July2013
ExecutiveSummary
Market Overview
ThehospitalmarketinIndiawasvaluedatINRx2 tnin20 andisexpectedtoreachINRx5 tnby 20 ThesectorisdividedprimarilyintopublicandprivatealongwithNGOoperatedhospitals Constantlyrisingpopulationresultsinperennialshortageofhospitalbeds
Drivers:
Challenges:
ShortageofMedicalProfessionals LackofInvestmentinITInfrastructure ShortageofFDIInflowinIndian Hospitals
Drivers& Challenges
ShortageinNumberofHospitalBeds IncreasingLifestyleDiseases SurgeinMedicalTourism GovernmentInitiativesPropelling Investment GrowingTargetHospitalizationPopulation Group GrowingHealthInsuranceMarket RisingDisposableIncome SpecialtyClinics GlocalHealthcareSystems
Key yTrends
LuxuryOfferings DiversifiedBusinessApproach
Competitive Landscape
HOSPITALMARKETININDIA2013.PPT
EconomicIndicators IndianHealthcareScenario Introduction MarketOverview Drivers&Challenges ITAdoption RoleofGovernment KeyTrends KeyInitiatives CompetitiveLandscape TradeFairs&Events RecentTransactions Strategic StrategicInsights Appendix
HOSPITALMARKETININDIA2013.PPT
EconomicIndicators(1/3)
INRtn 15 14 13 12 11 10 Q1 Q2 20 d1 c1 b1 a1 d2 c2 b2 a2
SAMPLE
d3 c3 3 b3 a3 d4 c4 b4 a4 Q3 20 Q4
N.B.:NewSeriesBase:200405
GrossDomesticProductAtFactorCost(AtConstantPrices):Quarterly
20
20
InflationRate:Monthly y
%
1.0 08 0.8 0.6 0.4 0.2 0.0
Nov20 Dec20
Dec20 Jan20
Jan20 Feb20
Feb20 Mar20
Mar20 Apr20 4
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HealthcaresysteminIndiarequiresalargerpublicoutlay duetohugepopulationbase
HealthcareIndustryOverview HealthcareSector MarketSize&Growth
A% a b c d f e INRbn AccordingtoWorldHealthStatistics2011Report,India, 10,000 healthcarecomprisedofr%ofIndiasGDPin20 PublicandprivateexpenditureonhealthaspercentageofGDP wasr1%andr2%respectively
8 000 8,000 6,000
Favorabledemographics,increaseinawarenesslevels 4,000 andbettermedicalcarearesomefactorsthataredriving 2,000 0 healthcaresectorinIndia 2012 2013e 2014e 2015e 2016e 2017e Hospitalformsthelargestsegmentofoverallhealthcare marketfollowedbypharmaceutical,medicaldevices, HealthcareMarketSegmentation 20 healthinsuranceanddiagnostics Gradual G d lpenetration t ti of fh health lthi insurancei isstepping t i up f% affordabilityofhealthservicesthroughincreaseddemand forpreventiveandcurativehealthcareservices d% e% a% Superiorqualityhealthcarecoupledwithlowtreatment c% costincomparisontoothercountriesisbenefitingIndian medicaltourism,therebysteeringforthIndianhealthcare b% market
TreatmentformajorsurgeriesinIndiacostsapproximatelym% ofthatindevelopedcountries A B C D E F
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FDIInflowinIndianHealthcareSegments
SAMPLE
INRm1 bn
Hospitalanddiagnosticcenters
Medicalandsurgicalappliances
INRm2 bn
Drugsandpharmaceuticalssector
INRm3 bn
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Hospitalscanbeclassifiedongroundsofownershipand clinicaloperation
ClassificationofHospitals
OwnershipBasis ClinicalBasis Hospitalsstaffedbyatleasttwomedical officersthatprovidesinpatient accommodationandmedicalcareformore thanonecategoryofmedicaldiscipline Providesmedicalattentionforonediscipline andisadministrativelyattachedtoageneral hospital Hospitalsforthecareofpersonssufferingfrom i f ti diseases infectious di StateandCentralgovernmenthospitals establishedintheirstatecapitals Ahospitaltowhichacollegeisattached formedical/dentaleducation Locatedinruralareaspermanentlystaffedby atleastonephysicianthatprovidesinpatient accommodationandmedicalcareformore thanonecategoryofmedicaldiscipline
Public Hospitals
RunbyCentralGovernment, StateGovernmentandlocalbodies
General Hospitals
Private Hospitals
RunbyCentralGovernment, StateGovernmentandlocalbodies
Corporate Hospitals p
Voluntary Hospitals
Functionswithpublicorprivatefundsona noncommercialbasis
Rural Hospitals
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HospitalsisthemostcrucialaspectofIndianhealthcare sector,constantlydevelopingtoprovideworldclassservice
MarketOverview(1/2)
HospitalsareamajorcomponentoftheIndian Healthcareindustryformingmorethana%ofthetotal healthcaresectors sector srevenue Hospitalsectorisdividedintopublicandprivate
Thereare~pprivatehospitalsand~qpublichospitalsacross thecountry
MarketSizeandGrowth PrivateHospitals
INRtn 6 5 +X% 4 3 2 1 0 20 20 20e 20e 20e 20e 20e x1 x2 x4 x3 x5 x6 x7
KeyHealthcare DeliveryFormats
SecondaryCareHospitals thatmayormaynotspecializeintreatmentofaspecificailmentbut offersmostessentialservices Inmostcasesitcatersto85%to90%ofmedicalrequirements Thesegmentconsistsofdistrictandallotherprivatelyrungeneralprivatehospitals TertiaryCareHospitals arespecializedwhichofferspecificfacilitiesandemployhighly specializedpractitionerswhoalsoofferspecializedconsultativecare Serviceisprovidedbyprivate,regionalorcentrallevelinstitutionssuchasmultispecialtyand singlespecialtyhospitals
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Drivers&Challenges Summary
Drivers
ShortageinNumberofHospitalBeds IncreasingLifestyleDiseases SurgeinMedicalTourism GovernmentInitiativesPropelling Investment Growing G i Target T H Hospitalization i li i PopulationGroup GrowingHealthInsuranceMarket RisingDisposableIncome
Challenges
ShortageofMedicalProfessionals LackofInvestmentinITInfrastructure ShortageofFDIInflowinIndian Hospitals
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Hugedemandsupplygapforhospitalbedsisthepotent drivingelementofthehospitalmarket
ShortageinNumberofHospitalBeds
Indiafacesanacuteshortageinnumberofhospitalbedsincomparisontopopulationlevelof thecountry
AccordingtoWorldHealthStatistics,Indiaispositionedamongthelowestcountriesonaglobal perspectivewithwhichisfarbelowtheglobalaverageofsbedspertpopulation AccordingtoNationalHealthProfile20,Indiahasapublicsectoravailabilityofonebedperfpopulation inggovernmenthospitalswhichisonlyhbedsperipopulation
Impact
HospitalBedsPer1,000Population 2010
Japan USA UK Russia SriLanka China Brazil Thailand India m n o p q r s t u
DevelopedNations EmergingNations
RuralUrbanHospitalBedRatioComparison
RuralIndiaPublic HospitalBedRatio s RuralIndiais characterizedbypublic hospitalswhileUrban Indiabyprivatehospitals Private Hospital BedRatio u CentralIndia SouthernIndia UrbanIndia
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Lackofforeigninvestmentsactsasanimpedimenttothe hospitalmarketofthecountry
ShortageofFDIInflowinIndianHospitals
IndianhospitalsislaggingbehindinacquiringsufficientshareofFDI
FDIequityinflowinhospitalsectorisfarlowevenwhencomparedtodrugsandpharmaceuticalsectorin India FDIinvestmentinhospital&diagnosticcentersranksard intermsofamountofFDIequityinflowsinperiod betweenApr20 toJan20
Impact
Therearebothinternalandexternalissuesthatdecelerateforeigninvestmentsinourcountry
ImbalanceinFDIInvestmentWithinHealthcareSector
Hospital&DiagnosticCenters INRnbn~b%
InternalIssues
Highcostinvolvementinhospital establishment Depreciationofmedicalequipments Feasibilityissueinupgradinghealthcare equipments
Drugs&Pharmaceuticals INRmbn~a%
ExternalIssues
Indianprivatehospitalsunabletoestablish hospitalsoverseas Requirementofindepthlocalized knowledge g ofhostcountry y Indiangovernmentfailstoprovideaclarity inpoliciesonoverallhealthcaresector
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ITAdoptioninHospitalisprogressingslowwithonlyhigh endcorporatehospitals
SAMPLE
ITSpendingonHealthcare 18.3% s r t q
INRbn
40 35 30 25 20 15 10 5 0
20 m%
20e
20e
20e
20e
20e
n% ITAdoptioninHospitals ITAdoptioninOtherHealthcareSegments
Businessstreamliningandpatientadministration systemsistheprimemotiveforITadoptionin hospitals Hospitals H it l canprovide id better b tt careand dmanagecosts t betterinternallyandpatientscanlookforlower healthcarecosts ITleveragingandsharingdataoncloudhelpsinsaving i f t t and infrastructure dmanpowerto t agreat textent t t
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RoleofGovernment:Summary
SAMPLE
BudgetaryAllocation Role of Government
FinancialIncentives
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KeyTrends
SAMPLE
Specialty Clinics DiversifiedBusiness Approach GlocalHealthcare Systems
Key Trends
Luxury Offerings Hospital InformationCentre HospitalMobile Applications
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KeyInitiatives Summary
SAMPLE
HealthCities
Key Initiatives
Telemedicine MobileHospitals
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HealthCitiesaregraduallybeingpopularizedtocater mostlytomedicaltourists
HealthCitiesprimarilyincludesuperspecialtyhospitalattachedtoamedicalcollege,residential areawithinhousehighenddiagnosticcenters,commercialzonesandothercommon infrastructure HealthCitiescatertolargerpopulationsbyofferingadditionalfacilitiessuchashotels,recreational facilitiessuchasspa,gymandevengolfcourses TheyarealsoexpectedtolayagreateremphasisoneducationandR&D NarayanaHrudayalaya
AsonMay20,thegroupaimstobuildsbedhealth citiesthatwilloffermedicalcarefacilitiesinheart, heart kidneyandcancer OnecityeachisplannedinJaipurandWestBengal, whiletwoshallcomeupontheoutskirtsofKolkata AsonDec20,thegroupisinplanstoinitiatea centreinLucknow,UPwithabedcapacityofmn beds
OdishaStateGovernment
AsonJul20,thestategovernmentisplanningto setupanintegratedhealthcityontheoutskirtsof Bhubaneshwar Conceptnoteoftheprojecthasbeenpreparedby IndustrialInfrastructureDevelopmentCorporationof Odisha Projectisaimedatmakingthestateacomplete healthdestinationandpromotemedicaltourism Thegovernmentwouldpromotetheprojecton publicprivatepartnershipwithoneortwomega healthcarepromotersasanchorsoftheproposedcity
Q QRG GEnterprises te p sesa announced ou cedits tsp plan a of o penetrating pe et at ghealthcare ea t ca eseg segment e twith t hospital osp ta c chain a inNCR C a along o gwith t Ludhiana, ud a a,Agra g aa and d Ja Jaipur pu as onJun20 ThegroupplanstosetupapbeddedsuperspecialtyfacilityinFaridabadthatisexpectedtobecommissionedinSep20 with an investmentofINRdbnthatwouldbenamedQRGHealthCity
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CompetitiveBenchmarking(2/5)
KeyRatiosofTop3Companies OperationalBasis(FY20)(1/3)
%
40 30 20 10 0
GrossMargin a1
OperatingMargin
NetMargin
a2 b1 c1 b2 c2 C
b3
c3
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MajorPublicCompanies Summary
NetProfit (INRmn)
500,000,000 400,000,000 300,000,000 200,000,000 100 000 000 100,000,000 0 100,000,000 200,000,000 300,000,000 400,000,000 500,000,000 600,000,000 700,000,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000 50,000 55,000 60,000 65,000 70,000
Sizeofbubblerepresents MarketCapitalizationinINRmn
Revenue (INRmn)
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Private:DomesticCompany PlayerA(1/5)
CompanyInformation
CorporateAddress TelNo. Website YearofIncorporation xx xx xx xx Delhi
OfficesandCentres India
ProductsandServices
Category SportsGoods FitnessEquipment Products/Services xx xx
HeadOffice
KeyPeople
N Name D i ti Designation
EquipmentSupplier
xx
Others
xx
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Private:DomesticCompany PlayerA(2/5)
ShareholdersoftheCompanyasonxx/xx/20
Name No.ofSharesheld
OwnershipStructure
Directorsorrelativesofdirectors
100 0% 100.0% 100 0% 100.0% 100 0% 100.0%
Total
20
20
20
20
Private:DomesticCompany PlayerA(3/5)
Financial i i lS Snapshot h
TotalIncome INRmn m NetProfit/Loss n INRmn
K Ratios Key i
Particulars yoychange (20 )
N.A. N.A. N.A. 1.47 0.00 0.00 0.00 0.00
20
20
20
20
ProfitabilityRatios
OperatingMargin NetMargin ProfitBeforeTaxMargin ReturnonEquity ReturnonCapitalEmployed ReturnonWorkingCapital ReturnonAssets ReturnonFixedAssets
N.A. N.A. N.A. 5.36% 0.00% 0.00% 0.00% 0.00% N.A. N.A. N.A. 3.89% 0.00% 0.00% 0.00% 0.00% N.A. N.A. N.A. 0.00% 0.00% 0.00% 0.00% 0.00% N.A. N.A. N.A. 0.00% 0.00% 0.00% 0.00% 0.00%
0 20 20
CostRatios
Operatingcosts(%ofSales) Administrationcosts(%of Sales) Interestcosts(%ofSales)
N.A. N.A. NA N.A. N.A. N.A. NA N.A. N.A. N.A. NA N.A. N.A. N.A. NA N.A. N.A. N.A. NA N.A.
FinancialSummary
CompanyearnedanetprofitofINRmunitsinFY20,as comparedtonetprofitofINRnunitsinFY20 ItreportedtotalincomeofINRpunitsinFY20, registeringanincreaseoftpercentfromFY20 Thecompanyreportedadebttoequityratioofx percentagepointsinFY20,anincreaseofypercentover FY20
LiquidityRatios
CurrentRatio CashRatio
10.83% 35.86% 1.76 0.16 1.97 0.24 1.71 0.20 2.07 0.32
LeverageRatios
DebttoEquityRatio DebttoCapitalRatio InterestCoverageRatio
14.21% 6.57% N.A. 1.16 0.54 N.A. 1.02 0.50 N.A. 0.50 0.33 N.A. 0.50 0.34 N.A.
EfficiencyRatios
FixedAssetTurnover AssetTurnover CurrentAssetTurnover WorkingCapitalTurnover CapitalEmployedTurnover
N.A. N.A. N.A. N.A. N.A. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Improved
Decline
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Private:DomesticCompany PlayerA(4/5)
BusinessHighlights
Description Overview Facilities
xx
News
xx
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XX XX
S O
XX
W T
XX
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Thankyoufortheattention
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