Resonandina Holanda BV

Company profile

Resonandina is a profitable, fast-growing medical equipment leasing company. It makes medical devices such as MRI, CT, and Radiotherapy accessible to everyone worldwide through a full-service and pay-per-use leasing model.

Problem: Hospitals often lack money, knowledge, or space for capital intensive medical equipment.

Solution: Resonandina developed an innovative all-inclusive pay-per-use medical lease model that makes diagnostics accessible for everyone.

Capital-intensive equipment becomes affordable for hospitals because a small amount has to be paid each month instead of a large lump sum. The key differentiator of Resonandina is the focus on a ‘simple’ and client oriented “B2B” business model based on “Pay-per-Use” lease with a “all-inclusive” package. The service includes project design, investment, installation, training, full maintenance, and extended life cycle (with upgrades, reuse, and recycling). The hospital has all the medical related responsibilities like patient logistics, quality management, liability and (insurance) invoicing.

We ensure that these hospitals can deploy advanced equipment so that diagnostics become accessible and available to all. This results in healthier people and fewer travel movements.

Resonandina started the services in 2015 in Bolivia with a step-by-step expansion to other Latin American countries. Submarkets are: “doctor owned” medium size hospitals, larger professionally managed hospitals, and Public Healthcare Services.

Having a unique concept of “use it, don’t own it” Resonandina is market leader with focus on the “niche” of high-end medical diagnostic imaging. With a strong partner in GE Healthcare. Fundamental is the Recurring Revenue model with long term (8+ YR) contracts. With 10+ units producing, 10+ in installation, and a pipeline (2024) for 25+ projects there is a great potential.

Resonandina aims at 500+ projects with €150 million ARR on 5 continents. The market size is estimated at 100.000 projects per 2030. Resonandina successfully created a recognized market position, defined the service and operational execution, managed to create ARR and profitability, has proven the concept, prepared footprints in the addressable markets and is ready for the leap ahead.

Developments since the last funding round with Invesdor

You know this company already because of the last funding round? Find out more about what has happened since then.

Company Info 

Products and services

Resonandina helps medical facilities not only equip themselves with necessary high-tech machinery but also supports the effective operation and maintenance of these facilities with essential human resources and infrastructure, all adaptable to the needs of specific situations.

Medical Equipment:
Resonandina provides a wide range of hardware equipment such as MRI, CT, Cath Lab, PET/CT, Gamma Cameras, Linear Accelerators, Cyclotrons, and more.

Container Box Type Buildings:
Additionally, we offer "container box type" buildings for specialized circumstances. These are portable, modular buildings designed to house medical equipment or provide extra space for medical services. These are especially useful in situations where permanent construction is not feasible or where mobility and flexibility are required, such as in remote areas or temporary medical camps.

How does it work?

This model is beneficial because it allows hospitals to offer advanced MRI services without bearing the full financial burden of purchasing the equipment. It also helps maintain operational liquidity and adaptability in financial planning. Moreover, the pay-per-use system with volume discounts incentivizes hospitals to maximize the use of the MRI machine, potentially increasing their operational efficiency and profitability. Resonandina offers a “practical and transparent” financial solution, making the service affordable.

Here's a short overview of machine leasing for an MRI-model with Resonandina:

Business model

Resonandina employs a unique business model centered on leasing medical equipment under an all inclusive and transparent financial arrangement. Here's an enhanced overview of how their model works:

Financial Model

• Pay-Per-Use System: Hospitals pay Resonandina a set fee for each diagnostic scan performed, such as an MRI. This aligns the hospital's costs directly with their usage, making the service more affordable and scalable.
• Volume Discounts: As the volume of scans increases, the cost per scan decreases. This tiered pricing model provides an incentive for hospitals to use the equipment more frequently, which can increase their service to the community and potentially enhance their revenue.
• Minimum Volume Guarantee: Hospitals agree to a minimum number of scans per month, ensuring a stable and predictable revenue stream for Resonandina and operational efficiency for the hospital.

Revenue and Billing

• Insurance Billing: Hospitals bill the patients or their insurance companies based on local tariffs and insurance schedules. For instance, if a patient is charged $100 per scan, the hospital pays Resonandina $50 per scan for the first 350 scans, and $45 for subsequent scans. This allows hospitals to maintain profitability while covering their costs.
• Revenue Potential: The pricing structure and volume guarantees establish a base annual revenue (ARR) that Resonandina can expect, with potential for higher earnings as scan volumes increase.

Contractual and Client Details

• Long-Term Contracts: The lease agreements typically last between 8 to 15 years, matching the economic lifetime of the equipment.
• Target Market: Resonandina primarily serves medium-sized, doctor-owned hospitals in regions with over 150,000 inhabitants that lack significant diagnostic services. These hospitals often have limited capital for investment after spending on infrastructure.
• Larger Hospital Strategy: For bigger, professionally managed hospitals, Resonandina's leasing options offer financial flexibility, allowing these hospitals to invest in other areas while keeping their balance sheets clear of heavy equipment assets.

Partnerships and Operational Support

• Third-Party Contracts and OEM Partnerships: Resonandina contracts first-class third parties and original equipment manufacturers (OEMs) like GE Healthcare, including distributors such as Global Medical Dominicana and Orimec, as well as companies like JMP Medical and Tekemi. These partnerships are crucial for rigging, shipment, construction, and engineering, ensuring that the equipment is properly installed and maintained.
• Medical Operational Services: Resonandina offers options for medical operational services, providing radiologic technicians, nurses, and medical reporting staff, usually on a temporary basis in cooperation with partners. This additional support helps hospitals manage increased patient load and complex imaging tasks efficiently.

