The surge in chronic disease prevalence (in conditions like diabetes, hypertension and hypercholesterolaemia) in South Africa is significantly increasing costs and impacting outcomes for members across all medical schemes. We provide specialised programmes to help members and their doctors actively manage and navigate care for specific conditions.

In the Discovery KidneyCare Programme, a dedicated Discovery Health team works with a patient’s doctor to manage the condition and aims to:

• Ensure joint participation by patients, doctors and dialysis care providers to improve quality of care
• Measure and report on the comprehensive management of the patient to institute improvement of care programmes
• Provide educational material to patients
• Improve the quality of life for patients on chronic dialysis
• Reduce additional costs incurred through repeat hospital admissions and avoidable complications in care.

The DiabetesCare Programme helps members and their doctor actively manage the condition based on established clinical and lifestyle guidelines. This includes a suite of tools to monitor and manage treatment, and ensure members can access high-quality coordinated care to stay healthy over time. In addition to the standard treatment basket of procedures and consultations available to members, an annual consultation with a dietician and biokineticist ensures members have access to the best advice about diet and exercise, tailored to their needs.

Discovery Health’s launched a specialised clinical management organisation in 2020 to take over administration of a cohort of diabetic patients from the Centre for Diabetes and Endocrinology. The clinical management organisation aims to significantly improve chronic disease clinical outcomes and healthcare costs, and is founded on fully integrated and unique approach to managing chronic disease. This includes multi-disciplinary care teams, disease-specific condition management and coaching, and a unique shared value model to align providers with evidence-based clinical protocols and desired patient outcomes.

The clinical management organisation currently coordinates and manages delivery of diabetes and cardiometabolic care for over 12 000 Discovery Health Medical Scheme members.

Over the past few years, we have been actively engaging with a number of specialist societies to collaborate on care delivery initiatives. The CADCare project is one of these, where Discovery Health is running a coronary artery disease care delivery project in collaboration with the South African Society of Cardiovascular Intervention. The project aims to demonstrate that a partnership with joint learning and data sharing can improve healthcare quality and cost outcomes for patients diagnosed with coronary artery disease syndrome.