Double-digit increases in medical aid member contributions already announced by medical schemes for 2017 perpetuate the dilemma the industry finds itself in, namely to accept increases imposed by private-healthcare service providers and recover these increases from members.
The weighted average 2017 medical-scheme increases already announced are:
- Bonitas Medical Fund: 11,9% (from 7,2% in 2016)
- Discovery Health: 10,2% (from 8,6% in 2016), with hikes ranging from 7,8% to 14,9% on the various options.
- Momentum Health Medical Scheme: 11%, with hikes ranging from 8,9% to 15% on the various options.
“Very little is done to break this impasse, but the members of the Day Hospital Association of South Africa offer substantial relief in this spiral in the form of cost-effective fees for same-day surgical procedures,” says Bert von Wielligh, chairman of the association (DHASA). The association represents a national day hospital footprint of 41 facilities throughout South Africa and form part of the National Hospital Network (NHN).
One of the problem areas in private healthcare is the disproportionate increase in private-hospital costs in relation to other increases. This has been acknowledged by government and led to a Competition Commission inquiry, which is ongoing.
These state-of-the-art day hospital facilities offer surgical procedures which can be performed on a one-day basis. Day hospitals are compact and custom-designed and -equipped for a wide range of surgeries. Staff overheads are reduced to one shift per day and patients and specialists benefit from stream-lined admission and turn-around times.
Acute hospitals are designed to cater for patients who are seriously ill and in need of additional facilities such as high-care wards and intensive-care units. Many of these patients are admitted for more than one day.
“Thanks to modern surgical techniques and equipment, some 70% of surgeries can be performed safely in a day hospital, with substantial savings for patients and medical schemes. International research has confirmed savings in excess of 30%,” says Von Wielligh.
The savings have already been acknowledged by many schemes, after Discovery Health took the lead by offering specialists an incentive to operate in a day hospital to reduce costs. These savings benefit medical-schemes and uninsured patients alike. Government-employee scheme GEMS also promotes the use of day hospitals, saying these procedures are known to be cost effective and are encouraged in principle. Polmed recently reaffirmed that surgery in day hospitals affiliated with the National Hospital Network requires no member co-payment on its Aquarium option.
“The utilisation of day hospitals in South African lags behind the rest of the world, but we are experiencing an upswing in patient numbers as the crippling cost increases force medical schemes and patients to search for viable alternatives to acute-hospital treatments where possible,” says Von Wielligh.
“Many of these day hospitals are running at occupancies between 30% and 50%, and have the capacity to double their volumes. We are ready for the migration of same-day surgical procedures from acute hospitals to day hospitals, which are specifically designed for short-stay procedures.
“We are optimistic that cost pressure will steer more patients to day hospitals, in their own interest. The drive by many medical schemes to promote day-hospital utilisation is encouraging and a proactive move to prevent a further loss of members, or a downscaling in the options members subscribe to, as fees continue to escalate to levels of unaffordability.”
For more information, contact the Day Hospital Association:
- Marti Gelderblom, Executive Officer: 082-776-1186 (firstname.lastname@example.org)
- Bert von Wiellich, Chairman: 082-557-5086 (email@example.com)
7th of October 2016.