The changing medical scheme landscape
THE medical scheme environment is dynamic – and over the past 18 months has had to be even more flexible and innovative.
The unpredictability of Covid-19, changing healthcare needs of members and economic instability, have made it a turbulent time for medical schemes. “We have taken a more assertive stance in making quality healthcare more affordable and accessible to all South Africans,” said Lee Callakoppen, principal officer of Bonitas Medical Fund. “It’s a balance between giving our members access to quality healthcare, while ensuring the sustainability of the scheme.” Last year, Deloitte estimated that medical scheme memberships in South Africa would fall by 8.6%. At the end of 2020, Bonitas recorded a membership loss of 1.6% – significantly lower than anticipated for the industry.
Membership numbers
There was minimal impact on Bonitas membership numbers for 2020, with a 2.2% increase in terminations compared to 2019.
This was partly due to the support offered by Bonitas during the initial Covid-19 lockdown through introducing virtual care, online and WhatsApp self-service channels, delivery of chronic medication and proactive outbound communication. During 2020, Bonitas facilitated more than 5 000 virtual consultations. Virtual care, a necessity during the worst of the global
The future
To retain and grow membership, Bonitas must continue to find new and innovative ways to grow the healthcare offering. “We focus on affordability and quality healthcare but also address primary healthcare and preventative care, as opposed to responding to illness. Technology connects us with members and plays a vital role in virtual and home-based care. The goal is to improve integration of care, enable more access to out-of-hospital services, clinical information and benefits via innovative solutions.
“To remain relevant and sustainable, we need to listen to our members’ needs and give them the healthcare solutions they need. A proactive and strategic approach to product development is required.
This includes extensive research, analysis of the macro-economic environment, evaluation of member satisfaction levels and actuarial modelling to ensure that we continue to put our members first.
“It’s evident through our performance over the past year, supported by our agile strategies, that we have been able to navigate the changing medical aid landscape. Members have remained loyal during these difficult times and we remain committed to providing quality healthcare, connecting with them and driving innovation,” said Callakoppen. pandemic, has found favour with members who have quickly adapted. Bonitas now offers virtual care across all its plans and introduced BonStart, with virtual care as the main option for GP appointments, at a reduced monthly premium.
Member movement
About 10 019 members changed their options in 2020. Of these, 38.1% upgraded their plans, while 61.9% downgraded. The movement was mainly between comprehensive cover to mid-levels of cover. Downgrades from mid-level plans were to similar network-based options. This is consistent across all plans.
The upswing
In Q1 of 2021, Bonitas welcomed 28 500 new members, 60% of these are under the age of 35. Network options, where members pay around 15% less for the same benefits, continue to grow. Options driven by technology and aimed at younger members, with a focus on virtual care, have also attracted new members.
The 2021 increases were the lowest ever, with BonFit Select being the only plan in the market with a 0% increase.
Managed care
The continued focus on managed care empowers members to take charge of their health. Bonitas is seeing a shift in its members’ behaviour, who have an increased interest in being proactive and involved in their health.