“I saw an opportunity to enable health care practitioners and insurance companies to share information with a swipe of a card.”
- Year selected
- Luis Navas
For decades Argentineans suffered under an archaic, paper-based health insurance system, enduring a tedious benefits validation process complete with long lines and inefficient paper vouchers. Seizing an opportunity to make validation electronic, in 2004 Luis and Sebastian bought Conexia, the information technology company that they had been managing for four years. With Conexia’s solution, healthcare insurance companies saw (for the first time in Argentina) the results of real-time adjudication (RTA) of benefits – a process which enabled practitioners and insurance companies to share information and validate medical procedures with the simple swipe of a patient’s health card. Today, Conexia processes more than 1.5 million transactions per month, serving 14,000 physicians, hospitals, laboratories, and pharmacies throughout Argentina. Conexia reduces medical costs 10% by blocking uncovered practices and reduces administration costs 15% by simplifying procedures such as claims processing. At the same time Conexia provides certainty to doctors about their billing and reduces their paperwork. Finally, patients get improved access as well as clarity about medical costs before these services are rendered. Conexia’s service comes at the right time. The global healthcare IT market is growing and is projected to reach US$53.8 billion by 2014.
Conexia has become the industry benchmark in Argentina, with impressive market share in the medical transaction IT industry. Customer identification, coverage verification, and payment now take place with the swipe of a card. Providers can access patient data and send prescriptions electronically to pharmacies, improving the quality of care. Health insurance companies enjoy reduced costs and have access to information that guides managerial decisions and facilitates preventative medicine.
Luis and Sebastian met each other (and were introduced to Conexia) through IMPSA, a multinational industrial conglomerate. Coming from separate backgrounds – Luis with a PMD from Harvard and Sebastian with an MBA from Wharton – the two began to work together in 2000 when they took over leadership of IMPSA’s technology incubator. Operating under the Impsat division, the incubator supported the development of start-up companies, including Conexia. As the respective CEO and CFO of the incubator, Luis and Sebastian were tasked with “fixing” Conexia, then in its fourth year and identified as a “problem start-up.” Initially, they wondered what they had gotten themselves into: the technology didn’t work, customers were angry, and it was losing money. Luis and Sebastian studied the interaction among the primary players in the industry – insurers, providers, and beneficiaries – and found there was an incredible amount of data, all in different formats and locations. They sought to connect the players through an integrated online network over which data could be exchanged, providing real-time information to insurers to guide managerial decisions. Targeting private and public sector health insurers, the duo saw their solution could lower clients’ costs significantly, improve the quality and speed of care for beneficiaries, and prevent identity fraud.