INDUSTRY ANALYSIS ON APOLLO HOSPITALS

Service Sector – Healthcare

Submitted By:

Gaurav Singh Rana (13609071)

Neha Chakraborty (13609083)

Shivani Wadhwa(13609151)

Shivika chandel (13609045)

Priya Singh (13609034)

Table of Contents

Topic Page numberHealth care industry in India 2

Chairman’s Profile 3-5Other business units 6-7Porters five model 8

Suggestions 9SWOT Analysis 10

Customer Service 11-12GDP Contribution 13

Statistical data 14-15Latest Development 16

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Health care Industry in India

In India, the Healthcare system is split into a public sector, a private sector and a wide network of informal healthcare providers operating together in a large and unregulated network. This irregularity has caused wide disparities in access, especially in regional and rural distribution of healthcare infrastructure. Currently, the Indian healthcare sector is valued at Rs.1, 360 (US $34) billion roughly 6 per cent of GDP. The healthcare business is projected to grow to over Rs.1, 600 (US $40) billion or 8.5 per cent of GDP by 2012, according to Price Waterhouse Coopers (PwC) report, 'Healthcare in India: Emerging market report 2007'.

The Hospital Industry

Size of the Industry

There would be increase in number of public and private healthcare facilities which are expected to propel demand for the industry, accounting for another US$ 6.7 billion

Geographical distribution

All the Major Cities like Mumbai, Delhi, Bangalore, Hyderabad, Pune, Chennai.

Output per annumIndian healthcare industry comprises of hospitals and allied sectors which is projected to grow 23 % per annum to touch US$ 77 billion by 2012

Market capitalization

The expenses of this industry comprises 5.25% of the GDP

Some Facts

India‟s healthcare industry is currently worth Rs 73,000 crore which is roughly 4 percent of the GDP. The industry is expected to grow at the rate of 13 percent for the next six years which amounts to an addition of Rs 9,000 crores each year.

The national average of proportion of households in the middle and higher middle income group has increased from 14% in 1990 to 20 % in 1999.

The population to bed ratio in India is 1 bed per 1000, in relation to the WHO norm of 1 bed per 300.

In India, there exists space for 75000 to 100000 hospital beds. Private insurance will drive the healthcare revenues. Considering the rising middle and

higher middle income group we get a conservative estimate of 200 million insurable lives

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Over the last five years, there has been an attitudinal change amongst a section of Indians who are spending more on healthcare. Corporate hospitals mushroomed in the late eighties. The boom remained short-lived and out of the 22 listed hospital scrips, most are being trading below par. An increasingly fragmented market, lack of statistics, capital intensive operations and a long gestation period are all wise reasons to shy away from investing in the healthcare industry. Government and trust hospitals dominate the scene. Many of the trust hospitals suffer from poor management. Good corporate hospitals are still too few to amount to a critical mass.

Factors affecting Corporate in Health care Sector

Recognition Industry: In the mid 80‟s, the healthcare sector was recognized as an industry. Hence it became possible to get long term funding from the Financial Institutions. The government also reduced the import duty on medical equipment‟s and technology, thus opening up the sector. Since the National Health Policy (the policy‟s main objective was „Health For All‟ by the Year 2000) was approved in 1983, little has been done to update or amend the policy even as the country changes and the new health problems arise from ecological degradation. The focus has been on epidemiological profile of the medical care and not on comprehensive healthcare.

Socio-economic changes: The rise of literacy rate , higher levels of income and increasing awareness through deep penetration of media channels, contributed to greater attention being paid to health. With the rise in the system of nuclear families, it became necessary for regular health check-ups and increase in health expenses for the bread-earner of the family.

Brand Development: Many family run business houses, have set-up charity hospitals. By lending their name to the hospital, they develop a good image in the markets which further improves the brand image of products from their other businesses.

Extension to related business: Some pharmaceutical companies like Wockhardt and Max India, have ventured into this sector as it is a direct extension to their line of business.

