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1 | Page PLATINUM HEALTH COMPANY PROFILE

PLATINUM HEALTH COMPANY PROFILE · The Platinum Health Group operates an integrated healthcare model which consists of Platinum Health Medical Scheme (PHMS) and Platmed (Pty) Ltd,

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Page 1: PLATINUM HEALTH COMPANY PROFILE · The Platinum Health Group operates an integrated healthcare model which consists of Platinum Health Medical Scheme (PHMS) and Platmed (Pty) Ltd,

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PLATINUM HEALTH

COMPANY PROFILE

Page 2: PLATINUM HEALTH COMPANY PROFILE · The Platinum Health Group operates an integrated healthcare model which consists of Platinum Health Medical Scheme (PHMS) and Platmed (Pty) Ltd,

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PROFILE OF PLATINUM HEALTH The Platinum Health Group operates an integrated healthcare model which consists of Platinum Health Medical Scheme (PHMS) and Platmed (Pty) Ltd, a medical service delivery company. Platmed (Pty) Ltd owns RA Gilbert (Pty) Ltd., a pharmacy group (9 pharmacies) and has a 40% shareholding in Peglerae Hospital (Pty) Ltd., a 269 bed hospital in Rustenburg. Platmed (Pty) Ltd is a wholly owned subsidiary of Anglo Platinum.

PLATINUM HEALTH GROUP

PLATINUM HEALTH MEDICAL SCHEME

AAANNNGGGLLLOOO

PPPLLLAAATTTIIINNNUUUMMM

110000%%

Platmed Properties (Pty) Ltd.

110000%%

RA Gilbert Pharmacy (Pty) Ltd.

110000%%

Platmed (Pty) Ltd.

4400%%

Peglerae Hospital (Pty) Ltd.

Page 3: PLATINUM HEALTH COMPANY PROFILE · The Platinum Health Group operates an integrated healthcare model which consists of Platinum Health Medical Scheme (PHMS) and Platmed (Pty) Ltd,

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PROFILE OF PLATMED (PTY) LTD. 1. BUSINESS MODEL The Platmed Health Care delivery system is a fully -fledged Staff Model Health Maintenance Organisation, which delivers healthcare services spanning two broad components:

Occupational Health – including medical surveillance, injuries on duty, tuberculosis, trauma management, rehabilitation and workplace wellness programs.

Medical Services – including medical scheme benefits, HIV/AIDS management, chronic disease management, membership and client liaison.

The model is capable of managing large volumes of patients and cost efficiencies are obtained through maximising the use of staff, facilities and infrastructure. The diagram below depicts the continual evolvement towards achieving the lowest cost possible, coupled with the highest quality of service. *Other external clients: Pilansberg Platinum, Platinum Group Metals, Wesizwe

1.1. PLATMED’S OBJECTIVES Platmed was established in 2001with the following objectives:

To lower the cost of providing healthcare benefits to employees

To provide equitable benefits to all employees

To maintain the long term cost of provision of healthcare benefits at affordable levels

To ensure the optimal use of existing infrastructure and capacity

To ensure that stakeholder expectations were considered

PLATMED

(PTY) LTD

New clients

Anglo Platinum

Achieved Cost and Quality Efficiencies

FURTHER improvement

towards

Lowest cost Best quality

ARM

Anooraq Resources

Royal Bafokeng

Northam

Page 4: PLATINUM HEALTH COMPANY PROFILE · The Platinum Health Group operates an integrated healthcare model which consists of Platinum Health Medical Scheme (PHMS) and Platmed (Pty) Ltd,

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1.2. PRINCIPLES At the outset it was determined that the Staff Model Health Maintenance Organisation comprised three interdependent components:

Management of the model

Funding the cost of the services and benefits

Rendering the services It was also identified that the key to the successful management of these interdependent components was the application of an effective management information system (see MIS in the diagram below). 1.3. VALUES The values subscribed to in the operation of this model are:

To lead by example.

