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EFFICIENCY DISCOUNTED OPTIONS VALUE …

EFFICIENCY DISCOUNTED OPTIONS VALUE PROPOSITIONM ondi Govuzela06 July2017 Outline Section 29(1)(n) Silo-type benefit option frameworkContextWhat are EDOs?EDO FrameworkEDO construct demonstrationPerformance of EDOs Study objectives & approachPreliminary observations1/26/20182 Context The medical schemes Act and its regulations are aimed at, amongst others, protecting the interests of medical scheme beneficiaries at all times, including ensuring that medical schemes are affordable and provide equitable access. medical scheme contribution rates have been increasing at above-inflation rates for as long as anyone cares to remember affordability under pressure The existing silo-type benefit option framework for medical schemes allows for de facto risk-related pricing for common benefits offered by medical schemes . This contradicts the intention of the medical schemes Act, as well as of health policy in general.

Context • The Medical Schemes Act and its regulations are aimed at, amongst others, protecting the interests of medical scheme beneficiaries at all times, including ensuring that medical schemes are affordable and

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