Cost containment cuts contribution hikes
• Following the merger between Bonitas and LMS medical funds in 2016, expectations were that cost of monthly member subscription fees would rise
Bonitas Medical Fund announced its lowest member contribution increase in six years last week. After a challenging year for the healthcare industry, the contribution increase for 2018 will be a weighted 8,7%, with raises on the various options ranging between 7.9% and 9.9%.
Despite increasing healthcare cost inflation and economic pressures in the past year, robust cost-containment initiatives enabled Bonitas to keep the weighted average contribution in single figures for 2018. The increase is the lowest seen from the fund in recent years – clearly signalling its good financial health. In 2016, speculation was rife following Bonitas’ amalgamation with LMS medical fund. However, the impact of this has been negligible.
Money saved through innovative strategic measures allowed Bonitas to emerge in a stronger financial position despite industry challenges. This resulted in a reduction in the overall net deficit incurred by the fund, which dropped from R205.5m in 2015 to R16.9m in 2016.
“As one of the largest and most stable medical schemes in South Africa, our mission is to make quality healthcare more affordable and more accessible,” says Gerhard Van Emmenis, principal officer.
“We have, therefore, focused on balancing costs while ensuring our members continue to receive rich benefits. It’s been a difficult few years for the healthcare industry, with medical schemes facing several challenges, including economic pressures and escalating healthcare costs. In addition, medical schemes have to comply with the strict parameters of the Medical Schemes Act.
“In spite of this, the fund recently announced that its reserves have been bolstered to R3,1-billion and it has also seen a significant growth in membership.
“Last year, we successfully concluded the largest amalgamation transaction in the industry with LMS medical fund. This will continue to have a favourable impact on our membership as a whole, as a larger scheme is in a better position to negotiate tariffs in favour of our members,” says Van Emmenis.
The relatively low increase has not led to a reduction of benefits but rather an enhancement.
“We’ve looked at the needs of our members and South Africa as a whole to introduce several new benefits in 2018. This includes a benefit for contraceptives and a mental wellness programme, among others.
“Increases are unfortunately inevitable, given the high healthcare costs and inflation, but we strive to keep premiums as affordable and accessible for all. Some of the benefits have been tweaked, others increased but all were aimed at helping members take control of their health and lead better lifestyles — and with South African socioeconomic factors in mind,” says Van Emmenis.
Bonitas reports that in times of economic uncertainty and political instability, healthcare costs and claims tend to increase – particularly with regard to anxiety and depression.
Recent studies show that more than 17-million people in SA were dealing with anxiety disorders such as agoraphobia, panic disorder, post-traumatic stress disorder and mood disorders. In addition, statistics from a global study presented at a recent mental health summit in Johannesburg revealed that patients with mental disorders had increased by 22.7%. In SA, 30% of people report lifelong psychiatric disorders, while one in three will be affected by a mental illness in their lifetime.
Bonitas has developed four mental wellness plans that will be available in 2018 to identified beneficiaries. The programme will provide access to specialised mental health doctors and to education on managing the condition as well as support for loved ones too.
Earlier this year Bonitas introduced Babyline, the first dedicated toddler’s health advice line to its members. In 2018, further benefits will be made available for Bonitas babies, including screening for congenital hypothyroidism for babies under a month old. Screening all newborns for hearing loss is internationally recommended and these tests will also be covered on all options (in or out-ofhospital).
Van Emmenis says benefits that help encourage positive lifestyle changes and focus on preventing serious conditions are one of the key elements to reducing chronic disease prevalence. “Bonitas’ ’Wellness Extender benefit has been increased by 15% to give members access to more consultations with a GP, dietician or biokineticist, or cover for a programme to stop smoking. Pap smears for women over 21 years will now be covered on BonEssential and BonCap, once every three years. Mammograms for women over 40 will be covered once every two years on BonSave and Primary to strengthen the preventive care benefits on offer.
“In previous years, out-ofhospital tests and specialist consultations for the management of Prescribed Minimum Benefit conditions (PMBs) were paid for from day-to-day benefits first on Standard, Standard Select and Primary. In 2018, cover for PMBs will be paid for solely from risk – allowing members to get maximum value for money and stretch their day-to-day benefits,” says Van Emmenis.
Bonitas has a new website, which features information on benefits and plans to help current members understand more about what their plan offers while potential members can select and choose a plan to meet their specific needs with a facility that allows the comparison of up to three plans on a like-forlike basis.