Marcos Rabello: Planting the Seeds of Extra-Hospital Care in Brazil

Hospitals were never meant to be long-term homes, yet across Brazil and beyond, they are filled with patients who stay far longer than intended. Beds are occupied by the elderly, by those with chronic conditions, and by individuals whose care could be delivered in more humane and efficient settings. This strains already limited resources, drives up costs, and leaves health systems struggling to balance compassion with financial reality. Extra-hospital care emerges as a vital solution, easing the pressure on hospitals while offering patients comfort, dignity, and continuity of treatment. It also ensures that healthcare can remain sustainable, meeting today’s needs without exhausting tomorrow’s capacity.

CaptaMed was born from this understanding, guided by the vision of  Marcos Rabello, whose journey blends medical knowledge, entrepreneurial spirit, and a commitment to human-centered care. For more than two decades, he has built a company dedicated to rethinking how patients are treated beyond hospital walls.

The Birth of CaptaMed

About 30 years ago, Marcos began to notice how many elderly people were spending long periods in hospitals. That observation revealed to him an important opportunity: providing care outside the hospital environment. From that moment on, he decided this would be his professional focus.

In 1996, Marcos came across the U.S. company Interim, which was entering Brazil with a franchising model. Together with his family, he decided to acquire the franchise office in Minas Gerais, and that is how the journey began. He traveled several times to the United States to study the model, negotiate the contract, and deepen his understanding of the business. After six months of preparation, operations officially started.

The beginning was very challenging. It was a completely new process in Brazil, and everything had to be built from the ground up. The company grew quickly, but the required five percent royalty fees left very little profit. Eventually, the difficult decision was made to close the company, a decision that Interim’s directors fully understood. Two years later, Marcos chose to return to the healthcare sector, this time with his own company. That was the foundation of CaptaMed.

The Power of Clinical Protocols

Marcos emphasizes that CaptaMed chose to go deeper into clinical protocols, as they are essential for ensuring quality and standardization across different units. Every day, the company faces a wide range of situations, from complex medical problems to fragile patients and, at times, very challenging families. Protocols provide greater security and consistency for teams, patients, ensure companies and families alike.

To guarantee excellence, CaptaMed adopts the ONA accreditation methodology, recognized nationally for its rigorous quality standards. In addition, for palliative care, the company partners with the New Health Foundation, a Spanish institution, through the NewPalex program. This seal of quality in palliative care is rare in Brazil and places CaptaMed among the few companies in the country to achieve it.

For its 24-hour service, the attendant follows strict protocols to identify risky patients and prioritize their needs. Depending on the urgency, the patient may receive a nurse or physician visit first, or even an ambulanceand hospitalisations. These protocols ensure safe, agile, and measurable improvements in recovery at home.

Resurrecting Vera Cruz

Marcos successfully led Hospital Vera Cruz through a major turnaround and eventual sale in 2017. He recalls that the hospital was originally a family-owned business. When his father grew older, the third generation, consisting of three brothers and two sisters, took over its management but without much success. At that point, Marcos gathered his siblings and persuaded them to give him their full support to lead a turnaround.

The first step was a comprehensive contract review, where he and his team identified the main issues with their largest clients. They then entered into tough negotiations to resolve these problems. At the same time, Marcos designed an expansion plan that included building a new facility on an internal plot of land, effectively doubling the hospital’s size.

He also placed strong focus on physicians and surgeons, bringing them closer to the company’s strategy and aligning them with results. Together, the team was able to generate significant value for the hospital. After achieving this successful transformation, a strategic decision was made to sell the company.

A Prescription for Financial Recovery

Marcos has also guided financially distressed healthcare institutions back to stability. He explains that the first step is always to evaluate corporate structure and leadership. A crucial question is who is in charge of the hospital. If the manager is a physicianor other professional , does that person truly have the skills to run a business? And, just as important, does that physician for example have the time to manage effectively while still performing surgeries or clinical work?

The second factor he considers is revenue concentration. If a provider  depends heavily on a few contracts, with more than forty percent of its revenues tied to them, the sustainability of those contracts must be examined.

Finally, Marcos highlights the importance of contract margins. A strong contract must guarantee a healthy gross margin. Without solid margins, profitability is simply impossible, regardless of revenue size.

120 Years of Life, and the Systems to Sustain It

Marcos explains that one of the greatest challenges facing healthcare operators is the increasing longevity of populations. He strongly believes that within a few decades, many individuals will reach 120 or even 150 years while maintaining good health. However, he emphasizes that leaders must recognize the urgent need to implement programs for managing chronic patients and supporting terminal patients. These programs must be designed to serve thousands of people across different levels of care.

Marcos highlights that this approach is not only humane but also financially sustainable. Health systems can save enormous amounts of money by adopting continuous, hands-on monitoring models. In practice, he has observed a return of about three dollars for every one dollar invested in chronic care programs, and as high as seven dollars for every one dollar invested in palliative care programs.

