Hospital Market in India HospitalMarketinIndia

July2013
ExecutiveSummary
Market
Overview
ThehospitalmarketinIndiawasvaluedatINRx
2
tnin20 andisexpectedtoreachINRx
5
tnby
20
ThesectorisdividedprimarilyintopublicandprivatealongwithNGOoperatedhospitals
Constantlyrisingpopulationresultsinperennialshortageofhospitalbeds
Drivers &
Drivers:
ShortageinNumberofHospitalBeds
IncreasingLifestyleDiseases
Challenges:
ShortageofMedicalProfessionals
LackofInvestmentinITInfrastructure
Drivers&
Challenges
SurgeinMedicalTourism
GovernmentInitiativesPropelling
Investment
GrowingTargetHospitalizationPopulation
Group
ShortageofFDIInflowinIndian
Hospitals
Group
GrowingHealthInsuranceMarket
RisingDisposableIncome
SpecialtyClinics
Glocal Healthcare Systems
HospitalMobileApplications
Hospital Information Centre
LuxuryOfferings
Diversified Business Approach
KeyTrends
Competitive
GlocalHealthcareSystems HospitalInformationCentre DiversifiedBusinessApproach
KeyPlayers
ApolloHospitalsEnterpriseLtd. FortisHealthcare(India)Ltd. CareHospitalsPvt.Ltd.
y
2 HOSPITALMARKETININDIA2013.PPT
Landscape
ColumbiaAsiaHospitalPvt.
Ltd.
ManipalHealthEnterprisesPvt.
Ltd.
MaxHealthcareInstitute
Ltd.
EconomicIndicators
IndianHealthcareScenario
Introduction Introduction
MarketOverview
Drivers&Challenges
ITAdoption
RoleofGovernment
Key Trends KeyTrends
KeyInitiatives
CompetitiveLandscape
TradeFairs&Events
RecentTransactions
Strategic Insights
3
StrategicInsights
Appendix
HOSPITALMARKETININDIA2013.PPT
SAMPLE
EconomicIndicators(1/3)
INRtn
15
d4
c4
d3
3
GrossDomesticProductAtFactorCost(AtConstantPrices):Quarterly
14
13
12
11
b4
a4
c3
b3
a3
d2
c2
b2
a2
d1
c1
b1
a1
10
Q4 Q3 Q2 Q1
20 20 20 20
InflationRate:Monthly
N.B.:NewSeriesBase:200405
y
0 8
1.0
%
E
C B
0.2
0.4
0.6
0.8
D A
4
0.0
Mar20 Apr20 Feb20 Mar20 Jan20 Feb20 Dec20 Jan20 Nov20 Dec20
HOSPITALMARKETININDIA2013.PPT
HealthcaresysteminIndiarequiresalargerpublicoutlay
duetohugepopulationbase
HealthcareIndustryOverview
AccordingtoWorldHealthStatistics2011Report,India,
healthcarecomprisedofr%ofIndiasGDPin20
Public and private expenditure on health as percentage of GDP
HealthcareSector MarketSize&Growth
8 000
10,000
INRbn
A%
f
e
d
PublicandprivateexpenditureonhealthaspercentageofGDP
wasr
1
%andr
2
%respectively
Favorabledemographics,increaseinawarenesslevels
andbettermedicalcarearesomefactorsthataredriving
healthcare sector in India
0
2,000
4,000
6,000
8,000
d
c
b
a
healthcaresectorinIndia
Hospitalformsthelargestsegmentofoverallhealthcare
marketfollowedbypharmaceutical,medicaldevices,
healthinsuranceanddiagnostics
G d l t ti f h lth i i t i
0
2017e 2016e 2015e 2014e 2013e 2012
HealthcareMarketSegmentation 20
Gradualpenetrationofhealthinsuranceissteppingup
affordabilityofhealthservicesthroughincreaseddemand
forpreventiveandcurativehealthcareservices
Superiorqualityhealthcarecoupledwithlowtreatment
a%
d%
e%
f%
c%
costincomparisontoothercountriesisbenefitingIndian
medicaltourism,therebysteeringforthIndianhealthcare
market
TreatmentformajorsurgeriesinIndiacostsapproximatelym%
b%
c%
A E C
5
ofthatindevelopedcountries B F D
HOSPITALMARKETININDIA2013.PPT
SAMPLE