Opening of the Insurance Sector: In India, approx. 60% of the total health expenditure comes from self paid category as against governments contribution of 25-30 %. A majority of private hospitals are expensive for a normal middle class family. The opening up of the insurance sector to private players is expected to give a shot in the arms of the healthcare industry. Health Insurance will make healthcare affordable to a large number of people. Currently, in India only 2 million people ( 0.2 % of total population of 1 billion), are covered under Mediclaim, whereas in developed nations like USA about 75 % of the total population are covered under some insurance scheme. General Insurance Company, has never aggressively marketed health insurance. Moreover, GIC takes upto 6 months to process a claim and reimburses customers after they have paid for treatment out of their own pockets. This will give a great advantage to private players like Cigna which is planning to

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launch Smart Cards that can be used in hospitals, patient guidance facilities, travel insurance, etc.

Some players

Fortis Healthcare

Fortis is the late Ranbaxy‟s Parvinder Singh‟s privately owned company. The company is a 250 crore, 200 bed cardiac hospital, located in the town of Mohali. The company also has 12 cardiac and information centers in and around the town, to arrange travel and stay for patients and family. The company has plans of increasing the capacity to around 375 beds and also plans to tie up with an overseas partner.

Max India

After selling of his stake in Hutchison Max Telecom, Analjit Singh has decided to invest around 200 crores, for setting up worldclass healthcare services in India. Max India plans a three tier structure of medical services – Max Consultation and Diagnostic Clinics, MaxMed, a 150 bed multispeciality hospital and Max General, a 400 bed hospital. The company has already tied up with Harvard Medical International, to undertake clinical trials for drugs, under research abroad and setting up of Max University, for education and research.

Escorts

EHIRC located in New Delhi has more than 220 beds. The hospital has a total 77 Critical Care beds to provide intensive care to patients after surgery or angioplasty, emergency admissions or other patients needing highly specialized management including Telecardiology (ECG transmission through telephone). The EHIRC is unique in the field of Preventive Cardiology with a fully developed programme of Monitored Exercise, Yoga and Meditation for Life style management.

Chairman Profile

Dr. Prathap C Reddy, Chairman Apollo Hospitals Group

His dream is to make India the Healthcare Destination of the World.

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Two decades ago, Dr. Reddy lost a patient who couldn't make it to Texas for an open heart surgery. This was the milestone in the Indian Healthcare Industry. Today people have the opportunity in India to receive the best that healthcare has to offer worldwide.

Driven by a deep urge to create world-class medical infrastructure in India and make it more accessible and affordable to a large cross section of our people, Dr. Prathap Reddy opted to give up his successful practice in the US to return to India in the early eighties.

Thus, Dr. Reddy began what was truly the process of revolutionizing the path of the Indian Healthcare Industry. Undeterred by initial constraints Dr. Reddy succeeded in setting up the first center of the Apollo Hospitals Group in Chennai in 1983.

Apollo Hospitals Enterprise Limited

Apollo Hospitals Enterprise Limited (AHEL) is a leading private sector healthcare provider in Asia. It was incorporated as a Public Limited Company in the year 1979, a comprehensive 250-bed hospital with an emphasis on speciality and super specialties in over fifty departments at Chennai. Dr. Prathap C Reddy promoted it. Apollo Hospitals Enterprise Limited (AHEL) owns and operates a network of leading primary, secondary and tertiary hospitals and clinics across India. The Company also has a pan India footprint of 873 standalone pharmacies. The Apollo Hospitals group today includes over 7500 beds across 43 hospitals in India and overseas, neighbourhood diagnostic clinics, an extensive chain of Apollo Pharmacies, medical BPO and health insurance services and clinical research divisions that are working on the cutting edge of medical science.

Apollo Hospitals Enterprise Limited has over 8065 beds across 46 hospitals in India, rest of Asia and Africa. The hospitals are multi specialty tertiary care facilities with centres-of-excellence in medical disciplines including cardiology, cardio-thoracic surgery, gastroenterology, orthopedics & joint replacement surgery, neurology, critical care medicine, nephrology, oncology, hand & micro surgery and reproductive medicine.

