Category Healthcare
SUB CATEGORIES General  |  HIV |  Medical Schemes | 

A survey

05 August 2004 Angelo Coppola

(3.8.04) Some interesting statistics about the sector.

The Board of Healthcare Funders of Southern Africa (BHF), in conjunction with Alexander Forbes Health Care Consultants have conducted a survey of the Medical Schemes industry to evaluate, analyse and benchmark trends to inform the industry of issues pertinent to the healthcare debate.

The scope of the survey covers the 2003 financial period and focuses on large open and restricted membership schemes. The sample covers 83% of open scheme membership and 61% of restricted scheme membership.

The survey examines the changes in membership; the financial results; solvency ratios; the distribution of scheme expenditure; claims distribution and for the first time, lists the credit ratings of some of the participating schemes.

Thiru Appasamy, head of Statistics & Informatics at the BHF said “one of the reasons for conducting the survey is that we identified the need for independent objective research not influenced in any way by commercial interests."

“This is a survey of large schemes. The sample, in terms of principal members, increased from 73% of the industry to 76% of the industry, roughly increasing from 1.9 million to 2.1 million principal members,” said Appasamy.

Other key findings of the report include:

* Hospital claims increased by a substantial 15.3%, continuing the trend established in previous years. Hospital claims paid now account for 34.3% of total claims paid in the sample;

* A substantial increase in solvency levels was recorded,

* Restricted schemes moving to 47.9%, up from 38.5% in 2002

* Open schemes increased to 17.9%, up from 12.1% in 2002

* The average for the sample increased to 25.1%, up from 18.8% in 2002

* The minimum statutory requirement was 22% at the end of 2003, increasing to 25% by the end of 2004.

* Average claims paid across all categories increased by 7.1%. Net claims incurred amount to 73.5% of the total spend.

* The average of non-medical expenses went up by 11.7%, broken down as average healthcare management expenses up by 13.3%, average administration costs increased by 9.9%. Administration costs remained steady at 10.1% of total spend.

* Contributions increased by 11.1%;

* The average age of all beneficiaries went up by 0.9 years;

* Average family size decreased from 2.56 to 2.50.

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