Elma: Providing Digital-First Health Services That Optimize Wellness While Keeping Costs Down in the Spanish Market

In a Nutshell: Spain’s national health service protects people when they need it, but many customers also purchase private insurance to avoid bureaucratic challenges and long wait times for routine procedures. These discerning healthcare consumers choose to work with Elma, a tech healthcare provider with a digital-first approach to care delivery that emphasizes easiness and prevention. As Covid-19 exposes the limitations of traditional in-person healthcare delivery everywhere, Elma’s app-based remote approach encourages people to continue to access care safely.

Spain offers a publicly funded national health service to all who live and work in the country. Even visitors to the country are eligible to receive health care in Spain with virtually no limitations.

But that system works best in urgent situations. Those looking for elective surgery or wellness care often experience long wait times and limited choices.

That’s why a substantial private healthcare system also exists in Spain. As many as 25% of Spanish people access the private market either on their own or through their employers. They draw mainly on a group of large providers that have achieved a legacy status in Spain.

Since 2017, Elma has emerged as a disruptor of the traditional health insurance status quo in Spain with its digital-first care solution that puts users in control. Elma allows healthcare consumers to promptly find the care they need while emphasizing wellness over specialists.

Although the private system operates separately from the public one, it doesn’t add a lot of extra perks other than speed. It achieves efficiency mostly by truncating primary and preventative care. In Spain’s private healthcare culture, people go to hospitals or even emergency rooms to see specialists, sometimes without a clear understanding of what kind of care they need or where they can find it.

“In the cloud, we’ve built a primary care center so our users can have access to everything from home,” Elma CEO and Founder Miguel Ángel Antón said. “You don’t have to visit seven hospitals when you have a common issue.”

Elma uses technology to streamline the system so it’s focused on preventative care and providing users with easy access to specialists. And with Covid-19 shutting down most of the Spain’s social life and economy for months this past spring, Elma’s app-based approach offered a way for thousands of users to sustain their health care and get answers during the crisis.

On one level, Elma works like most of the large private health insurers in Spain, mainly through agreements with employers. So far, during the Covid-19 pandemic, Elma has helped more than 120 corporations insure over 150,000 employees.

“During the worst of the pandemic, we decided to offer our platform for free to as many corporations as possible, and we took care of about 4,000-5,000 people who were sick with coronavirus,” Antón said. “Now everybody understands that Elma is here, it works, and it can deliver the same level of care remotely as with a personal visit.”

Employers that work with Elma essentially gain a company doctor available to workers at any time. By managing user registrations and housing records and transactions, the platform reduces HR overhead while including personalized prevention plans that emphasize nutrition, physiotherapy, and anti-stress solutions that promote well-being.

Elma offers telehealth options that users can access through its app.

“People with healthier habits live better lives,” Antón said. “And that benefits not only life expectancy but productivity as well.”

The platform also receives plenty of individual signups. Its affordably priced plans provide access to the same app and Elma’s entire network of more than 23,000 general practitioners and specialists. More advanced plans offer emergency coverage to members traveling abroad along with dental insurance and no or limited copays.

General practitioners in Elma’s plan act as the care nexus between the user and the network, putting the patient in control of decisions.

“Before you go into secondary, you talk to your primary care doctor about everything,” Antón said. “Through your medical record, Elma and the caregivers that have access to it can know you and help you navigate the entire health system.”

Elma is not an insurance firm or a tech company but a combination of both. It is a provider that caters to the kind of engaged health consumers the hybrid Spanish system increasingly brings forward.

As Spanish people have embraced tech services in other aspects of their lives, they have similarly sought to control their healthcare and expressed their desire to see it become a more competitive market.

Elma users have complete control over their own healthcare experiences and their medical records.

And they view Elma as a step forward. In contrast to the more opaque systems offered by legacy providers in Spain, Elma gives users transparent and secure control over their medical histories.

“You are the owner of your records — not the doctor or the hospital,” Antón said. “They’re in your app, and you allow your doctor access to them.”

Along with medical history, the app manages prescriptions and appointments as well as caregiver team info, with the physicians, nurses, and other caregivers and service providers working for Elma basically on a shift basis.

“We hire all our doctors,” Antón said. “They don’t all work full time for us, but when they do, they’re working only for Elma.”

Care providers find Elma caters to their needs as well. “It’s easy to get good, talented doctors and other caregivers on board,” Antón said. “They understand the future has to change, and they’re interested in technology.”

Most user feedback regarding their interactions with Elma are positive. The company takes negative customer feedback seriously, going so far as to reach out personally to every user who has a complaint.

“I always say that good reviews never give you anything to improve,” Antón said. “I’m quite obsessed about that, so every person who submits a bad review gets a call from us.”

The team receives comments through the app stores for Android and iOS and through the Trustpilot review platform.

“As we did a review recently about some feedback we received from a customer, I asked about how we could reward constructive reviews because they’re acts of faith from the customers who give you good information about how you can do better,” Antón said.

Of course, the Covid-19 pandemic in Spain has presented the Elma team with many opportunities to do better.

“When Covid-19 started to take hold, I talked to my team and said, I’m 47 — for the first time in my life, I can provide real help to my community,” Antón said. “And we did work hard and were super motivated.”

In addition to the 5,000 Covid-19 patients Elma helped treat, the company made access to non-Covid care possible for another 10,000 people — many within the safety of their own homes. Elma’s digital-first approach helps people who otherwise may have avoided medical care for fear of contracting the virus.

“We’re tending to some really serious cases simply because people don’t want to go to the hospital,” Antón said. “We’re ready to become a health tech leader in Spain.”