Renal Disease and Organ Transplant Management Programme

Renal disease and Organ Transplantation are two of the most costly areas of healthcare.

The MHS renal disease and organ transplant management programme is primarily aimed at providing comprehensive management of all aspects of the renal failure and organ transplant patients’ treatment regimes in order to optimise clinical, financial and quality of life outcomes. This is done through a number of clinical management processes

The MHS management programme makes provision for chronic medical management through the authorisation of appropriate treatment plans as well as in some instances the authorisation of surgical management.

Treatment plans are initially assessed and approved and thereafter reviewed on an annual basis. If necessary these treatment plans are updated or declined according to the member's current health status and as discussed with the member’s treating service provider.

Post-transplant medical management of immunosuppressive medication is integral to the management of the high costs related to organ transplants.

The design of the MHS renal disease and organ transplant programme differs in some aspects to other disease management programmes due to the fact that most of the intervention is related to the management of costs through the process of authorisation of treatment plans.

An analysis is performed on hospital authorisation and claims data and MHS establishes such norms through utilisation of the MHS Hospital Profiling software and systems and through the application of appropriate clinical expertise from the clinical management team.
  • Enrolment of members onto the programme by review of requests and authorisation of treatment plans of members applying for dialysis and the following organ transplant types: