Private Medicare

Every sound business in private medicare begins with one clear customer and one clear problem. In São Paulo and the wider state, demand is real but crowded, so a small, well-described customer group wins before a broad one.

• In private medicare: Patients choose by waiting time, trust and cost; map the payer mix.
• Write the customer in one sentence: a patient or a payer. Add the place, the moment of need and what they use today.
• List five rivals or substitutes within reach. For each, record price, strength, weakness and how people reach it.
• Interview at least eight real customers with open questions. Record exact words, not your summary.
• Count the market in units: how many consultations could one area buy in a month? Use two public sources and your own count, then take the lower figure.
• Choose one first segment and say why the others wait.

Activity. Write the one-sentence customer, a five-row rival table and eight interview records. Share them with a peer for a challenge round.

Standard to meet. Define a specific customer, build a rival table with prices, and trace every claim to an interview or a source.

Brazil asks every trader to be visible and accountable. Know which register, tax regime and sector rules apply before the first sale, and check each against the current official text.

• In private medicare: Clinics need health authority licences and registered clinicians; billing to health plans follows regulator rules (ANS).
• Choose a legal form: micro-entrepreneur (MEI) only if your activity appears on the official MEI list, or a company registered with a CNPJ. Regulated activities need their sector authorisation first. Check the current limits and lists on the official portal.
• Learn the tax regime that fits your size and write down which taxes you will collect and pay, and when.
• Find the sector rules for private medicare: licences, inspections, professional registers. List each with the office that issues it and the renewal date.
• Personal data of customers falls under Brazil's data protection law (LGPD). Collect only what you need, say why, keep it safe, and name who answers questions.
• Consumer law gives buyers clear rights on information, returns and complaints. Put your terms in plain Portuguese.

Activity. Build your own six-line compliance table for your first location. Mark what is done, what is pending and who confirms it.

Standard to meet. Cite an official source for every line, assume nothing, and date every pending item. Local law always wins over this course.

An offer states what the customer gets, how well, by when and at what price. For a private clinic or plan service, the offer must make the quality visible and the next step easy.

• In private medicare: Offer a clear fee list and appointment promise.
• Describe the core offer in three lines: what is delivered (a private clinic or plan service), the standard it meets, and the time it takes.
• Add one proof for each promise: a sample, a test result, a guarantee or a customer record.
• Price from cost upward and from customer value downward, then pick a price inside both.
• Write a simple one-page terms sheet: what is included, what is extra, how to cancel.
• Create two options at most, so choice stays easy.

Longer notes. Name the service your practice will give, such as check-ups, vaccination counselling or home visits, and who is qualified to perform each. List the rooms, equipment, cleaning steps and records needed before the first patient. Write the patient journey from booking to follow-up, with a consent form and a privacy notice for health data. Prepare a price list for consultations and exams and show it at booking. Explain what you will not treat and when you refer on. Confirm the clinic licence and each professional's registration with the proper health bodies, and lock patient files. Never promise cures or results.

Activity. Write the offer card, the proof list and the terms sheet. Test them with three customers and note every point where they hesitated.

Standard to meet. Check that promise, proof and price are consistent, fit the terms on one page, and record three customer reactions.

Good operations make results repeatable. For private medicare, write each step so a new person could follow it on their first day, and measure each step.

• In private medicare: Flow: booking, check-in, consult, tests, follow-up, billing; one record per patient.
• Map the process from first contact to paid and closed. Typical stages: enquiry, quote, preparation, delivery of the consultation, check, payment, follow-up.
• Name the key resource at each stage: registered clinicians and records. Note what happens if it is missing.
• Write a one-page standard procedure per stage: who, what, tool, time, record.
• Choose three measures: speed, quality (errors per 100) and customer rating. Review them every week.
• Fix the cause of a defect, not the symptom. Ask 'why' five times and record the answer.

Activity. Draw the process map and write procedures for the two riskiest stages. Run each once and time it.

Standard to meet. Write procedures a stranger can follow, record weekly numbers for each measure, and trace one defect to a root cause.

