Practice Code Numbering System
that promote Unity
16th Annual BHF Southern African Conference
Issued: 22 December 2015
Thank you for your continued support in 2015.
Wishing you and your family a very happy festive season and
a healthy and prosperous new year.
In 2016, we look forward to our continued partnership with your organisation in creating a more affordable, accessible and sustainable healthcare system for all.
Please note that our offices will close on the 24th of December 2015 at 12pm and we will reopen on the 4th of January 2016.
The BHF Team
Issued: 11 December 2015: BHF
Minister Aaron Motsoaledi releases White Paper on National Health Insurance
11 December 2015 – The introduction of National Health Insurance (NHI) in South Africa will look to expand current pooled healthcare funds, entailing a massive reorganisation of healthcare platforms in both the public sector and the private sector, with a view to addressing the former’s quality issues and the latter’s cost issues.
Speaking at the official launch of the White Paper on NHI in Pretoria, health minister Dr Aaron Motsoaledi described the envisaged process as one of ‘innovative disruption’, entailing significant and irreversible changes to laws and policies, and ‘the way things are done’.” He underscored that it is a complex process and not something that will happen suddenly – ‘an ultra-marathon as opposed to a sprint’. NHI will be implemented over a period of 14 years, divided into three phases of five, five and four years.
South Africa, along with the USA, is currently out of step with most of the rest of the world. “The global trend is currently towards mandatory prepayment in the form of some kind of universal health coverage/NHI. Yet in South Africa, as in the USA, a disproportionate share of healthcare funding is derived from voluntary pre-payment in the form of medical scheme contributions. The world average percentage of private health insurance as a share of total health expenditure is 4.1%, whereas in South Africa the figure is 42.2%,” he said. In addition to its being inequitable, this scenario is not associated with good outcomes as it is very hospital-centric with a strong curative, rather than preventive focus, is associated with fragmentation of services and uncontrolled consumerism. Dr Motsoaledi was adamant that the latter should not be a determining factor in who has access to care and the quality of care they receive.
But he underscored nonetheless that medical schemes will continue to exist and have a role to play under NHI, not least because of the existing expertise within the industry and the value it can bring to NHI. The exact details have yet to be finalised, but the future of medical schemes is one of six key areas that will be the focus of upcoming workstreams. The others are: establishment of the NHI fund; design of benefits; preparation for a purchaser/provider split; completion of NHI policy and development of legislation; and preparation of the district health system. These expert committees will develop the practical strategies and structures for the implementation of NHI. Board of Healthcare Funders’ CEO, Dr Humphrey Zokufa, will be a member of the committee charting the way forward for the industry.
Currently, the White Paper stipulates that under NHI Medical Schemes will only offer complementary or top-up cover for services not included in the NHI benefits package. This will entail changes to the Medical Schemes Act along with a complete overhaul of the current prescribed minimum benefits, taking into account burden of disease and changing population demographics, with a view to ensuring the greatest possible access to healthcare services by all South Africans within available resources.
The last mentioned is a key concern for government. “Schemes currently only provide for a select, elite few. Approximately 80% of the country’s specialists work in the private sector, caring for just 16% of the population, and this inequity needs addressing. Access to quality health care needs to be based on health needs, irrespective of an individual’s socio-economic status.” The work of many earlier historical documents on funding reform and how to achieve universal healthcare therefore informed the drafting of the White Paper. The purposes of NHI are to meet population health needs, remove financial barriers to access, reduce the incidence of catastrophic healthcare expenditure, facilitate the attainment of nationally and internationally agreed health goals and ultimately contribute to better quality of life, poverty alleviation and human development.
Addressing the question of how much NHI would cost, Dr Motsoaledi pointed out that that has yet to be determined. He cited the United Nations Sustainable Development Goals which maintain that NHI is not solely the prerogative of wealthy countries; it just needs to be done within each country’s own capacity. “‘What will NHI cost?’ is therefore the wrong question – or, at best, an incomplete question. What NHI will cost will ultimately be determined by how it is designed and implemented. It is therefore in our hands to design an NHI that is affordable for South Africa and which still provides quality healthcare.” Several methods/possibilities have been identified based on tax reforms currently envisaged.
Attention will also be paid to addressing issues of waste. He noted that there is actually a lot of money within South Africa’s healthcare system, but much of it is inefficiently or inappropriately spent. A key strategy to minimise this under NHI will be an emphasis on primary care, with a patient’s first point of contact with the system being either a primary clinic or a GP. “Self-referral to tertiary facilities or super-specialists will become a thing of the past,” he concluded.
Issued by the Board of Healthcare Funders of Southern Africa: Zola Mtshiya: Manager: Marketing, Branding and Communications: 0829031856
Issued: 27 November 2015
The Board of Healthcare Funders of Southern Africa (BHF) announces the date for the 17th Annual BHF Southern African Conference:
Issued: 12 November 2015
EOH HEALTH AND MEDSHIELD JOIN BHF
We are proud to announce the arrival of two new medical schemes into the BHF Family.
We are delighted to welcome Medshield Medical Scheme and EOH Health as members of the Board of Healthcare Funders of Southern Africa (BHF).
EOH Health has positioned itself as a leader in the African healthcare market. EOH Health touches the lives of over 2 million beneficiaries throughout Africa, Europe and the US and serves clients in the fields of Advisory and Consulting; Hospital, Dental and Primary Care Risk Management; Workplace Health and Wellness solutions; and Wellness Events Management.
