Opportunities and Challenges for Public sector Medical Insurance Schemes in a Private Sector Ms B Mfenyana 06 October 2016 Second colloquium
|
|
- Frederick McGee
- 5 years ago
- Views:
Transcription
1 Opportunities and Challenges for Public sector Medical Insurance Schemes in a Private Sector Ms B Mfenyana 06 October 2016 Second colloquium
2 Contents Purpose GEMS Background Mandate, Mission, Vision, and Values Strategic Focus Critical Aspects as a Medical Aid Governance and Operational structure Scheme Statistics GEMS Impact GEMS Options Recommendations Basic benefit package NHI work streams Success Measures Conclusion
3 Purpose To discuss the opportunities and challenges for the public sector Medical Scheme in the private sector
4 ABOUT GEMS
5 Challenges The public service is the country's largest employer with approximately 1.3 million employees In fulfilment of its obligation as an employer, the public service provides its employees with a remunerative package structured to include and cover: o Retirement/Pensions (GEPF/GPAA) o Housing Benefits (Allowance) o Medical Benefits (Subsidy) Prior to 2005, one of the challenges faced by the Employer was that a significant and growing number of its employees were unable to gain entry into existing medical schemes due to the high cost structure o Toaddressthischallengeitwasresolvedtoestablishasinglerestricted membership medical scheme to cover public service employees
6 Our Mandate, Mission, Vision and Values To ensure that there is adequate provisioning of healthcare coverage to public service employees that is efficient, cost-effective and equitable; and to provide further options for those who wish to purchase more extensive cover. Mandates Vision To provide all public service employees with equitable access to affordable and comprehensive healthcare benefits. An excellent, sustainable and effective medical scheme for all public service employees. Values Mission Excellence Member-centricity Integrity Value for money Innovation
7 Critical Aspects as a Medical Scheme Scheme Members Advisors Actuaries Auditors Investment Contributions Bank account Benefit options Claims Managed care Administrators o Scheme rules o Registrar and Council o Medical Schemes Act
8 Governance and Operational Structure Governance, Direction & Oversight Employer Employees Execution of Strategy & determination of Operational deliverables Members Board of Trustees Principal Officer Executive & Head Office Committees Support Services Advisory, Actuaries, Auditors Investment Performance of Operational Functions OUTSOURCED SERVICES Administration o Enrolment and Registration o Benefit Management and Claims Payment o Member servicing (Contact Centre Support). Managed Care o Authorization Management o Disease Management o Claims Adjudication
9 GEMS Overview Average age of Scheme beneficiary 50% Level 1 5 employees 30.8 Medical Scheme beneficiaries 1.8m 92.63% Claims ratio
10 GEMS Impact GEMS has realised significant and sustained growth and is now the second largest medical scheme in South Africa Over 1,8 million beneficiaries 1 in 5 beneficiaries 1 in R10 spent on healthcare continue
11 GEMS Impact Hospital centric care is dominant In and out of hospital spend Spend by discipline 10% 43% 38% 39% 13% 19% 38% Hospital spend Hospital related spend Out of hospital spend Nearly 60% of expenditure pertains to hospital or hospital related costs Family Practitioners Specialists Hospitals Other Only 10% of spend pertains to family practitioners (which is higher than the industry average of 7,0%)
12 Opportunities
13 GEMS Options
14 Strategic Focus Activist Purchaser and Payer of Healthcare Services Place emphasis on the Healthcare outcomes Increasingly focus on the management of Overall Population Health Achieve healthcare delivery that is integrated and coordinated
15 Sapphire Option. Unlimited Family Practitioner Consultations Family Practitioner Network based Referral Based system to Specialist Tariffs on Network agreements Out of Hospital Benefits Consultations Unlimited Family Practitioner Consultations required from Preauthorization 5th required from 5 th Referral Referral from from Family Family Practitioner to to Specialist Acute Acute Medication Medication Prescribed by Prescribed FamiUnlimited by Family used Practitioner Subject to formulary Network Pharmacy used Optometry Subject to formulary Unlimited Optometry Pathology and Radiology Ordered Unlimited by treating Pathology Family and Practitioner Radiology or Specialist Ordered by treating Family Practitioner or Subject for formulary Specialist Subject for formulary. Out of Hospital Benefits In hospital Benefits Unlimited hospitalization at State Facility Contracted Hospitals Only Prescribed Medical Benefits
16 Basic benefits package Introduction of a basic benefit package across the NHI and existing healthcare funders during the period where medical schemes will be required to offer supplementary benefits Basic benefit package to incrementally enhances as and when it is feasible to do so
17 Support to NHI work streams Contracts Accreditation and contracting of primary healthcare providers Strategic Sourcing Develop a recommended procurement policy and system for the central and strategic sourcing of goods and services Value based Healthcare Key principles of value based care are that are key to a successful network are cost efficiency, quality and access Provider Network Management Implementation of disease management programmes Interdependencies with Hospital tariff negotiations
18 Eastern Cape Project Objectives Legal support to future litigation against the EC DOH estimated at R14 Billion To increase the revenue generation for services rendered to medical aid patients Proposed Interventions Call Centre and Complaints Management Medical Support Progress to Date Engagement session between GEMS and EC DoH problem definition Briefing session with GEMS Service Providers project scope definition Pilot the revenue generation with Mthatha General Hospital Review of case files from EC DOH R Legal Support Case Management Revenue Generation
19 Success Measures Accessibility Monitoring of Outcomes Monitoring and Evaluation Revenue generation Stakeholder Management Consumer Education
20 Conclusion GEMS believes that the best way to establish a comprehensive NHI benefit is by establishing a basic benefit package. The basic benefit package can be incrementally enhanced as and when it is feasible to do so. GEMS experience with the Sapphire option can provide a template on which the basic benefit package can be constructed.
