Integrated chronic care actively reducing the burden of chronic disease

Source: Reuters.

“In Medscheme’s client population we see that over 60% of claims are attributable to chronic illness. “This information presents us with the perfect opportunity to engage more personally and directly with our members to encourage actionable behaviour change," says Ayesha Kriel, head of disease and medicine management from AfroCentric.

"We support our members through a combination of engagements by means of various platforms, helping them to navigate their health through various life stages – from being well and needing access to preventative screening and care, to being diagnosed with a chronic condition, to requiring hospitalisation and beyond. We support and care for our members during all these stages by guiding them to appropriate pathways of care."

Healthcare costs are expected to increase exponentially as the prevalence of chronic illnesses continues to rise, placing a significant strain on the country's already overburdened healthcare system.

“There has been an urgent need to up-end and innovate alternatives to traditional healthcare models as we continue to press towards a more accessible and affordable healthcare system,” adds Kriel.

Managing healthcare costs

AfroCentric’s integrated chronic care programme achieves just that; to stem the tide of rising chronic care costs and to help our members to manage their chronic illnesses more effectively, improving their quality of life and reducing unnecessary co-payments wherever possible.

"Our chronic care programme is supported by strong clinical policy makers, advanced analytical health models and top quality hospital and provider networks which we have created to ensure that our members are only serviced by the best providers and facilities in healthcare.

“With a more holistic view of our members we can ensure that AfroCentric’s subsidiaries, provider networks and partners are leveraged in the most effective and efficient way possible. This ultimately benefits the patient, making chronic disease management more accessible and sustainable,” Kriel adds.

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“We manage people, not diseases,” says Kriel. “We have to do everything we can to address the chronic disease burden because the truth is that we have a responsibility to help those individuals live much longer, healthier lives by removing all barriers to care and providing them with the tools to make better, healthier choices.”

Since prevention is better than cure, the group also leverages its digital wellness mobile platform to support members on a journey to adopting healthier lifestyles through diet, exercise, smoking, alcohol and environment related education and prompts – reducing the risk of chronic illnesses.

Data-informed decisions

The AfroCentric group has also incorporated its pharmaceutical division to provide direct access to affordable generics, courier services as well as discounted prices and fees. “Part of the burden of chronic illnesses lies in the cost and availability of chronic medication. We streamline that process for our members in a way that helps them focus on managing their condition.”

With data generated at every point in the care process, Kriel says that AfroCentric can make data-informed decisions to inform care programmes.

“Care through all stages of life is a top priority, but the cost of healthcare has been continuously burdened by siloed structures of care. We know that this integrated chronic care model which brings together all our value adding capabilities will not only reduce the burden of chronic disease, but also play a meaningful role in our members’ lives across the entire care continuum – we will support you when you are healthy, are showing signs of developing a chronic condition, have been diagnosed with a chronic condition and beyond," concludes Kriel.

Easing the burden of chronic disease is one of Afrocentric’s value adding Care initiatives and complements other interventions such as Wellness, Virtual Care, Cancer Care, Cardiac Care, HIV Care and Diabetes Care.