Partnerships
for sustainable healthcare
Tshiamo Health partners with organisations to implement value-based healthcare, guiding the shift from volume-driven fee for service models to outcome-focused care that matters to patients, clinicians and funders. We support the redesign of care pathways, outcomes measurement and reimbursement models to create sustainable, system‑wide value.
The Sustainability Crisis in Private Healthcare
South Africa's private healthcare system is at a critical juncture. Medical scheme membership has declined from 16% of the population in 2000 to 14.7% in 2023, while claims costs per beneficiary continue to rise at rates far exceeding inflation. At current growth trajectories, claims costs will triple within a decade—a trajectory that is structurally unsustainable.
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The root causes are multifaceted: an aging beneficiary population, rising prevalence of non-communicable diseases, fee-for-service reimbursement that incentivizes volume over outcomes, and inefficiencies including service duplication, fraud, and waste.
Annual Cost Increase
9.8%
Open schemes
Membership Decline
16% → 14.7%
2000 to 2023
Cost Projection
300%
In one decade
Value-Based Care: A Sustainable Path Forward
Value-based care represents a fundamental shift in how healthcare is delivered and financed. Rather than paying for each service provided, value-based models reimburse providers for the quality of outcomes achieved at appropriate cost.
For Patients
Improved outcomes, better care coordination, and attention to the wider determinants of health.
For Providers
Predictable revenue streams, reduced administrative burden, and focus on delivering excellent care.
For Funders
Sustainable cost growth, improved member experience, and competitive differentiation.