In India, Apollo hospitals can be grouped into the following categories based on their stage of maturity and occupancy levels: Mature hospitals at Chennai, Hyderabad, Madurai, Bilaspur, Mysore, and Visakhapatnam have occupancy levels exceeding 75%. New hospitals at Bangalore, Ahmedabad, have occupancy levels of 60%. Two Hospitals were commissioned during the year, Apollo Loga Hospital at Karur, Tamil Nadu, having 70 beds and a Hospital at Karim Nagar, Andhra Pradesh with 120 beds. As per the Accounting Standard 17 issued by The Institute of Chartered Accountants of India, AHEL has two reportable segments, healthcare services and Standalone Pharmacies, Healthcare services segment comprises hospitals, hospital-based pharmacies and Consultancy Division. The other segment comprises standalone pharmacies.

Apollo group of hospitals

Driven by its line of being the “architect of healthcare” in India, the Apollo Hospitals Group, comprising of one of the largest networks of 26 hospitals, 10 clinics and over 10,000 employees across the country, represents the changing face of healthcare in India contemporary and

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corporatized. It has been the first private company to administer health insurance in the country and Indraprastha Apollo Hospital in Delhi is the fourth largest corporate hospital in the world.

The Apollo group is India‟s first corporate hospital, the first to set-up hospital outside the country and the first to attract foreign investment. With 2600 beds, Apollo is one of Asia‟s largest healthcare players. The recent merger between its 3 group companies, Indian Hospitals Corporation Ltd., Deccan hospitals Corporation Limited and Om Sindoori Hospitals Limited, will help the group raise money at a better rate and by consolidating inventory, it will save around 10% of the material cost. The group is planning to invest Rs. 2000 crore , to bulid around 15 new hospitals, in India, Sri Lanka, Nepal and Malaysia.

Apollo claims to maintain the best of medical standards with a record of over 7.4 million treated patients, 3,15,000 preventive health checks done, 98.5 percent success rate in 45,000 cardiac surgeries, etc. And helping the company maintain a balance between the corporate culture and rigorous medical excellence is recognition of IT as intrinsic to every process, whether it is day-to-day running of hospitals, education or telemedicine.

The hospital today boasts of an integrated HIS, which provides for end-to-end integration of the various processes and functional areas within the hospital to make for a seamless workflow. The work processes hospital are primarily divided into two areas the patient (comprising of in-patient and out-patient) and the non-patient all the back-end departments like housekeeping, engineering, finance, materials, purchase and HRD.

Other Business units

Apollo Global Project consultancy

Apollo offers project and operations management consultancy services with the support of operational and functional specialists. The pre & post commissioning consultancy services include feasibility studies, strategic planning, infrastructure consultation, human resource recruitment, training and medical equipment consultancy, management contracts, establishment of medical and administrative protocols etc.

Apollo Health and Lifestyle Limited

Apollo Health and Lifestyle Limited, has established over 100 Apollo Clinics across the country, is an integrated model and offers facilities for specialist consultations, diagnostics, preventive health checks and 24-hour Pharmacy, all under one roof.

Apollo Pharmacy

Apollo Pharmacy is India's first and largest branded pharmacy network; with over 750 retail outlets in key locations across the country. The group adds one pharmacy every 23 hours.

Apollo Hospitals Education and Research Foundation

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AHERF was set up to establish, maintain and support educational institutions in promoting medical, paramedical and hospital management courses. The Institute offers over 18 post graduate teaching programmes, including ones certified by the Royal College of Edinburgh. MedVarsity Online Limited is backed by two giants; Apollo in medicine and NIIT Limited in the field of electronic-education. MedVarsity has developed in-house, over 1500 hours of medical content that is accessible to the medical community, anytime and anywhere. The research division currently undertakes diverse projects from clinical trials in multiple locations to molecular biology, stem cell transplants, epidemiological studies, and in the future identification of genetic Biomarkers.

Apollo Insurance Company limited

Apollo DKV is a joint venture of the Apollo Hospitals Group and DKV AG, Europe's largest private health insurer and a Munich Re Group company. The company offers innovative health insurance, wellness solutions and disease management to meet customer needs.

Apollo wellness plus

Apollo Hospitals launched the first Wellness Centre at Apollo Hospitals Chennai in Feb 2005. Wellness Plus is the perfect blend of modern and complementary medicine like aromatherapy, pranic healing, yoga, and meditation that fits the modern lifestyle.

Apollo Pharmacy

Apollo Pharmacy operates round the clock catering to all your medicine needs.

