Latest news with #HFA
Medscape
09-06-2025
- Health
- Medscape
Two-Step Approach Cuts HFpEF Diagnostic Complexity
Assessing left atrial volume and natriuretic peptides (LA/NP) can identify heart failure with preserved ejection fraction (HFpEF) with an 88% specificity and 97% positive predictive value. The strategy reduces the need for additional diagnostics by decreasing intermediate Heart Failure Association pre-test assessment, echocardiography & natriuretic peptide, functional testing, final etiology (HFA-PEFF) or H₂FPEF (Heavy, two or more hypertensive drugs, atrial fibrillation, pulmonary hypertension, elder age > 60 years, elevated filling pressures) algorithm scores by 27%-56%. METHODOLOGY: Researchers developed the diagnostic approach to rule in HFpEF using LA indexed for height 2 (LAViH 2 ; cut-off above 35.5 mL/m 2 in sinus rhythm or above 38.6 mL/m 2 in atrial fibrillation) and natriuretic peptides (as per the HFA-PEFF major criterion) with data from 443 patients with suspected HFpEF and validated in two independent cohorts. (LAViH ; cut-off above 35.5 mL/m in sinus rhythm or above 38.6 mL/m in atrial fibrillation) and natriuretic peptides (as per the HFA-PEFF major criterion) with data from 443 patients with suspected HFpEF and validated in two independent cohorts. End-systolic LA was manually traced in echocardiographic apical four- and two-chamber views and indexed for both body surface area and height 2 , with height 2 -indexed values showing better diagnostic performance in patients with obesity. , with height -indexed values showing better diagnostic performance in patients with obesity. Researchers developed the simplified approach by determining abnormal values for each measure of LA based on the highest value in control individuals, stratified by sinus rhythm/atrial fibrillation, and using elevated natriuretic peptides based on the HFA-PEFF major criterion. TAKEAWAY: The LA/NP approach identified 60% of HFpEF patients with an 88% specificity and a 97% positive predictive value in the derivation cohort, with similar results in the validation cohorts (76%-80% specificity, 92%-97% positive predictive value). The validation cohorts confirmed the LA/NP approach, with a 21%-57% reduction in intermediate scores, demonstrating consistent diagnostic accuracy across different clinical HFpEF profiles. Replacing LAViH2 with LA reservoir strain showed comparable results, suggesting flexibility in the echocardiographic parameters that can be used in this simplified diagnostic approach. IN PRACTICE: 'Using the LA/NP approach as a first step in patients suspected for HfpEF before using the HFA-PEFF or H 2 FPEF algorithm as a second step may substantially reduce the need for additional diagnostics to diagnose HfpEF,' the researchers wrote. SOURCE: The study was led by Jerremy Weerts, MSc, MD, of Maastricht University Medical Center in Maastricht, the Netherlands. It was published online in European Journal of Heart Failure and presented at the Heart Failure Association of the European Society of Cardiology (HFA-ESC) 2025 meeting. LIMITATIONS: The analyses were performed retrospectively in three independent, prospective cohorts from university hospitals, each with a high prevalence of diagnosed HFpEF, which may affect the performance of the LA/NP approach in less selected populations. The use of different natriuretic peptide assays across cohorts limited the derivation of new cut-off values for the LA/NP approach. Right heart catheterization was not performed in all patients, although this reflects daily clinical practice and aligns with large clinical trials in HFpEF. DISCLOSURES: Weerts reported receiving grants from Corvia Medical, CSL Vifor, and Boehringer Ingelheim, unrelated to the submitted work. The study was supported by the Dutch Heart Foundation (grant numbers CVON2017-21-SHE PREDICTS HF and CVON2015-10-Early HFpEF) and the Health Foundation Limburg. Additional disclosures are noted in the original article.
The Herald
07-06-2025
- Health
- The Herald
NHI is fiscally impossible, says the Health Funders Association
The Health Funders Association (HFA) has described the National Health Insurance (NHI) Act as fiscally impossible and has tabled a hybrid funding model that will enable private healthcare providers to provide services in tandem with the NHI. The HFA, accounting for 46% of the private healthcare market and representing 21 medical schemes and three administrators, this week became the latest entity to legally challenge the NHI for undermining the right of medical aid members to choose how to access health services. HFA commissioned an independent study released this week which found the NHI required substantial tax far beyond South Africa's fiscal capacity. 'What's more, the proposed model offers no guarantee of improved outcomes, while restricting the mechanisms that currently drive quality and innovation in health care,' said the FHA. Commenting on the report, HFA CEO Thoneshan Naidoo said South Africa needs a healthcare system that delivers equitable, quality care for all. 'However, in its current form, and without private sector collaboration, the NHI Act is fiscally impossible and operationally unworkable, and threatens the stability of the economy and health system affecting everyone in South Africa,' he said. Naidoo said the NHI Act centralises control of all healthcare financing in a single, state-run fund, removing the ability of medical schemes to offer cover for healthcare services reimbursable by the NHI. 'We continue to advocate for a more inclusive, hybrid funding model that incorporates medical schemes in NHI. We believe such a model would expand access to care while protecting the rights of all South Africans,' said Naidoo. The NHI, which introduces universal health coverage, has been challenged in court by Solidarity, the Board of Healthcare Funders, the South African Private Practitioners Forum, the Hospital Association of South Africa and the South African Medical Association. Foster Mohale, the health spokesperson, on Friday confirmed the department had received court papers. 'This is case number six. We have an evolving court process and we'll allow that process to take its course,' said Mohale. FHA commissioned a report by Genesis Analytics, which showed that personal income tax will need to increase from the current average rate of 21% to an average of 46% of income, pushing marginal tax rates in the lowest income bracket from 18% to 41%, and in the highest bracket from 45% to 68%. The Genesis model also considered a scenario of pooling existing healthcare expenditure, citing that personal income tax would need to increase from its average of 21% to 31%. At the same time, medical scheme members would face a 43% reduction in the level of healthcare services relative to what they currently received. 'In simple terms, the equation for medical scheme members therefore becomes 'Pay 1.5 times more tax for 43% less healthcare'. Such tax increases are fiscally impossible, particularly given South Africa's narrow personal income tax base of 7.4-million tax payers,' said the FHA. TimesLIVE
