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Sectorometer: Healthcare
In Focus: Hospital
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Table of Contents
Executive SummarySuggested Sector Strategy
Sector OutlookKey Performance MetricsRevenue StructureCost StructureCapex Investments in the SectorAnalysis of Stalled ProjectsProjected Bed Additions (Prime Cities)
Financial Summary of the IndustryTrend IndicatorsExternal Credit Ratings MigrationKey Takeaways from Delinquent Account
Player ProfilingApollo Hospitals
CARE GroupPulikkal Medical FoundationKovai Medical CenterDr Agarwals Eye Hospital
Annexures:Classification of Hospitals
Role of GovernmentRegulatory FrameworkList of Licenses & RegistrationsList of Accredited Hospitals
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Executive Summary
Market
Healthcare industry is expected to grow at a CAGR of 12% to reach Rs 4.2trillion in 2015-16 (from Rs 2.3 trillion in 2010-11). Hospitals contribute~50% of healthcare industry
Investments of over Rs 5.6 trillion is required in India over the next 5 yrsto meet global meridian of 24 beds/10,000 population (WHO statistics)
Drivers &
Challenges
Drivers Challenges
Increasing populationChanging demographic structureShortage in no. of hospital bedsIncreasing disposable income
Growing lifestyle related healthissuesThrust in medical tourismHealth insurance penetrationGovt. initiatives; focus on PPPmodels
Shortage of medical professionalsLack of investment in ITinfrastructureShortage of FDI flows in Indian
hospitals
CFD
ExposureSummary
#Clients 42POS (Rs Cr)* 86.35
% of Commercial Finance Portfolio 1.2%
Healthcare Sector - As on May 2012
*Includes exposure of Vasan Healthcare (in Infra book) of Rs 40 CrWe have recently sanctioned a LAS Exposure of Rs 60 Cr to PCR Investments against shares ofApollo Hospitals, which is yet to be disbursed. Including the same exposure would stand at 2.1%.
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Suggested Sector Strategy
-Healthcare contributes ~1% of commercial finance portfolio; and hence there is room to explore furtheropportunities in the sector. The near term outlook remains stable for the sector.
-Overall performance of the sector has remained satisfactory in India, reflective from the fact that tillMar 2012 total amount approved by Corporate Debt Restructuring cell constitutes relatively low amount~0.07% of total proposals approved. *
-Given large number of unorganized players in the segment, and few rated or listed players in the sectordata availability in public domain may be a challenge. Further, relatively long gestation periods, highreputation risks, availability of manpower and enforceability of security are issues that needs mitigation.
-To begin with we may focus on corporate hospitals; preferably present in multiple segments and/ormultiple locations to reduce concentration risk and/or manpower availability risk. In case of singlelocation/single specialty hospital stress should be given on proven track record and established brand inthe region.
-Given, large scale expansion plans we may explore relationships with established promoter group(s)(having acceptable brand recognition) towards supporting their capex plans. It is expected that someconsolidations may take place in the sector which may also offer us lending opportunities.
-Some of the hospitals may offer us equipment leasing and equipment financing opportunities. Some ofthe major manufacturers offer organizations schemes like pay per use (especially for expensiveequipments like MRIs etc.); we may explore tie ups with such manufacturers in supporting such schemes.
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*Source: www.cdrindia.org4
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Near Term Outlook: Stable (Growth likely to continue; slower pace)
Higher revenues;stressed margins
-Capacity additions seen over the past few years funded by both debt & equity.-More beds likely to become operational in 2012 resulting in increased revenues.-Operational costs likely to increase: manpower costs due to shortage of doctors & medical staff.Could affect profitability margins; thereby affecting credit profiles of some players.
Interest rate impact -Rise in interest rates may lead to slowdown in investments in 2012 & may affect the creditprofiles of small players, especially the ones which have carried out debt led expansion in thepast one/two years & are yet to reach meaningful occupancy levels.-Small players looking for capacity additions may have to rely on PE investments.
