Who we are
Rede D'Or
Operating for 45 years, we are Rede D’Or São Luiz S.A. (corporate name), a privately held, publicly traded Company that is a benchmark in technical quality and Latin America’s largest integrated healthcare network. We are present in 13 Brazilian states and the Federal District, and our administrative headquarters is located in São Paulo, SP. Part of the supplementary healthcare sector, we are focused on humanized care, team qualification, the adoption of new technologies, and the expansion of care. A full description of the Group’s main activities can be found in the Reference Form, and in the Institutional Presentation, publicly available documents that are updated annually. Our business relations cover our value chain, which includes business partners, which are people or entities with whom we have relationships. The value chain encompasses our stakeholders, which can be verified in the Stakeholder Engagement Policy and which are subject to the guidelines set out in Rede D’Or’s Code of Conduct.
Mission
Provide highly-effective medical and hospital care, with qualified and motivated teams, respecting ethics and individuals in their social and environmental context.
Vision
To be a reference in hospital management and the provision of medical services, based on the highest technical and social & environmental responsibility standards.
Values
- Competence;
- Credibility;
- Sustainable Development;
- Humanization;
- Integrity;
- Respect.
Value Chain
GRI 2-6
Timeline
Brazil’s largest healthcare ecosystema, b | GRI 2-6
Hospitals
Brazil’s largest independent private hospital network.
Benchmark in quality standards. Opened in 1998
Insurance
Brazil’s largest independent Insurance Company.
Diversified distribution model and nationwide presence.
128-Year history.
Oncology
Services fully integrated to the hospital network.
Leadership position.²
Opened in 2011.
Diagnosis
Brazil’s 3rd largest diagnostic operator³. Opened in 1977 and operations resumed in 2018.
Education and Research (IDOR)
Scientific collaboration with 60+ countries.
40+ medical residency programs
Private medical education plan under development
Supplementary services
D’Or Consultoria, and stake in Qualicorp S.A. (25.85%).
Brazil’s largest blood bank, acquired in 2017 (42.4% stake).
- Dialysis
- Distribution Materials and medicines
- Nephrology
- Complex transplants
Our structure is made up of 70 own hospitals in operation and another three under management; 55 oncology clinics; 11 laboratories; and 106.400 accredited physicians. With 9,598 operational beds, Rede D’Or records 5.3 million emergency room visits, 4.9 million outpatient visits, 498,000 surgeries and 44,000 births a year, totaling 2.8 million patient/days. We have one of Brazil’s largest diagnosis networks, a broad blood bank operation, one of the largest health consulting services in Brazil and the largest and most advanced robot-assisted surgery park in Latin America.
a. Footnote: Some figures and indicators relating to D’Or Consultoria; Oncologia D’Or; SulAmérica; Laboratórios Richet; and Instituto D’Or de Pesquisa e Ensino (IDOR) business were presented in the “Our presence in Brazil” chapter.
b. For more details, go to the Institutional Presentation.
(1) Number of beds in May/22;
(2) In terms of 2022FY EBITDA, including infusions and cancer surgeries;
(3) Considering 2020FY adjusted EBITDA for all publicly-held companies.
Business, segment and location
Our presence in Brazil
GRI 2-2, 2-6
Rede D’Or operates in 13 Brazilian states: Alagoas; Bahia; Ceará; Maranhão; Mato Grosso do Sul; Minas Gerais; Pará; Paraíba; Paraná; Pernambuco; Rio de Janeiro; São Paulo; and Sergipe, in addition to the Federal District.
In addition to healthcare units (hospitals, laboratories, and oncology clinics), we operate D’Or Consultoria, Instituto D’Or de Pesquisa e Ensino (D’Or Institute for Research and Education) and SulAmérica, which have a nationwide presence. Compared to the 2022 Sustainability Report, we merged SulAmérica’s operations, whose indicators were included in the ESG Indicators attachment.
