Grupo Fleury is a large Brazilian healthcare diagnostics provider with 251 care centers, more than 80 million exams performed every year and a valuation of around USD 2 bn. Its core business revolves around performing imaging (e.g. Ultrasounds, MRI, CT) and blood tests on patients and providing physicians with information on clinical data from such tests so better therapies and treatments can prescribed. According to the company’s chairman of the board, 70% of physician’s decisions regarding treatment were influenced by diagnostic exams.
Many changes were occurring in the healthcare scene in Brazil by the end of the 2010s that could impact diagnostic providers. A constant growth of healthcare expenditures over GDP during the decade and a steep increase in medical inflation at 5 times the overall inflation in 2019 pressured the healthcare industry to seek new ways of providing care in more cost-efficient ways. Diagnostic providers, usually smaller players when compared to payers, could disproportionately feel the impact of such pressure in profits, given the relatively low of bargain power they had in the industry. Moreover, verticalized players (healthcare systems that encompassed payers and providers under the same organization) were gaining market share and threatening non-verticalized players, such as Grupo Fleury (90% of the company’s revenue came from payers, such as health insurance companies). The healthcare system in Brazil is also known as being complex and very fragmented, with inefficiencies across the board (e.g. people do not have their clinical information in a single database and many people went to very expensive emergency rooms visits in cases that did not require them to do so).
With that scenario in mind, Grupo Fleury announced in its investor day in December 2019 that it would create a Health Platform to tackle the challenges of the industry. The company’s idea, presented by the CEO, was to create a connection across many players in the healthcare industry that would increase patient satisfaction, improve medical outcomes and reduce overall costs. Grupo Fleury acquired a health management company (a company that focused on using tools to decrease healthcare spending for corporate clients) and planned to use its expertise as the base of such platform. The platform would have two sides: payers, who paid for the patients’ healthcare services, and providers, who provided such services. Grupo Fleury would centralize data and help the patient to navigate the healthcare value chain. For instance, if a patient did not feel well, it could use a telemedicine tool provided by the company to talk to a physician, who would steer the patient the right way. That would be good not only for patients, who would have a much better experience, but also for payers, who would not need to spend money on unnecessary care if that patient chose to go to the emergency room when there was no need to do so. Providers would also benefit by having more information on patients and being able to be more effective in delivering care. Finally, Grupo Fleury could also eventually develop algorithms that would help to assess patients’ risk and be proactive in their treatment, improving clinical outcomes and reducing costs.
It was clear that the Health Platform could create a lot of value for the industry and for Grupo Fleury. Once set up, multi-homing would be very difficult and cross-sided network effects would be of average intensity, what could put Grupo Fleury and its partners in a very good position if they are able to pull this idea off. However, challenges were also great. Many players had already tried to integrate the chain and failed to do so, Grupo Fleury would need to develop digital and nimble competences that it currently does not have and many decisions – such as the billing methodology and openness of the platform – still need to be taken. Grupo Fleury is taking the decision of being a disruptor instead of being disrupted and its move towards creating a platform will be an interesting case of a 90 year traditional company transforming itself for the new economy.
Grupo Fleury, “Corporate Presentation January 2020” (PDF file), downloaded from Grupo Fleury website, http://ir.fleury.com.br/fleury/web/default_en.asp?idioma=1&conta=44, accessed March 24, 2020.
Author’s interview with Márcio Mendes, Grupo Fleury’s Chairman of the Board, call, February 20, 2020.
Branco, Leo and Casemiro, Luciana. “Brasil tem quarta maior inflacção medica do mundo.” O Globo, December 22, 2019. https://oglobo.globo.com/economia/brasil-tem-quarta-maior-inflacao-medica-do-mundo-24154211, accessed March 24, 2020.