1. Emerging Trends and Road Ahead Co-founder, Medanta, The Medicity
Funding Opportunities in Health Care
Emerging Trends and Road Ahead
Mr. Sunil Sachdeva
Co-founder, Medanta, The Medicity
July 21, 2014, Hotel Taj Gateway, Kolkata

2. India has $65B Healthcare Market which is expected to grow at 15% p
India has $65B Healthcare Market which is expected to grow at 15% p.a; Within Healthcare, Delivery is the biggest segment

3. Medanta as conceptualized …

4. … and Medanta today

5. Availability /Capacity
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Availability, Affordability, Quality and Physical access are crucial for efficient healthcare delivery
Affordability
Quality
Dimensions of
Healthcare access
Physical Access
Physical Reach
This component defines physical accessibility of a requisite healthcare facility, i.e.
availability of a healthcare facility having an outpatient department (OPD) for common
ailments, and an inpatient department (IPD) for hospitalization. These facilities may either
be public or private in nature. Physical reach is defined as the ability to enter a healthcare
facility within 5 kilometres (5km) from the place of residence or work.
Availability/Capacity
This component defines availability of the requisite healthcare resources to provide
patient treatment, i.e. doctors, nurses, in-patient beds, diagnostics, consumables, etc. The
availability is governed by minimum specifications defined by the Government of India
for public healthcare facilities, and international organizations such as WHO.
Quality/Functionality
This component defines the quality of the healthcare resources available at the point of
patient treatment.
Affordability
This component defines the ability of a patient to afford complete treatment for the
illness or disease
Survey by IMS health
for selecting a private healthcare facility, while quality of treatment was the second top reason
(56%)
Availability /Capacity
Source: IMS health, June 2013

6. Availability and access to quality doctors remains one of the biggest concerns for India
Healthcare Facilities concentrated in uRban areas
Available doctors & nurses are ~50% of required
“If shortage of doctors is one problem, their unwillingness to work in the rural hinterland is another, creating artificial scarcity in the area and high concentration in another”
Union Health Ministry
“It is alarming to note that doctor patient ratio in rural India is 1:20,000 as against the urban ratio of 1:2000 which itself is far below the WHO requirement of 1:250 in rural India ”
ONICRA, 2013

7. Disparities exist even at a regional level
Source: PwC report, 2013

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Poor quality and inadequate number of PHC’s make Primary Health Care a challenge
~26K government-run primary health care centers and 615 district-level hospitals
Poor quality of delivery at these institution,; highly underutilized
~200K privately-owned general physician clinics
No standardization in terms of processes, quality and service levels
Patients end up going to large tertiary care hospitals even for basic health care needs
more expensive and not easily accessible
Shortfall of ~17K PHC’s and ~2.6 M health workers nationwide; 41% of PHCs lack healthcare personnel
If you are having a stomach ache – where will you go

9. INNOVATION CONSTRAINTS Physical Access to quality healthcare
Lack of Primary Health centers
Unavailability of doctors in Rural Areas
Regional disparities
CHALLENGE
Infrastructure takes time and money
Artificial constraints – good doctors don’t want to go to rural areas
CONSTRAINTS
INNOVATION

10. M HEALTH 1
Source: PwC report, 2013

11. M HEALTH 1 India receptive to adopting Mhealth
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M HEALTH 1
India receptive to adopting Mhealth
Currently, MOST # of live projects in india
Mobile penetration on the rise
Developing economies more receptive to change
Offers solutions to the core problems – Availability and Physical Access
Source: PwC report, 2013

12. HEALTH CARE UNITS IN TIER 2 AND TIER 3 CITIES 2
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HEALTH CARE UNITS IN TIER 2 AND TIER 3 CITIES 2
Huge demand makes it a lucrative opportunity
Big as well new hospital venturing into small cities
Cost of setting up of infrastructure is low
Demand is high as income level of people residing in Tier 2 and Tier 3 cities on a rise
Government offering incentives
Big hospitals like Medanta, Fortis, Apollo and Manipal
Independent hospital chains like Vaatsalaya , Glocal
bed hospitals in tier 2 and tier 3 cities
>$15M raised from VC and PE funds

13. PUBLIC PRIVATE PARTNERSHIP FOR SETTING SUPER SPECIALITY HOSPITALS
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PUBLIC PRIVATE PARTNERSHIP FOR SETTING SUPER SPECIALITY HOSPITALS 3
Alone cannot best solve the problem of Health Care
Potential benefits include better quality , more resources – funds, technology, increased access etc
Models
Operations and management contracts
BOT through SPV for private financing
DBFO - Design, build, finance and operate – variation of BOT
Lease: Private sector provides own health care and risks.
Concessions: Government regulates price and quality. Private sector invests, pays for concession rights.
Government contributes to reduce commercial risk.
Joint ownership. Sharing revenues, expenses and assets. Technological expertise through private sector.

14. THE WAY FORWARD Hospitals in Tier 2 and Tier 3 cities Emerging Trends
Mobile Van
Primary Health Care Units
Hospitals in Tier 2 and Tier 3 cities
Super Speciality Hospitals

15. SO WHERE DOES THE FUNDING OPPORTUNITY LIE?
CHALLENGE
OPPORTUNITY
INNOVATION
FUNDING OPPORTUNITY