Café Apollo

Café Apollo is a sit down dining facility of the hospital. It offers a wide selection of snacks and a variety of meals.

Apollo Food Plaza

There is food facility located in the atrium of the hospital serving a delightful array of delicacies. Timings : 8.00am - 9:00pm

Fast Food Cafe

For the convenience of ICU attendants there is a 24 hours cafe in the ICU lobby.

Gift Shop

The Gift Shop carries a wide range of gifts including Confectionery, Cards, Books, Newspapers, Magazines and other novelties.

Bank Facilities

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The Oriental Bank of Commerce The Indraprastha Apollo Branch of the Oriental Bank of Commerce is located at one of the Gates.

Bank Hours

Monday to Friday : 10:00am - 2:00pm

Saturday : 10:00am - 12:00pm

The bank remains closed on Sundays and National Holidays.

Porter’s Five force model for Industry Analysis

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Threat of new Entrant

entry ease/barriers geographical factors incumbents resistance new entrant strategy routes to market

Supplier Power

1. brand reputation2. geographical

coverage3. product/service

level quality

Buying Power

buyers size/number change cost/frequency product/service

importance volumes, JIT scheduling

Competitive Rivalry

number and size of firms industry size and trends fixed v variable cost bases product/service ranges

Product and Technology Development

alternatives price/quality market distribution

changes fashion and trends legislative effects

Business strategy

Apollo‟s business model has been a successful as it is able to generate profit even in the face of being capital intensive in nature. Our mission is to continuously keep improving the quality of healthcare services provided to the communities we serve and strive to bring healthcare services of international standards within the reach of every individual. At the same time, we seek to generate strong financial performance and appropriate returns to our investors through disciplined and balanced execution of a comprehensive business strategy that reinforces both quality of care and financial strength. We seek to further strengthen our position as a leading healthcare service company by successfully differentiating our service offerings and increasing the scale of operations. We would be looking to dominate the healthcare space by increasing bed strength in the cities where we are already present in addition to commissioning of new hospitals in Tier 2 and Tier 3 cities through the “Reach initiative”. The Reach model is expected to be a “no-frills” model, providing cost-effective quality healthcare. The facilities shall be of the level of higher secondary and acute care, capable of developing into a tertiary care centre. Each facility will be conceptualized to cater to the shortage in nursing infrastructure in the country, by providing for nursing colleges. Leverage our intellectual property and domain knowledge to create “Centres of Excellence” of high-end medical care services at the new and existing facilities. Share best practices across all the locations to enable increase occupancies at newly launched hospitals.

Improve asset utilization across all the hospitals. We have also made significant investment in our human capital to meet both our in-house needs and our consultancy services business through the establishment of nursing schools and colleges and hospital administration colleges. Growth in Standalone Pharmacies revenues would be driven by new store rollouts as well as maturity of existing stores. We also believe that growth can also be achieved as we add new service lines in our existing markets, invest in new technologies desired by physicians and patients, and demonstrate the quality of the care provided in our facilities. Given the non-availability of adequate health care facilities in most parts of India, we believe that high-growth opportunities remain in our existing markets as well as new geographies that we are seeking to enter.

Some suggestions for improving the positions of the Apollo Hospitals

1. The general perception that large hospitals, with high bed-occupancy rate, are profitable, is misleading. Global experience shows that hospital with more than 250 beds don‟t do well. Many Indian hospitals are following the US healthcare industry, by

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decreasing the average length of stay of patients and increasing patient turnover. US research shows that 80% of the revenues form a patient comes in the first 72 hours post- admission. Hospitals generate a lot of revenues from General Inspection, because the patient turnover is very high. A large percent of revenues come from specialized services like operations and surgeries. It is because of these reasons that many corporates are planning for a small 100 beds specialized hospitals, which caters to specific diseases like cardiac, cosmetic surgery, neurology etc. Research shows that there exist a lot of space for super-specialized hospitals with 100-150 beds, which generate revenues equivalent to large 500 bed general hospital. Typically large hospitals with approximately 500 bed capacity takes about 9-10 years to break even whereas super-specialty hospitals with about 100 beds take about 6-7 years to break even. Therefore, going in for super-speciality hospitals seems to be a more viable option today.

