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R151bn paid by medical aid schemes to healthcare providers in 2016

06 October 2017 5:03 AM
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This was revealed on Thursday by the Council for Medical Schemes in its annual report for the 2016/2017 financial year.

The council‚ which is the regulator of the medical schemes industry‚ said the number of medical scheme beneficiaries had increased from 8.809 million members in December 2015.

The council‚ which announced that it had received an unqualified audit report from the Auditor-General for the 17th time in a row‚ also revealed that gross contributions increased to R169bn as at December 2016 from R151.6bn in December 2015.

The council said the total number of schemes registered on December 31 2016 was 82‚ down from 83. This was as a result of the amalgamation of LMS Medical Fund and Bonitas Medical Scheme on October 1 last year.

The council said total hospital expenditure by medical schemes comprised R56.61bn‚ or 34.44% of the R151.21bn that medical schemes paid to all healthcare providers in 2016.

The amount paid to supplementary and allied health professionals comprised R10.97bn‚ or 7.25%‚ in 2016.

Payments to all specialists such as anaesthetists‚ pathology services and surgical specialists amounted to R36.32bn or 24.02% of total healthcare benefits paid in 2016.

Expenditure on general practitioners amounted to R8.96bn or 5.93% of healthcare benefits paid.


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