Firm to introduce bio-metric membership cards
Says NO to shortfalls
More Zimbabweans to access medical cover
BY Donald Chidoori
A leading medical aid society has reiterated its commitment to, “championing the delivery of accessible, affordable and quality health care solutions,” in the health insurance industry in the country through the use of technology and improved work processes.
The Group Chief Executive Officer of Cimas, Vulindlela Ndlovu, made the disclosure at the recently held fourth session of the Insurance Journalist Mentorship programme, hosted by ZimSelector.com.
According to him, Cimas offers a holistic approach to medical insurance including traditional medical aid benefits, provision of health clinics and laboratories along with wellness and disease management programs. Cimas also has a dedicated research team that keeps an eye on the demands of the health insurance industry in Zimbabwe.
In his presentation at the recently held Cimas AGM, chairman of the Cimas board Mr Mordecai Mhalangu said that, “The society remains focused on its mission of making, quality, affordable health care accessible to as many people in Zimbabwe and the Diaspora as possible.”
At a time medical aid societies are losing close to $200 million dollars through leakages, Cimas is set to be the first medical aid society in Zimbabwe to introduce bio-metric membership cards to stem leakages such as fraud though card loaning, and to stem abuse of medical aid cards by its members and service providers.
“With bio-metric membership cards and new technologies card loaning would be curtailed and the improved patient data will significantly reduce the patient turnaround time,” Ndlovu said.
Since April 2017 Cimas has scrapped shortfalls in Maternity benefits, in a bid to reduce out of pocket payments for maternity related treatment and to improve maternal health care in Zimbabwe.
Once high-performing core elements of Zimbabwe’s Primary Health Care System, maternal and child health welfare are on the decline in Zimbabwe. This initiative according to Mr Ndlovu will lead to an improvement in the quality of maternal services in the country.
“With effect from April 2017, the maternity benefit has been reviewed to 100% of the Association of Health Care Funders of Zimbabwe (AHoFZ) tariffs. The reviewed maternity benefits is in line with the Cimas thrust to strive to improve quality and achieve universal health coverage of essential health services for maternal, newborn, child and adolescent health,” said Mr Ndlovu in a statement at a CIMAS AGM held last week.
The society is also working with service providers to reduce the shortfall or better still totally remove shortfalls.
“The society will accelerate efforts to establish partnerships with service providers for the ultimate benefit of the patient, you the member, through reduced or better still no short falls,” Mr Mhlangu said.
Mr Mhlangu added that Cimas was already some service providers to, “make sure that our members experience pleasant and flawless service when they interact with our service partners.”
The issue of shortfalls is a thorn in the flesh for many paying medical aid card holders, who expect to have their medical bills covered by medical aid only to be told that they have huge bills in shortfalls. While medical aid supports and sometimes is not meant to cover all your medical expenses. Shortfalls have been so high that one wonders why they took medical aid in the first place.
The issue of shortfalls is compounded by the ridiculous and often exorbitant tariffs charged by service providers for consultancy and services granted. For example charges for a specialist consultation for a lady with skin ulcers at $200, yet we live in a country with a minimum wage of $250.
Shortfalls have been a thorn in the flesh for many medical aid holders; however, it is encouraging that both service providers and health funders seem to be converging on the need to ensure that service fees are viable and sustainable for all stakeholders.
“We are encouraged that health funders and service providers have initiated the process of a scientific tariff for all health disciplines,” Ndlovu said.
The scientific method will bring parity and fairness to health related fees for funders and service providers alike and will hopefully lead to a reduction in shortfalls.
Cimas has been at the forefront on innovative health service products in Zimbabwe that are set to reduce the claims ratio and make health services affordable.
In June 2016, Cimas launched the iGO product which is set to transform health insurance in Zimbabwe. iGO is expected to save medical aid society millions of dollars in reduced claims ratios.
iGO is a wellness program that provides Cimas members with truly life changing experiences ensuring that its members can enjoy better health and enjoy longer lives.
“At Cimas our drive is on wellness and disease management and it’s not a drive that you get at Cimas it’s a global trend. We should actually that should take our energy and costs on wellness. We don’t want people to fall ill in the first place so we minimise that so even if they fall ill we want them to manage that illness.
“Because if we do that we manage the costs we manage the contributions but if we don’t do that the contributions go up,” said the group chief executive.
Cimas is also geared to establish a centre or centers of excellence that are going to transform the operations of medical specialists in Zimbabwe. As a build up towards that centre Cimas is already training medical doctors, pharmacists, medical laboratory scientists, technicians and healthcare specialists through its Child Health Education Fund.
Zimbabwe has been hit hard by a critical shortage of critical skills in the medical industry which has seen most Zimbabweans going overseas to get medical attention at a high cost for patients and this has also resulted in the country losing millions of dollars in potential revenue.
The training being undertaken by Cimas will provide the capacity for more treatments to be available in the country at more affordable rates.
“Cimas is committed to continue funding the training in order to create capacity in the healthcare sector and reduce scarcity of critical skills,” Mhlangu said.
To date the fund has trained 40 students and 15 of these have been absorbed into Cimas employment.
In addition to training medical practitioners the firm is also funding the only training Optometry Unit in Zimbabwe, at Sekuru Kaguvi Eye Unit housed at Parirenyatwa Hospital. This will enable the optometry to detect and treat eyesight problems early. This development will reduce the claims/loss ration and will lead to patients getting cost effective optometry services.
“This development has the potential of ensuring access to cost effective optometry services to our members, thereby reducing the claims/loss ratio,” said Mr Ndlovu.
Cimas handed over equipment for Zimbabwe’s first Optometry Training Unit, to the University Of Zimbabwe College Of Health Sciences in 2014. Bindura University of Science Education will open the second Optometry School in Zimbabwe later this year.
In his presentation to journalist at the breakfast meeting Mr Ndlovu indicated that Cimas will be opening a prototype state of the art clinic in Westgate, Harare, which will change the face of medical services in Zimbabwe.
The Cimas Board Chairman stated that Cimas seeks to use its more than 70 years of experience, knowledge of the local health sector and technology to offer a total customer experience in health care in the form of a comprehensive health care package that promotes good health and makes medical aid easily accessible to most people in the country.
According to the board chair, “Cimas in the long run would put more emphasis on the wellness of its members to reduce the claims ratio and advently lower contributions, which will make medical aid easily accessible to most people in the country.
Currently only 1 million people out of 13 million people have medical cover, mainly due to affordability issues.