Presentation on Tariff Guidelines. 22 August 2012 Parliamentary Portfolio Committee on Health. Who is SAMA?. SAMA is a Doctor’s organisation Originally founded in 1927 Transformed in 1998 by amalgamation of all major doctor groupings Section 21 company and a registered Trade Union
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Presentation on Tariff Guidelines
22 August 2012
Parliamentary Portfolio Committee on Health
History of coding and tariffs
What are the cost drivers in private healthcare?
- Average CPI Inflation = 14.2%
- Average Medical Scheme inflation =27.3%
- Average contribution PBP/m = R74.45
-Average CPI Inflation =5.4%
- Average Medical Scheme inflation =7.5%
- Average contribution PBP/m = R343.45
-Average CPI Inflation =4.3%
- Average Medical Scheme inflation =11.3%
- Average contribution PBP/m =R975.82
Administration & Managed Healthcare
“Administrators and businesses associated with administrators often provide managed healthcare services. In many instances, these services are merely additional layers of administration costs with questionable benefits for the schemes themselves.”
Council for Medical Schemes
2009/2010 Annual report p214
Determining a doctor’s worth?
SAMA 2012 RCF = R28.93
*Excludes risk compensation factor
& Way Forward?