Main Article Content
Abstract
Purpose: To develop a strategic framework that enhances service innovation within South African medical schemes by examining micro- and macro-level factors influencing innovation capacity and competitiveness, addressing the need for accessible and affordable healthcare.
Research Design and Methodology: A literature review guided by Willie’s Service Innovation Enabler (WSIE) framework was conducted, drawing on peer-reviewed articles, policy documents, and case studies relevant to South Africa’s healthcare system, focusing on digital transformation and regulatory trends.
Findings and Discussion: Key enablers included leadership support, favorable regulation, and scheme size. Smaller schemes leveraged technologies like telemedicine effectively. COVID-19 accelerated digital adoption, though regulatory complexity and organizational resistance often impeded innovation efforts.
Implications: Leadership-driven innovation strategies, supported by digital tools, are essential for improving service delivery. Supportive policy environments and further research are needed to assess long-term impacts on patient outcomes while addressing internal barriers to change within medical schemes.
Keywords
Article Details

This work is licensed under a Creative Commons Attribution 4.0 International License.
References
- Abubakar, H., Ruslan, M., & Suriani, S. (2024). The role of competitor analysis, market orientation, and service quality in working capital management and operational leverage as links to financial stability of manufacturing companies listed on the IDX: A qualitative approach. ATESTASI Jurnal Ilmiah Akuntansi, 7(1), 459-495. https://doi.org/10.57178/atestasi.v7i1.807
- Adewumi, A., Ewim, S. E., Sam-Bulya, N. J., & Ajani, O. B. (2024). Strategic innovation in business models: Leveraging emerging technologies to gain a competitive advantage. International Journal of Management & Entrepreneurship Research, 6(10), 3372–3398. https://doi.org/10.51594/ijmer.v6i10.1639
- Andreini, D., Bettinelli, C., Foss, N. J., & Mismetti, M. (2022). Business model innovation: A review of the process-based literature. Journal of Management and Governance, 26(4), 1089–1121. https://doi.org/10.1007/s10997-021-09585-3
- Arku, J. K., Shao, Y., & Ankrah, S. T. (2023). Building a hierarchical enablers framework for service business model innovation for sustainable performance: Evidence from Ghana’s electricity sector. Sustainability, 16(8), 3191. https://doi.org/10.3390/su16083191
- Attrey, A., Lesher, M., & Lomax, C. (2020). The role of sandboxes in promoting flexibility and innovation in the digital age. OECD Going Digital Toolkit Notes, (2). OECD Publishing. https://doi.org/10.1787/cdf5ed45-en
- Bailey, K., & Breslin, D. (2021). The COVID-19 pandemic: What can we learn from past research in organisations and management?. International Journal of Management Reviews, 23(1), 3–6. https://doi.org/10.1111/ijmr.12201
- Baporikar, N. (2014). Drivers of innovation. In Emerging Issues in Management and Technology (pp. 302–316). IGI Global. https://doi.org/10.4018/978-1-4666-6457-9.ch014
- Baregheh, A., Rowley, J., & Sambrook, S. (2009). Towards a multidisciplinary definition of innovation. Management Decision, 47, 1323–1339.
- Berry, L. L. (2019). Service innovation is urgent in healthcare. AMS Review, 9(1), 78–92. https://doi.org/10.1007/s13162-019-00135-x
- Berry, L. L., Shankar, V., Parish, J. T., Dotzel, T., & others. (2006). Creating new markets through service innovation. MIT Sloan Management Review, 47(2), 51–58.
- Blind, K. (2012). The influence of regulations on innovation: A quantitative assessment for OECD countries. Research Policy, 41(2), 391–400. https://doi.org/10.1016/j.respol.2011.08.008
- Brynjolfsson, E., & McAfee, A. (2014). The Second Machine Age: Work, Progress, and Prosperity in a Time of Brilliant Technologies. W.W. Norton & Company.
- Chen, J.-S., Tsou, H.-T., & Huang, A. Y.-H. (2009). Service delivery innovation. Journal of Service Research, 12(1), 36-55. https://doi.org/10.1177/1094670509338619
- Cheong, C. W. H., She, L., Ma, L., & Wong, L. (2024). Building a culture of innovation: Innovation 360. Global Business and Organizational Excellence, 43(3). https://doi.org/10.1002/joe.22255
- Christensen, C. M., Grossman, J. H., & Hwang, J. (2009). The innovator’s prescription: A disruptive solution for health care. McGraw-Hill Education.
- Christmals, C. D., & Aidam, K. (2020). Implementation of the National Health Insurance Scheme (NHIS) in Ghana: Lessons for South Africa and Low- and Middle-Income Countries. Risk Management and Healthcare Policy, 13, 1879. https://doi.org/10.2147/RMHP.S245615
- Ciasullo, M. V., Cosimato, S., & Pellicano, M. (2017). Service innovations in the healthcare service ecosystem: A case study. Systems, 5(2), 37. https://doi.org/10.3390/systems5020037
- Cohen, W., & Levinthal, D. (1990). Absorptive capacity: A new perspective on learning and innovation. Administrative Science Quarterly, 35, 128–152.