Focus on smallercities
-High competition & expensive real estate in big cities will drive expansion plans of the players inTier II & III cities where lack of healthcare services, cheaper real estate & lesser competition willbe the main growth drivers.-Hub & spoke model & PPP will guide investments in smaller towns.
Capacity additions -Likely to offer investment opportunities in increasing bed capacity, ancillary industries likemedical technologies & diagnostics in Tier II & III cities while specialty services (cardiology,neurology etc) are likely to attract most of the investments in bigger cities.
Factor Details Likely impact
Consolidation Some level of consolidation in the highly fragmented industry along with improvedoccupancy rates & avg. revenues per operating bed.
POSITIVE
High debt ledexpansion Debt led brownfield/greenfield expansion in bed capacity, in light of high interest rateenvironment & stressed profitability due to higher manpower costs & low occupancy,could hurt the credit metrics of healthcare providers.
NEGATIVE
Sensitivity factors
Source: FITCH
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Key Performance Metrics
Size & Level of IntegrationReliance on external agencies for its support functionsExtent of presence in primary/secondary/tertiary careDependency on external referrals.
Hospitals in the vicinity effect on margins or higher investments to increaseservice offeringsCompetition
Standalone Hospital Single location. Multispecialty eg. Lilavati Hospital,Mumbai; Single Specialty eg. Tata Memorial, MumbaiHospital Chains Catering to only one ailment, but present in all levels: eg.Sankara Nethralaya/Catering to single as well as multiple ailments & present in
all levels: eg. Fortis HealthcareIntegrated service providers Presence in diagnostic/pathology/pharmacycenters/hospital consultingSynergistic revenue streams Lowers dependency on one revenue stream, alsoact as feeders to the main hospital business. (eg. diagnostic centers, pharmaciesetc).Focus on medical tourism
Business Strategy
No. of in-patients = Ratio of beds occupied per year to average length of stayBed Occupancy Rate(BOR) = Ratio of no. of beds occupied to no. of bedsavailable. Hospitals strive to achieve high BORs and minimize ALOS.Ailment/Case mix Mix of various ailments treated.Surgery/Medical mix Higher surgery patients denote higher avg. billing per in-patient.
Operating Efficiency
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Revenue Structure
Surgery , investigations /diagnostics constitute ~80% of the in-patientrevenue
-Occupancy levels: Given high fixed cost component; hospitalneeds high occupancy levels; most well managed hospitalshave ~65-70% occupancy levels.Key factors for high occupancy levels: Good brandrecognition; reputed doctors & strong referral network
-Average length of stay (ALOS): Successful hospitals couplehigh levels of occupancy with short ALOS, ensuring facilitiesare utilized to their max. potential & highest possible no. ofpatients are treated.
-Medical patients vs. Surgical patients: Having higher no. ofsurgical patients strengthens revenues since these patients usethe facilities more extensively as compared to medicalpatients. ~30% of OPD patients get converted to IPD. In initialstages of operation of a hospital; dependence on IPD is higheron OPD. Diagnostics, pathology, surgeries & investigationusually contribute ~50% of total revenues for a hospital.
Ailment-wise ALOS
AilmentALOS(# days) Remarks
Cardiac 5
Complex cases: 8-10 daysAngiography: 1 day;Angioplasty: 2-4 days.
Orthopaedics 3-4Knee replacement: 8-10days
Oncology 4-5Chemotherapy: day carebed
Neurosurgery 10 Depends on complexity
Opthalmology 1 Day-care
AilmentOperatingMargins (%)
Avg.realization /patient
Cardiac 25-30 2,00,000
Orthopaedics 25-30 2,25,000Opthalmology 22-25 22,000
Oncology 30-45 85,000
Neurosurgery 16-18 N/A
Ailment wise margins &avg. realizations
Source: CRISIL Research
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Cost Structure
:Operating Costs:Wages & Salaries:
~15-20% of sales. Salaries are fixed costs;however, consultants fees can be variablelinked to operations. Bed to staff ratio variesfrom 1:3 to 1:5 depending on the nature ofservices being offered.
