Rigorous negotiations keep Bonitas’ premium increases low and choices robust
Members of Bonitas Medical Fund, the second-largest open scheme in the country, will see low increases in their medical aid premiums going into 2015, with the average increase coming in at 7.2%. The Standard option will see an increase lower than inflation at 5.7% while all other options will increase by 9.8%.
Speaking at the announcement, Dr Bobby Ramasia, Principal Executive Officer of the Bonitas Medical Fund said, “We work hard to make medical aid as affordable as possible.”
“The team has covered good ground in keeping the increases low, by delivering a network of healthcare providers that meets consumers' needs and giving them meaningful options that suit their pockets. Hard- nailed negotiations played a big role in ensuring single digit contribution hikes.”
Dr. Ramasia said that Bonitas took a stand on behalf of the members calling on hospital groups to work with other stakeholders in the healthcare value chain to address runaway costs.
“We have implemented a number of innovative initiatives on our own to reduce hospital costs. These include reimbursement models that encourage hospital and provider management to achieve efficiencies while discouraging waste.”
“Bonitas has also introduced measures to ensure that procedures that do not require overnight stays are performed in the most appropriate facilities, such as day clinics or operating theatres catering for minor procedures. Family practitioners are also actively encouraged to carry out specific, safe low-risk procedures in their rooms rather than in a hospital.”
To ensure members receive quality and cost-effective care and retain their health and wellness, Bonitas has implemented a number of programmes that identify specific medium to high-risk members and assist them in managing their health.
The programmes are aimed at influencing the behaviour of both the identified members and their general practitioners through targeted interventions. These are designed to improve adherence to prescribed medicines and treatment plans and modify behaviour to prevent avoidable medical costs.
“South Africans cannot achieve their full health potential unless they are able to take control of things which determine their health. Health cannot be guaranteed by the healthcare providers alone and demands collaborative efforts from all of us.”
“Thanks to such collaborations, we have been able to improve the members’ health outcomes, reduce claims and in turn implement lower premium hikes while still maintaining a strong financial position,” he adds.
In pursuance of this collaboration and increasing the return on health investments, all of the scheme’s options will now have an added wellness benefit to actively manage the members’ health. These benefits include blood pressure, glucose, cholesterol and BMI tests amongst others and should be performed by a registered provider.
A savings and a day to day benefit have been added to the Standard option. Savings can be used for acute medication, consultations, pathology, radiology and just about any out of hospital claims before use of the generous day to day benefits is required. Depending on the number of beneficiaries, the day to day benefits on this plan range between 38% to 53%.
BonClassic and BonComprehensive, the top-end executive options, will see increased savings benefits to the tune of 15% and 25% respectively. Depression, which affects 1 in 6 South Africans, has been included as a chronic condition on BonComprehensive as well as the Standard Option.
Bonitas is driving a strong case for reduced co-payments and helping members avoid financial stress due to rising medical costs. In doing so, Bonitas has reduced the co-payment for biological drugs by 10%.
“The wider benefits in 2015 seek to empower our members. We consider it an important and promising aspect of managing health in a way that can help people lead more proactive and fulfilling lives” Dr. Ramasia said.
