FEEDBACK ON MEDSCHEME LAPAROSCOPIC APPENDIX PROJECT
The pilot project for Laparoscopic Appendicectomies under the Medscheme umbrella came to an end on 31/12/2016.
Medscheme have started to unbundle the data which shows the following:
- A very small cohort of patients collected into the data base.
- Of those collected only 33% of the surgeons involved stayed within the designated price for basket of re-usables.
- One surgeon – two cases – overshot the basket being well above R8 000 for re-usables per case.
The way forward:
- As the Project Co-ordinator, I plan to contact the individuals involved to see if there are explanations for the overshoot on the basket price.
- I have suggested to Medscheme that if it was done in more hospitals – not just Netcare – with more of the Medscheme medical aids being involved there might be a bigger pool.
- If there were a bigger cohort we would get a better overview of surgeons’ usages.
One of the concerning features for the SASES Exco is that in spite of a huge amount of work, negotiation, and a basket price being established, only 33% of cases were kept within the limits.
It has been the mission of this Exco and those before us who initiated this project to make minimal access surgery financially affordable and sustainable – based on these results it would appear that the bench mark set for us by the medical aids was not attained by the membership making it difficult to try and renegotiate further pilot projects unless we, the membership, show intent to reduce costs.
More information to you as results or progress comes to hand.