Medical schemes
Your scheme members are at the centre of our programme.
We partner with you to manage the full spectrum of care for your HIV-positive scheme members, while working to mitigate your financial risk and providing strategic guidance for business sustainability through cost efficiencies and cost savings.
We provide easy access to all aspects of HIV management, helping ensure good health to HIV-positive members through a seamless member experience, from testing and treatment to medicine delivery. Our group business models deliver on pricing that is tough for competitors to beat.
Ensuring good health to HIV-positive members
In 2016 the World Health Organisation and UNAIDS set the 90/90/90 targets in respect of HIV to be reached by 2020. The reason for these three targets – testing, treatment and viral suppression – was to ensure that the HIV epidemic would not continue to outrun the global response.
The three 90s are:
- 90% aware of their HIV status, of which
- 90% on HIV treatment, of which
- 90% virally suppressed
The new targets beyond 2020 are 95/95/95 to be reached by 2030.
TESTING
A large percentage of new HIV infections are transmitted by people who don’t know they have the virus. For people with undiagnosed HIV, testing is the first step in maintaining a healthy life and preventing HIV transmission. For those who test positive, the earlier the diagnosis, the sooner they can start antiretroviral treatment, and the better the long-term clinical prognosis.
ANTIRETROVIRAL TREATMENT (ART)
The aim of ART is to reduce viral load in the blood thereby improving health and reducing transmissibility of the virus from one person to another. Studies have shown that patients who start on ART soon after infection are less likely to experience treatment failure or develop HIV drug resistance. Put simply, the earlier ART is started after infection, the longer ART remains effective and the better the long-term health prospects for the patient.
VIRAL SUPRESSION
Viral suppression in a patient leads to a decrease in the incidence of opportunistic infections and a significant improvement in overall health. Critically, when viral suppression reaches the level of being undetectable in the blood, it means the patient can no longer pass HIV on to another person. Undetectable = Untransmissable.
Where reaching the 90/90/90 targets has proved challenging globally, AfA has been able to exceed the last two:
- 97% of those registered on AfA are on ART, of which
- 91,3% are virally suppressed
While AfA does not provide HIV testing directly, we partner with organisations who do. We have access to our sister company for provision of wellness screening services.
MITIGATING FINANCIAL RISK AND ENSURING SUSTAINABILITY FOR A MEDICAL SCHEME
As a medical scheme, you want to mitigate financial risk and facilitate sustainability through cost efficiencies and cost savings. Financial risk is mitigated in the first instance by driving widespread screening to ensure that those beneficiaries who are HIV positive can be identified and registered on the AfA programme.
Once registered, the financial risk is primarily mitigated through good clinical outcomes. Viral suppression leads to a decrease in the incidence of opportunistic infections which in turn leads to fewer cases requiring expensive hospitalisation.
AfA is also able to manage a scheme’s medicine expenditure by partnering with Pharmacy Direct and Scriptpharm to drive generic substitution where appropriate.
Enhancing your members’ experience by providing easy access to all aspects of HIV management
A good member experience is critical to any medical scheme’s ability to attract and retain members. AfA’s programme has been designed to put your scheme’s member at the centre of our efforts.
- Registration onto the programme is easy.
- Your members have access to an inbound call centre for general query management.
- Our inbound and outbound call centres are staffed by trained counsellors who assist your members with advice on lifestyle, how to take treatment and understanding other aspects of HIV care such as pathology tests. Our counsellors also offer support with emotional challenges such as dealing with a new diagnosis, sex after an HIV diagnosis, dealing with stigma and any obstacles that may stand in the way of adhering to treatment.
- A ‘Please call me’ facility means your members can send an SMS and request a call back.
- Clear treatment plans are sent to both scheme members and their treating doctors and your members receive a follow-up call to make sure the treatment plan is understood.
- Confidentiality is 100% assured, giving your scheme member peace of mind.
- Your members are sent SMS reminders when they are due for pathology tests, making it easier for them to manage their time.
- AfA’s website has a dedicated ‘beneficiary’ section which allows scheme members to privately search for information related to prevention, lifestyle, managing their condition and much more.
- AfA’s track record in achieving outstanding clinical outcomes for scheme members on our programme gives them peace of mind that their health is in the hands of experts they can trust.
Unmatched value
AfA leverages off the capabilities of other AfroCentric Group companies to deliver solutions which result in significant cost savings to schemes and enhances your beneficiaries’ experience.
Wellness Odyssey is our AfroCentric partner for providing wellness screening, peer education and awareness. All our systems and processes are integrated and designed to deliver optimal impact across the full continuum of prevention, care and treatment. In the past, AfA provided HIV counselling and testing (HCT) as a stand-alone service. As the landscape has shifted, so has the approach to HIV screening. Due to stigma, uptake of HCT is always higher when it is not offered as a stand-alone service but rather as part of a broader set of wellness screening services. Furthermore, this broader approach to wellness in general is supported by the fact that HIV is now considered a chronic condition along with others like diabetes and hypertension. Managing all these chronic conditions under one umbrella is essential for holistic patient management.
Pharmacy Direct (PD) is an AfroCentric partner for providing medicines. PD is a courier pharmacy distributing more than 900 000 prescriptions every month; 150 000 to patients in the private market and almost 750 000 HIV prescriptions to patients receiving medication on the Centralised Chronic Medicines Dispensing and Distribution (CCMDD) Programme, managed for the National Department of Health.
- PD offers clients access to needed pharmaceutical products in a caring, convenient, accessible, and cost-saving manner through:
- A specialist team of pharmacists who provide patient care and ensure patients receive the correct medication, and consistently on time.
- Ensuring that the prescribed medication is conveniently delivered every 28 days.
- Ensuring that there is no address that PD cannot deliver to.
- Significant cost savings can be yielded to a scheme by appointing PD as the pharmacy DSP for medicines authorised by AfA. PD’s integration with AfA drives increased generic utilisation and optimises formulary adherence. Patients have access to a wallet-free (no out-of-pocket payments) experience on Prescribed Minimum Benefit (PMB) conditions. This integration can achieve significant savings in medicine costs, dispensing fees and HIV management fees.
Scriptpharm is another of our Afrocentric partner companies. It is involved in medicine distribution and is a national pharmacy network comprising over 2 000 community pharmacies operating throughout SA.
Give your members the best in HIV management that delivers for you too.