Consultancy/professional fees: 2 modelsDoctor on roll fixed salaryFee for service usually consultants take~75-85% of procedure fee; rest remain withhospitals
Operational overheads: ~5-7% of sales; highest
contributed by power~2-3% of sales.
Raw material/consumables: ~30-40% of sales.
:Capital Costs:-Overall capital costs: ~Rs 2 - 5 mn per bed. Forimported equipments costs are higher.
Land & building development:~40-60% of project cost depending onlocation. When Govt. provides land @
concessional rates, a particular percentage ofpatients are required to be treated free ofcharge & a particular percentage atsubsidized rates every year.
Area required: On an avg. floor space occupied bya bed is ~700-800 sq.ft.
Equipment cost: ~30-40% of project cost. MRI &cardiology equipments are most expensive & costs~Rs 60-100 mn and ~Rs 50 mn respectively.Maintenance costs of high end equipments are inthe range of ~5% of capital costs.
Components of cost
Source: CRISIL Research
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Capex investments
FY2011-12:111 new projects were announced entailing an investment of ~Rs 7265 Cr.Expected bed addition of 21,305 in future.69 projects were commissioned at a cost of ~Rs 4583 Cr.Bed capacity increased by 6,708. Bed capacity expected to increase by 21,564 & 12,728 beds in FY13 & FY14.
Increase in expenses like wages, depreciation & interest may be expected.In the event new capacities become operational by the beginning of FY2012-13, pressure on margins may ease andprofits may return to growth. It is expected that PAT margins may revert back to growth from FY13-14, as full benefitof revenue growth from new capacities may be visible by then.
Company/Project/Locations Capacity Unit Cost
(Rs Cr)Completion date
Global Hospitals Ltd.
Mumbai Hospital Project, Mumbai
250.0
200.0
Beds
Beds
300.00 May 12
Ministry of Labor, Rajajinagar ESIC Hospital Upgradation Project,Bangalore
- - 700.00 Jun 12
Wockhardt Hospital Ltd, Adams Wylie Hospital Project, Mumbai 350.0 Beds 400.00 Jun 12
Govt. of Tamil Nadu, Omandurar Secretariat Hospital & Medical CollegeProject, Chennai
- - 575.00 Jul 12
Mandi ESI Medical College & Hospital Project, Himachal Pradesh - - 1000.00 Oct 12
Columbia Asia Hospital, Multilocation Community Hospital Project,Ahmedabad
800.0 Beds 800.00 Dec 12
BMC, KEM Hospital Modernization Project, Mumbai 740.0 Beds 700.00 Dec 12
List of major projects scheduled till Mar 2013
Source: CMIE IAS
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Summary of Capital Expansion (since CY 2011)
-Total 190 projects were announced since 2011; out of whichpvt. sector announcements comprised ~86%; remaining from thepublic sector. Total involved cost of ~Rs 18,500 Cr.
-~97% of the pvt. sector investments (~Rs 15650 Cr) pertain tonew capacity additions; rest pertain to expansion of existingunits/renovations/modifications.
Project cost - status summary since May 11
Top 10 States in terms of investments
Top 3 States constitute~40% of the total projectinvestments
Source: CMIE, Commercial Finance Risk
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Analysis of Stalled Projects click here
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Analysis of Stalled Projects
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The prime cause for projects getting stalled was funding issues or reputation issues which affected thepromoter companies; preventing them to implement the projects as per planned schedule.
