Fintech firm uses analytics to offer affordable palliative care

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Shivani Ranchod, co-founder and director at Alignd.
Shivani Ranchod, co-founder and director at Alignd.

Newly launched fintech health start-up Alignd uses real-time data analytics to bring alternative and affordable palliative care to the South African market.

Alignd works in collaboration with medical schemes to provide financial solutions to palliative patients, improving the quality of life for patients with serious or life-threatening diseases such as cancer.

The company uses a series of algorithms to identify patients who meet the clinical criteria for its palliative care programme, and offers the necessary financial assistance and healthcare to address the patient as a whole, not just their disease.

The medical care offered aims to help treat, as early as possible, the symptoms and side effects of the disease and related psychological, social and spiritual problems, according to the company.

Alignd is the brainchild of three South African women: Dr Linda Holding, a palliative-trained doctor with 20 years of clinical risk management experience; Victoria Barr, a healthcare economist and senior director at FTI Consulting; and Shivani Ranchod, a healthcare actuary and academic.

The current focus of end-of-life care for palliative patients is mostly in a hospital setting, making it hugely expensive to manage the patient's medical costs in the final stages of their life. Alignd says it offers end-to-end financing solutions for the optimal care of complex cases, aligning the incentives of all stakeholders (patients, finance providers and schemes) to deliver patient-centred, value-based healthcare.

"In current medical scheme approaches, healthcare costs in the last year of life are more than three times higher than in the second-last year. This ramping up of cost represents the huge efforts to stave off death; efforts that are often invasive and non-beneficial," explains Ranchod, who is also the director of Alignd.

"Using a combination of innovation, data analytics and a desire to bring the patient's life to the fore, we believe we have a model that benefits all stakeholders and incentivises them to collaborate for the greater comfort of the patient and their wellbeing."

The solution is sold to medical schemes or health insurers, and not directly to patients. The medical schemes pay Alignd a small fee per patient registered on its programme.

In order to identify patients in need, Alignd uses a combination of diagnosis codes, based on clinical "flags" in medical scheme claims data. These codes identify the patients' medical condition and the medication they are on.

Current medical aid models for end-of-life care will pay for costly in-hospital care but will not pay for home-based care, notes Alignd. Under its programme, patients can receive palliative care in a hospital, an outpatient clinic, a long-term care facility or at home.

The fee is used to help the patient navigate access to their palliative benefits, including connecting them to a network of palliative care teams.

"We have developed a new way of paying for care by designing the contracts between funders and providers of care to enable co-ordinated care in a fragmented system. We help build trust between funders of healthcare and those on the frontline delivering care, enabling co-ordinated care and teamwork in a fragmented system," adds Ranchod.

In SA, metastasised cancer absorbs a disproportionately high percentage of funding from medical aids. The most recent estimates indicate 8% of scheme expenditure is in the last year of life; a staggering R11.6 billion in 2017 alone, says Alignd.

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