HSM on Exchange: Field Report from South Africa

Tarika MansukhaniToday Ross Beerman, Managing Director and co-Founder of AllLife sat down with an intimate circle of students in the library at the University of Cape Town Graduate School of Business to talk about the company he started in 2004. While the name and even font in the logo suggests that AllLife is an old and traditional insurance company, it is really an innovative business model providing affordable life coverage for individuals living with HIV in South Africa. Over 10% of South Africans are HIV+, and most managed care companies immediately shy away from this group. Ross explains that the messaging around HIV in South Africa is generally “HIV = Aids = death = Use a condom.” While this certainly drives prevention, it does nothing to promote positive behavior in HIV+ patients who feel their life is over, a feeling affirmed when you can’t access insurance.

Ross’ team approached this problem by disregarding the age old insurance mantra that past behaviors drive those in future. They simply set out to change behavior, by changing the message HIV+ patients hear. While the average managed care company considers 75% adherence a success, AllLife now boasts 98% adherence rate for their lives under coverage. AllLife uses a system driven approach to create a high-touch, low cost model. They link to existing electrical medical record (EMR) systems in South Africa, and in doing so successfully track all their lives and use and strict monitor and reminder process to motivate their customers. When a patient is non-adherent they are immediately made aware of negative consequences to their policy, making it a very transparent and informative system that keeps patients involved. Ross explained that cost of healthcare is rarely an issue, as customers can access free healthcare in South Africa, and medical aid will cover the basic tests or treatments AllLife requires. They don’t use highly skilled staff, just data, IT and a system driven approach to create high-touch interaction with customers in an affordable manner. Ross says that people often think it’s about an emerging markets story of success because it’s South Africa, but he insists it’s a solution taking advantage of available first world technology.

I found this is particularly interesting, since I wasn’t aware that South Africa’s EMR system was that far advanced, especially given the host of trouble we’re having implementing it Stateside. Ross explained that they have similar issues here, and challenges with EMR platforms being compatible across hospital systems, but AllLife’s software serves as the technological link between all of them (there’s hope after all!). This makes it possible to track patient behavior everywhere, and also what makes them so uniquely able to provide their solutions at a low cost, something absolutely necessary in emerging markets. While the story of launch and success is more involved, Ross offers a great example of leveraging existing strengths in resource poor developing countries as a solution. He even mentioned they’ve recently begun coverage for patients with diabetes and will shortly begin pilot programs to test success of coverage. Certainly any success in improving patient adherence in this area could be a valuable lesson exportable not just to other developing countries, but back home as well.

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