Inaugural Session - Arvind singhal

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Presentation delievered by Arvind Singhal, Technopak at the launch of TiE Delhi NCR's Healthcare SIG.

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  • Inaugural Session - Arvind singhal

    1. 2. Contents Indian Healthcare Landscape Section 1 Some Opportunities Section 2 Q & A Section 3
    2. 3. Section 1
    3. 4. Healthcare Delivery System Evolution ….. Charitable Trust/ Government/ Clinics Private Nursing Homes Large Super specialty Private hospitals Mix of Super specialty and Multispecialty Chains Medicities Upgraded Secondary Care Chains Daycare Surgery Centers Integrated Health Systems Till 1980s Till 2000 Till 2007 In Vogue 2010 Onwards
    4. 5. Indian Healthcare – Driven By Private Expenditure At about US$ 122 per capita, India’s spending on healthcare is amongst the lowest in the world United States Australia South Africa Russia Brazil China India US$ 3 Trillion 15.2% Healthcare Expenditure as % of GDP Per Capita Healthcare Expenditure (in $) Public Expenditure Private Expenditure US$ 60 Billion: 4.2%
    5. 6. Healthcare Delivery Landscape
    6. 7. Indian Consumer Spending On Healthcare 2010 $800b 2020 $2500b The share of average household spend on Healthcare in India is expected to increase from 7% to 10% by 2020 Source: National Accounts Statistics, Technopak Analysis 2015 $1400b
    7. 8. Growth Drivers For Healthcare Delivery Others: Regulatory Impact, Increased Awareness, Quality up gradation, corporatization, etc. Growth Factors Source: Technopak Analysis
    8. 9. Indian Healthcare Market Today Indian Healthcare Market Breakup of Indian Healthcare Market Billion US$ CAGR 15% Source: National Health Accounts, Technopak Analysis
    9. 10. Organized Vs Unorganized Share <ul><li>Healthcare delivery in India is still very much concentrated in the unorganized sector </li></ul><ul><li>Organized healthcare constitute a very miniscule share in the overall healthcare delivery market but is expected to grow with the growth rate of 25%. </li></ul>Organized Vs Unorganized Healthcare Organized Healthcare Projected Growth CAGR 25% Source: Technopak Analysis US$ Billion
    10. 12. Indian Healthcare Industry – Weaknesses <ul><li>Very limited focus so far on accessibility & affordability </li></ul><ul><li>Absence of integrated pan India (or even pan region) players </li></ul><ul><li>Providers of quality healthcare largely focused on the top 10-12 cities, though some recent efforts to go to smaller cities now </li></ul><ul><li>Few, if any, of the players adequately integrate both the financing and delivery of care </li></ul><ul><li>Technology usage very limited </li></ul><ul><li>Focus on reactive rather than preventive care </li></ul>
    11. 13. Indian Healthcare Industry – Weaknesses <ul><li>Generally flawed business models for many: </li></ul><ul><ul><li>Very high capital cost </li></ul></ul><ul><ul><li>Multiple specialties under one roof without achieving a critical mass in any single one </li></ul></ul><ul><ul><li>Seemingly random expansion </li></ul></ul><ul><ul><li>Lack of integration between primary, secondary, and tertiary facilities </li></ul></ul><ul><ul><li>Poor / wrong city / site selection </li></ul></ul><ul><ul><li>Very high operating costs due to systemic design flaws </li></ul></ul>
    12. 14. How Accessible Is Healthcare Today? * Source: Technopak’s India Healthcare Trends ’08 Specialty Distance Traveled (Kms) It is estimated that more than 46% of the patients travel over 100 Km from small towns to these facilities to seek proper medical care*.
    13. 15. Accessibility Very Poor Outside The Cities Maximum concentration of healthcare facilities Presence of mostly unorganized players providing sub optimal care at high cost to patients Rural Few basic healthcare facilities, forcing travel for millions to urban centers for most situations.
    14. 16. Absence Of Financing Mechanism Over 70% of the expenditure on healthcare is still being met by consumers “out of pocket”. Less than 15% of India’s population today has some form of health insurance cover Beneficiaries (Mn) % Population Private Insurance 33 3% Social Insurance ESIS 50 5% CGHS and Others 6 Community Insurance RSBY, Others (Micro Insurance etc.) 69 6% Employer Cover 25 2% Total 183 16%
    15. 17. Humungous Infrastructure Requirements Source: WHO Stats ,Technopak’s Analysis Existing (Mn) Additional Required Today (Mn) Needed By 2020 (Mn) Beds 1.1 1.9 3.6 Doctors 0.7 0.9 1.9 Nurses 1.5 1.8 3.7 Immediate 2020 2030 Investment Need (US$ Billion) 80+ 500+ 500+
