MOH-PSP Initiatives - Invest Saudi · Private Sector Participation (PSP) aims to… increase the...

MOH-PSP Initiatives

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Private Sector Participation (PSP) aims to…increase the share of private sector in healthcare delivery via Public-Private-Partnership (PPP) Models.

MoH-PSP Initiatives

Primary Care Hospital Commissioning

Medical City Rehabilitation Radiology Laboratory Long-Term Care Home Care

Strategic Frameworkand Modelling

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Strategic Frameworkand Modelling

PSP aims to…shift patients towards efficient and cost optimized services

Medical City Hospital Care Rehabilitation Long-Term Care Home Care PHC

High cost Low cost

PSP Initiatives Status

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PSP Initiatives Status

Initiative Inception Data Collection and Analysis

Strategic Framework

PilotSelection

Needs Assessment

Transaction Structure

PilotLaunching Full Implementation

Radiology

Laboratories

Primary Care

Medical Cities

Hospitals

Rehabilitation

Long Term Care

Home Care

Primary Health Care (PHC)Findings Highlights

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2300 PHC with annual expenditure of 4-3B USD. PHC have lost %10 visitors , equivalent to 0.5B USD during the last 5 years. Most PHC lack patient’s trust.Around 500 PHC are rented.Up to 200 PHC are not operational.Unbalanced utilization of PHC (less than5% in some PHC centers).

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Details or source documentInformationCategory

Project details

Specificadvantages

Businesscase

Location options

Purpose/ Idea

Infrastructure & Resources

Other advantage/ incentives

Timeline

Investment

Returns

Capacity/ Size

Revenue model

Overview

PRO

JECT

/ DEA

L LE

VEL

Minimum requirement Optional information

▪ Different Cities

▪ The Project :- DFBOT –400 PHCs in different cities

▪ The project is located in the Capital of Saudi Arabia and urban areas in Riyadh region, hence available infrastructure (e.g., Easy access to vendors and contractors)

▪ Ability to have a commercial investment within the property as well as benefits such as land utilization, credit support, low tax and material exemptions

▪ 12 months for bidding, 12-18 months construction, 10-15 years operation - All specific dates are pending upon the assignment of the transaction advisor

▪ Expected capital cost is more than 0.6 Billion U.S Dollar. It will be SPV - JV

▪ The expected IRR is depending on the financial model and bidders prices

▪ The project is expected to serve the catchment area of around 1 million of population

▪ PPP project that is based on guaranteed offtake agreement which will be structured according to the prices provided by the transaction advisors and bidders

Medical Cities and Hospital CommissioningFindings Highlights

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32 hospitals with 6395 beds are either completed or partially completed, but not operational due to limited financial, HR and IT resources (~1.6B USD already spent).

2 incomplete MCs with 1000 beds under-construction (~0.3B USD already spent).The 2 incomplete MCs needs 1.3B USD over 2 years to be completed. Average construction time by MoH is 10 years,plus another 10 years to be fully operated.

Hospitals Commissioning :

Medical Cities:

North Riyadh Hospital Prince Mohammed Medical City

8.1

6.1

4.3

2.2

Germany France Greece KSA

Beds per 1000 Population

8.27.1

5.0

2.5

Turkey Australia UK KSA

Outpatient Visits per Capita

Medical Cities and Hospital Commissioning


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Project details

Specificadvantages

Businesscase

Purpose/ Idea



Timeline

Investment

Returns

Capacity/ Size

Revenue model

Overview

PRO

JECT

/ DEA

L LE

VEL


▪ The project: BLOT - To operate 1000 beds for the hospitals and build 2 medical cities with 2000 beds

▪ The project is located in the Capital of Saudi Arabia and Madinah city with available infrastructure (e.g., Easy access to vendors and contractors)


▪ 12 months for bidding, 12-18 months construction, 20 years operation - All specific dates are pending upon the assignment of the transaction advisor

▪ Expected capital cost is more than 1.3 Billion U.S Dollar. It will be SPV - JV


▪ The project is expected to serve more than 500,000 population in Madinah and 300,000 population in Riyadh


Medical Cities and Hospital Commissioning

RehabilitationFindings Highlights

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There is 1 bed / 130K population. MoH rehabilitation beds are 238 ONLY!In 36K accident injured patients, competing for the available 238 rehabilitation beds.Many cases were sent abroad for rehabilitation (too expensive).

RehabilitationFindings Highlights

2015

86

50 50 50 50

6 4.50

306090

120150180

Finland

German

ySpain USA UK

Canad

a

New Zeala

ndTurk

ey

S. Arabia

PT per 100,0004.89

4.403.59

2.97 2.701.96

1.300.42

0.001.002.003.004.005.00

Spain

Belgiu

m

Switze

rland

France

Turkey

Germany

Canada KS

A

PMR Physician per 100,000

1 bed Per 1k population 1 bed Per 130k populationBed Capacities

Germany1,000

US10,000

UK16,000

Turkey30,000 KSA

130,000

Home CareFindings Highlights

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Home CareFindings Highlights

Only available through hospitals Paper-based documentations Lack of IT system

Insufficient consumables and equipment Unqualified staff & lack of some specialties

Transportation issues

30,000

300,000

- 50,000

100,000 150,000 200,000 250,000 300,000 350,000

Number of PatientsUnder Home Care

Benchmark is 1.5%of Popluation couldbe under home care

Number of Patients

Extended Care

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Extended Care


Project details

Specificadvantages

Businesscase

Location options

Purpose/ Idea



Timeline

Investment

Returns

Revenue model

Overview

PRO

JECT

/ DEA

L LE

VEL


▪ Riyadh city. Jedddah City and Dammam City & others

§ DFBOT 1-Rehablition to build 1000 beds by 2022, Increasing the number of rehabilitation beds from 0.77 per 100,000 population to global benchmark level of 10 per 100,000.2- Long-term care to build 1000 beds by 2022, Freeing up the acute hospital beds which are being occupied by the long-term care patients.3- to recruit 20,000 patients by 2022, Freeing up the acute hospital beds which are being occupied by the home care patients

▪ The projects are located in major cities in Saudi Arabia (e.g., Easy access to vendors and contractors)


▪ 12-18 months for bidding, 24-36 months construction, 20 -25 years operation

▪ Expected capital investment more than 0.5 Billion U.S Dollar. It will be SPV - JV



RadiologyFindings Highlights

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The waiting time is more than 3 months in some hospitals. %30 only of machines utilization is reachedAlmost half of the scans are not reported.only %9 of cancer cases (120K currently) are covered with PET-CT imaging that is needed for diagnosis and treatment.

8786

3021

5986 5020

13547

2317

12257

5984

8986

5799

11585

4006

0

5000

10000

15000

France USA Canada Spain Turkey KSA (MOH)

MRI exams CT exams

Annual Exams Per Machine

960 1010

550 770

1330

90

1880

2540

1480

1010

1610

357

0

500

1000

1500

2000

2500

3000

France USA Canada Spain Turkey KSA (MOH)

Annual Exams per 10,000 Population

MRI exams CT exams

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Project details

Specificadvantages

Businesscase

Location options

Purpose/ Idea

Other details



Timeline

Investment

Returns

Capacity/ Size

Revenue model

Overview

PRO

JECT

/ DEA

L LE

VEL


▪ Different Cities

▪ The Project :-BOFM (Build Operate Finance and Maintain) to meet 50% of estimated demand by 2022

▪ The contractor (SPV) will provide full operation and MoH will pay per radiology report

▪ The project is located in Riyadh region in 7 hospitals with equipment and IT system with their manpower as well as available infrastructure (e.g., Easy access to vendors and contractors)

