Few fields are quite as dynamic as the medical sector today.
Innovations are paving the way for improved well-being – from advances in telemedicine, to the development of wearables, to the increasing use of AI for more accurate treatment and diagnoses.
“It’s possible, now, to gain an understanding of your current – and even future – health concerns simply by undergoing a facial screening,” enthused Werner van Deventer, Head of Product and Business Development at Medihelp.
That’s great news for medical scheme members, who are excited about the potential impact on their lifestyles. It’s also positive for schemes, as improved outcomes can lead to lower costs over time.
van Deventer is deeply passionate about this.
With two decades of experience in the medical scheme industry, he is driven to make quality healthcare available to more people.
Innovation is key
Of course, innovation plays a critical role here – and not only in terms of fostering new medical treatments.
“Innovation has the potential to revolutionise the administrative side of schemes, promising a lower risk of fraud while increasing efficiency,” said van Deventer.
Medihelp, for example, has streamlined member enquiries considerably thanks to AI.
Where once a member may have engaged with several different staff members about their various queries, there is now a single point of contact.
AI has also simplified benefit structures, making the medical aid experience easier and more user-friendly.
But providing access to innovation can be expensive.
“Innovation promises to improve the efficiency of treatment and outcomes. But it comes with a significant upfront cost at a time when our members already feel financially stretched,” said van Deventer.
“As such, we have to carefully balance offering innovation and maintaining affordability.”
The greatest good for the most members
Not all members will benefit equally from the innovations available out there. For some, as exciting as they are, there is no real benefit.
“We need to prioritise the innovations that will make the greatest impact for the broadest base of members, and that’s where we focus our attention first,” said van Deventer.
Medihelp carefully considers whether a new introduction adds true value or is simply surrounded by hype.
“Our team also works hard to keep costs down by, for example, negotiating fair tariffs with providers,” said van Deventer.
Furthermore, the scheme is exploring alternative reimbursement models that reward providers with the best outcomes.
This helps prevent hospital readmissions, which are both stressful and costly.
And while Medihelp constantly reviews ways to keep contributions affordable, it also collaborates with regulators, technology providers, and healthcare providers to meet the needs of all stakeholders.
Shared responsibilities
Members have a role to play, too.
“We offer many benefits that promote preventive screening, which can help members avoid serious health conditions in the long term,” said van Deventer.
Taking advantage of these benefits, being rigorous about taking prescription medicine, and keeping up with Medihelp communications all help members stay healthy.
This is the best protection against traumatic health events or costly hospital stays.
“As we move forward, we need to remember that innovation and affordability are not a zero-sum game,” said van Deventer.
“Instead, we should create a cycle where thoughtful innovation drives better care.”
