Signing of an Investment Agreement for the "Medical Access Improvement Project" in Brazil (Private Sector Investment Finance): Impact investing in a health-tech company providing primary care to low- and middle-income people through efficient AI-based operations
The Japan International Cooperation Agency (JICA) signed an investment agreement with dr. consulta, a Brazilian health-tech company, on August 7. dr. consulta will use the funds from the agreement to further expand its business and contribute to universal health coverage (UHC, Note 1) by investing in medical equipment and facilities.
Although Brazil has a universal health insurance system (SUS), the capacity of both public and private medical institutions that accept patients with SUS coverage is limited due to budget shortfalls caused by issues such as the country’s fiscal constraints. The average waiting time at such SUS-eligible hospitals reaches 300-400 days, which includes medical procedures postponed due to the COVID-19 pandemic. For this reason, people with a certain income level purchase private health plans either on their own or through their employers, and receive private medical care without using the SUS. However, it is estimated that there are more than 100 million low- and middle-income people who cannot afford such private plans and fail to receive adequate medical care through SUS alone.
dr. consulta provides primary care to this low- and middle-income segment of the population that is underserved under the incumbent public and private health-plan systems. The company was founded in 2011 by Thomaz Srougi, who was born into a family of doctors. After gaining experience in investment banking and other businesses, he founded dr. consulta with the opening of a medical clinic in a favela—a shantytown—in the state of São Paulo, Brazil. Aiming to provide primary care that is physically and economically accessible to low- and middle-income people, the company has established efficient medical operations at 28 clinics, planned carefully in terms of epidemiology, demographics, and resource sharing, as well as having built an online-consultation system. It has developed AI algorithms from its own data on a total of 2.5 million patients, and the AI performs the auto-matching of medical appointments and identifies the necessary medical process. In addition, the company maintains a high quality of medical care through the digitization and operation of more than 300 medical guidelines, drawn up by physicians using international standards. Compliance with these guidelines is one of the key performance indicators (KPIs) used to decide the amount of compensation received by a physician. Moreover, utilization of medical equipment from Japanese companies backs dr. consulta's robust operation.
The company has consolidated its business model to satisfy the diverse needs of patients, establishing a subscription service that allows the subscriber—as well as up to four friends or family members—to receive discounted medical services for a certain fee. The company has also launched a low-cost health plan that allows unlimited access to medical services in partnership with Cuidar.me, an insura-tech startup. With these integrated menus, dr. consulta covers more than 60 medical specialties, attending to more than 700,000 patients annually. These efforts have succeeded in lowering medical costs and reducing waiting times to the point where walk-in appointments are also possible. As a result, the patient satisfaction rate (Net Promoter Score) is approximately twice that of public hospitals.
This is JICA's first direct investment in Latin America. JICA joined dr. consulta’s Series D (Note 2) financing round, led by Kamaroopin, a growth equity fund under Patria Investments Ltd., the largest regional investment company in Latin America, with extensive initial public offering (IPO) and mergers and acquisitions (M&A) experience in the Brazilian health sector. This is a co-investment with IDB Invest, a regional development finance institution in Latin America, under the Co-investment and Loan Framework (CORE: see link below) between IDB Group and JICA. JICA, together with its local partners, will continue to support companies like dr. consulta that aim for UHC with innovative business models and contribute to the achievement of SDGs (Sustainable Development Goals) Goals 3 (Good health and well-being) and 17 (Partnerships for the goals). The agency will also support the introduction of high-quality Japanese medical equipment and contribute to the expansion of business-matching efforts.
(Note 1) UHC: A state in which all people have access to the full range of quality health services they need, when and where they need them, without financial hardship.
(Note 2) Series D: A financing-round stage, after the seed stage and stages A-C, and before stage E, in which a startup raises funds to accelerate its business. A financing round by a relatively mature later (growth) stage startup usually falls into this category.