Discovery is paying R340,737 per patient on ventilation for Covid-19 in schemes it runs

  • Of the total known cases of SARS-CoV-2 detected in South Africa to date, just under 10% have been among members of medical schemes administered by Discovery.
  • The average cost of hospitalisation for the 39 such members who were put on ventilators was R340,737, Discovery said this week.
  • But thanks to the majority of patients needing only care in normal wards, its average cost of hospital treatment came in at R84,708 per person.
  • That’s far lower than costs reported by Medscheme in mid May.

Of the just more than 18,000 cases of SARS-CoV-2 detected in South Africa so far, just under 10% were members of one of the medical aid schemes administered by Discovery Health, numbers released by the company this week show.

Based on what it has seen, Discovery believes medical schemes will be looking at a total of between R7.3 billion and R31 billion in extra claims due to Covid-19 over the next year and a half.

That averages out to between R816 and R3,561 per scheme beneficiary. But projections remain tricky; like other administrators Discovery has seen a reduction in claims for elective procedures and other non-critical care thanks to lockdown and people avoiding medical facilities where possible, which means medical aids are saving money in the short term.

In the longer term, though, there is a fear that ill people who do not go to hospital will be worse off – and will ultimately cost more to treat.

The cost of treating the Covid-19 caused by the novel coronavirus can also vary wildly, depending on severity.

To date Discovery-administered schemes have seen 39 patients put on ventilators, the company said, at an average cost of R340,737.

For those admitted to intensive care units, the average cost was R169,525.

And treatment in a normal ward came in at R37,091 per person.

That averages out to a per-person cost of R84,708 to treat Covid-19 in hospital, Discovery said

That is far lower than the average reported by competing administer Medscheme in mid May, which said it had seen cost of around R150,000 per Covid-19 patient on average.

Medscheme represents 3.8 million people, while Discovery represents 3.5 million.

Like in the rest of the world, South African numbers suggest that the severity of Covid-19 is best predicted by age, and whether patients have existing conditions. That makes for big variations between medical schemes, depending on the profile of their members.

“Medical schemes with more members who are older will likely have higher rates of hospitalisation as a proportion of the confirmed Covid-19 diagnoses, and higher costs for these admissions,” said Discovery in a statement.

Testing and treatment for Covid-19 is a prescribed minimum benefit in South Africa, which means medical schemes must pay for it, regardless of the type of medical aid plan a member subscribes to.

(Compiled by Phillip de Wet)

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