Operational Review: Medscheme


Medscheme was founded in March 1971 as an innovative specialist medical scheme administrator focusing on the corporate medical scheme market. This was an industry first for South Africa. Over the ensuing 42 years, the Company has become the largest health risk management and third largest health administration provider in South Africa.

The business operates within three regionally focused units:


Operational review

    Well positioned for growth  
  Our client medical schemes continue to achieve strong solvency ratios, well in excess of the stipulated minimum levels set by the Council for Medical Schemes, positioning them well for growth and sustainability.  
  International recognition of our health informatics capabilities: In 2014, Johns Hopkins University in the United States conferred a prestigious award to Medscheme for work conducted on understanding the health needs of our scheme populations, using Adjusted Clinical Groupers (“ACG”).  
  Medscheme South Africa has invested significantly in an infrastructure of knowledge, building up the capability of the Health Actuarial, Health Intelligence and Health Policy Units, and strengthening the newly formed Clinical Fund Management and Provider Management areas. Collectively this investment in skilled people has enabled us to provide the appropriate guidance and solutions to our client schemes so that they are able to continue to meet their strategic objectives.  
  Medscheme is the leading provider of managed care services to low-contribution scheme options. In 2013, Medscheme took over the managed care services for Boncap, Bonitas Medical Fund’s low-contribution option, and in 2014 Medscheme was awarded the contract to provide health risk management services to Medshield Medical Scheme’s newly launched low-contribution option MediPhila.  
  The implementation of new reimbursement payment models which have enabled Medscheme to significantly reduce the costs associated with certain healthcare procedures and associated healthcare services.  

Membership growth – Received and distributed

Overview of the business

Medscheme is committed to delivering on the Group’s Vision which is to create a world of sustainable healthcare. Across all our products and services, we focus on securing the well-being of members under our administration. Whether we accomplish this through a direct relationship or in conjunction with corporate policies, we are committed to providing innovative solutions and delivering and servicing them with respect and fairness.

Our vision has been to create a range of services that:

allows client schemes to engage with their members in new ways in order to better impact the health and well-being of the client schemes and, as a result, the employees of the corporations they serve
measures results by using client feedback, expectations, outcomes and benchmarks
uses new analytical models to identify scheme members who are most vulnerable and likely to have the greatest financial impact on the client scheme, and then to use this information to focus the benefits of the scheme and the activities within Medscheme on meaningful interventions
actively drives change and improvement across the board
is delivered with integrity and is always transparent, collaborative, and innovative

Health administration

Medscheme’s Health Administration division delivers comprehensive, integrated solutions, which recognise that flexibility and differentiation are crucial to remain competitive. The focus of the division is the customer. Customers are placed at centre stage within the business. Decisions are guided by what is best for the customer and whether a course of action is aligned to our objective of delivering the ultimate customer experience.

This is reflected in the structure of the business, which features client dedicated teams. Each team is managed by a General Manager, supported by a senior management structure, to promote ownership and understanding of each client. The objective in this customer-centric model is to ultimately deliver service that consistently exceeds the service expectations of our clients. Operational effectiveness is complemented by a fully integrated operational structure where there is a focus on automation and a largely paperless operational environment where more than 95% of claims are received and processed electronically, without any human intervention.

In exceeding the needs of members, everything we do must be performed with accuracy and care. We constantly strive to improve so that we can pass the benefits of a more affordable and efficient model on to our members. This has led to a proven record of client-centricity and expertise, which is founded on excellence in corporate governance and world-class information technology – investing prudently in our infrastructure, innovation and research. First and foremost is our investment in our people. We recognise that our employees are our greatest assets and we do everything possible to provide them with the assistance they require to execute their duties according to the high standards of quality on which we pride ourselves.

Excellence is achieved through our policy of continuous improvement. This approach involves constant monitoring of systems, processes, customer touch points, products and regulatory requirements through ongoing Voice of the Customer surveys, Voice of the Employee surveys and ISO 9001:2008 certification.

Customer experience is a key differentiator

At Medscheme, our focus on quality interactions begins and ends with the member. We ensure that we have a deep understanding of their experience and requirements so that we not only meet but exceed their expectations, as well as those of the client schemes. This is not achieved through an academic approach, but through quality interactions that start by understanding, first and foremost, the members’ experience and expectations, which then forms the benchmark for future engagement.

