AfroCentric Investment Corporation Limited’s acquisition of a majority stake in Medscheme’s holding company, Lethimvula Investments Limited, has positioned the Group as the largest, listed, black-owned healthcare company in South Africa.

Medscheme’s vision is to achieve industry leadership through the delivery of innovative, efficient medical scheme administration and health risk management solutions of exceptional quality.

The company’s unique solutions are based on an intimate knowledge of the healthcare environment developed over almost four decades of experience in the industry. This offering is differentiated in four distinct areas:

1- Focused customer solutions and partnerships
Medscheme is a true multi-medical scheme administrator and health risk management solutions provider that recognises that each client is unique. The organisation’s approach is to build mutually beneficial partnerships with clients and, having developed a rigorous understanding of their needs, to tailor unique, focused solutions that empower clients to achieve their
strategic objectives.

2- Efficient, effective, quality administration
Medscheme’s primary objective is to deliver efficient,quality service to its client partners. This is achieved through the implementation of a strategy of continuous improvement based on constant measurement of outputs against specific stringent quality standards. This ensures that service level agreements with client partners are consistently achieved or exceeded.

3- World-class information technology
One of Medscheme’s primary business imperatives is to ensure that its IT platforms and technology comply with international best practice. This strategy ensures that Medscheme’s IT platform and technology are optimised to deliver maximum business value and generate efficiencies that improve service delivery to our client partners.

4- Quality, health and financial risk management
Managing financial and health risk in the context of the healthcare industry is the essence of Medscheme’s business. The company’s depth of clinical, actuarial and financial expertise enables Medscheme to deliver health and financial risk management solutions of exceptional quality that are a source of competitive advantage to our client partners.

Audited financial results demonstrate that the company is financially sound with a strong balance sheet and cash reserves while corporate governance and internal audit practices are held in high regard by external auditors and clients alike.

Medscheme’s integrated offering is delivered by its two operating divisions, Medscheme Health and Medscheme Health Risk Solutions.

Leaders in Medical Scheme Administration

Medscheme Health’s vision is to be recognised as the leading medical scheme administrator in South Africa in terms of service excellence and quality.

The division delivers a comprehensive series of integrated solutions which recognise that flexibility and differentiation are paramount to remaining competitive in the highly competitive medical scheme industry.

Serving a diverse base of customers which include medical schemes, boards of trustees, scheme members as well as intermediaries and healthcare professionals, the primary goal of Medscheme Health is to meet the needs of its clients through sheer service excellence, quality, differentiation and personalised solutions.

This business model is based on six pillars:

• a unique, client-centred business philosophy
• highly skilled, experienced managers and staff
• state-of-the-art technology
• constant monitoring of quality and efficiency
• excellence in corporate governance and
• a national branch network.
  

The smooth running of the scheme is ensured by a comprehensive spectrum of services including fund management, dedicated call centres, scheme finance, secretarial and key accounts. Similarly, medical scheme members receive the best possible service through a wide variety of convenient client touch points which include: 

• scheme-specific call centres
• interactive websites
• email services
• SMS services
• Client Liaison Officers

In 2009, Medscheme Health achieved PMR.africa’s highest award for excellence having achieved the highest overall score in an independent annual survey which measures accredited medical scheme administrators across 24 relevant criteria.

This award demonstrates Medscheme’s commitment to excellence and quality in service delivery.

New Standards in Health Risk Management

Medscheme Health Risk Solutions (MHRS), Medscheme’s health risk management division, has been at the cutting edge of health risk management for 20 years. The division is now considered South Africa’s pre- eminent health risk management organisation and continues to set new standards.

The discipline of health risk management aims to balance cost (price and utilisation of healthcare services) with quality of care (best healthcare results or outcomes) and access to healthcare services.

Health risk management solutions are continuously evolved to ensure continued industry leadership and differentiated in the following areas to ensure MHRS continues to set the standards in health risk solutions:

• “Best of breed” health risk management components.
• Flexibility, client-focus and -support.
• Investment in and ongoing development of clinical, analytical and operational (using intelligent systems) capabilities.
• A focus on new initiatives to bring about healthcare professional and beneficiary behaviour change through:
  
  – Information sharing
  – Development of scheme-specific reimbursement models (aligning incentives).
  – Co-ordination of care.

MHRS has consistently demonstrated positive results in presentations to clients and at national and international conferences.

Aid for AIDS is an example of this standard of excellence. Its clinical guidelines are the norm in South Africa and it boasts a large and satisfied medical scheme and corporate client base. The quality of its services and the superior health outcomes of its enrollees have been demonstrated in numerous internationally published scientific papers.

MHRS’ industry leadership was recognised in 2009 when the business was awarded seven Diamond Arrow awards and one Golden Arrow award for excellence in managed care services. In addition MHRS received the highest overall score in disease management.