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Ahmc presentation june 2014 for healthcare private investment conference

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  • 1.  AHMC is a private US company headquartered in Washington D.C. recognized as the leading international hospital development and management company offering clients “individualized turn-key services and total hospital solutions.”  AHMC’s 16 year track record includes successful collaboration in more than 50 hospital projects, on 5 continents and 24 countries around the world.  AHMC’s management model is based upon the very best characteristics of American management practices and Joint Commission International (JCI) Standards.  AHMC’s successful model has been adapted to the needs of clients around the world in order to deliver enhanced operational capabilities, quality, and profitability.  AHMC’s business philosophy and experience enable it to deliver global resources locally in order to provide state-of-the-art quality medical services  AHMC’s affiliated healthcare facilities are Five Star, Class “A” academic medical centers that are committed to quality, service and long-term financial success.  Unique to AHMC is its experience in the management and development of world-class healthcare facilities that include private hospitals, Private-Public hospital Partnerships (PPP), and academic teaching hospitals. AHMC OVERVIEW
  • 2. GLOBAL NETWORK:  Hospitals and Projects: 33  Operational facilities: 15  Licensed Beds: 2,900  Physicians: 3,000  Staff/Employees: 4,500  Avg. Patient satisfaction: 97% UNIQUE EXPERIENCE:  Private-Public Hospital Partnerships  New hospital commissioning  Academic and teaching hospital AHMC OPERATIONS OVERVIEW
  • 3. AHMC HOSPITAL FEATURES  Operated at Joint Commission International standards  Adoption of world class clinical guidelines  Commitment to continuous quality improvement and enhanced care  State-of-the-art medical technology and healthcare services  Commitment to continuing medical education and employee development through constant education and technology transfer  Transparent administration and business practices for to earn investors’ trust and in order to enhance ROI  Access to AHMC’s prestigious Strategic Alliances and related resources
  • 4. AHMC HOSPITAL CHARACTERISTICS Award winning design and according to JCI Standards
  • 5. AHMC HOSPITAL CHARACTERISTICS Modern and focused on patient safety/quality and efficiency
  • 6. AHMC HOSPITAL CHARACTERISTICS Patient and family centered environments
  • 7. AHMC SCOPE OF SERVICES PHASE 1-FS/BP Development TIMEFRAME: 2 – 3 MONTHS  Conduct Feasibility Study  Develop Business Plan  Develop the Financial Projections  Analysis of the site and architectural design  Preliminary staffing plan  Market analysis PHASE 2- PROJECT MANAGEMENT CONSULTING TIMEFRAME: 18-24 MONTHS  Work with architect and construction manager  Operating procedures development  Equipment planning  HIT Selection and implementation  Development of bylaws for the board and medical staff  Establish governance structure PHASE 3- PRE-OPERATIONS & COMMISSIONING TIMEFRAME: 6 - 9 MONTHS  Staffing core operating team  General staffing and recruitment  Physician recruitment  Implement operating policies and procedures  Implement process design and protocol  Equipment procurement and installation  Establish financial controls and measures  Hospital commissioning PHASE 4- OPERATIONS TIMEFRAME: 10-15 YEARS  Turnkey executive management and control of daily business operations  Implement international mode of clinical procedures and medical care  Implement quality improvement and patient safety framework  Implement AHMC best practice financial and operations management  Recruitment, training and retention of physicians, nurses and hospital staff  Selection/implementation of HIT System AHMC Onsite Full-TimeAHMC Consulting and Support
  • 8. PHASE I: FEASIBILITY STUDY AND BUSINESS PLAN TIMEFRAME: 2 MONTHS SCOPE OF WORK  Conduct a Feasibility Study to validate hospital project  Develop the associated Business Plan and related Financial Projections  Conduct site and review architectural design  Conduct market analysis DELIVERABLES  Feasibility Study serves to validate the proposed hospital project's operational and financial feasibility from a strategic perspective.  Business Plan gleams information from the feasibility study to develop the proposed hospital’s framework and a preliminary operational plan. Also serves as a prospectus grade document.  Hospital size, scope/breadth of hospital services  Address needed investments related to building, equipment, HIT and working capital needs  Outline space allocations  Preliminary employee and medical staffing plan  Assess and project operational costs and external service suppliers  Develop future strategic objectives and marketing strategies  5 year financial projections including opening financial statements of operation, balance sheet, and cash flow statement.