To consistently exceed customers’ service requirements.

To constantly strive to establish world-best practice.

To maintain strong relationships with each other.

To excel in corporate governance.

To lead a balanced lifestyle.

To recognise and reward superior performance

To appropriately develop our people.

Employer

Funding vehicle

Service Providers

M ANAGEMENT

MIS

Employer

Funding Vehicle

Service Providers

M ANAGEMENT

MIS

Page 5: PLATINUM HEALTH COMPANY PROFILE · The Platinum Health Group operates an integrated healthcare model which consists of Platinum Health Medical Scheme (PHMS) and Platmed (Pty) Ltd,

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1.4. PLATMED’S INTEGRATED HEALTH CARE MODEL

The above diagram shows employer and employees (red) as funders of the medical scheme benefits on the right hand side. It also shows the employer (blue) as funder of healthcare services for work-related injuries and illnesses on the left hand side. Platmed (Pty) Ltd provides an integrated solution to the funders through its four divisions (pink) – namely:

Services (occupational healthcare, medical services, emergency services, HIV/AIDS management and Employee Assistance Programmes)

Pharmacy

Medical Scheme Administration

Managed Care

Workplace Wellness Programmes Platmed integrates the management and application of systems (green) to provide a holistic and seamless process of healthcare delivery.

* Primary Healthcare

* Secondary Healthcare

* Tertiary Healthcare

Pharmacy Division

Platmed (Pty) Ltd

Service Division

Occupational Healthcare

Medical Services

E

M

P

L

O

Y

E

R

HMO

MANAGEMENT

Medical Scheme

Administration Division

Managed Care Division

S

Y

S

T

E

M

S

Emergency Services

ART

EAP

E

M

P

L

O

Y

E

R

E

M

P

L

O

Y

E

E

M

E

D

I

C

A

L

S

C

H

E

M

E

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1.5. PLATMED’S GOVERNANCE STRUCTURE It is Platmed’s intent to offer and support a sound governance structure to its clients. The diagram below illustrates that the client’s Executive Committee and trustees of the medical scheme determine the healthcare strategy. The Group Medical Consultant and/or representative for our client would be responsible for setting policies and procedures in line with the strategy, and would then effect these through the Service Delivery partner, Platmed. Service level agreements would be in place to regulate the relationship between our client and Platmed.

1.6. THE STAFF MODEL HEALTH MAINTENANCE ORGANISATION The fundamental basis for evaluating a healthcare delivery system is to examine the incentives within such a system. Critical to the delivery of high quality services is the incentives employed for the healthcare professionals within the system. The staff model system of employing health care professionals is well-known within the Mining Industry in general, but it is unique within the private healthcare sector in South Africa, and it is thus worth noting the fundamental differences between this system and other systems in the private health care sector. The Platmed staff model originates from the mine health services that arose with the advent of mining in South Africa. The primary objective of these early mine based health services was to treat injured miners. This intent was soon expanded to incorporate non-work related injury and illness. The mining houses carried the cost of providing these people with healthcare services. There thus arose a structure of providing healthcare that was unique within the private healthcare sector. This structure employs all necessary staff to provide a comprehensive set of health interventions. Where it is not economically viable to provide a particular high-level service (e.g. neurosurgery, cardiac surgery), it is obtained from an appointed preferred provider.