The most serious risk in this field is a missed diagnosis or a billing error. A calm, written risk routine protects people first and the business second.

• In private medicare: Misdiagnosis, infection and billing errors are risks; peer review and audit.
• List ten things that could go wrong. Score each for how likely (1 to 5) and how serious (1 to 5). Multiply and sort.
• For the top five, choose a control: remove the hazard, replace it, guard it, train people, or use protective gear, in that order of preference.
• Write who does what in an emergency, and rehearse it once a quarter.
• Keep an incident and near-miss log. Near-misses are free lessons.
• Check that insurance and legal duties match the risk you actually carry.

Activity. Build a ten-row risk register and a one-page emergency plan. Run a ten-minute drill with a peer and note two improvements.

Standard to meet. Rank controls by preference for the top risks, run the drill, and start the log. Where a regulation applies, follow the official rule.

People deliver the promise. Define roles, train to a standard and give feedback in the open.

• In private medicare: Train front desk and clinicians on privacy and consent.
• Write a role card for each person: purpose, five tasks, the standard for each, and who to ask for help.
• Train by showing, doing with support, then doing alone with a check. Record sign-off per task.
• Set service rules for answering customers: reply times, tone, how to apologise and fix.
• Hold a ten-minute team check each day: yesterday's problem, today's plan, one risk.
• Build a growth path: what a new person can do in week 1, month 3 and month 12.

Longer notes. Assemble the clinic team: the professional, a receptionist, a cleaner and a person who keeps records. Write a role sheet for each, with consent checks at reception and a stop rule when a patient shows alarming symptoms. Teach hand hygiene and instrument cleaning with a printed sequence and a timer. Rehearse an emergency: call the ambulance, bring the kit, note the times. Train the front desk to confirm name, birth date and permission before giving results. Lock paper files and give each person a computer password. Hold a fifteen-minute huddle each morning and record accidents and near misses in a book.

Activity. Write two role cards and a training plan for one new hire. Role-play a hard customer conversation twice and review.

Standard to meet. Write role cards with measurable standards, show the sign-off steps in training, and write the service rules in plain words.

A business lives or dies on a few numbers. Know your contribution per unit, your fixed costs and the volume you need.

• In private medicare: Collect from plans and patients; track denied claims and days to pay.
• Contribution per consultation = price minus variable cost. Fixed costs are paid whether you sell or not.
• Break-even units = fixed cost divided by contribution. Plan to pass it by a safe margin.
• Make a 12-month cash plan. Cash timing matters as much as profit: customers may pay late, suppliers may want money first.
• Keep money for business and money for the owner apart.
• Test the plan: what if sales fall by a quarter, or cost rises by a tenth?

Activity. Build your own table: price, variable cost, contribution, fixed cost, break-even and a downside case at 75% of sales. Show it to a peer or mentor.

Standard to meet. Calculate correctly, give every figure a source or mark it as an assumption, and show a downside case.

Growth should follow proof. Measure, learn, then add; and keep returning to the customer.

• In private medicare: Grow by waiting time and outcome measures.
• Pick one growth lever at a time: new customers, a higher repeat rate, a better price, or a new offer.
• Set one measurable target for 90 days, such as 'raise repeat customers from 20% to 30%'.
• Ask each customer how they found you, and record it. Spend more where the record shows results.
• Review monthly: numbers, defects, complaints, cash. Write three decisions each time.
• Plan the renewal of licences, equipment and skills a year ahead.

Longer notes. Track waiting time, missed appointments and return visits each month. Phone patients who missed and note whether the cause was cost, distance or forgetfulness. Send a reminder the day before and compare no-show counts across two months. Compare real consultation length with the slot to see if slots are too short. Read complaints and thank-you notes together and list three fixes. Ask patients, without pressure, how they found you. Consider evening hours only after checking that demand justifies them. Never use patient names or photos in promotion without written permission, and keep every advertising claim to services the clinic actually provides.

Activity. Write a 90-day plan with one target, three actions and a review date. Present it in five minutes and take questions.

Standard to meet. Set a measurable, dated target, break the actions down small enough to start this week, and put the review date in the calendar.