Bonitas limits increases despite challenging environment

Dr Bobby Ramasia, Principal Executive Officer, Bonitas Medical Fund.

Bonitas Medical Fund, the second largest open medical aid scheme in the country today announced an average increase of 10.9% across all its options.

Dr Bobby Ramasia, Principal Executive Officer, Bonitas Medical Fund said that while these increases are slightly higher than last year, they come during a particularly challenging time for the industry and Bonitas in particular. 

“As reported by the Council for Medical Schemes, the market has not been successful in attracting young, healthy people to join medical schemes while expenditure on claims continues to increase at a rate of more than 11%. At the same time, there have been particularly steep increases in the cost of specialists and hospitals, which together account for more than 61 % of total claims paid.

“Bonitas’ membership base is also representative of the South African population. As a result we have a higher-than-average exposure to costs flowing from conditions such as obesity and diabetes which are becoming increasingly prevalent in certain population groups.”

“In this context, Bonitas continues to explore and implement solutions to limit medical aid contribution increases as far as possible so that our members can still afford quality healthcare cover,” he says.

To this end Bonitas announced three new product offerings.

The scheme’s new Standard Select option offers similar benefits to Bonitas’ Standard option but at a lower contribution rate. This has been made possible through the use of hospital and doctor networks which members will be required to use.

BonFit, an affordable, new generation option, targets younger members and their families. The option combines generous risk benefits with a savings component from which day-to day claims are paid.

Following the Council for Medical Schemes’ (CMS) approval of the framework and guidelines for Low Income Benefit Options, Bonitas is also launching a low cost option that will provide primary health to low income groups.

“The option will be positioned below BonCap in terms of price and implementation will take place as soon as is practically possible – certainly within the first quarter of next year.”

Bonitas has also introduced an income band in the BonCap option which caters specifically for students. The Student Option allows students to be main members on their own medical aid at a very competitive rate.

The option simply requires that they provide proof of registration with recognised institutions of education in South Africa. In addition, Bonitas ensures improved access to healthcare by contracting providers/networks located near tertiary institutions.

“Affordability is of particular concern to consumers and Bonitas alike and our members will now be able to choose from a broader range of options for one that best meet their needs in terms of benefits and price,” added Dr Ramasia.

Bonitas is also embarking on a fundamentally new strategy, Intercare for an incremental fix as the healthcare system continues to struggle with rising costs and uneven quality despite the hard work of well-trained doctors.

The pilot pioneers the philosophy of having a family practitioner as the primary treating doctor. The family practitioner has the best understanding of the patient’s health and treatment and is best positioned to share this information with an expert healthcare team.

These initiatives are underpinned by the philosophy of co-ordination of care that ensures that the patient receives the best possible health care from the right person, with the right skills, at the right time and better control managing their benefits.

Initially, the pilot will involve Bonitas and Intercare through a network of 95 family practitioners together with the support of nine nurse practitioners or health coaches in 15 Primary Care centres in Gauteng, the Western Cape, the Eastern Cape and KwaZulu-Natal. The feasibility of adding independent family practitioners will also be explored.

As part of this pilot, Bonitas will be introducing an Electronic Health Record that supports the network family practitioner with a comprehensive medical record, care pathways for each beneficiary, clinical decision support and information on the beneficiary’s adherence to clinical pathways.

Bonitas’ managed care strategy, in addition to providing better value, has created an environment where healthcare professionals, the patient and Bonitas are able to work together to coordinate the patient’s care, improve healthcare outcomes, and remove wastage to bring down healthcare costs.

Bonitas’ membership base has remained stable and the scheme has been successful in keeping the solvency ratio above 30%. Pleasing returns on its investment portfolio also contributed to the scheme reporting a net surplus for the financial year ending 31 December 2014.

“One of Bonitas’ greatest successes is our sustained financial soundness and solvency level. Our key indicators, demographics and expense ratios remain significantly better than the industry average and this year we successfully reduced our non-healthcare costs by a significant margin.”

“Cost continues to be one of the major barriers to people accessing private healthcare. This is why we are committed to bringing new products to the market that suit individual budgets to make quality healthcare more affordable and accessible to more people,” Dr Ramasia says in conclusion.