Despite having to confront all these challenges, we successfully met the conditions of our service-level agreements across all schemes, which is a notable achievement. On the membership front, despite the economic challenges referred to above, the uptake of new members was comparable to previous years and some schemes even experienced a net gain in membership. Risks, challenges and opportunities From an organisational point of view, the most notable challenge of 2021 remained the COVID-19 pandemic and the economic slowdown that followed in its wake. In such an uncertain environment, we had to be both astute and adaptable in our strategic planning and budgeting. Taking a more long-term view, the greatest risks to the business are the constantly changing regulatory environment and the consolidation of the medical schemes administration market. We are one of 11 administrators competing for the business of the 80 private medical schemes in South Africa. As schemes merge and consolidate, their membership increases, but the overall pool of potential future clients becomes smaller. Uncertainty about the introduction of a national health insurance (NHI) scheme remains both a challenge and an opportunity. We are, however, taking a proactive approach in this regard and actively engage with the Department of Health. Accelerating technological change presents both a challenge and an opportunity. The challenge is one of keeping up in a constantly evolving environment, while the opportunity this presents is one of getting closer to our clients and their members, developing new services to meet changing needs and maintaining a process of continuous improvement in operational efficiencies. Improvement of our B-BBEE scorecard is a strategic objective for PPSHA. During the reporting period, we improved from a Level 5 to a Level 4 rating, and we anticipate that we will achieve a Level 3 during the 2022 financial year. Innovation One of our most notable innovations in 2021 was the introduction of the PPS Wallet for Profmed. This is an add-on savings account that is independent of the main medical benefit, but which works seamlessly with the medical benefit to cover the payment of healthcare expenses. It is available to Profmed members across all scheme options and is highly flexible in terms of the amount that can be paid into the PPS Wallet. The money in the PPS Wallet can be used to pay healthcare expenses for any beneficiary registered on the member’s profile. The claims processing is seamless and hassle-free for the Profmed membership, thus enhancing the private client experience. The roll-out of our private client service model continues to be very successful. We provide a high-touch environment with exceptional levels of service, especially to professional members who expect only the best. In support of this objective, we continuously implement technological innovations and enhance both our online capabilities and the functionality of our mobile app. The onboarding of new members takes less than a day, and our app is frequently voted as the best healthcare app in the Android app store. At the end of 2020, we implemented an AI-enabled capability to read paper claims and convert them into a digital format. This solution has added a new level of efficiency to claims processing, especially for schemes that still receive most claims on paper or as scanned documents. This has enabled faster claims payment processing to members. Innovations in the pipeline include communicating with members via WhatsApp for Business; the use of SnapScan for collection of contributions, which will automatically allocate the contribution received; a 24/7 self-service option for both members and providers; and voice-recognition capabilities for when members contact our call centres. Prospects While the environment in which we operate is still constrained, our prospects for 2022 are good. The schemes we administer and manage are stable, as are their membership bases. Growth is likely to come from growing membership at scheme level as well as from developing new services for members. Enhanced services will help to embed members and will have long-term benefits for both PPSHA and our clients. We will continue to keep tight control of costs by consistently introducing new technologies and efficiencies. The affordability of medical aids remains a major issue for members, and this naturally increases the risk of attrition. We are constantly working with our schemes to ensure that they can offer affordable packages tailored to meet the needs of their members. PPSHA continues to hold steady despite operating in such a fluid environment and we look forward to a successful year in 2022. 73 | PPS Group performance at a glance PPS Integrated Report 2021
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