Nobilis health corporate presentation march 3.23.18 final[2]
Creating Differentiation in Healthcare Provision in a competitive_Mark Adams_V4
1. Creating Differentiation in Healthcare Provision in a
Competitive Market Place
GCC Healthcare Innovation Congress Mark Adams, CEO, Anglo Arabian Healthcare 25th November 2014
2. WHERE IS THE UAE HEALTHCARE SECTOR TODAY?
• Fragmented delivery of primary, secondary and tertiary
care
• Multiple regulators with a level of disconnection across
Emirates
• Polarisation of standards according to the ability to pay
• A lack of public confidence and too high a level of
outbound health tourism
• Hostile relationships between Insurers and Providers
• Over utilisation by some providers and over rejection
from some insurers
• Mandatory Health Insurance slowly being introduced
across the UAE
• Rapid expansion of the sector
• Looming consolidation!
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
3. DRIVERS OF CHANGE
Healthcare
Funding
Change
Technology
New
Competition
Super
Brands
Regulation
Inbound
Investment
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
4. FUNDING
• Mandatory Health Insurance is slowly being rolled out across
the MENA region
• Health Insurance companies struggle to have a positive
combined ratio. With low initial premiums and high benefits,
Insurers are facing 95-120% combined ratios (administration
costs and claims)
• Insurers will leave quality concerns to regulators and will push
for the lowest possible prices.
• With a fragmented Insurer market, more and more will use
TPA’s to aggregate their purchasing to drive down prices.
• We are already seeing Daman move to halve reimbursement
for diagnostic tests in Abu Dhabi in a unilateral move
• Next we will see the growth of Networks where patients will
only be allowed to go to approved clinics and hospitals
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
5. TECHNOLOGY
Technology changes the game:
• Internet empowers the consumer – researching their
illnesses and treatment options, checking out reputations of
Doctors and Providers – Think ‘Trip Advisor’ for healthcare
• Surgical procedures are changing; Cataracts, Laproscopic
Procedures, Robotics
• Doctors don’t need to be in the room; telemedicine allows
access to the best specialist radiologists, geneticists and
specialist consultations
• Diagnostic capabilities of new equipment, Stem Cell
applications and Chromosomal modifications at conception
– tackling thalassemia and other conditions – all point to a
very different way of applying medicine in the future
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
6. NEW COMPETITION
• There is unprecedented growth in new healthcare facilities across the region – 18 new
hospitals are under construction in Dubai alone
• The DH is licencing 1.5 new facilities per day
• Enlightened operators are building ‘feeder clinics’ to secure their referral base into
Secondary Care – 2-4% outpatient to inpatient referrals
• Market is segmenting into four categories of provider:
1. Labour Camp (20%)
2. Low cost (50%)
3. Mid Market (20%)
4. Luxury(10%)
• Quality, Pricing and Customer Experience are all being challenged
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
7. SUPER BRANDS
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
8. INBOUND INVESTMENT
Private Equity Groups see healthcare as a growing,
profitable and defensive area to invest in, they will help to
continue market growth and consolidation;
• Ithmar Capital, Farj Capital, Abraaj Capital, Al WAHA Capital
are just some of the investors specifically targeting
healthcare
• Stock market Floatation's have also been successful with Al
Noor and NMC and the Dr Moopen Group should list next
year. Access to capital markets and Investors wanting to see
continued expansion will also increase the consolidation of
smaller operators.
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
9. REGULATION
Regulation builds public confidence and allows systems
to mature with the right checks and balances, however
regulation will also:
• Increase costs of operating
• Force some historic facilities to close (Hospitals in
residential buildings, facilities without good access and
egress, property without the right HVAC systems etc)
• Make it difficult for one man clinics to see patients and
cope with the reporting and paperwork involved
• Drive out poor practices like referral fees and
commissions to Doctors
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
10. SO WHAT SHOULD EXISITING OPERATORS DO?
• Ignore?
• Sell?
• Retire?
• Evolve?
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
11. FORCED EVOLUTION!
Questions to ask?
1. What sector of the market am I targeting?
2. How am I going to be sure that I remain empanelled on Insurer networks, what makes my facility special?
3. With the majority of the population moving out of the UAE every 3-5 years, how will I continue to attract replacement
patients to my clinic/hospital?
4. How will I retain and attract good doctors in a very competitive new world?
5. How good is my marketing, customer care, recall procedures, first impressions as you enter the facility and are my staff
brand ambassadors for me?
6. For my specialty, am I really up to date and setting the right standard
7. How am I able to demonstrate my commitment to quality?
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
12. WHAT DOES BUILDING A BRAND MEAN?
For many Clinics and Hospitals in the region the basics are not even being met and there is a journey
to reach an acceptable standard before thinking about outflanking the competition and
differentiating the business model.
In an era where we are dealing with SARS, H1N1 and Ebola, is your facility using modern sterilisation
techniques, does it have the hand washing dispensers (regularly topped up) and are you clear on who
is in charge of cross infection control, who is in charge of life safety, is your Head of Quality, Nursing
and Medical Director appointed in each premises.
Many facilities still don’t sterilise correctly, they wash endoscopes in the sink or use Sidex sterilising
solution for other equipment.
Unless the basics are in place no amount of marketing or cheap pricing will sustain the business for
the long term.
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
13. BUILDING A BRAND
• Be clear on what your service stands for; Family Medicine, Chronic Conditions, Well Man, Well
Woman, Cardiology, Multi Service Polyclinic etc.
• Get the basics right: appropriate and trained staff, standard operating procedures in place, good
and well maintained equipment, correct disposal of medical waste, code blue policies and
equipped and maintained crash carts etc.
• Move towards ISO, JCI or equivalent standards
• Make sure all staff have job descriptions and understand them
• Reception staff are vital to any organisation, is the phone answered in a maximum of four rings, do
the reception staff stand up to greet a new patient, what is the average length of time for a patient
to settle a bill
• Do you measure patient satisfaction and train accordingly?
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
14. Hospitals
• We need to move away from small
‘General Hospitals’
• Dedicated centres of Excellence
are the next stage in GCC
healthcare
• Recent Examples:
1. Imperial College Diabetes
2. Moorfields Eye Hospital
3. Burjeel and Medcare
Orthopaedic Hospitals
4. Neuro Spinal Hospital
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
15. For Many Small Healthcare Facilities the Brand is ‘You’
What is your personal brand?
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
16. PLANNING FOR SUCCESS
• Appropriate investment into the facility for the
sector targeted but cleanliness, clear policies on
display and a visible commitment to quality and
safety essential for all.
• Regular team meetings with review of successes
and failures
• Strong patient engagement through social
media, SMS’s and newsletters and regular recall
for screening and check ups
What to do wrong?
• Poor presentation of the facility
• No visible commitment to patient safety and
quality
• No training to staff at reception and poor
attitude in front of patients
• No team culture
• Invisible leadership
• No SOP’s and staff guessing what to do
• Communication with patients only if they visit
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
What to do right?
17. STARTING TO DIFFERENTIATE
• Work with clinics who you respect to actively
cross refer
• Work to build purchasing groups with other
clinics to negotiate with Insurers on prices and
discounts
• Offer local employers access to your ‘network’
for the different services that they need
• Invest in expensive diagnostics on a syndicate
basis to maximise utilisation
External Networking
• Corporate partners with special prices or
Occupational Health services
• Schools and Colleges to build credibility with
staff, pupils and parents
• Corporate Social responsibility, building
credibility as a group who put something back
• Active development of relationships with
journalists and broadcasters to offer expert
opinion or even regular articles or radio shows
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
Build referral networks
18. MORE ADVENTUROUS DIFFERENTIATION
Mobile Healthcare Homecare
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
19. TECHNOLOGY AND OTHER BUSINESS MODELS CAN HELP
• Work with partners to run HR, Payroll, Claim
processing, Quality training, Customer Care and
Marketing.
• If these business areas are not core strengths,
bring in partners who free clinical time and avoid
full time costs
Technology
• Mobile applications exclusively for your patients
• Active management of patients with Diabetes,
Asthma, High blood pressure or other chronic
conditions – bespoke treatment plans,
telemedicine, emails and newsletters
• Outsource some clinic functions to telemedicine
partners for access to more expertise or second
opinions
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
Outsourcing
20. WITH THE BASICS IN PLACE - GET THE MESSAGE OUT THERE
Creating Differentiation in Healthcare Provision in a Competitive Market Place
25 November 2014