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Projected bed additions prime cities FY2011-13
Mumbai
Bed supply in 2011 43,900
Upcoming supply 2013 6,837
Bed/ 1000 population 3.5
Pune
Bed supply in 2011 17,930
Upcoming supply 2013 1,343
Bed/ 1000 population 5.8
Ahmedabad
Bed supply in 2011 15,586
Upcoming supply 2013 3,060
Bed/ 1000 population 2.8
National Capital Region
Bed supply in 2011 47,748
Upcoming supply 2013 8,606
Bed/ 1000 population 4.2
Kolkata
Bed supply in 2011 24,959
Upcoming supply 2013 11,985
Bed/ 1000 population 5.6
Hyderabad
Bed supply in 2011 28,287
Upcoming supply 2013 2,301
Bed/ 1000 population 4.2
Bengaluru
Bed supply in 2011 29,528
Upcoming supply 2013 5,579
Bed/ 1000 population 3.5
Chennai
Bed supply in 2011 28,731
Upcoming supply 2013 4,530
Bed/ 1000 population 6.1
Bedcapacity(# beds)
# of major hospitals
Mumbai Pune Ahmedabad NCR Kolkata Hyderabad Bengaluru Chennai
>=1000 8 3 3 7 6 5 5 5
500 999 17 6 2 21 7 6 11 13
300 499 19 4 8 18 9 9 12 4
200 299 18 9 3 24 14 10 15 16
100 199 43 19 11 57 21 35 32 27
Existing hospital supply
Ahmedabad, Mumbai andBengaluru likely to have
higher demand support incase of capacity addition inthese cities have lowerbed/population ratio ascompared to other locations.
Source: CRISIL Research
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Financial Summary of the Industry
-At operating levelsEBIDTA% is seen at~15.5% for the industryover the last 7 yrs. PAT%
seen at ~3% for the sameperiod.-While debt/NCAremains high at~8x forthe industry on a/c ofrelatively longergestation projects aswell as expansionsundertaken, however,the players remainsignificantly capitalizedwith healthy D/E of ~1x-Interest cover remainssatisfactory for theindustry at ~2.4x.-For FY2011-12, toplinegrew by ~16.5%;
however, PAT de-grew by~22.9% (detailedfinancials yet to bemade available.
Source: CMIE Prowess Return to Top
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Trend indicators
Income continued to grow, although pace subdued inFY2011-12.EBIDTA of the companies remained flat in FY2011-12,after a peaking in FY2010-11.PAT showed a de-growth in FY2011-12 due tosignificant interest cost effect.
Source: CMIE IAS; Commercial Finance Risk
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External Credit Rating Migration
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-Sample size relativelysmall of 23 cases.-Weighted average ratingof the companies in thesector is BBB; highestavailable rating pertains
to Apollo Group of AA-;and lowest being B+.-Ratings were found tohave been reaffirmed inmost of the cases studied
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Study of Delinquent Case: Key Takeaways
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Name of the Company: Innova Childrens Heart Hospital Pvt Ltd.Sanctioned Amount: Rs 0.80 Cr (Equipment Finance); POS: Rs 0.44 Cr; OD: Rs 0.16 Cr (DPD: 31-60)Sanctioned Tenor: 5 Yrs; Residual Tenor: ~2.5YrsCheque bounce history: Consistent cheque bounces noticed in the account cheque bouncesfor all the consecutive months since Oct 2011; regularized with an avg. delay of ~10-12 days.Cheque bounces for May 2012 and Jun 2012 are yet to be fully regularized.
Brief on the borrower: Incorporated in 2006; Hyderabad based; specializes in pediatriccardiology. Set up by group of doctors led by Dr K S Murthy to provide dedicated care forchildren suffering from heart diseases.
External Credit Rating: B+ by ICRA as on Oct 2011.
Concerns at the time of original sanction:-Relatively low vintage of ~2 yrs of operation; single location hospital-Cheque bounces in bank statement of existing lender.
Credit challenges currently faced:
-Moderate scale of operations-High attrition of consultants/doctors on account of competition in the industry-High gearing & stretched liquidity profile given ongoing capex (being undertaken to set upmultispecialty unit)
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Player Profiling
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Few Key Players in the Segment
SrNo.
