Partnerships are healthcare’s new currency
By Dr Wayne Riback, Chief Medical Officer at Medshield Medical Scheme
12 October 2026
This time of year is synonymous with medical scheme announcements, as schemes unveil contribution increases and benefit options for the year ahead. It is a key moment in the healthcare calendar, as schemes balance rising costs and evolving member needs with the imperative to keep cover of quality affordable and sustainable.
Yet beyond the annual focus on contributions and benefits, a more fundamental shift is underway. Partnerships are increasingly shaping how healthcare is delivered, expanding access and creating value for members.
South Africa’s medical schemes face rising healthcare costs, increased use of specialised healthcare resources, a growing burden of chronic disease, increasing mental health needs and rapid advances in medical technology.
No single organisation can provide every element of an effective healthcare journey. For years, the funding model was largely linear: schemes funded care, doctors provided treatment, hospitals delivered acute services, and pharmacies dispensed medicines. Each had a defined role.
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Collaboration has become key
Members now expect something more connected: affordability, convenience and accessibility, as well as better outcomes and a healthcare experience that follows them throughout their journey, rather than forcing them to navigate fragmented services.
That expectation is reshaping collaboration across the industry. Alongside its 2027 benefit options, Medshield Medical Scheme is placing greater emphasis on partnerships tailored to members' needs and to points in the care journey, as well as moving to value-based care and paying for services based on improved health outcomes.
These include 4 exciting and innovative managed care products being launched for scheme members, come 1st January 2027: primary care-led mental health services via Clicks, hospital-at-home care with Mediclinic, and access to innovative oncology treatment and primary care-led integrated chronic care management via Medscheme. These partnerships extend beyond individual services. They raise a broader strategic question: how can schemes integrate expertise, infrastructure, clinical capability and technology to make care more accessible, coordinated and effective?
Across healthcare, collaboration among funders, providers, retailers, managed care organisations and technology platforms is increasingly important for improving member value.
Many decisions that shape health outcomes are made long before a patient enters hospital or consults a specialist. Working with retailers, pharmacies, providers and technology platforms can help schemes engage members earlier and integrate prevention, diagnosis, treatment and ongoing care.
Mental healthcare and acute care are good examples
Mental health needs continue to strain healthcare systems, yet accessibility, affordability and stigma can prevent people from seeking help early. Bringing support closer to where people live can reduce barriers and make earlier intervention more practical. The value goes beyond the service itself: it creates a more accessible entry point and potentially a more connected care journey.
The same principle is reshaping acute care. Hospitalisation has traditionally been the default response to many acute conditions. Advances in remote monitoring, digital health and coordinated clinical care now make it possible, in selected cases, to deliver hospital-level care safely outside a traditional hospital setting.
Hospital care is also changing
The Mediclinic hospital-at-home model exemplifies this shift. Where clinically appropriate, patients can receive hospital-level care at home. Beyond cost, they may recover in familiar surroundings, stay closer to support networks and avoid some risks associated with hospitalisation.
But hospital-at-home only works when its different parts work together. It requires coordination among the funder, clinicians, hospitals, technology providers and the patient. Without integration, it risks becoming another isolated service rather than a genuinely different model of care.
Oncology presents a distinct challenge. Cancer treatment is becoming increasingly sophisticated, and new therapies can place significant pressure on healthcare funding. The task is to expand access to appropriate treatment while safeguarding the long-term sustainability on which all members depend.
This requires collaboration among medical schemes, managed care organisations, healthcare providers and other stakeholders, underpinned by robust clinical governance and evidence-based decision-making.
The same principle applies to chronic disease. Diabetes, hypertension and cardiovascular disease require sustained rather than episodic management. A model in which members engage with healthcare only when something goes wrong is neither clinically ideal nor financially sustainable. The Integrated Chronic Care Program and Network provides prevention, monitoring, early intervention and ongoing support, ultimately resulting in improved outcomes as relates to management of chronic disease both for individuals as well as overall population health.
Partnerships across primary care, specialist services, disease management and digital health can integrate these elements. The objective is not simply to manage claims more efficiently, but to help members manage their health more effectively and stay healthier for longer.
A fundamental shift in how healthcare value is measured
Traditionally, much of healthcare has measured activity: consultations, admissions, procedures and treatments. Increasingly, more meaningful questions focus on outcomes and the member’s experience of care.
Is a person with diabetes managing the condition effectively? Is someone with hypertension receiving support to prevent complications? Is a cancer patient receiving appropriate treatment at the right time? Can someone experiencing mental health difficulties access support before reaching a crisis point? No single organisation can answer these questions alone. They require collaboration across the healthcare ecosystem.
That is why partnerships should be more than commercial arrangements, marketing initiatives or loyalty programmes. Their value should be judged by whether they improve access, coordination, outcomes and the sustainability of care.
As schemes face financial pressures, shifting disease patterns, technological disruption and sophisticated member expectations, the ability to build and manage effective healthcare ecosystems will become increasingly important.
Retailer networks, digital health platforms, provider partnerships, chronic care programmes, mental health services, oncology networks and home-based care may look different, but they share the same idea: healthcare works better when its parts work together around the member. Annual benefit announcements will continue to matter. Contributions will continue to matter. Benefit design will continue to matter.
But increasingly, so will the ability to bring the right partners together to deliver what no single organisation could deliver alone. That is where the next generation of healthcare value can be created, with the member at the centre and, ultimately, as the beneficiary.
FIN (Word count 989)
EDITORS’ NOTE:
On 28 September 2026, Medshield Medical Scheme announced its 2027 benefit options and contributions, delivering a low 7.9% weighted average contribution increase, with 125 603 lives experiencing increases of just 6% to 7.9%. As one of South Africa’s most financially stable, open medical schemes, Medshield mapped its existing benefits against members’ needs to identify strengths and gaps, reviewed the competitive landscape, and considered the role of modern technology in delivering greater value and access. The Medshield 2027 offering is about more than benefits and contributions. It brings together sustainable benefit design, enhanced benefits, improved service and strategic collaborations to deliver greater value and support across every stage of the healthcare journey. Visit https://medshield.co.za/2027-products/2027-benefit-options/ for all the details on the 2027 Medshield benefit options across Medshield’s 8 plans designed around different people, different stages of life and different needs.
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