  • 9. PHASE II: PROJECT MANAGEMENT CONSULTING TIMEFRAME: 18-24 MONTHS SCOPE OF WORK  Work in collaboration with architect and construction manager  Develop hospital operating procedures  Equipment planning  HIT Selection and implementation  Develop bylaws for the board and medical staff  Establish governance structure DELIVERABLES  Detail Room Program: AHMC works with architects to assure each room is appropriately equipped with medical gases, electrical needs and other necessities for both clinical and diagnostic areas.  Equipment Plan: AHMC will develop the list of clinical equipment, supplies and furniture necessary to open the hospital to be approved by the Board of Directors.  HIT Plan: AHMC will develop the implementation plan for selected HIT system, as well as, evaluate the leasing and/or purchase of hardware and software relevant to the project.  Bylaws for the Hospital Board and Medical Staff: Hospital Governance will conform to Accreditation standards as well as develop a system that can be audited to ensure transparency in all transactions.  General Hospital Organization (“Hierarchy of Control): To be approved by the Board of Directors. ARCHITECTURAL DESIGN AND RELATED EXPENSES AHMC is not an architectural firm, however we work with renowned architects experienced in the design of world-class international standards hospitals worldwide. At the discretion of the owners, architects can be integrated as part of our team. Related fees and costs are billed separately from AHMC.
  • 10. PHASE III: PREOPERATIONS AND COMMISSIONING TIMEFRAME: 6-9 MONTHS SCOPE OF WORK  Placement of CEO and staffing of the core operating team  Recruitment of physicians and general staff  Implement operating policies and procedures  Equipment planning, procurement, installation and training  Implementation the Health Information Technology (HIT)  Develop and implement methods of procurement  Establish financial controls and measures  Hospital commissioning DELIVERABLES  Operating Plan and Procedures  Employee Policies and Procedures  Job Descriptions, Employee handbooks, and Salary/Benefit Structures  Medical Equipment Planning, Procurement, Installation and Training Plan HOSPITAL COMMISSIONING- (LAST 2 MONTHS OF PHASE III) AHMC team will conduct “practice runs” in order to insure all equipment is functioning appropriately and that all staff understand how to move patients through the system efficiently and effectively prior to hospital opening.
  • 11. PHASE IV: ADMINISTRATION AND OPERATIONS TIMEFRAME: 7-15 YEARS SCOPE OF WORK  Turnkey executive management  Management and control of daily business operations  Recruitment, training and retention of physicians, nurses and hospital staff  Implement international mode of clinical procedures and medical care  Implement quality improvement and patient safety framework  Implement AHMC’s best practice financial and operations management service DELIVERABLES  Clinical Practice and Medical Care Model  Framework for Quality and Patient Safety Programs  Financial and Operation Management Services Plan  Hospital performance benchmark data and KPI’s  Marketing and Branding Implementation Plan  Monthly Reports: formal monthly reports prepared for Hospital Board and investors. Reports include comparison against budget, variance analysis and benchmarks.
  • 12. AHMC HOSPITAL NETWORK
  • 13. Country Client /Project Beds Contracted Services Contract Start Date Contract End Date Current Status Honduras La Lima 180 Phase 4 2003 2008 Completed and Current investor Ecuador Hospital Del Rio 90 Phase 2-4 2003 2010 Completed and Current Investor Honduras Honduras Medical Center 49 Phase 3 -4 2002 2007 Completed and Current investor Saudi Arabia Mohammed Khan Hospital 70 Phase 4 2014 Present Management/Operations Saudi Arabia Bakhsh Hospital 120 Phase 4 2014 Present Management/Operations India Sama Healthcare 31 Phase 4 2012 Present Management/Operations Antigua & Barbuda Mount Saint John's Medical Center 185 Phase 3-4 2007 Present Management/Operations Colombia Pastuer Labs NA (Lab/DX) Allaince 2004 Present Management/Operations Panama Hospital Nacional 120 Phase 4 2000 Present Management/Operations India Re- Hospital 120 Phase 3 - 4 2014 Present Pre-Operations Saudi Arabia Al-Jazeera Medical Hospital 120 Phase 3 & 4 2014 Present Pre-Operations Saudi Arabia AlQadi Specialty Hospital 140 Phase 1-4 2012 Present Pre-operations Libya VIP Hospital 60 Phase 1, 3-4 2010 Present Pre-Operations AHMC HOSPITAL NETWORK
  • 14. AHMC HOSPITAL NETWORK Country Client /Project Beds Contracted Services Contract Start Date Contract End Date Current Status Libya Swani Road 200 Phase 1-4 2010 Present Construction Russia Russian American Hospital 100 Phase 1-4 2010 Present Construction Peru Clinica Delgado 120 Phase 2-4 2009 Present Construction Peru Torre Trecca NA (OP) Phase 2-4 2009 Present Construction Libya Swani Road 200 Phase 1-4 2010 Present Construction Russia Russian American Hospital 100 Phase 1-4 2010 Present Construction Peru Clinica Delgado 120 Phase 2-4 2009 Present Construction Peru Torre Trecca NA (OP) Phase 2-4 2009 Present Construction Georgia American Hospital Tiblisi 120 Phase 1-5 2013 Present Financing Libya Libyan American Hospital 120 Phase 1-4 2013 Present Financing Nigeria Lagos American Specialty Hospital 50 Phase 1 2013 Present Financing Nigeria Crystal Thorpe Lagos 150 Phase 1 2012 Present Financing Nigeria Chystal Thorpe Abuja 120 Phase 2 2012 Present Financing Nigeria Chystal Thorpe Yola 100 Phase 3 2012 Present Financing Egypt Egyptian American Medical Center 182 Phase 1-4 2011 Present Financing Jordan MIS Surgical Centre NA (OP) Phase 1-4 2011 Present Financing Mexico Cancun Medical Center 100 Phase 1 2011 Present Financing Morocco Moroccan American Hospital 182 Phase 1 2011 Present Financing
  • 15. Al-Jazeera Medical Hospital Riyadh, Kingdom of Saudi Arabia  Recruiting Physicians and Staff  Cath lab projected online by mid-2014  Implementation of P&Ps and quality program  Develop marketing strategy Beds: 120 Type: General Hospital Status: Operations
  • 16. Bakhsh Hospital Jeddah, Kingdom of Saudi Arabia  Recruiting Physicians, staff, and executive team  Strategic and Operational Development  Implementation of P&Ps and quality framework Beds: 120 Type: General Hospital Status: Operations
  • 17. Dr. Mohammed Khan Hospital Hafr-al-Batin, Kingdom of Saudi Arabia  Recruiting of physicians and staff  Strategic and operational planning  Implementation of P&Ps and quality framework Beds: 70 Type: General Hospital Status: Operations
  • 18. AlQadi Specialty Hospital Najran, Kingdom of Saudi Arabia  Construction in final stages  Staffing imminent  Equipment procurement underway  Financing Beds: 140 Type: Specialty Hospital Status: Pre-Operations
  • 19. Memorial Souad Kafafi Medical Center 6th of October, Egypt  Moved into Extension with new ED, OR & Cath Lab  CCU, NICU, ICU, OB  Remodeling of Old Building  Transition to Fee for Service Model Beds: 140 Type: General Hospital Status: Operations (Completed April 2014)
  • 20. Hospital Nacional Panama City, Panama  Kidney Transplant Program  Da Vinci Robotic Surgery  Radiation Oncology Center  Expansion ICU, Surgery and ED Beds: 100 Type: General Hospital Status: Operations
  • 21. Mount Saint John’s Medical Center St. John’s, Antigua & Barbuda  New Executive Team & Board  Updating Strategic Plan  GPO Pilot Program  Teaching Accreditation  Cancer Centre of Eastern Caribbean Beds: 185 Type: General Hospital Status: Operations
  • 22. AHMC HOSPITAL NETWORK Hospitals Under Development (continued) VIP Hospital Tripoli, Libya 60 Beds Status: Construction (Pending) Swani Road Tripoli, Libya 200 Beds Status: Pre-Operations (Pending) Tripoli American Hospital Tripoli, Libya 120 Beds Status: Design and Capitalization
  • 23. AHMC HOSPITAL NETWORK Hospitals Under Development (continued) Moroccan American Medical Center Casablanca, Morocco 110 beds Status: Design and Capitalization Egyptian American Medical Center Cairo, Egypt 180 beds Status: Design and Capitalization Minimally Invasive Surgery Center Amman, Jordan Status: Design and Capitalization
  • 24. AHMC HOSPITAL NETWORK Hospitals Under Development (continued) Lagos American Medical Center Lagos, Nigeria 50 Beds Status: Design and Capitalization Crystal Thorpe (3 hospitals) Yola, Abuja and Lagos, Nigeria 100, 120 and 150 Beds Status: Design and Capitalization R&H Specialty Hospital Accra, Ghana 100 Beds Status: Design and Capitalization
  • 25. AHMC HOSPITAL NETWORK Hospitals Under Development (continued) Russian American Medical Center Tver, Russia 120 beds Status: Design and Capitalization American Hospital Tbilisi Tbilisi, Republic of Georgia 120 beds Status: Design and Capitalization
  • 26. AHMC HOSPITAL NETWORK Hospitals Under Development (continued) Clínica Delgado Lima, Peru 120 Beds Status: Phase 2 Construction Torre Trecca Lima, Peru Ambulatory and Urgent Care Center Status: Phase 2 Construction Hospital Solaris Guayaquil, Ecuador 100 Beds Status: Phase 2 Construction
  • 27. AHMC HOSPITAL NETWORK Completed and Current Investor Honduras Medical Center Tegucigalpa, Honduras Status: Commissioned, Operated and own equity in Hospital La Lima Medical Center Tegucigalpa, Honduras Status: Renovated, Operated, and own equity in Hospital Hospital Del Rio Cuenca, Ecuador Status: Business Plan, Commissioned, Operated and own equity in Hospital
  • 28. 6/6/2014 FAMILY HOSPITAL GROUP 29 INVESTING IN HEALTHCARE  Hospitals are complex businesses  Business of “people”  High technical skills required  Long-term perspective and dedication required  Significant ROI is possible
  • 29. 6/6/2014 FAMILY HOSPITAL GROUP 30 HEALTH MARKET TRENDS  Scarcity of Capital  Human  Financial  Increased Complexity  Capital Markets and Investor Expectations  Quality & the Patient Experience  Cost Pressures
  • 30. 6/6/2014 FAMILY HOSPITAL GROUP 31 HEALTH MARKET TRENDS  Transitions:  Financial Markets  Reimbursement  Aging Hospitals  Younger Populations  New Technology  Increased Complexity
  • 31. 6/6/2014 FAMILY HOSPITAL GROUP 32 BUSINESS MODELS Classic:  Public  Public Private Partnerships  Private:  Foundation  Family Owned  Doctor Owned  Investor Owned Alternative:  Hospital within a Hospital  Doctor – Investor Hybrid  Joint Ventures  Collaboration with Insurance Companies  Tenant Hospitals  Concession of Services
  • 32. 6/6/2014 FAMILY HOSPITAL GROUP 33 CHARACTERISTICS OF SUCCESS  Focused Business Plan – Clear investment objectives  Clearly identified and sustainable local market  Socio-economic levels of patients are top “informed” 40%  Class “A” tertiary care with quality and economic volumes  Class “B” volume and service focused 1 and 2 level care  Aligned, well-trained and multi-specialty medical staffs  Operated to International Standards (ISO9000/HQS/JCAHO)  Emphasis on “value” technology as a clinical and business tool  Clinical benchmarking and measuring of outcomes  Ability to understand the relationship and implications between clinical care and financial performance
  • 33. 6/6/2014 FAMILY HOSPITAL GROUP 34 CHARACTERISTICS OF FAILURE  Over reliance on the government for patients & revenue  Alienating the physicians or insurance companies  Poor quality and patient experience  Lack of clear strategic plan and/or poor implementation  Ineffective leadership and lack of accountability  Wrong or incompatible investor expectations  Focusing on the socio-economic levels of patients in the top 5% to 10% or the bottom 50%  Too many hospitals/beds in market, lack of differentiation  Too much technology or too little technology  Lack of resources: financial and human capital  If you build it, they will come
  • 34. 6/6/2014 FAMILY HOSPITAL GROUP 35 CRITICAL INVESTMENT QUESTIONS  Why are you investing?  What is the expected ROI?  What are the incentives?  Understand how all investors will make money  Who is in charge and who is accountable?
  • 35. 6/6/2014 FAMILY HOSPITAL GROUP 36 KEYS TO SUCCESS  Demand in market – priced for the market  Diversified referral base of patients  Clear focus of the business and strategic plan and objectives of the hospital  Service selection – Cannot be all things to all people: Ok to be a Wal-Mart and ok to be a Saks 5th Avenue, you just cannot be both  Realize the uniqueness of the hospital business and the uniqueness of the customers
  • 36. 6/6/2014 FAMILY HOSPITAL GROUP 37 THE PHYSICIAN KEY Working in partnership with the medical staff:  Doctors are unique customers  Doctors bring patients  Doctors spend the money  The Doctor Workshop
  • 37. 6/6/2014 FAMILY HOSPITAL GROUP 38 THE PATIENT EXPERIENCE  Differentiating and understanding quality care and quality service:  The patients and families’ expectations  The patient experience  The “little things” of service  Voting with their feet
  • 38. 6/6/2014 FAMILY HOSPITAL GROUP 39 ALIGNMENT OF INCENTIVES  Owners / Investors  Doctors that Bring Patients  Insurance Companies  Other Hospitals
  • 39. 6/6/2014 FAMILY HOSPITAL GROUP 40 MAXIMIZING PROFITS  Programs – not “Bricks and Sticks”  Day to Day control of money and information  Understanding the true and the incremental costs of care  Productivity and flexibility  Appropriate and sufficient capitalization – with reality based financing  Accountability, transparency and long-term relationships
  • 40. 6/6/2014 FAMILY HOSPITAL GROUP 41 MAXIMIZING PROFITS  Best practices and standardization  Clear strategic plan for insurance and third party contracting of local domestic patient referrals: Healthcare is local  Share the risk – share the rewards  Doctors  Insurance companies  Competing hospitals  Clinical partners
  • 41. 6/6/2014 FAMILY HOSPITAL GROUP 42 REDUCING THE RISK  Not Re-Inventing the Wheel:  Learn from Others  Clinical Partners  Best Practices  Invest in Human Capital:  Professional Management  Technical Training
  • 42. CASE STUDY Mount St. John’s Medical Centre is a state-of-the-art hospital facility centrally-located on the island of Antigua and has been prepared to be the premier hospital of the Eastern Caribbean region.
  • 43. OVERVIEW  185 bed hospital structured as a Public Private Partnership ownership model.  The Hospital is professionally managed and operated as a modern, private enterprise by American Hospital Management Company that ensures the effective management of all business operations  The hospital provides comprehensive medical services to the public and private patients  Regional demand for quality healthcare services is growing with lack of adequate private facilities in the region  Private, insurance and for tertiary level government patients, reimbursement is under fee for service  Primary and secondary services for government sponsored patients are reimbursed under a capitation agreement with he Government of Antigua and Barbuda on a monthly basis  Antigua and Barbuda is centrally located within the Eastern Caribbean Economic Market and a major transportation hub
  • 44. SERVICES  Medical / Surgical  Suites  Private Rooms  Semi-Private Rooms  Intensive Care  Maternity  Nursery  Neonatal Intensive Care  Operating Theaters  Radiology  MRI  CT-Scan  Fluoroscopy  Ultrasound  Full Clinical Laboratory  Rehabilitation  Emergency Room  20 Medical Offices  Helicopter Landing Pad
  • 45. 6/6/2014 FAMILY HOSPITAL GROUP 46 SUMMARY  Significant new opportunities exist  Know who you are and know your market  Everyone must understand why they are going into business and the expectations  Align your incentives with the doctors  Focus on quality and the patient experience  Human capital and resources  Maintain the optimal mix of technology and financial resources
  • 46. CONTACT INFORMATION

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