FDIInflowinIndianHealthcareSegments
SeveralhealthcaresegmentsinIndia haveearnedgoodvolumeofFDIovera12
yearsspanbetween20 to20
INR m bn
Hospital and diagnostic centers
INRm
1
bn
Hospitalanddiagnosticcenters
INRm
2
bn
Medicalandsurgicalappliances
INRm
3
bn Drugsandpharmaceuticalssector
6 HOSPITALMARKETININDIA2013.PPT
Hospitalscanbeclassifiedongroundsofownershipand
clinicaloperation
ClassificationofHospitals
OwnershipBasis ClinicalBasis
Public
Hospitals
RunbyCentralGovernment,
StateGovernmentandlocalbodies
General
Hospitals
Hospitalsstaffedbyatleasttwomedical
officersthatprovidesinpatient
accommodationandmedicalcareformore
thanonecategoryofmedicaldiscipline
Private
Hospitals
RunbyCentralGovernment,
StateGovernmentandlocalbodies
Specialized
Hospitals
Providesmedicalattentionforonediscipline
andisadministrativelyattachedtoageneral
hospital
Isolation
H it l
Hospitalsforthecareofpersonssufferingfrom
i f ti di
Corporate
Hospitals
Publiclimitedcompaniesformedunder
CompaniesActruncommerciallyandislikely
t t h i f h it l
Hospitals infectiousdiseases
Tertiary
Hospitals
StateandCentralgovernmenthospitals
establishedintheirstatecapitals
p
tooperatechainofhospitals
Voluntary Functions with public or private funds on a
Teaching
Hospitals
Ahospitaltowhichacollegeisattached
formedical/dentaleducation
Rural
Locatedinruralareaspermanentlystaffedby
atleastonephysicianthatprovidesinpatient
7
Voluntary
Hospitals
Functionswithpublicorprivatefundsona
noncommercialbasis
Hospitals
accommodationandmedicalcareformore
thanonecategoryofmedicaldiscipline
HOSPITALMARKETININDIA2013.PPT
HospitalsisthemostcrucialaspectofIndianhealthcare
sector,constantlydevelopingtoprovideworldclassservice
HospitalsareamajorcomponentoftheIndian
Healthcareindustryformingmorethana%ofthetotal
healthcare sectors revenue
MarketOverview(1/2)
MarketSizeandGrowth PrivateHospitals
INRtn
6
x7
healthcaresector srevenue
Hospitalsectorisdividedintopublicandprivate
Thereare~pprivatehospitalsand~qpublichospitalsacross
thecountry
PotentialgrowthprospectofIndianhealthcareis
attracting many foreign companies who are willing to
5
4
3
+X%
x6
x5
x4
x3
x2
attractingmanyforeigncompanieswhoarewillingto
investorestablishbaseinIndia
ThereisagrowingtrendtotapthehighpotentialtierIIand
tierIIIcities
Atrendofgrowthinspecialtyandmultispecialtyhospitals
in the country is also observed
2
1
0
20e 20e 20e 20e 20e 20
x2
20
x1
inthecountryisalsoobserved
20 e 20 e 20 e 20 e 20 e 20 20
PrimaryHealthcare facilitiesactsasthebackboneofpublichealthcaresystemestablishedand
operatedprimarilybygovernmentinstitutionswithlowinvolvementofprivate
Basedonapproachofuniversality,comprehensivenessandequityinhealth,thecountrylags
behindintermsofstandardizationofprocesses,qualityandservice
KeyHealthcare
DeliveryFormats
SecondaryCareHospitals thatmayormaynotspecializeintreatmentofaspecificailmentbut
offersmostessentialservices
Inmostcasesitcatersto85%to90%ofmedicalrequirements
Thesegmentconsistsofdistrictandallotherprivatelyrungeneralprivatehospitals
TertiaryCareHospitals arespecializedwhichofferspecificfacilitiesandemployhighly
8
