DISCOVERY Health Medical Scheme said on Tuesday that it planned to launch a benefit option in January that would enable members to have virtual consultations with their doctors.
The “Smart Plan”, launched to brokers on Tuesday, will work via an app that allows a patient to book a consultation with a participating doctor, either face to face or via video link.
“The plan is designed around algorithms that channel members to the most efficient service providers … and achieve more cost-effective cover,” said Jonathan Broomberg, CEO of Discovery Health, which administers Discovery Health Medical Scheme.
He said the plan was priced 23% lower than Discovery’s hospital plans, but provided greater benefits, such as unlimited cover for general practitioner visits and acute medication. It also provided more generous cover in hospital.
Members would be restricted to a network of doctors, specialists, hospitals and pharmacies or face co-payments, he said.
A virtual consultation would not carry a co-payment, but a face-to-face visit to a general practitioner would carry a R50 charge.
Members could also obtain an international second opinion for complicated cases from the Cleveland Clinic in the US.
The Smart Plan app would also allow patients to order medicines, submit claims, view their full medical record and rate their healthcare providers.
The ranking builds on work Discovery has been conducting for several years to measure patient satisfaction at private hospitals.
Dr Broomberg said patient satisfaction surveys provided a good indication of a hospital’s clinical standards, as they reflected management capacity.
He said Discovery would soon provide consumers with data on the best-and worst-performing private hospitals, in the expectation that publication of this information would stimulate underperforming hospitals to up their game.
Patients in many countries already have access to objective data on the quality of healthcare services. In the UK, the National Health Service publishes details of consultants’ mortality rates and indicates whether they are within an acceptable range.
However, so far attempts in SA have stalled. This is Discovery’s second attempt at a hospital ranking system. It was forced to withdraw its hospital ranking index 10 years ago after it ran into resistance from private hospitals and doctors who took issue with its methodology.