Operational Strategy

• Network Establishment: Successfully implementing this model requires Resonandina to maintain a strong network of clients and partners, including hospitals like CEDISA, Hospital Arco Iris, and Kenko Saude, among others. This network helps in ensuring the availability and efficient use of leased equipment across different regions.

Market

Resonandina Revolutionizes Hospital Diagnostic Imaging with Medical Lease Solutions in Rapidly Growing Global Market

Resonandina operates in the Hospital Diagnostic Imagining Services environment. In fact, a typical capital-intensive Equipment Sale market where we developed a Medical Lease solution.

The OECD country average for MRI/CT/PET-CT is 48 per one-million inhabitants. In developing markets, the availability is a fraction thereof.

Estimating the market size: ~115,307 scanners are installed worldwide until 2030. With a lifetime cycle of 15 years, roughly 7,500 units are replaced every year. While markets continue to grow – especially in Latin America (>10% / year) – every year roughly 5,000 units are added to the market. Together this leads to a yearly MRI/CT market opportunity of 12,500 units.

Resonandina aims at 500+ projects with 150 million ARR on 5 continents. The market size is estimated at 100.000 projects per 2030.

The principal competitors are the OEMs like Siemens, Philips and GE Healthcare offering sale including traditional financing with local banks. There is no specific competitor with our full blown USP “pay-per-use” service concept without asset backed guarantees by the client.

Since the Resonandina concept, market footprint, and project pipeline has been reached over the years, the entry-barrier is a complex mix for competition.

Resonandina focus on various countries in Latin America and Caribbean is to diminish local risks and create “first mover advantage” in a “slow moving” dispersed and medical specific “niche market”.

Management

Distribution of company shares

QMED BV is a private holding company controlled by founder Floriaan van Bemmelen.

Company structure

You are investing in Resonandina Holanda BV which lends money to its 100% subsidiaries in Peru and Ecuador. These subsidiaries own the equipment and are 100% guarantor. The subsidiaries have to repay this loan to the holding. Both the holding and the subsidiaries can be addressed to repay the Invesdor loan. Besides these two subsidiaries, the Company has 11 other subsidiaries.

Developments at Resonandina since the last crowdfunding 

In 2023, we successfully raised €4.2 million across three Invesdor (OnePlanetCrowd) funding rounds as well as nearly €3 million from private investors.
Here are the key achievements:

1. Installations: We initiated and completed installations for 7 projects across several countries: three in the Dominican Republic (one funded by Invesdor), one in Brazil, one in St. Vincent, one in St. Lucia, and one in Colombia (funded by Invesdor).

2. Revenue: Our revenue surged by nearly 100% to €5 million. This increase was driven by ongoing projects in Brazil, Bolivia, and St Maarten, along with three new projects in the Dominican Republic and a significant project sale.

3. Profit: Since becoming profitable in 2021, we saw a nearly 500% profit increase in 2023, reaching €275.000. This was achieved while continuing to invest substantially in new projects and expansion efforts.

4. Impact: We significantly contributed to SDG3 (Good Health and Well-being), enhancing diagnostic access for an estimated 2.5 million people, directly serving 75,000 individuals.

5. Expansion: We expanded our footprint by signing contracts in new countries and planning future installations. Projects funded by Invesdor set for 2024 include one PET/CT in Peru and three MRIs in Colombia, with an additional PET/CT in Peru and an MRI in Ecuador from the latest funding round.

Looking ahead, we are preparing for potential projects valued at over €25 million, which include expanding the nuclear medicine ecosystem in Peru (adding a Cyclotron, three more PET/CTs, and three Gamma Cameras), five MRIs in the Dominican Republic, three MRIs in Peru, and a comprehensive radiotherapy ecosystem in Colombia, the Caribbean, and Peru.

Use of funds

The funds will be used to finance a MRI in Ecuador and a PET-CT in Peru.

Investment related documents

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Note:

In this update section you will find new, project-relevant information that we receive.

Invesdor does not conduct a separate review of information received after the start of the financing phase.

UPDATE on 28.05.2024: Investor Q&A
 

1. Could you help explain why this project has a 9% interest rate, whereas the recent investment in Resondina was only at 8%? 

The interest rate for investing in Resonandina has increased from 8% to 9% due to recent changes in the broader economic environment, specifically the rise in interest rates within the European Union. The European Central Bank raised rates to control inflation, impacting global financial markets. To remain competitive and attractive to investors in light of these global changes, Resonandina adjusted its interest rate accordingly. This ensures offering competitive returns and maintaining investor interest.

2.Where can I find detailed financial information?

You can find detailed financial information on the project page under the "Financial Figures and Growth" section. Additionally, the KIIS document, available under the "Documents" section, provides comprehensive details. The annual statement is linked under section A(d) on page 2. You can also find a summary of the financial figures from 2021 to 2023 in these documents.

3.Are there reasons why Resonandina is not (yet) expanding its business model to Europe?

Resonandina started in Latin America because hospitals in developing countries often lack the opportunity to buy expensive equipment due to various constraints. Last year the company founded entities in Asia and South Africa while it received some initial requests from there. In the next 1-2 years management believes it will also start operating in developed countries.