Medshield one of the most trusted medical aid schemes in the country, proving its stability, support and professionalism over the years. Founded in the 1968, Medshield’s current membership profile covers more than 157 000 people. With an impeccable reputation of prompt payments to hospitals, doctors, pharmacies and other medical caregivers guarantees approval from service providers, Medshield is counted amongst the country’s largest and most reliable medical aid schemes.
As the long-standing and acknowledged industry body representing open and restricted medical schemes, administrators and qualifying managed care organisations, BHF arguably has an important role to play to address industry needs, to add value to its members.
We are excited to have EOH Health and Medshield come on board during this challenging period in the private healthcare funding environment, this will help advance BHF’s call for a unified healthcare sector.
Issued: 29 October 2015
Overdue PCNS accounts to be de-registered
The Board of Healthcare Funders (BHF) administers the Practice Code Numbering System (PCNS).
We send out renewal reminders and invoices annually to update provider practice details and to facilitate payment. This is to ensure that the information shared with all the schemes is true and correct and the payment is for the ongoing running and maintenance of the system.
As a result, healthcare providers who have not paid their annual subscription fees will have their practice numbers de-registered from the PCN System. Accounts that are in arrears are being cut-off over a staggered period commencing on the 26th October 2015 to the 04th November 2015. Please note healthcare providers are required to make payment and update their details for full re-instatement.
Affected healthcare service providers and users may contact the PCNS Contact Centre on 0861 30 2010 or 011 537 0200 to request their statement of accounts and to re-instate their practice numbers.
Healthcare providers can pay their accounts at the till point of any outlet that accepts Easypay payments.
BHF through the PCN System is committed to meeting the needs of the healthcare industry by maintaining the system to provide efficient services.
Issued: 22 October 2015
On the 16th October 2015, the Commission published, in the government gazette, the amended the Terms of Reference (ToR) for the completion of the market inquiry into private healthcare. The Commission has also published a revised administrative timetable in line with the amended ToR.
The full press release is available to download below:
Issued: 21 October 2015
BHF Member Summit presentations.
Member schemes, Managed Care and Administrators gathered at The Venue, Melrose Arch for the BHF Member Summit on the 20th October 2015.
Issued: 24 November 2015
Applications for Ambulance Service will close on the 30th November 2015, as SAPEASA will be closed over the December period. SAPEASA will accept new inspection and re-inspection requests up until Thursday, 3 December 2015 from BHF. Please note any inspection requests received after 3 December 2015 will be held over until January 2016.The SAPEASA will re-open on Monday, 11 January 2016.
Issued: 23 November 2015
RE-OPENING OF REGISTRATION FOR PARTICIPANTS TO MAKE ORAL SUBMISSIONS AT THE PUBLIC HEARING OF THE HEALTH MARKET INQUIRY
THE Competition Commission is reopening registration for participants to make oral submissions at public hearings into the Health Market Inquiry (HMI).
The public hearings will commence on 1 February 2016 and conclude by 31 May 2016. To ensure that the public hearings proceed expeditiously and in an orderly manner, the HMI has decided on a staggered approach. The first set of hearings will take place over a five day period, between 1 to 12 February 2016 and are aimed at hearing the voices of consumers on the issues raised in Terms of Reference of the HMI.
In order to make oral submissions at the hearings, the public must submit a HI2 form, (which is attached) by no later than 11 December 2015.
Stakeholders who registered previously are encouraged, but are not obliged, to register again.
Issued: 04 November 2015
The number of queries have been growing exponentially since we announced the deactivation of all outstanding accounts from the PCN System. As a result, our Client Services phone lines are congested due to high call volumes.
We value all your queries. To receive your account statement or practice information, or have a general PCNS query, email: or email@example.com or firstname.lastname@example.org. or follow us on twitter: @bhfglobal or on facebook: https://www.facebook.com/bhfglobal/
Accounts that are in arrears are being cut-off over a staggered period commencing on the 26th October 2015 to the 04th November 2015.
Please note healthcare providers are required to make payment for re-instatement. It takes 24 to 48 hours to fully re-instate an account.
Healthcare providers can pay their accounts via the following payment channels.
At the till point of any outlet that accepts Easypay payments:
– SA Post office
– Pick n Pay
You can do your payment via EFT:
Branch code 197705
Cheque account number: 1958 518 530
Please use your practice number as reference: last seven digits
Medical aid allowed to cap cancer drug benefit
Bonitas Medical Scheme does not have to pay for a year’s supply of the breast cancer drug Herceptin for one of its members.
The final-appeal committee of the Council for Medical Schemes has ruled in favour of Bonitas, saying the plan chosen by the claimant, Veroney Judd-Stevens, of Pietermaritzburg, did not cover her for a year’s supply of the drug.
Posted: 2015-10-13 07:10:42Read More
Childhood cancer in focus at conference
THE focus will be on childhood cancers this week as leading experts gather in Cape Town to attend an international oncology convention. More than 1 400 delegates from around the world will be at the Cape Town International Convention Centre to attend
the 47th Congress of the International Society of Paediatric Oncology.
Posted: 2015-10-13 07:10:29Read More
Towards a lean and efficient health service
AT ONE of Gauteng’s largest state hospitals, there is a small room with thousands upon thousands of patient files, haphazardly thrown onto aluminium bookshelves without any kind of noticeable filing system or method to the madness. Some files lie on the ground in a disorganised heap.
Posted: 2015-10-13 08:10:02Read More
NMC Health of Abu Dhabi Approaches Al Noor About Counteroffer
NMC Health Plc, a United Arab Emirates health-care company, made an approach to Al Noor Hospitals Group Plc about a possible offer that would challenge an earlier proposal by South Africa’s Mediclinic International Ltd.
Posted: 2015-10-13 13:10:20Read More