R8.04 billion through an initial public offering, likely to be South Africa's largest IPO on record.The company, which operates private hospitals across South Africa, said on Tuesday it plans to sell 431.3 million shares at a price between 14.5 and 17 rand.

Cardiac Unit at Baragwanath a 'disaster'

No major heart operations have been done at Chris Hani-Baragwanath Hospital's cardiac unit in the past three years because of broken equipment, leaking roofs and supply shortages.

More than a 100 patients, referred to the unit from other hospitals and clinics, are on waiting lists for catheters. Another 40 patients who need pacemakers have been referred back to peripheral units because the hospital cannot do the procedures.

The dysfunctional state of Bara's cardiac unit, hailed just last year as the best-staffed unit in the country, was revealed by Health MEC Qedani Mahlangu in a written reply to a question from DA MPL Jack Bloom.

Actuaries develop model to help government estimate how much national health insurance will cost

Actuaries have developed a detailed costing model for national health insurance (NHI) to help the government formulate its health policy for the country.In a presentation to the recent International Congress of Actuaries, Deloitte's Ashleigh Theophanides said Deloitte and Discovery Health had funded the development of the NHI costing model and had handed it over to the Actuarial Society of South Africa to be used as a resource to further the public debate on NHI.Theophanides says that the team working on the model had, on request, presented the model to some members of the Minister of Health's task team on NHI, but the model has not been presented formally to the task team. The model can be used by policymakers to test the cost of various NHI scenarios and their impact on the health system, she says.Theophanides says the model is a tool that will help policymakers to determine what will be required to implement a successful NHI system.
Regulator presses on with Bonitas matter The Council for Medical Schemes  remains of the opinion that the governance structure at Bonitas is fundamentally flawed and that the Board should be removed. The CMS believes it is necessary, desirable, and in the best interests of the beneficiaries of the scheme to appoint a curator at Bonitas to address the problems at the scheme and introduce good corporate governance.

Medical industry at odds over treating PMBs

The PMB system, under which you are guaranteed treatment of certain conditions by your medical scheme, is causing headaches for schemes and service providers alike.

Minimum benefits, which are the backbone of your medical scheme, face serious threats of being undermined by legal uncertainties, unsustainable billing practices and non-compliance with the law, key roleplayers said this week. The problems have continued for a number of years now, despite warnings from the regulator of medical schemes, rulings from its appeal board, approaches to the Minister of Health, previous task teams, draft regulations, legal action and threatened legal action.