INSIDE SOUTH AFRICA’S LARGEST SELF-ADMINISTERED MEDICAL SCHEME
BESTMED MEDICAL SCHEME
HEALTHCARE
Providing a Helping Hand
How South African medical scheme Bestmed is fulfilling its pledge to ensure the safety and wellbeing of its beneficiaries, employees and partners Writer: Dani Redd | Project Manager: Callam Waller
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et’s face it: it’s easier to be happy when you’re healthy. And when people are healthy, they work harder, live longer and enjoy their lives. As a result, they generate prosperity, thereby creating healthy societies and strong, healthy economies. This understanding is what makes healthcare an exciting space to work in for Leo Dlamini, CEO and Principal Officer of Bestmed – the largest self-administered medical scheme in South Africa. Fulfilling members’ needs and improving their wellbeing, and the impact that can make on the country as a whole, are powerful motivators. Dlamini acknowledges, however, that the sector is also decidedly challenging. “Organisations in the healthcare industry have the responsibility to help people live full and productive lives. It’s a big task,” he says. “It’s essential to be on the alert for opportunities to improve our service and to keep finding ways of making it easier for our members to access our huge network of healthcare providers. And, of course, interaction with our members requires
Leo Dlamini, CEO and Principal Officer of Bestmed
sensitivity. People are often vulnerable when they contact their medical scheme, and we want their experience with us in those circumstances to be positive.” Another challenge is the regulatory framework within South Africa’s healthcare industry, which is very strict – understandably so. Bestmed’s approach is to be vigilant in reviewing its processes and procedures to ensure unwavering compliance. However, Dlamini points out that the downside of this is that innovation and adoption of relevant global trends are near impossible in this country. Related to this is the ever-increasing cost of providing healthcare, a problem that is exacerbated by the prevalence of fraud, waste and abuse in the industry. The monitoring and prevention of the latter has now been designated as a strategic risk requiring regular scrutiny by Bestmed’s top management. Africa Outlook issue 86 | 3
BESTMED MEDICAL SCHEME
PPN YOUR OPTICAL BENEFIT Your benefit covers 100 percent of your consultation, 100 percent of clear single vision or clear bifocal lenses or clear base multifocal lenses depending on your benefit option. Your frame and lens enhancement benefit is considerably better at a PPN network provider. There is no need for expensive co-payments unless you wish to enhance your benefit. Members can elect to retain their existing frame and use the frame benefit to reduce the cost of lens enhancements such as hard coating, tints, etc. Make sure your PPN optometrist explains any co-payments on your account before you approve the purchase of your spectacles.
A PIONEERING MEDICAL SCHEME So, when was Bestmed founded and what does it look like today? The organisation has been providing quality healthcare to South African residents since 1964. In those days it was a relatively small and closed medical scheme called SOMS. It was not until 1990, when it was registered as an open scheme and renamed Bestmed, that it gained 15,000 principal members. Over the years the scheme grew both organically and through several amalgamations, bringing it to today’s 4 | Africa Outlook issue 86
95,000-plus principal members and in total more than 200,000 beneficiaries. As mentioned earlier, it is also the largest self-administered medical scheme in the country, providing what would previously have been an unthinkably broad range of expert services to its diverse and constantly growing pool of beneficiaries. Dlamini explains that today the scheme designs its benefit options to suit every life stage and pocket. Beneficiaries can also access complementary products, such as immunisations and female contraceptives,
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HEALTHCARE
PPN the Optical Network of Choice Providing Bestmed members with a unique benefit design and competitive pricing : • 100% cover for consultation. • 100% cover for clear prescription lenses in either Single vision or Bifocal design. • 100% cover for clear prescription lenses in base Multifocal design for certain options. • A generous frame benefit value that can be used to either fund a new frame or used to offset co-payments for lens enhancements elected by members. • Allows any family member needing corrective prescription spectacles to receive a benefit. The PPN Optical Benefit design allows members to access Optical benefits at a network provider without a co-payment unless the member elects lens enhancements or designer frames. Members are encouraged to engage their network optometrist to explain their optical account and the reason for any co-payments. Scheme Rules apply. B-BBEE Level 1 For more information email : info@ppn.co.za / management@ppn.co.za
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Africa Outlook issue 86 | 5
BESTMED MEDICAL SCHEME
LEADERSHIP FOCUS
