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EF: 2020 was the year of diagnostics, and 2021 was the year of vaccines. When we look back at 2022, what will it be the year of and why?  

SM: Things are not completely back to normal; many things are happening this year. Some companies were incredibly active during 2020 and 2021, but many people did not take adequate care of themselves during these years. Now we see that many things must be done and catch up from the past years. We see a degree of a bounceback in terms of services that we could not provide and investments from companies that had to postpone. Things are getting back, but we are not completely there yet.  

EF: From an organizational perspective, what are the key lessons from navigating a pandemic? 

SM: You need to be prepared for a hurricane, even if there isn’t an ocean where you live. We already had aspects developed that we initially were not aware could help us. When the pandemic hit, we had everyone working from home within fifteen days, we were prepared with the Videocon Systems, and all the IT platforms were cloud-based, which made it easier. We moved from around monthly 500 PCR tests before the pandemic to 500,000. The change was huge, but we had the capacity and the people trained. We own a university and operate it, which helped to develop the protocols, and we also have an institute for research that is excellent in training. We used the institute to roll out the protocols to our people and third parties. The HR department was well-prepared for remote work; they had all the necessary resources and processes transferred to their homes.  

Preparation for the future is integral so that processes are for an event such as COVID ten years later. Being mentally prepared and considering the circumstances in two years will result in a faster reaction. We need to be very flexible, we never thought we could perform 2,000,000 virtual teleconsultations, and we convinced providers, nurses, and doctors to transition to virtual. They switched by 100% in one week and did well.  

EF: Can you elaborate on the portfolio performance of Keralty in Colombia and beyond and its evolution?  

SM: We are the healthcare leader in Colombia, and it’s our biggest operation, with the second in the US. We manage the healthcare of nine million people in the countries we operate in, Venezuela, Colombia, Peru, Mexico, the US, the Dominican Republic, and the Phillippines, the only operation outside of the Americas. Six million people we represent are based in Colombia, and we own and operate four hundred centres and thirteen hospitals; eleven are in Colombia, one in Venezuela, and one in the US. We have 60 medical centres in the US and 200 in Colombia, including labs, dental clinics, and the university. We are an end-to-end healthcare corporation. We do everything from insurance to training, and we are one of the biggest medical organizations in Latin America. During 2020 we brought together 100,000 providers and medical doctors to provide different pieces of training, with the majority of them conducted online; now we are doing both physical and virtual, and we put together around 10,000 to 20,000 people in the healthcare sector, with around 25,000 and 10,000 additional providers working part-time. 

EF: With Keralty operating in different facilities and private and public sectors, how is the company contributing toward sustainability in the healthcare sector? 

SM: In the context of both the US and Colombia, starting with the US. When we arrived, we saw that all our knowledge and our mode of operation at the patient centre model helped the payers have the highest service standards and cost control. We also saw the impact on the people, the first regarding access in different facilities or online with small co-payments and for primary care with no co-payment. The second aspect is that we have kept the grades stable with a steady increase over the past five years. In the US, we are talking about inflation increases, so people are becoming healthier at a lower cost and with greater stability in the treatments and annual expenses.  

In Colombia, we do the same for private businesses or pre-paid medicine. Colombia has very good healthcare outcomes, the best in the region, well-trained people working for the private sector, and that is developing the education facilities and the professionals to continue to grow; and we have small out-of-pocket expenses, some of the lowest in the region that comes to around 15%. The private sector allows the government to have a first-class service in the healthcare system with a constrained budget.  

EF: How do you assess the uncertainty surrounding the potential structural reform of the healthcare system, and how does Keralty plan to adapt should reforms take place?  

SM: We will continue taking care of the people. The government and policy can change, but the population's needs remain the same. This doesn’t mean that this is not an uncertain environment right now; the government is taking place and are considering implementing changes. My advice to the government would be to build above the building, this is one of the best healthcare systems in the world and is amongst the top three in the Americas, so we need to work to improve the system's opportunities, not to modify it. In our case, the goal will remain the same, taking care of the people that trust us and maintain their well-being, that is a huge responsibility, but we need the government to pay attention to new members that come from other companies and are closing down. We need the government to be careful about inflation because it will impact the quality of service provided to the population. We also need them to be aware of the problems and how to face them to provide the best healthcare to the people, as we have been doing for the last 30 years.  

