CAPE TOWN – A refreshing new market entrant, Health Squared Medical Scheme, is set to redefine healthcare funding through a personalised approach to healthcare cover for members at all income levels.
“In recent years, and largely due to macroeconomic factors, there has not been significant growth in the number of medical scheme members, a trend that received special mention by Dr Sipho Kabane, acting chief executive officer and registrar of the Council for Medical Schemes [CMS], in the Council’s recent annual report. The trend is further exacerbated by rising private healthcare costs, prompting many members to question whether their medical scheme offers true value for money,” says Health Squared spokesperson, Bianca Viljoen.
“In the midst of an industry-wide trend towards members ‘buying down’ on their healthcare cover, we believe that Health Squared’s disruptive approach will clearly illustrate that comprehensive cover can indeed be affordable. In fact, we believe that our new scheme is uniquely positioned to usher in a new paradigm, emphasising true value for money and highly accessible benefit structures that suit the needs of individuals, families and corporate clients.
“In the context of ongoing national economic challenges, employers are generally not keeping pace with healthcare inflation on their employees’ medical scheme subsidies, if these are offered at all. As a result, every Rand spent on healthcare must reflect a notable return on investment. Coupled with productivity measures and the high cost of employment, Health Squared also offers its employer groups Employee Wellbeing programmes that integrate with the scheme’s disease and other risk management programmes – a truly unique value proposition to the market,” she adds.
“For many months, the product development team of the scheme worked long hours to ensure a product and an offering that integrates healthcare risk management with other factors influencing human capital and employee benefit risk management. Therefore employers can now partner with a true expert in understanding human capital risk management and not just a product provider.”
To individuals, Health Squared’s integrated health offering ensures you can “build your own healthcare cover”, yet again a unique and integrated approach to healthcare planning, as opposed to the commodity-based solutions that have become the norm.
Capitation options
“Health Squared, for example, offers one of the most affordable entry-level capitation options where members are required to make use of network healthcare providers. The approach offers much-needed relief for both lower income markets, as well as employer groups that provide healthcare cover for their lower income staff, while still providing comprehensive out-of-hospital and risk benefits.
When Resolution Health and Spectramed medical scheme members voted in favour of merging the two schemes, these industry trends and the growing demand for affordable, quality healthcare cover were carefully considered. The merged scheme, which brings together 80 years of combined experience, is in a stronger position to compete in the highly saturated healthcare funding market, while maintaining financial sustainability and offering exceptional value.
As a standalone independent medical scheme, Health Squared is a strong emerging competitor with more than 40 000 members and some R210 million in reserves.
“The launch of the new scheme offered an opportunity to design our benefit options to specifically fulfil these gaps in the market by providing an array of choice for any income level, life stage or family size, and even allows for preference of benefit structure between traditional, savings and even hybrid structures, and this clearly differentiates Health Squared from its competitors.”
According to Viljoen, many consumers are moving to traditional plans that deliver substantial benefits at an affordable price. “The significance of the benefits typically offered by traditional options cannot be overstated. The combined value of out-of-hospital benefits on traditional plans are considerable, although new generation options also remain popular.
“Each of the 11 Health Squared benefit options offer unsurpassed value and richness of benefits at highly competitive prices, from the entry-level capitation hospital plans, through to comprehensive, traditional, savings and hybrid options, which include traditional benefits and personal medical savings accounts in one structure,” she adds.
“Our promise is to make sure our members are covered from every angle. Core to this promise is understanding the wants and needs of our members while remaining agile and adaptable. These principles were built into our business plan, which paves the way for an entirely new approach to the way medical schemes relate to and deal with their members.
“If the industry is to remain sustainable, such an agile approach, which embraces positive change in the interest of both the scheme and its membership base, is essential and ensures we remain relevant and at the cutting edge of what it is possible for healthcare funders to offer beneficiaries,” Viljoen concludes.