Saturday, August 25, 2018

South Africa has a new ‘best’ medical aid scheme

The latest South African Customer Satisfaction Index (SAcsi)
for medical schemes, conducted by Consulta, has been published
– showing that the big medical aid schemes are struggling to
keep customers happy, while a new industry leader has emerged.
According to the satisfaction index, the medical scheme
industry average dropped from 74.2 in 2017 to 72.7 in 2018 –
primarily due to two of the large brands showing declining
Bonitas’ score declined from 73.1 to 70.2 and Discovery Health
also reported a decline from 74.8 to 73.1 over the year.
Medihelp was the only open scheme in this year’s benchmark to
see an improved SAcsi score, continuing to reap the benefits of
its turnaround strategy noted in 2017. It consistently improved
from 70.7 in 2015 to 72.6 in 2017 and 75.1 in 2018 to lead the
industry in customer satisfaction.
Consulta noted that Momentum Health maintained its SAcsi score
of 2017 – now on 72.0.
Although GEMS is a closed scheme, Consulta was requested to
measure its SAcsi score for the last three years in addition to
the open scheme brands. Having dipped from 67.5 in 2015 to 64.3
in 2017, GEMS recovered substantially (68.8) in 2018.
The table below outlines the performance:
#Medical aid scheme2017 score2018 scoreChange
Industry Average74.272.7-1.5
The Medical Scheme SAcsi results reflect the years from
2015 – 2018, excluding 2016 as it was not measured. The
2018 SAcsi sample included 1,675 respondents who were randomly
selected from five medical schemes to participate in the
According to Consulta head Adre Schreuder, the 2018 medical
scheme SAcsi reflects an industry battling to find a
competitive position in the market – particularly as the the
implementation of the National Health Insurance (NHI) looms
over them.
Further, South Africans are becoming increasingly frustrated by
rising premiums and shrinking benefits, as well as a feeling of
lower value for money in comparison to other financial service
“While the market’s dominant heavyweights remain strong
competitors, pack leader Discovery seems to have shifted focus
to other business offerings in its product suite, including the
launch of its anticipated banking services and its long- and
short-term insurance offerings,” Schreuder said.
“This has allowed its competitors to even out the playing field
in the medical product suite by delivering simpler, traditional
medical insurance that is seen to be less expensive and easier
to understand.”
With more than 270 options available, choosing medical
insurance products is even more confusing to customers. Many
are left feeling frustrated when their claims aren’t covered
and the general customer experience of medical schemes remains
one of capped benefits and rising premiums, Schreuder said.
“To remain relevant in the face of NHI, private medical schemes
need to assess the value they provide to customers, such as
quality, affordability, transparency and ease of use, which
should be integrated into their daily operations.”
NHI challenges ahead
In June, Minister of Health Aaron Motsoaledi announced the NHI
and Medical Schemes Amendment Bill, proposing sweeping changes
to the running of medical schemes.
These changes are aimed at benefitting a wider range of members
and paving the way for the NHI financing system for all South
African citizens, not just those who can afford medical aid
Opponents of the plan point to various challenges to the
viability of the NHI, should it be implemented.
According to Schreuder, there are also concerns that the
changes announced will have a significant effect on increasing
premiums for 2019 and medical aid schemes will have to deliver
commensurate improvement in their service offerings to
neutralise the potential negative impact in customer
satisfaction levels.
“Over the years we have noted the impact of organisational
changes, including restructures and changes in management on
customer experience as the organisational focus and energy tend
to shift towards internal developments rather than on customer
“Medihelp’s strategy to focus on leveraging the contributions
and focused delivery from its strong leadership team, which is
underpinned by targeting a niche audience and offering exactly
what members want and understand, is working,” he said.

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