- Competition Commission (CompCom). (2019). Health Market Inquiry: Final findings and recommendations report. Pretoria: Competition Commission of South Africa. http://www.compcom.co.za/wp-content/uploads/2020/01/Final-Findings-and-recommendations-report-Health-Market-Inquiry.pdf (accessed 22 March 2025).
- Costa, A., Crupi, A., De Marco, C. E., & Di Minin, A. (2023). SMEs and open innovation: Challenges and costs of engagement. Technological Forecasting and Social Change, 194, 122731. https://doi.org/10.1016/j.techfore.2023.122731
- Council for Medical Schemes (CMS). (2024) CMS Annual Report 2023/24. Retrieved from https://www.medicalschemes.co.za
- Council for Medical Schemes (CMS). (2025). CMS Industry Report 2024/25. Retrieved from https://www.medicalschemes.co.za
- Crossan, M. M., & Apaydin, M. (2010). A multi-dimensional framework of organisational innovation: A systematic review of the literature. Journal of Management Studies, 47, 1154–1191.
- Damanpour, F., & Aravind, D. (2012). Managerial innovation: Conceptions, processes, and antecedents. Management and Organization Review, 8, 423–454.
- Damawan, A. H., & Azizah, S. (2020). Resistance to change: Causes and strategies as an organisational challenge. Proceedings of the 5th ASEAN Conference on Psychology, Counseling, and Humanities (ACPCH 2019). https://doi.org/10.2991/assehr.k.200120.010
- Dasgupta, M. (2016). Service innovation in practice: Drivers and enablers. International Journal of Management Concepts and Philosophy, 9(3), 255–270.
- Deep, G. (2023). Digital transformation’s impact on organisational culture. International Journal of Science and Research Archive, 10(2), 396–401. https://doi.org/10.30574/ijsra.2023.10.2.0977
- Deep, G. (2023). Strategic decision-making: A crucial skill for business managers. World Journal of Advanced Research and Reviews, 20(3), 1639–1643. https://doi.org/10.30574/wjarr.2023.20.3.2463
- Feng, C., Ma, R., & Jiang, L. (2020). The impact of service innovation on firm performance: A meta-analysis. Journal of Service Management, ahead-of-print. https://doi.org/10.1108/JOSM-03-2019-0089
- Garrido-Moreno, A., Martín-Rojas, R., & García-Morales, V. J. (2024). The key role of innovation and organisational resilience in improving business performance: A mixed-methods approach. International Journal of Information Management, 77, 102777. https://doi.org/10.1016/j.ijinfomgt.2024.102777
- Ghani, B., Hyder, S. I., Yoo, S., & Han, H. (2023). Does employee engagement promote innovation? The facilitators of innovative workplace behavior via mediation and moderation. Heliyon, 9(11), e21817. https://doi.org/10.1016/j.heliyon.2023.e21817
- Ghobakhloo, M., Hong, T. S., Sabouri, M. S., & Zulkifli, N. (2012). Strategies for successful information technology adoption in small and medium-sized enterprises. Information, 3(4), 36. https://doi.org/10.3390/info3010036
- Hall, B. H., & Lerner, J. (2010). The financing of R&D and innovation. In B. H. Hall & N. Rosenberg (Eds.), Handbook of the Economics of Innovation (Vol. 1, pp. 609-639). Amsterdam: Elsevier.
- Harrington, S. E. (2010). The health insurance reform debate. Journal of Risk and Insurance, 77(1), 5–38. https://doi.org/10.1111/j.1539-6975.2009.01345.x
- Hermundsdottir, F., & Aspelund, A. (2021). Sustainability innovations and firm competitiveness: A review. Journal of Cleaner Production, 280, 124715. https://doi.org/10.1016/j.jclepro.2020.124715
- Jerab, D. A., & Mabrouk, T. (2023). Strategic excellence: Achieving competitive advantage through differentiation strategies. SSRN Electronic Journal, September. https://doi.org/10.2139/ssrn.4575042
- Kaplan, J., & Ranchod, S. (2014). Analyzing the structure and nature of medical scheme benefit design in South Africa. South African Health Review, 15(1), 165–178.
- Katz, Y. (2021). Government’s role in advancing innovation. Randwick International of Social Science Journal, 2(2), 31–45. https://doi.org/10.47175/rissj.v2i2.213
- Kirby, N. (2023, November 9). National Health Insurance: A future for medical schemes? Possibly. Retrieved from https://www.werksmans.com/legal-updates-and-opinions/national-health-insurance-a-future-for-medical-schemes-possibly/
- Lawson, B., & Samson, D. (2001). Developing innovation capability in organisations: A dynamic capabilities approach. International Journal of Innovation Management, 5(3), 377–400.
- Leyens, L., Simkins, T., & Horst, N. K. (2022). The COVID-19 pandemic as a catalyst for innovation: A regulatory framework to assess fit-for-purpose innovative approaches in clinical research. Trials, 23, 833. https://doi.org/10.1186/s13063-022-06707-w
- Lin, L. (2013). The impact of service innovation on firm performance. The Service Industries Journal, 33(15), 1541–1555. https://doi.org/10.1080/02642069.2011.638712
- Lopes, J. M., Gomes, S., Pacheco, R., Monteiro, E., & Santos, C. (2021). Drivers of sustainable innovation strategies for increased competition among companies. Sustainability, 14(9), 5471. https://doi.org/10.3390/su14095471
- Mahavarpour, N., Marvi, R., & Foroudi, P. (2023). A brief history of service innovation: The evolution of past, present, and future of service innovation. Journal of Business Research, 160, 113795. https://doi.org/10.1016/j.jbusres.2023.113795
- Makgopa, S. S. (2021). Drivers of service innovation in service organizations. Academic Journal of Interdisciplinary Studies, 10(2), 45–53. https://doi.org/10.36941/ajis-2021-0037
- McIntyre, D., & McLeod, H. (2020). The challenges of pursuing private health insurance in low- and middle-income countries: Lessons from South Africa. In S. Thomson, A. Sagan, & E. Mossialos (Eds.), Private health insurance: History, politics, and performance (pp. [specific page range]). Cambridge University Press.
- McLeod, H., & Ramjee, S. (2007). Medical schemes: Pooling of resources and risk. Medical Schemes Act No. 131 of 1998. Available at: https://www.gov.za/sites/default/files/gcis_document/201409/a131-98.pdf
- Mkhwanazi, T. (2024). Assessing the National Health Insurance (NHI) in South Africa: Policy formulation, stakeholder engagement, and implementation challenges. European Journal of Medical and Health Research, 2(6), 198–215. https://doi.org/10.59324/ejmhr.2024.2(6).27
- Mncedisi Willie, M. (2024). The impact of marketing strategies on service innovation in medical schemes in South Africa (Doctoral thesis, MANCOSA). Graduate School of Business (GSB). Supervisor: Dr. Abigail Chivandi.
- Motsi, L. (2024). Electronic health records model to improve the quality of patients’ healthcare. Health SA Gesondheid, 29(0), a2414. https://doi.org/10.4102/hsag.v29i0.2414
- Nel-Sanders, D., & Thomas, P. (2022). The role of government in promoting innovation-led entrepreneurial ecosystems. Africa’s Public Service Delivery and Performance Review, 10(1), a640. https://doi.org/10.4102/apsdpr.v10i1.640
- Nelson, R. R., & Winter, S. G. (1982). An evolutionary theory of economic change. Harvard University Press.
- Pauw, T. L. (2022). Catching up with the constitution: An analysis of National Health Insurance in South Africa post-apartheid. Development Southern Africa, 39(6), 921–934. https://doi.org/10.1080/0376835X.2021.1945911
- Pawelek, J., Baca-Motes, K., Pandit, J. A., Berk, B. B., & Ramos, E. (2022). The power of patient engagement with electronic health records as research participants. JMIR Medical Informatics, 10(7), e39145. https://doi.org/10.2196/39145
- Pisano, G. P. (2006). Science business: The promise, the reality, and the future of biotech. Harvard Business Review Press.
- Porter, M. (1979). How competitive forces shape strategy. Harvard Business Review, March Issues. Retrieved from https://hbr.org/1979/03/how-competitive-forces-shape-strategy
- Porter, M. (1980). Competitive strategy: Techniques for analysing industries and competitors. The Free Press.
- Porter, M. (1985). On Competition (Updated and Expanded Edition). Harvard Business School Publishing.
- Porter, M.E., & Heppelmann, J.E. (2014). How smart, connected products are transforming competition. Harvard Business Review, 92, 64–88.
- Purchasing of health care. South African Health Review, 47-70.
- Rammila, D. (2023). Evaluating the potential impact of National Health Insurance on medical scheme members’ rights to have access to healthcare services in South Africa. Law, Democracy & Development, 27, 360–391. https://doi.org/10.17159/2077-4907/2023/ldd.v27.14. Available from: http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2077-49072023000100014&lng=en&nrm=iso
- Rodríguez-Espíndola, O., Chowdhury, S., Dey, P. K., Albores, P., & Emrouznejad, A. (2022). Analysis of the adoption of emergent technologies for risk management in the era of digital manufacturing. Technological Forecasting and Social Change, 178, 121562. https://doi.org/10.1016/j.techfore.2022.121562
- Ryu, H.-S., & Lee, J.-N. (2018). Understanding the role of technology in service innovation: A comparison of three theoretical perspectives. Information & Management, 55(4), 453–462. https://doi.org/10.1016/j.im.2017.08.003
- Sacavém, A., & Dos Santos, J. R. (2025). Leading in the digital age: The role of leadership in organizational digital transformation. Administrative Sciences, 15(2), 43. https://doi.org/10.3390/admsci15020043
- Sagan, A., Webb, E., McKee, M., et al. (2021). Health systems resilience during COVID-19: Lessons for building back better. In N. Azzopardi-Muscat & I. de la Mata (Eds.), Health policy series, No. 56. European Observatory on Health Systems and Policies. Available from https://www.ncbi.nlm.nih.gov/books/NBK590210/
- Schumpeter, J. A. (1934). The theory of economic development: An inquiry into profits, capital, credit, interest, and the business cycle. Harvard University Press.
- Sethibe, T., & Steyn, R. (2016). Innovation and organizational performance: A critical review of the instruments used to measure organizational performance. The Southern African Journal of Entrepreneurship and Small Business Management, 8(1), 12 pages. https://doi.org/10.4102/sajesbm.v8i1.50
- Snyder, H., Witell, L., & Gustafsson, A. (2020). Service innovation: A new conceptualization and path forward. Journal of Service Research, 23(2). https://doi.org/10.1177/1094670520908929
- Sounderajah, V., Patel, V., Varatharajan, L., Harling, L., Normahani, P., Symons, J., Barlow, J., Darzi, A., & Ashrafian, H. (2020). Are disruptive innovations recognized in the healthcare literature? A systematic review. BMJ Innovations, 7(1), 208. https://doi.org/10.1136/bmjinnov-2020-000424
- Stremersch, S., Cabooter, E., Guitart, I. A., & Camacho, N. (2024). Customer insights for innovation: A framework and research agenda for marketing. Journal of the Academy of Marketing Science, 53(8). https://doi.org/10.1007/s11747-024-01051-8
- Swartz, et al. (2021). In his study, he found that leadership advocating for the value of digital health solutions is crucial for scaling up and sustaining digital health solutions, despite challenges in investment, human resource capacity, and monitoring.
- Swartz, A., LeFevre, A.E., Perera, S., Kinney, M.V., & George, A.S. (2021). Multiple pathways to scaling up and sustainability: An exploration of digital health solutions in South Africa. Global Health, 17(1), 77. https://doi.org/10.1186/s12992-021-00716-1
- Tagscherer, F., & Carbon, C. (2023). Leadership for successful digitalisation: A literature review on companies’ internal and external aspects of digitalisation. Sustainable Technology and Entrepreneurship, 2(2), 100039. https://doi.org/10.1016/j.stae.2023.100039
- Teece, D.J. (2010). Business models, business strategy, and innovation. Long Range Planning, 43, 172–194.
- Tidd, J., & Bessant, J. (2021). Managing innovation: Integrating technological, market, and organisational change. Wiley. ISBN 978-1-119-71330-2.
- Tien, J.M. (2007). Services innovation: Decision attributes, innovation enablers, and innovation drivers. In C. Hsu (Ed.), Service enterprise integration (pp. 13–32). Springer. https://doi.org/10.1007/978-0-387-46364-3_2
- Topp, S. M. (2023). Health system resilience as the basis for explanation versus evaluation: Comment on “The COVID-19 system shock framework: Capturing health system innovation during the COVID-19 pandemic.” International Journal of Health Policy and Management, 12, 7481. https://doi.org/10.34172/ijhpm.2023.7481
- Tukker, A., & Tischner, U. (2006). Product-services as a research field: Past, present, and future. Reflections from a decade of research. Journal of Cleaner Production, 14(17), 1552–1556. https://doi.org/10.1016/j.jclepro.2006.01.022
- van den Hoed, M. W., Backhaus, R., de Vries, E., Hamers, J. P. H., & Daniëls, R. (2022). Factors contributing to innovation readiness in healthcare organisations: A scoping review. BMC Health Services Research, 22, 997. https://doi.org/10.1186/s12913-022-08206-3
- Vargo, S. L., & Lusch, R. F. (2003). Evolving to a new dominant logic for marketing. Journal of Marketing, 68(1), 1–17. https://doi.org/10.1509/jmkg.68.1.1.24036
- Verhoef, P. C., Broekhuizen, T., Bart, Y., Bhattacharya, A., Qi Dong, J., Fabian, N., & Haenlein, M. (2020). Digital transformation: A multidisciplinary reflection and research agenda. Journal of Business Research, 122, 889-901. https://doi.org/10.1016/j.jbusres.2019.09.022
- Verhoef, P. C., Kannan, P. K., & Inman, J. J. (2015). From multi-channel retailing to omni-channel retailing. Journal of Retailing, 91(2), 174-181. https://doi.org/10.1016/j.jretai.2015.02.005
- Willie, M. M. (2025). Adoption of digital marketing strategies by medical schemes in South Africa: A case study of two large open medical schemes. Advances in Business & Industrial Marketing Research, 3(1), 57–67. https://doi.org/10.60079/abim.v3i1.409
- Willie, M. M., Childs, B., & Goolab, G. (2021). The value proposition of efficiency discount options: The Government Employees Medical Scheme Emerald value option case study. African Journal of Primary Health Care & Family Medicine, 13(1), 1–8. https://doi.org/10.4102/phcfm.v13i1.2292
- Willie, M.M. (2024). The impact of marketing strategies on service innovation in medical schemes in South Africa (Doctoral thesis, MANCOSA). Graduate School of Business (GSB).
- Willie, M. M., & Nkomo, P. (2014). Market structure in the South African healthcare system. World Medical Journal, 60(2), 32–44.
