Bonitas Medical Fund is the latest medical aid to release its fee increase for 2017. The fee increase across all Bonitas scheme options will be 11.9%, with no decrease in savings. This follows a challenging year for the healthcare industry.
Dr Bobby Ramasia, principal executive officer, Bonitas said: “Negligible economic growth, increased interest rates, inflation and basic costs of living have resulted in significant financial strain on consumers. These factors were compounded by: A falling Rand, adverse global developments, rising costs of hospital admissions, fraud, wastage and abuse, the cost and increased use of PMBs. Medical inflation has, as expected, surpassed the consumer price index by between three and five percent.
“Despite the challenges and pressures faced by the industry, we have managed to curtail our 2017 contribution increase to be competitive and only marginally more than the 2015/2016 weighted increases of 10.6% and 7.2% respectively.”
While some medical schemes reduce benefits to help curb fee increases, Bonitas noted that it finds other ways to curtail costs. Reductions in benefits mean that consumers are left carrying the weight of the costs.
Cost-containment solutions
Bonitas will implement a range of cost-containment solutions to help limit healthcare cost increases. These include:
- Negotiating rates with healthcare providers and hospital groups to encourage members to use preferred providers to extend their benefits, limit co-payments and ensure they receive quality healthcare.
- Increasing their focus on prevention and utilisation of managed care protocols in disease management and co-ordination of care and wellness through the Managed Care programme. Early detection and proactively managing the diseases are key components of this.
- Partnering with Document Based Care – this is an interdisciplinary functional rehabilitation including treatment from doctors, physiotherapists and biokineticists to treat severe neck and back pain. It is an integrated approach and in 85% of cases surgery can be avoided.
- Using the Emerging Risk Model, an innovative tool to identify emerging risk members before they develop high risk conditions, with concomitant increases in costs to the members.
- Bringing new products and a broader product range of options to make quality healthcare more affordable and accessible to all South Africans
- Upskilling family practitioners and partnering with quality service providers.
Product restructuring
In addition to the above changes, Bonitas is also restructuring their offerings for 2017, in order to appeal to a wider market. These changes include a full suite of traditional medical aid options, as well as various saving options to suit a range of healthcare needs and budgets.
BonComplete is a new product offering. This is a new savings plan which includes an above threshold benefit. This product covers 31 chronic conditions including ADD for children under 18 years of age. Other benefits include: unlimited hospitalisation at 100% of the Bonitas rate, basic and specialised dentistry paid for from risk, and general and specialised radiology in and out of hospital with no co-payment, along with a range of other benefits.
Furthermore, Bonitas revealed: “Although some members enjoyed a richer over the counter benefit in 2016, many found that their savings were exhausted early in the year. To give members more choices on how to use their benefits, we have re-introduced an over the counter medicine sub-limit within the new increased day-to-day benefit.”
Hearing aid benefits have also been restructured. Bonitas highlighted that co-payments for hearing aids on the Standard and Standard Select options have increased from 10% in 2016 to 20% in 2017. For the BonComprehensive, BonClassic, Standard and Standard Select options, members will have to wait 24 months between claims for hearing aids.
Bonitas has also announced the reduction of age for the preventative care benefit for mammograms. “Early detection of breast cancer is essential to its treatment. Mammograms are one of the most advanced diagnostic tools, as they can detect breast cancer up to two years before a tumour can be felt. Because breast cancer is one of the most common cancers in South Africa, we have followed best practice guidelines and reduced the minimum age for mammograms from 50 to 40 on BonComprehensive, BonClassic, Standard and Standard Select.”
Bonitas and LSM amalgamation
A merger between Bonitas and LSM (previously Liberty Medical Scheme) has been approved by the Competition Commission, as well as the Council for Medical Schemes (CMS), effective from 1 October 2016.
According to Bonitas, the benefits of their merger include:
- A stronger and more sustainable scheme providing enhanced cover and benefits though economies of scale.
- A broader national footprint and consolidation of resources and fixed costs which will assist with relieving pressure on future contribution increases.
- Bonitas’ strong financial stability and generally predictable claims history should also translate to more value for members of the new scheme.
