Rising costs, fraud push Africa healthcare to digital shift

 

Biometric verification and digital health platforms are helping insurers across Africa curb fraud and rising medical costs, as traditional models come under pressure.

Rising medical costs and rampant fraud are forcing insurers and corporate medical schemes in Africa to turn to digital health platforms to sustain financing and keep schemes afloat.

 Industry experts warn that traditional models are becoming unsustainable as fraud continues to drain resources and unchecked hospital billing drives up costs.

Companies are struggling to manage medical scheme expenditure, with some reporting year‑on‑year double‑digit growth in claims.

Across sub‑Saharan Africa, medical inflation is outpacing general inflation, with fraudulent billing and collusion between providers and claimants estimated to account for as much as 20 to 30 per cent of healthcare expenditure.

This has left insurers under pressure to sustain schemes without passing unsustainable costs to workers.

Health underwriters across the continent are now investing in technology to verify claims, curb abuse, and improve efficiency in service delivery.

Organisations are also seeking solutions that offer transparency in billing and guarantee value for the contributions made on behalf of staff.

Technology providers have stepped in with tools ranging from biometric‑controlled access cards to mobile apps and analytics platforms designed to reduce waste and improve patient experiences.

One of the firms leading this shift is Smart Applications International, which has built a digital health ecosystem spanning 12 African countries.

The company, founded in 2003, works with more than 9,000 health facilities and serves over 1.6 million users.

“Our clients have reported between 25 and 40 per cent savings on their medical scheme expenditure within the first year of using the Smart system,” said Esther Muiruri, Group Marketing Director, adding, “This demonstrates not only the value we deliver but also the commitment to transforming the healthcare industry.”

Smart started with MediSmart, a biometric‑controlled card system that helped reduce fraud, and has since expanded to the Smart Access app, which has been downloaded more than 500,000 times.

 It has also rolled out SmartHealth+, a hospital management system, and Smart Analytics, a data platform for insurers and employers.

 “We are deeply honoured to receive recognition as a Superbrand,” said Executive Director Mary‑Ann Musangi.

“This accolade affirms the strength of our brand and the trust we have earned in the market,” she added.