Managed care programmes can benefit medical schemes

22 December 2011

Managed care programmes can lower medical cost inflation by reducing unnecessary hospitalisations and specialist visits. If used properly, these programmes can play a huge role in managing the financial risks of medical schemes.

Many schemes use savings accounts or authorisation requirements to lower the number of hospitalisations. But a managed care programme aims to keep patients healthy within the constraints of their medical aid, while their scheme keeps an eye on their health and the costs involved.

If managed care programmes and medical schemes can work together, they can decrease unnecessary expenditure and significantly reduce non-healthcare costs. Most importantly, this can lead to more affordable benefit rates for the individual.

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