21
The Product offerings differ from each other on the basis of the following criteria:
blueprint2009 The BESTmed product offering The BESTmed product offering is extensive with seven options that meet the unique and individualistic healthcare needs of our members. We have taken great care
More informationLOW COST BENEFIT OPTION FRAMEWORK. Paresh Prema GM: Benefits Management CMS Indaba 8 September 2015
LOW COST BENEFIT OPTION FRAMEWORK Paresh Prema GM: Benefits Management CMS Indaba 8 September 2015 Introduction Council approved framework on LCBOs in February 2015 with requirement of mandatory minimum
More informationGuideline for the preparation of a business plan pursuant to an application for an amalgamation of medical schemes as per Section 63 of the Medical
as per Section 63 of the Medical Schemes Act 131 of 1998, as amended. September 2009 1. INTRODUCTION... 3 2. BUSINESS PLAN FORMAT... 4 2.1 EXECUTIVE SUMMARY... 4 2.1.1 Objective... 4 2.2 MEDICAL SCHEME
More informationNational Treasury. Financing NHI. Pharmaceutical Society SA 24 June 2018
Financing NHI Pharmaceutical Society SA 24 June 2018 1 Principles of National Health Insurance Public purchaser Provision by accredited public and private providers Affordable and sustainable Primary care
More informationHealthcare regulatory reform where to?
Healthcare regulatory reform where to? Christoff Raath Health Monitor Co Agenda slides look like this 1. A brief history 2. Where are we now? 3. Future scenarios 4. Role of the Profession 2 The need for
More informationWhat s on the Menu? DR JOHN JUTZEN SAPA Legislative History on Health Policy. Our Disease Burden. Can the State Deliver NHI?
What s on the Menu? Legislative History on Health Policy DR JOHN JUTZEN SAPA 2017 Our Disease Burden Can the State Deliver NHI? Existing Private Sector & Options for the Future What is the impact on companies
More informationN I H S at a e e o f Re R a e d a ines e s Joe S e S oloane
NHI State of Readiness Joe Seoloane 1 The South African Envisaged Model of NHI Mandatory Enrolment For all citizens and Legal Residents No financial or other barriers equal access to all health care services
More informationGuideline for the preparation of a business plan pursuant to an application for the registration of a new/restructured benefit option(s) as per
Guideline for the preparation of a business plan pursuant to an application for the registration (s) as per Section 33 of the Medical Schemes Act 131 of 1998, as amended February 2012 Guideline for the
More informationMEDICAL SCHEMES ACT OF SOUTH AFRICA AMENDMENT BILL, 2018
MEDICAL SCHEMES ACT OF SOUTH AFRICA AMENDMENT BILL, 2018 Purpose The Medical Schemes Amendment Bill 2017 ( the Bill ) seeks to improve The legislative oversight of the medical schemes industry, To align
More informationValue for money. Providing affordable, accessible and quality health care to our members. Health & Lifestyle benefits REMEMBER
Value for money The total monthly contribution for 2018 is provided below. These amounts exclude any employer subsidy. The schemes average weighted contribution increase for 2018 is 9.3% All benefit limits
More informationGuideline for the preparation of a business plan pursuant to an application for the registration of a new/restructured benefit option(s) as per
Guideline for the preparation of a business plan pursuant to an application for the registration of a new/restructured benefit option(s) as per Section 33 of the Medical Schemes Act 131 of 1998, as amended.