    16. 18. Key Challenges… Real Estate <ul><li>High cost impacting viability </li></ul><ul><li>Non availability in dense population pockets </li></ul><ul><li>Healthcare REITS </li></ul>Workforce <ul><li>Medical, Nursing and Allied </li></ul><ul><li>Professional Managers </li></ul><ul><li>Inadequate skill sets </li></ul>Quality Accreditation Clinical Outcomes <ul><li>Inadequate focus </li></ul><ul><li>NABH/ NABL </li></ul><ul><li>Protocols </li></ul>Data for Comparables <ul><li>No Central Repository </li></ul><ul><li>Non Disclosure of Sentinel Events </li></ul>Regulatory Compliances <ul><li>Lack of Enforcement </li></ul><ul><li>Antiquated legislation </li></ul>1 3 2 4 5
    17. 19. Key Challenges Mitigation Mechanism <ul><li>Non Metro towns and rural hospital network </li></ul><ul><li>Telemedicine </li></ul><ul><li>Mobile healthcare </li></ul><ul><li>Micro Insurance </li></ul><ul><li>Risk sharing options </li></ul><ul><li>Health savings account </li></ul><ul><li>Quality </li></ul><ul><li>Transparency </li></ul><ul><li>Governance </li></ul><ul><li>Distance from home </li></ul><ul><li>Unavailability at convenient times </li></ul><ul><li>Miniscule insurance coverage </li></ul><ul><li>High treatment cost </li></ul><ul><li>No standard protocols </li></ul><ul><li>Lack of data repository </li></ul>Challenges
    18. 20. Summary : Section 1 <ul><li>Private sector to remain the engine of growth for Healthcare delivery in India </li></ul><ul><li>Providing accessible, affordable, and accountable healthcare services meets both business and social imperatives </li></ul><ul><li>Very favorable regulatory environment </li></ul><ul><li>Government’s role shifting from “Provider” to “Payer” </li></ul><ul><li>Non Top-12 Metro cities to see much more robust growth </li></ul><ul><li>Innovative low-cost, high-impact, high return-on-investment business models can be created </li></ul>
    19. 21. Section 2
    20. 22. Opportunity Segments In Healthcare Delivery <ul><li>Primary Care </li></ul><ul><li>Neighborhood clinics </li></ul><ul><li>Dental Clinics, Dialysis centers, eye-centers etc. </li></ul><ul><li>Diagnostics - Labs/Radio diagnostics </li></ul><ul><li>Secondary Care / Upgraded secondary care </li></ul><ul><li>100-150 bed hospitals </li></ul><ul><li>Mother & Child / other specialty Hospitals </li></ul><ul><li>Alternative Medicine/Wellness hospitals </li></ul><ul><li>Day Care Centers </li></ul><ul><li>Tertiary Care </li></ul><ul><li>Academic Medical Centres </li></ul><ul><li>Single specialty Hospitals </li></ul><ul><li>Multi Super-specialty Hospitals </li></ul><ul><li>Medical Cities </li></ul>$ 19 Billion $ 10 Billion $ 3 Billion Source: Technopak Analysis Segmentation of Private Healthcare Delivery Market $ 32 Bn
    21. 23. Opportunity Segments In The Eco-System <ul><li>Just about everywhere… some illustrative ones include: </li></ul><ul><ul><li>Facilities management: </li></ul></ul><ul><ul><ul><li>Bio-medical waste management </li></ul></ul></ul><ul><ul><ul><li>Housekeeping </li></ul></ul></ul><ul><ul><ul><li>Food services </li></ul></ul></ul><ul><ul><ul><li>IT solutions and IT enabled services </li></ul></ul></ul><ul><ul><li>Supply side: </li></ul></ul><ul><ul><ul><li>Medical devices and consumables </li></ul></ul></ul><ul><ul><ul><li>Other consumables </li></ul></ul></ul><ul><ul><ul><li>Furniture </li></ul></ul></ul><ul><ul><ul><li>Man-power solutions </li></ul></ul></ul><ul><ul><ul><li>Ambulance services </li></ul></ul></ul>
    22. 24. The Way Ahead For Entrepreneurs … <ul><li>Healthcare sector is undergoing major transformation – invest time and effort and perhaps some money in studying and understanding </li></ul><ul><li>India will need “India” specific solutions – hence resist the temptation of getting “inspiration” from the USA, EU, or elsewhere </li></ul><ul><li>If interested in delivery side, look at niches or look beyond the top 15-20 cities of India, and imbibe the mantra “ affordable , accessible , and accountable ” </li></ul><ul><li>If interested in the supply side, invest first in understanding current and emerging needs, and then try to create fundamentally new products / services or fundamentally new price / delivery paradigms </li></ul>
    23. 25. Section 3
    24. 26. <ul><li>Thank You ! </li></ul>
    25. 27. For Further Dialogue, Please Contact: Arvind Singhal / Dr. Sameer Khan Chairman / Sr. Vice President & Head (Healthcare Division) Technopak Advisors 4th Floor, Tower 8-A, DLF Cyber City Phase II Gurgaon (National Capital Region Of Delhi) India Tel: +91 124 4541111 www.technopak.com [email_address] [email_address]

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