LEO DLAMINI Q: Why did you decide to join Bestmed after a long tenure in the energy sector? A: “Well, to start with I had a vested interest in Bestmed as one of its members! And when the opportunity to stand for an appointment to the Bestmed Board came my way in 2015, I decided to take it. I had already served on a number of other boards, and the role of a trustee within a closely regulated environment was a familiar one. By July 2019, when I was appointed as Principal Officer and CEO of the organisation, I was already versed in Bestmed’s strategic and operational mandate. In addition, having had more than 20 years of operating at senior management and executive level, the leadership role in itself was not a novelty. “The transition from the energy sector to the health insurance industry was both stimulating and challenging. It was also useful, in the sense that I was able to bring a different perspective to the fundamentals of Bestmed’s growth strategy. “My background and life experience enable me to relate to the national agenda and upcoming changes in the medical insurance space. Within that space, we at Bestmed are poised to grow our footprint throughout South Africa. We are deeply committed to keeping the organisation steady and to delivering on our strategic drivers.”
that add flexibility to the options. For people who are battling with conditions such as diabetes, HIV/AIDS or cancer, there are also nine managed healthcare programmes. In addition, preventative care products and wellness programmes have been gradually introduced and consistently emphasised over many years of research and development. These have now become part of the scheme’s mainstream offerings. Bestmed also has one of South Africa’s most extensive service networks, with over 15,000 healthcare providers and ancillaries across the nation to whom its members have access. The organisation itself also employs 462 professionals (known to staff and members as Heartbeats because of the essential services they provide). Turning back to the scheme’s pioneering spirit, Dlamini remarks that “a fundamental principle that has, from the beginning, been ingrained in everyone at Bestmed is that we must make it easy for members to make contact with us”. “Today there are walk-in centres at the Pretoria head office and the regional offices, where members can deal with a range of administrative tasks and enquiries,” he continues. “Various digital channels are also available: the Bestmed app, a web chat facility and a contact centre. For members who prefer to deal with a personal advisor, there is also an extensive network of independent medical aid advisors with whom they can connect.”
WHAT IS SPECIAL ABOUT BESTMED? Dlamini says he’s tempted to say “everything”! He does, however, identify a number of key factors that distinguish Bestmed from other medical scheme providers. The first of these is the unique benefits that make the scheme good value for money. For example, members whose
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HEALTHCARE
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Africa Outlook issue 86 | 7
BESTMED MEDICAL SCHEME children are pursuing post-school studies can continue to register them as beneficiaries at child dependent rates, up to the age of 26. There is a hidden and incalculable value here, says Dlamini: that of assisting and encouraging parents to give their kids the best education they can afford Keeping annual price hikes as low as possible is a target most businesses aim to achieve. In this domain, Dlamini and his team have hit the bull’s eye for four years in a row, with yearly contribution increases kept within a single digit percentage since 2017. Dlamini points out that another distinguishing factor is the wide variety of
BESTMED BENEFITS Beneficiaries of Bestmed receive the following benefits: • Access to the Bestmed Tempo Wellness Programme at no extra cost. Corporate groups can also access Virtual Bestmed Tempo wellness initiatives such as COVID-19 information sessions, holistic wellness workshops and virtual Pilates classes • Preventative care benefits, including pneumonia and flu vaccines, paediatric immunizations and a backand-neck preventative care programme • Women’s health benefits such as female contraceptives, maternity benefits, HPV vaccinations for those aged 9 to 26, and mammograms for members over 40 • Managed healthcare support programmes for diabetes, oncology and HIV/Aids
8 | Africa Outlook issue 86
preventative care and wellness benefits that the scheme has included in the various benefit options. He emphasises that not only do these benefits minimise the risk of future illness and impairment, they also save members the associated treatment costs. “So, it is a mutually beneficial approach,” Dlamini says. “All our beneficiaries have access to the Bestmed Tempo Wellness Programme at no additional cost. This programme guides members to follow a healthier lifestyle through health assessments (including checking of blood pressure and glucose levels), free personalised consultations with dieticians and biokineticists, a range of group fitness classes and much more.” Bestmed has a long tradition of participating in country-wide assessments of its organisational profile, and in 2020 it took part in the medical scheme category of the South African Customer Service Index (an independent national benchmark of customer
satisfaction concerning service and product quality). The scheme performed best in the industry regarding perceived quality, perceived value, overall customer service index, and customer loyalty.