More informationDiscovery Health Note to Investors on recent regulatory developments
23 July 2018 Discovery Health Note to Investors on recent regulatory developments Universal health coverage Discovery Health continues to support the objectives of transforming the national health system
More informationSEMINAR Funders market concentration and countervailing power. 20 February 2019
SEMINAR Funders market concentration and countervailing power 20 February 2019 1 INTRODUCTION 1. This note briefly sets out the background, purpose and objectives of the HMI s seminar on funder concentration,
More informationCommon Managed Care Terms & Definitions
Contact Us: Email: info@emedbiz.com Phone: 561-430-2090 Fax: 561-430-2091 Website: www.emedbiz.com Common Managed Care Terms & Definitions Balance billing: The practice of billing a patient for the amount
More informationHEALTH MARKET INQUIRY
HEALTH MARKET INQUIRY Introduce Cape Medical Plan Regulatory Environment Not-for-Profit Insurance model vs the For-Profit model Third Party Administration Tariff Negotiations Member Choice on Scheme Selection
More informationMEDICAL AID COVER GUIDE 2017
MEDICAL AID COVER GUIDE 2017 Visa Regulations for study in South Africa All international students taking up studies in South Africa must comply with the Visa Regulations in the Immigration Act (Act No.
More informationBENEFITS BROCHURE Nurture your health
BENEFITS BROCHURE 2016 Nurture your health ABOUT US The Chartered Accountants Medical Aid Fund (CAMAF), which was established in 1951, was originally designed for accounting professionals and offers superior
More informationINTEGRATED REPORT 2017
FOR OUR MEMBERS INTEGRATED REPORT 2017 INTEGRATED REPORT 2017 Discovery Health Medical Scheme s Integrated Report is designed to cater for various readers by grouping information in a logical way according
More informationNational Health Insurance Policy 2013
National Health Insurance Policy 2013 1. Background The Interim Constitution of Nepal 2007 provides for free basic health care as a fundamental right of citizens. Accordingly, the Government of Nepal has
More informationPresentation to SAMA Conference 2015
Presentation to SAMA Conference 2015 NHI MODEL, RELATIONSHIP TO FINANCE AND ITS EFFECTS ON PUBLIC AND PRIVATE MEDICAL PRACTITIONERS Date: 19 SEPTEMBER 2015 Venue: Sandton Convention Centre Dr Aquina Thulare
More informationPrepared by cde Khwezi Mabasa ( FES Socio-economic Transformation Programme Manager) JANUARY 2016
Prepared by cde Khwezi Mabasa ( FES Socio-economic Transformation Programme Manager) JANUARY 2016 Political Context: Social Democratic Values Social policy and the access to basic public goods are the
More informationHead 06: Service Commissions
Head 06: Service Commissions A summary of the Service Commissions Expenditure, Divisions and Projects Financial Scrutiny Unit, Parliament of the Republic of Trinidad and Tobago Table of Contents About
More informationAssociation of Healthcare Funders of Zimbabwe AHFoZ
Association of Healthcare Funders of Zimbabwe AHFoZ (Formerly NAMAS) No. 6 King George Court Telephone: 308538, 332829, 302260 Cnr. King George/Argyle Roads Telefax 308538 Avondale, Harare E-mail: ahfoz@ahfoz.co.zw
More informationUnderstanding how legislative provisions impact on Medical Schemes, their plan design, benefits to members and financial stability
Understanding how legislative provisions impact on Medical Schemes, their plan design, benefits to members and financial stability Introduction Provision of medical benefit funding has become the most
More informationFactsheet on the Non-Negotiable Budget Items in the Provision of Public Health and HIV/AIDS Services in South Africa 1
Factsheet on the Non-Negotiable Budget Items in the Provision of Public Health and HIV/AIDS Services in South Africa 1 Silindile Shezi, Plaxcedes Chiwire, Nhlanhla Ndlovu 12 September 2014 E-mail: nhlanhla@cegaa.org
More informationCOVERED CALIFORNIA: THE GOOD, THE BAD & THE UNDEFINED FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS
1 COVERED CALIFORNIA: THE GOOD, THE BAD & THE UNDEFINED FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS Ann-Louise Kuhns President & CEO California Children s Hospital Association Health Care Reform: The Basics
More informationEXECUTIVE PROPOSED LEGISLATION NM HEALTH SOLUTIONS Revised Draft September 17, 2007
EXECUTIVE PROPOSED LEGISLATION NM HEALTH SOLUTIONS Revised Draft September 17, 2007 I. PRINCIPLES To Achieve Universal Health Coverage and Improvements in Access, Cost and Quality of Health Care Delivered
More informationUsing National Health Insurance to Finance Health Care: Ghana s. Experience. Research Associate, NHIA. Francis Asenso-Boadi
Using National Health Insurance to Finance Health Care: Ghana s Experience Francis Asenso-Boadi Research Associate, NHIA Introduction The National Health Insurance Scheme (NHIS) was introduced in 2003
More informationProduct Structure 2016
Product Structure 2016 is now part of Welcome to Wanthanzi Health Plan Wanthanzi Health Plan was established in 2006 as a medical aid scheme to provide essential affordable care to more people in Zambia.