Our service differentiators include:

the focus of delivery on quality service that is firmly entrenched in our culture
highly motivated staff, ensuring quality service
a performance culture that recognises top staff through our 110% Achievers’ Awards
relevant and timely communications to all stakeholders
strong relationships with all service providers
strong employer group support
a fully integrated IT administration system
an industry-recognised Internal Audit function

However, our overall service differentiator, when weighed up and considered, is the ability to consistently ensure that all the various elements that go into the efficient and effective administration of our client schemes are operationalised in a manner that provides the scheme and its members with confidence that the highest levels of service are rendered in a customer-centric manner, taking into account both quality, efficiency and governance.

Our Value proposition

Our people are our biggest value proposition, they are the custodians of our vision and values and pushing beyond boundaries to ultimately improve the lives of our members which creates value to our client schemes.

We have strong partnerships with our clients to ensure that we have an understanding and deep insight in their strategic objectives, that enable us to deliver a unique service offering to meet those objectives. We strive to deliver service that consistently exceeds clients' expectations by:

tracking customer satisfaction through ongoing surveys
having superior processes and technology that allow us to deliver services efficiently and effectively
having committed and passionate staff who are skilled and highly knowledgeable
focusing on quality in all our business units

Our services

We offer support to our client schemes by offering the following comprehensive range of services to ensure smooth running of the schemes and that schemes are competitive in the market.

All aspects of the administration system, e.g. member record management, contribution management, financial management, call centre and claims management, are fully integrated and consolidated onto one platform to provide a seamless environment for all administration functions from the scheme, pay-point and member point of view. Full modular integration ensures that any changes processed on a membership number are made online in real time, ensuring accessibility to all relevant users of the system.

Membership and contribution management

Welcoming new members onto the scheme, their activation triggers the generation of a new membership card and an email or SMS to the member advising them of their membership number.

Accuracy in the capturing and maintaining of member records is essential to the effective administration of a medical scheme, so all the modules in our fully integrated system are driven by the membership number and the member record.

Contributions are raised in accordance with the relevant rules of the client scheme and interface files are submitted to the employer’s human resources or pension department for ease of reconciliation.

Credit control management services – Age analyses of all debtors and creditors in respect of claims and contributions are closely monitored and proactively addressed by the Scheme Finance department – All debt is strictly managed in terms of the client scheme’s credit control policy.

Claims management

Our system has the ability to handle large volumes of claims for a variety of options and schemes and currently houses membership data for over 3 million lives and processes, an average of over 6.5 million claim lines per month.

We currently receive just over 95% of its claims electronically, via EDI hubs and switches. The balance of the claims is received in paper format.

Various aspects are key to the success of this function:

The ability to incorporate the correct tariff codes: We incorporate all the latest tariff codes and diagnostic codes to ensure the accurate assessing and payment of claims for client schemes.
Payment records: Claims payment records are held on the system at claim line level.
Claims processing: Our system is written in true modular form, separating processing into logical units, all of which are fully integrated.
Claims collection: Our claims collection processes are capable of receiving, and responding to, claims in various formats.
Claims validation: Prior to any claim being assessed, processed and paid, the basic data on the claim is checked and validated for correctness. This process ensures that all data can be processed throughout the assessment and payment process. This level of verification is the first level of rejection for most claims.
Payment instruction: Once the claims validation is complete and the system has determined the amount payable for a specific claim line or claim, a payment instruction is created.
Claims history: The system holds comprehensive claims history records for each member.
Detailed and accurate claims statements: At the end of each month, members receive a simplified monthly consolidated claims statement.
Claims communication: The system has an advanced realtime communication module for members who have access to email and/or cellphones.

Through our claims management process, we have strengthened reserve levels of our client schemes and enhanced best practice actuarial approaches.

The outcome of claims management to client schemes is improved positive customer experience, expense management and indemnity management that results in client retention and a positive bottom line.

Our scheme members

We are also committed to ensure that scheme members are referred to experts and are treated with compassion, understanding and professionalism. Members receive excellent service through the following various touch points:

Scheme specific call centres
SMS services
Live chats
Interactive website
Key accounts officers
Nationwide branches

Member and provider services

A range of communication vehicles are available to client schemes for the communication of more generic client scheme information. The messages in the various communication vehicles are tailored to specific, pre-determined outcomes required from various audiences.

