An Introduction to the South African Oncology Consortium (SAOC) - A Value Proposition to the South African Healthcare Funder Industry

Coordination of prescribing patterns in a provider network through agreed treatment guidelines: Low/Mid/High
True peer-to-peer review of all providers based on treatment guidelines
Facilitation of accreditation of oncology facilities
Working toward innovative billing models

The SAOC is a registered Managed Care Organisation in accordance with the criteria set by the Council for Medical Schemes.

The SAOC seeks to co-ordinate the prescribing patterns of the Private Oncology sector within tiered treatment guidelines and acts as a peer-to-peer and utilisation review body.

It unites oncologists with the common goal of cost-efficient appropriate treatment delivery whilst ensuring delivery of appropriate quality care and sustainability of the specialty of oncology in South Africa.

It seeks to facilitate the provision of appropriate treatment to all patients diagnosed with cancer, allowing incorporation of patients on lower benefit options into the private sector. To make this possible, a tiered oncology treatment guideline structure was developed in which treatments have been tailored to accommodate the financial constraints of the patient's healthcare benefits.

Three tiers are available:

Tier 1 - Equivalent of Prescribed Minimum Benefits (PMB)
Tier 2 - Standard of Care
Tier 3 - Referral Tier (peer review)

Low cost benefit options / schemes will be accommodated within a treatment guideline structure at least equivalent to that which is generally available in state hospitals and in line with internationally accepted norms and standards of care.

All additional benefits of treatment in the private sector including all psychosocial support remain unchanged irrespective of the member benefits or tier of treatment. Similarly, zero waiting times to treatment and reliable drug delivery are afforded to all patients.

All treatment guidelines were developed in accordance with evidence based medicine utilising the highest possible levels of evidence. The guidelines were developed through participation and consensus amongst members of the network of participating doctors. All guidelines reflect a unique set of reference treatment codes for ease of management. All treatment guidelines are available to contracted Funders and oncologists in the spirit of transparency.

The SAOC network of participating doctors has a nationwide footprint with its current membership of 140 oncologists. The SAOC is represented in every oncology centre in South Africa.

The Utilisation Review Committee (URC) elected from within the network, is tasked with all functions relating to peer review, updating and maintenance of the tiered treatment guidelines and ongoing administrative duties relating to pricing and coding processes.

The Information Technology Committee (ITC) oversees a project to collate comprehensive oncology treatment data for purposes of practice/provider profiling and for developing a program for measuring patient outcomes. This is achieved by the installation of proprietary software in each member practice that links up to a central database.

Whilst treatment guidelines for the delivery of chemotherapy and radiation therapy form the backbone of the program, strictly applied participation criteria for SAOC members ensure that the standard of care compares with the best available internationally.

In addition to the technical requirements outlined, all practices are required to have within the practice (or have an established referral system to) either appropriately qualified or experienced psychologists or social workers to deliver the necessary psychosocial support to both patients and families.

The SAOC seeks to be inclusive - however membership is subject to compliance with strict eligibility criteria and subsequent accreditation of facilities.

The SAOC believes that private healthcare in South Africa is only sustainable through active and efficient working relationships between care providers, healthcare funders and patients.