More informationEvolving with you BENEFITS BROCHURE 2017
Evolving with you BENEFITS BROCHURE 2017 About Us The Chartered Accountants Medical Aid Fund (CAMAF), which was established in 1951, was originally designed for accounting professionals and offers superior
More informationACCESS TO THE HIGHEST QUALITY PRIMARY HEALTHCARE AT AFFORDABLE PRICES
ACCESS TO THE HIGHEST QUALITY PRIMARY HEALTHCARE AT AFFORDABLE PRICES WELCOME TO ELIXI MEDICAL INSURANCE PURPLE PLAN - PRIMARY AND HOSPITAL CARE Elixi Medical Insurance aims to make private healthcare
More information2008 PMB Review consultation document. Proposed construct and work plans. 27 March 2008
2008 PMB Review consultation document Proposed construct and work plans 27 March 2008 Contents 1 Introduction and purpose of this document... 1 2 The legislated mandate and the context of the 2008 PMB
More informationWhat are your options for 2018?
What are your options for 2018? MEDXXI R 1,760.00 R 1,750.00 R 899.00 Unlimited hospital cover at any of the Scheme s Designated Hospitals, paid at 100% of Agreed Tariff 25 PMB Chronic Conditions Ante-natal
More informationInvesting for the future: Spire
Investing for the future: Spire Healthcare Aslam Dalvi - Associate Portfolio Manager The UK public healthcare system has come under increasing pressure in recent times. An ageing population coupled with
More informationElectronic Version. GapCARE XtraCARE ProfessionalCARE
Electronic Version GapCARE XtraCARE ProfessionalCARE Medway MedCARE Plan WHO IS MEDWAY? Medway is a leading network of healthcare advisors in South Africa. First established in 1990, Medway has consistently
More informationMAKING HEALTH INSURANCE MARKETS WORK FOR THE POOR IN SOUTH AFRICA
MAKING HEALTH INSURANCE MARKETS WORK FOR THE POOR IN SOUTH AFRICA Jeremy Leach Roseanne da Silva IAAHS 2007 IAA Health Section Colloquium 13 th 16 th May 2007 CTICC www.iaahs2007.com FinMark Trust Independent
More informationPMB Review: What s next? Evelyn Thsehla Clinical Researcher
PMB Review: What s next? Evelyn Thsehla Clinical Researcher Contents Background PMB Development Identified Gaps PMB review phases Proposed Intervention Work-plans Conclusion Background The Medical Schemes
More informationSection Eleven. Referrals and Prior Authorization REFERRAL PROCESS. Physician Referrals within Plan Network
REFERRAL PROCESS Physician Referrals within Plan Network Physicians may refer members to any Specialty Care Physician (Specialist) or ancillary provider within the Fidelis Care network. Except as noted
More informationThe Affordable Care Act and the Essential Health Benefits Package
October 24, 2011 The Affordable Care Act and the Essential Health Benefits Package A. Background Under the Affordable Care Act (the ACA or the Act ), and starting in 2014, certain low to moderate income
More informationMr. Abbey Chikane Executive Chairman Annual Report financial year Portfolio Committee of Human Settlements, Old Assembly 25 October 2016
Mr. Abbey Chikane Executive Chairman Annual Report 2015 2016 financial year Portfolio Committee of Human Settlements, Old Assembly 25 October 2016 10/24/2016 1 Table of Content 1. Organogram 2. NHBRC mandate
More informationUCT - MEDICAL AID COVER GUIDE 2018
UCT - MEDICAL AID COVER GUIDE 2018 Visa Regulations for study in South Africa All international students taking up studies in South Africa must comply with the Visa Regulations in the Immigration Act (Act
More informationZIMBABWE HEALTH FINANCING. GWATI GWATI Health Economist: Planning and Donor Coordination MOHCC Technical team leader National Health Accounts.
