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| Medical
schemes |
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| Among other objectives, PMBs want to achieve
appropriate healthcare, resulting in lower costs associated with
complications and hospitalisation. When beneficiaries are properly taken
care of and their illnesses managed, the need for expensive hospitalisation
decreases. |
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| Medical schemes have a critical role to play
in making PMBs work. |
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Schemes have to educate their
beneficiaries about PMBs and the benefits that are included
in them. |
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Schemes must inform their
beneficiaries of their DSPs and keep them updated should any changes
occur. |
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Schemes should empower their
beneficiaries with information on matters such as the intricacies
of rules and the formularies for specific conditions. |
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Medical schemes have to guarantee
and ensure reasonable access and availability of DSPs. |
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The public sector cannot
be designated as a DSP without the medical scheme ensuring
that the necessary service will be available. |
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