Medical Scheme Performance Evaluation Criteria Training

Learning Outcomes

• Analyze the key financial and operational criteria affecting medical scheme performance.
• Evaluate the impact of risk management and solvency requirements on scheme sustainability.
• Apply regulatory frameworks to assess the administration and governance of medical schemes.
• Interpret performance indicators to identify areas for improvement in scheme operations.
• Demonstrate the ability to compile a performance evaluation report based on objective criteria.

Target Audience

This course is designed for medical scheme administrators, healthcare fund managers, and professionals involved in the oversight or management of medical schemes. It is also suitable for auditors, consultants, and regulatory compliance officers in the healthcare financing sector.

Prerequisites

None — open enrollment. However, a basic understanding of healthcare financing or medical scheme operations is recommended.

Course Outline

Practicals

Overview

Practical sessions involve hands-on analysis of real medical scheme data, including financial statements, operational metrics, and clinical indicators. Learners will compute ratios, interpret results, and draft evaluation reports using industry templates.

Practical Activities

• Financial Ratio Calculation and Interpretation — Using actual medical scheme financial data, learners calculate solvency ratios, claims ratios, and non-healthcare expenditure percentages, then interpret the results in terms of scheme sustainability. (6h)
• Operational Efficiency Data Analysis — Learners analyse claims processing turnaround times, complaint resolution rates, and member satisfaction scores, and benchmark these against industry standards. (6h)
• Clinical Quality Indicator Assessment — Using chronic disease management data, learners evaluate hospitalisation rates, readmission rates, and preventive care uptake, and propose quality improvement interventions. (6h)
• Comprehensive Performance Evaluation Report — Learners integrate financial, operational, clinical, and governance data to draft a full performance evaluation report for a hypothetical medical scheme, including recommendations. (6h)

Summatives

Each delegate is assessed continuously throughout the course via daily exercises, scored practical assignments, and a final summative test at the end.

Practical Assignments — 30%

Practical assignments are observed and scored against a rubric during the practical sessions. Each delegate's practical mark is averaged into a single 100% score and contributes 30% to the final total.

Daily Exercises — 20%

Every training day ends with a multiple-choice exercise scored out of 100%. The scores from each daily exercise are averaged across the duration of the course to produce a Daily Average mark, which contributes 20% to the final total.

Final Test — 50%

On the last day a final summative test is written. It is a multiple-choice paper with multiple-answer questions: each question may have more than one correct option, and a single wrong selection on a question marks the entire question wrong — no partial credit. The final test is scored out of 100% and contributes 50% to the overall mark.

Final Total

Component	Out of	Weight
Practical Assignments (rubric-scored)	100%	30%
Daily Average (multiple choice)	100%	20%
Final Test (multi-answer multiple choice)	100%	50%
Final Total	—	100%

All marks are recorded on the AATICD LMS and visible to each learner under their account.

Certificate

How it works

• Certificates are auto-generated on the AATICD LMS as soon as the marks pass the 50% threshold.
• Each certificate is a branded PDF with the delegate's name, the course title, the unit standard ID, NQF level, credits, and the date of issue.
• You can download or print your certificate from your LMS dashboard at any time after issue — there's no reissue fee and no expiry date.
• If you scored under 50% you can sit the final test again at the next scheduled session at no extra cost.

Where to find it

Sign in to the LMS, open your dashboard, and your certificates appear under My Certificates. Each entry has a View / Download button and a print option.

Training Discounts

Group discounts apply automatically — the more delegates you enrol, the greater the saving. Discounts are calculated at 3% per 5 delegates, scaling up to 40% off for 100+ delegates.

Delegates	Discount
5	3% off
10	6% off
15	9% off
20	12% off
25	15% off
30	18% off
50	30% off
75	35% off
100	40% off

3% discount per 5 delegates, up to 40% off for 100+ delegates. Contact us for a custom group quote.