2. Hospitals could also generate revenues from medicines if they are supplying them in-house. Some hospitals make it mandatory for the patients to buy medicines from the hospital‟s chemist shop. A margin of 15-20 % can be charged for such medicinal supplies. Though many hospitals run by Trusts do not earn this way, but new entrants or corporates for whom private healthcare sector is a direct extension of their line of business ( eg. Pharma companies), can generate good returns from medicine supply.

3. Health Plan packages can be provided by hospitals to family and corporate. For example Family Health Plan Services (FHP), a subsidiary of Apollo Hospitals does health management of employees of its clients.With a wide net work of Hospitals and Healthcare providers countrywide, and a tie -up with General Insurance Corporation of India, FHP offers a range of services to employees and dependants, such as Preventive Healthcare, Corporate Counseling, welfare Programmes, Claims Administration, Patient-care Coordination and so on. So FHP's healthcare packages, optimize the benefits while keeping the cost under control.

4. Apart from preventive healthcare, stress management programs could be provided. For example „Effective Stress Management Programme‟ offered by Wockhardt Hospital. This programme provides a medical perspective of stress and is conducted by a medical professional. The programme includes a series of one-to-one sessions, with a clinical Psychologist highlighting the factors responsible for inducing stress, and the methodologies, which can be adopted to cope with this phenomenon practically.

5. Hospitals can become integrated healthcare systems i.e. when medicines, food services, laundry and linen etc will become "purchased" services. These third-party operations will increase the profit margins.

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6. Mergers could be used for synergy of skills - i.e. to help the merged organisations benefit from one another's individual strengths by applying them across the board. It also helps them to make joint investments in branding or information technology and also to react effectively to the changed market forces. Alternatively hospitals can go in for Group Purchases, as in USA. The buying power of large GPOs in USA like Premier, VHA / UHC and AmeriNet gives them the clout to exert price pressure on suppliers, particularly for products in lower demand. And as GPOs have consolidated, manufacturers have offered bigger discounts to hang on to their contracts. So there exists a lot of supply management opportunity, which will affect spending productivity.

SWOT Analysis

Strengths

Provides end to end services to the patients

All hospitals equipped with the well maintained pharmacy where it has got unique advantage compared to competitors.

Best technology & resources to deliver quality services

Good infrastructure and quality resources

Weakness

It has added 297 stand-alone pharmacies during the year, since most of the pharmacies are in the incubation stage which can depress the margin.

High attrition rate among the nursing workforce to western countries and competitors due to high salaries and perks being offered requires higher investment for providing requires training to keep the quality services.

Opportunities

In India every 1000 persons 1.1 beds are available. An investment of Rs.3480 billion is required

Booming Medical Tourism: Increasing number of medical tourists.

In India every 1000 persons 0.3 doctors 0.8 nurses are available.

Threats

Medical Equipment accounts 40-45 % of the total expenditure in hospitals constant investment in new healthcare care devices i.e. in upgrading the technology.

US is trying to provide health care services in low cost as per new president plan Obama care, this may reduce revenue.

Why Customer Service Matters in the Healthcare Industry?

The importance of customer service is a given in business, where companies such as Zappos and Southwest Airlines have built their success and reputations on the concept of delivering an outstanding customer experience. Yet traditionally, this philosophy unfortunately has not translated to healthcare, and more specifically, hospitals or health systems. This is especially unfortunate

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because hospital “customers” are very different than those in any other industry for one important reason—they don’t want to be there. The experience is scary, confusing, and they often feel as though no one understands them. Yet often these same patients are made to feel that because healthcare is a necessity rather than a luxury; they aren’t entitled to a superior patient experience. And this is probably the biggest mistake our industry makes.

In fact, the focus on the customer/patient should be the most important thing in healthcare—and it can be a real differentiator for hospitals. But for many hospitals, patient experience is about making and keeping patients happy, which misses the point completely because patient experience is also about a hospital’s philosophy about the delivery of care. Yet too many doctors spend hours improving their medical knowledge, without thinking about improving their approach to patient care.