Generic written communication: Printed or email/web-based, for example AGM communication, benefit review communication, quarterly newsletters and articles for in-house publications. An exciting new development is an electronic member guide optimised for smartphone reading, as well as a contribution calculator. This member guide format also allows us to structure different virtual member guides, specific to members’ needs. For example, one view of the member guide can cater for new members and the choices they need to make, while other views can offer members plan-specific views.

Member-specific written communication: Mailed/emailed/SMS messages that coincide with certain events, for example claim notifications, tax certificates and member statements. The system includes over 80 types of automated communication triggers, generating messages for members and healthcare providers, such as benefit limits reached, new and updates to chronic medicine authorisations, claim receipt acknowledgement, contact details updated, member statements, tax certificates, member’s portion/outstanding debt letters to members.

Telephonic communication/contact centre: Client scheme specific contact centre agents handling queries from members or other audiences, with full access to history/background information on the system to resolve queries. Self-service facilities: Medscheme’s website, with its capability for full administration of any member or beneficiary record, as well as the telephonic self-help facility enables members (and relevant other audiences) to access information and certain capabilities 24/7.

Face-to-face communication: Personal and professional walk-in customer care centres – currently 11 branches, spanning all nine provinces.

This extensive branch network, which is in every major metropolitan area in South Africa, ensures that client scheme members have a wide reaching service infrastructure for members to have face-to-face interaction with a consultant. These branches service all members belonging to schemes administered by Medscheme, thus the client scheme is welcome to display its branding at the various branches.

With the services above, we are able to communicate with members/service providers promptly, as and when necessary, thus improving client loyalty and retention.

Scheme support services

Fund Manager – The primary role of the Fund Manager is to ensure that all the requirements of the Board of Trustees and Principal Officer are addressed in respect of the range of services provided by Medscheme. This enables the Board of Trustees and Principal Officer to liaise with a dedicated person within Medscheme, therefore avoiding the hassle of interacting with numerous people in different service areas.

Scheme secretarial services – Scheme secretarial services typically include preparation of minutes of all operational meetings, safekeeping of official scheme documents that are not in the possession of the client scheme, coordination of meetings and assisting in scheme rule maintenance.

Expert reporting – Extensive reporting is provided to the client scheme’s Board of Trustees and Principal Officer to assist them in executing their fiduciary responsibilities. Reports are customisable to the individual client’s requirements.

Below is an example of administration reporting for one of the closed schemes under our management:

Efficient client-centric administration

Forensic services

The main objective is one of mitigating financial, reputational and operational risk to our contracted clients. AfroCentric Health Forensics has been mandated to provide a range of services to meet the ever-growing demand of effective fraud management services in the healthcare industry specifically relating to fraud, waste and abuse.

Our forensic services have evolved their approach and direction to align with international trends and best practice in fraud management while moving away from the reactionary type of fraud detection currently exercised in the healthcare industry. This change in approach has proven to be very effective in the detection and containment of rapidly escalating events of fraud.

Key strategic focus areas for 2014/5

Reducing non-healthcare costs. The containment of administration fee increases while reducing operating costs through further automation of administration processes as well as the refinement of processes to achieve further efficiencies will be key areas for attention.
Diversifying revenue sources and maximising growth opportunities. Tenders and business opportunities where similar services are required than are currently provided to medical scheme clients will be pursued. Growth in schemes under administration will be encouraged through a number of avenues. Partnerships with key brokers will be pursued, also providing them with more comprehensive administrative support. Close partnerships with Principal Officers will be fostered to support their growth initiatives and constant feedback to client schemes regarding new innovations and service delivery mechanisms rolled out.
Going green and reducing the administrative burden on stakeholders. There will be a continuation of improvements in administration systems and processes to reduce the administrative burden on employees, members, brokers, employee benefits administrators or pay points, service providers and Boards of Trustees whilst simultaneously focusing on going green. These initiatives will include the creation of differentiated servicing channels to increase the ease of doing business with Medscheme as well as increasing the use of popular electronic communication media.
Employee engagement and culture enhancement. A continued drive to deliver service levels in excess of contracted levels and continued fostering of an environment of high productivity and high quality will be important areas of emphasis in the upcoming year. The Medscheme training Academy will be optimised to ensure staff members perform business functions at their peak during the enhancement of processes, systems and technology.

