Subject: July Newsletter

July 2019
Private Healthcare Update

We have established a Private Practice Committee consisting of the following members:

Phillip Webster
Richard Kyte
Mark Human
Jurek Piertzak
Graeme Davis

Event based Contract
The Administrative Entity (AE) contract which completes the loop between the health care provider and the hospital group and funder has been completed. This allows for a tripartite agreement where we will have the ability to audit both hospitals and funders, through leverage of the other party. The leverage is provided by peer review.

The contract is being assessed by the DH legal team and then will be reviewed by Tabacs before release.

The EBC annexure B has been modified into 3 or 4 options to allow for more efficient surgeons to negotiate with hospital managers as to which option they qualify for. This will only affect the hospital portion of the fixed fee and will not affect any other healthcare practitioner. This will provide a more ethical alternative to the current tiering system because the reimbursement will be directly from the funder and not vial a third party.
   Hospital Groups

   1. Life Healthcare. 
   2. Netcare.
   3. Mediclinic


Funders
1. Discovery Health   2. Medscheme   3. GEMS/CAMAF
SAOA Registry
This has been a key focus in the last 6 months and I thank Brian Bernstein for taking over the mantle of this in the future.

We have finally concluded a contract with Amplitude for the SAOA registry. There were several stumbling blocks to this, such as ethical approval, approval by our attorneys and assessment of financial sustainability.

We are commencing a trial program at 3 centres and the system will be ready to roll out fully in September.
Other projects.
1. Discovery Health Arthroplasty Network
2. DH Day Centre Network.
3. Rule G.
For those interested and for more information a Power Point Presentation on Alternate Reimbursement Models is available. Please fell welcome to contact me for this or to give any feedback or suggestions on pwebster@global.co.za

Phillip Webster

www.saoa.org.za          info@saoa.org.za
South African Orthopaedic Association, PO Box 12918, Brandhof, Gauteng 9324, South Africa
You may unsubscribe or change your contact details at any time.