Comprehensive Managed Care Services

Optimising Health and Wellness Outcomes

Welcome to Universal Care

We are a proud subsidiary of Universal Healthcare, a dynamic healthcare services group that is transforming the industry. As an unconditionally accredited managed care organisation, Universal Care has established itself as a pre-eminent provider of care management services for nearly two decades.

With a comprehensive and fully integrated portfolio of services, we set a new benchmark in care management. Our brand promise is to deliver evidence-based, cost-effective quality care that optimises health outcomes for each person. We combine business intelligence with excellence in healthcare management to meet the unique needs of every medical scheme and its members.

Background and Experience

Universal Care remains at the forefront of managed care principles in South Africa, establishing itself in the early 1990s. As a privately-owned company contracted to provide hospital utilisation management and other managed care services to medical scheme clients and employer groups, we have been leading the way in care management. Today, we perform care management services for open and restricted medical schemes. Our comprehensive portfolio includes individualised and carefully designed services, such as disease management and provider network management, tailored to the specific needs of our clients.

Extensive Range of Accredited Services

Universal Care boasts one of the most extensive ranges of managed care services accredited by the Council for Medical Schemes (CMS). With an extensive suite of care management services covering all categories of managed care, we provide a fully integrated managed care offering that aligns with the ideal model. Our services include:

    • Hospital Benefit Management Services
    • Pharmacy Benefit Management Services
    • Active Disease Risk Management Services
    • Disease Risk Management Support Services
    • Dental Benefit Management Services
    • Managed Care Network Management Services and Risk Management
    • Health Care Services (Risk Transfer)

Personalised Approach to Managed Care

We take a personalised approach to managed care, ensuring that each intervention is based on each person’s specific medical situation. This approach guarantees access to clinically appropriate care while closely managing and containing costs for the client. We are passionate about delivering value-based healthcare to members and beneficiaries of our Medical Aid Scheme clients and employer groups. Our goal is to achieve positive healthcare outcomes and derive both the best quality and cost-effectiveness for all beneficiaries.

Experience the Universal Care difference as we optimise health outcomes through comprehensive managed care services. Trust us to provide evidence-based, cost-effective solutions that prioritise well-being and enhance the sustainability of our clients.

Empowering World-Class Healthcare Solutions

Our core strengths lie in providing access to world-class healthcare solutions and driving the improvement of human health and wellness. We achieve this through our unique offering and expertise.

Our Unique Offering:

  • Personalised medicine approach
  • Comprehensive suite of managed care services
  • Innovative holistic solutions
  • Unconditional accreditation

Our Expertise:

  • Staff with exceptional institutional expertise
  • Stable management structure and workforce
  • Respected reputation and proven track record
  • Agile team adept at critical reasoning and making paradigm shifts

What Sets Us Apart

We differentiate ourselves through our unique approach to healthcare management. By personally managing each individual holistically applying detailed oversight to healthcare events and incidents, and utilising evidence-based funding decisions guided by international best practices, we ensure the best outcomes for patients and schemes. We actively track protocol adherence and measure healthcare outcomes across all managed care services.

By paying attention to every aspect of the healthcare delivery chain, Universal Care offers unparalleled healthcare funding solutions to medical schemes, employer groups, and providers. Our commitment to excellence and innovation drives us to continually raise the bar and consistently deliver positive health outcomes.

Our industry experience equips us with foresights that allow us to consider scenarios and solutions for universal healthcare coverage as proposed by the National Health Insurance (NHI). Through early identification and review of potential changes to our industry, we build innovations to ensure a sustainable future for our clients.

Experience the Universal Care difference and unlock the potential of world-class healthcare solutions. Trust us to be your partner in driving the improvement of human health and wellness, delivering exceptional care for every individual, client and scheme we serve.

Driving Integrated Value-Based Healthcare: Our Strategic Focus

We are driven by a commitment to integrated value-based healthcare that embraces industry changes and embodies a personalised patient-centric, approach. We constantly strive for service excellence at every touchpoint in the healthcare journey, staying at the forefront of healthcare innovation curve.

Value is unlocked as we prioritise cost efficiencies, demonstrate the impact on contributions, and conduct thorough costing assessments to optimise healthcare management.

We are committed to driving integrated value-based healthcare and ensuring cost efficiencies that benefit both our schemes and patients. By actively intervening with providers, demonstrating the value of our interventions, and conducting comprehensive health technology assessments, we deliver measurable cost savings and contribute to the containment of contribution increases.

Trust us to continuously innovate and optimise healthcare management, putting the needs of members, schemes and employer groups at the centre of our strategic drivers.

Clinical Committee and Member Information: Empowering Informed Healthcare

At Universal Care, we prioritise informed healthcare decisions and effective member communication. Our multi-disciplinary Clinical Committee includes medical practitioners, pharmacists, and nurses with access to a panel of specialised consultants for expert advice. Regular meetings ensure that the Committee remains current on clinical protocols and funding decisions that ensure that evidence-based decision-making and optimal healthcare management remain at the core of our operations. Additionally, our Medicine Formulary Committee ensures comprehensive oversight of medication formularies.

Member information and patient education programs include clear and helpful member communication contributing to successful managed care services. Our patient-centric approach includes providing information and educational materials through various channels (telephonic, email, post, website, SMS, and mobile applications). We also cater to members’ preferred language, utilising 11 of the 12 official South African languages for improved understanding.

At Universal Care we value the importance of an informed approach to healthcare. Our Clinical Committee and Medicine Formulary Committee drive evidence-based decision-making, while our member information and patient education programs empower individuals with the knowledge they need for better health outcomes. Through effective communication channels and tailored materials, we strive to ensure members understand their options, manage chronic illnesses, and embrace wellness and preventive care.

Experience the difference of an informed healthcare journey with where client empowerment is at the heart of our services.

Contact Us

Experience the difference of our collaborative approach to healthcare delivery, where partnerships and a focus on quality drive excellence and improved health outcomes.
Contact Number:  +27 (0)11 208 1000
Email Address:  [email protected]
Email Address:  [email protected]
Contact Number:  +27 (0)86 011 9553
Email Address:  [email protected]
Contact Number:  +27 (0)86 011 1900
Email Address:  [email protected]