Founded just six months ago, Rivio, a startup that provides administrative and financial management for hospitals, has raised $20 million (nearly R$ 100 million) from funds Valor Capital and Monashes, as well as Endeavor. With the investment, the business created to address what can be a major headache for healthcare providers is now valued at R$500 million.
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In healthcare and education businesses, it is common to find doctors and teachers managing hospitals and schools with difficulty. Most naturally devote themselves to their professional vocations, and financial and administrative practices end up being deprioritized.
The startup is a project by Ricardo Sales and Silvio Frison, who are not physicians but were drawn to healthcare after encountering the level of losses in the sector. It is estimated that nearly 13% of the industry’s revenue, totaling R$284.5 billion over the first nine months of this year, is lost to fraud and waste. Waste includes everything from repeated medical procedures to inefficient administrative practices, according to a study by EY.
Sales is a former executive at General Atlantic and one of the founders of Isaac, a financial management startup for schools sold to Arco Educação for $150 million, which served as inspiration for Rivio. Frison, in turn, created Serasa’s credit score for individuals and was one of Isaac’s angel investors.
Rivio already manages about 50 facilities, including hospitals, clinics and laboratories. “Two years ago, creating Rivio would have been unthinkable. Today, it’s possible because we have artificial intelligence that analyzes hospitals’ revenue cycles. Hospitals suffer many losses from underbilling. Many are unable to charge for all the materials they use; losses due to lack of processes are common,” says Frison, Rivio’s CEO.
One of the startup’s edges is that it assumes the risk. If a facility does not receive 100% of the amounts owed by health insurance operators, Rivio covers the difference. This mirrors Isaac’s business model with schools, where the education startup also assumes the risk when parents fail to pay tuition.
“By assuming financial risk, we completely reposition the relationship. The hospital gains predictability and can focus on patient care, while we handle the operation,” says Sales, Rivio’s co-founder.
Hospital management has become even more relevant since 2022, amid a crisis in the healthcare sector. At that time, health plan operators began pressuring hospitals, questioning medical procedures and withholding payments—a practice known in the sector as “glosa” or claim denial.
Data from the National Association of Private Hospitals (Anahp) show that R$5.8 billion in services provided by hospitals last year had payments withheld. This amount equals 15.89% of the R$36.7 billion hospitals were due to receive from operators in 2024, an increase of four percentage points from 2023.
Rivio is entering a healthcare segment that remains underserved. Most financial management companies work for health plan operators on the other end of the chain. The healthcare market struggles to reconcile interests: when a hospital’s revenue rises due to more medical procedures, operators’ margins shrink—and vice versa.
Rivio’s team brings together technology and healthcare professionals who conduct audits of medical bills. “We don’t just deliver software, as is usually the case in the market. Hospitals often lack trained staff to use the technology,” says Sales.
