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Problem Tech Solves
Tech Brief
We know that access to good healthcare is essential for everyone. But in Brazil, only 23% of the population has private health insurance, and the rest of the population have to rely on an overstretched and underfunded public healthcare system. This means 160 million Brazilians do not have guaranteed access to good quality health care services because they can't afford it. To change that reality and democratize access to quality healthcare in the country, we created the health tech Sami. In less than two years of operation, we have been able to achieve 10 thousand members with this purpose - 75% of whom did not have health insurance before.
Tech Differentiators
Sami is the revolution of health insurance plans. Our moonshot is healthcare affordability. Our superpower is to create a new health system from scratch, one that finally works. We asked ourselves: "What would the ideal health system look like? How can we deliver the best healthcare outcomes to people at the lowest cost?". So we created the "How to win" checklist. - A family physician and a care team for every person - Care given by protocols with the best medical evidence available - Strong use of telemedicine to increase convenience, take care of anyone anywhere and reduce cost - Interoperability: data exchanged across providers so we can better understand and improve our member journey - Value-based care - a system of incentives to hospitals and doctors to be paid by better care, not by volume of procedures. - Gym memberships with real data exchange - so we can help our members to stay active and track that.
Validation
When accessing the Sami app, the member goes through a health questionnaire that returns to the clinical team their clinical risk based on self-reported responses. Patients classified as high and medium risk are referred to the family medicine health team and go through the clinical activation process, where a nurse presents the model, the team and collects more information. We observed that the member who has clinical activation as a first event at the operator and performs the event in less than 60 days of plan has an average medical cost 20% lower than those who perform activation as a later event. This impact is mainly observed in hospitalization and emergency room events (the cost of the emergency room is up to 50% lower). In this way, Sami invested in hiring health professionals and improving processes to increase the share of members who have clinical activation as their first event. Comparing the first two quarters of 2022 with the last two of 2022, we can see a 38% decrease in the time between effective, which increased by 10% the members with activation as the first event. We evaluated a total of 6,118 members, of which 3,992 were activated as their first event in the last 12 months. This group generated an average monthly savings of R$71.57 per member and an operating cost of R$61.37, which generates a total monthly avoided cost of R$40,714.38 and an ROI of 0.17.
