EXCLUSIVE: Medical schemes losing out on risk transfer contracts
Business Day 20 March 2019 – Council for Medical Schemes has allowed the arrangements with service providers to continue despite R1.179bn flowing out of schemes between 2013 and 2017
Some of SA’s best known medical schemes are losing money hand over fist in opaque “risk transfer” arrangements, in which they pay service providers millions of rand to manage claims that critics say they could easily handle in-house. The deals mean there is less money available for their own members and raises questions about the oversight role being played by the sector’s watchdog, the Council for Medical Schemes (CMS). Despite noting the phenomenon in every annual report it has published for the past five years, the regulator appears to have left schemes to continue with these arrangements unfettered. In all, R1.179bn flowed out of schemes in this manner between 2013 and 2017, according to Business Day’s analysis of data published by the CMS in its annual reports. Bonitas, SA’s second biggest medical open scheme, appears to have consistently lost money on these arrangements on a scale unparalleled in the industry. It lost a total of R692m on its risk transfer contracts between 2013 and 2017, more than half the industry total, and almost three times more than the next biggest loser, Momentum Health, which lost R238.7m over the period. Third in line was Sizwe, which lost R117.7m.For the article click here.
Netcare taps new growth areas
Sunday Times 24 March 2019 - SA's biggest hospital group, Netcare, has finalised the sale of two of its hospitals as it shifts focus towards mental health care.
This week, Netcare announced it had sold its Rand Hospital in Johannesburg and Bell Street Hospital in Krugersdorp to burgeoning hospital group RH Bophelo, for R124m. The deal is part of Netcare's agreement linked to its acquisition of mental health-care facility group Akeso Clinics for R1.3bn. Akeso has facilities in the Western Cape, Gauteng, Mpumalanga and KwaZulu-Natal and the acquisition presents a growth opportunity in an area where Netcare didn't have a presence. For the article click here
Health alert for Discovery
Sunday times 24 March 2019 - Global banking giant Citi rates Discovery, which is due to open the digital doors of its new bank this week, as a high-risk investment.
Among the red flags for Discovery, Citi lists high levels of debt gearing, the regulatory risk associated with health insurance, complex products and cross-selling, and the company's dependence on its strong retail brand in SA. Not fazed by the Citi report, Discovery CEO Adrian Gore said he was feeling pretty good about the business. For the article click here
Major battles have been won against TB. But the war isn't over
BizCommunity 22 March 2019 - There’s a chronic funding gap for TB research and development. The Global TB Alliance estimates that it’s as high as $1.3 billion per year.
While still inadequate, there has been a shift towards reducing the funding gap over the last two years. This, together with invigorated research strategies from large funding organisations such as the National Institutes for Allergy and Infectious Diseases, point to a shift in the TB landscape. As a consequence, there have been some exciting and positive movements on both treatment as well as prevention aspects. For the article click here
GIULIETTA TALEVI: Aspen retains taste for acquisitions despite its current debt levels
Business Day 22 March 2019 - CEO Stephen Saad says it is important to note that the company has always sold its acquisitions at higher prices
Aspen’s shares have steadied since plunging as much as 50% on the release of the pharma company’s interim results two weeks ago. But the stock has a long way to climb before recouping even 2019’s losses, and is trading at less than a quarter of its all-time highs. For the article click here
Wider use of antibiotics could stem the spread of TB, say experts
Business Day 21 March 2019 - Failure to implement TB prevention strategies is one of the key reasons we still have not made enough progress against tuberculosis
A short course of antibiotics for people with latent tuberculosis could prove to be the most effective way of stopping the spread of the disease, since there is currently no effective vaccine, says a report published by the Lancet on Thursday. TB is the world’s biggest infectious killer, felling 1.6-million people in 2017. In SA, its spread has been fuelled by HIV, which makes people more vulnerable to infection. SA had the world’s second highest TB infection rate in 2017, with about 567 cases per 100,000 population. About 132,000 people were newly infected, and 78,000 people died from TB in SA, according to the World Health Organisation (WHO). For the article click here
THE LEX COLUMN: Battling the depression drugs blues
Business Day 20 March 2019 - The first new type of antidepressant since Prozac provides hope amid the gloom
This month, Johnson & Johnson’s Spravato — a molecular mirror-image of party drug and anaesthetic ketamine — got the green light. It is the first new type of antidepressant since Eli Lilly launched Prozac more than 30 years ago. Less uplifting was March’s news that Allergan’s new depression drug Rapastinel — also inspired by ketamine — flopped in clinical trials. For the article click here
Non-disclosure: Doctors should not attack medical schemes for acting
Medical Brief 20 March 2019 - Deception by patients of medical schemes through the non-disclosure of health information is sharply on the increase, writes Elmarie Jensen, marketing manager of Genesis Medical Scheme.
