Chairperson Report AGM 2019

CHAIRPERSON’S REPORT FOR THE FINANCIAL YEAR-END 2018

In presenting the report on behalf of the Board of Trustees I am mindful of the people who have contributed to Heritage Health Medical Aid Fund’s 2018 modest results given that the Fund commenced its business in June 2015 implying the Fund is just over three years old.

I want to thank all the members present at today’s AGM - we appreciate your efforts to be present and your continued support as members of the Fund. To my fellow Trustees and the principal officer, I have had the privilege of working with you and helping to maintain a fierce determination to preserve the relevance and “independence” of Heritage Health’s founding principles allowing access to affordable healthcare while curbing out of own pocket costs.

During 2018 there have been certain achievements, and which have a rewarding impact on the members and our expression of thanks to the Administrator who with their determination has brought this to fruition.

Risk Management:

• The only real-time live system with a live switch being used by the Administrator has controlled utilisation, fraud and abuse whereby costs is controlled efficiently and effectively.
• The live system has made Heritage Health the preferred medical aid fund amongst healthcare disciplines when it comes to the payment of invoices. The records reflect that 82.33% of the claims received is being assessed and paid within less than ten days after having received the invoice/claim. This ensures accurate utilisation of benefits and allows members to manage their benefits and costs within their respective benefit plans.
• An off-site accredited clinical team has set new standards in the Namibian healthcare industry when it comes to the principles of clinical managed care norms, standards and principles ensuring that our members receive only the very best clinical services and clinical outcomes.

Applying proper risk methods ensures cost-controlled payments and which directly impacts the annual increases.

Uniqueness of Heritage Health:

• The benefit/product design of Heritage Health is unique allowing members to design their cover in terms of needs and affordability. The benefit design allows persons from different age brackets to obtain medical aid cover. 
• Heritage Health is the only medical aid fund who does not use the NAMAF fees to do reimbursements to healthcare disciplines and members but who pays 100% the amount being charged by the respective healthcare providers. This has a huge impact on the budget of our members as shortfalls are curbed.
• Heritage Health is the only medical aid fund where the only co-payment of 15% is applicable where those members who use chronic medication prefer branded items instead of generic items.

Having a benefit design which is unique, and which caters for specific needs within a cost-effective environment makes Heritage Health a leader and even more so in times of economic recess.

Targets and Initiatives for 2019:

Heritage Health is now set to move forward to the next stage of securing itself as a competitive stakeholder with the principle target being to grow the membership base.

We have introduced several new benefits for our members for the year ahead and which in many cases again makes your Fund unique setting new standards:

• Introducing Digital Health Platforms as these technologies have the potential to reduce healthcare costs especially when it comes to managing chronic diseases.  Virtual care is at the doorstep of each member by enabling non-evasive self-monitoring and disease management and helping them detect patterns and indicators of various health conditions and risks. Vital signs parameters such as blood-pressure trending, blood oxygen, blood glucose, hydration and sleep quality is monitored and stored.
• Doctor.me or Telemedicine has been introduced as an after-hour service to all our members where qualified nurses answer calls and or messages and assisting members on whether to visit a hospital after hours or not and is useful for those members who geographically are unable to have easy access to a healthcare facility.
• PatientEd Online an education platform to educate our members on healthy lifestyles and provide basic information on diseases and medication.
• Heritage Health Mobile Application which can be downloaded on all smartphones enabling our members to have access to all the information they require on managing their benefits and which includes payments – another first only for our members.
• Our members are the only medical aid members who can submit their invoices by taking a picture/photograph and which is directly submitted to the system – no more scanning, hand deliveries or faxing – another convenient first only for Heritage Health members.

At the centre of all that we do will be the continued innovative client service and unique product design. The ethos of the Fund will remain the same regardless of any challenges that we may face as the Fund is owned by its members and it is in our interest that it should succeed.