CPC Qualicare / DocWeb | Doctor's Online resource for South African Doctors

September 2016 Newsletter

Breaking news  !!!!!!!!!

Termination of Discovery Keycare contracts will affect up to 1 300 Family Practitioners

Keycare currently has over 420, 000 covered lives, serviced via over 3000 contracted Family Practitioners.

Discovery has reported a loss ratio of 113% on the scheme which means that it pays providers 13% more than the total members’ annual contributions.

As part of the Discovery strategy to save the option, they have embarked on an optimization program that will lead to about 1 300 FPs having their Keycare contracts terminated by the end of this year.  Discovery reports that doctors servicing fewer than 50 Keycare patients are not able to display cost effective methodologies required by the scheme.

Numbers of Doctors whose contract will be terminated on the basis of less than 50 Keycare patients in the practice is as follows:

  • 174 doctors – who have less than 5 members
  • 601 doctors – who have less than 50 members

Discovery has also looked into practices with more than 50 patients but which have poor outcomes based on the DH Profiling system (Poor Quality, not sticking to formulary, not paying attention to the Keycare protocols, duplication of costs etc). As a result:

  • 497 doctors – who have less than 300 members and 42 doctors who have more than 300 members, will also have their contracts terminated.

Termination letters have been sent out during the month of October by Discovery and members will be requested to change practitioners.

Last modified on Tuesday, 18 October 2016 20:12

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