- Willie, M.M. (2023, August 5). The effect of marketing initiatives and expenditure on organisational performance in the South African healthcare market. SSRN. https://ssrn.com/abstract=4532254
- Witell, L., Snyder, H., Gustafsson, A., Fombelle, P., & Kristensson, P. (2016). Defining service innovation: A review and synthesis. Journal of Business Research, 69(8), 2863–2872. https://doi.org/10.1016/j.jbusres.2015.12.055
- Wirtz, J., & Lovelock, C. (2016). Services marketing: People, technology, strategy (8th ed.). World Scientific Publishing Co. Inc.
References
Abubakar, H., Ruslan, M., & Suriani, S. (2024). The role of competitor analysis, market orientation, and service quality in working capital management and operational leverage as links to financial stability of manufacturing companies listed on the IDX: A qualitative approach. ATESTASI Jurnal Ilmiah Akuntansi, 7(1), 459-495. https://doi.org/10.57178/atestasi.v7i1.807
Adewumi, A., Ewim, S. E., Sam-Bulya, N. J., & Ajani, O. B. (2024). Strategic innovation in business models: Leveraging emerging technologies to gain a competitive advantage. International Journal of Management & Entrepreneurship Research, 6(10), 3372–3398. https://doi.org/10.51594/ijmer.v6i10.1639
Andreini, D., Bettinelli, C., Foss, N. J., & Mismetti, M. (2022). Business model innovation: A review of the process-based literature. Journal of Management and Governance, 26(4), 1089–1121. https://doi.org/10.1007/s10997-021-09585-3
Arku, J. K., Shao, Y., & Ankrah, S. T. (2023). Building a hierarchical enablers framework for service business model innovation for sustainable performance: Evidence from Ghana’s electricity sector. Sustainability, 16(8), 3191. https://doi.org/10.3390/su16083191
Attrey, A., Lesher, M., & Lomax, C. (2020). The role of sandboxes in promoting flexibility and innovation in the digital age. OECD Going Digital Toolkit Notes, (2). OECD Publishing. https://doi.org/10.1787/cdf5ed45-en
Bailey, K., & Breslin, D. (2021). The COVID-19 pandemic: What can we learn from past research in organisations and management?. International Journal of Management Reviews, 23(1), 3–6. https://doi.org/10.1111/ijmr.12201
Baporikar, N. (2014). Drivers of innovation. In Emerging Issues in Management and Technology (pp. 302–316). IGI Global. https://doi.org/10.4018/978-1-4666-6457-9.ch014
Baregheh, A., Rowley, J., & Sambrook, S. (2009). Towards a multidisciplinary definition of innovation. Management Decision, 47, 1323–1339.
Berry, L. L. (2019). Service innovation is urgent in healthcare. AMS Review, 9(1), 78–92. https://doi.org/10.1007/s13162-019-00135-x
Berry, L. L., Shankar, V., Parish, J. T., Dotzel, T., & others. (2006). Creating new markets through service innovation. MIT Sloan Management Review, 47(2), 51–58.
Blind, K. (2012). The influence of regulations on innovation: A quantitative assessment for OECD countries. Research Policy, 41(2), 391–400. https://doi.org/10.1016/j.respol.2011.08.008
Brynjolfsson, E., & McAfee, A. (2014). The Second Machine Age: Work, Progress, and Prosperity in a Time of Brilliant Technologies. W.W. Norton & Company.
Chen, J.-S., Tsou, H.-T., & Huang, A. Y.-H. (2009). Service delivery innovation. Journal of Service Research, 12(1), 36-55. https://doi.org/10.1177/1094670509338619
Cheong, C. W. H., She, L., Ma, L., & Wong, L. (2024). Building a culture of innovation: Innovation 360. Global Business and Organizational Excellence, 43(3). https://doi.org/10.1002/joe.22255
Christensen, C. M., Grossman, J. H., & Hwang, J. (2009). The innovator’s prescription: A disruptive solution for health care. McGraw-Hill Education.
Christmals, C. D., & Aidam, K. (2020). Implementation of the National Health Insurance Scheme (NHIS) in Ghana: Lessons for South Africa and Low- and Middle-Income Countries. Risk Management and Healthcare Policy, 13, 1879. https://doi.org/10.2147/RMHP.S245615
Ciasullo, M. V., Cosimato, S., & Pellicano, M. (2017). Service innovations in the healthcare service ecosystem: A case study. Systems, 5(2), 37. https://doi.org/10.3390/systems5020037
Cohen, W., & Levinthal, D. (1990). Absorptive capacity: A new perspective on learning and innovation. Administrative Science Quarterly, 35, 128–152.
Competition Commission (CompCom). (2019). Health Market Inquiry: Final findings and recommendations report. Pretoria: Competition Commission of South Africa. http://www.compcom.co.za/wp-content/uploads/2020/01/Final-Findings-and-recommendations-report-Health-Market-Inquiry.pdf (accessed 22 March 2025).
