PART C CHAPTER-1-INTRODUCTION

A. OVERVIEW OF THE SERVICE SECTOR AND ITS CONTRIBUTION IN THE ECONOMY

The Indian healthcare industry, unlike other industries, stands untouched by recession. There had been a steady growth in this sector, revenues from the healthcare sector accounts for 5.2% of the GDP, making it the third largest growing sector in India, and further the healthcare sector is projected to grow to nearly 1,80,000 crores by year 2012 and a compounded annual growth rate (CAGR) of 15-17 percent for at least the next 7-10 years. Indian Healthcare Sector structure / Market size The sector comprises hospital and allied sectors that include: (a) Medical care providers that includes physicians, specialist clinics, nursing homes and hospitals (b) Diagnostic service centers and pathology laboratories (c) Medical equipment manufacturers (d) Contract research organizations and pharmaceutical manufacturers (e) Third party support service providers

In India, 80% of all the healthcare expenditure is borne by the patients. Expenditure borne by the state is 12%. The expenditure covered by insurance claims is 3%. As a result the price sensitivity is quite high. The high level healthcare facilities are out of reach for the patients.

Among the top five therapeutic segments, gastro-intestinal and cardiac are experiencing both high volume and value growth. Opthologicals, cardiovascular, anti-diabetic and neurological drugs continue to top the growth list. The anti-

infective, neurology, cardiovascular and anti-diabetic segments have witnessed a high number of new product launches in recent years. Current Healthcare Landscape

Amount spent on healthcare - 103,000 crores / annum 86,000 crores is the Healthcare delivery market 17,000 crores is the Retail pharma market

Key finndings of current private spending

Private spending on healthcare delivery 69,000 crores 61 % of this is spent on OPD services, 44,000 crores Indicates low levels of affordability and a disease pattern dominated by infections

39 % on IPD services = 25,000 crores 85 % of IPD spend is in 5 areas : cardio, cancer, accidents, infections and maternity

Road Ahead 2012

Private spending on healthcare delivery 156,000 crores because of an increase in population will lead to increase treatments

Change in socio-economic mix will lead to 8 % increase in treatment rate and 30 % increase in avg. price paid

Change in prices 26 % increase in price per treatment Change in mix of diseases 50 % increase in prevalence of lifestyle diseases will lead to 12% increase in treatment rate & 7 % in price and this would lead to a change in GDP from 5.2%to 6.2%

Richest 15% will account for 50% of all private healthcare spending & 60% of inpatient spend

Private spending would increase by another 39,000 crores if the insurance is likely to impact on middle-income households approx. 350 million in 2012, leading to achieving GDP spending to 7.5% and private spending on healthcare delivery to 195,000 cr.

Healthcare Fact File Parameters No. Of Beds No. Of Doctors No. Of Nurses Infant Mortality Rate Maternal Mortality Rate % of population Insured Total Private Spending OPD Spending Hospitals Current 1.2 beds per 1000 50,00,000 doctors 0.8 per 1000 34:1000 4:1000 12.00% 69,000 Crores 44,000 Crores 30,000 hospitals approx By 2012 9,14,543 In addition 6,25,130 In addition 8,36,000 In addition 10:1000 1 :1000 50.00% 156,000 Crores 82,000 Crores 17300 In addition 1,64,000 In addition 24,000 In addition 179 New 1,80,000 Crores 74 years

Primary Health Centres / 1,50,000 approx Community Health Centres Retails chemist outlets Medical Colleges Estd Current mrkt size Average life Expectancy 3,50,000 229 103,000 Crores 63.3 years

Investments plan in Healthcare The sector has been attracting huge investments from domestic players as well as financial investors and private equity (PE) firms. Funds such as ICICI Ventures, IFC, Ashmore and Apax Partners invested about US$ 450 million in the first six months of 2008-09 compared with US$ 125 million in the same period a year ago, according to an analysis carried out by Feedback Ventures. Feedback Ventures expects PE funds to invest at least US$ 1 billion in the healthcare sector in the next five years.

According to a Venture Intelligence study, 12 per cent of the US$ 77 million venture capital investments in the July-September 2009 quarter were in the healthcare sector. As part of its Healthymagination initiative, GE will spend US$ 3 billion over the next six years on research and development, provide US $2 billion of financing over the next six years to drive healthcare information technology and health in rural and under served areas, and invest US$ 1 billion in partnerships, content and services.

The government, along with participation from the private sector, is planning to invest US$ 1 billion to US $2 billion in an effort to make India one of the top five global pharmaceutical innovation hubs by 2020.

The Ajay Piramal Group-owned private equity (PE) firm, India Venture Advisers, will launch its second US$ 150 million healthcare fund next year.

Leading international clinic chain Asklepios International is gearing up for a foray into the Indian healthcare market. As part of the 2.3 billion euro groups strategy to enter the sub-continent, Asklepios is mulling the launch of a US$ 100 to US$ 200 million fund.

Gulf-based healthcare group Dr. Moopen is investing over US$ 200 million for setting up hospitals and eye-care centers across India.

Healthcare major, Fortis Hospitals plans to invest US$ 55 million, to expand its facilities pan-India.

