Alexander Forbes Health has published its latest edition of Diagnosis, an annual publication that analyses key trends in the medical schemes industry from 2000 to 2017. “Members can be confident that the country’s largest schemes, both open and restricted, have sufficient reserves to pay their claims,” says Zaid Saeed, Senior Actuarial Specialist at Alexander Forbes Health.
These insights were drawn from the Alexander Forbes Health Medical Schemes Sustainability Index which tracks key performance metrics of medical schemes and aims to provide a comparative assessment of future sustainability between schemes.
The index is calculated from a base year of 2006 and considers a scheme’s membership size, membership growth, average beneficiary age, operating results, accumulated funds per beneficiary, and trends in the scheme’s solvency levels.
“In the open schemes industry, the sustainability index for the top 10 schemes has improved since 2006, meaning that the medical schemes industry has become stronger,” says Saeed. Among restricted schemes, Polmed has been the top performer in the index over the 10-year period considered, although it was not the top performer for 2017. The scheme achieved an operating deficit for 2017 and saw a decline in its level of reserves. Transmed has consistently been one of the worst performers on the index because of its sustained loss of membership, worsening demographic profile, low solvency ratio and persistent operating deficits.
Other key findings included in Diagnosis include: