This paper aims to explore regional variability in healthcare expenditure and outcomes for the South African Insured population based on the methodology and approach used in the Dartmouth Atlas Project.  The Dartmouth Atlas Project aims to provide information to reduce unwarranted variation in the healthcare industry. The following factors will be explored by region as well as the consequent impact on cost:

-          the demand for healthcare resources (the disease burden)

-          supply of healthcare services

-          bed days per patient

-          mortality rate

This paper is relevant and useful to healthcare actuaries internationally as it acknowledges that healthcare is provided in systems. If all healthcare providers practiced evidence based medicine (for relevant clinical conditions) there would be little variation in utilisation rates and cost (adjusted for regional disparities in price). Where variation exists, understanding it provides insights into future claims experience given specific regional growth in lives assured it assists with more targeted management strategies.