Payor/provider vertical integration is the most successful strategy in Brazil according to our experts. 2022 February finally saw the merger of the two Brazilian giants of vertical integration, Grupo Notredame Intermédica (GNDI) is now a wholly owned subsidiary of Hapvida. Together they became the second largest health care company in the southern hemisphere and currently have a market cap of US$17.2bn and approximately 17% of the Healthcare Plan insurance market, according to experts.