With the Agora Tem Especialistas programme, the Ministry of Health has started paying for specialist care based on completed shifts, rather than isolated procedures. Otolaryngology is among the pioneering specialities, and we have already seen this logic work on the ground.

Source: Go Scope — Newsroom
Author: Go Scope Team
17/09/2026

For decades, the SUS paid for specialised care on a procedure-by-procedure basis: a consultation here, a test there, a follow-up months later, with each stage involving its own waiting list. The 'Agora Tem Especialistas' programme, established by Ministry of Health Ordinance (Portaria GM/MS) No. 7,266 of 18 June 2025, has inverted this logic with Integrated Care Offers (Ofertas de Cuidados Integrados – OCI): packages of procedures, consultations, tests and care technologies designed to complete an entire stage of the care pathway, whether for diagnosis or rapid-resolution treatment. The system has stopped measuring isolated actions and now measures completed journeys, recorded in the official systems for monitoring care output.

The OCIs already cover seven specialties: cardiology, gynaecology, ophthalmology, oncology, orthopaedics, otolaryngology, included among the pioneering areas by SAES/MS Ordinances Nos. 1,822 to 1,826 of June 2024 and, since June 2026, infectious diseases, by SAES/MS Ordinance No. 4,306. The Ministry of Health has even published a Referral Protocol for Otolaryngology OCIs, guiding Primary Care on when to refer and what each provision must conclude: consultation, examination and definition of management in a single journey. For the patient, the promise is simple: to leave with an answer, not another queue.

The specialty bottleneck is, in most cases, precisely what OCI solves: the diagnostic stage. Complaints such as nasal obstruction, persistent hoarseness and hearing loss depend on in-office endoscopic examinations, nasofibroscopy and videolaryngoscopy, in order to become a diagnosis and management plan. In the fragmented model, the patient waits for the consultation, then waits for the examination, then waits for the follow-up appointment. In the OCI model, these steps happen in a single, resolutive journey.

In May 2026, during the initiative with the Instituto Barco Sorriso in riverside communities a 24-hour boat journey from Manaus, we put this exact design into practice, even before knowing it by name: in a single care journey, there were 43 otolaryngology patients, 26 endoscopic examinations with diagnoses finalised on-site, three defined surgical indications and one referral for polysomnography. Consultation, examination and management in the same visit, care completed, not an isolated procedure. The experience also highlighted the missing piece for scaling this model: data integration. Care that the system cannot see is care that the system cannot complete, monitor or fund. Read the full article about the action in the Amazon

The AT-GS1, our portable video endoscopy set, operates precisely at the stage that the otolaryngology OCI wants to unlock: the diagnostic endoscopic examination performed at the point of care, with examination recording and digital reporting. That is why, as Partners of the InovaSUS Digital Laboratory, we have been working with the integrative protocols of the public healthcare network—the standards that allow the examination performed at the frontline to enter the official SUS workflow. The thesis that drives us is the same as that of the programme: rapid diagnosis, close to the patient and recorded on the network is not a convenience, it is the condition for the waiting list to move.

Sources
Now We Have Specialists Programme – Ministry of Health: gov.br
Referral Protocol to ENT OCIs – MS/SAES (official PDF)
Inclusion of infectiology in the OCIs – SAES/MS Ordinance No. 4,306, Jun/2026: gov.br