PMB Out-of-Hospital Procedures
A strategic framework for fixed fee sedation services in day theatres and practitioner rooms — reducing costs for funders while ensuring sustainable remuneration for practitioners.
Strategic Intent
This initiative outlines the introduction of a structured fixed fee model for Procedural Sedation Analgesia (PSA) services in South Africa. The core objective is to incentivise appropriately selected procedures to be performed in alternative settings — such as day theatres and practitioner rooms — rather than in high-cost acute hospital theatres.
By aligning remuneration with site-of-service efficiency, the model seeks to:
- Reduce overall procedural costs to funders
- Support sustainable income for sedation practitioners
- Enable referring doctors to operate in lower-cost environments
- Improve access to safe, high-quality sedation services
Background: Procedural Sedation Analgesia (PSA)
Procedural Sedation Analgesia (PSA) refers to the administration of sedative and/or analgesic agents to facilitate diagnostic or therapeutic procedures while maintaining cardiorespiratory stability and patient safety.
PSA has evolved globally as a safe and effective alternative to general anaesthesia. When delivered by trained practitioners, PSA enables:
- Shorter recovery times
- Reduced facility utilisation
- Lower infrastructure costs
- High patient satisfaction
Proposed Remuneration
Minimum R1,500 per 30-minute procedure with up to 200% more payment depending on procedure type.
The Opportunity
The opportunity lies in aligning incentives to promote safe migration toward alternative sites of service — reducing costs for medical schemes while maintaining clinical excellence.
The Role of SOSPOSA
The South African Society of Sedation Practitioners of South Africa (SOSPOSA) serves as a professional body representing trained sedation practitioners and promoting best practice standards in PSA delivery.
The organisation plays a pivotal role in:
- Establishing clinical practice guidelines
- Promoting standardised sedation protocols
- Supporting practitioner education and governance programmes
- Engaging with regulatory and funding stakeholders
Rationale for a Fixed Fee Structure
Site-of-Service Migration
Encourages procedural migration away from high-cost acute theatres to day facilities.
Financial Alignment for Funders
Reduces facility overhead, lowers total procedural claims, improves scheme sustainability.
Income Stability for Practitioners
Revenue predictability, reduced administrative disputes, faster billing cycles.
Strengthening Referral Networks
Transparent patient quotations, improved scheduling flexibility.
Eligible Day Procedures
The following procedures can be safely performed under procedural sedation in day theatres or practitioner rooms:
Strategic Outcome
The introduction of a fixed fee PSA model achieves:
- Cost containment for funders
- Sustainable remuneration for sedation practitioners
- Operational flexibility for proceduralists
- Improved patient access to affordable care
Register Your Interest
We need 80 qualified sedation practitioners to finalise preferred provider agreements with major medical schemes.
Yes, I Am Interested