Article published in the MediBrief November 2016 issue:
Cost savings achieved by the Scheme
Each member can contribute towards reducing healthcare costs by using the right healthcare providers and by negotiating with them.
The Scheme itself has many initiatives and programmes in place to reduce healthcare costs for all members. Over the last two years, AMS was able to participate in provider and tariff management initiatives facilitated by our administrator. This buying power enabled the Scheme to save R14.8 million on hospital and pathology costs and oncology medicine, as well as through fraud intervention. Over R1 million was also saved by our administrator's procurement strategy team, who negotiated rates on behalf of AMS for prostheses necessary for shoulder, hip, knees and intraocular lens operations. In many instances, members also benefited from savings through Discovery's optometry network and the GP network on the Managed Care Plan which was introduced this year.
Together with our pharmacy benefit management partner, MediKredit, the Scheme not only offered members the ease of a convenient paperless claims' experience and great administrative efficiency when registering for chronic medicine, but also facilitated substantial cost savings for medicines. AMS has enjoyed savings in the amount of R25 million since 2014 as a result of 'Therapeutic Reference Pricing' managing co-payments for medication. An initiative called 'Dispensing for Choice' was introduced in 2014 that resulted in minimal or no surcharges/co-payments for members with an increased revenue for pharmacies. A win-win situation! The savings to the Scheme was to the value of R1.6 million.
To find out more about 'Reference Pricing' and how to avoid co-payments, please refer to the February 2015 MediBrief. You can find it on Info Centre > MediBrief Newsletter Archive. Alternatively speak to our medicine management team on
0860 222 633.