Health risk management (known as managed care)

For over 20 years Medscheme has provided managed care services to our client medical schemes, with the ultimate objective to ensure the provision of sustainable healthcare funding whilst at the same time ensuring that the quality and outcome of care is not compromised for the more than three million lives that we serve.

Medscheme offers an integrated, proactive approach to managing the health and wellness of scheme members – from collectively optimising the coordination of medical care, improving health outcomes and managing excessive or unnecessary utilisation of healthcare services to empowering members in maintaining their health.

Over the past year, Medscheme has expanded the sophisticated predictive tools used to identify high-risk members. In an industry first, Medscheme is able to identify with a high degree of accuracy, members who are relatively healthy but will shortly incur significantly greater healthcare costs. Interventions are then implemented for this specific population to address and mitigate the risks.

Our innovative health risk management approach ensured the following successes during the year under review:

Medscheme is the leading provider of managed care services to low-contribution scheme options. In 2013, Medscheme took over the managed care services for Boncap – Bonitas Medical Fund’s low-contribution option, and in 2014 Medscheme was awarded the contract to provide health risk management services to Medshield Medical Scheme’s newly launched low-contribution option, MediPhila.
The implementation of new reimbursement payment models which have enabled Medscheme to significantly reduce the costs associated with certain healthcare procedures and associated healthcare services.
The implementation of an enhanced medicine benefit management system which not only optimises process efficiencies but also provides a more seamless and member centric service.
Ground-breaking work on the identification of emerging health risk. In an industry first, Medscheme is able to identify with a high degree of accuracy, members who are relatively healthy but will shortly incur significantly greater healthcare costs. Interventions are then implemented for this specific population to address and mitigate the risks.

Our people

Medscheme has invested in employing highly skilled resources in order to create the capacity to implement the strategies that drive affordable, quality healthcare.

Currently, the Medscheme managed care structure includes:

dedicated managed care operational teams that focus on performing the actual managed care interventions, which are measured on activity, outcomes and client satisfaction for specific client schemes
a dedicated team that focuses on enhancing the processes within managed care
a dedicated team that focuses on healthcare provider relations and strategies to contract affordable, high-quality services
a dedicated team that focuses on sharing relevant information with the scheme and addressing client-specific issues
a dedicated health informatics team
a dedicated health policy team that provides research and guidance on funding decisions, the appropriateness of new technologies and complex clinical matters
a dedicated health actuarial team that focuses on benefit design as well as pricing and risk

Operational support structures to ensure a personalised and seamless health management process

Together these teams integrate to provide
Medscheme’s client medical schemes with a
comprehensive health risk management support
structure that cannot be easily replicated.

In 2014, structural changes were made within the managed care areas to better support the client specific customer-centric model:

the managed care operational teams were split into smaller distinct business units that serve a limited number of schemes, creating a more personalised and focused environment
simultaneously, the hospital benefit management and medicine management teams were integrated in order to provide a more holistic end-to-end solution
the philosophy, values and culture of each of the client medical schemes was entrenched in the managed care unit through training and interaction with scheme representatives
Voice of the Customer surveys were introduced in order to drive continuous improvement through feedback from customers on their service experience

The change in structure has also facilitated greater integration between the administration and managed care areas. This has supported a seamless member experience, particularly through the implementation of initiatives such as the member call centre handling pre-authorisation requests.

Member engagement

Medscheme believes that effective communication is crucial in the health risk management process. We believe that interactions should be personalised to the extent that this is possible, steering away from a generic, general approach. Targeted engagement takes place with individuals who fall into any of the following categories:

high-risk members in the Beneficiary Risk Management ("BRM") programme
members who are hospitalised as part of comprehensive case management and discharge planning
specific groups identified as being ‘at risk’, e.g. complicated maternity cases and those at risk for spinal surgery or members identified as high risk through wellness screenings

Communication with these members is primarily telephonic, supported by email and SMS correspondence. In addition, Medscheme is implementing a health portal with interactive health tutorials to assist high-risk members. For other more general interactions, channels of communication are telephone, email, web and SMS. Medscheme is also in the process of rolling out interactive messaging as well as a mobi-site that will extend beyond the administration services into the managed care area.

