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EF: Can you elaborate on the impact of AfroCentric on the healthcare market in South Africa?

AB: AfroCentric Group is the most diversified healthcare company in South Africa. Our diversified service model allows us to unlock value while transforming healthcare. We leverage the unique assets and scale of the group as well as best practice analytics to achieve superior operating excellence linked with modern, simple service tools. Following an acquisitive phase, we have embarked on a new mission to integrate our operations and optimise costs across the value chain to offer a seamless end-to-end service, while leveraging the power of technology to transform client service. This integrated strategy promotes value-enhancing coordination between members, schemes and providers; and improves access, quality and affordability of care for long-term sustainability.
AfroCentric is all about innovation and over the past few years, we have been focused on innovating a new integrated model of sustainable healthcare that measurably improves access to quality healthcare. Coupled with that was our recent brand refresh, which has seen our biggest subsidiary, Medscheme, evolve beyond its core administrative services, providing an enhanced member experience through its Smart Solutions. As a technological and increasingly data-driven company, Medscheme is using one of our biggest assets – data – to offer a personalised healthcare experience focusing on both curative and preventative interventions.

How then, does this impact the healthcare market in South Africa? The South African market has been stuck in a costly and outdated service model. People have always focused on seeing a doctor first which may be an overkill in some cases. We are building toward a virtual HMO model which appropriately triages the level of care.  In a nutshell, a medium through which maximum care is offered at the right time, in the right setting and right cost. This can be offered on virtual and mobile platforms as well.

In a country where 50 million people are not covered by private insurance and where a large proportion of the population is in outlying rural areas, appropriate virtual triaging of services can bring cost-effective care to those that need it most. A virtual mobile-enabled service model can allow for anyone to have a consult with a nurse or then be triaged by a doctor depending on the requirements. This can make a meaningful difference in truly achieving universal healthcare at a lower cost point. Chronic medicine policy, formularies and other tools are a form of triage in themselves; ensuring that members are treated with the first line of drugs before moving on to more costly drugs. Which bears more weight in the cost-effectiveness perspective since you can diagnose, and prescribe to patients virtually or through a mobile phone, and get served at the local pharmacy. This caters to the infrastructure challenges observed in rural South Africa.

Sanlam, who has taken a 28.7% stake within our business and is the largest scale financial services organization in Africa is a key partner in our ability to expand both our offerings by close collaboration., We also look at how life insurance and dread disease can be underwritten more effectively based on the knowledge of somebody's health status, or how the pathology results can influence and impact underwriting rules for our partners.

We're looking at how we can help our people save and receive the best care at a subsidized cost. Hospital systems have been the drivers of our healthcare system and the reality is that if we want to provide a healthy healthcare system that's not commercialized, then the future has to be derived from outside of the four walls of the hospital system. We launched our virtual care in 2020. It is a phone call teleconsulting either on voice or on video with a nurse. It is a massive step forward given that people are settling into the new norm of hybrid and working from home models. Human behaviour has changed where we are all a lot more comfortable having conversations virtually. We have therefore invested in digital solutions to facilitate virtual care access. This comes in handy to care for patients in ways that are convenient, and coordinated and that enable multidisciplinary teams to collaborate through technology. This dissolves the myth of a lack of healthcare services.

According to research, patients recover faster at home, surrounded by their loved ones, resulting in better or improved clinical outcomes, patient experience, lower mortality, and complication rates as well as low costs. This is a relief to most patients since they’re not susceptible to secondary infections that might be sustained in hospitals. ‘At home’, also offers a getaway from overburdened healthcare systems. Home nursing and hospital at home concepts were launched in 2021 and have grown by 11.7% since 2020. Results show that 63% of a case cost can be saved by treating somebody in a home-based care setting.
For cases that have a combination of in-hospital treatment and home-based care is a saving of 27%. We're focusing a lot of our energy and effort on cost efficiency.
The readmissions, in a 30-day readmission rate, for case types of home-based care, are 74% lower when cases are treated in the home-based care environment as well to traditional in hospital. There’s a big behaviour change. All this burdens the cost dynamic in the country, reaffirming our focus on it.  

One of the areas we are doing further research on is trying to understand why in excess of 70% of all births, and childbirths, are through a caesarian section in South Africa. Our agenda is to educate pregnant women about the benefits of natural birth and C-Section.
The youth (ages 15 to 24) spearhead this C-Section curve with a notable 62% of all births on our medical schemes. According to global research, young women prefer the C-Section, a move inspired by psychological reasons such as fear of pain. Our obligation is to inform the woman about their options for delivery. It has also well known that a C-Section is relatively expensive compared to normal delivery by double, increasing financial strain on the healthcare scheme.

EF: What is your perspective on the level of awareness of mental health in South Africa?

AB: Mental health as an issue escalated with COVID-19 because of the psychosocial impact of everything that we had to endure. These are intensified issues that can't be seen by the naked eye. There is a need for medical professionals, funders, and all stakeholders involved and aware of the supportive needs of the varied effects and symptoms that patients experienced during and following the pandemic. We need to act now.

As an organization, we are developing mobile screening tools in order to achieve early detection signs. We have created a concept of a health score (similar in concept to a credit score) which supervises your BMI, blood pressure, and stress levels from the face, picking trends that show symptoms of stress or mental challenges so they can be attended to. In this realm, a virtual consultation on mental disease is a lot more effective because it's random. Pre-COVID, there was an awareness of it in the workplace, where there's an inclusion of an employee value proposition called emotional assistance programs. However, we are not where we need to be, but from an awareness perspective, we are better than a lot of emerging market countries.

June 2022
South Africa