Costa, A., Crupi, A., De Marco, C. E., & Di Minin, A. (2023). SMEs and open innovation: Challenges and costs of engagement. Technological Forecasting and Social Change, 194, 122731. https://doi.org/10.1016/j.techfore.2023.122731
Council for Medical Schemes (CMS). (2024) CMS Annual Report 2023/24. Retrieved from https://www.medicalschemes.co.za
Council for Medical Schemes (CMS). (2025). CMS Industry Report 2024/25. Retrieved from https://www.medicalschemes.co.za
Crossan, M. M., & Apaydin, M. (2010). A multi-dimensional framework of organisational innovation: A systematic review of the literature. Journal of Management Studies, 47, 1154–1191.
Damanpour, F., & Aravind, D. (2012). Managerial innovation: Conceptions, processes, and antecedents. Management and Organization Review, 8, 423–454.
Damawan, A. H., & Azizah, S. (2020). Resistance to change: Causes and strategies as an organisational challenge. Proceedings of the 5th ASEAN Conference on Psychology, Counseling, and Humanities (ACPCH 2019). https://doi.org/10.2991/assehr.k.200120.010
Dasgupta, M. (2016). Service innovation in practice: Drivers and enablers. International Journal of Management Concepts and Philosophy, 9(3), 255–270.
Deep, G. (2023). Digital transformation’s impact on organisational culture. International Journal of Science and Research Archive, 10(2), 396–401. https://doi.org/10.30574/ijsra.2023.10.2.0977
Deep, G. (2023). Strategic decision-making: A crucial skill for business managers. World Journal of Advanced Research and Reviews, 20(3), 1639–1643. https://doi.org/10.30574/wjarr.2023.20.3.2463
Feng, C., Ma, R., & Jiang, L. (2020). The impact of service innovation on firm performance: A meta-analysis. Journal of Service Management, ahead-of-print. https://doi.org/10.1108/JOSM-03-2019-0089
Garrido-Moreno, A., Martín-Rojas, R., & García-Morales, V. J. (2024). The key role of innovation and organisational resilience in improving business performance: A mixed-methods approach. International Journal of Information Management, 77, 102777. https://doi.org/10.1016/j.ijinfomgt.2024.102777
Ghani, B., Hyder, S. I., Yoo, S., & Han, H. (2023). Does employee engagement promote innovation? The facilitators of innovative workplace behavior via mediation and moderation. Heliyon, 9(11), e21817. https://doi.org/10.1016/j.heliyon.2023.e21817
Ghobakhloo, M., Hong, T. S., Sabouri, M. S., & Zulkifli, N. (2012). Strategies for successful information technology adoption in small and medium-sized enterprises. Information, 3(4), 36. https://doi.org/10.3390/info3010036
Hall, B. H., & Lerner, J. (2010). The financing of R&D and innovation. In B. H. Hall & N. Rosenberg (Eds.), Handbook of the Economics of Innovation (Vol. 1, pp. 609-639). Amsterdam: Elsevier.
Harrington, S. E. (2010). The health insurance reform debate. Journal of Risk and Insurance, 77(1), 5–38. https://doi.org/10.1111/j.1539-6975.2009.01345.x
Hermundsdottir, F., & Aspelund, A. (2021). Sustainability innovations and firm competitiveness: A review. Journal of Cleaner Production, 280, 124715. https://doi.org/10.1016/j.jclepro.2020.124715
Jerab, D. A., & Mabrouk, T. (2023). Strategic excellence: Achieving competitive advantage through differentiation strategies. SSRN Electronic Journal, September. https://doi.org/10.2139/ssrn.4575042
Kaplan, J., & Ranchod, S. (2014). Analyzing the structure and nature of medical scheme benefit design in South Africa. South African Health Review, 15(1), 165–178.
Katz, Y. (2021). Government’s role in advancing innovation. Randwick International of Social Science Journal, 2(2), 31–45. https://doi.org/10.47175/rissj.v2i2.213
Kirby, N. (2023, November 9). National Health Insurance: A future for medical schemes? Possibly. Retrieved from https://www.werksmans.com/legal-updates-and-opinions/national-health-insurance-a-future-for-medical-schemes-possibly/
Lawson, B., & Samson, D. (2001). Developing innovation capability in organisations: A dynamic capabilities approach. International Journal of Innovation Management, 5(3), 377–400.
Leyens, L., Simkins, T., & Horst, N. K. (2022). The COVID-19 pandemic as a catalyst for innovation: A regulatory framework to assess fit-for-purpose innovative approaches in clinical research. Trials, 23, 833. https://doi.org/10.1186/s13063-022-06707-w
Lin, L. (2013). The impact of service innovation on firm performance. The Service Industries Journal, 33(15), 1541–1555. https://doi.org/10.1080/02642069.2011.638712
Lopes, J. M., Gomes, S., Pacheco, R., Monteiro, E., & Santos, C. (2021). Drivers of sustainable innovation strategies for increased competition among companies. Sustainability, 14(9), 5471. https://doi.org/10.3390/su14095471
Mahavarpour, N., Marvi, R., & Foroudi, P. (2023). A brief history of service innovation: The evolution of past, present, and future of service innovation. Journal of Business Research, 160, 113795. https://doi.org/10.1016/j.jbusres.2023.113795
Makgopa, S. S. (2021). Drivers of service innovation in service organizations. Academic Journal of Interdisciplinary Studies, 10(2), 45–53. https://doi.org/10.36941/ajis-2021-0037
McIntyre, D., & McLeod, H. (2020). The challenges of pursuing private health insurance in low- and middle-income countries: Lessons from South Africa. In S. Thomson, A. Sagan, & E. Mossialos (Eds.), Private health insurance: History, politics, and performance (pp. [specific page range]). Cambridge University Press.
