Because a forward-thinking, patient-centric medical scheme partnered with Alignd, a 74-year-old man with metastatic cancer received the care and support he wanted right from diagnosis until he died peacefully in his own bed.
Morally sound design. High quality care. Cost effective. Three phrases every medical scheme wants to hear. And that’s how we’ve developed Alignd.Palliative.
Most people want to die at home, but in the South African private healthcare sector they are more likely to die in an intensive care or high care unit, frequently receiving aggressive, invasive and non-beneficial care. The consequence for funders is the high cost of care at the end-of-life. It’s estimated that the medical scheme industry will spend more than R20 billion this year on patients in the last year of life.
Alignd.Palliative is a palliative care product that offers medical schemes an easy-to-implement, comprehensive palliative care benefit for their members. The medical schemes who have already partnered with Alignd.Palliative are able to provide meaningful palliative care from the moment of diagnosis of advanced stage or metastatic cancer.
The end result is a win-win-win: for patients, who feel more empowered and better supported without enormous out-of-pocket expenses; for healthcare providers, who feel respected for the specialist palliative care they provide and are fairly compensated; and for funders, who have been able to give their members additional cover when they need it most, while saving money.
Alan Langley’s* story is a powerful example of Alignd.Palliative in action…
Meet Alan
Alan was 74 when he was diagnosed with stage 4 metastatic colon cancer which had spread to his lungs, liver and peritoneum. His family, who were everything to him, were shocked to the core at how quickly the cancer was spreading.
When no further chemotherapy was planned, Alan requested palliative care. Because his medical scheme was an Alignd partner, he was able to access the Alignd.Palliative benefit – at no extra cost – which offers so much more than a two-week end-of-life benefit**. With a performance status/ score of 2 (significantly decreased mobility), and symptoms such as abdominal swelling (recurrent ascites), severe nausea, pain, fatigue, and depression, Alignd put a palliative care team together for Alan and his family, who were very distressed.
The medical scheme approved home-based palliative care on 7 September, and a pigtail drain was inserted for abdominal ascites on the same day. Alan was looked after at home by an Alignd palliative care trained network doctor and registered nurse, who could assist with the drain.
As part of the Alignd. Palliative initial benefit, he had completed his advance care plan with his palliative care doctor, in which he made it clear he wanted to be at home, with his family.
Without an indwelling pigtail catheter, patients typically require admission to hospital for the drainage of their ascites under ultrasound guidance, once or twice a week. This cost is about R7,000 per admission. Alan was able to avoid these uncomfortable trips to the hospital five times, and his medical scheme was spared the expense of covering R35,000.
In comfort
As Alan entered the terminal phase a few weeks later, when typically, a patient is admitted to hospital for pain control and other symptom management, his doctors and family members knew he didn’t want to be in hospital. As part of the Alignd.Palliative initial benefit, he had completed his advance care plan with his palliative care doctor, in which he made it clear he wanted to be at home, with his family.
Alan’s palliative care doctor set up a subcutaneous syringe driver that included morphine and other meds to keep him comfortable, and home-based nursing was increased to 24 hours a day.
He died about 48 hours later, and the family’s social worker arrived shortly after to provide them with the emotional and practical support they so needed at this time.
Alan’s palliative care doctor said he died peacefully. “It was wonderful that we were able to activate a palliative care plan for Alan. He died peacefully at home, as he wanted, on a syringe driver. And his family were exceedingly grateful.”
Good to know
Alignd is currently partnered with Fedhealth and Bonitas medical schemes. To contract with us or find out more, email info@alignd.co.za. To become part of the Alignd.Palliative network of palliative care doctors and practitioners you can find out more here.
If you think palliative care might be something to consider for yourself or a loved one, or if you have struggled with access to palliative care, please also be in touch with us at info@alignd.co.za.
*names have been changed
**current Prescribed Minimum Benefit requirement for palliative care, which is expected to be expanded in the medium term
