Big ideas from the conversation with Andre Florence & Gui Azevedo, co-founders at one of Brazil's largest healthtechs Alice: revolutionizing $200B healthcare market, building resilient corporate culture and lessons learned from fundraising bonanza 💸🇧🇷🤝

Brazil is the largest healthcare market in Latin America and spends 9.47% of its $1.84tr GDP on healthcare which represents a whooping $161b. The Sistema Único de Saúde (SUS) is Brazil’s national health system that reaches universal health coverage within the country. It is decentralized with administrative responsibilities at all levels of government: federal, state, and municipal. SUS is the sole provider of health services to approximately 72% of the population. It is estimated that 50.7m or ~23% Brazilians have access to the private healthcare system. The majority of beneficiaries receive private health insurance through their employers as a benefit.
Brazilian private healthcare insurance market is the second largest in the world behind the United States. It is projected to grow from $50.66B in 2022 to $98.01B by 2030, registering a CAGR of 8.6% during the period. But why would you need a private health insurance in the country that provides free healthcare for all, you might ask. Well, because it’s overstretched and underfunded. It’s not uncommon for patience to wait six months for a doctor’s appointment and several years for the surgery - these gaps in the public healthcare system have led to a growing number of Brazilians to rely on private health insurance. The Brazilian private healthcare insurance market faces several key challenges though:

☠️ High market concentration and lack of competition
The market is highly concentrated, dominated by a few large players like Bradesco Saúde, Amil, Sul America and Porto Seguro

📈  Rising healthcare costs
Healthcare costs in Brazil are rising due to factors like new technologies, aging population, payment methods that incentivize volume over value, and lack of competitive markets. This makes health insurance plans more expensive for employers and hence for consumers

💥 Regulatory challenges
While regulations aim to promote competition and consumer rights, paradoxically they may enable further market concentration by large insurers if their market power is not checked

There’s a number of tech companies that try to create a paradigm shift in a healthcare market in Brazil by adapting the so-called Kaiser Permanente model  that combines health coverage and care delivery into one coordinated experience. For the most recent episode of The J Curve, I sat down with Andre Florence and Guilherme (Gui) Azevedo, co-founders of Alice which is one of the biggest startups in the space.

 Here are the five big ideas from our conversation with Andre and Gui 👇🏻

1️⃣ Avoid Negative Gross Margins

Growing with negative gross margins is risky and not sustainable. Depending too much on future funding is precarious—after all, the next round might not come. Sometimes, you have to learn this lesson more than once!

2️⃣ Decisiveness is Key

In entrepreneurship, swift and bold decisions are crucial. The faster you act, the better equipped you are to tackle challenges head-on.

3️⃣ Culture Drives Resilience

At Alice, a strong corporate culture is non-negotiable. They meticulously build a culture based on high standards, trust, and alignment towards a common vision. This intentional approach extends to their hiring practices, ensuring everyone, from specialists to founders, embodies these core values.

4️⃣ Revolutionizing Healthcare

Integrating clinical and claims data can transform healthcare management in Brazil, leading to more effective and efficient solutions.

5️⃣ Embrace the Struggle

Navigating the complex and regulated world of healthcare entrepreneurship is fraught with challenges. Developing a growth mindset and maintaining a clear mission are vital to persevering through tough times

You can watch the full interview with Andre and Gui on Youtube 👀👇🏻

Or listen / watch the episode on Spotify 🎧

Before you go, here’s a super interesting read if you want to gain some understanding of Brazilian healthcare insurance market.

Thanks for reading,

Olga