centre for actuarial research prescribed minimum benefits package

Centre forActuarial Research

Prescribed Minimum Benefits Package

Centre forActuarial Research

Incidence All Ages

Incidence of PMB Admissions by Age

97.6850

0

50

100

150

200

250

300

350

400

450

0-1

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75+

All

ages

Inci

denc

e

0

50

100

150

200

250

300

350

400

450

0-1

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75+

All

ages

Inci

denc

e

Centre forActuarial Research

Incidence of PMB Admissions by Age

0

50

100

150

200

250

300

350

400

450

0-1

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75+

Inci

denc

e

TotalHighMedium-olderMedium-youngerLow

Centre forActuarial Research

Average Cost of PMBs by Age

Centre forActuarial Research

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

0-1

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75+

All

ages

Ave

rage

Cos

t

R9 127

Average Cost for All

Ages

Centre forActuarial Research

Raw PMB Price by Age (pbpa)

Centre forActuarial Research

R 891.56 pbpa

Average Price for All

Ages

R 0

R 500

R 1,000

R 1,500

R 2,000

R 2,500

R 3,000

R 3,500

R 4,000

R 4,500

R 5,0000-

1

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75+

All

ages

Centre forActuarial Research

Age Profile of Study

0.00%

5.00%

10.00%

15.00%

0-1

1-5

5-10

10-1

5

15-2

0

20-2

5

25-3

0

30-3

5

35-4

0

40-4

5

45-5

0

50-5

5

55-6

0

60-6

5

65-7

0

70-7

5

75+

TotalHighMedium-olderMedium-youngerLow

Centre forActuarial Research

Age Profile Beneficiaries Admitted for PMBs

0.00%

5.00%

10.00%

15.00%

20.00%0-

1

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75+

TotalHighMedium-olderMedium-youngerLow

Centre forActuarial Research

Incidence of PMB Admissions by Age

0

50

100

150

200

250

300

350

400

450

0-1

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75+

Inci

denc

e

TotalHighMedium-olderMedium-youngerLow

Centre forActuarial Research

R 0

R 2,000

R 4,000

R 6,000

R 8,000

R 10,000

R 12,000

R 14,000

R 16,000

R 18,000

0-1

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75+

Aer

age

Cos

t in

Ran

dsTotalHighMedium-olderMedium-youngerLow

Average Cost of PMBs by Age

Centre forActuarial Research

Centre forActuarial Research

R 0

R 1,000

R 2,000

R 3,000

R 4,000

R 5,000

R 6,000

0-1

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75+

TotalHighMedium-olderMedium-youngerLow

Raw PMB Price by Age and Cluster (pbpa)

Centre forActuarial Research

Centre forActuarial Research

Chronic Disease List Package

Centre forActuarial Research

Age of Exposed Beneficiaries

0%

2%

4%

6%

8%

10%

12%

14%

0

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

Prop

ortio

n of

ben

efic

iarie

s

Centre forActuarial Research

Centre forActuarial Research

Age of Claiming Beneficiaries

0%

2%

4%

6%

8%

10%

12%

14%

0-1

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

Prop

ortio

n of

Cla

imin

g B

enef

icia

ries

Centre forActuarial Research

CDL Prevalence by Age

0

100

200

300

400

500

6000-

1

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

All

ages

Prev

alen

ce p

er 1

000

bene

ficia

ries

Centre forActuarial Research

Average Cost of CDL by Age

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

5,0000

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

All

Age

s

Ave

rage

Cos

t per

cas

e pa

Centre forActuarial Research

Raw Price of CDL by Age

0

250

500

750

1,000

1,250

1,500

1,750

2,000

2,250

2,500

0

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

All

Age

s

Pric

e pe

r ben

efic

iary

pa

Centre forActuarial Research

Age Profile by Cluster

0%

2%

4%

6%

8%

10%

12%

14%

0

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

Prop

ortio

n of

ben

efic

iarie

s

Total High Additional

Low Medium-older Medium-younger

Centre forActuarial Research

Centre forActuarial Research

Prevalence by Cluster

0

100

200

300

400

500

600

700

0

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

Prev

alen

ce p

er 1

000

bene

ficia

ries

High and Medium High Medium-older Medium-younger

Centre forActuarial Research

Prevalence by Cluster

Centre forActuarial Research

0

100

200

300

400

500

600

7000

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

Prev

alen

ce p

er 1

000

bene

ficia

ries

Total High and Medium Additional Low

Centre forActuarial Research

Average Cost by Cluster

Centre forActuarial Research

0

1,000

2,000

3,000

4,000

5,000

6,000

0

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

Aver

age

Cos

t per

cas

e pa

Total High Medium-older

Medium-younger Additional Low

Centre forActuarial Research

Raw Price by Age and Cluster

0

500

1,000

1,500

2,000

2,500

3,000

0

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

Pric

e pe

r ben

efic

iary

pa

Total High Medium-older

Medium-younger Additional Low

Centre forActuarial Research

Raw Price High vs. Low Cluster

Centre forActuarial Research

0

500

1,000

1,500

2,000

2,500

3,000

0

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

Pric

e pe

r ben

efic

iary

pa

Total High Low

Centre forActuarial Research

Complete PMB Package

Centre forActuarial Research

Price of PMB Package by Age

0

2,000

4,000

6,000

8,000

10,000

12,000

0

1-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

Mis

sing

All

ages

Pric

e pb

pa

Total CDL package

Total Outpatient package

Total Inpatient package

Complete PMB packagePublic sector