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First contract was closed with lawyers’ association; another one is under negotiation with health insurance company

07/25/2022


Daniel Grecca — Foto: Silvia Zamboni/Valor

Daniel Grecca — Foto: Silvia Zamboni/Valor

The Sírio-Libanês Hospital is diversifying its operations by forming partnerships with health insurance companies in the creation of health plans in which the hospital’s entire network is accredited – a verticalization that has the credibility of the brand to its advantage. It is also expanding its primary medical care services to companies that hire Sírio to offer this type of care to their employees. This week, the fifth unit dedicated to primary health care was opened in São Paulo.

“I am a great believer in the primary care model, which focuses on prevention and not on disease. With digitalization, more people have access to private health care and access to quality care. With the growth of prevention actions there won’t be as many large hospital structures like ours, but high complexity hubs,” said Sírio-Libanês CEO Paulo Nigro.

The first contract of a group health insurance plan that includes just the doctors and laboratories from the Sírio-Libanês hospital was signed with the Lawyers’ Assistance Fund, from Brasília, where the hospital has a facility. The lawyers and their dependents also have the option of choosing health plans with an open network. The hospital is in final negotiations with a health insurance company to offer this same product format, which in general has a lower cost than health plans with a broad service network.

“In this model, there is a family doctor who accompanies the patient’s entire journey. The consultations with specialists, exams, and hospital procedures are done internally, with our own protocols,” said Daniel Grecca, head of population health at Sírio-Libanês, the area responsible for these partnerships.

Mr. Grecca’s department is responsible for a portfolio formed by 180,000 people, who are health plan users or employees whose companies or health insurance hire Sírio for certain services such as primary medical care, digital emergency care, and management of chronically ill patients, one of the segments that most increase the cost of the health plan.

“With digitalization, it is possible to offer a variety of services. Currently, 60% of the hospital’s consultations are digital, the resolution rates are 80%, and satisfaction rates reach 95%,” said Mr. Grecca. The online service will allow Sirio to serve other markets. Today, its operations are restricted to São Paulo and Brasília, but the idea is to partner with other establishments in case there is a need for face-to-face service.

The creation of health plans with specific hospitals began about three years ago in the market when Amil withdraw accreditation of hospitals from Rede D’Or. The measure affected Rio de Janeiro, where the main hospitals belong to Rede D’Or. To attend this niche and to be able to offer a product at a price like Amil’s, Bradesco developed a health insurance plan with a network of accredited doctors and hospitals composed of D’Or’s hospitals and doctors. Many Amil users migrated to this product, which had a great demand.

Besides, it is a way to compete with Hapvida/NotreDame Intermédica, which has a wide vertical network and a much lower cost.

*By Beth Koike — São Paulo

Source: Valor International

https://valorinternational.globo.com/