Stability and sustainability remain top priorities for Fedhealth in 2013

Fedhealth, one of the larger medical schemes in the country, announced yesterday that once again, due to its forward planning, partnerships and drive to provide sustainable, guaranteed cover for its members, a modest and predictable average contribution i

Peter Jordan, Principal Officer for Fedhealth, says the significant surplus of R144m as well as the continual healthy solvency levels from 30.7% in 2010 to 37% in 2011, well above the 25% required by the Act, assisted in limiting the annual contribution increase. Fedhealth's total premium income remained constant at R2.4 billion.

"Once again we retained our AA- Global Credit Rating which we have held for the past six years. Retaining the rating is proof of our very high claims paying ability, that our protection factors are strong and that Risk is only modest. Our solid partnership model also ensures every necessary step has been taken to ensure that Risk is maintained at the most conservative of levels," he says. "The focus remains to provide members with the assurance of predictable and affordable increases into the future."

In line with the scheme's goal to transition healthcare management from reactive control to pro-active holistic condition management, Fedhealth has introduced new screening benefits for all its members in 2013. "The new screening benefits will provide access for members to a number of screening and preventative programmes. These screening programmes are focused on women's, children, geriatric and cardiac health."

"Our objective to ensure quality and value-for-money healthcare for all has also led us to introduce a percentage decrease in the self-payment gaps for our basis, standard and standard net options. The exec option has had a 42% decrease in its self payment gap, based on a principal member, adult and child. Self-payment gaps have traditionally been high in the industry and we are pleased to be able to offer this benefit to our members," Jordan says.

To remain competitive and ensure growth, Fedhealth continues to steer its focus from the individual market to that of groups within the corporate sector. "Our strategy to achieve this is to enhance the benefits of Real Medical Aid with a more corporate-centric service offering. This includes tailor-made solutions with option mapping to suit the organisation's staff; group implementation and training; and dedicated Client Liaison Officers that interact in a one-on-one way with employees," says Jordan. He adds that making the transition process for corporates from a current scheme to Fedhealth as easy and hassle-free as possible continues to be the scheme's focus.

Jordan reports that Fedhealth's Networks continue to grow with over 4 700 doctors currently belonging to the Fedhealth GP Network. 96% of all members have access to a Network Doctor within a 10km radius of where they reside and 80% of claiming beneficiaries on the comprehensive options are already using network GPs for unlimited GP visits. "In 2012, we introduced the benefit that all GP visits would be paid purely from Risk, without ever touching the member's savings. This will continue for the 2013 year."

"We have 3 000 specialists from all disciplines signed up to the Fedhealth Specialist Network. Using a Fedhealth Network Specialist means no co-payments for members in-hospital and price certainty out-of-hospital.

"Our objective is to ensure that members are able to access meaningful benefits without having to resort to out-of-pocket payments. Our long term strategy is all about improving health outcomes and bending the cost curve by leveraging our partnerships for mutual benefit."

In terms of the year ahead, Jordan says Fedhealth is proudly the scheme which focuses on paying the most from risk to its members. "We have already made headway into the groups and corporate market and will continue our focus in this direction for 2013. As always, stability and sustainability of the scheme remain our top priorities to ensure our individual and corporate members enjoy peace of mind as they look to the future and their medical needs. We are optimistic about the year ahead and all it has to offer,"

concludes Jordan.