Putting members first

Lee Callakoppen, Principal Officer, Bonitas Medical Fund

2021 continues to put the spotlight on the importance of healthcare, with the second wave of Covid-19 infections seeing countries, borders and businesses being closed down. The vaccination brings hope that we will be able to fight and contain the pandemic but, until ‘herd immunity’ has been achieved, we still need to follow protocols and remain vigilant.

There is a great deal of misinformation around Covid-19 and our members need a trusted source to provide accurate information about symptoms, tests, treatment and vaccinations against the virus. Now, more than ever, guidance and sound advice is of paramount importance to help members make the right medical aid choices.

In an industry like ours, it’s challenging to be different – to innovate, disrupt – to be better. Covid-19 has highlighted the need for stakeholders in the healthcare environment to evaluate and adapt their models. Our focus is to remain sustainable while delivering on our mandate of making quality and affordable healthcare accessible to all of South Africa. This requires driving product leadership, connecting with members and ensuring operational excellence. During the pandemic, access to private health care has shown its true value. Although the medical aid industry may be perceived as not being agile and a grudge purchase by members, we feel that the swift adaptation to the pandemic, our virtual care model and agility within the Scheme, is changing this perception.

It is also a necessity, rather than an opportunity, for the healthcare industry to accelerating change, to make virtual care a viable option and to explore new ways to grow and develop this offering. We have taken a major leap in digital adoption with virtual platforms, such as apps, making it easier for members to take control of their membership and have 24/7 access to medical care. This includes access to support and advice on Covid-19.

As the medical aid for South Africa, we are constantly stepping up and improving customer experience across all member and stakeholder engagement channels. But equally important for the customer experience are brokers. We cannot overemphasise their value. A broker’s role is not simply to sign up members; it’s to help explain the many medical aid options and scenarios available. One size does not fit all, thus it is necessary for brokers to help members make an informed decision when choosing a plan by balancing the options available against the members specific healthcare needs and affordability of the contributions. Brokers, therefore, provide an independent evaluation of a person’s specific circumstances, both from a financial and healthcare perspective.

From a servicing viewpoint, brokers continue to be ‘invaluable’ as they assist members to resolve their queries quickly and efficiently and help educate them.

Further proof of their value, combined with our wide and diverse range of product offerings, is in the fact that from a net termination movement perspective, there was a loss of membership of 0.6% for 2020. Considering the impact of the Covid-19 pandemic, this is significantly lower than anticipated.

When Covid-19 became a reality, the first step was to identify high-risk members.
Interventions and communication were put in place to make certain members understood the importance of sticking to the protocols, maintaining their medication regime and eliminating as much risk as possible. The medicine supply chain was also monitored and measures between pharmaceutical and courier companies were implemented, with chronic medication was delivered to members’ homes.

We set up the Covid-19 platform, providing information on everything from symptoms through to treatment, recovery, transmission, costs covered by your medical aid, frequently asked questions, updated statistics on active cases, recoveries and death and self-screening.

There has been minimal impact on our membership numbers for 2020, with a 2.2% increase in terminations compared to 2019. Of our total members, 10 019 changed their options in 2020 of these, 38.1% upgraded their plans, while 61.9% downgraded their plans. The movement is mainly from plans offering comprehensive cover to plans covering mid-levels of cover. We focus on providing a balance between affordability and quality care, which means that even if members downgrade, we try to ensure that they are still able to access necessary care.

To ensure the sustainability of our industry we need to get the balance of products, services and premiums right. We introduced four Efficiency Discounted Options (EDOs) over the past few years, plans where members use network healthcare providers and pay around 15% less for comparable benefits.

For 2021 there is a new category – Edge – with a plan called BonStart. The plan is driven by technology, intelligence and innovation and designed for economically active singles, or couples, living in larger metros.

Good health should never be taken for granted. It is to be invested in and valued and is why we remain vigilant in the management of our members’ health, to provide quality care and remain a trusted source of information and assistance for them.

Momentum Investments is part of Momentum Metropolitan Life Limited, an authorised financial services (FSP6406) and registered credit (NCRCP173) provider.