Medshield announces positive performance and continued member-centric approach amid pandemic

At Medshield Medical Scheme’s 52nd annual general meeting held on June 30 2021, Thoneshan Naidoo, principal officer, said Medshield had to embrace the heightened responsibility to serve its members' healthcare needs during 2020. The scheme will continue to focus on innovation to serve its members in the new pressurised and changed healthcare context.

The Global Credit Ratings Agency recognised the scheme’s sound financial position by awarding it with an AA- rating with a stable outlook for the 14th consecutive year. Its solvency ratio at the end of the financial year was 52.6%, well above the statutory minimum of 25% as prescribed by the Medical Schemes Act (MSA). The governance structures of the scheme functioned efficiently and effectively during 2020, with the board of trustees and various committees continuously monitoring and evaluating the work implemented by Medshield’s executive management team.

Medical schemes, like many businesses and individuals, found themselves in uncharted territory and had to adapt to the challenges brought on by the Covid-19 pandemic. 

Innovation has always been a priority for Medshield. During the past year, the scheme invested in its IT infrastructure, improved IT security, and made many enhancements to its member-centric digital tools to ensure easier and safer healthcare provision to members. 

Medshield will continue to deploy innovative digital tools and service channels, with a focus on innovation as a strategic priority. During 2020 and into 2021 Medshield implemented a digital strategy, introducing digital tools to service members and enabling virtual healthcare consultations via the Medshield member app.

Medical schemes are not-for-profit organisations and exist to bring value to its members. The monthly contributions paid by members are pooled into a trust fund and used to pay for the healthcare claims of members according to the scheme rules and their particular choice of plan or benefit option. Any surplus funds are transferred to the scheme’s reserves to mitigate risk during rainy days or healthcare pandemics. 

Medical schemes operate in a highly regulated environment which gives members peace of mind knowing their funds are safeguarded. 

Naidoo believes the pandemic has shown how important membership to a medical scheme is. “In 2020 our top 10 claiming patients collectively cost Medshield R29m in healthcare claims. The highest claim was from a 56-year old member with major complications as a result of Covid-19. As a prescribed minimum benefit all costs associated with a Covid-19 diagnosis are covered by the scheme’s plans.”

The member was covered by Medshield’s MediValue plan, which costs just over R2,000 a month, said Naidoo, revealing the scheme covered the member’s claims which amounted to R7.4m. “At his current monthly premium, it would have taken this member 300 years to pay this amount. This is the real value of a medical scheme because by pooling all the contributions of members the scheme can afford claims of this size.”

South Africans have the benefit of a world-class private medical sector. “In my view, it's a national treasure and should be protected and nurtured.” A public and private healthcare sector can successfully coexist, as they have done in countries such as the UK and Australia. There is no reason that the same should not be happening in SA,” he said.

That being said, there is no question that SA should be finding ways to supercharge the National Health Insurance (NHI) given it will benefit the country. “Healthcare has a close correlation to productivity and a country’s GDP. The entire country will prosper with a healthier population.”

The recent Covid-19 vaccine rollout has been a good example of the public and private sectors successfully working together. “We are further ahead in terms of the vaccine rollout than if government had done it alone. Covid-19 can be a terrible disease for some and vaccinations are the only way we’re going to curb its spread. The cost of a diagnosis for a test is R850, which medical schemes cover. The cost for the double dose of the Pfizer vaccination is R870 including the administration costs. The financial cost of the vaccine is insignificant when compared to the physical, emotional, social, and economic toll of Covid-19, so we need to get as many people vaccinated as quickly as possible,” said Naidoo.

The effect of Covid-19 and securing access to vaccines will remain a priority. The scheme foresees that the constrained economic environment will place a strain on membership affordability, membership growth, and retention well into 2022. This heightens the call for member value, which the Medshield offering will continue to enhance as a focus area. 

It is foreseen that new regulations will be introduced to better govern the rapidly changing healthcare environment and Medshield is committed to adding value by engaging on new regulations such as NHI, the MSA Amendment bill and the S59 investigation, as well as unlocking the value of enhanced BBBEE initiatives.

With a history that dates back more than 53 years, Medshield is driven by its mission to provide access to affordable high-quality healthcare through partnerships at competitive prices. “We are confident that our member-centric business approach will continue to translate into quality healthcare and good value for money,” says Naidoo.

Medshield confirms its position as a transparent and sensible supporter of national initiatives to provide greater access to quality healthcare for all South Africans.

This article was paid for by Medshield.