Demand Management
Demand Management is about providing people with the care they need, when they need it, in a way that leaves them satisfied with their care encounter. The member remains in the driving seat, retains freedom of choice and is not financially compromised. This is achieved through educating members on how to make appropriate use of health care services and medical scheme benefits and to remain in control of their healthcare spend by being informed
Demand Management is therefore not a process of limiting benefits but rather a process that ensures that each patient gets the right treatment at the right time and at the right price.
Demand Management encourages behavioural change and empowerment through professional education, case management, and personalised nurse support.
In order to provide the decision support and education of members of Schemes under administration, PHA uses Registered Nurses who are trained in the philosophy of Demand Management for claims processing and managed care interventions.
Every member has a right to be educated and empowered in their health care decisions - true patient advocacy is provided through Demand Management.
Notes
- Demand Management is "the use of decision support and self-management to enable and encourage individuals to make appropriate use of medical care through informed choice” (Vickery and Lynch 1995).
- The term Demand Management in healthcare, is trademarked by Sweidan Trust (Pty) Limited. Permission to use this was granted for the purpose of this website and leaflet.