Paulino Decanni
Executive Vice President
View from the Top

Innovative Insurance Bridges Care Gap

Thu, 09/07/2017 - 12:07

Q: SiSNova is a young company. What strategy has it employed to compete against established companies and new models?

A: Our differentiator is that we prioritize medical criteria over financial or economic criteria. Our offer is based on early prevention and the promotion of a change in healthcare culture. This has a significant impact on costs because if we change our habits, we can prevent chronic diseases and their related complications and if we detect diseases on time we can treat them before they become too complex and expensive. Therefore, our focus is on integral medical care, from prevention to treatment.

Changing healthcare culture is a long process, so first we want to provide access to immediate medical care without a direct cost for the user. We establish specific parameters to be able to provide follow-up and organize our insured population by demographic and epidemiological characteristics. We promote this by giving users benefits as they accomplish their goals, so they can have access to better services without higher prices

. Q: It says on your website that a new era in medical insurance began on May 2, 2015. How so?

A: This is because our greatest goal is to give the Mexican population more access to a better healthcare service with international standards and quality. Major expenses coverage was designed to avoid an economic rupture when there is a health problem within the family but the deductible and co-payment must be covered first by the patient. Insurance companies never cover prevention, primary care or early diagnosis. Everything is designed for treatment. Traditional insurance companies have tried to administrate healthcare with the goal of containing costs, but their policies are designed for major health expenses. This makes the system inefficient and this is one of the major factors why private insurance is so expensive in Mexico, and one of the main reasons why out-of-pocket expenditure is so high and increasing despite extensive healthcare infrastructure. Also, since public services sometimes receive a subsidy, the public believes it has the right to healthcare, but this comes at a cost.

Q: What is SiSNova’s growth strategy?

A: We have agreements with more than 300 hospitals and 5,000 affiliated doctors across Mexico. In mid-2015, we did not have any clients but by the end of 2015 we had over 7,000. In 2016, we insured over 40,000 people and in the first quarter of 2017 we were near 50,000. The main internal drivers of this growth are our focus on medical care and our response to the insured patient. Once a user becomes a patient, we answer as a provider of medical aid not as an insurance company, recovering the essence of why someone approaches an insurance company, especially when they require specific medical care. We have a 99 percent policy renewal rate.

There are also external factors that boost this growth, the most important of which is the big gap that is not covered by the public or private health sectors. There are 121 million people in Mexico, around six million of whom have private insurance. But more than 30 million Mexicans belong to the C segment, where some have coverage but want to access a system with better services. Therefore, there still is a great opportunity to open access to the Mexican population. The public sector has limited capacity to offer punctual and complete service and the private sector is becoming increasingly expensive, leaving behind the larger part of the Mexican population. We grow by looking for new users and through references from our team and our clients.

Q: What are the company’s objectives for 2017 and the coming five years?

A: We would like to keep growing at the rates we have seen so far. However, we are conscious that uncontrolled growth can affect the level of service in solving medical problems. The challenge is huge because the need is infinite. Our business is not to sell policies, it is to offer medical care with quality and security through an insurance policy.