specializedpractitionerswhoalsoofferspecializedconsultativecare
Serviceisprovidedbyprivate,regionalorcentrallevelinstitutionssuchasmultispecialtyand
singlespecialtyhospitals
HOSPITALMARKETININDIA2013.PPT
Drivers&Challenges Summary
Drivers
Shortage in Number of Hospital Beds ShortageinNumberofHospitalBeds
IncreasingLifestyleDiseases
Challenges
SurgeinMedicalTourism
GovernmentInitiativesPropelling
Investment
G i T H i li i
ShortageofMedicalProfessionals
LackofInvestmentinITInfrastructure
GrowingTargetHospitalization
PopulationGroup
GrowingHealthInsuranceMarket
ShortageofFDIInflowinIndian
Hospitals
RisingDisposableIncome
9 HOSPITALMARKETININDIA2013.PPT
Hugedemandsupplygapforhospitalbedsisthepotent
drivingelementofthehospitalmarket
Indiafacesanacuteshortageinnumberofhospitalbedsincomparisontopopulationlevelof
thecountry
ShortageinNumberofHospitalBeds Impact
AccordingtoWorldHealthStatistics,Indiaispositionedamongthelowestcountriesonaglobal
perspectivewithwhichisfarbelowtheglobalaverageofsbedspertpopulation
AccordingtoNationalHealthProfile20,Indiahasapublicsectoravailabilityofonebedperfpopulation
inggovernmenthospitalswhichisonlyhbedsperipopulation
Publicsectoraswellasprivatesectorneedstopullupthenumberofhospitalsandother p p p p
healthcareinstitutionsaspopulationgrowthwillraisedemandformorehospitalbeds
By20,populationsizewillbedmnthatwillnecessitateemnbedstoachieveHighLevelExpertGroup
(HLEG)targetofibedsperjpopulation
HospitalBedsPer1,000Population 2010
UK o
USA n
Japan m
RuralUrbanHospitalBedRatioComparison
s
RuralIndiaPublic
HospitalBedRatio
RuralIndiais
characterizedbypublic
hospitalswhileUrban
India by private hospitals
Brazil s
China r
SriLanka q
Russia p
UK o
u
c
Private
Hospital
BedRatio
Indiabyprivatehospitals
10 HOSPITALMARKETININDIA2013.PPT
India u
Thailand t
DevelopedNations
EmergingNations
UrbanIndia SouthernIndia CentralIndia
Lackofforeigninvestmentsactsasanimpedimenttothe
hospitalmarketofthecountry
Impact ShortageofFDIInflowinIndianHospitals
IndianhospitalsislaggingbehindinacquiringsufficientshareofFDI
FDIequityinflowinhospitalsectorisfarlowevenwhencomparedtodrugsandpharmaceuticalsectorin
India
FDIinvestmentinhospital&diagnosticcentersranksa
rd
intermsofamountofFDIequityinflowsinperiod
betweenApr20 toJan20
Therearebothinternalandexternalissuesthatdecelerateforeigninvestmentsinourcountry
Hospital&DiagnosticCenters
INR n bn ~ b%
InternalIssues
Highcostinvolvementinhospital
establishment
Depreciation of medical equipments
ImbalanceinFDIInvestmentWithinHealthcareSector
Drugs&Pharmaceuticals
INR m bn ~ a%
INRnbn b%
Depreciationofmedicalequipments
Feasibilityissueinupgradinghealthcare
equipments
ExternalIssues
INRmbn a%
Indianprivatehospitalsunabletoestablish
hospitalsoverseas
Requirementofindepthlocalized
knowledgeofhostcountry
11 HOSPITALMARKETININDIA2013.PPT
g y
Indiangovernmentfailstoprovideaclarity
inpoliciesonoverallhealthcaresector
SAMPLE
ITAdoptioninHospitalisprogressingslowwithonlyhigh
endcorporatehospitals
35
40
INRbn
18.3%
u
t
ITSpendingonHealthcare
10
15
20
25
30
p
18.3%
t
s
r
q
0
5
10
20 20e 20e 20e 20e 20e
m%
Businessstreamliningandpatientadministration
