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Category Healthcare
SUB CATEGORIES General  |  HIV |  Medical Schemes | 

Well planned strategy secures strong wins in the financial wellness of healthcare funding

13 July 2015 Karin Claassen, Momentum Health

A decade ago, market commentators were less likely to mention Momentum Health as one of the industry leaders in healthcare. However, in contrast to many of the then prominent schemes that subsequently disappeared, Momentum Health outperformed all expectations by more than doubling in size and currently boasting the most enviable risk profile amongst the top ten biggest open schemes in SA. Momentum Health today, as the 3rd largest open scheme, is firmly positioned to lead the way in years to come.

“To ensure the sustainability of a scheme over a ten year period requires strong conviction that your business plan is fundamentally sound,” says Karin Claassen, Marketing Manager at Momentum Health. “You will be challenged by competitors along the way who pull no punches during your building phase, and it is then very important to stay focused and follow through on your patient approach to build on a strong, long-term foundation. For us, this focused approach has paid off as we have secured a very strong, financially well medical scheme that can aptly cater for the healthcare needs of its members.”

Starting from a philosophy that focused on the GP as primary caregiver, and building flexibility into its product offering, the Scheme engineered the environment for members to shape cover that suits their financial, as well as healthcare needs. By partnering with groups of providers, this Scheme can save members significant amounts off their monthly contribution, if they select to make use of associated provider groups. As an example, a member on their Custom Option with one adult and one child dependant can pay up to R1 430 per month less, simply by making use of Momentum Health’s provider choice model. That is a 38% saving on the standard contribution for this option.

Active members on Momentum Health have also greatly benefited through the scheme’s association with Momentum. Momentum’s HealthReturns programme is one-of-its-kind, rewarding members with up to R5 400 a year – in addition to extra GP benefits and higher in-hospital specialist cover – in return for being more active and complying with treatment plans.

Adding a cellphone app further empowered members to remain in control of their membership, being more aware of their claims status, Savings balances, HealthReturns earned and so forth.

“We now provide cover to almost 130 000 families, whilst the Scheme boasts a healthy solvency level, comfortably above the requirements set by legislation,” Claassen reports. “The challenges facing us now will be to maintain our notably high client satisfaction levels, especially in terms of finding ways to accommodate the increasing membership growth rates without impacting on turnaround times.”

Client education has become one of the key focus areas, with world-first initiatives like Hello Doctor creating opportunities for instant telephonic engagement with health professionals at all hours of the day or night. Significant increases in member satisfaction have been achieved by simply helping members to more frequently make use of the technology and benefits now available to them. Claassen is confident that as members become more comfortable with a deeper level of involvement and understanding of their health and lifestyle, the Scheme’s popularity will continue to accelerate.

 

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