South African healthtech startup Alignd has secured new funding from E Squared Investments, marking a significant step in its mission to transform private healthcare. The women-led company, founded to counter the inefficiencies of the “fee-for-service” model, will use the fresh capital to broaden its focus beyond palliative care into maternity and kidney disease. While the investment amount remains undisclosed, the deal highlights growing momentum for value-based healthcare in emerging markets.
Challenging the Fee-for-Service System
South Africa’s private healthcare market has long been dominated by the pay-per-procedure approach, where providers are reimbursed for the number of interventions rather than outcomes. Critics argue that this model drives unnecessary treatments, increasing costs without improving patient well-being. Alignd positions itself as a challenger, offering a system where payments are tied to results, aligning financial incentives with patient health and sustainability.
Proven Results in Palliative Care
Alignd began by addressing the costly sector of end-of-life care, which places an estimated R20 billion annual burden on medical schemes. Its network of over 300 providers delivers home-based, person-centred care designed to reduce unnecessary hospitalisation. Results show a one-third reduction in non-beneficial interventions such as late-stage chemotherapy, while two-thirds of patients die at home or in hospice rather than in hospital.
Partnerships with Medical Schemes
The company’s approach has already attracted major partners in South Africa’s healthcare system. Agreements with GEMS, Fedhealth, and Bonitas extend Alignd’s services to 2.9 million beneficiaries, creating both scale and impact. For funders, the model translates into measurable cost savings, while families experience reduced financial and emotional stress during critical health periods.
Expansion into New Sectors
Backed by E Squared, Alignd is now moving into two new verticals: maternity care and kidney disease. Both are high-cost areas with fragmented service delivery, making them ripe for disruption through value-based principles. The expansion aims to replicate the successes achieved in palliative care, delivering better outcomes while easing the burden on South Africa’s strained healthcare system.
Strengthening Leadership
The investment also reinforces Alignd’s leadership capacity. Sharon Dlomo, an Allan Gray Fellow and former investment professional at 3 Capital Ventures, has joined the company to lead strategic finance. Dlomo emphasised Alignd’s ability to balance the needs of patients, providers, and funders, calling it a model for building sustainable healthcare systems.
Investor Perspective
E Squared described the deal as part of its broader commitment to combining economic value creation with social impact. “Alignd exemplifies what it means to create economic value and social impact in equal measure,” said Chief Portfolio Officer Tshilidzi Matlala. Announced during South Africa’s Women’s Month, the investment underscores E Squared’s long-term strategy to support women-led businesses in high-impact sectors.
A Model with Global Relevance
Although its current operations remain focused on South Africa, Alignd sees its model as adaptable to other emerging markets facing similar cost and care challenges. Countries with fragmented health systems and rising chronic disease burdens could benefit from value-based approaches that prioritise patient outcomes. For Alignd, the next phase of growth is both a national opportunity and a potential template for global reform.
Alignd’s latest funding round represents more than capital injection—it reflects a shift in how healthcare can be financed and delivered. By expanding into new verticals and reinforcing its leadership, the startup is positioning itself as a pioneer in South Africa’s transition away from fee-for-service models. With the support of E Squared, Alignd aims to prove that value-based healthcare can lower costs, improve outcomes, and deliver impact at scale.