systemsistheprimemotiveforITadoptionin
hospitals
H it l id b tt d t
n%
Hospitalscanprovidebettercareandmanagecosts
betterinternallyandpatientscanlookforlower
healthcarecosts
ITleveragingandsharingdataoncloudhelpsinsaving
i f t t d t t t t
12
ITAdoptioninHospitals
ITAdoptioninOtherHealthcareSegments
infrastructureandmanpowertoagreatextent
HOSPITALMARKETININDIA2013.PPT
SAMPLE
RoleofGovernment:Summary
SAMPLE
BudgetaryAllocation
Role
of
Government
Financial Incentives
PublicPrivate
Partnerships FinancialIncentives Partnerships
(PPPs)
13 HOSPITALMARKETININDIA2013.PPT
SAMPLE
KeyTrends
SAMPLE
Specialty
Diversified Business
Clinics
Glocal Healthcare DiversifiedBusiness
Approach
GlocalHealthcare
Systems
Key
Trends
Luxury
Offerings
HospitalMobile
Applications
Trends
Hospital
InformationCentre
14 HOSPITALMARKETININDIA2013.PPT
SAMPLE
KeyInitiatives Summary
HealthCities
Key
Initiatives
Telemedicine Mobile Hospitals Telemedicine MobileHospitals
15 HOSPITALMARKETININDIA2013.PPT
HealthCitiesaregraduallybeingpopularizedtocater
mostlytomedicaltourists
HealthCitiesprimarilyincludesuperspecialtyhospitalattachedtoamedicalcollege,residential
areawithinhousehighenddiagnosticcenters,commercialzonesandothercommon
infrastructure
H l h Ci i
HealthCitiescatertolargerpopulationsbyofferingadditionalfacilitiessuchashotels,recreational
facilitiessuchasspa,gymandevengolfcourses
TheyarealsoexpectedtolayagreateremphasisoneducationandR&D
HealthCities
NarayanaHrudayalaya
AsonMay20,thegroupaimstobuildsbedhealth
cities that will offer medical care facilities in heart
OdishaStateGovernment
AsonJul20,thestategovernmentisplanningto
setupanintegratedhealthcityontheoutskirtsof
Bhubaneshwar
citiesthatwilloffermedicalcarefacilitiesinheart,
kidneyandcancer
OnecityeachisplannedinJaipurandWestBengal,
whiletwoshallcomeupontheoutskirtsofKolkata
As on Dec 20, the group is in plans to initiate a
Bhubaneshwar
Conceptnoteoftheprojecthasbeenpreparedby
IndustrialInfrastructureDevelopmentCorporationof
Odisha
Projectisaimedatmakingthestateacomplete
health destination and promote medical tourism AsonDec20 ,thegroupisinplanstoinitiatea
centreinLucknow,UPwithabedcapacityofmn
beds
healthdestinationandpromotemedicaltourism
Thegovernmentwouldpromotetheprojecton
publicprivatepartnershipwithoneortwomega
healthcarepromotersasanchorsoftheproposedcity
QRGEnterprisesannounceditsplanofpenetratinghealthcaresegmentwithhospitalchaininNCRalongwithLudhiana,Agraand Jaipuras
16 HOSPITALMARKETININDIA2013.PPT
Q G te p ses a ou ced ts p a o pe et at g ea t ca e seg e t t osp ta c a C a o g t ud a a, g a a d Ja pu as
onJun20
ThegroupplanstosetupapbeddedsuperspecialtyfacilityinFaridabadthatisexpectedtobecommissionedinSep20 with an
investmentofINRdbnthatwouldbenamedQRGHealthCity
CompetitiveBenchmarking(2/5)
KeyRatiosofTop3Companies OperationalBasis(FY20)(1/3)
40
%
NetMargin OperatingMargin GrossMargin
10
20
30
40
c3
b3
c2
b2
a2
c1
b1
a1
0
C B
c2
A
Arecordedgrossmarginofa1%,higherthanBwhichrecordedgrossmarginofa2%
Arecordedanoperatingmarginofb1%,higherthanbothBandCthatrecordedanoperatingmarginofb2%andb3%
respectively
