John Cranke, head of Healthcare at PSG Konsult Corporate discusses the vital signs of medical schemes, the symptoms, the diagnosis and the prognosis for a healthy future. One of the most important vital signs in a medical scheme is the risk claim ratio and 2009 saw unusually high claims pushing up the ratio across the industry. Consequently, many schemes introduced measures like benefit reduction, co-payments, stricter protocol management, provider network arrangements like DSP’s and referral management in order to curb costs. These measures have been proving successful, and 2010 and 2011 saw a recovery in risk claim ratios. Size counts … Continue reading
Minding the Gap – Proposed Demarcation Legislation
from left to right – John Cranke, head of healthcare (PSGK Corporate), Anton le Roux, head of business development, (PSGK Corporate), Tiago De Calvalho (Ambledown Risk and Underwriting Managers) PSG Konsult Corporate (PSGK Corporate) recently facilitated a discussion around decision making in the health care industry. This addressed both the draft demarcation regulations and the potential impact of these on the future of health insurance products such as gap cover. Participants included Tiago De Carvalho, the Managing Director of Ambledown Risk and Underwriting Managers, who specialise in the area of health insurance underwriting and John Cranke, the head of … Continue reading
NHI – trio of top medical aids offer perspective (Bonitas)
Dr Bobby Ramasia – Principal Officer- Bonitas Medical Scheme National Health Insurance (NHI) has been widely debated in South Africa since the government first presented its green paper and called for public comment. General consensus is that it is needed in South Africa but there are concerns around its implementation and the impact on current medical schemes. PSG Konsult Corporate (PSGK Corporate), which manages nearly 140 000 medical schemes and health insurance contracts for 400 000 individuals, posed some critical questions to three of the top open medical schemes in South Africa about the plausibility and future of the NHI … Continue reading
NHI – trio of top medical aids offer perspective (Momentum)
Damian McHugh – head of sales & marketing – Momentum Health National Health Insurance (NHI) has been widely debated in South Africa since the government first presented its green paper and called for public comment. General consensus is that it is needed in South Africa but there are concerns around its implementation and the impact on current medical schemes. PSG Konsult Corporate (PSGK Corporate), which manages nearly 140 000 medical scheme and health insurance contracts for 400 000 individuals, posed some critical questions to three of the top open medical schemes in South Africa about the impact and plausibility of … Continue reading
NHI – trio of top medical aids offer perspective (Discovery)
Dr J Broomberg – CEO of Discovery Health John Cranke, head of healthcare at PSG Konsult Corporate, speaks to Dr Broomberg, CEO of Discovery Health, the largest medical scheme in South Africa, about the future of the NHI and the challenges facing medical schemes. Cranke: Per the Green Paper, the NHI is to be implemented over 14 years in three phases, while the National Development Plan says this process could take up to 25 years. Do you think this is feasible and are you in favour of the introduction of NHI? Broomberg: We think 15 -25 years is more realistic, … Continue reading