Learnings from the Swiss Re Foundation’s Entrepreneurs for Resilience Award portfolio

Improving access to healthcare for underserved populations has been a priority for the Swiss Re Foundation since its inception. Five of the six most recent editions of our Entrepreneurs for Resilience Award (E4RA) programme have recognised ventures that make healthcare more accessible and affordable to low-income populations.

More than 1 000 ventures operating in over 30 countries have been screened and analysed to select the E4RA award finalists. As extensive information is collected and verified from the top 12 candidates in every edition, the Swiss Re Foundation and our partner LeFil Consulting now have access to a trove of data on healthcare ventures that target the underserved.

To maximise the learnings from this evidence base, we asked LeFil Consulting to conduct an in-depth study to take stock of the field, identify emerging trends and commonalities in ventures’ approaches and models and shed light on the key characteristics, strengths and challenges of ventures that follow specific approaches and models. From a donor’s or investor’s standpoint, this analysis offers insights into the potential trajectory of different kinds of ventures and how best to support them.

The study is based on detailed data collected from 26 health-related ventures (61% based in Africa, 19% in Asia, 12% in the Americas and 8% global), of which 13 were among the top three candidates and 13 among the top six candidates in their respective E4RA editions. Each venture was assigned to one of three clusters, each reflecting a distinctive approach to improving healthcare access. Key findings include:

• Ventures that deliver primary healthcare through networks of physical clinics, telemedicine or mobile clinics (Cluster 1) have the most positive impact on patients, particularly in terms of improving health outcomes and healthcare affordability and accessibility. Relative to the other two clusters, the high impact of this cluster is experienced by a relatively small, slow-growing user base. Financially, ventures in this cluster generate by far the highest earned revenue and achieve above-average results, especially in terms of gross margins and share of total revenue from grants.
• Ventures that provide insurance and other financial solutions that enable patients to access to healthcare (Cluster 2) generally deliver less direct impact than those in Cluster 1, but stand out for improving users’ financial resilience and focusing on users living in informal urban settlements. The average user base in this cluster is the smallest and fastest growing in the study. Despite generating the least earned revenue, ventures in this cluster also display relatively strong financial performance thanks to being most likely to have reached breakeven, needed the shortest time to reach breakeven and achieved the highest net margins.
• Ventures that develop and distribute software and platforms for other players to improve healthcare delivery and financing (Cluster 3) have very limited direct impact on health outcomes and healthcare affordability and accessibility while achieving by far the largest scale. Financial sustainability is a challenge for these ventures as they depend on significant external funding to operate and grow.
• To make healthcare more more accessible and affordable to low-income people sustainably, all the ventures need more non-financial support in the areas of data management and analytics, technological improvement, financial product development and scaling strategy.

The full report can be accessed here

An executive summary can be accessed here