Javier Potes
Director General
Consorcio Mexicano de Hospitales (CMH)
View from the Top

Alliances Can Help Create Integrated Health Ecosystem

Thu, 05/16/2019 - 11:01

Q: What strategies has CMH implemented to reach its 2025 goal of becoming the most important private health system in Mexico?
A: CMH provides the widest health coverage in the country. However, rather than remaining a group of hospitals, we want to evolve into a health system where patients can find a solution to all their health-related issues. The goal is to prepare for the future and lighten the public sector’s burden regarding chronic degenerative diseases. This is complicated because it implies that all players must start working as a team, focusing their new healthcare business model towards the patient. At the same time, patients must also take responsibility for their own health.
We have started analyzing how we can best provide the services patients need, looking at different avenues toward easy, economic and fast accessibility. The big challenge is convincing all players to work together based on information analysis and standardizing quality and level of attention across hospitals and clinics. This involves everything from phone calls to a call center, access to mobile apps, access to medical appointments adjacent to pharmacies and hospitalization.
Q: How can CMH work to improve healthcare access and quality?
A: Whenever a patient has a health problem, we need to be the first point of contact so we can obtain information about the problem and start generating solutions. Doctors should have access to a single medical record they can share with specialists. Moreover, general doctors need to have a list of specialists they can recommend to patients, with preferential prices and according to the information gathered. Patients also need to understand that once they are registered in the system, their information automatically will be available to all specialists, who will be able to access background information and any other medical consultations the patient might have received. Similarly, patients can access their information from an app at all times. We already have the technology and are in the process of strengthening the necessary alliances to ensure implementation.
The first step we took toward implementing this platform was an agreement with Laboratorios Médicos El Chopo in early 2019. With this agreement, we have a combined total of about 350 points of contact with patients. Anyone in need of lab work during nonworking hours can call a joint call center shared between El Chopo and CMH and if the office near that person is not open, access to our hospitals is provided at a preferential price.
Q: How else are CMH’s hospitals putting patients at the center of their operations?
A: We see many patients migrating from the public to the private sector. These patients are added to those we already have who pay out-of-pocket or through an insurance policy. We are talking about a total of 25 million Mexicans, which represents a financial challenge when ensuring all patients have coverage for their health problems. Even though it seems that this issue does not impact hospitals directly, being able to afford healthcare is a central aspect of the health ecosystem and the solution must be found among all players, not only patients.
One of our priorities is to look for alliances with insurance companies. However, it is not easy, since the financial sector has an operational trajectory that for many years has been focused on certain segments of the population. Insurers do not understand that mid and mid-low segments of the population have other characteristics and require other types of health plans and suppliers. They are used to selling an elite product, at high costs and high premiums. However, these solutions are constantly losing market share. We have been advancing in this dialogue but we still have much work to do to make companies understand the need for more private-sector penetration. We have already worked with GNP, Banorte and Seguros Atlas.