McLeod, H., & Ramjee, S. (2007). Medical schemes: Pooling of resources and risk. Medical Schemes Act No. 131 of 1998. Available at: https://www.gov.za/sites/default/files/gcis_document/201409/a131-98.pdf
Mkhwanazi, T. (2024). Assessing the National Health Insurance (NHI) in South Africa: Policy formulation, stakeholder engagement, and implementation challenges. European Journal of Medical and Health Research, 2(6), 198–215. https://doi.org/10.59324/ejmhr.2024.2(6).27
Mncedisi Willie, M. (2024). The impact of marketing strategies on service innovation in medical schemes in South Africa (Doctoral thesis, MANCOSA). Graduate School of Business (GSB). Supervisor: Dr. Abigail Chivandi.
Motsi, L. (2024). Electronic health records model to improve the quality of patients’ healthcare. Health SA Gesondheid, 29(0), a2414. https://doi.org/10.4102/hsag.v29i0.2414
Nel-Sanders, D., & Thomas, P. (2022). The role of government in promoting innovation-led entrepreneurial ecosystems. Africa’s Public Service Delivery and Performance Review, 10(1), a640. https://doi.org/10.4102/apsdpr.v10i1.640
Nelson, R. R., & Winter, S. G. (1982). An evolutionary theory of economic change. Harvard University Press.
Pauw, T. L. (2022). Catching up with the constitution: An analysis of National Health Insurance in South Africa post-apartheid. Development Southern Africa, 39(6), 921–934. https://doi.org/10.1080/0376835X.2021.1945911
Pawelek, J., Baca-Motes, K., Pandit, J. A., Berk, B. B., & Ramos, E. (2022). The power of patient engagement with electronic health records as research participants. JMIR Medical Informatics, 10(7), e39145. https://doi.org/10.2196/39145
Pisano, G. P. (2006). Science business: The promise, the reality, and the future of biotech. Harvard Business Review Press.
Porter, M. (1979). How competitive forces shape strategy. Harvard Business Review, March Issues. Retrieved from https://hbr.org/1979/03/how-competitive-forces-shape-strategy
Porter, M. (1980). Competitive strategy: Techniques for analysing industries and competitors. The Free Press.
Porter, M. (1985). On Competition (Updated and Expanded Edition). Harvard Business School Publishing.
Porter, M.E., & Heppelmann, J.E. (2014). How smart, connected products are transforming competition. Harvard Business Review, 92, 64–88.
Purchasing of health care. South African Health Review, 47-70.
Rammila, D. (2023). Evaluating the potential impact of National Health Insurance on medical scheme members’ rights to have access to healthcare services in South Africa. Law, Democracy & Development, 27, 360–391. https://doi.org/10.17159/2077-4907/2023/ldd.v27.14. Available from: http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2077-49072023000100014&lng=en&nrm=iso
Rodríguez-Espíndola, O., Chowdhury, S., Dey, P. K., Albores, P., & Emrouznejad, A. (2022). Analysis of the adoption of emergent technologies for risk management in the era of digital manufacturing. Technological Forecasting and Social Change, 178, 121562. https://doi.org/10.1016/j.techfore.2022.121562
Ryu, H.-S., & Lee, J.-N. (2018). Understanding the role of technology in service innovation: A comparison of three theoretical perspectives. Information & Management, 55(4), 453–462. https://doi.org/10.1016/j.im.2017.08.003
Sacavém, A., & Dos Santos, J. R. (2025). Leading in the digital age: The role of leadership in organizational digital transformation. Administrative Sciences, 15(2), 43. https://doi.org/10.3390/admsci15020043
Sagan, A., Webb, E., McKee, M., et al. (2021). Health systems resilience during COVID-19: Lessons for building back better. In N. Azzopardi-Muscat & I. de la Mata (Eds.), Health policy series, No. 56. European Observatory on Health Systems and Policies. Available from https://www.ncbi.nlm.nih.gov/books/NBK590210/
Schumpeter, J. A. (1934). The theory of economic development: An inquiry into profits, capital, credit, interest, and the business cycle. Harvard University Press.