COMBATTING COVID-19 Asked about COVID-19, Dlamini says wryly that “the past six months have most definitely not been ‘business as usual’, especially during the national lockdown to combat the pandemic. And I’m proud to say that during this time, we’ve fulfilled the scheme’s most crucial role by ensuring that our members have had the peace of mind of knowing that Bestmed was there for them in their time of need. All the way.” The Scheme remained fully operational during every phase of the lockdown. Services were monitored throughout the period and communication with members was on-going to ensure that their interaction with Bestmed remained optimal. Most of
HEALTHCARE
“I’M PROUD TO SAY THAT DURING THIS TIME, WE’VE FULFILLED THE SCHEME’S MOST CRUCIAL ROLE BY ENSURING THAT OUR MEMBERS HAVE HAD THE PEACE OF MIND OF KNOWING THAT BESTMED WAS THERE FOR THEM IN THEIR TIME OF NEED” its employees were able to work at full capacity from home with minimal disruption to operations. Bestmed also applied to the Council for Medical Schemes for payment exemptions to alleviate difficulties for those in financial distress. This meant that downgrades to cheaper membership options could be offered, debit order deduction relief was made available for members relying on state pensions, and in some instances members were allowed to use their vested savings with the scheme to fund their contributions. Dlamini comments that Bestmed’s membership remained stable during
this period. “In fact,” he says, “with the new members who have joined, we’ve experienced a net growth in principal members for 2020. Clearly, people understood the importance of having and maintaining adequate healthcare cover during this pandemic, despite the calamitous economic climate.” Bestmed’s response to the impact of COVID-19 has not been confined to concern for only its beneficiaries; its employees, partners and suppliers have all been considered. In terms of employees, the scheme partnered with research unit Afriforte, which conducted a study to assess the wellbeing of its employees during
lockdown as part of an initiative dubbed the Wellbeing of Heartbeats. Dlamini explains: “The initiative aimed to encourage and motivate employees by allaying fear of the unknown and confronting insecurities that are coupled with ultra-challenging circumstances. Departmental debriefing sessions focused on promoting hope and normalising fears through best- and worst-case scenarios.” The company also partnered with ICAS to provide individual debriefing sessions for staff members with high stress levels. Meanwhile, an organisation-wide webinar ensured that employees were consistently updated on Bestmed’s performance. The continuous high levels of engagement with and investment in its employees allowed Bestmed to fare well during the lockdown period. The feedback from the webinar was very positive, and similar initiatives are likely to be undertaken in the future. Africa Outlook issue 86 | 9
BESTMED MEDICAL SCHEME advisors (brokers) and members have access to the relevant Bestmed teams. Even as we continued to work from home, our teams have been available over the phone, email, WeChat and Teams Outlook since the start of the lockdown,” the CEO comments. He emphasises, however, that this commitment to building strong relationships, with suppliers and partners as well as with members, had been embedded in Bestmed’s DNA long before the pandemic. “For example,” he continues, “to ensure mutually beneficial relationships and brand visibility with our healthcare providers, we visited 758 practices during 2019 to assist with any queries that they might have had. This approach ensures that we build and maintain strong, long-term relationships, and give the healthcare providers direct access to our consultants as and when they need it.” IN FOCUS
CORPORATE SOCIAL RESPONSIBILITY Bestmed recently participated in several CSR initiatives, including:
CONTINUING TO CONNECT Positive experiences and needs remain central to the enrolment and retention of members. Although 2020’s planned member engagement events were cancelled due to the COVID-19 restrictions on social distancing, engaging with members, advisors and corporate representatives is still a key element of Bestmed’s “Personally Yours” brand promise. A series of advisor webinars has ensured that Bestmed has remained in contact with its extensive advisor network. “We have ensured that providers, 10 | Africa Outlook issue 86
PARTNERS FOR POSSIBILITY (PFP): This is a flagship programme run by Symphonia for South Africa (SSA), which focuses on making a difference one school at a time. Bestmed partnered with Mamelodi East Prevocational School through this programme. The scheme transferred skills in planning, leadership and budgeting to make a positive longterm impact, while Bestmed itself gained exposure to the education community and the challenges it faces. Bestmed also organised a wellness day, which included health tips and free eye screenings for the learners. OPERATION HUNGER: Bestmed donated funds to this vital monthly feeding scheme, which provides meals for around 5,000 vulnerable families every month. The funds from Bestmed were used to distribute 1,200 emergency food parcels following the COVID-19 outbreak. PALESA PADS: These washable sanitary pads are made by South African women. Bestmed delivered 1,000 sanitary pad kits – which consist of three pads, a bucket, cleaning materials and drying clip – to eight clinics, together with 15 300 branded Bestmed masks. Bestmed’s employees also pulled together and contributed more than R600,000 to COVID-19 related projects in vulnerable communities.
HEALTHCARE Outlook draws to a close, Dlamini re-emphasises some of the challenges that the South African healthcare industry is experiencing alongside the pandemic: intense competition, economic difficulties faced by members, and the massive undertaking of rolling out a vast NHI programme. However, he feels optimistic about Bestmed’s ability to chart a course through these somewhat turbulent waters, and believes the scheme is well-positioned to excel in this environment.
Bestmed’s employees have pulled together and contributed more than R600,000 to COVID-19 related projects in vulnerable communities to date Over the upcoming months, Bestmed will continue to connect with its wide range of stakeholders through increasing its efforts towards digitisation. Dlamini mentions that Bestmed “is the first medical scheme to partner with Intermedix, a digital healthcare innovator, to bring GPs, specialists and healthcare providers an exciting selection of functionalities to maximise service efficiency and boost patients’ medical outcomes.” He explains that this unique partnership enables Bestmed’s network of GPs to access the digital platform iCanRefer to make easy referrals,
rather than trawling directories and programmes to find scheme-approved specialists. Doctors can also access iCanScript, an e-scripting web application that allows both GPs and specialists to generate digital prescriptions that can be sent directly to a pharmacy, thereby ensuring medical compliance. Bestmed’s doctors have recently been given access to CLICKDOC Video Consulting, which means they can ensure that members can get access to the healthcare they need by giving them virtual appointments where necessary. As the conversation with Africa
“The Bestmed team is committed to our brand promise of being ‘Personally Yours’. We are focused on what the scheme needs to achieve, including product development, maintaining a strong service provider network, remaining a preferred choice for members and advisors, retaining existing members and ultimately growing the principal membership,” he concludes.
BESTMED MEDICAL SCHEME Tel: +27 (0)86 000 2378 newbusiness@bestmed.co.za www.bestmed.co.za
Africa Outlook issue 86 | 11
BESTMED MEDICAL SCHEME Head office: Bestmed Medical Scheme, Glenfield Office Park, 361 Oberon Avenue, Faerie Glen, Pretoria, 0081, South Africa Tel: +27 (0)86 000 2378 newbusiness@bestmed.co.za www.bestmed.co.za PRODUCED BY AFRICA OUTLOOK MAGAZINE