A3Data creates ‘virtual clinic’ for employees and generates an 11% reduction in claims for companies

A3Data creates ‘virtual clinic’ for employees and generates an 11% reduction in claims for companies

Named ‘Maria Saúde’, the platform offers primary health care services with the support of AI supervised by a multidisciplinary team. Application is aimed at companies that offer health insurance to employees.

A3Data, a data and AI consultancy, has developed Maria Saúde, a digital primary care service that uses technologies such as GenAI to promote more comfort, agility and effectiveness in medical care.

Initially aimed at companies that offer health insurance to employees, the system has generated for its customers a reduction of about 11% in the loss ratio, and with an ROI (Return on Investment) of 67% in 12 months of service.

“We designed a service supported by Artificial Intelligence to offer immediate care, avoiding unnecessary patient travel and overloading emergency services. The adoption of this technology improves access to quality health care, which represents an investment of human capital, determining business success in the long term,” said Rodrigo Pereira, CEO, A3Data.

The strategy to develop this application has the support of the Mater Dei Health Network, which, at the end of 2021, acquired 50.1% of A3Data to boost the creation of AI and Data Analytics solutions for the sector.

In addition to Maria, this partnership also created the recently launched Nuvie app – a medical copilot that uses advanced voice recognition technologies.

Improved service, reduced costs

According to data from Brazil’s National Supplementary Health Agency (ANS), the average loss ratio in health plans is 88.2% – an indicator that directly impacts the annual adjustment of health plans. I

In this context, the economic scenario requires effective strategic decisions on the part of companies to avoid excessive increases in the values of this benefit.

“Curbing the cost for the sustainability of the sector is one of the biggest challenges of supplementary health in the market. As a result, Maria’s implementation strategy ranges from improving employees’ access to health care to a significant revolution in the way companies manage operating costs,” said Pereira.

In the first year of implementation of the system, operated by A3Data itself, which, at the time, had 230 employees, it was possible to observe an 11% reduction in the loss ratio.

With the positive result, the system moved on to the second stage of the trial – which was carried out at the Mater Dei Health Network.

The health network has an average of 7,000 employees and has achieved the same success in the accounts – generating a significant reduction in the loss ratio.

From then on, the solution won the market.

Currently, the platform is in operation at Cemig Saúde (Self-Management of Companhia Energética de Minas Gerais) and in the implementation phase at two other companies.

Primary Health Care Assistant

Available on the PlayStore and App Store, Maria works as a ‘virtual clinic’ for the employees of the companies that implement the system. The service has an average rating of 9.8 in a survey based on almost 20,000 appointments, which confirms its quality.

After the simple download of the app on the mobile phone, the user sends a message through a chat. Then, a virtual assistant powered by GenAI initiates the service and, in natural language, identifies the patient’s need.

Once the screening is done, the patient is directed to a professional from the platform’s multidisciplinary team, composed of a doctor, psychologist, nurse, nutritionist and concierge – defined according to the need for the consultation and without the need for prior scheduling.

At this stage, the user has the option to follow via chat or change the service to video.

Continuous and quality service

In Brazil, there is a culture of seeking specialist doctors and more than 80% of cases could be solved by a family doctor, who attends to the basic needs and, when the need is identified, makes the referral to the appropriate specialist.

“It is in this aspect that the Maria platform differs from other telemedicine services. We offer comprehensive and personalized care, in which patients are always accompanied by the same health team, strengthening the bond and creating a relationship of trust with our professionals”, said Dr Gustavo Landsberg, Chief Medical Officer of A3Data, family doctor and one of the creators of the project.

“One of the main challenges of the health sector in Brazil is the culture of not prioritizing primary care, resulting, among other things, in the overuse of emergency services and the performance of unnecessary tests and procedures. With the application of Maria, it is possible to strengthen the sector in a coordinated and responsible way, bringing benefits to both the patient and the companies, which now have control of the cost of the health plan, facilitating negotiation to avoid annual adjustments, which in 2023 was, on average, 14.38%,” he said.

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