#3  Improving Healthcare Coverage: BHF's Tool for Medical Schemes | BHF Conference 2023 | Episode 3

--:--
In this conversation, Lubaletu Dube, an actuary consultant at Insight, is joined by Dr. Rajesh Patel from BHF (Board of Healthcare Funders). They discuss a tool developed by BHF that measures the coverage provided by medical schemes and their ability to meet the needs of their members. Dr. Patel explains that the tool supports the strategic positioning of universal healthcare coverage and helps schemes identify gaps and necessary interventions for improvement.
They touch upon the waiting system and risk adjustment incorporated in the tool, which allows schemes to reflect their demographic profile and compare their results to the industry on a like-for-like basis. The tool focuses on specific areas of coverage such as maternity care, child health, noncommunicable diseases (hypertension, diabetes, mental health), infectious diseases (HIV prevention, pneumonia in the elderly), and cancers (breast and cervix).
Dr. Patel mentions that the tool is new and currently being launched, with 10 participating schemes and 4 schemes already using it for management purposes. The goal is to empower schemes to make informed decisions about benefit design based on health needs, ultimately improving the health status of members. The tool's data can also be used to demonstrate value to employers, linking improved health to productivity and absenteeism in the workplace.
The conversation highlights the importance of employers as stakeholders and the need to demonstrate the value that schemes bring to companies and their employees. They emphasize the role of schemes in contributing to a healthy community and a healthy economy. The discussion concludes on a positive note, with Valle expressing gratitude for the insights gained from the conversation.
Season 1 / Episode 3 21 Aug 2023 English South Africa Tech News · Tech News

Other recent episodes

Margie Conradie is an open book

In this episode of In Focus with Insight, Pamela Hellig sits down with the remarkable Margie Conradie, a healthcare actuary, high school mathematics teacher, university lecturer, and the voice behind the podcast So What's It Actuary About? Margie’s career has taken her from consulting to teaching at a boys' boarding…
Season 1 / Episode 38 59 min

Board Succession Planning & Governance: Insights with Michelle Beneke | BHF Conference 2024

In this episode of In Focus with Insight, Lubalethu Dube talks with Michelle Beneke, an attorney and company secretary, about board succession planning in medical schemes. They discuss governance gaps in the Medical Schemes Act, balancing institutional memory with fresh thinking, and practical ways to improve board effectiveness. Michelle highlights…
Season 4 / Episode 5 24 min

Nicky Patchett is an open book

In this episode of Open Books, Pamela Hellig sits down with Nicky Patchett, an experienced actuary and Head of Actuarial Function for multiple Old Mutual entities. Nicky shares insights from her career journey, her involvement in the actuarial profession, and her passion for justice and championing the interests of policyholders…
Season 5 / Episode 2 59 min

Mental Health, Climate Change, and the African Experience with Dr Sara Touirsi

Join us for an insightful episode of In Focus as we dive into a conversation with Dr Sara Touirsi, a psychiatrist from Casablanca, Morocco, speaking live from the BHF Conference in Cape Town. Dr Touirsi shares her unique perspectives on the intersection of climate change and mental health, touching on…
Season 4 / Episode 4 22 min

Dalisu Dube is an open book

In this episode of Open Books, Pamela Hellig chats to Dalisu Dube, CEO and Founder of Linar Insurance, for an inspiring conversation that bridges entrepreneurship, leadership, and personal growth. Dalisu shares his journey from growing up in a small town to leading a micro-insurance company with a purpose-driven mindset. He…
Season 5 / Episode 1 59 min