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EF: Could you elaborate on Beneficência Portuguesa de São Paulo's (BP) footprint in Brazil and your role as Business Development & Expansion Director in consolidating the organization into a regional health reference center?

PH: BP is a health hub based in Sao Paulo, with considerable influence in the country. Our services cover a wide spectrum, from primary care to high-complexity procedures.  

In my role, I oversee a portfolio encompassing over 100 clients, including healthcare insurance firms. I am also involved in the business development aspect of the company, where our focus revolves around orchestrating our expansion initiatives in collaboration with clients and suppliers.

Together with our partners, we co-create products and services to achieve sustainable growth. Recently, BP signed a joint venture with Bradesco, a larger health insurance group, and Grupo Fleury, a major diagnostic company, to extend our oncology services. Now, we are looking to expand into other specialties.

EF: What are BP's main priorities, and where are you allocating resources to achieve this growth?

PH: Brazil is facing rising health costs, and there is a need for restructuring the system. Nevertheless, our ambition is to become one of the top three health hubs with the best reputation in Latin America, with sustainable growth, besides these challenging times.  

In collaboration with our partners, we aim to reach feasible business models among stakeholders. We are building up different healthcare lines for what is most requested. For instance, Oncology (mainly breast and prostate cancer), Obesity care, and Cardiology (e.g. cardiac failure), to smoothly carry the patient through the system. Our goal is to ensure integral, high-quality care while establishing a transparent cost structure for our clients.  

We are putting more focus on comprehensive health and well-being for all people by redesigning protocols and digitalization. Procedures like bone marrow transplants for over 1,000 patients (making us number one in Brazil’s private sector), robotic surgery (over 1,700 surgeries performed since 2018), or cell therapy (licensed by major suppliers) illustrate where we invest and distinguish ourselves at BP. Being on the leading edge in our key specialties moves us in the right direction of becoming a main healthcare reference in the region.  

The private sector market is increasing in number of beneficiaries, and BP is gaining market shares. Our revenue has grown both for inpatient and outpatient surgeries and will surpass more than 2.2 billion reais with sustainable results.

EF: How is BP fostering partnerships with the public sector, and where do you see opportunities to build a more sustainable and fairer health system for the country?

PH: Healthcare costs in Brazil make up nearly 10% of the country's GDP, with a significant access imbalance. Approximately 6% of GDP serves 50 million people in the private sector, while around 4% serves 160 million people in the public sector (rounded figures). Given the escalating expenditures and the need for streamlined budget allocation, it is crucial that we establish effective planning strategies to harness opportunities that foster system sustainability and ensure high-quality healthcare for the population.

BP is one of six hospitals of excellence in Brazil. These hospitals are in partnership with the Ministry of Health, supporting the program for the development of public health called PROADI-SUS. We are collaborating on projects focusing on areas like medical assistance, quality, training, and management. We are present in all the states of Brazil and contribute to making the healthcare system more accessible for all.  

We also have a strong interest in genetics. We currently participate in Genoma Brazil as one of the PROADI-SUS projects, which maps Brazilian genomics. We use our assets and key expertise strengths to capture valuable data to improve health across key specialties.  

EF: How are you using AI, telehealth, and other digital solutions to make your operations more efficient and raise your standards of care?

PH: We have earned the distinction of being a hospital EMRAM Level 7, the highest level of digitalization in healthcare. This recognition is granted by the Health Information Management System Society (HIMSS). This organization assesses hospitals worldwide based on their digitalization efforts, which also translates into patient safety. Globally, only approximately 300 hospitals have reached this ranking, with seven located in Brazil, including two affiliated with BP.  

We are running a dozen MVP projects on innovation regarding AI, sensors, networks, 3D printers, blockchains, and synthetic biology, all to improve access to healthcare.

Interoperability plays a pivotal role in transforming us into a smart hospital. We have been digitalizing BP for the past ten years, implementing digital medical records and other key tools to ensure the system's compatibility with partners and suppliers.
Partnerships with health-tech companies like Sami and Alice, which operate as digital health insurance, help us seamlessly integrate and share the necessary healthcare data to support informed medical decisions. This streamlined approach allows us to fast-track assistance for inpatients and quickly access the patient’s treatment history when they return to primary care or see specialists.

As a starting point for transparency, we often share with payers how their customer base uses our hub based on DRG (disease-related group) analysis and discuss alternatives for joint optimization efforts. We are continuously expanding and adapting our commercial offerings within our lines of care to include more comprehensive bundles. As different payers offer different plans at different segments, we adjust to this segmentation and tailor our products to the demand. With this model, we ensure sustainable and viable margins without losing the focus on care and patient safety.

EF: What are the three pillars for building a sustainable healthcare business in Brazil?

PH:  The first pillar relates to market adaptability. We have to evaluate and reflect on the current trends in varied markets (e.g., entry-level healthcare markets to the latest screening or surgery alternatives) within our services and adapt quickly.  

The second pillar would revolve around sustainable regulation. Today's healthcare market is based on mutuality. There is a fund available for those in need. Still, it does not consider the precise responsibility for care because it includes payments for individuals not dealing with chronic illnesses. Implementing regulatory changes would involve a more accountable approach to self-care.

The third pillar focuses on adjusting our services to explore ways to promote efficiency and innovation, such as accelerating processes, providing fast care, and enhancing the overall productiveness of the system. Interoperability can be a key factor in achieving this. Although not all systems can seamlessly exchange information, when our sector embraces technology, we can significantly enhance the various aspects of care pathways, ultimately contributing to overall sustainability.

EF: Do you have any final remarks that you want to include?

PH: Apart from focusing on regulation, care, accountability, and innovation, we have the responsibility to drive the market forward. We need to think of healthcare as a systemic organism. Thus, all stakeholders must move together.
In this sense, as doctors are key stakeholders of the system, medical education plays a crucial role in developing the market. BP has partnered with the School of AI to educate doctors and healthcare professionals in AI. We need to anticipate trends and avoid falling behind.  
In this sense, our goal is to broaden our medical education to include postgraduate and short-term training programs, soon expanding to undergraduates.  

In parallel, we offer training so our team can keep pace with the evolving ecosystem.

We must maintain a collective pace and move steadily to grow the market. Collaborative efforts are essential as we can move farther together.  

November 2023