Preventative care is therefore critical to managing emergency and specialised healthcare costs, and this has become a key focus for Medshield Medical Scheme. “The challenge is not simply to reduce healthcare costs, but to reduce unnecessary costs,” says Dr Wayne Riback, chief medical officer at Medshield Medical Scheme. However, responsibility for improvement is shared between schemes, healthcare professionals and members. Dr Riback identifies three critical outcome areas relating to the use of emergency care: survival following timely emergency intervention; unplanned returns to emergency facilities; and the patient’s reported experience and recovery. More efficient emergency healthcare does not mean denying or rationing necessary treatment.