Member contributions being significantly subsidised by the state (their employer) along with healthcare services being delivered by both public and private providers renders the Government Employees Medical Scheme (GEMS) potentially the largest public private partnership in South African healthcare.
Making this claim at the weekend’s KZNDHC Conference in Durban, GEMS principal officer Dr Guni Goolab said that his organisation had become a public private partnership “which yields exceptional results”.
By its broadest beneficiary definition, he said, the scheme has facilitated sustained growth and access for more than 1 million previously uncovered lives: “Also, with more than 1.8 million beneficiaries, this makes GEMS the largest closed medical scheme in South Africa.”
Providing funding to 6400 family practitioners, 6500 specialists and 6500 allied healthcare practitioners, Goolab noted that GEMS has over 90 million claim lines paid and over R30 billion claims paid. To this he added that GEMS outperforms the industry in 2 out of every 3 of quality metrics
“The public private partnership which is GEMS has begun a virtuous cycle that is helping to create a more accessible and efficient healthcare system which is to the benefit of all South Africans,” he concluded.