Bonitas announces annual increase and changes for 2018
In September 2017 Bonitas Medical Fund (Bonitas) announced its lowest increase in six years today. Read on to find out about Bonitas medical scheme prices in 2018. 2017 was a challenging year for the healthcare industry. So Bonitas’s contribution increase for 2018 will be an average increase of 8.7%. The with increases on the various options will range from 7.9% to 9.9%.
There was increasing healthcare inflation and economic pressures in 2017. However, robust cost-containment initiatives have enabled Bonitas to keep the weighted average contribution in single figures for 2018. The increase in Bonitas medical scheme prices is the lowest from the Fund in recent years. That clearly signals its sound financial health. Last year, speculation was rife, following Bonitas’ amalgamation with LMS Medical Fund. However, the impact of this has been negligible.
Money saved through innovative strategic measures allowed Bonitas to emerge in a stronger financial position despite industry challenges. This resulted in a reduction in the overall net deficit experienced by the Fund. That reduced the net deficit from R205.5 million in 2015 to R16.9 million in 2016.
Van Emmenis Talks About Bonitas Medical Scheme Prices
‘We are one of the largest and most stable medical schemes in South Africa. Our mission is to make quality healthcare more affordable and more accessible,’ says Gerhard Van Emmenis, Principal Officer. ‘We have, therefore, focused on balancing costs while ensuring our members continue to receive rich benefits.’
It’s been a difficult few years for the healthcare industry, with medical schemes facing several challenges including economic pressures and escalating healthcare costs. In addition, medical schemes have to comply with the strict parameters of the Medical Schemes Act.
In spite of this, the Fund recently announced that its reserves increased to R3.1 billion. Also the fund has also seen a significant growth in membership, enabling minimal increases in Bonitas medical scheme prices.
Van Emmenis Explains
‘Last year, we successfully concluded the largest amalgamation in the industry with LMS Medical Fund. This will continue to have a favourable impact on our membership as a whole. That is because as a larger scheme is in a better position to negotiate tariffs in favour of its member. Thus we have contained Bonitas medical scheme prices,’ says Van Emmenis.
The relatively low increase has not led to a reduction of benefits but rather an enhancement. ‘We’ve introduced several new benefits in 2018. This includes a benefit for contraceptives and a mental wellness programme, among others.
‘Increases are unfortunately inevitable because of the high healthcare costs and inflation. Nonetheles we strive to keep premiums as affordable and accessible for all. We tweaked some of the benefits and increased others. But all aimed at helping members take control of their health and lead better lifestyles,’ concluded Van Emmenis.
In times of economic uncertainty and political instability, healthcare costs and claims tend to increase. That applies particularly to anxiety and depression. Recent studies show that over 17 million people in South Africa are dealing with anxiety disorders. These include panic disorder, post-traumatic stress disorder and mood disorders.
In addition, statistics from a global study presented at a recent mental health summit in Johannesburg revealed that mental disorders have increased by 22.7%. In South Africa, 30% of people report life-long psychiatric disorders. And 1 in 3 will suffer a mental illness in their lifetime.
Selfmed has developed a Mental Wellness programme for kickoff in 2018, to identify beneficiaries on four plans. It provides access to specialised mental health doctors as well as education on managing the condition and support for loved ones too.
More benefits for families
Early in 2017, Bonitas introduced to its members Babyline, the first toddler’s health advice line. In 2018, Bonitas babies will receive further benefits, including screening for congenital hypothyroidism for newborns under a month old across on all options. Screening all newborns for hearing loss will be standard and Bonitas will cover these tests on all options (in or out-of-hospital).
A focus on wellness and preventative care
Benefits that help encourage positive lifestyle changes and focus on preventing serious conditions are one of the key elements to reducing chronic disease prevalence. So Bonitas will increase the Wellness Extender benefit by 15% to give members access to more consultations with a GP, dietician or biokineticist or cover for a programme to stop smoking. Women over 21 years will now on BonEssential and BonCap will get pap smears once every 3 years. Also, women over 40 will get mammograms once every 2 years on BonSave and Primary to strengthen the preventive care benefits on offer.
PMBs – making benefits last longer
In previous years, out-of-hospital tests and specialist consultations for the management of Prescribed Minimum Benefit conditions (PMBs) were paid for from day-to-day benefits first on Standard, Standard Select and Primary. In 2018, cover for PMBs will be paid for solely from risk – allowing members to get maximum value for money and stretch their day-to-day benefits.