Name Sales(Rs Cr)
N/Worth(Rs Cr)
External Credit Rating Remarks
1 Apollo Hospitals
Enterprises Ltd.
2827.92 2352.27 CRISILAA/A1+
(May 12)
2 Fortis Healthcare Ltd. 592.75 3204.61 CRISIL A-/A2+ (Mar 12) Recentlydowngraded fromA+/A1+
8 Quality Care India Ltd. 265.68* 160.17* CRISIL A+/A1 (Jun 12)
4 Kovai Medical Center &
Hospital Ltd.
223.93 61.11 CARE BBB (Nov 11)
3 AMRI Hospitals Ltd. 213.23 212.14 CARE BBB- (Apr 12) Affected by fire inone of thehospitals
5 Dr Agarwals Eye Hospital 105.68* 13.12* CARE BBB- (Oct 11)
6 Pulikkal Medical
Foundation
89.89* 68.93* CARE A-/A2+ (Apr 12)
7 Peerless Hospitex Hospital& Research Center Ltd.
57.22* 23.77* FITCH B- (Jan 12) EBIDTA level losses
*As on Mar 11
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Apollo Hospitals Enterprises Ltd.
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Brief Background
-Started operations in 1983 with Apollo Chennai; first Indian corporate hospitals-As on Dec 2011: 51 hospitals; 8276 beds. 37 hospitals are owned including subsidiaries, JVs &associates with bed capacity of 5888, remaining hospitals are managed or franchised.-Also operates retail pharmacy chains of 1290 stores. It holds 39.38% in a healthcare BPO services and
11% in Apollo Munich.
As on Mar 12 50.41% of the promotersshares were pledged; which had reducedfrom 58.96% as on Mar 11.Source: CMIE
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St th Ri k R d ti
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Strengths Risks - Recommendations
Mitigants Risks Sensitivity Factors
-Established & leading marketposition in the industry
-Healthy operating profitability
-Healthy financial risk profile
-Project risk embedded inGreenfield projects
-Sizeable exposure to ApolloHealth Services Ltd. (BPO;Investment Rs 180 Cr)
-Higher than estimated capex &funding plan
-Acquisitions & their fundingplans
-Operational viability of newprojects
-Performance of Group
companies
-Significant increase in supportto associate & JV cos.
Recommendations: Commercial Finance had sanctioned an exposure of Rs 60 Cr in the form of LAS topromoter company PCR Investments with underlying scrip of Apollo Hospitals which stands undisbursedas on date. In the event the same stands undisbursed we may look at exploring entry into the
Company, as there are capex plans which may require support.
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Source: CRISIL
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Quality Care India Ltd. (CARE Group)
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Brief Background
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Brief Background
-Group was set up in 1997 by cardiologists, Dr B Soma Raju & Dr N Krishna Reddy in Hyderabad-Presence across various locations in India; combined bed capacity of 1577 beds.-Provides tertiary healthcare services in multi-specialty areas; focus on cardiac.-Has presence in Vishakhapatnam, Surat, Nagpur, Pune, Raipur, Bhubaneshwar and Hyderabad.
Advent became as majority shareholder in May12 through a combination of fresh equityinfusions and acquisitions from erstwhileinvestors incl. Mr Rakesh Jhunjhunwala
Source: CMIE
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Financials Summary
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Financials Summary
Remarks: Detailed financials of the Group for FY2010-11 and FY2011-12 are not available.-FY2010-11: Sales: Rs 430 Cr; PAT: Rs 21.15 Cr-FY2011-12: Sales: Rs 490 Cr; PAT: Rs 20.97 Cr.
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Strengths Risks Recommendations
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Strengths Risks - Recommendations
Mitigants Risks Sensitivity Factors
-Established market position in thetertiary healthcare segment
-Healthy operating efficiencies
-Groups healthy financial riskprofile
-Expected benefit from equityinfusions by Advent International;it has majority shareholding in the
Group.