ZIMBABWE HEALTH FINANCING GWATI GWATI Health Economist: Planning and Donor Coordination MOHCC Technical team leader National Health Accounts. Our approach to HFP Development Key steps in the development
More informationINFORMATION ABOUT YOUR OXFORD COVERAGE
OXFORD HEALTH PLANS (CT), INC. INFORMATION ABOUT YOUR OXFORD COVERAGE PART I. REIMBURSEMENT Overview of Provider Reimbursement Methodologies Generally, Oxford pays Network Providers on a fee-for-service
More informationCIRCULAR 4 OF 2013: EVALUATION OF COST INCREASE ASSUMPTIONS BY MEDICAL SCHEMES FOR 2013 FINANCIAL YEAR
CIRCULAR Reference : Evaluation of contribution increase assumptions for 2013 Contact : Nondumiso Khumalo Telephone : 012 431-0514 Facsimilee : 012 431 0612 E-mail : n.khumalo@medicalschemes.com Date :
More informationB e n e f i t O p t i o n s
2018 Benefit Options 2018 What determines your decision to join a medical aid? At Selfmed we cut straight to the Is it the add-on s, you know the free gym membership and movie tickets or, is it the reliable
More informationCHOOSING A PRODUCT ACCORDING TO YOUR LIFESTYLE NEEDS:
Feel confident that someone is always on your side. 2014 CHOOSING A PRODUCT ACCORDING TO YOUR LIFESTYLE NEEDS: I need quality care where I control my benefits Bonitas offers you unlimited hospitalisation
More informationEl Paso County Hospital District d/b/a University Medical Center of El Paso A Component Unit of El Paso County, Texas Auditor s Report and Financial
Auditor s Report and Financial Statements Contents Independent Auditor s Report on Financial Statements and Supplementary Information... 1 Management s Discussion and Analysis... 4 Financial Statements
More informationMethodology to assess the cost impact of PMB benefit definitions
Methodology to assess the cost impact of PMB benefit definitions Version 1.0.0 07 March 2012 Contents 1 Background... 1 2 Aim... 1 3 Objectives... 1 4 Methods... 2 5 Variables for data collection, data
More informationStrategic Corporate Plan
Strategic Corporate Plan 2012-2017 Dr. Jeffrey Mahachi Acting chief Executive Officer Jeffreym@nhbrc.org.za Click to edit Master subtitle style 13 March 2012 Vision A world class home builders warranty
More informationPrescribed Minimum Benefit compliance and the protection of beneficiaries. Council for Medical Schemes PMB Compliance workshop 11 May 2010
Prescribed Minimum Benefit compliance and the protection of beneficiaries Council for Medical Schemes PMB Compliance workshop 11 May 2010 1 Contents Purpose of the day Context PMB review process Industry
More informationHead 23: Ministry of Attorney
Head 23: Ministry of Attorney General and Legal Affairs A summary of the Ministry of Attorney General and Legal Affairs Expenditure, Divisions and Projects Financial Scrutiny Unit, Parliament of the Republic
More informationSALGA REFERENCE GUIDE. Feel confident that someone is always on your side.
2014 SALGA REFERENCE GUIDE Feel confident that someone is always on your side. CHOOSING A PRODUCT ACCORDING TO YOUR LIFESTYLE NEEDS: I need quality care where I control my benefits Bonitas offers you
More informationPresentation to the Portfolio Committee on Health Dr Jonathan Broomberg Dr Penny Tlhabi Discovery Health 2 June 2010
Presentation to the Portfolio Committee on Health Dr Jonathan Broomberg Dr Penny Tlhabi Discovery Health 2 June 2010 Agenda 1 Introduction to the private healthcare funding environment 2 Key issues, challenges
More informationCompCare Wellness Medical Scheme. Product Summary Administered by
CompCare Wellness Medical Scheme Product Summary 2014 Administered by CompCare Wellness Medical Scheme CompCare Wellness has implemented overall benefit and limit enhancements of 6% across all options
More informationMARKET DEFINITION FOR FINANCING OF HEALTHCARE. 18 November 2016
MARKET DEFINITION FOR FINANCING OF HEALTHCARE 18 November 2016 CONTENTS CONTENTS... ii ABBREVIATIONS... iii INTRODUCTION... 1 MEDICAL SCHEMES... 2 Product market... 2 Key provisions of the Medical Scheme
More informationTHE SELF-EVALUATION CHECKLIST
Accreditation of Managed Care Organisations THE SELF-EVALUATION CHECKLIST Accreditation Standards for Managed Care Organisations- (Version 4) NOVEMBER 2011 Chairperson: Prof. Y Veriava Chief Executive
