News About Payor and Operator Models


Funding change to force Finnish groups back into preventive care

From next year Finland, one of Europe's largest occupational healthcare markets, will change funding structures to incentivise employers to spend more on preventive care and less on medical care. HBI explains the law and looks at how it will affect the market.

Kenyan NHIF C-section costs soar

C-sections now account for a third of all maternity costs under Kenya's national health insurance scheme, with some experts concerned that operators have been cashing in on inflated prices.

UnitedHealth replaces CEO of Brazilian operations

UnitedHealth Group (UHG), the largest private healthcare company in the world by revenue ($226bn) and owner of Brazilian insurer Amil, has replaced the CEO of its Brazilian operations with an executive from Amil itself. The change coincides with the group's Q3 results.

Unilabs and Ribera Salud JV loses lab outsourcing contract

BR Salud, the Spanish JV owned by Unilabs and Ribera Salud, has lost its multi-million euro public contract to the country's fourth-largest lab group Analiza. It was worth, HBI estimates, 15-20% of Unilabs' Spain revenue.

DomusVi wins contract and expands into Colombia

Spain's largest PE-backed nursing home group by revenue, DomusVi, has won a public tender in the Basque Country to provide residential nursing home care and opened its first facility in Colombia through subsidiary Acalis.

AAR Healthcare teams up with e-payment platform in Kenya

Kenyan insurer and healthcare service provider AAR Healthcare says it is tackling low uptake and fraud by allowing customers to pay for treatment and manage medical payments with their mobile through a new partnership with e-payment system M-TIBA.

UK applies €1.5bn band aid to care sector in crisis

The UK government has pledged £1.5bn (€1.6bn) to local authorities' social care budgets in order to tide the care sector over for another year (which includes both nursing homes and homecare). But while councils welcome the funding, a market investor tells us it won't be sufficient to patch up a system in crisis. A provider tells us the amount is in line with what the sector expected but is a tempory solution.

Insurers in Croatia trying to verticalise polyclinics

HBI hears that some of Croatia's private health insurers have been buying polyclinics in a bid to verticalise the outpatient market, but an investor says that it can be difficult to make the model work.

Interview: Julian Andriesz, CEO, Verita Healthcare

The massive latent demand to live longer is being tapped by a new generation of health care providers. British entrepreneur Julian Andriesz, 53, made a first fortune building business in SE Asia and got into prevention after watching his mother die of ovarian cancer, diagnosed late. He says his intention is to help his clients, whether they are healthy, have cancer or auto-immune diseases, to live longer, better lives. Verita has a chain of 10 clinics, believes its digital health disease prevention and management platform is about to become the largest in the world and owns IP, and research and manufacturing in Europe, Asia and Australia.

Parnassia struggles as Dutch psychiatry “bleeds money”

The largest Dutch psychiatric providers are struggling to turn a profit with Parnassia, the biggest of the bunch, reporting losses of €29m for 2018. We speak to the company about the reasons behind the sector's troubles.

How insurers are delivering preventative care through tech

HBI speaks to Hong-Kong-based insure tech startup CareVoice about how its solution supports insurers to deliver more bespoke plans in China, following its $10m Series A. As most global insurers are trying to pivot from being gatekeepers to caregivers, can solutions that provide preventative support help?

Amil under pressure as business is restructured

UnitedHealth Group (UHG) is implementing cost-cutting measures to improve Brazilian insurer Amil's balance sheet and has laid off 300 employees as it restructures operations.

MedMa invests in radiotherapy

The Russian investor behind Citilab, Nefroline and Genome is set to invest RUB350m ($5.5m) in a radiotherapy centre in western Russia.

DomusVi: Insurers need to see the value in homecare

Europe's third-largest nursing home operator by revenue, DomusVi, claims its homecare business saves 35% on hospitalisation costs for private Spanish insurers. So why do they still need convincing to pay for homecare services? We speak to the director of DomusVi Healthcare, David Fernández.

Improving insurance and pricing models in South East Asia

Both overtreatment and lack of access in South East Asian healthcare systems are pushing stakeholders to find innovative solutions to improving care. At HBI 2019 we heard key insights into these challenges from investor Fosun Healthcare Holdings and the CEOs of two care providers, teleconsultations platform MyDoc and homecare specialist Lotus Eldercare.

Does Value Health have a future?

Value health is the revolutionary idea pioneered by Harvard guru Michael Porter. He had the temerity to suggest providers should be rewarded for quality, rather than activity and that the patient should be viewed and consulted as customers. Invented in the early noughties, it hit a high water mark 7-8 years ago when Obamacare was rolled out incorporating the concept. Then it felt like an inexorable river.

Portugal’s public insurer close to announcing new price list

The health insurer for Portugal's 1.2 million civil servants says it will soon announce its new price list for services rendered by the country's private hospitals, the biggest of which briefly cut ties with the body at the start of 2019. We talk to one of their executives.

UK healthcare market – surprisingly strong

How is Europe's largest private equity invested market faring in these uncertain times, as staff shortages and the continuing uncertainty of Brexit make forecasting the future difficult? In most cases, better than you might think! This was the general response from HBI 2019's learned panel of UK and Ireland experts - but as always there were exceptions that proved the rule.

UnitedHealth’s Amil de-lists chunk of Brazil’s biggest hospital chain

Brazilian payor-provider Amil, owned by UnitedHealth, has partially or fully de-listed almost half of Rede D'Or's hospitals, the country's largest operator, while its president talks about "not referring patients to anyone who is wasting money". One local source thinks this is the beginning of a massive tussle between the two giants, while another says their size makes a swift compromise inevitable.

How to innovate homecare commissioning and recruitment

Two key challenges in homecare emerged at HBI 2019's panel on homecare models, chaired by LEK Consulting. How do we innovate commissioning to improve patient engagement and independence? And how do we tackle the biggest issue yet, staff recruitment and retainment? Argentinian medicalised homecare company PalCare and the UK arm of domiciliary care franchise Home Instead shared their views.
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