This report reviews health system benefits policy and purchasing mechanisms in Chile to inform the development of National Health Insurance policy in South Africa. It has been prepared by R4D in consultation with South Africa’s National Treasury and with financial support from The Atlantic Philanthropies.
The aim of this paper is to highlight the key methodological considerations in an investigation into the costs incurred by health insurers arising from the provision of benefits during the 12 months preceding a beneficiary’s death. A South African dataset is used to illustrate the suggested methodology. Download the paper to read more
This project was commissioned by the Hospital Association of South Africa (HASA). The aim of the project is to compare the hospital-inpatient admission rates and length of stay of the South African medical scheme population with a set of international comparators. Download the paper to read more
The South African private healthcare industry faces significant changes in national health policy which most notably include the likely introduction of National Health Insurance (NHI). The possibility exists that the NHI agency will seek to contract with both public and private healthcare providers (referred to as plurality of provision). This raises questions of relative pricing between the two sectors. The concept of “price” from a consumer or funder perspective is complicated because services in the public sector are frequently not sold, and where prices do exist (for those above the means test) they are not determined by the existence [...]
Imagine you are the CEO of a company. Let’s say your business is middle to large sized. It could even be a small business which has a decent customer base and is starting to gain traction in its industry. As any other type of business, you are either providing a service or selling a product. If it’s 2015 (which it is) and you have a strategic mind-set concerning your business (which we trust you do), you have probably harnessed the power of collecting information about your customers so that you can tailor your marketing to appropriately target your customers. If you [...]
It’s 2015 and loyalty programmes have become the norm in industries ranging from retail to healthcare. What started off as small perks to thank customers for purchasing products or services has fast evolved into the modern way of doing business. Not only are these programmes many in number but they have evolved into diverse and complex offerings that are now an integral part of service providers’ product suites. While some brands have developed loyalty programmes reacting purely to peer pressure, those gaining the greatest traction and attention from customers have created ecosystems around their offerings which are fully supported [...]
Designing an effective model to assess the risk (and hence predict the future level of claims) of medical scheme members is, without doubt, a complex and arduous undertaking. There are an array of factors to consider. As a result, one can easily overlook the most seemingly basic question: “for what purpose?” The consideration of this question is of fundamental importance in designing any predictive model. Although the question may appear simple and obvious, determining an answer actually requires careful consideration of rather subtle aspects of the overall problem. Furthermore, the answer to such a question should play a direct [...]
When we look around us we can see there are limited resources at our disposal – limited natural resources, limited space, limited time, and limited human capital. However, creativity, ingenuity and innovation seem to know no bounds. Businesses based on sourcing more raw material are finding it increasingly difficult to grow at the pace they did in former decades. The new waves of growth unlock value in economies in a new way. “Uber, the world’s largest taxi company, owns no vehicles. Facebook, the world’s most popular media owner, creates no content. Alibaba, the most valuable retailer, has no inventory. And [...]