Earlier this month Linked Foundation Executive Director Nancy Swanson and I had the opportunity to attend Innovations in Healthcare’s 5th annual forum in Washington D.C. Healthcare innovators and investors from around the globe came to “connect, collaborate and learn” as they work to build sustainable solutions to health challenges. Private sector health solutions are rapidly growing, even in Latin America, where government health systems play a huge role in healthcare delivery. Because of the large government role in healthcare, the region has often been considered unviable territory for health social enterprises – but as existing government structures have fallen short in their ability to provide timely, high quality services to the people who depend on them, private sector complimentary solutions have been increasingly present to fill the void.
Many of the emerging health enterprises focus on new service delivery models to improve care and expand access. For example, Dr. Consulta and Clinicas Sim in Brazil are low-cost, high quality clinics allowing low- and middle-income residents to avoid the long waiting periods and spotty quality they experience in public sector clinics. New health technologies or new uses of existing technology is also a focus of emerging enterprises in Latin America, ranging from diagnostic tools to telemedicine, and utilizing technology approaches such as data mining and crowdsourcing to increase efficiency and quality in the sector.
Combining this new approach to service delivery with innovative use of health technologies is a group of enterprises focused on chronic disease management. As incomes and living conditions increase with development, infectious diseases (the so called diseases of poverty) are reduced, and the concern shifts to chronic and non-communicable diseases (NCDs). Diabetes has become a major cause of mortality in Latin America – Mexico has one of the highest rates of type 2 diabetes in the world, which currently plagues almost 15% of the population (source). Health social enterprises are rising to the challenge of NCDs like diabetes with models that use a patient-centered approaches to make care easier, more efficient, higher quality and as low-cost as possible. Clínicas del Azúcar in Monterrey, Mexico, offers low-cost one-stop-shops for diabetes care, strategically placed near big-box stores, with the full spectrum of diabetes services – from nutrition and education, to exams, medication, and counseling. Services are offered on a subscription basis, financial assistance is available for those who can’t afford services, and people can make small, frequent payments (easier than saving for one annual payment) at convenience stores around the country.
Another approach is telemedicine, for in-home prevention, education and care for people living with chronic illness. Accuhealth Chile is a B2B model that allows doctors to monitor patients outside of the hospital or clinic, in the comfort of their homes, using a device that allows the patient to both send and receive personalized health information and complete daily diagnostic testing and treatment plans. This helps to prevent and predict adverse events among patients, which results in improved health outcomes and cost savings.
The biggest question with these models is the extent to which they can fulfill their social mission to reach low-income, rural patients (in other words not only improve but expand access to health care) and still achieve financial sustainability. It seems to depend upon thinking outside of the traditional B2C box and employing innovative mechanisms like cross-subsidization and flexible financing options. What I would like to see more of is partnership between new private sector models and government health systems – particularly in Latin America where the government plays a large role in healthcare – rather than strictly parallel approaches. Combining existing government infrastructure and funding with social innovation funded by impact investors and philanthropists may be the only way to effectively reach the lowest income populations and achieve true sustainability.
Linked Foundation and other impact investors and foundations I work with are beginning to invest in health social enterprises in Latin America, and in a future post I’ll dig into the opportunities and challenges with funding a public good like healthcare through private investment. In the meantime – are you excited about any market-based health solutions that expand access to people who need it? I’d love to hear about them!
Anna De La Cruz
Anna De La Cruz is a Senior Advisor to the Linked Foundation and this post orginally appeared on Anna’s consulting website on April 18, 2016.