- Managed Care Programme offers access to quality healthcare through interventions that ensure good clinical outcomes for BPOMAS members and their dependants.
- Central to MCP is ensuring that quality healthcare is delivered to clients at appropriate cost without adversely affecting clinical outcomes.
- MCP also endeavours to ensure that evidenced based care is delivered by all service providers registered with the scheme.
The programme is administered by a team of healthcare professionals at the Managed Care Department (MCD) who have specialized skills and knowledge of evidence based medicine. These professionals on a continuous basis engage with service providers to ensure that BPOMAS patients get standard of healthcare matching with international best clinical practices. The MCD team applies the well known concept of “Managed Care”, which is used internationally in healthcare insurance industry.
Managed Care as concept looks at issues around;
- The cost and utilization of a wide spectrum of services that members of medical aid schemes access on a regular basis.
- It seeks to establish balance between quality of healthcare and associated cost of interventions.
Managed Care Department has over the years introduced a number interventions or disease management programmes ranging from;
Plans are at advanced stage to introduce other services such as Wellness Programmes and Case Management for certain specified disease conditions.
Future Interventions
In the short to medium term MCD will introduce the following interventions namely, Case Management and Wellness Programmes. It is hoped that these interventions will enhance the services provided by MCD for BPOMAS members.
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