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Through the employment of health professionals on a full time basis, the following outcomes are achieved:

removal of perverse incentives of health professionals

a cost profile that does not inhibit access

the ability to manage large volumes of patients and maintain quality

integrated health interventions

management control of professional standards and support services. The “fee-for-service” type of funding practised in the private sector creates scope for perverse incentivisation - utilising healthcare to maximise income/profit. The staff model system (as currently practised) receives its income via the following mechanisms:

capitation fee directly

capitation fee directly from a medical scheme The costs of providing healthcare benefits include the salaries of all full-time health professionals. No health professional is allowed to charge for services nor does the company bill on their behalf. The staff model HMO system has achieved cost profiles of at least 50 percent below that of the private sector, for a similar set of benefits. This system ensures that access, and consequently equity, is achieved by treating pathology at the correct level. Primary care entry with escalation to appropriate levels of care ensures cost effective and high quality healthcare. No employee is denied access to any level of care providing the presenting problem requires it. This is true for the lowest paid employee as well as the highest paid. The staff model system, as operated by Platmed (Pty) Ltd. is run as a business. It is thus accountable to a Board and shareholders. In addition it is answerable to its customers for both price and quality of service. It is also accountable to certain stakeholders, such as labour organisations. 2. STRATEGY Platmed’s strategy is centered on four key objectives:

Providing appropriate healthcare of high quality through an integrated health care delivery model

Continuously exploring opportunities to optimize efficiencies and to provide affordable and sustainable health care

Pursuing growth through service excellence

Keeping abreast of legislative change to ensure that the management and provision of healthcare services is optimally positioned to benefit stakeholders

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It is important to note that Platmed would report into, obtain strategic guidance and be subject to audit by its clients. 3. CLIENTS AND ACHIEVEMENTS Platinum Health clients are:

1. Anglo Platinum 2. Anglo American 3. Northam Platinum 4. Royal Bafokeng Platinum 5. Modikwa Platinum 6. Bokoni Platinum 7. Aquarius Platinum 8. Two Rivers Platinum 9. Dwarsrivier Chrome Mine 10. SAN Contracting 11. PGM 12. Modi Mining 13. Reagetswe 14. Rocsafe 15. Swallow Fork 16. Masego Cleaning 17. Andulosite Mining 18. Umnotho Chrome Mining

Achievements over the past few years include:

Upgraded infrastructure to world class standards

Established network of preferred service providers

Continued profitability and improved solvency margins of Platinum Health. The following table depicts annual contribution increases for the medical scheme:

2002 11.94%

2003 9.60%

2004 6.57%

2005 7.31%

2006 5%

2007 2.8%

2008 5.2%

2009 10.3%

2010 *24.4%

2011 6.7%

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2012 5.91%

2013 4.7%

*Art treatment previously carried by company and from 2010 included in Medical Scheme costs.

Improved quality of healthcare

Development and implementation of a service delivery model in the Eastern Limb of the Anglo Platinum business (Polokwane to Lydenburg areas)

Successfully administering dramatic increase in membership

High level of satisfaction amongst stakeholders

Overcoming numerous legislative changes Health Care Informatics: Extensive development time, effort and money were put into the in-house developed Healthcare Management system. This system replaces all paper based records, integrates with Human Resource Systems, T& A Systems, Laboratories, etc. Identification of clients via biometric scanning is part of the system.

Page 10: PLATINUM HEALTH COMPANY PROFILE · The Platinum Health Group operates an integrated healthcare model which consists of Platinum Health Medical Scheme (PHMS) and Platmed (Pty) Ltd,