Healing in the Digital Age

Marcos sees technology as a transformative force for the future of home care in Brazil. He notes that while the extra-hospital care industry is still small, it is growing rapidly. Many companies are trying to enter the market, yet most lack the quality and structure necessary to succeed. Meeting service level agreements for admissions remains challenging, and families can often be difficult to manage.

At Captamed, the vision is to become fully digital within the next year. Marcos believes this shift will allow the company to leverage a wide range of tools to deliver care more efficiently and at lower cost. Remote sessions and monitoring are already being explored, such as follow-ups with speech therapists after the initial in-person visit. Monitoring devices are also being implemented to track patients’ conditions, helping to prevent complications and avoid unnecessary hospitalizations.

He stresses that the future belongs to services that provide continuous care across all levels of need for patients with one or more chronic diseases. These patients often interact with the health system in fragmented and disorganized ways, creating additional pressure on hospitals and insurers. While many healthcare companies focus on simply expanding their workforce, Marcos chose to do much more. By dedicating himself to understanding human nature and the complexity of people, he has positioned Captamed to deliver not only high-quality care but also meaningful and sustainable results.

Healing Beyond Species                                                                                                            

Marcos’s journey into healthcare leadership carries a unique influence from his early passion for animals, particularly horses. Since childhood, he was an extremely curious boy, captivated by insects, birds, dogs, and most of all, horses. By the age of eight or nine, he had already developed a strong passion for horses, medicine, and music, and he was certain of his path—he wanted to become a veterinarian.

He studied at UFMG, which was recognized at the time as the best veterinary school in Brazil. During college, he specialized in the clinical and surgical care of sport horses, gaining early exposure to X-rays and complex diagnoses. Within a few years, he established a clinic that grew rapidly. Working with horses and their owners proved to be a complex endeavor that demanded resilience and adaptability.

At the same time, Marcos was also involved in his family’s hospital, where he supported his father by monitoring financials and assisting with human resources managementwhile he especially in Financial, Management and Technology and more recently Epidemiology.These experiences, though distinct from veterinary medicine, provided invaluable lessons that later shaped his path as a healthcare entrepreneur and leader.

The Harmony of Music and Leadership

Outside of his corporate role, Marcos is an accomplished violinist whose lifelong passion for music has deeply influenced his leadership philosophy. Growing up in a musical household, he absorbed classical violin concertos from his father, progressive rock from his older brother, and the gentle rhythms of bossa nova from his mother’s family. At the age of nine, he insisted for a full year that he wanted to play the violin until his parents finally allowed him to audition. After being accepted, he began lessons and has continued to play ever since.

For Marcos, the violin has been a profound teacher. It has instilled resilience, concentration, discipline, persistence, and purpose, qualities that he believes are essential in leadership. Mastering the instrument requires balance: the left hand must move with precision while the right hand produces clarity and strength. He sees a clear parallel to leadership, where the leader and the team must work in harmony to achieve excellence. Music, he explains, is more than a passion; it is a calling that connects the spiritual with the practical. He believes that love, energy, focus, and purpose must guide everything in life, and that the higher the purpose, the greater the results, not only for oneself but for everyone who depends on that vision.

Balancing Care and Sustainability in Healthcare Entrepreneurship

Marcos acknowledges that entrepreneurship in healthcare carries particularly high stakes. The sector is both complex and inherently risky, especially in the area of extra-hospital and home care. The challenge lies in ensuring that innovation is balanced with uncompromising safety and compliance.

He points out that while most healthcare professionals rightly focus on the immediate needs of patients, it is equally important to understand the practices that guarantee the sustainability of the business itself. By adopting and integrating these principles into everyday routines, organizations can deliver excellent care while also ensuring long-term financial viability. For Marcos, true progress in healthcare requires equal attention to medical outcomes and economic stability.

Roadmap to Healthcare Leadership in Brazil

Looking to the future, Marcos has a bold vision for CaptaMed. By 2026, he aims for the company to become the leading extra-hospital medical provider in Brazil in both revenue and scope. Currently the second-largest player in the market, CaptaMed is strategically positioned to achieve this goal.

He sees enormous opportunity in Brazil, a country of continental proportions, where the healthcare market continues to evolve rapidly. To capture this potential, CaptaMed has defined five major sectors for expansion: insurance companies, medical groups, physicians’ cooperatives, public companies with internal healthcare systems, and local government or public health plans. This segmentation allows the company to design tailored services that meet the unique needs of each segment.

Brazil’s public healthcare system alone serves nearly 200 million people, while roughly 25 percent of the population also has private health insurance. Despite this, the two systems largely operate in parallel with very little integration. While CaptaMed already has a strong foothold in the private sector, Marcos identifies the public system as a vast and largely untapped market with immense potential for sustainable expansion.