Employment Opportunities

India faces a huge need gap in terms of availability of number of hospital beds per 1000 population. With a world average of 3.96 hospital beds per 1000 population India stands just a little over 1.2 hospital beds per 1000 population. Moreover, India faces a shortage of doctors, nurses and paramedics that are needed to propel the growing healthcare industry. India is now looking at establishing academic medical centers (AMCs) for the delivery of higher quality care with leading examples of The Manipal Group & All India Institute of Medical Sciences (AIIMS) already in place. A recent survey conducted by HarNeedi.com, gives an out look on the roles that are in great demand, Specialist doctors such as, Cardiologists, Cardiothoracic surgeons, Interventional Cardiologists, Orthopedics, Emergency Medicine Specialists, Oncologists, Radiologists, Ophthalmologists, Neurologists, Neuro-surgeons, Gynecologists, Urologists, Duty doctors etc are in great demand. Some of the other profiles that are in great demand are that of experienced nurses and technicians who can handle various specialties such as ICUs, Cath labs, Operation Theaters, Emergency Departments etc. Technicians, like Radiographers, CT Technician, Radiotherapy technicians, emergency medical technicians etc. are also in great demand. Considering all the above facts and the massive growth in the healthcare industry, huge investments would offer several opportunities for Indian companies to create 'win-win' situations and there would be emerging opportunities for professionals as well in the near future.

CHAPTER-2- ABOUT THE COMPANY A. PROFILE OF THE COMPANY Sri Balaji Action Medical Institute has been established with a mission to provide world class integrated healthcare facilities to all sections of the society with a humanitarian touch, while maintaining a high standard of ethical practice and professional competency with emphasis on training and education leading to research. "The Institute will impart free Medicare to the poor and needy people with an aim to run the institute on no profit no loss basis ". "The Institute has been promoted by Lala Munni Lal Mange Ram Charitable Trust of Action Group of Companies. The chairman of the trust Lala Mange Ram Agarwal, a great philanthropist had a strong desire to build a hospital for the service of mankind. ". Equipment, facilities and nursing standards are all structured keeping patient welfare as the ultimate goal. The core catalyst of the hospital functions is patient welfare and recovery. For us, freedom from pain, restoration of perfect health and resumption of normal life with respect to the patient is of paramount importance and throughout the treatment process the mental and physical well being of the patient is the main priority. We have thus encapsulated these work ethics in our motto healing with a human touch and strive to always uphold it. The Logo of the Institute portrays its philosophy; it consists of a hand embracing the flame of life with a sphere in the background. The Human Hand represents the healing touch and health care our dedicated teams of professional provide to brighten the lives of those who come to us. The Flame denotes the traditional values of honesty and selfless service towards our patients. The Sphere in the background reflects our commitment to maintain international standards of excellence.

Associated hospitals and clinics 1. Action Cancer Hospital, Paschim Vihar, New Delhi 2. Sri Balaji Hospital, Hissar, Haryana 3. Sri Balaji Hospital(Charitable ), Shazadabagh, New Delhi 4. Balaji Nirogdham Naturopathy and Yoga Centre, Bakhtawarpur, New Delhi 5. Day Care OPD Sarai Rohilla, New Delhi 6. Balaji Ashram at Vrindavan, Utter Pradesh

B. HISTORY OF THE COMPANY

C. VISION AND MISSION STATEMENT OF THE COMPANY

Vision To become the largest healthcare provider NGO in the country with a human touch. Mission Sri Balaji Action Medical Institute has been established with a mission to provide world class affordable health care facilities to all sections of the society with a humanitarian touch, whilst maintaining high standards of ethical practices and professional competency with emphasis on training and education leading to research.

D. KEY COMPETITORS OF THE COMPANY Adiva Hospital, Anand Lok Aster eye care, faridabad

All India Institute of Medical Sciences, Ansari Nagar Artemis Health Institute, Gurgaon Batra Hospital, Tughlakabad Columbia Asia,[3] Block F, Gol Chakkar,Palam Vihar, Gurgaon, Haryana 122 017 Cosmos Institute of Mental Health & Behavioural Sciences (CIMBS) Deen Dayal Upadhyay Hospital, Hari Nagar Dharamshila Cancer Hospital and Research Centre, Dharamshila Marg, Vasundhara Enclave

Escorts Heart Institute & Research Centre, Jasola Vihar Fortis Healthcare Limited, Karol Bagh, Greater Kailash, Vasant Kunj Guru Teg Bahadur Hospital, Dilshad Garden Holy Family Hospital, Jamia Nagar, Friends Colony Indraprastha Apollo Hospitals, Sarita Vihar Institute of Liver & Biliary Science, Vasantkunj D-Sector Jaipur Golden Hospital, Rohini, Sector-3 K K Surgical & Maternity Centre, West Jyoti Nagar Kalawati Saran Children's Hospital Kasturba Hospital, Daryaganj Lady Hardinge Medical College, Shaheed Bhagat Singh Marg Lok Nayak Jai Prakash (LNJP) Hospital, Delhi Gate