More information1 July Guideline for Municipal Competency Levels: Chief Financial Officers
1 July 2007 Guideline for Municipal Competency Levels: Chief Financial Officers issued in terms of the Local Government: Municipal Finance Management Act, 2003 Introduction This guideline is one of a series
More informationTHE STATE OF FLORIDA
THE STATE OF FLORIDA OFFICE OF INSURANCE REGULATION MARKET INVESTIGATIONS TARGET MARKET CONDUCT FINAL EXAMINATION REPORT OF THE FLORIDA PATIENT S COMPENSATION FUND AS OF April 25, 2014 FLORIDA COMPANY
More informationStaff Care Solutions. Quality, affordable healthcare solutions for the low-income market
Staff Care Solutions Quality, affordable healthcare solutions for the low-income market Why the need for low-income healthcare solutions? Access to healthcare is an integral component to an employee s
More informationAnglovaal Group Medical Scheme
Anglovaal Group Medical Scheme Benefit Brochure 2018 Your Scheme The Anglovaal Group Medical Scheme is a registered medical scheme under the Medical Schemes Act 1998. The Scheme is a restricted access
More information1. BENEFICIARIES 2. MEMBERSHIP
RULES, REGULATIONS, CONTRIBUTIONS AND BENEFITS OF THE FURNMED SICK BENEFIT SOCIETY hereinafter referred to as ( The Society or The Furnmed Sick Benefit Society ) 1. BENEFICIARIES A member in good standing
More informationAnnual Notice of Changes
Annual Notice of Changes Utah Davis, Salt Lake, Utah and Weber Healthy Advantage Plus (HMO) (877) 644-0344, TTY/TDD 711 7 days a week, 8 a.m. 8 p.m. local time HealthyAdvantagePlus.org 2018 H5628_18_1127_0007_HPAE2
More informationHEALTHCARE INSURERS MANUAL. November 17
HEALTHCARE INSURERS MANUAL November 17 PREAMBLE The Department of Health (DOH), previously known as the Health Authority - Abu Dhabi (HAAD), is the regulator of the Abu Dhabi health system. The Health
More informationIssue brief: Medicaid managed care final rule
Issue brief: Medicaid managed care final rule Overview In the past decade, the Medicaid managed care landscape has changed considerably in terms of the number of beneficiaries enrolled in managed care
More informationSUMMARY OF 2003 INSURANCE LEGISLATION SIGNED INTO LAW BY GOVERNOR ROBERT L. EHRLICH, JR.
ROBERT L. EHRLICH, JR. GOVERNOR STEVEN B. LARSEN COMMISSIONER MICHAEL S. STEELE LIEUTENANT GOVERNOR DONNA B. IMHOFF DEPUTY COMMISSIONER STATE OF MARYLAND MARYLAND INSURANCE ADMINISTRATION 525 St. Paul
More informationJuly 2014 Kagiso Asset Management Quarterly
July 2014 Kagiso Asset Management Quarterly Global brewers: working harder for growth pg 1 Volkswagen s ambitious vision pg 5 The coal conundrum pg 13 www.kagisoam.com Hospital groups face tougher times
More informationStockouts: The legal framework
Stockouts: The legal framework Sasha Stevenson 25 July 2013 The legal obligations to ensure the availability of essential medicines Constitution Legislation Regulations Policy 1 + The stockouts seen across
More informationMedicare payment policy and its impact on program spending
Medicare payment policy and its impact on program spending James E. Mathews, Ph.D. Deputy Director, Medicare Payment Advisory Commission February 8, 2013 Outline of today s presentation Brief background
More informationUniversal, quality, lifetime and affordable health insurance: A roadmap that won t bankrupt us
Universal, quality, lifetime and affordable health insurance: A roadmap that won t bankrupt us Presenter Disclosures The following personal financial relationships with commercial interests relevant to
More informationSTRATEGIC PLAN
2017 2022 STRATEGIC PLAN O V E R V I E W IOWA PUBLIC EMPLOYEES RETIREMENT SYSTEM 7401 REGISTER DRIVE DES MOINES, IOWA MISSION Administer a cost-efficient retirement plan that provides lifetime pension
More informationANNUAL NOTICE OF CHANGES FOR 2018
Cigna HealthSpring Preferred (HMO) offered by Cigna HealthSpring ANNUAL NOTICE OF CHANGES FOR 2018 You are currently enrolled as a member of Cigna HealthSpring Preferred (HMO). Next year, there will be
More informationAnnual Notice of Changes for 2018
