Venture capital firm Knife Capital has invested in Cape Town‑based health‑tech startup Alignd through its Knife Fund III, aiming to scale the company’s outcome‑based financing model beyond palliative care.

The size of the investment was not disclosed, but the capital will support Alignd’s rollout of coordinated maternity and chronic kidney disease programmes.

Founded in 2018, Alignd designs payment arrangements that link compensation to patient outcomes rather than the volume of procedures performed.

The model challenges South Africa’s fee‑for‑service system, which reimburses providers for each consultation or treatment regardless of long‑term health impact.

Alignd works directly with medical schemes, creating programmes that align the financial interests of insurers, providers and patients while curbing unnecessary spending.

Its first large‑scale test was a home‑based palliative‑care network of more than 500 providers, which the company says generated roughly R600 million in savings for participating schemes.

The palliative programme now covers over 3.3 million beneficiaries across seven schemes, reduced end‑of‑life chemotherapy by 33 % and saw two‑thirds of patients die at home or in hospice.

CEO Dr Lungi Nyathi says the success provides a commercial foundation for expanding the model into other high‑cost areas where fragmented care drives rising insurer expenses.

Knife Capital partner Catherine Young highlighted the women‑founded team’s proven ability to improve outcomes and lower costs, describing the investment as a strategic addition to the firm’s health‑tech portfolio.

The funding arrives as African health systems face pressure to contain costs while expanding access, positioning Alignd’s model as a potential scalable solution for insurers seeking efficiency without compromising care.