TimesLIVE
06-06-2025
- Health
- TimesLIVE
NHI is fiscally impossible, says the Health Funders Association
The Health Funders Association (HFA) has described the National Health Insurance (NHI) Act as fiscally impossible and has tabled a hybrid funding model that will enable private healthcare providers to provide services in tandem with the NHI. The HFA, accounting for 46% of the private healthcare market and representing 21 medical schemes and three administrators, this week became the latest entity to legally challenge the NHI for undermining the right of medical aid members to choose how to access health services. HFA commissioned an independent study released this week which found the NHI required substantial tax far beyond South Africa's fiscal capacity. 'What's more, the proposed model offers no guarantee of improved outcomes, while restricting the mechanisms that currently drive quality and innovation in health care,' said the FHA. Commenting on the report, HFA CEO Thoneshan Naidoo said South Africa needs a healthcare system that delivers equitable, quality care for all. 'However, in its current form, and without private sector collaboration, the NHI Act is fiscally impossible and operationally unworkable, and threatens the stability of the economy and health system affecting everyone in South Africa,' he said. Naidoo said the NHI Act centralises control of all healthcare financing in a single, state-run fund, removing the ability of medical schemes to offer cover for healthcare services reimbursable by the NHI. 'We continue to advocate for a more inclusive, hybrid funding model that incorporates medical schemes in NHI. We believe such a model would expand access to care while protecting the rights of all South Africans,' said Naidoo. The NHI, which introduces universal health coverage, has been challenged in court by Solidarity, the Board of Healthcare Funders, the South African Private Practitioners Forum, the Hospital Association of South Africa and the South African Medical Association. Foster Mohale, the health spokesperson, on Friday confirmed the department had received court papers. 'This is case number six. We have an evolving court process and we'll allow that process to take its course,' said Mohale. FHA commissioned a report by Genesis Analytics, which showed that personal income tax will need to increase from the current average rate of 21% to an average of 46% of income, pushing marginal tax rates in the lowest income bracket from 18% to 41%, and in the highest bracket from 45% to 68%. The Genesis model also considered a scenario of pooling existing healthcare expenditure, citing that personal income tax would need to increase from its average of 21% to 31%. At the same time, medical scheme members would face a 43% reduction in the level of healthcare services relative to what they currently received. 'In simple terms, the equation for medical scheme members therefore becomes 'Pay 1.5 times more tax for 43% less healthcare'. Such tax increases are fiscally impossible, particularly given South Africa's narrow personal income tax base of 7.4-million tax payers,' said the FHA.
eNCA
06-06-2025
- Health
- eNCA
Health Funders Association challenges NHI Act over cost and constitutionality
JOHANNESBURG – The Health Funders Association (HFA) is mounting a legal challenge against key aspects of the newly signed National Health Insurance (NHI) Act, citing serious constitutional and economic concerns. HFA CEO Thoneshan Naidoo says while the organisation supports the goal of universal healthcare, the current NHI framework is fundamentally flawed. 'The debate around national health insurance has been ongoing for years,' said Naidoo. 'Unfortunately, despite consistently raising our concerns, we've now been forced to take legal action.' The HFA commissioned an independent expert to assess the economic impact of implementing the NHI as it currently stands. The findings are stark: For South Africa to provide the same level of care promised under the NHI -- equivalent to what private medical schemes currently offer -- it would require the country's 7.4 million taxpayers to double their current tax contributions , a cost Naidoo says is simply unaffordable. In addition to the financial strain, Naidoo highlighted a massive shortfall in human resources. 'To provide the same level of care across the population, we would need an additional 286,000 healthcare professionals, which the country currently does not have,' he added. Naidoo maintains the Act, in its current form, is economically unsustainable and constitutionally questionable, and does not align with the realities of South Africa's healthcare infrastructure. The legal challenge is expected to intensify debate around the future of healthcare reform in the country.
The Citizen
06-06-2025
- Health
- The Citizen
Experts warn NHI is economic suicide
Lower earners could face marginal tax rates of 41%, sparking concern that NHI funding will punish the most vulnerable. Research just released by the Health Funders Association (HFA) is the most-stark warning yet that the ANC's push to implement the National Health Insurance (NHI) is not only doomed to failure, it is going to drag down our economy with it. The HFA commissioned Genesis Analytics – an independent economic consultancy with experience in over 115 countries – to build a financial and economic model to test the viability of NHI and to compare the system with those in similar, middle-income countries. The analysis was that, for NHI to fund a level of care equivalent to what medical scheme members now receive, personal income tax would have to increase by 2.2 times (a 115% increase in tax) from the current average rate of 21% to an average of 46% of income. This would push marginal tax rates in the lowest income bracket from 18% to 41% and in the highest bracket from 45% to 68%. ALSO READ: Health funders also heading to court about NHI Act HFA estimated that were VAT used, it would have to increase from 15% to 36%. Even a hybrid public-private system would require personal income tax to increase by 47%. HFA is going to court to fight the proposals – and they aren't the only ones. This is simply financial madness. NOW READ: Health minister defends nearly R10 million legal spend on NHI court battles