HealthTeam Advantage Plan I (PPO) offered by Care N Care Insurance Company of North Carolina, Inc. Annual Notice of Changes for 2018 You are currently enrolled as a member of HealthTeam Advantage Plan
More informationPROVIDENT INSTITUTIONS DIVISION
FORM MAF1 PROVIDENT INSTITUTIONS DIVISION MEDICAL AID FUNDS AND FRIENDLY SOCIETIES DEPARTMENT APPLICATION FOR REGISTRATION OF A MEDICAL AID FUND APPLICATION FOR NEW REGISTRATION IN TERMS OF SECTION 23
More informationTERMS OF REFERENCE FOR CONDUCTING MID-TERM EVALUATION FOR MALARIA PROJECT IN GEITA
TERMS OF REFERENCE FOR CONDUCTING MID-TERM EVALUATION FOR MALARIA PROJECT IN GEITA Harnessing on the Private Health Sectors Potential in the Fight against Malaria 1.0. Introduction and Background Information
More informationCase Study New Hospital Development : Project Management
SAFHE/CEASA 2017 The 12 th Biennial Conference and Exhibition Durban 7 9 March 2017 Case Study New Hospital Development : Project Management Presented by Keith Bonsall, Director Halcyon Management Services
More informationHEALTH FLEX PLAN PROGRAM
HEALTH FLEX PLAN PROGRAM Annual Report January 2016 Agency for Health Care Administration 2727 Mahan Drive, MS 45 Tallahassee, FL 32308 1-850-412-4502 http://www.floridahealthfinder.gov http://ahca.myflorida.com
More informationNUTS AND BOLTS TRAINING FOR LEGISLATORS:
NUTS AND BOLTS TRAINING FOR LEGISLATORS: FUNDING FOR COMMUNITY MENTAL HEALTH, SUBSTANCE USE DISORDER AND INTELLECTUAL OR OTHER DEVELOPMENTAL DISABILITIES LEZA WAINWRIGHT, CEO Transforming Lives TRILLIUM
More informationMGMA BUSINESS PLAN COMPETITION. Team 2
MGMA BUSINESS PLAN COMPETITION Team 2 IDS HOSPITAL, LAREDO, TX (Team 2) Executive Summary Integrated Delivery Systems (IDS) is a 200 bed, medium-sized comprehensive service provider hospital in Laredo,
More informationANNUAL NOTICE OF CHANGES FOR 2018
Cigna HealthSpring Preferred (HMO) offered by Cigna HealthSpring ANNUAL NOTICE OF CHANGES FOR 2018 You are currently enrolled as a member of Cigna HealthSpring Preferred (HMO). Next year, there will be
More informationAn Introduction to Value Based Care. Evan Richards Product Leader Value Based Care Solutions May 2016
An Introduction to Value Based Care Evan Richards Product Leader Value Based Care Solutions May 2016 2016 General Electric Company All rights reserved. This does not constitute a representation or warranty
More informationCIRCULAR 23 OF 2015: EVALUATION OF COST INCREASE ASSUMPTIONS BY MEDICAL SCHEMES FOR 2015 FINANCIAL YEAR
CIRCULAR Reference: Evaluation of contribution increase assumptions for 2015 Contact person: Kgotsofatso Phaswana Tel: 012 431 0407 Fax: 012 431 0642 E-mail: k.phaswana@medicalschemes.com Date: 25 March
More informationStaff Care Solutions Quality, affordable healthcare solutions for the low-income market
Staff Care Solutions Quality, affordable healthcare solutions for the low-income market Employer Guide 2018 Why the need for low-income healthcare solutions? Access to healthcare is an integral component
More informationHealth-Care System Reform in Germany
Health-Care System Reform in Germany Katsuaki Matsumoto, Director Department of Health and Social Services National Institute of Public Health February 13, 2006 1 Table of Contents 1. Trends in Health-Care
More informationPublic Employees Benefits Program Legislative Session Bill Tracking Updated: 3/27/2017
Public Employees Benefits Program Legislative Session Bill Tracking Updated: 3/27/2017 Bill Number & Description Impact to PEBP & Bill Status AB249 (BDR 38-858) Requires the State Plan for Medicaid and
More informationDuties and responsibilities of the trustee
Duties and responsibilities of the trustee 15 Any person assigned the duty to manage interests on behalf of others has a responsibility to fulfil this duty to the best of his ability, and in accordance
More informationACCREDITATION STANDARDS FOR MANAGED CARE ORGANISATIONS
ACCREDITATION STANDARDS FOR MANAGED CARE ORGANISATIONS Chairperson: Dr RV Simelane Chief Executive & Registrar: Dr M Gantsho Block E Hadefields Office Park 1267 Pretorius Street Hatfield Pretoria 0028
More informationContribution inflation in Medical Schemes
