New KeyCare Start Regional medical aid option embraces shift towards affordable healthcare, featuring access to cutting-edge healthcare technologies and partnerships

Discovery Health Medical Scheme (DHMS) has introduced a first-of-its-kind, regional medical aid option called KeyCare Start Regional, which is the most affordable option in the extensive range of DHMS plan types.

“The new option, developed in partnership with Mediclinic and Intercare, provides benefits for a full suite of day-to-day healthcare and in-hospital treatment through region-specific provider networks,” says Dr Ronald Whelan, Chief Commercial Officer at Discovery Health.

“This unique partnership with Intercare and Mediclinic allows for the strategic coordination of healthcare on a regional basis. This approach opens up a new way to address affordability barriers and extend affordable access to private medical scheme membership to more people.”

“We have introduced KeyCare Start Regional at a very compelling price point. This aligns with Discovery Health’s ongoing efforts to improve access to high-quality, affordable healthcare and extend this to more people living in South Africa. Our partnership with Mediclinic and Intercare makes it possible for currently uninsured members of the public in specific parts of the country to take on private medical scheme cover, and to access this at one of the most affordable rates in the industry. The extensive benefits included in the KeyCare Start Regional plan design cover day-to-day and in-hospital care.”

• The KeyCare Start Regional option is available from 1 June 2022.
• KeyCare Start Regional membership starts from R930 and contributions are income-based.

“Medical schemes face a complex dynamic when it comes to improving the affordability of membership. Traditional pricing models often see a reduction in contributions at the expense of access to or quality of healthcare,” adds Dr Whelan. “Through KeyCare Start Regional, we aim to break down these tradeoffs by delivering comprehensive benefits and extensive cover through our partnerships with contracted providers in the regional healthcare ecosystem. This is a truly innovative and dynamic approach to private medical scheme cover.”

KeyCare Start Regional, available in select provinces and regions

“Initially, the KeyCare Start Regional option will be available to residents of Belville and George in the Western Cape, Tzaneen and Polokwane in Limpopo, and Mbombela and Trichardt in Mpumalanga, with plans to expand on regions in the future,” adds Dr Whelan.

The design of a regional medical aid plan option was inspired by the analysis included in the Competition Commission’s 2020 Health Market Inquiry which suggested that regionally-based medical schemes have the potential to introduce innovative healthcare measures that match the needs of the individuals in each region based on their unique demographic and risk profiles.

Partnerships bring KeyCare Start Regional members extensive benefits

With more than 3.7 million medical scheme members under administration, Discovery Health has extensive claims data and private health system utilisation data and is uniquely positioned to identify opportunities for innovation in the private healthcare domain.

“We strive to ensure that our 2.7 million DHMS members have access to patient-centred care in all of their interactions with the scheme and private healthcare system,” says Dr Whelan. “This ethos is carried through to KeyCare Start Regional.”

“Looking back over the past two years, the COVID-19 pandemic has shone a spotlight on the need for equitable access to high quality healthcare,” says Dr Whelan. “This has fuelled the emergence of cross-company and cross-industry partnerships to navigate COVID-19 and healthcare capacity constraints. A strong foundation to extend these partnerships beyond COVID-19 has been created, focusing on reducing the entry price of private medical aid, and in turn access to private healthcare, while improving the quality of care offered to members.”

Discovery Health’s partnership with Intercare and Mediclinic offers KeyCare Start Regional members:

• Cashless benefit design with full cover for contracted network providers
• Access to primary and tertiary healthcare services, including health and wellness support
• Support for members to efficiently navigate every step of their interaction with the healthcare ecosystem.

Digital innovation and technology is central to the KeyCare Start Regional plan

“The COVID-19 pandemic has also accelerated the uptake of digital technologies and proven their worth in extending access to healthcare to ever more people,” says Dr Whelan.

“We’ve particularly seen a shift towards virtual healthcare over the course of the pandemic. And, we are seeing continual improvement in the range and quality of available virtual healthcare offerings, to meet growing consumer need for digital access to these services.”

Through the KeyCare Online Practice, the KeyCare Start Regional plan harnesses technology to make access to healthcare easier and more affordable to its members.

Initially, members have access to virtual GP consultations through KeyCare Online Practice, anywhere and anytime. If required, the GP consulted with can prescribe medicine or refer the member for a face-to-face consultation with a GP who is part of the KeyCare Start Regional network.

If the KeyCare Start Regional GP is contacted, the medical doctor can refer the member to a KeyCare network specialist or arrange admission to a KeyCare Start Regional hospital, if necessary.

“In addition, eligible KeyCare Start Regional members have access to advanced digital technologies and point-of-care devices which enable them and their doctor to access and deliver hospital-level healthcare from the comfort of a member’s own home,” says Dr Whelan.

• Certain patients are eligible for hospital-level care in the comfort of their own homes. Discovery Health uses wearable monitoring devices such as the cutting-edge Biofourmis device which is worn on a patient’s arm to monitor their vital signs. It shares these in real-time with the patient, on an app, and with the care team and a 24/7 control centre. This gives the care team the information they need to detect issues and intervene early if necessary. Nurses and doctors can visit the patient at home when necessary.

Benefits available to KeyCare Start medical scheme members in summary:

KeyCare Start Regional 2022 benefits (accessed from R930/month) include:

Major Medical Benefits

• Cover for emergencies in any private hospital
  
• Unlimited cover for planned admissions in the chosen KeyCare Start Regional network hospital
• Full cover in-hospital for specialists on the KeyCare Start Regional network
• Extensive maternity cover for pre- and postnatal healthcare services on the KeyCare Start Regional network
• Benefits for chronic illness treatment through the KeyCare Start Regional network GP
• Screening and prevention to detect early warning signs of serious illness

Day-to-day benefits

• Unlimited virtual and face-to-face GP consultations and other day-to-day benefits, including blood tests, X-rays or medicine subject to referral by the KeyCare Start Regional network GP
• Specialist consultations subject to referral. Up to 2 visits per annum
• Eye care including an eye test and glasses through a KeyCare network optometrist
• Dentistry including consultation, fillings and tooth removals at a dentist in the dentist network

Patient-centric services with a focus on holistic healthcare

Notably, South Africa is faced with concerning levels of disease burden, as a consequence of communicable diseases such as HIV/AIDS; as well as non-communicable diseases like hypertension; and injury and trauma.

“Discovery’s core purpose is to make people healthier, and to enhance and protect their lives. This was top of mind in selecting the regions for KeyCare Start Regional. Supported by Mediclinic and Intercare, KeyCare Start Regional, provides a guided healthcare journey to people in regions with a particularly high disease burden and is designed to give individuals in these areas peace of mind that their most important healthcare-related needs are catered for,” explains Dr Whelan.

“Our focus on holistic healthcare cover starts with putting the patient at the centre of healthcare and really looking at their needs,” says Dr Whelan. “We will continue our drive to offer more effective, high-quality care at lower prices to members, always with access to extensive benefits. We also look forward to rolling out the KeyCare Start Regional plan to more areas in the near future.”