A groundbreaking new primary health care network which will provide affordable health care to people not previously able to afford medical aid cover has been launched jointly by a leading IT company, AFFIN Financial and Management Consultants and a group of independent medical practitioners associations (IPAs).
The initiative, named Lengana, aims to reduce the total cost of health care by linking clients directly to a national network of accredited health professionals via a smart card system. The smart card system will revolutionise management of the health care services provided by enabling them to focus on quality assurance and cost containment programmes.
This backbone could ultimately play a leading role in the establishment of the government`s proposed national health insurance system (NHIS), says project sponsor Hennie du Plessis, MD of PQ Africa`s health care IT provider PQ Health. It is estimated that the network will sign up 100 000 clients within the first few months of operation, with a medium-term goal of between 500 000 and 1 million clients.
The core of the system will be a client database around which cards are issued, health services are managed and financial transactions are posted. Participating doctors will be paid a monthly retainer and a capitation fee per consultation, with a clinical management software system monitoring the quality and cost of delivery of health care.
"Although recent changes to the medical schemes act aim to make membership more affordable, the fact is that medical aid remains inaccessible to a large section of the public because of the high monthly contributions," says du Plessis. "What Lengana does is allow the patient and the health care professional to directly contract under a managed care system to buy and deliver health care services. The total cost of basic health care is then reduced and will enable each Lengana cardholder to live a healthier lifestyle."
Du Plessis describes Lengana as a "major step" in the IPAs` quest to provide affordable health care to the masses, saying the same infrastructure and methodology can be used by the government to provide primary health care to the public. "The whole focus of the project is to provide a cost-effective alternate health care solution which enforces managed care rather than financial benefit," says du Plessis.
PQ Health will provide the backbone of the Lengana network through the current infrastructure of its medical switching subsidiary QEDI to "ensure optimisation in terms of support and operational costs. The Lengana business will be jointly managed by AFFIN, PQ Health and an accredited managed care organisation representing the participating service providers"
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PQ Health
PQ Health, a division of South Africa`s largest IT group, PQ Africa, uses its deep understanding of the South African health care industry to provide business-driven and patient-centred solutions for the full spectrum of health care professionals and managed care organisations.
PQ Health`s (www.pqhealth.co.za) end-to-end solutions are firmly rooted in effective business strategies, reducing costs and increasing efficiencies to enable both funders and providers to run effective and profitable health businesses. PQ Health`s enterprise-wide business offering includes medical claims management, software development, connectivity and innovative administration and information systems.
A powerful grouping of information technology and business offerings within the PQ Africa group, collaborative partnerships are the basis on which PQ Health is able to service the entire health industry, including funders, service providers, hospitals and clinics and even one-person practices.
PQ Africa
PQ Africa (www.pqafrica.co.za) is SA`s leading provider of competitive, innovative and flexible business solutions based on Information and Communications Technology ("ICT"). Comparex Holdings Limited has a 50% minus one share interest in PQ Africa. The black empowerment group NITAC (the National IT Acquisition Consortium), led by Real Africa Holdings Limited, holds a controlling interest of 50% plus one share in PQ Africa.