Key strategic focus areas for 2015

Implementing new interventions and initiatives that will result in a better coordination of care for high-risk beneficiaries enrolled on the beneficiary risk management programme. Care coordination is defined as “the deliberate organisation of patient care activities between two or more participants (including the patient) involved in a patient’s care, to facilitate the appropriate and costeffective delivery of healthcare services. Organised care involves the marshalling of personnel and other resources needed to carry out all required managed care activities and is often managed by the exchange of information among participants responsible for different aspects of care.” Enhancements to the programme include greater integration and sharing of information with the nominated family practitioners and extended mechanisms with which to engage with the high-risk beneficiaries themselves.
Improving hospital and post discharge ambulatory care management. The strategic objective for this focus area is to refocus current case management processes in order to improve coordination of care. High priority admission categories (mental health, orthopaedic procedures, cardiovascular events, pneumonia and cataract procedures) have been prioritised for specific attention.
Exception management. With a service business which is inherently operational in nature, there is an ongoing focus on operational improvement in order to reduce the costs associated with delivering the service and improving the member experience. Exception management is the focusing of resources on areas where interventions will have the highest impact while simultaneously creating operational efficiencies. Not only is this of value to the member who is struggling to navigate the healthcare system but reduces unnecessary administration so that the healthcare professional is able to spend more time treating their patients. In 2014, a significantly more efficient process of authorising medicine to pay from the chronic medicine benefit was introduced. In 2015, the exception management focus is on interrogation of the hospital benefit management processes.
Wellness services. A range of services that enable schemes and employers to better impact the health and wellbeing of their constituents is in development. Crucial components of the service include the use of new analytical models to identify vulnerable or “at risk” beneficiaries and the provision of targeted personalised wellness interventions for these identified individuals.



Operational review

    Well positioned for growth  
  Pursuing equity in a key private healthcare player in Zimbabwe.  
  Advanced stages in contracting switching solutions in Zimbabwe.  
  Rolling-out Aid for Aids to corporates in Namibia.  
  Through AfroCentric Health Solutions Kenya, we recently partnered with AAR Holdings in Kenya, providing East Africa distribution networks.  
  Identified prospecting opportunities in Ghana.  
  Several prospects in Zimbabwe including the finalisation of an offer to acquire equity in a key healthcare player in Zimbabwe.  
  Healthcare claims switching solution prospects at an advanced stage.  
  Aid for Aids roll-out to employer groups (Namibia).  
  AfroCentric Health Solutions (“AHS”) Kenya concluding a transaction with a significant health insurance player in East Africa.  
  Advanced discussions with a health insurer in Central Africa.  

Key strategic objectives

Diversify revenue in current countries of operation through mergers/acquisitions.
Diversify revenue through new clients/acquisitions in new territories.
Develop capacity for growth through management development.

Medscheme Africa clients   Medscheme Africa shareholding

Medscheme Africa performance highlights


Our highlights

Namibia Health Plan (“NHP”) was awarded the PMR Diamond Arrow award for the best medical aid fund in Namibia for three successive years.
NPPF survey results – NHP was ranked the best in claims administration, turnaround times and services rendered.
Introduction of Bidco call centre system in Swaziland enabling improved CRM.
Through AHS Kenya, taking over Sanlam's health insurance business in Uganda, Tanzania and Zambia.

Operational projects under way

ISO implementation throughout the division.
Standardisation of quality assurance.
Introduction of Voice of the Customer surveys.
Introduction of dashboard reporting systems.
Introduction of Voice of the Employer surveys.


Operational review

    Well positioned for growth  
  We are at an advanced stage with negotiations to acquire a stake in a business in South East Asia to enable our entry into that market.  
  The United Kingdom, although highly developed, has potential for Medscheme to implement our managed care services. We are in discussions to acquire a business in that market through which we can offer these services to insurers.  
  Despite being a highly competitive environment, the growth in membership in the Mauritian operations has exceeded our expectations.  
  Revenue diversification and growth outside the borders of South Africa is the strategic objective of the Group that Medscheme International aims to fulfil.  
  Growth targets for the next three years have been set with a clear mandate from the Board and Investment Committee to empower management to achieve the targets.  

Overview of the business

Medscheme continued to provide services to several large European and UK-based health insurance companies during the year, from our international business process outsource (“BPO”) centre in Mauritius. These services include:

Medical coding of claims
Data transcription services
Claim adjudication
Call centre services
Provider network management
Pre-authorisation and guarantee of payment for in-patient claims
Software development and support

Medscheme continued to grow market share in the Mauritian market, with a client base encompassing both open and closed schemes, as well as health insurance products. Notwithstanding the above progress, the global financial crisis in Europe resulted in companies reconsidering their outsource arrangements, rather choosing to in-source processes to counter unemployment pressures. This has limited growth in our BPO operations. We have therefore focused on acquisition opportunities in identified preferred markets during the year.

