/ SAcsi

New "top" Medical Aid 2018

The latest results for the South African Customer Satisfaction Index (the SA-csi) for medical schemes reveal that Medihelp has the most satisfied customers in a competitive, yet underwhelming industry.

Here below are the 2018 scores for Medical Schemes:
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Year-on-year comparisons:

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There has been a general decline in the customer satisfaction of members of medical schemes on an industry level in the past 12 months. This was primarily the result of members of Discovery and Bonitas, two of the biggest players in the industry, rating their schemes slightly lower on aspects relating to satisfaction and value for money.

Only two schemes managed to improve their position on ratings of customer satisfaction from last year, namely Medihelp and GEMS. As a result of this improvement, Medihelp managed to take the leadership position, with the most satisfied members in the industry. Although GEMS still remains in a below par position compared to the rest of the industry, the improvement does buck the downward trend of the last number of measures.

Members of Momentum Health have been stable in their rating of the provider, with similar scores achieved to the 2017 measure.

Satisfaction levels for medical schemes are substantially lower than those measured in other financial services industries. In order to understand this better, it is insightful to look at what members complain about most often. In the case of all providers, the claims process is where most frustration is felt. Members often feel that they do not receive the cover and benefits they expect from their medical scheme and this is most strongly expressed when claims are not honoured or paid in full as they expect.

This speaks to an underlying sense of complexity that exists within the industry, with many members expressing their sense of low value for money with their scheme (compared to other financial services). With more than 270 options available, choosing medical insurance products can be very confusing to customers.

“While the market’s dominant heavyweights remain strong competitors, pack leader Discovery seem to have shifted focus to other business offerings in its product suite, including the launch of its anticipated banking services and its long- and short-term insurance offerings. This has allowed its competitors to even out the playing field in the medical product suite by delivering simpler, traditional medical insurance that is seen to be less expensive and easier to understand,” says Consulta CEO Prof Adré Schreuder. Medihelp offers a good example – 3 years ago the scheme was in a below par position. Efforts to focus on delivering a simplified product, coupled with improved service levels, has resulted in strong improvements in the perception of value for money and overall customer satisfaction.

Now in its sixth year, the SA-csi for Medical Schemes offers impartial insights into South African medical aid schemes by measuring customers’ overall satisfaction out of 100. This satisfaction score is based on medical schemes exceeding or falling short of customer expectations and the respondents’ perception of the ideal service provider. The Index also includes, among other measures, a Customer Expectations Index, a Perceived Quality Index and a Perceived Value Index. The 2018 sample included 1675 respondents who were randomly selected from five medical schemes to participate in the survey.

“Medical premiums rose past inflation increasing on average by 9% this year, and are significantly higher than premium increases in short-term insurance and life insurance,” Schreuder says. “The cost of medical services continues to increase at a rapid rate as consumers are challenged with a supply-induced demand scenario, where medical schemes are forced to carry the cost of unnecessary treatments or admissions by doctors, which is ultimately passed on to members.”

The effect of this can best be seen in the Perceived Value Index, where Medihelp and Momentum Health share the leadership position in 2018. For both brands this came from showing remarkable increases in the year. The Medihelp score from 70.9 to 73.6 in 2018 and Momentum Health increased its score from 70.5 to 72.3 over the same period. Although not to be compared with open schemes, GEMS, which is still behind the industry average of 69.4, scored 67.5 in this measure, which was a 3.9-point jump from its 2017 score of 63.6 marking notable improvements in this year’s survey. Bonitas fell from 70.7 to 68.3 and Discovery Health dropped from 72 to 69 in its perceived value score.

In June, Minister of Health Aaron Motsoaledi announced the NHI and Medical Schemes Amendment Bill, proposing sweeping changes to the running of medical schemes. These changes are aimed at benefitting a wider range of members and paving the way for the NHI financing system for all South African citizens, not just those who can afford medical aid products. To remain relevant in the face of NHI, private medical schemes need to assess the value they provide to customers, such as quality, affordability, transparency and ease of use, which should be integrated into their daily operations.
“As the Government takes steps to roll out healthcare financing for the entire population, the central issue it will have to address is ensuring that it operates to the same level currently delivered by the private health care industry, and customer experience will be the driving force behind this,” concludes Schreuder.

See Consulta for more information, or visit Consulta’s blog for other theSAcsi results.