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Hospital Market in India
March 2012
Executive Summary
               The hospital market is currently worth INR xx units and is expected to reach INR yy units by 20--
  Market       The sector is divided primarily into public and private along with NGO operated hospitals
               Constantly rising population results in perennial demand for hospital beds exceeding its supply
               Drivers:                                                  Challenges:
                Shortage in number of hospital beds                        Shortage of medical professionals
                Growing healthcare market                                  Lack of investment in IT infrastructure



                                    LE
  Drivers &     Growing affordability among people                         Shortage of FDI flows in Indian
                                                                           hospitals


                                   P
 Challenges     Growing Medical tourism
                Increasing lifestyle diseases



   Role
    of
                                SAM
                Changing demographic structure
                Growing health insurance market
               Government contribution to raise number of hospitals
               Financial incentives to private sector
Government     Future Plans

               Secondary Care Hospitals          Private Equity                          Telemedicine
  Trends       Foreign Hospitals                 Mobile Hospitals                        Health Cities
               Public Private Partnership        Expansion plans to foreign shores

                                                      Major Hospitals Chains
                                                                    Player C
Competition   Player A                                              Player D
              Player B                                              Player E
                                                                    Player F

                                     HOSPITAL MARKET IN INDIA 2012.PPT                                               2
•Introduction
•Market Overview
•Drivers & Challenges


            PLE
•Role of Government
•Recent Trends

         SAM
•Competition
   •Region wise hospital profiles
   •Hospitals commissioned in 2012-13
   •Key Players
•Strategic Recommendation
•Appendix
             HOSPITAL MARKET IN INDIA 2012.PPT   3
Hospitals can be classified on grounds of ownership and
 clinical operation
                                             Public Hospitals                        Voluntary Hospitals

                                  Run by Central Government,               Functions with public or private funds
                                  State Government and local bodies        on a non-commercial basis

            Ownership Basis   `             Private Hospitals                        Corporate Hospitals




                        E         Hospitals owned and operated by          Public limited companies formed



                       L          individual or group of people as         under Companies Act run



                      P
                                  business for purpose of profit earning   commercially and is likely to operate
                                                                           chain of hospitals



                     M
 HOSPITAL




                                            General Hospitals                          Rural Hospitals




                   SA             Hospitals staffed by at least two
                                  medical officers that provides in-
                                  patient accommodation and medical
                                  care for more than one category of
                                  medical discipline
                                                                           Located in rural areas permanently
                                                                           staffed by at least one physician that
                                                                           provides in-patient accommodation
                                                                           and medical care for more than one
                                                                           category of medical discipline

                                          Specialized Hospitals                      Teaching Hospitals
             Clinical Basis   `
                                  Provides medical attention for one
                                                                           A hospital to which a college is attached
                                  discipline and is administratively
                                                                           for medical/dental education
                                  attached to a general hospital

                                           Isolation Hospitals                        Tertiary Hospitals

                                  Hospitals for the care of persons        State and Central government
                                  suffering from infectious diseases       established in their state capitals

Source:

                                     HOSPITAL MARKET IN INDIA 2012.PPT                                              4
Hospital market accounts for half of the healthcare sector's
 revenues that has tremendous future growth potential
 Market Overview                                                                    Market Size and Growth – Private
 • Hospitals are a major component of the Indian                                INR tn
   Healthcare industry forming a more than 50% of                               4
   healthcare sector revenues                                                                                                          X7
 • The hospital market is currently worth INR X1 units                                                            a              X6
   and is expected to reach INR X7 units by 20--                                                                           X5
 • The market is expected to grow at a CAGR of a%                                                                 X4
   between 20-- to 20--                                                         2                        X3



                                                   LE
                                                                                                 X2
 • The hospital sector is divided into of public and                                   X1
   private

          operated
                                                  P
          In 20-- total number of hospitals was XX of which A1 were
          public operated while the remaining B1 were private


                                                 M
                                                                                0
                                                                                       20--      20--   20--e 20--e 20--e 20--e 20--e


                                                A
          In 20-- total number of hospital beds was estimated to be
          YY of which A2 was under public ownership and the


   hospital beds far exceeds the supply        S
          remaining B2 was under private ownership
 • With the constant rising population, demand for

          According to recent study conducted by WHO, there are
          only p beds per 1000 population which is far below the
          target of q beds per 1000 population by the Indian Health
                                                                                    Hospital Market Segmentation – 20--


          Ministry
                                                                                    Hospitals              A1%                  B1%
 • A huge shortage of beds is a major driver for
   investment in the hospital industry
          There is a trend of growth in speciality and multi speciality      Hospital Beds                A2%                   B2%
          hospitals in the country

                                                                                                              A        B              100%
Source:

                                                             HOSPITAL MARKET IN INDIA 2012.PPT                                               5
Drivers & Challenges – Summary

  Drivers

  Shortage in number of hospital beds

  Growing healthcare market
                                                                   Challenges
  Growing affordability among people


                                       PLE                         Shortage of medical professionals

  Growing medical tourism

  Growing health insurance market
                                    SAM                            Lack of investment in IT infrastructure

                                                                   Shortage of FDI flows in Indian
                                                                   hospitals
  Increasing lifestyle diseases

  Changing demographic structure




                                        HOSPITAL MARKET IN INDIA 2012.PPT                                    6
Role of Government: Summary


                        Direct and Indirect
                            Initiatives




                          PLE   Role



                       SAM       of
                             Government


        Future Plans                                       Financial Incentives




                       HOSPITAL MARKET IN INDIA 2012.PPT                          7
Trends - Summary

          Secondary Care Hospitals

          Foreign hospitals are showing interest to penetrate Indian market


          Indian hospitals expansion plans to foreign shores


          Private Equity
 Trends
      `




       PLEMobile Hospitals




    SAM   Telemedicine

          Health Cities


          Public Private Partnerships

                             HOSPITAL MARKET IN INDIA 2012.PPT                8
Major Public Companies - Summary

        Net Profit
        (INR mn)
500,000,000
400,000,000                                                                          Size of bubble represents
300,000,000
200,000,000

                                          PLE                                       Market Capitalization in INR xx




                                         M
100,000,000



                                        A
          0          B                                                                                A
-100,000,000
-200,000,000
-300,000,000
                                       S
-400,000,000
-500,000,000
-600,000,000
                                                                                                                            Revenue
-700,000,000
                                                                                                                            (INR mn)
          19,000         19,500   20,000   20,500       21,000     21,500       22,000       22,500       23,000   23,500

                                             Player A      Player B




                                                HOSPITAL MARKET IN INDIA 2012.PPT                                                 9
Public: Domestic Company – Company A Ltd (1/4)
 Company Information                                               Head Office and Hospital Network– India
                         Company A
                         Address Line 1
 Corporate Address
                         Address Line 2
                         City
 Tel No.                 xxx
 Fax No.
 Website
 Year of Incorporation
                         yyy
                         www.companyA.com
                         19--
                                         PLE
 Ticker Symbol
 Stock Exchange


 Products and Services
                         mmm
                         ---


                                      SAM                                      City N
                                                                                                 City M
                                                                                                           Head Office
                                                                                        City O             Hospital Network
                                                                   Key People
 Category                Products/Services

 Healthcare Facilities                                              Name                          Designation
                                                                    Person A                      Founder, Executive Chairman
 Healthcare
 Consultation                                                                                     Managing Director, Executive
                                                                    Person B
                                                                                                  Director

 Others                                                             Person C                      Chief Executive Officer
                                                                    Person D                      Group President
Source:

                                             HOSPITAL MARKET IN INDIA 2012.PPT                                                   10
Public: Domestic Company – Company A Ltd (1/4)
 Financial Snapshot                                                               Key Ratios
                                  Total Income                                                                    y-o-y change
                                                                                            Particulars                          20--   20--   20--       20--
 INR unit                                                            INR unit                                      (20– to --)
                                  Net Profit / Loss
                                                             Y4                   Profitability Ratios
25                                                                         2.0
20                                            Y3                                   Operating Margin
                            Y2                                             1.5
                                                                                   Net Margin
15           Y1
                                                            X4             1.0     Profit Before Tax Margin
10                                            X3
                           X2                                              0.5     Return on Equity
  5          X1
                                                                                   Return on Capital Employed
  0                                                                        0.0     Return on Working Capital
            20--           20--              20--           20--                   Return on Assets




                                                        LE
 Financial Summary                                                                 Return on Fixed Assets
                                                                                  Cost Ratios



                                                       P
 • The company incurred a net profit of INR Y4 unit in FY 20--, as                 Operating costs (% of Sales)
   compared to net profit of INR Y3 in FY 20--                                     Administration costs (% of




                                                      M
 • The company reported total Income of INR X4 in FY 20--, registering               Sales)
                                                                                   Interest costs (% of Sales)



                                                     A
   an increase of m per cent over FY 20--
                                                                                  Liquidity Ratios


                                                    S
 • The company earned an operating margin of n per cent in FY 20--, an
                                                                                   Current Ratio
   increase of o percentage points over FY 20--
                                                                                   Cash Ratio
 • The company reported debt to equity ratio of p in FY 20--, an                  Leverage Ratios
   increase of q per cent over FY 20--                                             Debt to Equity Ratio
                                                                                   Debt to Capital Ratio
Financial Summary
                                                                                   Interest Coverage Ratio
Indicators                               Value (dd/mmm/20--)                      Efficiency Ratios
  Market Capitalization (INR)                                                      Fixed Asset Turnover
                                                                                   Asset Turnover
  Total Enterprise Value (INR)
                                                                                   Current Asset Turnover
  EPS (INR)                                                                        Working Capital Turnover
  PE Ratio (Absolute)                                                              Capital Employed Turnover
Source:                                                                                                                             Improved    Decline

                                                              HOSPITAL MARKET IN INDIA 2012.PPT                                                             11
Public: Domestic Company – Company A Ltd (1/4)
 Key Business Segments                                                         Key Geographic Segments

                               A     B          C
                                                                                             100%     The company
                                                                                  100                 operates only
                                                                                   80                  in Country A
                                                     A4                            60
                                         A3
                         A2                                                        40
             A1




                                                        LE
                                                         B4                        20
                                           B3
           C1 B1        C2 B2        C3             C4                              0



                                                       P
                                                                                               20--
            20--        20--             20--       20--




                                                      M
 Business Highlights
          Description
           Overview

           Services
                                                    SA                                  News
                                   • Treatment facilities in fields of cardiology, oncology, neurology, orthopedics
                                   • Telemedicine services, education, training programs & research services and a host of
                                     other non-profit projects




Source:

                                                         HOSPITAL MARKET IN INDIA 2012.PPT                                   12
Appendix

Ratio                          Calculations                        Ratio                       Calculations
                               (Operating                                                      Current Assets / Current
Operating Margin                                                   Current Ratio
                               Income/Revenues)*100                                            Liabilities

Net Margin                     (Net Profit / Revenues) *100                                    {(Cash & Bank Balance +
                                                                   Cash Ratio                  Marketable Securities) / Current
                               (Income Before Tax / Revenues                                   Liabilities)}
Profit Before Tax Margin       *100



                                                 LE
                                                                                               Total Liabilities / Shareholders
                                                                   Debt to Equity
                               (Net Income / Shareholders                                      Equity



                                                P
Return on Equity (ROE)
                               Equity)*100
                                                                                               {Total Debt / (Shareholders
                                                                   Debt to Capital Ratio



                                               M
                               EBIT / (Total Assets – Current                                  Equity + Total Debt)}
Return on Capital (ROCE)       Liabilities)*100

Return on Working Capital

Return on Assets
                               *100
                                             SA
                               (Net Income / Working Capital)


                               (Net Income / Total Assets)*100
                                                                   Interest Coverage Ratio


                                                                   Fixed Asset Turnover

                                                                   Asset Turnover
                                                                                               EBIT / Interest Expense


                                                                                               Sales / Fixed Assets

                                                                                               Sales / Total Assets
Return on Fixed Assets         (Net Income / Fixed Assets) *100

                               (Operating Expenses / Sales)        Current Asset Turnover      Sales / Current Assets
Operating Costs (% of Sales)
                               *100

Administration Costs (% of     (Administrative Expenses / Sales)   Working Capital Turnover    Sales / Working Capital
Sales)                         *100
                                                                   Capital Employed Turnover   Sales / Shareholders Equity
Interest Costs (% of Sales)    (Interest Expenses / Sales) *100



                                                                                                                              13
Thank you for the attention
The Hospital Market in India report is part of Research on India’s Healthcare Industry Series.
For more detailed information or customized research requirements please contact:

Tamojit Roy
Phone:         +91 33 4064 6215
E-Mail:        tamojit.roy@netscribes.com
Research on India is a product of Netscribes (India) Pvt. Ltd. Research on India is dedicated to disseminating information and providing quick
insights on “hot” industries in India and other emerging markets. Track our new releases and major updates in these industries on




About Netscribes
Netscribes is a knowledge-consulting and solutions firm with clientele across the globe. The company’s expertise spans areas of investment &
business research, business & corporate intelligence, content-management services, and knowledge-software services. At its core lies a true
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objectives.


Disclaimer: This report is published for general information only. Although high standards have been used the preparation, Research on India,
Netscribes (India) Pvt. Ltd. or “Netscribes” is not responsible for any loss or damage arising from use of this document. This document is the
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                                                                                                                                             14

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Market Research Report : Hospital Market in India 2012

  • 1. Hospital Market in India March 2012
  • 2. Executive Summary The hospital market is currently worth INR xx units and is expected to reach INR yy units by 20-- Market The sector is divided primarily into public and private along with NGO operated hospitals Constantly rising population results in perennial demand for hospital beds exceeding its supply Drivers: Challenges: Shortage in number of hospital beds Shortage of medical professionals Growing healthcare market Lack of investment in IT infrastructure LE Drivers & Growing affordability among people Shortage of FDI flows in Indian hospitals P Challenges Growing Medical tourism Increasing lifestyle diseases Role of SAM Changing demographic structure Growing health insurance market Government contribution to raise number of hospitals Financial incentives to private sector Government Future Plans Secondary Care Hospitals Private Equity Telemedicine Trends Foreign Hospitals Mobile Hospitals Health Cities Public Private Partnership Expansion plans to foreign shores Major Hospitals Chains Player C Competition Player A Player D Player B Player E Player F HOSPITAL MARKET IN INDIA 2012.PPT 2
  • 3. •Introduction •Market Overview •Drivers & Challenges PLE •Role of Government •Recent Trends SAM •Competition •Region wise hospital profiles •Hospitals commissioned in 2012-13 •Key Players •Strategic Recommendation •Appendix HOSPITAL MARKET IN INDIA 2012.PPT 3
  • 4. Hospitals can be classified on grounds of ownership and clinical operation Public Hospitals Voluntary Hospitals Run by Central Government, Functions with public or private funds State Government and local bodies on a non-commercial basis Ownership Basis ` Private Hospitals Corporate Hospitals E Hospitals owned and operated by Public limited companies formed L individual or group of people as under Companies Act run P business for purpose of profit earning commercially and is likely to operate chain of hospitals M HOSPITAL General Hospitals Rural Hospitals SA Hospitals staffed by at least two medical officers that provides in- patient accommodation and medical care for more than one category of medical discipline Located in rural areas permanently staffed by at least one physician that provides in-patient accommodation and medical care for more than one category of medical discipline Specialized Hospitals Teaching Hospitals Clinical Basis ` Provides medical attention for one A hospital to which a college is attached discipline and is administratively for medical/dental education attached to a general hospital Isolation Hospitals Tertiary Hospitals Hospitals for the care of persons State and Central government suffering from infectious diseases established in their state capitals Source: HOSPITAL MARKET IN INDIA 2012.PPT 4
  • 5. Hospital market accounts for half of the healthcare sector's revenues that has tremendous future growth potential Market Overview Market Size and Growth – Private • Hospitals are a major component of the Indian INR tn Healthcare industry forming a more than 50% of 4 healthcare sector revenues X7 • The hospital market is currently worth INR X1 units a X6 and is expected to reach INR X7 units by 20-- X5 • The market is expected to grow at a CAGR of a% X4 between 20-- to 20-- 2 X3 LE X2 • The hospital sector is divided into of public and X1 private operated P In 20-- total number of hospitals was XX of which A1 were public operated while the remaining B1 were private M 0 20-- 20-- 20--e 20--e 20--e 20--e 20--e A In 20-- total number of hospital beds was estimated to be YY of which A2 was under public ownership and the hospital beds far exceeds the supply S remaining B2 was under private ownership • With the constant rising population, demand for According to recent study conducted by WHO, there are only p beds per 1000 population which is far below the target of q beds per 1000 population by the Indian Health Hospital Market Segmentation – 20-- Ministry Hospitals A1% B1% • A huge shortage of beds is a major driver for investment in the hospital industry There is a trend of growth in speciality and multi speciality Hospital Beds A2% B2% hospitals in the country A B 100% Source: HOSPITAL MARKET IN INDIA 2012.PPT 5
  • 6. Drivers & Challenges – Summary Drivers Shortage in number of hospital beds Growing healthcare market Challenges Growing affordability among people PLE Shortage of medical professionals Growing medical tourism Growing health insurance market SAM Lack of investment in IT infrastructure Shortage of FDI flows in Indian hospitals Increasing lifestyle diseases Changing demographic structure HOSPITAL MARKET IN INDIA 2012.PPT 6
  • 7. Role of Government: Summary Direct and Indirect Initiatives PLE Role SAM of Government Future Plans Financial Incentives HOSPITAL MARKET IN INDIA 2012.PPT 7
  • 8. Trends - Summary Secondary Care Hospitals Foreign hospitals are showing interest to penetrate Indian market Indian hospitals expansion plans to foreign shores Private Equity Trends ` PLEMobile Hospitals SAM Telemedicine Health Cities Public Private Partnerships HOSPITAL MARKET IN INDIA 2012.PPT 8
  • 9. Major Public Companies - Summary Net Profit (INR mn) 500,000,000 400,000,000 Size of bubble represents 300,000,000 200,000,000 PLE Market Capitalization in INR xx M 100,000,000 A 0 B A -100,000,000 -200,000,000 -300,000,000 S -400,000,000 -500,000,000 -600,000,000 Revenue -700,000,000 (INR mn) 19,000 19,500 20,000 20,500 21,000 21,500 22,000 22,500 23,000 23,500 Player A Player B HOSPITAL MARKET IN INDIA 2012.PPT 9
  • 10. Public: Domestic Company – Company A Ltd (1/4) Company Information Head Office and Hospital Network– India Company A Address Line 1 Corporate Address Address Line 2 City Tel No. xxx Fax No. Website Year of Incorporation yyy www.companyA.com 19-- PLE Ticker Symbol Stock Exchange Products and Services mmm --- SAM City N City M Head Office City O Hospital Network Key People Category Products/Services Healthcare Facilities Name Designation Person A Founder, Executive Chairman Healthcare Consultation Managing Director, Executive Person B Director Others Person C Chief Executive Officer Person D Group President Source: HOSPITAL MARKET IN INDIA 2012.PPT 10
  • 11. Public: Domestic Company – Company A Ltd (1/4) Financial Snapshot Key Ratios Total Income y-o-y change Particulars 20-- 20-- 20-- 20-- INR unit INR unit (20– to --) Net Profit / Loss Y4 Profitability Ratios 25 2.0 20 Y3 Operating Margin Y2 1.5 Net Margin 15 Y1 X4 1.0 Profit Before Tax Margin 10 X3 X2 0.5 Return on Equity 5 X1 Return on Capital Employed 0 0.0 Return on Working Capital 20-- 20-- 20-- 20-- Return on Assets LE Financial Summary Return on Fixed Assets Cost Ratios P • The company incurred a net profit of INR Y4 unit in FY 20--, as Operating costs (% of Sales) compared to net profit of INR Y3 in FY 20-- Administration costs (% of M • The company reported total Income of INR X4 in FY 20--, registering Sales) Interest costs (% of Sales) A an increase of m per cent over FY 20-- Liquidity Ratios S • The company earned an operating margin of n per cent in FY 20--, an Current Ratio increase of o percentage points over FY 20-- Cash Ratio • The company reported debt to equity ratio of p in FY 20--, an Leverage Ratios increase of q per cent over FY 20-- Debt to Equity Ratio Debt to Capital Ratio Financial Summary Interest Coverage Ratio Indicators Value (dd/mmm/20--) Efficiency Ratios Market Capitalization (INR) Fixed Asset Turnover Asset Turnover Total Enterprise Value (INR) Current Asset Turnover EPS (INR) Working Capital Turnover PE Ratio (Absolute) Capital Employed Turnover Source: Improved Decline HOSPITAL MARKET IN INDIA 2012.PPT 11
  • 12. Public: Domestic Company – Company A Ltd (1/4) Key Business Segments Key Geographic Segments A B C 100% The company 100 operates only 80 in Country A A4 60 A3 A2 40 A1 LE B4 20 B3 C1 B1 C2 B2 C3 C4 0 P 20-- 20-- 20-- 20-- 20-- M Business Highlights Description Overview Services SA News • Treatment facilities in fields of cardiology, oncology, neurology, orthopedics • Telemedicine services, education, training programs & research services and a host of other non-profit projects Source: HOSPITAL MARKET IN INDIA 2012.PPT 12
  • 13. Appendix Ratio Calculations Ratio Calculations (Operating Current Assets / Current Operating Margin Current Ratio Income/Revenues)*100 Liabilities Net Margin (Net Profit / Revenues) *100 {(Cash & Bank Balance + Cash Ratio Marketable Securities) / Current (Income Before Tax / Revenues Liabilities)} Profit Before Tax Margin *100 LE Total Liabilities / Shareholders Debt to Equity (Net Income / Shareholders Equity P Return on Equity (ROE) Equity)*100 {Total Debt / (Shareholders Debt to Capital Ratio M EBIT / (Total Assets – Current Equity + Total Debt)} Return on Capital (ROCE) Liabilities)*100 Return on Working Capital Return on Assets *100 SA (Net Income / Working Capital) (Net Income / Total Assets)*100 Interest Coverage Ratio Fixed Asset Turnover Asset Turnover EBIT / Interest Expense Sales / Fixed Assets Sales / Total Assets Return on Fixed Assets (Net Income / Fixed Assets) *100 (Operating Expenses / Sales) Current Asset Turnover Sales / Current Assets Operating Costs (% of Sales) *100 Administration Costs (% of (Administrative Expenses / Sales) Working Capital Turnover Sales / Working Capital Sales) *100 Capital Employed Turnover Sales / Shareholders Equity Interest Costs (% of Sales) (Interest Expenses / Sales) *100 13
  • 14. Thank you for the attention The Hospital Market in India report is part of Research on India’s Healthcare Industry Series. For more detailed information or customized research requirements please contact: Tamojit Roy Phone: +91 33 4064 6215 E-Mail: tamojit.roy@netscribes.com Research on India is a product of Netscribes (India) Pvt. Ltd. Research on India is dedicated to disseminating information and providing quick insights on “hot” industries in India and other emerging markets. Track our new releases and major updates in these industries on About Netscribes Netscribes is a knowledge-consulting and solutions firm with clientele across the globe. The company’s expertise spans areas of investment & business research, business & corporate intelligence, content-management services, and knowledge-software services. At its core lies a true value proposition that draws upon a vast knowledge base. Netscribes is a one-stop shop designed to fulfil clients’ profitability and growth objectives. Disclaimer: This report is published for general information only. Although high standards have been used the preparation, Research on India, Netscribes (India) Pvt. Ltd. or “Netscribes” is not responsible for any loss or damage arising from use of this document. This document is the sole property of Netscribes (India) Pvt. Ltd. and prior permission is required for guidelines on reproduction. 14