Medical Aid Funding in South Africa 2016 - Product Image

Medical Aid Funding in South Africa 2016

  • ID: 4035752
  • Report
  • Region: Africa, South Africa
  • 121 pages
  • Who Owns Whom
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FEATURED COMPANIES

  • Anglo Medical Scheme
  • Bonitas Medical Fund
  • LA-Health Medical Scheme
  • Medshield Medical Scheme
  • Moto Health Care
  • Sizwe Medical Fund
  • MORE
Medical Aid Funding Sector: This report focuses on South Africa’s medical aid funding industry. The sector comprises 83 registered medical schemes, 23 open and 60 restricted, and currently serves almost 8.8 million beneficiaries. With scheme contributions of R140.2bn and healthcare expenditure of R124.1bn for the financial year ending 31 March 2015, the industry plays a critical role in South Africa’s private health sector, which is currently the subject of a Competition Commission inquiry.

Consolidation and Growing Pressure: During the past fifteen years, the South African medical aid funding industry has consolidated, with numerous small medical schemes amalgamating with larger schemes. Between 2000 and 2015, the total number of registered medical schemes decreased by 42%. According to the Council for Medical Schemes (CMS), consolidation is viewed as “a response to market forces and is not necessarily a negative development or an indication of instability in the South African medical schemes environment.” However, the medical aid funding industry is a sector under increasing pressure. Regulatory uncertainty continues to undermine the industry. Challenges identified by stakeholders include demarcation regulations and regulations governing Prescribed Minimum Benefits (PMBs). Many role players have called for a review of regulations relating to solvency calculation, risk equalisation and governance. While the number of beneficiaries receiving treatment for chronic diseases rises, the number of new members is decreasing, a trend that is expected to continue. Role players have cited unemployment and the lack of disposable income as the major contributing factors.

Report Coverage:
The report on the medical aid funding sector describes the current market, the latest regulatory developments and discusses factors influencing the success of the sector. The report profiles nine medical fund administrators and 23 medical aid companies including market leader, Discovery Health which increased its market share in the open medical schemes segment from 52.4% in 2013 to 53.4% in 2014, and the Government Employees’ Medical Scheme (GEMS), the largest of the restricted medical schemes.
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2 of 4

FEATURED COMPANIES

  • Anglo Medical Scheme
  • Bonitas Medical Fund
  • LA-Health Medical Scheme
  • Medshield Medical Scheme
  • Moto Health Care
  • Sizwe Medical Fund
  • MORE
1. Introduction

2. Description Of The Industry
2.1. Value Chain
2.2. Geographic Position

3. Size Of The Industry

4. State Of The Industry
4.1. Local
4.1.1. Corporate Actions
4.1.2. Regulations
4.1.3. Enterprise Development And Socio-Economic Development Initiatives
4.2. Continental
4.3. International

5. Influencing Factors
5.1. Economic Environment
5.2. Government Intervention
5.3. Input Costs
5.4. Commercial Health Insurance
5.5. Managed Health Care
5.6. Technology, Research And Development (R&D) And Innovation
5.7. Labour Resources
5.8. Environmental Concerns
5.9. Cyclicality

6. Competition
6.1. Barriers To Entry

7. Swot Analysis

8. Outlook

9. Industry Associations

10. References
10.1. Publications
10.2. Websites
Appendix 1
Registered Medical Schemes – 2014/2015
Appendix 2
Medical Scheme Administrators
Appendix 3
Managed Care OrganiSAtions (Mcos) – 2014/2015
Company Profiles – Open Medical Schemes
Bestmed Medical Scheme
Bonitas Medical Fund
Discovery Health Medical Scheme
Fedhealth Medical Scheme
Keyhealth Medical Scheme
Liberty Medical Scheme
Medihelp Medical Scheme
Medshield Medical Scheme
Momentum Health
Sizwe Medical Fund
Spectramed Medical Scheme
Company Profiles – Restricted Medical Schemes
Bankmed Medical Scheme
Chartered Accountants Medical Aid Fund
Government Employees Medical Scheme
La-Health Medical Scheme
Moto Health Care
Nedgroup Medical Aid Scheme
Platinum Health
Profmed Medical Scheme
SAmwu National Medical Scheme
SAsolmed Medical Scheme
South African Police Service Medical Scheme
Transmed Medical Scheme
Company Profiles – Fund Administrators
Agility Holdings (Rf) (PTY) Ltd
Discovery Health (PTY) Ltd
Medscheme Ltd
Metropolitan Health Corporate (PTY) Ltd
MMI Health (PTY) Ltd
Professional Provident Society Healthcare Administrators (PTY) Ltd
Providence Healthcare Risk Managers (PTY) Ltd
Sechaba Medical Solutions (PTY) Ltd
Strata Healthcare Management (PTY) Ltd
Universal Healthcare Administrators (PTY) Ltd
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  • South African Police Service Medical Scheme
  • Bankmed Medical Scheme
  • Transmed Medical Scheme
  • Sasolmed Medical Scheme
  • LA-Health Medical Scheme
  • Nedgroup Medical Aid Scheme
  • SAMWU National Medical Scheme
  • Government Employees Medical Scheme
  • Chartered Accountants Medical Aid Fund
  • Platinum Health Medical Scheme
  • Profmed Medical Scheme
  • Moto Health Care
  • Anglo Medical Scheme
  • Metropolitan Health Corporate (Pty) Ltd
  • MMI Health (Pty) Ltd
  • Discovery Health (Pty) Ltd
  • Providence Healthcare Risk Managers (Pty) Ltd
  • Universal Healthcare Administrators (Pty) Ltd
  • Sechaba Medical Solutions (Pty) Ltd
  • Professional Provident Society Healthcare Administrators (Pty) Ltd
  • Agility Holdings (RF) (Pty) Ltd
  • Medscheme Holdings (Pty) Ltd
  • Sizwe Medical Fund
  • Discovery Health Medical Scheme
  • Medihelp Medical Scheme
  • Bonitas Medical Fund
  • Spectramed Medical Scheme
  • Fedhealth Medical Scheme
  • Medshield Medical Scheme
  • Momentum Health
  • Liberty Medical Scheme
  • Bestmed Medical Scheme
  • Keyhealth Medical Scheme
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