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4. LOCATION OF FACILITIES

Service Delivery Model

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Rustenburg Region

- RPM Hospital

√ √ √ √ √ √ √ √ √ √ √ √ √ √ √

- Peglerae Hospital

√ √ √ √ √ √ √ √ √ √ √

- PH Medical Centre

√ √ √ √ √ √ √ √ √

- Royal Bafokeng Clinic

√ √ √ √ √ √ √ √ √ √

- Phokeng Clinic

√ √ √ √

- Paardekraal Clinic

√ √ √ √

- Mogwasi Clinic

√ √ √ √

Thabazimbi Region

- Swartklip Hospital

√ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

- Amandelbult Hospital

√ √ √ √ √ √ √ √ √ √ √ √ √

- Thabazimbi Medical Centre

√ √ √ √ √ √

Eastern Region

- Mogolakwena

√ √ √ √ √ √ √ √ √ √

- Bokoni Clinic

√ √ √ √ √ √ √ √ √ √ √ √ √

- Twickenham Clinic

√ √ √ √

- Modikwa Clinic

√ √ √ √ √ √ √ √ √ √ √ √

- Burgersfort C Rooms

√ √ √ √ √ √ √

- Two Rivers/Dwarsrivier

√ √ √ √ √

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RUSTENBURG- THABAZIMBI SERVICE DELIVERY NETWORK

15 km

15 km

AMANDELBULT 48 Bed Sick Bay, Primary and Occupational Health

Services

SWARTKLIP (UNION) Hospital

MOGWASI Primary Health Care Clinic

23 km

ROYAL BAFOKENG PLATINUM

MINE Primary and Occupational Health Clinic

PHOKENG Primary Health

Care Clinic

PAARDEKRAAL Primary Health Care

Clinic

RPM Hospital

PLATINUM HEALTH

Medical

Centre

PEGLERAE

Hospit

al

17 km

40 km

15 km

LA FEMME

Women’s Clinic

THABAZIMBI Medical Centre

15 km

20 km

PLATINUM HEALTH

Medical Centre

PEGLERAE HOSPITAL

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EASTERN LIMB SERVICE DELIVERY NETWORK

POLOKWANE SMELTER Occupational Health

Clinic

BOKONI PLATINUM MINE

10 Bed Sick Bay, Trauma, Primary Health Care and

Pharmacy Services

TWICKENHAM MINE Small Clinic, Nurse Based

MODIKWA PLATINUM Clinic & Trauma Centre

BURGERSFORT Medical Centre

LIMPOPO Medi - Clinic

MOGALAKWENA Clinic

POLOKWANE

PRETORIA

LYDENBURG

10km

70km

60km 15km

TWO RIVERS/ DWARSRIVIER

CLINIC

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5. SERVICES The services provided at each of these facilities range from hospital based services, to sick bays, clinics, trauma services and occupational health services. Netcare 911 provides the EMS service. Pharmacies and/or the dispensing of medicines are located at all operations. Platmed has invested in an extensive pharmaceutical network, which is currently a separate company, but controlled by Platmed. There are currently nine registered pharmacies with smaller dispensing units wherever the issuing of medicine is required. The location of services is depicted on the maps above. Outsourced services are managed through preferred provider arrangements, which are closely monitored and managed. Transport services are in place for medically transfers of patients, but patients requiring access to the health care facilities for non-emergency and non-life threatening reasons, need to be transported by their employer or utilize their own mode of transport. Platmed (Pty) Ltd has a 40% shareholding in the Peglerae private hospital in Rustenburg. This facility is utilised for intensive care, medical and surgical management of patients at very competitive rates. The trauma unit at this hospital was designed and endorsed by Dr. Jacques Goosen, a leading authority on trauma management in South Africa with extensive experience in the mining industry. Platinum Health also has contractual arrangements in place with the Limpopo Mediclinic for secondary and tertiary level hospitalization for the mines in the Polokwane and surrounding areas. The occupational health services provided by Platmed offer the following:

Focused management of the occupational health centre and occupational health issues in a variety of operations, including conventional mining, mechanized mining, opencast mining, metallurgical crushing, milling, flotation, smelting and refining.

Occupational medical experience with issues including ergo-dynamics, noise-induced hearing loss, first aid training, disability management, functional and physical work capacity assessment, emergency service dispatchers, paramedics, patient transport, routine medical examinations, occupational nickel and platinum salt exposures.

The occupational health centre offers an occupational medical surveillance programme for healthcare workers, including hepatitis B and tuberculosis surveillance.

A Voluntary Counseling and Testing system is integrated into the routine medical surveillance.