When this is discovered, it ‘does not behoove doctors to defame a medical scheme because they caught the culprit and acted to protect the honest members of the scheme’. According to Katlego Mothundi, MD of the Board of Healthcare Funders of SA (BHF) who spoke at the recent Council for Medical Schemes’ Fraud, Waste and Abuse Summit, up to 25% of the money paid as medical scheme contributions annually, is lost through fraud, corruption and abuse. The cumulative cost burden of fraud, abuse and waste is estimated between R22bn and R28bn a year. For the article click here
Samwumed to be back in control of trustees tied to troubled union
Medical Brief 20 March 2019 - Joe Seloane, curator of Samwumed, and Sipho Kabane, registrar of medical schemes, are quoted in the report as saying that the scheme is financially and operationally sound and will be ready for trustee elections by the end of August.
This is despite the union reportedly facing an application by the labour registrar asking the Labour Court to put the union under administration for failure to comply with financial accounting laws. Mfana Maswanganyi, a senior investigator at the council, said the council is monitoring developments at the union and if the union is put under administration, its curator will appoint the scheme’s union-member trustees. Seloane said in the report with member approval he will apply for an amendment to the schemes rules to reduce the 19-member board of trustees to 12. For the article click here
SA ranked as the unhealthiest nation on earth in new index
Medical Brief 20 March 2019 - A new global health index has identified, on 10 key measures, the world’s healthiest (Canada) and most unhealthy (South Africa) countries in 2019, reports Business Insider .
The Indigo Wellness Index, compiled and led by Richard Davies at economics consultancy Bloomsbury Economics, is one of the most comprehensive to date, covering 191 countries across the globe. For the article click here
Cancer pain can be eased by palliative radiation therapy
BizCommunity 20 March 2019 - Many patients receive radiation as part of a treatment to try to cure their cancer, but around half of radiation treatments are given with “palliative intent.”
The goal of palliative radiation therapy is not to eliminate the cancer, but to alleviate symptoms like pain, bleeding or shortness of breath — to improve a patient’s quality of life. However, despite an estimated 60 to 90% chance of improving symptoms, palliative radiation remains underused around the world. For the article click here
Bridging the mental health gap
BizCommunity 19 March 2019 - Only a small portion of those in distress can afford the available care, which is concentrated in the private sector.
In the public sector there are approximately 2.75 psychologists for every 100,000 people. The new Counselling Hub, an initiative of the South African College of Applied Psychology (Sacap) Foundation and the KK Educational Fund (KKEF), in Woodstock, Cape Town offers low cost mental health services to people living and working in the surrounds. With one-on-one sessions at only R50, and free workshops, people with low incomes can now seek the professional support they need to navigate their life challenges. For the article click here
Regulating telemedicine in South Africa
Bizcommunity 19 March 2019 - Telemedicine services will gain more traction and prominence in the South African healthcare environment in the coming months and years, with the support of new technologies, such as the rollout of 5G mobile networks across the country.
Both established and start-up businesses are competing for pole position in developing innovative and disruptive new technologies, software, platforms and solutions to capture the healthcare market in South Africa and around the world. However, buy-in from healthcare practitioners, patients, funders and regulators is required. It is against this backdrop that the Health Professions Council of South Africa (HPCSA) developed, approved and published the General Ethical Guidelines for Good Practice in Telemedicine (Guidelines) in August 2014. For the article click here
Health department is ‘innocent party’ in using picture without permission
Business Day 19 March 2019 – The Advertising Regulatory Board has ruled against the health department despite saying it is “keenly aware” it was an “innocent party” in using a photograph without the photographer’s permission.
Nonkazimale Mbanjwa complained after the health department used one of her photographs on some of its billboards on the N1 and N3 without her permission. On the billboard is the photo of a woman and a baby with the claim: “Prevent 6 life-threatening diseases with one vaccine”. “The photographer has now sold her image to various organisations‚ including the advertiser. The use of her image in this advertisement is not with her consent.”
C-section 50 times more deadly for women in Africa, study finds
Business Day 18 March 2019 – Findings highlight the urgent need for improved safety for the procedure, researchers say.
The death rate among women undergoing a caesarean section to deliver a baby is about 50 times higher in Africa than in most wealthy nations, researchers said on Friday. One in 200 women perished during or soon after a caesarean in a sampling of nearly 3,700 births across 22 African countries, they reported in The Lancet Global Health. For the article click here
Publication date: 3/24/2019