Jaime Cervantes, Director General of Vitalmex, spoke to Mexico Health Review of its ambitious plan to build its own clinics.
Q: Last year, Vitalmex was analyzing the possibility of developing its own clinics and hospitals for chronic diseases as part of a 10-year plan. How has this project evolved?
A: We conducted the necessary market research, through which we evaluated different hypotheses, and we also carried out a geographical study across the country to pinpoint appropriate locations. In 2018, we will start the construction and operation of these clinics, which will be directed to a sector of the population that does not have access to services for non-transmittable diseases.
The most interesting part of our model is that it will benefit both patients and the health sector. This infrastructure will help the government reduce its investment in this specialty and will promote joint private-public investment to care for patients from the low-income population.
Q: What are the main challenges that arise when developing projects for this population niche?
A: When people need expensive surgeries, they try to delay them to protect their expenses. People in segments D and E have an income of less than MX$31,000 per year, less than the minimum wage, so we must help them save money and introduce them into the banking system. This project requires that we educate patients and their families, since families will also participate in the recovery of the patient.
Q: What can this model offer to the public service?
A: We take ideas from different countries. For example, the idea of family participation comes from India and the idea of accessing the clinic with a fingerprint comes from Chile. We want between 20 and 30 percent of the project’s capacity to be used by the government. We also can help the public sphere in specialty areas where the government lacks presence. Patients affiliated with social security are not our market; we want to help those who do not have access to any type of coverage. We want to formalize this population group through their experience in healthcare.
Q: What type of financial schemes will you provide?
A: The objective is to make sure money does not become a barrier. In Mexico, 50 percent of health expenditure is private and 93 percent is out-of-pocket. It will be wonderful when patients arrive and can scan their fingerprint to gain access. In that moment, an automatic payment will be initiated from the insurance company and each week they will pay a portion of the expense. They can also pay for six months through weekly payments.
Q: What are the company’s longer-term plans?
A: Vitalmex’s priority is to grow with the opening of new markets. We like working with the government because it is a very good partner. However, we are now diversifying, so we are exploring projects in the private sector. There are many services in which we can contribute; for example, the productivity in surgical rooms at private hospitals is very low. There are many opportunities to create synergies between the public and private sectors to generate economies of scale, which require an element of articulation. Vitalmex could be that element. The Iztapalapa Hospital, the Leon Hospital or any of the existing PPAs were not planned correctly and they are under-used. There are almost 2,900 private medical units in Mexico that are underutilized. Our goal is to improve private and public integration through scalable economies. We also want to become the link that guarantees the same level of care regardless of a patient’s status and background.
Q: How can a future Health Reform adapt these models?
A: First, it should focus on making the acquisition law more flexible, since this flexibility could open space for new models, such as micro PPAs and mid and short-term projects that could address specific needs. Another reform should focus on the certification process. Quality certifications should be strengthened for health service providers because there is an extensive black market and it is affecting the economy. We also must include in the reform sanctions for corruption in the sector.