Contribution inflation in Medical Schemes 10 August 2016 by Charlton Murove 10 August 2016 1 Overview I. Inflation & medical inflation as measure by Statistics South Africa (Stats SA) II. Contribution
More informationRULES OF TENNESSEE DEPARTMENT OF FINANCE AND ADMINISTRATION DIVISION OF TENNCARE CHAPTER COVERKIDS TABLE OF CONTENTS
RULES OF TENNESSEE DEPARTMENT OF FINANCE AND ADMINISTRATION DIVISION OF TENNCARE CHAPTER 1200-13-21 COVERKIDS TABLE OF CONTENTS 1200-13-21-.01 Scope and Authority 1200-13-21-.02 Definitions 1200-13-21-.03
More informationProgramme based budgeting: the health budget programme structure in South Africa
Programme based budgeting: the health budget programme structure in South Africa WHO symposium on Health Financing Presenter: Mark Blecher National Treasury of South Africa 1 November 2017 1 Presentation
More informationOECD Health Committee Survey on Health Systems Characteristics 2016 ROUND
OECD Health Committee Survey on Health Systems Characteristics 2016 ROUND PART I. HEALTH CARE FINANCING Section 1: Characteristics of basic health care coverage Section 2: Regulation of health insurance
More informationAnnual Notice of Changes for 2017
HealthTeam Advantage Plan II (PPO) offered by Care N Care Insurance Company of North Carolina, Inc. Annual Notice of Changes for 2017 You are currently enrolled as a member of HealthTeam Advantage Plan
More informationOptometrist Provider Manual 2013
Optometrist Provider Manual 2013 Summary of benefits/services Benefit AECI Medical Aid Society CompCare Wellness Medical Scheme NBCRFLI Health Plan Tiger Brands Medical Scheme Transmed Medical Fund Umvuzo
More informationNORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES
STATE OF NORTH CAROLINA OFFICE OF THE STATE AUDITOR BETH A. WOOD, CPA NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES RALEIGH, NORTH CAROLINA FINANCIAL STATEMENT AUDIT REPORT FOR THE YEAR ENDED
More informationSouth African Private Practitioners Forum. Submission on Draft MSA Bill to the National Department of Health
South African Private Practitioners Forum Submission on Draft MSA Bill to the National Department of Health 20 09 2018 1 Table of Contents Introduction... 3 SUBMISSIONS ON THE DRAFT MSA BILL... 4 Definitions...
More informationTHE K 12 PUBLIC SCHOOL EMPLOYEE HEALTH BENEFITS REPORT EXECUTIVE SUMMARY
THE K 12 PUBLIC SCHOOL EMPLOYEE HEALTH BENEFITS REPORT EXECUTIVE SUMMARY HCA 52-151 (12/2011) EXECUTIVE SUMMARY 2 EXECUTIVE SUMMARY executive summary TABLE OF CONTENTS executive summary... 5 overview...5
More informationPublic sector employers already face growing financial. How Public Sector Employers Can Manage Retiree Health Liabilities. Retirement Strategies
Retirement Strategies How Public Sector Employers Can Manage Retiree Health Liabilities Changes in the Governmental Accounting Standards Board (GASB) reporting requirements will increase the liabilities
More informationRegulating healthcare financing Benefit options Risk pooling Antiselection In what context?
Regulating healthcare financing Benefit options Risk pooling Antiselection In what context? HMI Seminar on regulatory gaps in healthcare financing 1 February 2018 1 Boshoff Steenekamp MMI Health Contents
More informationNational Payment System Department. Position paper on access to the national payment system
National Payment System Department Position paper on access to the national payment system Position Paper NPS 02/2011 Dated June 2011 1 1. Executive summary This document outlines the position of the South
More informationMINISTERIAL STATEMENT TO THE HOUSE OF ASSEMBLY BY THE HONOURABLE KIM N. WILSON, JP, MP MINISTER OF HEALTH HEALTH FINANCING REFORMS
MINISTERIAL STATEMENT TO THE HOUSE OF ASSEMBLY BY THE HONOURABLE KIM N. WILSON, JP, MP MINISTER OF HEALTH HEALTH FINANCING REFORMS Friday 6 th July 2018 I m pleased to give this statement today to update
More informationhow to choose a medical scheme Craig Torr Crue Consulting
how to choose a medical scheme Craig Torr Crue Consulting agenda overview of industry and role-players aims and impact of Medical Schemes Act 10 questions to ask when choosing a medical scheme choosing
More information