EF: Could you elaborate on the importance of innovation in your operations and to what extent you promote local innovation in Colombia?  

SM: It is one of the pillars of our operations. Efficiency, quality, and innovation are the three pillars on the operational side, so talking about innovation is not just about developing new techniques and helping others to navigate new drugs; we have the university and the hospitals, two of which are teaching facilities. We have 22 clinical investigation groups in development working on different projects such as cancer, orthopaedics, primary care, and mental health. Innovation goes beyond the clinical process for us, so we are working on methods to innovate the strategies to achieve greater efficiency and avoid complexity for the user; we want a smoother journey for the patient. Regarding innovation in the processes, we are developing tools and AI for clinical operations for processing and communications with members.  

We signed an agreement with Google to develop and build an ecosystem together. It contains specific aspects such as chat diagnosis and video consultations and allows booking appointments. The idea is that in some years, the electronic medical record will use AI and a big data platform with Google, meaning that it will become an electronic live record. We will create a community for what is happening in the different centres and areas, providing further insights for our providers and better information for the patient. The first one was launched in Miami along with Florida Blue; there are 50,000 members here, so we expect to see growth over the next year. 

EF: How did the physicians adapt to the technological changes? 

SM: They are adapting very well due to getting used to the changes during the pandemic, it isn’t easy, but a new system that was developed for them makes it simpler. The system is designed to meet current needs, and we see a lot of chat usage here in the US, Colombia, and Mexico; it’s a growing country. For example, we’re working with Uber drivers, some using our virtual platform, and some other big names. The primary thing is that it’s a system designed for the doctors, so they are happy using it.  

EF: Could you elaborate on how you establish partnerships and what can be achieved in Colombia through increasing collaborations in the sector? 

SM: We wouldn’t be able to succeed without partners, especially during the pandemic. We gained significant help from the government with vaccines and ventilators, and we also have providers that provide ventilators, ICU equipment and PPEs. We gained much support from the call centres we worked with when our employees began working virtually. The industry was united against a common enemy, so there was no competition; we faced it together. Working together will deliver much more than any individual is capable of. When it came to winning the contracts, my friends told me we needed to leave something for others because we won so many; there’s an institution called La Cuenta de Alto Costo, and we got 10 out of the 11 prices on managing cancer. We were the winner of all the categories. I was awarded the Executive of the Year here in the state with the Chamber of Commerce; I’m lucky, it’s been a good year.   

EF: What three pieces of advice would you give to young professionals that want to follow in your footsteps in becoming an industry leader? 

SM: You need to work in something you like and something you're capable of doing. For example, it won't work if I were someone who would like to be a surgeon, but I'm not trained and don't have the hands to do that, it won't work. You need to find something within your skillset that you enjoy; if you’re good at math but don't want to work in math, you can find something in which you will use your math skills, such as big data engineering. That’s what I would say to a young person looking at the future, looking at the young managers working with us; I would first tell you to need common sense. You can have technical skills in financing or HR but running a company requires common sense. You need vision as well, but that’s based on experience. 

You must also consider the company as part of you, and you are also a part of it, be committed and responsible. To be a leader, you need to take care of others. If you give opportunities to other people and help them improve, you will also become better. In the age of virtual work, it’s also important to go to the office and meet your partners. In-person interactions are integral. It’s a combination of many things. 

EF: What will you celebrate at the end of the year? 

SM: We will celebrate growth as a company, constantly growing for the past five years. Being in a growing company will always mean opportunities, whether opening in a new country or a new division. We will keep in mind every single drawing that kids gave us when they came to our hospitals and the recognition we get from their families. The thing that makes us happier is knowing that the people are well cared for, especially the members and employees. We know we are doing something right when we have more than 90% quality survey ratings. I will celebrate the prices being good and recognized as a cancer institution and a Chronic Disease Control Institution. We are very happy with our efforts in mental and behavioural health, things are growing post-COVID, and we are opening our first centre, fully dedicated to patients with food disorders. We are very proud of this and all of our social care efforts.  

EF: Do you have a final message? 

SM: I would like to thank all the people that rely on us, first the clinical staff that is always fully committed to the people in front of them, but also the people behind the scene and the ones paying the bills. All the engineers, partners, and hospitals with private and public institutions. I’m very thankful for having everyone aligned with us to deliver the mission and purpose of caring for people and their families. I’m grateful that they trust us and that we will be there for them whenever they need us.  

October 2022