Home > Medical schemes > News Updated 15 January 2014 Is your GP contracted in? If GPs are contracted in to a medical scheme network, they might be pressurised to recommend cheaper treatment options and medications, say SA health bodies. 0 iStock Like us on Facebook » Subscribe to the newsletter » Ask CyberDoc » Quiz How long will you live? » Medical history Bacteria gallery The Board of Healthcare Funders (BHF) and the IPA Foundation (IPAF) is extremely concerned at the comments made recently by the Health Professions Council of South Africa concerning Designated Service Providers (DSPs). The HPCSA recently released a statement to the effect that healthcare practitioners should be cautious when concluding designated service provider (DSP) agreements with medical schemes as the medical schemes attempted to reduce costs by applying pressure on practitioners within a DSP network to prescribe medication or recommend treatment options, when other more appropriate, albeit more expensive, options were medically indicated and readily available.Pushing healthcare costs downIn the current environment where there are no regulated tariffs for healthcare procedures, the ability for medical schemes to contract with DSPs is an important mechanism to moderate the uncertainty relating to cost of healthcare. Without this, medical scheme patients could be faced with unaffordable co-payments which will impact on their access to quality health care. DSP contracted providers agree to service patients within defined parameters and costs.Medical scheme formularies (the list of medicines covered by schemes) are compiled in consultation with healthcare practitioners in order to manage efficiency and to ensure that the healthcare rand is optimally spent. The formulary does not dictate what a doctor may prescribe but is a guide as to what will be covered by the scheme.The IPA Foundation supports responsible contracting between doctors in DSPs and schemes, based on widely accepted principles of fair competition, and embracing the “any willing provider” concept. Registered providers voluntarily subject themselves to peer profiling, peer review and mentoring, all of which are based upon the highest quality assurances, combined with reduction of unnecessary, and often wasteful down-stream costs. In return for this behaviour the providers qualify for an enhanced remuneration fee. The IPA Foundation is attuned to both over-servicing, and under-servicing and is committed to the elimination of both together with the delivery of the highest quality medical services at all times by its GP supporters.Both parties fully identify with the cautionary offered by Regulation 7(3) of the Ethical Rules of Conduct for practitioners registered under the Health Professions Act of 1974, which states that practitioners “shall not offer or accept any payment, benefit or material consideration which is calculated to induce him or her to act or not to act in a particular way not scientifically, professionally or medically indicated or to under-service, over-service or over-charge patients”.The BHF and IPAF believe that the HPCSA and the CMS should engage with the Medical scheme industry and organised doctor groupings to find a solution to the HPCSA’s concerns.About The Board of Healthcare Funders Southern AfricaThe Board of Healthcare Funders of Southern Africa (BHF) is the representative body for the majority of medical schemes and members throughout South Africa, Lesotho, Namibia, Botswana and Zimbabwe.About the IPA FoundationThe IPA Foundation (IPAF) is a section 21 company which represents the interests of GPs committed to the principles of managed care and who can provide accessible, cost-effective healthcare. Tony Behrman is the COO of the IPA Foundation Tel 021 4264777. email@example.com Press release by the Board of Healthcare Funders More in Medical schemes Low-cost medical schemes on the horizon More: Medical schemesNews advertisement Read Health24’s Comments Policy Comment on this story 0 comments Comments have been closed for this article. Logout Comment 0 characters remaining Share on Facebook Loading comments... Other news Fitness Exercises that bring out the best in your body shape Sex Regular sex may boost a woman's fertility Medical Medical marijuana appears safe for chronic pain Medical Blind, abandoned and gang raped – girl turns life around Columnists Why does Oscar suddenly need psychotherapy? Medical How a doctor would diagnose and treat piles From our sponsors Dehydration at a glance What could happen in the next 37 seconds? Fifty and fabulous! There’s something newly cool about turning 50 World Thrombosis Day 2015 Live healthier Make a change and get moving! » The dangers of blood clots Fit people live longer Exercise is key to health in old age How you can get moving Fee like a useless lump of laziness just laying on the couch? Fear not, there's hope for you! Here's how you can get active. Up for grabs! » To vape or not to vape? Twisp's new range of e-cigs Discover your Twisp Win one of the 3 new devices from Twisp! Now you can stand a chance of winning one of the 3 new devices, as well as flavours and accessories worth R2000 each!