The x-ray systems are completely digital and all records are stored in a secure digital system

The rehabilitation and functional assessment centre assists in establishing employees’ individual ability to perform work safely and productively in a scientific, fair and reproducible manner. The centre is also valuable in the rehabilitation process of employees in conjunction with a large and well-staffed physiotherapy and occupational therapy department. A leading

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Occupational Health Hygienist, Professor Kielblock, designed this entire concept, together with the physical structure and evaluation methodology.

The diagnostic audiology service offers a comprehensive range of testing, is staffed by full-time audiologists and supported by bi-weekly ENT specialist visits, which perform the necessary assessments for severe noise –induced hearing loss cases.

Platmed occupational health centers are currently streamlining and documenting processes so as to achieve ISO 9000 accreditation. The centre has been audited on numerous occasions for ISO14000 and OSHAS 18000 for its various operational clients and awarded accreditation accordingly for all operational sites.

Platinum Health/Platmed offers a comprehensive Wellness Programme for the management of HIV/AIDS. It is based on solid scientific principles, which highlight the need for the timely commencement of anti-retroviral therapy (ART), for individuals diagnosed as having HIV/AIDS. The programme assesses the risks of starting ART too early, such as toxic effects and unnecessary high costs; with the risks of delaying ART too late, which include a declining of immune function and the progression to death. Once a patient has been tested HIV positive, he/ she is entered onto a wellness register, and the first counselling session after the pre- and post testing counselling, is set up. If the patient agrees to ART, baseline blood tests (CD4, VL, FBC and LFT) are taken, and the individual’s condition is reviewed after a two-week period to determine whether to start ART or not, based on clinical and immunological criteria. On commencement of ART, patients are initially followed up on a two weekly basis for the first two months, and then once a month thereafter. Seven page visit forms are filled in at each visit up to three months, and then at every three monthly follow-up. Further blood tests (FBC, CD4, and VL AND LFT) are taken at six monthly visits. It is important to note that wellness doctors review all patients in the hospital outpatient department, in the wards as well as at the casualty department. Patient education focuses on addressing ART defaulters, the concurrent use of herbal medicines and patients presenting too late for treatment. 6. MANAGEMENT, ADMINISTRATION AND SYSTEMS 6.1. Staff skills and experience Staff skills and experience are one of the major contributors to Platmed’s success. In addition to their collective vast experience in the mining industry, the management team and employees have also made the transition from the historical “cost centre” approach to running mine health care facilities, to a business model approach. Platmed operates as a business, where all overhead costs are borne by the business. Having successfully made this transition to a business model, Platmed then also successfully managed the transition to providing services to medical scheme members. This also required a shift in approach, procedures, etc.

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Management Experience Platinum Health Industry D le Roux 16 25 Dr M Fourie 9 18 Dr P Motapo 7 9 Dr K Naidoo 7 16 Dr T Pieterse 15 20 W Mboniso 10 21 R Lotz 10 15 C Steyn 7 15 Dr T Langa 10 12 A Kokota 15 27 C Kern 16 34 6.2 Staff development programmes The following training is endorsed and fully funded by Platmed: 6.2.1 All medical practitioners (doctors) undergo ATLS (Advanced Trauma Life

Support) and ACLS (Advanced Cardiac Life Support) training, while those working in the clinics where children are treated also undergo the APLS (Advanced Pediatric Life Support) training.

6.2.2 All medical practitioners undergo the HIV/AIDS training which sets standards

and protocols in terms of HIV/AIDS management – Voluntary Counselling and Testing, treating opportunistic infections, ante-retroviral treatment.

6.2.3 All occupational medical practitioners have a Diploma in Occupational Health 6.2.4 All medical practitioners attend relevant courses and conferences. 6.2.5 The nurses attend both internal and external training as required. In house

training focuses on wound care, infection control and tuberculosis management. Basic life support is compulsory

6.2.6 Those nurses who require dispensing licenses are fully funded by Platmed to

complete the course. Platmed also funds the cost to maintain valid licenses each year.

6.2.7 In terms of non-clinical staff, courses such as the Management Development

Programme are offered.