Combining technology with the human touch

Digital innovations have the potential to lower barriers to access high-quality private healthcare

THE INTENTION BEHIND SMARTCARE IS BASED PURELY ON ACCESS AND CONVENIENCE WITH A GOOD PRICING BENEFIT

Medshield Medical Scheme recently launched an innovative benefit which combines cutting edge healthcare technology with a human touch.

The scheme’s SmartCare offering provides members with access to nurse-led primary healthcare consultations and Videomed doctor consultations from enabled pharmacies and clinics. Balancing affordability with high quality healthcare and convenient access, Medshield is the first medical scheme in SA to offer this service as a benefit for all members, at no additional cost, says Medshield’s principal officer Thoneshan Naidoo.

While SA has generally been slow to embrace the fourth industrial revolution in healthcare, Naidoo believes that innovations such as Medshield’s SmartCare offering will bridge the digital healthcare gap in SA and pave the way for increased adoption of telemedicine and for accessible healthcare services. “Technology has the potential to lower the barriers to access high quality private healthcare and conveniently save our members precious time in their busy schedules,” he says.

Videomed is designed around the experience and capabilities of registered nurses operating from pharmacy clinics. A nurse completes the initial patient examination and, if necessary, calls a doctor into the consultation via a real-time video connection. The doctor is able to see all the investigations and examinations conducted by the nurse, and can provide a diagnosis and prescription where required. Videomed general practitioners are fluent in 10 of SA’s official languages and have special interests in a range of disciplines including paediatrics, family medicine, geriatric care, anaesthetics, rheumatology, drug rehabilitation, orthopaedics and pain management.

Not only does SmartCare allow Medshield members to stretch their benefits but also to access healthcare providers after hours and over weekends without an appointment.

“Our members love the Medshield SmartCare value proposition and in 2020 we are enabling unlimited SmartCare nurse consultations across all our plans,” says Naidoo.

He points out, however, that SmartCare doesn’t replace the need for general practitioners, but will create new opportunities for referrals to local GPs. “The intention behind SmartCare is based purely on access and convenience with a good pricing benefit.”

Affordability is becoming a significant issue for many medical aid members, he concedes. While healthcare inflation is significantly higher than general consumer inflation, Medshield has found innovative ways to offer its members value, which includes the introduction of the Prime and Compact networks on its MediPlus and MediValue plans.

“Through our Prime and Compact networks members are empowered within their plans: they can benefit from a 0% increase on our Compact networks by following the healthcare provider networks and rules specifically designed for their access.”

Other new products being introduced include MediCurve, an affordable plan which has been specially designed with younger, digital savvy members in mind. The plan is largely driven via a mobile app.

Medshield, a not-for-profit medical scheme, uses 90% of member contributions to pay claims. “New technologies and new medications have had an impact on medical inflation which has informed our increases for 2020,” says Naidoo. “However, we believe our products are about 20% cheaper than the industry average when taking into account the richer benefits we offer. At the lower end of our plan range we’ve managed to avoid a contribution increase while at the more affluent upper end there is a 12.5% increase with an effective risk contribution of 8.5%.”

With the advent of technology and easy access to information, members are becoming more financially savvy and conscious of deriving value for money from their purchase. To compete, medical schemes must innovate and adapt to cater to these consumers.

As part of Medshield’s enhanced value proposition it has collaborated with partners Just Rewards and Elevate to offer a Freemium loyalty programme benefit which provides free legal advice and a fuel rebate at Shell garages as well as rewards for living a healthy lifestyle. Members can also select the Premium Loyalty Programme offering and receive discounts on gym memberships and from grocery retailers, twofor-one dining options and tailored financial services.

“As a scheme we are well capitalised with R1.7bn in reserve and have recently been reaccredited as AA- by the Global Credit Ratings Agency. We’ve taken a conscientious decision to use part of our high solvency to unlock better benefits for members,” he says.

Naidoo is cognisant of the need for schemes to cater not only for those who can afford it but also the additional seven to 14-million South Africans who use private healthcare on a cash basis.

“Good healthcare is not just for the affluent and those who can afford it. Everyone deserves this privilege,” maintains Naidoo.

Medshield is creating a platform where all South Africans have access to quality healthcare. Pending regulatory approval from the Council for Medical Schemes, it’s looking to launch a MediAlpha plan, a series of low-cost benefit options starting at R130 per month that will enable access to private primary healthcare to millions of uncovered South Africans who have not traditionally been able to afford medical cover.

MediAlpha, says Naidoo, is motivated by a social mandate to ensure quality primary healthcare is more easily accessible to more people.