-Competition in the healthcareindustry
-Sub-par performance of few ofthe Groups recently addedhospitals
-Exposure to risks related tostabilization of operations aftercompletion of its large proposedcapex.
-Capex & acquisition plans; andtheir funding mix
-Operational stability of newprojects
-Performance of loss makinghospitals
Recommendations: The Group has planned capex of ~Rs 360 Cr (to be implemented b/w FY12-13 andFY14-15); equity tied up with PE investor Advent ~Rs 50 Cr infused in Mar 12 and ~Rs 25 Cr each iscommitted to be infused in each of the years FY13 and FY14. Group has requirement to raise ~Rs 250Cr of debt in future.
However some of the Groups recently added hospitals (Raipur, Nagpur and Musheerabad units) haveshown moderate profitability. Groups operating lease model of operations have pulled down theprofitability to ~13% as compared to ~15% for other multi-location hospitals. Losses are expected in someof the Greenfield projects and margin is likely to be under pressure.
Group: Ganga Care Hospitals; Visakha Hospitals & Diagnostics; Ramakrishna Care Medical Sciences; Care Instt. of MedicalSciences; Galaxy Care Laparoscopy; Quality Care Medical Excellence Center Pvt Ltd and Quality Care Health Services
Source: CRISIL
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Pulikkal Medical Foundation
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Brief Background
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Brief Background
-Kochi based company; runs a 750 bed hospital in the name of Medical Trust Hospital (MTH) & arelated education and research instt. in the name of Medical Trust Instt. of Medical Science.-Initially established as a partnership firm in 1972 as Pulikkal Corporation and subsequently in 1976was incorporated and took over MTH from Pulikkal Corporation.
-It is a multi-specialty tertiary care referral hospital.-Presently accredited by National Board of Examination in 16 specialties.-It also conducts graduate & post-graduate nursing courses and diploma courses in radiology andophthalmic assistance, among others.
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Financials Summary
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Financials Summary
Remarks: Financials of FY2011-12 not available. Till H1FY12 the Company has achievedtopline of Rs 49.20 Cr.
Source: CMIE
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Strengths Risks - Recommendations
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Strengths Risks Recommendations
Mitigants Risks Sensitivity Factors
-Established presence in Kochiregion
-Vast experience of promoters inhealthcare industry
-Long & stable operational trackrecord with relatively highoccupational levels
-Stable financial position marked
by consistent revenue & surplusgrowth. Healthy cash accrualsavailable for further development& low leverage ratios
-Qualified & experienced team ofdoctors; advanced medicalequipments.
-Single location hospital
-Dependence on scarcely
available medical professionals
-Growing competition in theindustry
-Ability to diversify its incomeby establishing hospitals in newlocations
-Maintain higher occupancylevels
-Retain its current pool ofmedical professionals
Recommendations: We may explore supporting the Company in the event it decides to diversify to otherlocations based on internal due diligence. We may also seek entry by way of equipment finance etc. inthe Group.
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Source: CARE
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Kovai Medical Center & Hospital Ltd.
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Financials Summary
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y
Source: CMIE
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Strengths Risks - Recommendations
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g
Mitigants Risks Sensitivity Factors
-Experience of promoters;supported by qualified &
experienced team of doctors
-Hospitals established brandpresence
-Long & stable operational trackrecord
-Major expansion program isnearing completion; though minordelays in commissioning of thecancer block
-High leverage
-Dependence on scarcelyavailable medical professionals
-Growing competition in theindustry
-Ability to grow its patientregistration
-Successfully achieve &maintain higher occupancylevels
Recommendations: The Company had comfortable liquidity position (WC utilization of ~3% as on Nov11). It had undertaken expansion with a project cost of ~Rs 267 Cr (D:Rs 226 Cr; E: Rs 41 Cr); wherethere were minor delays in completion from Jun 11 to Nov 11. The overall gearing & debt/NCA ratios
remain significantly high; hence we may explore secured funding to the Company; subject tosatisfactory internal due diligences.