Arecordedanetmarginofc1,higherthanbothBandCthatrecordednetmarginofc2andc3respectively
17 HOSPITALMARKETININDIA2013.PPT
MajorPublicCompanies Summary
500,000,000
NetProfit
(INRmn)
100 000 000
200,000,000
300,000,000
400,000,000
Sizeofbubblerepresents
MarketCapitalizationinINRmn
200,000,000
100,000,000
0
100,000,000
b a
500,000,000
400,000,000
300,000,000
700,000,000
600,000,000
15,000 20,000 25,000 30,000 35,000 40,000 45,000 50,000 55,000 60,000 65,000 70,000
Revenue
(INRmn)
18
B A
HOSPITALMARKETININDIA2013.PPT
Private:DomesticCompany PlayerA(1/5)
CompanyInformation OfficesandCentres India
CorporateAddress xx
TelNo. xx
Website xx
YearofIncorporation xx
Delhi
HeadOffice
ProductsandServices
Category Products/Services
KeyPeople
N D i ti
Category Products/Services
SportsGoods xx
FitnessEquipment xx
Name Designation
EquipmentSupplier xx
Others xx
19 HOSPITALMARKETININDIA2013.PPT
Private:DomesticCompany PlayerA(2/5)
ShareholdersoftheCompanyasonxx/xx/20
OwnershipStructure
Name No.ofSharesheld
100 0% 100 0% 100 0%
Directorsorrelativesofdirectors
100.0% 100.0% 100.0%
Total
20 20 20
20 HOSPITALMARKETININDIA2013.PPT
OwnershipstructurecorrespondstoDateofAGM:xx/xx/20,
xx/xx/20 andxx/xx/20
i i l S h K i
Private:DomesticCompany PlayerA(3/5)
FinancialSnapshot KeyRatios
Particulars
yoychange
(20 )
20 20 20 20
ProfitabilityRatios
OperatingMargin N.A. N.A. N.A. N.A. N.A.
NetProfit/Loss TotalIncome
INRmn INRmn
n
NetMargin N.A. N.A. N.A. N.A. N.A.
ProfitBeforeTaxMargin N.A. N.A. N.A. N.A. N.A.
ReturnonEquity 1.47 5.36% 3.89% 0.00% 0.00%
ReturnonCapitalEmployed 0.00 0.00% 0.00% 0.00% 0.00%
ReturnonWorkingCapital 0.00 0.00% 0.00% 0.00% 0.00%
ReturnonAssets 0.00 0.00% 0.00% 0.00% 0.00%
m
FinancialSummary
ReturnonFixedAssets 0.00 0.00% 0.00% 0.00% 0.00%
CostRatios
Operatingcosts(%ofSales) N.A. N.A. N.A. N.A. N.A.
Administrationcosts(%of
Sales)
N.A. N.A. N.A. N.A. N.A.
Interest costs (% of Sales) N A N A N A N A N A
0
20 20
CompanyearnedanetprofitofINRmunitsinFY20,as
comparedtonetprofitofINRnunitsinFY20
ItreportedtotalincomeofINRpunitsinFY20,
registeringanincreaseoftpercentfromFY20
Interestcosts(%ofSales) N.A. N.A. N.A. N.A. N.A.
LiquidityRatios
CurrentRatio 10.83% 1.76 1.97 1.71 2.07
CashRatio 35.86% 0.16 0.24 0.20 0.32
LeverageRatios
DebttoEquityRatio 14.21% 1.16 1.02 0.50 0.50
Thecompanyreportedadebttoequityratioofx
percentagepointsinFY20,anincreaseofypercentover
FY20
DebttoCapitalRatio 6.57% 0.54 0.50 0.33 0.34
InterestCoverageRatio N.A. N.A. N.A. N.A. N.A.
EfficiencyRatios
FixedAssetTurnover N.A. 0.00 0.00 0.00 0.00
AssetTurnover N.A. 0.00 0.00 0.00 0.00
Current Asset Turnover N.A. 0.00 0.00 0.00 0.00
21
Improved Decline
CurrentAssetTurnover N.A. 0.00 0.00 0.00 0.00
WorkingCapitalTurnover N.A. 0.00 0.00 0.00 0.00
CapitalEmployedTurnover N.A. 0.00 0.00 0.00 0.00
HOSPITALMARKETININDIA2013.PPT
Private:DomesticCompany PlayerA(4/5)
BusinessHighlights
Description News
Overview xx
Facilities xx
22 HOSPITALMARKETININDIA2013.PPT
Public:DomesticCompany SWOTAnalysis PlayerA(5/5)
XX
XX
XX
O
W
S
T
O
XX XX
23 HOSPITALMARKETININDIA2013.PPT
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