HFA now offers Trustee Training through a series of online lectures, enabling trustees and other professionals working within the medical schemes industry to learn at their own pace and at a time that suits their schedules.
Module 1 provides a comprehensive introduction to the medical schemes environment. It covers key data and insights on the size of the industry, patterns of expenditure, and governance structures, equipping new trustees with the foundational knowledge needed to carry out their responsibilities effectively.
Module 2 explores the financial soundness of medical schemes in greater depth. Topics include scheme income and expenditure, regulatory oversight, capital requirements, and the criteria used to assess financial sustainability. The lecture also examines recent medical scheme failures and the lessons arising from them.
Module 3 explores Prescribed Minimum Benefits (PMBs), which sit at the heart of medical scheme regulation — yet they remain one of the most misunderstood and operationally complex aspects of benefit design. In this Trustee Training module, we unpack the building blocks of PMBs, from diagnosis and treatment pairs and the Chronic Disease List, to the definition of a PMB emergency condition and the rules governing payment. We also explore the strategic risk management implications for schemes, common areas of dispute, and the practical challenges trustees must navigate in balancing regulatory compliance with financial sustainability. This session equips trustees with the clarity and confidence needed to exercise informed oversight in an area that directly affects members, providers and the long-term stability of their scheme.
Module 4 focuses on Managed Care, a key area at the intersection of cost control, quality of care, and responsible benefit management. This session unpacks the core concepts trustees need to fulfil their governance responsibilities, including value-based healthcare and the risk management processes underpinning medical schemes. It also explores how managed care works in practice, from contracting to regulatory standards, and how to assess its return on investment. By the end, trustees will have a clear understanding of how managed care supports scheme sustainability while ensuring members receive appropriate, high-quality care.
Upcoming lecture recordings will cover:
- The role and responsibilities of trustees
- Benefit design
- National Health Insurance (NHI) and universal healthcare
- Fraud, waste, abuse and errors (FWA)
Useful resources:
