Skip Ribbon Commands
Skip to main content

With the growing burden of modern-day diseases and continued financial pressure experienced by employees, both of which have a direct impact on business productivity, South African employers are constantly searching for innovative solutions to address these very real issues.

So is there a place for alternative and affordable solutions that address primary healthcare services only, within a South African context? The answer is a definite yes, and it is increasingly clear that access to affordable, high-quality primary healthcare in the private sector can make our healthcare system more accessible to everyone. The Council for Medical Schemes (CMS) has also recently made provision for the formal design and delivery of such health insurance products to address these primary healthcare requirements.

There has been a proliferation of primary healthcare solutions of late. Therefore, in order to make them more accessible to employers and employees, it is essential that such solutions:

  • be aligned to the recent legislative allowances,
  • provide real day-to-day cover,
  • focus on chronic disease diagnosis and treatment,
  • include special investigations,
  • provide psychosocial medicine addressing both psychological and social aspects, and
  • provide responsible hospitalisation for traumatic events.

As general practitioners (GPs) are the gatekeepers to accessing the abovementioned treatment value chain, a primary care product must also provide for:

  • ease of access to GPs,
  • GPs located in the right areas,
  • a cashless member engagement, and
  • dispense medication through practices where possible.

In addition, primary healthcare network providers should follow a responsible approach as to how they treat and remunerate their GPs, to ensure quality service delivery that is affordable for members. All of these services should be aligned and provide the member with a seamless and positive health experience and outcome.

Well-constructed and CMS-exempted primary healthcare solutions will provide South Africans with alternative access to private healthcare and should be a key consideration (in conjunction with medical schemes) when designing health-funding solutions for employers and employees alike.

Contact your Simeka Healthcare Consultant, on our Client Care line at 0860 122 340 or email for a free quotation, or if you require a needs analysis.



CMS Report 2018 – interesting factsCMS Report 2018 – interesting facts, /simekahealth/marketinsights/PublishingImages/CMS-Report.jpg6/10/2019 3:01:33 PM055440aspx325 latest Annual Report 2017/2018 of the Council for Medical Schemes (CMS) highlights a number of interesting statistics regarding the medical schemes industry.
NHI Bill developmentsNHI Bill developments, /simekahealth/marketinsights/PublishingImages/billDevelopmentsBanner.jpg11/14/2019 2:51:11 PM0134170aspx79 proposed National Health Insurance (NHI) system to be introduced in South Africa has drawn much attention in the media over the past months.

 Related Posts



Fedhealth Amalgamation with Topmed Medical SchemeFedhealth Amalgamation with Topmed Medical Scheme, /simekahealth/marketinsights/PublishingImages/fedhealth_banner.jpg4/30/2019 1:47:14 PM0168573aspx1350 members will automatically be defaulted into Fedhealth matching options.
Council of Medical Schemes propose amendments to 2019 Discovery Health contributions and benefitsCouncil of Medical Schemes propose amendments to 2019 Discovery Health contributions and benefits, /simekahealth/marketinsights/PublishingImages/contributions_benefitsbanner.jpg12/11/2018 10:09:59 AM0126867aspx654 the announcement of the 2019 Discovery Health Medical Scheme contribution increases and benefit changes, the Trustees have approved the following changes, as outlined in this post, for 2019.

 Most Read

Sanlam Life Insurance is a licensed financial service provider.
Copyright © Sanlam