Sethibe, T., & Steyn, R. (2016). Innovation and organizational performance: A critical review of the instruments used to measure organizational performance. The Southern African Journal of Entrepreneurship and Small Business Management, 8(1), 12 pages. https://doi.org/10.4102/sajesbm.v8i1.50
Snyder, H., Witell, L., & Gustafsson, A. (2020). Service innovation: A new conceptualization and path forward. Journal of Service Research, 23(2). https://doi.org/10.1177/1094670520908929
Sounderajah, V., Patel, V., Varatharajan, L., Harling, L., Normahani, P., Symons, J., Barlow, J., Darzi, A., & Ashrafian, H. (2020). Are disruptive innovations recognized in the healthcare literature? A systematic review. BMJ Innovations, 7(1), 208. https://doi.org/10.1136/bmjinnov-2020-000424
Stremersch, S., Cabooter, E., Guitart, I. A., & Camacho, N. (2024). Customer insights for innovation: A framework and research agenda for marketing. Journal of the Academy of Marketing Science, 53(8). https://doi.org/10.1007/s11747-024-01051-8
Swartz, et al. (2021). In his study, he found that leadership advocating for the value of digital health solutions is crucial for scaling up and sustaining digital health solutions, despite challenges in investment, human resource capacity, and monitoring.
Swartz, A., LeFevre, A.E., Perera, S., Kinney, M.V., & George, A.S. (2021). Multiple pathways to scaling up and sustainability: An exploration of digital health solutions in South Africa. Global Health, 17(1), 77. https://doi.org/10.1186/s12992-021-00716-1
Tagscherer, F., & Carbon, C. (2023). Leadership for successful digitalisation: A literature review on companies’ internal and external aspects of digitalisation. Sustainable Technology and Entrepreneurship, 2(2), 100039. https://doi.org/10.1016/j.stae.2023.100039
Teece, D.J. (2010). Business models, business strategy, and innovation. Long Range Planning, 43, 172–194.
Tidd, J., & Bessant, J. (2021). Managing innovation: Integrating technological, market, and organisational change. Wiley. ISBN 978-1-119-71330-2.
Tien, J.M. (2007). Services innovation: Decision attributes, innovation enablers, and innovation drivers. In C. Hsu (Ed.), Service enterprise integration (pp. 13–32). Springer. https://doi.org/10.1007/978-0-387-46364-3_2
Topp, S. M. (2023). Health system resilience as the basis for explanation versus evaluation: Comment on “The COVID-19 system shock framework: Capturing health system innovation during the COVID-19 pandemic.” International Journal of Health Policy and Management, 12, 7481. https://doi.org/10.34172/ijhpm.2023.7481
Tukker, A., & Tischner, U. (2006). Product-services as a research field: Past, present, and future. Reflections from a decade of research. Journal of Cleaner Production, 14(17), 1552–1556. https://doi.org/10.1016/j.jclepro.2006.01.022
van den Hoed, M. W., Backhaus, R., de Vries, E., Hamers, J. P. H., & Daniëls, R. (2022). Factors contributing to innovation readiness in healthcare organisations: A scoping review. BMC Health Services Research, 22, 997. https://doi.org/10.1186/s12913-022-08206-3
Vargo, S. L., & Lusch, R. F. (2003). Evolving to a new dominant logic for marketing. Journal of Marketing, 68(1), 1–17. https://doi.org/10.1509/jmkg.68.1.1.24036
Verhoef, P. C., Broekhuizen, T., Bart, Y., Bhattacharya, A., Qi Dong, J., Fabian, N., & Haenlein, M. (2020). Digital transformation: A multidisciplinary reflection and research agenda. Journal of Business Research, 122, 889-901. https://doi.org/10.1016/j.jbusres.2019.09.022
Verhoef, P. C., Kannan, P. K., & Inman, J. J. (2015). From multi-channel retailing to omni-channel retailing. Journal of Retailing, 91(2), 174-181. https://doi.org/10.1016/j.jretai.2015.02.005
Willie, M. M. (2025). Adoption of digital marketing strategies by medical schemes in South Africa: A case study of two large open medical schemes. Advances in Business & Industrial Marketing Research, 3(1), 57–67. https://doi.org/10.60079/abim.v3i1.409
Willie, M. M., Childs, B., & Goolab, G. (2021). The value proposition of efficiency discount options: The Government Employees Medical Scheme Emerald value option case study. African Journal of Primary Health Care & Family Medicine, 13(1), 1–8. https://doi.org/10.4102/phcfm.v13i1.2292
Willie, M.M. (2024). The impact of marketing strategies on service innovation in medical schemes in South Africa (Doctoral thesis, MANCOSA). Graduate School of Business (GSB).
Willie, M. M., & Nkomo, P. (2014). Market structure in the South African healthcare system. World Medical Journal, 60(2), 32–44.
Willie, M.M. (2023, August 5). The effect of marketing initiatives and expenditure on organisational performance in the South African healthcare market. SSRN. https://ssrn.com/abstract=4532254
Witell, L., Snyder, H., Gustafsson, A., Fombelle, P., & Kristensson, P. (2016). Defining service innovation: A review and synthesis. Journal of Business Research, 69(8), 2863–2872. https://doi.org/10.1016/j.jbusres.2015.12.055
Wirtz, J., & Lovelock, C. (2016). Services marketing: People, technology, strategy (8th ed.). World Scientific Publishing Co. Inc.