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Leading International Hospital Development Firm
1.
2. 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
4. 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
8. 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
9. 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.
10. 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.
11. 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.
12. 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.
14. 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
15. 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
16. 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
17. 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
18. 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
19. 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
20. 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)
21. 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
22. 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
23. 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
24. 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
25. 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
26. 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
27. 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
28. 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
29. 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
30. 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
31. 6/6/2014 FAMILY HOSPITAL GROUP 31
HEALTH MARKET TRENDS
Transitions:
Financial Markets
Reimbursement
Aging Hospitals
Younger Populations
New Technology
Increased Complexity
32. 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
33. 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
34. 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
35. 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?
36. 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
37. 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
38. 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
39. 6/6/2014 FAMILY HOSPITAL GROUP 39
ALIGNMENT OF INCENTIVES
Owners / Investors
Doctors that Bring Patients
Insurance Companies
Other Hospitals
40. 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
41. 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
42. 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
43. 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.
44. 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
45. 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
46. 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