What is Sympany doing to counter rising health costs?
The rise in health costs is relentless. We know that many policyholders are finding it increasingly difficult to pay their premiums. Sympany is working hard to counter the rise in health costs and premiums by joining forces with industry association santésuisse and other partners.
We use strict invoice verification procedures to identify invoicing errors. This saves several million Swiss francs per year.
Invoice verification prevents unjustified payments, thereby making an important contribution to curbing rising costs. Industry association santésuisse estimates that this verification process carried out by health insurance companies yields savings of nearly 5% on premiums for policyholders. This amounts to somewhere between CHF 2,000 and 3,000 per policyholder each year.
The charges applied in the healthcare system are the result of regular collective bargaining between health insurance companies and the service providers such as doctors and hospitals. In its negotiations with the service providers, Sympany is committed to ensuring that services are provided efficiently and that charges and prices for treatments represent value for money.
tarifsuisse ag often conducts tariff negotiations on behalf of numerous health insurers to ensure that the interests of premium payers are fairly represented. Our industry association santésuisse is also involved in the policy for fair tariffs, flat rates and medication prices to avoid misguided incentives being created within the healthcare system while maintaining the high quality of healthcare provided in Switzerland.
Premiums must always cover the costs of medical treatment. Insurance companies are also required by law to build up reserves so that they can respond to unexpectedly high benefit costs. If the reserves exceed the minimum amount required by the Federal Office of Public Health, Sympany reduces them: reduction of reserves.
Surpluses arise if the cost of medical treatment ends up being lower than anticipated when setting premiums. Sympany no longer plans to repay surpluses in basic insurance. Instead, Sympany wants to take advantage of the voluntary reduction of reserves. Sympany will continue to pay back surpluses in supplementary insurance if possible.
As a fair health insurer, Sympany believes in the importance of offering affordable premiums. As a result, Sympany is taking advantage of a voluntary reduction of reserves. This enables us to give unnecessary reserves back to our basic insurance customers. You receive a monthly compensation amount which is indicated on the premium invoice and is deducted from the premium.
All of Sympany's alternative insurance models offer affordable and professional primary care. Insured persons receive medical advice or treatment at one of the contact points, which vary depending on the model. These so-called managed care models contribute to cost savings. This means that policyholders receive discounts on their premiums within these models.
Sympany strives to be a fair and reliable insurance partner for its customers when they fall ill. That’s why we ensure that additional health-related activities are within a defined framework. For example, Sympany supports its customers by contributing to preventive measures, such as vaccinations, check-ups and courses or activities in keeping with the principles of getting fit (recognised health-promoting courses such as smoking cessation, back training, nutritional advice) and staying fit (gyms, sports clubs, sports associations).
Sympany sets great store by keeping its administrative costs low. In recent years, the company has succeeded in becoming even more operationally efficient by introducing innovations such as automated processing and new IT systems. The march of digitalisation is also bringing efficiency improvements and helping to save on paper and postage costs, among other things.
Partners and associations (e.g. RVK, santésuisse and tarifsuisse) handle some core administrative tasks centrally for many health insurance providers (e.g. tariff negotiations, invoice verification, insurance medical advisory services), meaning that health insurers don’t all have to enter into negotiations or introduce technical solutions individually.
It’s now possible to automate many tasks that would have previously been completed manually. This saves time and reduces the risk of mistakes being made. We’ve been busy interconnecting many of our systems. For example, when a policyholder changes their address on mySympany, it is automatically updated in our database and new policy documents are sent out. Invoices and receipts are usually processed automatically upon submission, triggering reimbursements. Invoices are now exchanged with service providers (medical practices and hospitals) digitally as far as possible.