Customers in any other industry get to vote with their wallets. If they don’t like the service at a restaurant, they don’t go back. If they have a bad experience ordering online from one company, they’ll just use another company the next time. The hospital industry hasn’t had that same type of pressure before, but things are changing, especially as we prepare for a new world of healthcare service outlined by the Affordable Care Act. The Medicare-required, 27- question Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey asks patients about such things as communication with doctors, communication with nurses, responsiveness of hospital staff, and communication about medicines. And the implications of that survey are financial and they are real: beginning this year, nearly $1 billion of Medicare reimbursements are contingent upon the results of the survey, as well as data on the quality of care publicly available online. That trend is expected to continue into the private sector as well.

Many in the healthcare industry are already recognizing the financial benefits of focusing on an excellent patient experience. According to a survey from Health Leaders, 36 percent of respondents—senior hospital leadership, doctors, and nurses— cite improving HCAHPS scores as the main goal of patient experience efforts.

But what’s in it for the patient? What does great customer service in a hospital actually look like? The answer really isn’t that different than for any other industry. It all boils down to two concepts: attention and communication. Yes, that probably seems incredibly simple, but the truth is that too many patients are going through sometimes life-changing medical procedures in hospitals without those two basic needs—and rights—being met.

Being in the hospital can be a scary time. It’s an unfamiliar environment where there are sometimes more questions than answers. Patients are woken up every few hours to have their vitals taken or be given medication—all with a stranger in the bed next to theirs (unless they’re one of the few who can afford a private room). In short, it’s an experience—from the doctors to nurses to food to medication. And it’s one that needs to be communicated, soup to nuts, before the patient ever steps through the door. As “paying customers”, it’s what we all deserve.

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Whether there are 50 or 500 patients in a hospital, it is a patient’s right to feel as though he or she is the only one there. This means attention from doctors and nurses at all feasible times, time to understand what each medication treats and any possible side effects, and, most important, what to do after discharge.

Customer service in the healthcare industry is an idea whose time has come—and it deserves serious attention. Given the impending changes brought on by the Affordable Care Act, the patient experience is going to likely be more important to hospitals than ever before. Unfortunately, patients are already so disillusioned with the hospital system that they believe they shouldn’t expect the same superior customer service there that so many other companies proudly proclaim. But nothing could be further from the truth—customer service is something our patients should demand. It’s up to us to deliver it so we not only deliver the best possible care, but so that in return we are given something that every business covets: satisfied and repeat customers.

GDP Contribution

The health industry has emerged as one of the most challenging sectors as well as one of the largest service sector industries in India with an estimated revenue of UA$35 billion; it constitutes 5.2% of India’s GDP and employs 4 million people. The Indian health industry is expected to grow at 15% per annum to US$78.6, reaching 6.1% of GDP and employing 9 million people by 2012.

Recognizing the significant potential and challenges in the health sector, the government has prioritized it in the Eleventh Five Year Plan. The private sector plays a significant role by contributing 4.3% of GDP and 80% share of healthcare provision. However, deficiencies persist with respect to access, affordability, efficiency, quality and effectiveness, despite the high level of overall private and public expenditure on health.

In order to be comparable with the healthcare parameters of other developing countries, India’s healthcare sector faces many challenges. For example, to reach a ratio of two beds per 1000 population by 2025, an additional 177 billion beds will be required which willl need a total investment of US$86 billion. There is an acute shortage of doctors, nurses, technicians and healthcare administrators and an additional 0.7 million doctors are needed to reach a doctor population ratio of 1:1000 by 2025. Although the health insurance sector is projected to grow to US$3.8 billion in collected premiums by 2012 from the annual collected premium of US$711 million in 2006, there is a dismal health insurance penetration rate; at present only 2% of the total population is insured.

For the desired changes and a healthy growth of the healthcare sector, a well-defined partnership between the government and the private sector is essential.

The Health Services Committee has been pivotal in facilitating interaction among stakeholders to jointly work towards Health Services reforms and provision of ‘Quality Healthcare to All’, a fundamental right of each Indian citizen. In view of the inadequate healthcare infrastructure, human resource, regulations and quality, the Committee has submitted recommendations to the Government from time to time.

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Objectives

Provide recommendations for policy change and regulatory reforms Promote and disseminate information on Quality Assurance Mechanism Facilitate streamlining of sectoral issues amongst stakeholders Develop white papers on relevant issues with stakeholder consultation Provide Networking and collaboration Platform

Statistical Data

Rank

2004-05

2005-06

2006-07

2007-08

2008-09

2009-10

2010-11

1 Apollo Hospitals Enterprise Ltd. 29.96 27.92 26.7 23.64 21.66 21.21 23.492 Indraprastha Medical Corpn. Ltd. 9.47 8.55 7.36 6.64 5.83 4.95 4.43 Max Healthcare Institute Ltd. 1.73 2.35 3.62 3.79 3.26 3.09 3.14 Quality Care India Ltd. 4.9 4.74 4.63 4.09 3.55 3.02 2.845 Fortis Healthcare Ltd. 2.92 3.91 3.72 3.2 2.51 2.38 2.546 S R L Ltd. 2.37 2.32 1.93 2.02 1.93 2.257 Apollo Gleneagles Hospitals Ltd. 3.35 3.18 2.89 2.37 2.1 1.97 2.228 Amri Hospitals Ltd. 0.88 0.76 0.68 2.23 2.14 2.149 Sterling Addlife India Ltd. 1.84 1.59 1.73 2.01

10 S R L Diagnostics Pvt. Ltd. 2.1 2.37 2.26 1.9611 Wockhardt Hospitals Ltd. 5.94 6.26 7.09 7.53 6.48 4.7 1.7812 International Hospital Ltd. 0.67 1.92 2 1.77 1.45 1.48 1.78

13Kovai Medical Center & Hospital Ltd. 2.33 2.3 2.17 1.53 1.64 1.51 1.76

14 Miot Hospitals Ltd. 1.86 1.82 1.87 1.68 1.76 1.65 1.6415 Artemis Medicare Services Ltd. 0.38 1.15 1.46 1.56

16Malabar Institute Of Medical Sciences Ltd. 1.32 1.18 1.1 0.98 0.91 0.95 1.37

17 Fortis Hospitals Ltd. 1.53 1.3318 Sahyadri Hospitals Ltd. 0.12 0.21 0.65 1.12 1.01 1.04 1.3119 Kims Health Care Mgmt. Ltd. 1.15 1.56 1.67 1.53 1.33 1.18 1.29

20Krishna Institute Of Medical Sciences 1.77 1.71 1.46 1.26

21 Mandke Foundation 0.14 1.4 1.21

22Escorts Heart & Super Speciality Hospital Ltd. 0.01 0.44 0.74 1.18

23Asian Heart Institute & Research Centre Pvt. Ltd. 1.79 2.58 1.76 1.27 1.32 1.15

24 Shalby Ltd. 0.36 0.51 0.52 0.37 1.09 1.17 1.0125 Kailash Health Care Ltd. 1.37 1.29 1.16 126 Breach Candy Hospital Trust 3.35 2.85 2.38 1.75 1.34 1.15 0.9927 Aditya Birla Health Services Ltd. 0.1 0.5 0.72 0.78 0.9128 Pulikkal Medical Foundation 1.8 1.66 1.71 1.31 0.99 0.9 0.9129 Jaypee Development Corpn. Ltd. 0.77 0.9130 Billroth Hospitals Ltd. 0.33 0.33 0.34 0.67 0.72 0.89 0.9

31Imperial Hospital & Research Centre Ltd. 0.5 0.86 0.78 0.89

32 Rama Medicares Ltd. 0 0.07 0.12 0.15 0.29 0.41 0.8633 Fortis Malar Hospitals Ltd. 0.68 0.6 0.51 0.39 0.49 0.75 0.84

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Investments : Health Services Industry2010-11 to 2015-16Year Value of projects commissioned Capacity addition

Rs. million Beds2010-11 29,022.10 8,010.002011-12 47,491.80 8,783.002012-13 45,339.90 10,471.002013-14 53,042.80 17,142.002014-15 1,03,520.70 20,539.002015-16 1,05,612.00 14,135.00

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Latest Developments

Health services industry’s capacity to increase by 11,900 beds during 2015-16

Aggregate net sales of health services industry rise by 12.6% y-o-y in December 2013 quarter

Union Budget 2014-15: Arun Jaitley announces to set up 4 new AIIMS-like institutions

Health care industry on a capex spree Projects worth Rs.206.8 billion to come up during 2013-15

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