This year’s Annual Board of Healthcare Funders (BHF) Conference, the 22nd edition, spotlighted what many in the medical scheme industry strive to achieve, but few manage to attain – person-centricity.
The conference was held recently at the Cape Town International Convention Centre (CTICC) and was themed: “Convergence to a person-centric health ecosystem – leaving no health citizen behind”.
Robust engagements in the over 14 conference sessions held from May 14-17 ensured that the over 1 000 industry stakeholders and delegates were challenged to not only deliberate on the challenges facing the health system environment – but provide realistic and progressive ideas to the tackle the challenges too.
The first day started off with sobering insights of the exact landscape that health funders across Africa find themselves in today.
And that is one of stagnant growth environment, coupled with rampant inequality, the ever-rising high cost of care, and a system that is structurally skewed around financial arrangements rather than patient or member centricity.
Breast cancer survivor, Margo Riley provided a heart-wrenching account of her journey navigating her daunting journey through the industry’s continuum of care over the past 12 years since her diagnosis.
Despite her acknowledged privilege of having access to quality diagnostic care and treatment – her despair at the often cold and dismissive care she experienced at both the levels of the health professionals’ conduct, and the frustration of the tiresome administrative processes, were evident.
“…what am I paying a premium for? Am I just a policy number? God forbid anyone goes through this [what she experienced]]. Right now, my monthly medical bill is R30 000… what do we do about the 84% of people that don’t have medical aid?” she said.
Having detailed her exhaustive experiences of being directed from pillar to post through ‘faceless’ scheme case management agents, she recounted that it was only nurses and one doctor in all the years who, “treated me like a human”.
Dr Rajesh Patel, Head of Health System Strengthening at BHF, said the following when reminding the medical scheme industry that the business is meant to be patient centric, “The business of medical schemes is not simply that of a health short-term insurer and should not be mistaken for one. The business of medical schemes is to ensure the health of their beneficiaries. It is to protect, promote, maintain, and improve their health”.
The second day brought on more food for thought, as Dr Wuleta Lemma. Founder of Lalibela Global-USA – a social-enterprise startup leading digital transformation of the health sector in Africa – reminded attendees that patient-centricity was “ground-zero”.
“Patient-centredness is not a ‘fad’…. All of us have used the healthcare system in one way or another… for all of us who are either patients or healthcare providers, patient-centred care is very personal to us. For us, it’s where it all starts,” Lemma stated.
Lemma reminded delegates that much of what continues to hold back the sector’s ability at efficiency throughout the continent, is its reliance on outdated methods of paper-based patient records and files. Often the result of which is either the loss or damage of those physical records, or their duplication. She proposed the inclusion of the use of social media as well as mobile money in health strategies that could reach more people in this continent of 1.3 billion people.
The complexity of the health care ecosystem featured prominently on the day’s discussions, with Barry Childs, Joint CEO of Insight Actuaries & Consultants saying: “Even if you know how benefits work, the health system is difficult to navigate.”
Childs added that the delivery of improved value through the offering of wider and better benefits in the medical scheme industry was critical in improving patient-centredness; and so too was the easing of the complexities that exist, to foster better patient-centredness.
The 2023 Edelman Trust Barometer – the consultancy firm’s 23rd annual trust and credibility survey – brought into focus the value of trust, especially from the perspective of patient-centricity.
Carolyn Paul, Global Managing Director and EMEA chair, Health (UK) and Busi Roberts, Head of Health at Edelman Africa unpacked the report which shows that the high cost of healthcare remains the number one barrier keeping people from being as healthy as they want to be.
Of the over 1 000 South Africans surveyed, 88% said that inflation [and the rising cost of living] was negatively impacting their health. Additionally, respondents highlighted the high cost of care as a considerable barrier to them accessing good healthcare, as well as the lack of information and contradictory expert advice.
The third day showcased how innovative approaches to providing tailored low-cost benefit options (LCBOs) aimed at providing more inclusive and accessible primary healthcare to more citizens, and individualise care, are at the heart of creating a ‘person-centric’ medical scheme industry ecosystem.
The Government Employees Medical Scheme (GEMS) – one of South Africa’s largest closed medical schemes with over 2.16 million beneficiaries – showcased how they were delivering innovative solutions for their Efficiency Discounted Options (EDOs) through care-coordination for their members.
The last day of the conference provided hard-hitting discussions on the medical scheme sector’s own challenges that required urgent reflection, action, and legislative coherence, as well as the need for unified accountability frameworks.
The conference ended with a poignant moment of reflection on the deliberations raised through the robust sessions held, and which are set to take the industry forward in person-centricity. Dr Katlego Mothudi, Managing Director at the BHF, called on the over 1 000 stakeholders in the scheme industry that were present at the conference to unify under a Declaration that serves as a pledge on the way forward.
“As BHF – the largest representative body of medical schemes, administrators, and managed-care organisations throughout southern Africa – we were not here to merely highlight the challenges in the sector but to also develop tangible next steps in achieving person-centricity.
“As such, we commit ourselves to seven objectives and trust that as we undertake a roadshow over the coming months to explain these objectives in more detail, our stakeholders will sign and align along with our intent around person-centricity” Mothudi stated.
To sign the pledge, visit: https://bhfglobal.com/