HOSPITALS
70 owned
3 managed
LABORATORIES
STATES
and the Federal District
ONCOLOGY CLINICS
The entities included in our sustainability report are those listed on pages 74 and 75 of the Financial Statements (4Q23). For situations where the information does not cover all the units, we use explanatory notes.
D'Or Consultoria
Operating in seven Brazilian states, D’Or Consultoria provides operational, risk and health management; market consultancy, diagnosis and evaluation; marketing services and specialized communication.
BRL
5
BILLION
Premium amount
3,400
CUSTOMERS
2.5
MILION
Lives under management
900
EMPLOYEES
Oncologia D’Or
Oncologia D’Or, our specialized oncology care structure, operates more than 55 units in 10 Brazilian states (Rio de Janeiro, São Paulo, Maranhão, Bahia, Pernambuco, Paraíba, Ceará, Sergipe, Alagoas and Paraná) and the Federal District. Offering world-class services, these units have more than 480 physicians and around 1,374 employees from different academic backgrounds, who are dedicated to the diagnosis and treatment of various types of solid tumors and the group of diseases characterized by the multiplication of blood cells (hematologic neoplasms).
In 2023, Oncologia D’Or inaugurated a new molecular pathology laboratory, in partnership with IDOR. The unit will enable faster and more accurate diagnosis, without the need to send samples abroad for analysis (more information on this here). The oncology, pathology and other specialty teams work together all the time, discussing the appropriate therapeutic approach for the patient’s individual needs.
In 2023, an average of 52,900 care services were carried out each month, applying the different treatments to approximately 29,000 patients. We must emphasize the first hepatic radioembolization with Yttrium-90 in Brazil’s Midwest region, carried out by Hospital DF Star. This radiotherapy directly treats diseased cells a therapeutic option for liver tumors, such as primary liver cancer (hepatocellular carcinoma), and liver metastases, such as colorectal tumors.
55
ClInics
52,900
consultations per month on average
29,780
patients per month on average
COVERED BY
170
healthcare plans
UNITS OPENED IN 2023:
ONCOLOGIA D’OR RIBEIRÃO PRETO
The integrated work of clinical oncologists, hematologists, pathologists, radiologists and physicians from other specialties involved in cancer treatment in each of our hospitals is one of the advantages of Oncologia D'Or. This integrated working model enables faster diagnosis and more efficient treatment strategies. The model also benefits from daily multidisciplinary meetings (called Tumor Boards) to discuss cases online, bringing oncologists from all the regional units closer to Rede D'Or's physicians involved in cancer patient care across Brazil.
We have extensively worked on different fronts in projects already in place at Oncologia D'Or. The Green Line project, for example, continued to deliver excellence in patient care, making it easier to schedule exams and surgeries, thus reinforcing the differential advantage of a single integrated flow between the oncology diagnosis, surgery and treatment units of Oncologia D'Or and Rede D'Or hospitals.
Thus, the project continued to help cancer patients throughout all the necessary stages in the group's structures, speeding up diagnosis and consequently reducing the time it takes to start treatment, which in turn increases the chances of a better prognosis. The national Oncogenetics project has strengthened precision medicine within the Company, enabling patients to anticipate possible health problems.
Oncologia D'Or's app optimizes the routine of patients undergoing cancer treatment, as it is an essential tool for them to keep track of information on their journey, such as a list of the medicines they are taking. details of exams, scheduled appointments, prescriptions and personalized medical advice. The app also allows patients receiving outpatient cancer care to record symptoms and vital signs, which can be done daily, so that their case can be monitored by the medical team.
Moreover, a nursing professional (called a reception nurse) has the mission of acting as a coordinator in the patients' line of care. guiding them throughout their treatment to facilitate processes and boost results, providing greater comfort and agility for patients and their families.
The new Oncologia D'Or website is also an important milestone in 2023, offering better navigability, high-quality information and data about our structure, eg., clinic addresses, information on the clinical staff and accepted healthcare plans. This is another improvement to complement a good patient experience at our clinics.
Sponsorship of medical-scientific events
In 2023, Oncologia D’Or supported the most varied medical-scientific events organized by the main Brazilian medical societies in the specialties of colorectal surgery, hematology, gynecology, mastology and urology.
Monthly events were held for patients, addressing their main topics of interest. The Encontros Oncologia D’Or (Oncologia D’Or Meetings) project in Rio de Janeiro was maintained, alternating between online and in-person formats; in São Paulo, the project took place every two months; and the Bahia regional office joined the project in special sessions, scheduled according to the demand for certain topics. The project also resulted in a 10-episode web series for Oncologia D’Or’s YouTube channel and had a special in-person edition for Pink October, which was part of the activation calendar for patients in the O Ano Todo Rosa (Pink All Year) campaign.
The 8th Oncologia D’Or International Congress atreached a record number of attendees — more than 6,000 people registered —, and exhibitors — 17 partner brands present on three floors of the event —, with 300 speakers gathered to discuss the latest developments in cancer diagnosis and treatment, divided into seven rooms with simultaneous modules.
International and Brazilian guests were part of this historic edition, which took place in April at the Windsor Oceânico Hotel’s convention center in Rio de Janeiro.
The event’s wide program discussed the latest and most important developments in the diagnosis and treatment of cancer, including topics such as robotic surgery, organ transplants, integration of specialties, lines of care, new molecular tests, interventions for treating pain and clinical research, with a broad participation of IDOR.
With the resumption of face-to-face events, in 2023, Oncologia D’Or held its medical meetings and its six scientific symposia in person (some in the hybrid format). The Company held the 8th Oncologia D’Or International Uro-oncology Symposium, in Salvador (June); the 8th Oncologia D’Or International Lung Cancer Symposium, in Recife (August); the First Oncologia D’Or International Gynecologic Cancer Symposium, in Rio de Janeiro (September); the 10th Oncologia D’Or International Gastrointestinal Cancer Symposium, in Brasília (September); the 9th International Breast Cancer Symposium, in Fortaleza (October); and the 8th Oncologia D’Or International Hematology Symposium, in São Paulo (November).
The symposia were attended by 195 nationally and internationally renowned speakers, during the six meetings, with almost 3,291 registrations and nearly 200 participants, 896 of whom attended in person and 130 online, to follow more than 80 hours of original scientific knowledge on the main advances in oncology
In 2023, we expanded events for patients in the Pink October campaign, with activations of the Oncologia D’Or’s Ano Todo Rosa campaign in different regions. The aim was to raise awareness of breast cancer in the month in which the world shines a light on the subject, while delivering the content of Oncologia D’Or website, which is available all year round, in order to inform people about ways of preventing and treating this type of tumor. The main events were:
- Street Run for Life (Salvador);
- Event with Frevo dance classes and light show at fine artist Francisco Brennand’s Crystal Tower (Recife);
- Papo pela Vida (Chatting about life) – Talk Show with specialists and guests and parade with patients (São Paulo);
- Dance event and talk sessions with professionals (Fortaleza);
- Morning with work out sessions at Morro da Urca (Rio de Janeiro);
- Encontro Delas: Edição Especial O Ano Todo Rosa (Women Together: Pink All Year Special Edition) – Talk session with guests (Rio de Janeiro);
- Unraveling Breast Cancer Myths - morning lecture for the NGO “Marque esse Gol”, for women undergoing breast cancer treatment, and guided tour of the recently renovated Flamengo Museum (Rio de Janeiro); and
- O Ano Todo Rosa street run (Brasília).
Oncology pharmacies
We also have oncology pharmacies, which are essential for ensuring the quality of drug-based therapies (such as chemotherapy, target therapy, immunotherapy, hormone therapy, radiotherapy and bone marrow transplantation, called antineoplastic therapies), helping to guarantee greater safety, speed and savings in drug preparation processes.
Throughout 2023, the pharmacy team implemented the processes to use the Data Matrix code (a two-dimensional matrix barcode) to automatically import batch and expiry data into the hospital’s IT system, without the need to print identification labels. This allows for the traceability of drugs, keeping a record of their history from the moment they are received until the moment they are used, as well as eliminating the possibility of information errors and impacts on the pharmacy’s inventory management. The process allows for greater speed and security, optimizing the operational time of the pharmacy’s team.
New units and certifications
In 2023, we opened new Oncologia D’Or units in different Brazilian regions. In São Bernardo do Campo (SP), the Oncologia D’Or clinic opened at a new address, in the same space as the Rede D’Or Medical Center. Oncologia D’Or Itaim opened in the Visionare Medical Center, in the Itaim neighborhood in São Paulo. In Rio de Janeiro, the Oncologia D’Or Campo Grande unit also began operating in a new space.
In this reporting cycle, the following units were certified:
- Pio X, Taguatinga, Biosphere and Anchieta units – JCI recertification;
- Pio X Unit – QOPI (ASCO) recertification.
SulAmérica
GRI 2-6
On December 23, 2022, our value proposition was significantly enhanced by the completion of the business combination with SulAmérica — one of Brazil’s leading independent insurance companies. Operating in the segments of healthcare, dental care, life and personal accident insurance; asset management; and private pension products, SulAmérica had more than 7 million customers spread across Brazil by year-end 2023.
In a challenging year for the supplementary healthcare sector, the insurance company focused on reducing administrative expenses and gaining synergies from the integration of its businesses, seeking greater efficiency while maintaining its essence. SulAmérica’s financial statements, as of 2023, have already been incorporated into Rede D’Or’s balance sheet. SulAmérica recoded a 14.6% increase in net revenue, totaling R$27 billion. Consolidated claims ratio, an important sector indicator, fell by 2.1 percentage points in 2023 versus 2022, ending the consolidated year at 86.4%.
SulAmérica ended the year with a positive balance, related to the growth in the number of beneficiaries, adding close to 40,000 new lives, considering health and dental care plans. This result arises from several strategies adopted, ranging from the fight against fraud to the launch of products, including the intelligent network of hospitals and laboratories with national or regional coverage at competitive prices. The investments in cross-sell initiatives and customer activation, which standardized, automated and tailored approaches and communication. In addition to a continuous campaign and offer routine, several multidisciplinary projects were implemented, focused on improving data visualization, such as linking customers with brokers, and a business platform for brokers to work on commercial opportunities.
Another important step was to control the parameters of claims, thus curbing fraud, reviewing the operational strategy and investing in technology in the beneficiary relationship interface.
Fighting Fraud
SulAmérica, like the entire sector, has seen a substantial growth in fraud against healthcare plans. For this reason, in 2023, the company sought to raise awareness among beneficiaries, service providers, client companies and brokers about the correct use of the benefit, which is essential to maintaining the sustainability of supplementary healthcare. In addition to joining the campaigns promoted by the Brazilian Association of Healthcare Plans (Abramge, in Portuguese) and the Brazilian Federation for Private Health Insurance and Plans (FenaSaúde, in Portuguese), SulAmérica invested in technological resources to map abuses and signs of fraud in the use of the plan. The company also adopted a new approach in its communications and developed a targeted communication plan.
Studies show that cost of claims for people impacted by the communication reduced by almost 30%. Given its success, the project will continue and be expanded to other operations. SulAmérica will invest in technology to improve its algorithm to have a timelier response.
The company also expects to make progress in mapping advertisers for a daily routine of solutions, and advanced measurement tools will be implemented in order to guarantee efficient results.
Relacionamento com os stakeholders
New Products
One of the solutions adopted to contribute to business sustainability, both for the operator and its client companies, was to invest in the sale of products with co participation, offering a more affordable price to end users and raising awareness among beneficiaries about the best way to use the health insurance (avoiding wastage and reporting fraud).
Aimed at pursuing profitability, new regional products were launched to offer a range of alternatives that meet the characteristics and demands of each Brazilian region.
This business strategy, combined with customer relationship, has resulted in an increase in the number of beneficiaries of 8.7% in the period from 2021 to 2023, which represents more than 4.9 million beneficiaries of health and dental insurance.
Products launched in 2023
- Novo Portfólio Odonto
- Direto Aracajú
- Direto Nacional SP
- Direto Nacional RJ
- Direto Nacional Fortaleza
- Direto Nacional Salvador
- Direto Nacional BH
- Direto Recife
- Especial Mais SP Capital
- Especial Mais SP Interior 1 (Campinas)
- Especial Mais SP Interior 3 (Ribeirão)
- Especial Salvador
- Especial Mais Interior 2
- Especial Mais Direto Aracaju
Incentivized projects
In 2023, SulAmérica sponsored three projects by using the Culture and Sports Laws. Focused on broadening access to culture and leisure, the company continued its partnership with the Ouro Preto Orchestra, promoting an open concert for 15,000 people, at Villa Lobos Park, in São Paulo (SP), with the special participation of singer Diogo Nogueira. Together with the orchestra, the company also sponsored the Ouro Preto Orchestra Academy, which is responsible for accelerating the careers of 17 young musicians. As regards sports, to encourage people to exercise, we promoted another edition of the Move project, a free arena for 2,000 people in Villa Lobos Park, with street running and walking, dance classes, Pilates, activities for children and consultations with a nutritionist.
SulAmerica Investimentos
In 2023, SulAmérica Investimentos reaffirmed its commitment to the ongoing pursuit of excellence in asset management and fiduciary principles. The company stood out among the country’s leading independent asset managers and was recognized as the Best Investment Grade Fixed Income Pension Manager by the Valor / FGV ranking and the Best Fixed Income Asset in the Guia de Fundos FGV (FGV Fund Guide), in the group of specialist managers. It has reached BRL 63 billion in assets under management and administration, more than 200,000 shareholders and BRL 18 billion in private credit assets.
For the 14th consecutive year, Standard & Poor’s rated SulAmérica Investimentos with the highest score in its evaluation of investment fund managers. The confirmation of the top rating “AMP-1 — Very Strong” reflects the business’ good profile and financial structure; disciplined investment processes, aligned with best management practices; diversified product portfolio; company strategy; and good fiduciary principles, as well as the team’s expertise.
Repeating such an achievement shows the company’s ongoing concern with improving processes, strict risk control and transparency in customer relationship.
SulAmérica in numbers
BRL
27
billion
NET REVENUE
59%
OF LEADERSHIP AND EXECUTIVE LEADERSHIP POSITIONS HELD BY WOMEN
37,000
ACTIVE AGENTS
4.9
million
BENEFICIARIES
More information about SulAmérica is available on the company's website or through the Investor Relations channel.
Laboratórios Richet
Acquired in 2018, Laboratórios Richet are advanced diagnostic and immunization centers, with 11 units for carrying out medical laboratory tests and diagnostic imaging. With a team of around 450 employees, it operates 10 units in the city of Rio de Janeiro and 1 in Niterói (RJ).
Richet operates both in hospitals and in partnership with clinics specializing in fertility, executive check- ups, geriatrics, sports medicine, nutritional support and occupational medicine. It offers a laboratory service structure for clinical research centers with technical, operational and logistic support.
Laboratórios Richet
are advanced diagnostic and immunization centers
11
units laboratory tests and diagnostic imaging
450
EMPLOYEES
With a team of around
Instituto D’Or de Pesquisa e Ensino [D’Or Institute for Research and Education]
Through D’Or Institute for Research and Education (IDOR), we contribute to the production of knowledge; establish partnerships with universities, as well as research and teaching institutions, both in Brazil and abroad; and, at the same time, invest in training and developing professionals in different health fields. This is yet another way in which we seek to contribute to society and the country’s healthcare industry.