Group structure

Medscheme’s international business unit is situated in Mauritius. The business unit comprises Medscheme (Mtius) Ltd and Medscheme International Ltd, both 100% subsidiaries of Medscheme Holdings Ltd.

Medscheme International Ltd holds a global business licence with the Mauritian Financial Services Commission.
Medsquared Ltd has been established as the marketing and distribution company of Medscheme in the Mauritian market. The company has secured licences from the Mauritian Financial Services Commission as an agency for Swan Insurance, Jubilee Insurance and Island Life Insurance.
Medscheme Ireland Ltd was established as a joint venture in Ireland to pursue prospective business with the Irish Government. As this project has not progressed, this entity will be deregistered.

The following diagram sets out the structure of the business unit:

Our performance

The revenue from international clients is currently low relative to total Group revenue; however, the business unit has consistently delivered growth since 2011:

  ZAR'000 2011 2012 2013 2014
  Revenue 19 950 22 788 32 715 36 875
  % growth   14% 44% 13%

Two potential international acquisitions are currently under consideration which, if concluded, will add significantly to revenue from the international business unit in the future. The international operation has contributed positively to earnings in the current year achieving an acceptable margin relative to its size.

Our highlights

Progress made in identifying potential international acquisition opportunities and advancing negotiations for acquisitions in South East Asia and the United Kingdom.
Development and roll-out of a loyalty programme, branded “Xperience”, in the Mauritian market.
Development of an Information Security Management System (“ISMS”) and securing ISO27001 certification.

Membership growth

Principle members 25 334 37148 39 288 40 005 40 984
Dependants 18 693 28 032 29 648 32 108 32 485
Total beneficiaries 44 027 65 160 68 936 72 113 73 469
Annual % growth   48% 6% 5% 2%
Cumulative %growth   48% 56% 64% 67%

Market share – Mauritius



International recognition of our health informatics capabilities

In 2014, Johns Hopkins University in the United States conferred a prestigious award to Medscheme for work conducted on understanding the health needs of our scheme populations, using Adjusted Clinical Groupers ("ACG")

Medscheme Africa awards

NHP PMR Diamond Arrow award, awarded for the best medical aid fund in Namibia for three successive years
NPPF survey results – NHP rated the best in claims administration, turnaround times and services rendered

Service excellence awards

A number of independent industry surveys have recognised Medscheme’s exceptional service record:

THINKMONEY SURVEY results revealed that two of the top ranked schemes were administered by Medscheme (Fedhealth and Bonitas).

Two of the top three schemes in the PWC SURVEY were schemes that were administered by Medscheme (Fedhealth and Bonitas).

HELLOPETER.COM is a respected consumer website that provides an independent rating on the quality of service delivery across a number of industry sectors including medical aids.

Our clients Bonitas and Fedhealth have consistently occupied first and second places in the medical aid league achieving the highest compliments and lowest complaints ratios.

The abovementioned results can be further supported by the outcome of the recent independent annual OMSMAF MEMBER SURVEY to gauge member experience of the service they received. The results indicated that there was a consistent improvement across all services surveyed. We believe the results are directly linked to our ongoing focus on customer experience.

GEMS LEADS ASK AFRICA AWARDS. The Government Employees Medical Scheme ("GEMS") topped the medical scheme category and achieved third place overall (after Truworths and Toyota) for service excellence in the 2013 Orange Index survey conducted by Ask Afrika. Ask Afrika conducts an extensive survey annually to identify trends and highlight organisations that are truly committed to customer-centricity. GEMS’ performance is all the more remarkable given that this year the survey extended across 23 industries. Medscheme is proud to be associated with GEMS and to provide a number of services to the scheme.

