FANews
FANews
RELATED CATEGORIES
Category Healthcare
SUB CATEGORIES General  |  HIV |  Medical Schemes | 

Momentum Health in 2010 - Continuing to Offer Value through Choice

07 October 2009 Momentum Health
Lee-Ann Du Toit, Head of Health Marketing
Momentum

Lee-Ann Du Toit, Head of Health Marketing Momentum

Momentum Health, South Africa’s fifth largest open medical scheme, has announced an average contribution rate increase of 11.6% across its six healthcare options for 2010. The increase is spread between 7.3% and 16.1%, depending on the actual option chosen by members.

Astute members can however reduce their contribution rates by up to 30% on the same benefit option (i.e. retaining all their current benefits) by choosing to use more cost-effective healthcare providers. Momentum Health has specifically structured various ground-breaking partnerships to give members the option of reducing their contributions.

Healthcare Provider Partnerships in the Interest of Members

Commenting on the cost-saving options and choices available to members, Lee-Ann du Toit, Head of Health Marketing for Momentum said, “We have worked tirelessly to set up a network of healthcare-provider partnerships. By selecting to use these preferred providers, ranging from hospitals to pharmacies and GPs, members can receive considerable discounts on their contributions. So far this year (2009), Momentum members have saved over R160-million by utilising this feature to choose less-expensive provider options.”

Claims increases on specialist visits have now also prompted Momentum to extend their partnership network and curb costs on specialist visits by entering into an agreement with Associated Specialists, a network of specialists aligned to Momentum Health.

Du Toit explains, “This partnership allows for a negotiated rate, as well as direct, faster payment to providers, making them happier to deal with Momentum Health members. In turn, members are assured that their healthcare costs will be fully covered when using the Scheme’s Associated Specialists.”

“By capping specialist reimbursement rates for other specialists on our Custom option for 2010 at 100% of Momentum Health Rates (MHR), and at 200% of MHR on our Incentive and Extender options, our benefits offer competitive value of specialist healthcare.”

Du Toit says that Momentum Health’s innovative, customer-centric approach is based on providing value through choice, and predominantly through choice of providers.

“The value of choice, on which we pride ourselves, is further carried through in our comprehensive list of complementary products, aimed at enhancing the chosen treatment preference of individual members,” explains Du Toit.

Commenting on industry trends, Du Toit said that the past two to three years had been characterised by difficult operating conditions for medical schemes. “These include the current economic downturn, increased claims patterns and pressure from The Council for Medical Schemes to address the increase in medical inflation due to higher hospital and specialist costs. Notwithstanding these challenges, our increase compares favourable when weighed against average contributions within the healthcare industry.”

Life saving and Cost saving Innovations from Momentum Health

By optimising other innovative features from Momentum Health members can save even more by simply tapping into the preferential provider networks.

Momentum Health’s Health Platform

The only offering of its kind in the South African healthcare funding market is Momentum Health’s Health Platform, which covers dental check-ups, gynaecologist visits and scans during pregnancy – among other preventative healthcare tests – for free. In this way members can take pro-active (and life-saving preventative) care of their health without depleting their savings or day-to-day benefits. The fact that the average member using Health Platform spends more then R1,000 per month attests to the usefulness of this service offering.

Momentum’s Compliance Incentive Programme

Momentum’s latest value-add innovation is the Compliance Incentive™ Programme, whereby members can earn HealthReturns of up to R1,800 per adult, per year for taking ownership of their health. This programme is based on three simple steps that include undergoing a health assessment, complying with prescribed treatment where applicable and being active.

Multiply – Momentum’s Wellness Programme

Multiply, Momentum’s wellness programme makes it easier for members to join the Journey to Wellness by providing the necessary tools, incentives and information through more than 30 providers. Multiply members spend more than R82-million per year with the providers of the programme. This indicates a high level of participation and value for the member in terms of the significant savings that they can enjoy. For instance, a member on Private Club status can fly return to London for under R1,000.

The Momentum Health Saver

The Health Saver, enables members to provide for any medical expenses incurred that fall outside of the benefits provided by their chosen option. The Health Saver currently reflects well over R85-million in positive balances and is another market-leading product launched several years ago.

The Momentum MobiCard

Even technological innovations are helping members save time and money. The MobiCard, a digital member card for cellular phones, is proof positive of a leading-edge solution that empowers members. “Based on the extremely positive feedback we have received from doctors and other providers like Medicross, we know that this will make the lives of our members so much easier,” says Du Toit.

Momentum Health members have an electronic version of the card on their phone with their membership details, and when providers require proof of membership, this can be emailed or faxed directly from the phone. Members are also able to “find a doc” on their MobiCard. This allows them to locate a preferential Momentum Health Associated hospital, GP or specialist in their area.

If members need to pre-authorise any of their Health Platform benefits, they can do it immediately via the MobiCard. This will ensure that the Health Platform benefits are paid by the Scheme and not from savings. The MobiCard also shows the Savings account or Health Saver balance. This information can be refreshed on the spot to ensure that all recent claims have been taken into account.

If they want to check whether their recent claims have been paid, the MobiCard will display the last three claims and their current status. Members can also request a detailed statement to be emailed or faxed to them. The MobiCard also interacts with other complementary Momentum products. Members on Momentum’s wellness programme, Multiply, can check their activity levels, how many Multiply points they have accrued and how many points they require to move to the next status level.

In conclusion Du Toit said, “Against the background of a poor economic climate Momentum Health has approached its changes for 2010 with the objective of affecting as few members as possible in terms of contribution rate increases, while implementing the lowest possible sustainable increase alongside the greatest possible value and choice. Going forward into 2010, the scheme remains solid and stable, and well positioned to have a marked impact on the healthcare funding market.”

Quick Polls

QUESTION

What do you consider the most significant challenge in implementing the Two-Pot Retirement System?

ANSWER

Coping with new, unfinalised legislation, leading to uncertainty in implementation
Adapting to brand new claim types, requiring the development of digital, member-initiated claims capabilities
Addressing member education and awareness to correct misconceptions and ensure understanding of the system, including tax implications
All of the above
fanews magazine
FAnews June 2024 Get the latest issue of FAnews

This month's headlines

Understanding prescription in claims for professional negligence
Climate change… the single biggest risk facing insurers
Insuring the unpredictable: 2024 global election risks
Financial advice crucial as clients’ Life policy premiums rise sharply
Guiding clients through the Two-Pot Retirement System
There is diversification, and true diversification – choose wisely
Decoding the shift in investment patterns
Subscribe now