Driving cost efficiency through digital health solutions

My colleague Mojca and I recently travelled to São Paulo to do research on Telefónica’s AxisMed subsidiary, a Brazilian health management intelligence company, for our upcoming case study – part of a series of scaled digital health solutions.

Brazil’s national health system Sistema Único de Saúde (SUS) promises to provide free healthcare to all its 207 million inhabitants. It consists of a group of health services provided by public organisations and institutions on national, state and municipal levels with over 73,000 healthcare units such as basic care units and hospitals. Brazil’s sheer size in terms of geography and population provides an enormous challenge to the SUS. Overburdened medical practices lead to long waiting times for appointments, which prompt people to go to the emergency room instead.

Additionally, there is little emphasis on illness prevention in Brazil, and patients can visit a doctor and the emergency room as much as they want, resulting in unnecessary consultations, exams and hospitalisation. High amounts of corruption and fraud in the health sector also lead to increases in health expenditure overall. Brazilians who are either part of the formal employment system or can afford it will opt for the private health insurance. This has led to 75% of the population solely using the SUS, with the remaining 25% being covered by private health insurance.

High levels of corruption, fraud and money laundering as well as rising costs for new procedures and medicines has led to an increase in cost for employers who offer private health insurance to their staff.

This is where AxisMed comes in: It offers a multi-channel platform that allows patients to be in touch with doctors, psychologists, nutritionists, pharmacists, social workers, nurses and physiotherapists via mobile app, SMS, video, web and voice. The focus is on determining risks through data intelligence and influencing individual behaviour change while ultimately reducing costs and improving spent of private health insurance.

During a highly interesting week in São Paulo, we learned that AxisMed provides multiple solutions to address risks which lead to improved cost efficiencies for private insurance companies and reduced health costs for private corporates offering insurance to their staff.

These solutions include:

  • Access to information and health experts 24 hours a day through a portal or app
  • Specialised support for chronic, elderly, pregnant and obese patients
  • A 24-hour telephone support for health emergencies and incidents
  • Pre-, during and post-hospitalisation support
  • Cost reductions through rational use of resources
  • Business intelligence and health information management

 

This has greatly contributed to better access to health information, improved quality of care and reduced costs through prevention and resource optimisation for AxisMed clients. For example, the specialised support for chronic, elderly, pregnant and obese patients has led to savings of USD 15 million over seven years through identifying the risk for patients with or prone to chronic diseases with an emphasis on medical advice and behaviour change, enabled by various prevention methods.

Another example is the reduction of excessive usage of health systems through providing the right information at the right time: whereas a group of so-called hyper-users showed an average increase of costs of 12% on a yearly basis before the introduction of AxisMed’s services, AxisMed managed to lower the cost of average monthly expenditure by 35% in less than ten months, resulting in USD 1.6 million savings.

We are excited to share the results of our research in the next couple of months. Stay tuned via twitter or our blog page.

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