Maharaja Agrasen Hospital, West Punjabi Bagh Maulana Azad Medical College, Bahadur Shah Zafar Marg Max Healthcare, Max Super Speciality Hospital, Saket, New Delhi, 1, 2 Press Enclave Road, Saket, New Delhi - 110017

Medanta The Medicity, Gurgaon Metro Center For Liver & Digestive Diseases, Noida Metro Center For Respiratory Diseases, Noida Metro Hospital & Heart Institute, Lajpat Nagar Moolchand Hospital, Lajpat Nagar National Heart Institute (Delhi), Community Centre, East of Kailash Paras Spring Meadows Hospital Primus Super Speciality Hospital, Chanakyapuri Pushpanjali Medical Centre, Vikas Marg Pushpawati Singhania Research Institute Rajiv Gandhi Cancer Institute, Rohini Ram Manohar Lohia Hospital, Baba Kharag Singh Marg RG Stone Urology & Laparoscopy Hospital, Pitam Pura, Rajouri Garden Rockland Hospital, Dwarka Sector 12, Delhi Rockland Hospital, Qutub Institutional Area Safdarjang Hospital

Sanjeevan Hospitals, Daryaganj, Paharganj Shree Hospital, Dwarka Sir Ganga Ram Hospital, Rajendar Nagar St. Steven Hospital, Tis Hazari Sucheta Kriplani Hospital, Connaught Place Titupati Kidney Stone Hospital VIMHANS (Vidyasagar Institute of Mental Health and Neuro-Sciences), Nehru Nagar

World Laparoscopy Hospital, Gurgaon

E. ORGANIZATIONAL STRUCTURE Board of members Lala Mange Ram Agarwal Shri Nand Kishore Agarwal Shri Raj Kumar Gupta Shri R.C. Chharia Shri Laxmi Naraian Goel Shri Subhash Chandra Agarwal Shri B.P. Jain Chairman Vice-Chairman President General Secretary Member Member Member

Shri Naresh Kumar Agarwal Shri O.P. Gupta Dr. Y.P. Bhatia Shri H.K. Agarwal Shri Anil Kumar Agarwal Dr. Deepika Singhal

Member Member Member Member Member Member

CHAPTER-3- MARKETING STRATEGIES OF THE COMPANY A. INTRODUCTION ABOUT THE MARKETING STRATEGIES Marketing strategy is a process that can allow an organization to concentrate its resources on the optimal opportunities with the goals of increasing sales and achieving a sustainable competitive advantage.[1] Marketing strategy includes all basic and long-term activities in the field of marketing that deal with the analysis of the strategic initial situation of a company and the formulation, evaluation and selection of market-oriented strategies and therefore contribute to the goals of the company and its marketing objectives. B. SEVEN PS OF THE MARKETING The first four elements in the services marketing mix are the same as those in the traditional marketing mix. However, given the unique nature of services, the implications of these are slightly different in case of services. 1. Product: In case of services, the product is intangible, heterogeneous and perishable. Moreover, its production and consumption are inseparable. Hence, there is scope for customizing the offering as per customer requirements and the actual customer encounter therefore assumes particular significance. However, too much customization would compromise the standard delivery of the service and adversely affect its quality. Hence particular care has to be taken in designing the service offering. 2. Pricing: Pricing of services is tougher than pricing of goods. While the latter can be priced easily by taking into account the raw material costs, in case of services attendant costs - such as labor and overhead costs - also need to be factored in. Thus a restaurant not only has to charge for the cost of the food served but also has to calculate a price for the ambience provided. The final price for the service is then arrived at by including a mark up for an adequate profit margin. 3. Place: Since service delivery is concurrent with its production and cannot be stored or transported, the location of the service product assumes importance.

Service providers have to give special thought to where the service would be provided. Thus, a fine dine restaurant is better located in a busy, upscale market as against on the outskirts of a city. Similarly, a holiday resort is better situated in the countryside away from the rush and noise of a city. 4. Promotion: Since a service offering can be easily replicated promotion becomes crucial in differentiating a service offering in the mind of the consumer. Thus, service providers offering identical services such as airlines or banks and insurance companies invest heavily in advertising their services. This is crucial in attracting customers in a segment where the services providers have nearly identical offerings. We now look at the 3 new elements of the services marketing mix - people, process and physical evidence - which are unique to the marketing of services. 5. People: People are a defining factor in a service delivery process, since a service is inseparable from the person providing it. Thus, a restaurant is known as much for its food as for the service provided by its staff. The same is true of banks and department stores. Consequently, customer service training for staff has become a top priority for many organizations today. 6. Process: The process of service delivery is crucial since it ensures that the same standard of service is repeatedly delivered to the customers. Therefore, most companies have a service blue print which provides the details of the service delivery process, often going down to even defining the service script and the greeting phrases to be used by the service staff. 7. Physical Evidence: Since services are intangible in nature most service providers strive to incorporate certain tangible elements into their offering to enhance customer experience. Thus, there are hair salons that have well designed waiting areas often with magazines and plush sofas for patrons to read and relax while they await their turn. Similarly, restaurants invest heavily in their interior design and decorations to offer a tangible and unique experience to their guests.