MEDSCHEME WINS ITS THIRD IRMSA AWARD. For the third consecutive year, Medscheme has been recognised for its efforts in enterprise risk management when it received an award from the Institute of Risk Management South Africa ("IRMSA") in the healthcare category. The risk management awards are presented annually by IRMSA to recognise excellence in risk management across different sectors of the economy. Commenting on the award, Andy Mothibi (Executive Director: Legal Governance Risk Compliance) said that “risk management can only be effective when there is team effort and commitment. At Medscheme, we are fortunate that we have a sound risk management framework and process which is strongly supported by the entire Medscheme team. This risk award is an assurance that we are on the righttrack and that we are making excellent progress.” Each year companies registered with IRMSA are invited to submit entries outlining their risk management initiatives and practices. The entries are then evaluated by the IRMSA Executive Committee, which is made up of no less than 10 committee members and judged on the basis of the soundness of their practices as well as innovation.

MEDSCHEME WINS THE BARBARA STARFIELD AWARD. Medscheme’s Health Intelligence Unit has been awarded the Barbara Starfield Award by Johns Hopkins University in the United States. The award was instituted to acknowledge Professor Starfield’s legacy and to recognise the organisation that makes the best use of the university’s Adjusted Clinical Groups® ("ACG®") system which she co-developed.

The ACG® System provides a unique patient-centred approach to measuring morbidity and improves both accuracy and fairness in evaluating provider performance, identifying patients at high risk, forecasting healthcare utilisation and setting equitable payment rates. Aligned with our Vision of Creating a World of Sustainable Healthcare, the system:

Addresses multi-morbidity in patients and populations;
Reduces disparities in the delivery of primary healthcare; and
Improves population health.

The award was presented to Medscheme at the university’s annual ACG® conference in April 2014 where the team delivered a 30-minute presentation during the plenary session.

GROUP FINANCE WINS SAKE24 AWARDS. As a JSE listed entity, our shareholders, AfroCentric Investment Corporation, publishes its results as at the end of the financial year-end. Sake24 presents awards to companies for excellence in financial reporting and this year AfroCentric received the following accolades for its financial results publications:

AfroCentric achieved third place in the Sake24 financial advertisement competition 2013 in the content category of the fourth quarter (July to September 2013) for the financial results published in September 2013.

AfroCentric was also awarded first place in the visual category for the second quarter (January to March 2013) for the AfroCentric financials published in March 2013. The Group’s financial reporting is the responsibility of Group Finance.

SWITCHLAB SCOOPS AN ASSEGAI AWARD. AfroCentric Health’s innovation campaign, SWITCHLAB, has won an Assegai award for excellence in internal communication and marketing. SWITCHLAB was entered for the annual Assegai Awards – the recognition programme of the Direct and Interactive Marketing Association of South Africa ("DMASA"). The submission was entered in the category employee-related marketing ("ERM"), for internal marketing excellence targeting employees. The awards recognise marketing, strategy, design and execution excellence, and the largest component based on the responses derived from the campaign/brand. In other words, the Assegai awards are not about excellent, good-looking evocative campaigns – they recognise excellent, good-looking evocative campaigns that work! SWITCHLAB received the award in the face of challenging competition from major national and international consumer brands with massive employee bases to take silver.

SABC CAPITAL CITY BUSINESS LEADER OF THE YEAR AWARD FOR 2014. The award conferred by the national broadcaster SABC & the Capital City Business Chamber honoured Dr Anna Mokgokong, Chairperson, AfroCentric Investment

Corporation Limited, for her contribution towards the economic growth of the capital city and her spirit and determination to the upliftment of the community with a desire of empowering them.

Dr Mokgokong accepted the award at a dinner held on 12 November 2014 in Pretoria attended by Mr David Makhura, Premier of Gauteng and Mr Kgosientso Ramokgopa, Executive Mayor, Tshwane Metropolitan Municipality amongst other dignitaries. The awards evening brought together some of the city’s key business leaders to honour the capital city’s most inspirational leaders.

The SABC Capital City Business Leader Awards recognise entrepreneurs who demonstrate extraordinary success in the areas of business, personal commitment to the city and the communities.

In addition to being the Chairperson of the AfroCentric Board, Dr Mokgokong is a leader in the community and has received numerous international awards for her entrepreneurial ability. She was the President of the South African women Entrepreneurs Network (SAwEN), and the International women’s Forum of South Africa (IwFSA).

She joined the Women Leadership Board of the Harvard JF Kennedy Business School in Boston in 2002. She has also been honoured by Star Group of the United States as one of the 50 Leading Woman Entrepreneurs of the World in 1998 and 2002. Dr Mokgokong was South Africa’s Business Woman of the Year in 1999. In 2010, she was invited by former US president Bill Clinton to become a member of the Clinton Global Initiative.


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