“The resilience of South Africans, widely renowned as it already is, continued to be tested throughout 2023. Acknowledging that the same is true for an increasing number of global economies does not diminish the stress of individually coping with numerous challenges with which so many are currently faced.
"We are acutely aware of the huge responsibility we have to help alleviate these pressures, by finding sustainable, yet affordable solutions for all,” says Damian McHugh, chief marketing officer for Momentum Health Solutions.
“As the administrator of medical schemes with almost three million members, we have seen claims costs increasing to higher than pre-Covid levels. At the same time, inflation means that the average cost per claim has also increased notably,” McHugh points out.
“Medical schemes have to be very deliberate and precise in their benefit design to remain relevant, solvent, and able to provide peace of mind to their members that they will continue enjoying reliable cover when they most need it.
“What you don’t want to see is increasing contributions, coupled with reduced benefits, of which we have recently seen a few examples. Momentum Medical Scheme has consistently had one of the lowest increases in the market without reducing benefits and has managed to bring certainty to advisers and consumers in difficult times.”
By adding a seventh benefit option to its offering in the form of the newly launched Fusion Option, Momentum Medical Scheme aims to make it easier for employer groups to enable access to healthcare cover for those who have not had access before or who have experienced the worst of the economic climate.
Momentum Health Solutions expects large employer groups to combine an option like Fusion with Health4Me health insurance, thereby custom-fitting cover to the unique needs and budget of individuals who, in many instances, have not previously been able to afford any form of private healthcare cover.
“It is critical that we address the imbalances in our healthcare industry in a collaborative manner, both in the private- and public sectors, in a way that strengthens our healthcare system, without placing any additional burden on consumers’ already stretched pockets,” argues McHugh.
“A strong private sector does not undermine the public sector, in fact, we believe in perfecting a system where the private sector alleviates pressure on the public sector and contributes to more effective utilisation of the available budget.”
In addition to the new option added to Momentum Medical Scheme’s benefit offering, the Scheme has also reduced the need for prenotification before utilising several preventative screening tests, in an effort to encourage members to more regularly make use of these free tests.
McHugh says that uptake of free, preventative tests has yet to recover to pre-Covid levels, and that active participation in early detection programmes is not only crucial to members’ ability to detect and deal with potentially life-threatening challenges before they become major events, but also contributes to lower contribution increases over time, as it is much less costly to address health challenges during early-detection stages than the alternative.
Having enhanced benefit limits by around 5.5%, in line with medical inflation, the Scheme’s weighted average increase for 2024 will be 9.6%.
“Momentum Medical Scheme is fortunate in that the Scheme’s average member age remains lower than the industry average, its membership numbers are not in decline, and it is able to continue introducing benefit enhancements to keep up with its members’ evolving needs,” says McHugh.
“From the perspective of administrators like Momentum Health Solutions, we are confident that we can continue to shape complementary solutions that address affordability constraints, incentivisation of healthy consumer behaviours and just generally ways for South Africans to be able to take ownership of their wellbeing despite the current economic environment.”
McHugh concludes, “Momentum Health Solutions remains focused on innovation and problem solving and is committed to establishing holistic healthcare offerings that meet the needs of companies and individuals across the spectrum, uniquely positioning us to provide affordable and seamless healthcare services to our clients.”
