Welcome to Metropolitan Health
Metropolitan Health, part of the Health solutions business is a subsidiary of Momentum Metropolitan Holdings with a key strategic focus to support the achievement of financial wellness for public sector communities by enabling and delivering sustainable, integrated outcomes-based healthcare solutions.
We leverage the strength of our solutions and our economies of scale to deliver high quality administration and esteemed managed care capabilities which are proven to deliver improved health outcomes.
GEMS is the largest restricted membership medical scheme in South Africa with just over 2 million beneficiaries and more than 750 000 principal members. GEMS was established via a cabinet mandate and tasked with the provision of healthcare cover for public service employees. Their mandate is to ensure that there is adequate provisioning of healthcare coverage for public service employees that is efficient, cost effective and equitable, and to provide further options for those who wish to purchase more extensive cover.
Metropolitan Health has been an integral part of GEMS’ growth and has played a pivotal role since its inception. All these efforts were to a very large extent buoyed and underpinned by GEMS’ impeccable governance and management structures, as well as a well-oiled ecosystem that has been fostered with other service providers to the Scheme. Metropolitan Health has been at the helm of GEMS’ administration since the start and continues to be the hub that is seamlessly integrated into the service provider systems and offerings.
GEMS, in their quest to provide the blueprint for NHI, has been able to demonstrate scale, claims processing ability, above average customer experience and, most importantly, a delivery mechanism that is backed by an ecosystem of service providers, with Metropolitan Health being the hub of this integrated hub-and-spoke administration model.
Our client value proposition is underpinned by an insights-driven approach and unrelenting focus on continuous improvement that enables us to identify improvement opportunities to ensure we deliver solutions that realise and maintain exceptional financial performance across the entire value chain. We provide a ‘cradle to grave’ scope of support aligned with our core purpose of delivering cost savings for our clients which is done by leveraging analytics, behavioural insights, and design thinking to identify, create and deliver solutions that capture value for schemes/employers and their members.