▪ Ability to have a commercial investment such as land utilization, credit support, low tax and material exemptions

▪ Concession period expected from 7 -10 years - Specific dates will be updated at a later stage

▪ The type of investment will be equity share in the new SPV (the total investment is 0.2 billion U.S Dollar)


▪ Total size of the project is from 150 to 200 million SAR / 400K examinations annually



LaboratoriesFindings Highlights

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%60 of PHC centers have laboratories (%20-10) (1266 efficiency), causing a major impact on public health (chronic diseases) which will complicate disease management.Results delay for PHC centers by 2 days ( the benchmark is 6hrs).

%30 sample rejection rate (the benchmark is %10) as a result of inappropriate collection and transportation systems.High volume of send out samples (out of KSA), annual average expenditure of 55 Million USD.%50 of reagents and diagnostic kits is wasted.

National Health Lab 0

Regional Labs 10

Hospitals Labs 273

Primary HC Labs 1266 Riyadh vs. Ankara

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Project details

Specificadvantages

Businesscase

Location options

Purpose/ Idea

Other details



Timeline

Investment

Returns

Capacity/ Size

Revenue model

Overview

PRO

JECT

/ DEA

L LE

VEL


▪ Riyadh region Followed by Jeddah and will cover different region

▪ BOFM (Build Operate Finance and Manage) to meet 50% of estimated demand by 2022

▪ The contractor (SPV) will provide full operation and MoH will pay per test

▪ The project is located in Riyadh City with available infrastructure (e.g., IT infrastructure, Project equipment, manpower, Easy access to vendors and contractors)


▪ Concession period expected from 5 -10 years - specific dates are pending upon the assignment of the transaction advisor

▪ The type of investment will be equity share in the new SPV (the total investment is 0.2 billion U.S Dollar)


▪ 9 million tests annually / Approximately 350 million USD project size (PHC only)



New Initiatives Opportunities

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Project details

Specificadvantages

Businesscase

Location options

Purpose/ Idea

Other details



Timeline

Investment

Returns

Capacity/ Size

Revenue model

Overview

PRO

JECT

/ DEA

L LE

VEL


▪ Covering all regions in the Kingdom, more than 150 dialysis centers

▪ BOT (Build Operate and Transfer) to meet 100% of estimated demand by 2021

▪ The contractor (SPV) will provide full operation and MoH will pay per session

▪ Some centers will be available in MoH facilities and the others have to be build or rented.



▪ The type of investment will be equity share in the new SPV (the total investment is 4 billion U.S Dollar)


▪ 17000 Patients


National Dialysis Project

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Project details

Specificadvantages

Businesscase

Location/ Capacity

Purpose/ Idea

Other details



Timeline

Investment

Returns

Revenue model

Overview

PRO

JECT

/ DEA

L LE

VEL


▪ Covering all regions in the Kingdom

▪ OFM (Operate Finance and Manage) to meet the demand of MoH and Red Crescent

▪ The contractor (SPV) will provide full operation and MoH will pay for service

▪ Private sector will provide and provide air craft with all required locations and support



▪ The type of investment will be equity share in the new SPV (the total investment is 800 Million U.S Dollar)



National Air Ambulance Project

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Extended Care Details or source documentInformationCategory

Project details

Specificadvantages

Businesscase

Location options

Purpose/ Idea



Timeline

Investment

Returns

Revenue model

Overview

PRO

JECT

/ DEA

L LE

VEL


▪ Makkah City (DFBOT) , Taif City (DFBOT) and Riyadh City (Equip & Operate)

§ DFBOT (Design, Finance, Build, operate and transfer) to build 1000

▪ The projects are located in major cities in Saudi Arabia (e.g., Easy access to vendors and contractors)


▪ 12-18 months for bidding, 24-36 months construction, 20 -25 years operation

▪ Expected capital investment more than 0.3 Billion U.S Dollar. It will be SPV - JV



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