The use of networks by medical schemes are becoming increasingly prevalent as it allows them to channel volumes into the network in return for lower tariffs. Whilst networks have historically mainly been restricted to hospitals, doctor networks are growing as a means of controlling other costs associated with hospitalisation. Through lobbying, Lenmed enjoyed considerable success in the 2019 network appointments.
- The Polmed tender resulted in all Lenmed hospitals being included on this network.
- Our hospitals also now enjoy full representation on the Sizwe Medical Scheme.
- Significant lobbying was done with Medshield. We made detailed representations for the inclusions of our hospitals on their network. The representations focussed on factors such as geographical position to network facilities, scarce disciplines/skills and community affiliation/history. As a result of this background work, five Lenmed facilities were appointed to the Medshield network as filler hospitals – Ahmed Kathrada Private Hospital, Daxina Private Hospital, Kathu Private Hospital, La Verna Private Hospital, and Royal Hospital and Heart Centre. Due to the network anchors, it was not possible to get our hospitals situated in the more metropolitan areas appointed to this network. We believe that our appointment to the above networks is a satisfactory result for 2019. However, we will be working hard to improve our representation for 2020. Should you practice at a non-participating hospital and wish to admit a Medshield patient, please engage with hospital management as we are flexible with negotiating co-payments.
As part of our drive to increase our Funder Relations presence to our hospitals, we have sent out an initial communique to our Doctors introducing Gavin Harrison (Head: Funder Relations) as well as explaining how we can assist you. The next step to this process is meeting with our Doctors at the hospital PAB meetings for a more personal introduction and initial engagement. This process has started at Zamokuhle Private Hospital and will continue at select facilities over the next two months. We look forward to introducing this initiative to you, hearing your feedback, and assisting you where appropriate.