Optimised online systems and services
A new website features information on Bonitas medical scheme prices, benefits and plans to help current members understand more about what their plan offers while potential members can select and choose a plan to meet their specific needs. A facility allows you to compare Bonitas medical scheme prices up to three plans on a like-for-like basis.
Further cost-containment initiatives
- 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. Hospital admissions account for half of Bonitas’s annual claims costs, around R6 billion. Through renegotiated rates Bonitas saw healthcare savings of R32 million, negotiations remain key to managing costs.
- Increasing 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. This included using the Emerging Risk Model, an innovative tool to identify emerging risk members before they develop high-risk conditions. Bonitas’s back and neck, oncology, hip and knee and HIV/AIDS programmes respectively, continue to offer members emotional, clinical and financial support. These initiatives have also worked from a cost-containment perspective – leading to savings of over R100 million in 2016 alone.
- Fraud, waste and abuse in the healthcare industry are one of the main drivers of healthcare inflation and the increase in claims costs. The private healthcare funding industry spends over R150 billion on private healthcare annually. A staggering 10-15% of these claims contained elements of fraudulent information – adding an estimated R22 billion to the annual cost of private healthcare in South Africa.
- To curb the impact Bonitas introduced advanced analytical software into the live claims environment last year. Using this, software the Fund was able to identify over R79 million in irregular claims in 2017 for medical practitioners alone. Money which could have paid for around 57 000 more GP consultations or 18 lung or liver transplants. The model will now include all pharmacy and hospital claims.
- To curb the impact Bonitas introduced advanced analytical software into the live claims environment last year. Using this, software the Fund was able to identify over R79 million in irregular claims in 2017 for medical practitioners alone. And that money could have paid for around 57 000 more GP consultations or 18 lung or liver transplants. The model will include all pharmacy and hospital claims.
- An increased prevalence of chronic conditions and diabetes, in particular, is one of the key contributors to a rising disease burden. After reviewing the programme Bonitas developed the Diabetes Management Programme, in conjunction with the clinical team at Medscheme, to address diabetes as well as the specific comorbidities that it brings. This will allow for more holistic treatment and management of the condition which is tailored to a member’s specific needs.
Summary of changes for the year
- A weighted increase of 8.7% will apply to 2018
- A separate benefit for contraceptives will be added to all options
- Newborn hearing screening tests will be covered on all options (in or out of hospital)
- TSH test covered on all options for newborns
- Pap smears for women over 21 years will be extended to BonEssential and BonCap
- Mammogram screenings for women over 40, will be extended to BonSave and Primary
- Bone Density Screenings available on BonClassic and BonComprehensive will now be available to men aged 70 and over
- Children under 18 will no longer be required to complete the Health Risk Assessment to access the Wellness Extender.
- The family limit for the Wellness Extender will increase by 15% in 2018.
- Out-of-hospital tests and specialist consultations for PMBs paid from risk on Standard, Standard Select and Primary
- A generous dentistry benefit package paid from risk to be added to BonFit
- Unlimited terminal healthcare benefit introduced on all options
- The corneal graft limit BonComprehensive, BonClassic, Standard, Standard Select, BonComplete and BonSave will increase from R22 000 to R30 000.
- In addition, the sublimit for specialised drugs for retinal disorders will increase from R42 000 to R50 000 on BonComprehensive, BonClassic and Hospital Plus.
- An internal prosthesis benefit of R30 000 per family (excluding joint replacement prosthesis) will be introduced to BonSave and Primary
- Introduction of the Bonitas Mental Health Programme
For more information on Bonitas medical scheme prices and or to compare options, go to www.bonitas.co.za.
Bonitas Medical Fund (Bonitas) is the second largest open medical scheme in South Africa. Administered by Medscheme Holdings (Pty) Ltd, Bonitas aims to make quality healthcare accessible to all South Africans and offers a wide range of plans that are simple to understand and easy to use. The Fund has the largest GP network in South Africa, a Specialist Network and a host of supplementary benefits paid from risk and carefully crafted managed care programmes to cover chronic conditions, cancer, diabetes and HIV/AIDS. This allows members to derive real value for money and stretch their benefits as far as possible.