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Source: CARE
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DrAgarwals Eye Hospital Ltd.
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Brief Background
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-Super specialty eye hospital set up in 1994 to offer eye care services.-Family has been in the profession of providing total eye care services for ~5 decades.-It has a network of 29 branches, predominantly in Tamil Nadu and one each in Andhra Pradesh &Rajasthan.
As on Mar 12 none of the promotersshares were pledged; which was at 51.52%as on Mar 11.
Source: CMIE
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Financials Summary
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Source: CMIE
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Strengths Risks - Recommendations
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Mitigants Risks Sensitivity Factors
-Experience of promoters;supported by qualified &experienced team of doctors
-Established brand presence acrossTamil Nadu
-Availability of latest technology &medical equipment providingcomprehensive eye care services
-Benefits out of enhanced reachthrough newly establishedbranches
-Small size of operations
-Dependence on scarcely
available medical professionals
-Growing competition in theindustry
-Ability to grow its patientregistration
-Improve profitability margins
-Ability to retain its team ofdoctors
Recommendations: The Company has long vintage in the field of eye care and enjoys good brandpresence in the local market. However, given the size of operations we may look at an entry opportunitywith a small exposure (by way of equipment finance; leasing opportunities etc.)
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Source: CARE
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Annexures
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Classification of Hospitals
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Ownership Basis
Public
Run by Central Govt., State Govt, andlocal bodies
eg. BMC Hospital, KEM Hospital,Cooper Hospital, Mumbai
VoluntaryFunctions with public/private funds ona non-commercial basis
Private
Owned & operated by individual orgroup of people as business for profitearning
eg. CARE Group
Corporate
Public ltd. cos. formed underCompanies Act run commercially & islikely to operate chain of hospitals
eg. Apollo, Fortis etc.
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Role of Government
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Govt. spending on healthcare has been amongst the lowest in India when compared to similareconomies.An increasing contribution is being witnessed in the recent times, though not at the required pace.Important steps taken by the Govt. in the past few years are: efforts to deepen the healthcarereach through insurance schemes, encouraging PPP & fiscal incentives to channel investments intothe sectorGovt. intends to increase its focus in the next 5 yr plan (2012-17) by increasing healthcarespending from current 1.3% of GDP to ~2.0%-2.5%.These benefits could subsidize part capex & consequently reduce funding requirements.
Lowest spending as compared to BRIC nations and far lower as compared to Global standards
Source: CRISIL Research
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Regulatory Framework
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Union Ministry of Health & Family Welfare:Apex authority for various Central Govt. programs. Also assists State Govt. in healthcare through technicalassistance.Ministry also formulates & implements various World Bank assisted projects.State health projects, though implemented through State Govts., the Department of Health assists theStates.
FDI in India100% foreign equity participation is permittedApproval is automatic.Examples: Pacific Hospitals, Hyderabad and Columbia Asia Hospital, Bangalore.
Accreditation of hospitalsVoluntary processAids in building community confidence; helps in getting credible & authentic information on services.National Accreditation Board for Hospitals & Healthcare Providers (NABH) has been set up for thepurpose. [For complete list of NABH accredited hospitals, click here ]NABH accreditation is compulsory for empanelment under Central Govt. Health Scheme (CGHS)Examples of Hospitals accredited: P D Hinduja Hospital (Mumbai), Max Super Specialty Hospital (NewDelhi), Apollo Specialty Hospital (Chennai), Narayana Hrudalaya (Bangalore), Medwin Hospital (Hyderabad)
SECTOR FACTSCumulative FDI inflow in hospital and diagnostic centers was US$ 1.3 billion during April2000 to March 2012, according to the latest Department of Industrial Policy &Promotion (DIPP) data
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Source: CRISIL Research
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List of NABH Accredited Hospitals
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Source: NABH
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Source: NABH
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Source: NABH
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