While other sectors like microfinance have been on the radar of impact investors and market-minded philanthropists for over a decade, health social enterprises are generally a newer player to the scene. But the last few years have seen huge advances for these market-based health solutions globally, including in Latin America – particularly in Brazil, Colombia and Mexico. In July Linked Foundation had the opportunity to visit some of these budding health social enterprises in Mexico, together with our colleagues at Global Partnerships. Linked and Global Partnerships currently support health enterprises in Mexico such as Clinicas del Azucar, and both organizations are looking to expand their portfolios to support more of this work in Mexico.
We spent most of our time in Mexico City visiting Sala Uno, a company that provides low-cost eye care services to low- and middle-income Mexicans. Based on the non-profit Aravind mode in India, Sala Uno is a for-profit enterprise that provides eye care ranging from vision exams and glasses to Lasik and cataracts surgeries, with the goal of “eliminating needless blindness in Mexico.” A hub-and-spoke model, they currently have one central surgical center and several smaller “spoke” clinics as well as partners through which they operate campaigns to reach diverse populations.
One specific population of interest is those who have diabetes and therefore are at higher risk of blindness, especially if their eyes are not checked and treated frequently. Our team was incredibly impressed by the mission, the management team, the appearance of the clinics, and the operational and technological efficiency of the company. The specific component that perhaps impressed us most was the pricing model that Sala Uno has developed, based on tiered service levels. This model allows them to depend upon patient self-selection which they have found corresponds directly to ability to pay, and also allows them cross-subsidize so that they offer services affordable to anyone who needs care – including free services for those who cannot pay. Having examined many health social enterprises in Latin America, we have found that one key to successfully achieving both sustainability and reaching the poor is to crack the pricing and cross-subsidization code.
Our other visits in Mexico City included meeting with Previta, a pioneer in the health industry there, which is centered around its eHealth Tracker software that allows for e-record keeping, health risk assessment and remote patient monitoring. Previta also operates clinics located in Walmart stores as well as mobile clinics. Some of the newer health enterprise visionaries we had the fortune to meet included: Salud Cercana, an integrated subscription primary care provider that allows patients access to several services – clinics, a mobile platform and health coordinators; Disculpe Doctor, an online chat platform for people to connect with doctors and ask health questions; and Kiwi, a provider of health payment plans.
Through this exploration of Mexico’s emerging health enterprises, we learned that they face many of the same challenges, including difficulty generating demand among the poor, as well as developing a revenue model that allows the business to provide free and subsidized services to people who can’t afford to pay. They also struggle with determining how to effectively partner with and compliment the public health system, and how to compete with existing, often lower quality health service providers.
Luckily, we also learned that there are incredibly smart and hard-working entrepreneurs tackling these challenges, and in many cases, making incredible progress to overcome them.
Anna De La Cruz
Anna De La Cruz is a Senior Advisor to the Linked Foundation