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Chapter 8 : Purchasing of Health Services


275. A key element of the NHI reforms is to create a purchaser-provider split by creating an institution that will strategically purchase healthcare services77. Currently personal services are purchased passively in the health sector but under NHI, the Fund will be an active purchasing organisation. The NHI Fund will receive and pool funds that it will use to strategically purchase services for the entire population.


276. As an active purchaserm, the NHI Fund will assess the population needs to determine health service requirements and to ensure that the required services are available through purchasing these services from accredited providers. Acting as a single-payer and single purchaser, the NHI Fund will be able to reap the efficiency benefits of monopsony purchasing power and economies of scale, and ensure that incentive structures for healthcare providers are integrated and coherent.


8.1 Purchaser-Provider Split

8.2 Accreditation of Providers by NHI Fund

8.3 Treatment Guidelines

8.4 Provider Payment Mechanisms

8.5 NHI Information systems

8.6 Health Technology Assessment

8.7 The future role of Medical Schemes