文章基本信息

标题：Classification of a member in terms of healthcare risk
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作者：A. De Villiers ; C. A. Van Der Merwe ; T. J. Van Wyk Kotze 等
期刊名称：South African Journal of Business Management
印刷版ISSN：2078-5585
电子版ISSN：2078-5976
出版年度：2004
卷号：35
期号：4
页码：21-26
DOI：10.4102/sajbm.v35i4.665
出版社：African Online Scientific Information Systems
摘要：Legislation by government has changed the playing fields in the medical scheme industry in South Africa. Medical schemes can no longer choose their members or discriminate against members who claim more than projected amounts. Only those medical schemes that are able to manage their risk optimally, will ultimately survive. In the research it was established that the number of chronic beneficiaries in a family is an important risk factor if a member is classified into a normal claim category or an above-normal claim category. The medical schemes should make sure that they have systems in place to manage the health of such beneficiaries holistically. This group of individuals is ideally suited for a preventative healthcare programme.