The J Curve Insider: Why the Most Scalable Health-tech Companies Look Like Logistics Startups

Brazil’s healthcare system is massive—US$70 billion in annual private sector spending—but plagued by regulatory friction, legal bloat, and operational inefficiency. Up to 30% of that spend is lost on lawsuits, commissions, and bloated overhead. Meanwhile, 75% of Brazilians remain outside the private system altogether, relying on a public infrastructure that struggles to meet demand.

Today, I sit down with Vander Corteze, founder and CEO of Beep Saúde, Brazil’s leading at-home healthcare company, to break down where the system is failing, why at-home care is becoming the new standard, and how logistics, AI, and trust are unlocking a US$10B opportunity hiding in plain sight.

Let’s get into it.

THE SYSTEMIC INEFFICIENCIES.

Olga Maslikhova: Vander, let’s start with the big picture. What are the most broken parts of Brazil’s healthcare system—where are the business opportunities lie?
Vander Corteze: If you zoom out, Brazil’s private healthcare insurance sector transacts over US$70 billion annually. But over 30% of that—over US$20 billion—is being drained by inefficiencies. Specifically:

• 8–11% of revenue from major health insurers like SulAmérica is spent on legal claims, driven by regulatory mandates from ANS that force insurers to cover treatments beyond their original policies.

• Another 8% goes to distribution fees—brokers required by law who often add no real value.

• Over 10% is burned on bloated administrative costs (G&A), particularly by legacy insurers with decades of operational baggage.

That’s nearly US$1 in every US$3 being burned before a single patient is seen—an open invitation for disruption.

THE CASE FOR BURNING THE OLD PLAYBOOK.

OM: So if you were building a healthcare company from scratch, how would you attack that inefficiency?
VC: Start by building outside the ANS regulatory umbrella. That alone would eliminate a huge chunk of the legal overhang. Then go direct-to-consumer—cut out the brokers. And finally, leverage technology to build a lean, efficient operating model from day one. That’s exactly what we did at Beep.

BETTING BIG ON AT-HOME HEALTHCARE.

OM: Why start with at-home services, and why vaccines?
VC: It was the Amazon-books playbook. Vaccines are low-margin and low-interest for incumbents. But they gave us a foothold. We built consumer trust, optimized logistics, and scaled without facing heavy competition.

Today, we’re Brazil’s #1 vaccine company—without a single clinic. That gave us the infrastructure to expand into lab tests, infusions, and more.

OM: That’s wild. What’s powering your growth?
VC: Operational efficiency. Specifically: geo-density and logistics. We track appointment density per km², optimize routes daily, and use AI to simulate better outcomes. It’s operational chess. Over five years of backtesting and refinement, that’s become our moat.

That’s what allowed us to offer a premium at-home experience at the same cost insurers were already paying brick-and-mortar clinics.

THE REAL MONEY IS AT HOME.

OM: How big can this get?
VC: Just in lab tests, the addressable market is US$6 billion. I believe most of that moves at home in the next 5–10 years—just like we moved from bank branches to mobile banking.

Add infusions, drug delivery, chronic care support, eye care—it’s a US$10B+ revenue opportunity for Beep. And that’s without doing anything “crazy.” No surgeries, no ICU—just low-complexity services delivered at home, efficiently.

OM: Why aren’t incumbents going after this?
VC: It’s the Innovator’s Dilemma. They’re trapped in profitable, real-estate-heavy models. Going asset-light and mobile would cannibalize their core business. That’s our edge.

GROWTH ENGINE: TRUST + NPS + MOMS.

OM: Beep’s consumer love is off the charts. How did you build trust in such a sensitive space?
VC: Trust is everything. Healthcare doesn’t have “early adopters.” No one wants to experiment when it comes to their kid’s vaccine. Initially, I leaned on my network—doctors I trained with who trusted me. But what really drove word of mouth was punctuality and professionalism. 89% of appointments happen exactly on time. When we’re late, we proactively notify the patient via WhatsApp with a new ETA. That alone shocked people.

OM: That’s a better experience than most banks or airlines.
VC: Exactly. And we hired and trained our own nurse workforce from day one—not freelancers. That gave us consistency.

Word of mouth among mothers was our first growth loop. Then we layered on doctor referrals, influencers, and digital ads. We’re now growing 50% YoY, and on track to cross US$200M in revenue by 2027—profitably.

PRICING A NEW CATEGORY.

OM: And how did you price the service?
VC: That was the battle. Insurers told us, “We’ll only pay you what we pay a clinic.” No convenience premium. So we had to hit brick-and-mortar costs—but with at-home logistics.

We did it through efficiency. Every KPI we track—travel time, appointment clustering, routing optimization—is designed to maximize ROI per nurse-hour. And we never generate demand ourselves. We require a doctor’s prescription. That’s intentional—so insurers trust we’re not overusing care for profit.

AI, BUT MAKE IT BRAZILIAN.

OM: Let’s talk AI. Buzz or breakthrough?
VC: Huge breakthrough—especially for patient navigation. Brazil’s healthcare system is chaotic. You have a headache and decide you need a neurologist? In most cases, you can just book it. There’s no triage layer.

That’s where AI agents will win: symptom-checking, directing you to the right care, scheduling appointments, even helping with prescriptions.

And this needs to happen on WhatsApp, because that’s where Brazil lives.

THE UNTAPPED 75%.

OM: Outside of insurance, where are the biggest healthcare opportunities?
VC: Huge opportunity in low-budget, pay-per-use care. 75% of Brazilians don’t have private insurance. They still need diagnostics and routine care. If we can match them with unused slots at clinics—especially through a trusted, tech-first aggregator—we unlock massive value. Think iFood for healthcare.

There’s also mental health. Post-pandemic, online therapy exploded. Companies are now legally required to offer mental health programs. That regulation created demand overnight for platforms like Conexa. It’s one of the fastest-growing verticals in telehealth.

FINAL TAKEAWAYS.

✓ Build where incumbents won’t go. The next billion-real opportunity is in what incumbents ignore: overlooked services, underserved people, and unstructured logistics.

✓ Treat inefficiency as a business model. Regulation, legal waste, and bloated overhead aren’t obstacles—they’re signals for where to build.

✓ At-home care is becoming the default. What used to be VIP treatment is now a consumer expectation. Beep is ahead because it built for that inevitability.

✓ Don’t wait for consumer trust—engineer it. Punctuality, clean UX, and real-time communication built Beep’s reputation faster than ads ever could.

✓ Price like a clinic, operate like a tech company. Beep didn’t charge a premium for convenience—it engineered efficiency until it could match brick-and-mortar unit economics.

✓ Geo-density is the moat. Beep’s edge isn’t just logistics—it’s precision. Every car, nurse, and route is modeled and optimized for scale and repeatability.

✓ The channel is the product. In Brazil, WhatsApp isn’t just a comms layer—it’s where healthcare interactions should start and finish.

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