moh-psp initiatives - invest saudi · private sector participation (psp) aims to… increase the...
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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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Primary Health Care (PHC)Findings Highlights
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).
Primary Health Care (PHC)Findings Highlights
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Primary Health Care (PHC)Findings Highlights
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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Medical Cities and Hospital CommissioningFindings Highlights
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
Medical Cities and Hospital CommissioningFindings Highlights
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Medical Cities and Hospital CommissioningFindings Highlights
Details or source documentInformationCategory
Project details
Specificadvantages
Businesscase
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
▪ 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)
▪ 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, 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 expected IRR is depending on the financial model and bidders prices
▪ The project is expected to serve more than 500,000 population in Madinah and 300,000 population in Riyadh
▪ 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 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
Details or source documentInformationCategory
Project details
Specificadvantages
Businesscase
Location options
Purpose/ Idea
Infrastructure & Resources
Other advantage/ incentives
Timeline
Investment
Returns
Revenue model
Overview
PRO
JECT
/ DEA
L LE
VEL
Minimum requirement Optional information
▪ 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)
▪ Ability to have a commercial investment within the property as well as benefits such as land utilization, credit support, low tax and material exemptions
▪ 12-18 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
▪ The expected IRR is depending on the financial model and bidders prices
▪ PPP project that is based on guaranteed offtake agreement which will be structured according to the prices provided by the transaction advisors and bidders
RadiologyFindings Highlights
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RadiologyFindings Highlights
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
RadiologyFindings Highlights
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Details or source documentInformationCategory
Project details
Specificadvantages
Businesscase
Location options
Purpose/ Idea
Other details
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 :-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)
▪ The expected IRR is depending on the financial model and bidders prices
▪ Total size of the project is from 150 to 200 million SAR / 400K examinations annually
▪ PPP project that is based on guaranteed offtake agreement which will be structured according to the prices provided by the transaction advisors and bidders
RadiologyFindings Highlights
LaboratoriesFindings Highlights
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LaboratoriesFindings Highlights
%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
LaboratoriesFindings Highlights
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Details or source documentInformationCategory
Project details
Specificadvantages
Businesscase
Location options
Purpose/ Idea
Other details
Infrastructure & Resources
Other advantage/ incentives
Timeline
Investment
Returns
Capacity/ Size
Revenue model
Overview
PRO
JECT
/ DEA
L LE
VEL
Minimum requirement Optional information
▪ 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)
▪ Ability to have a commercial investment within the property as well as benefits such as land utilization, credit support, low tax and material exemptions
▪ 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)
▪ The expected IRR is depending on the financial model and bidders prices
▪ 9 million tests annually / Approximately 350 million USD project size (PHC only)
▪ PPP project that is based on guaranteed offtake agreement which will be structured according to the prices provided by the transaction advisors and bidders
LaboratoriesFindings Highlights
New Initiatives Opportunities
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Details or source documentInformationCategory
Project details
Specificadvantages
Businesscase
Location options
Purpose/ Idea
Other details
Infrastructure & Resources
Other advantage/ incentives
Timeline
Investment
Returns
Capacity/ Size
Revenue model
Overview
PRO
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/ DEA
L LE
VEL
Minimum requirement Optional information
▪ 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.
▪ Ability to have a commercial investment within the property as well as benefits such as land utilization, credit support, low tax and material exemptions
▪ 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 4 billion U.S Dollar)
▪ The expected IRR is depending on the financial model and bidders prices
▪ 17000 Patients
▪ PPP project that is based on guaranteed offtake agreement which will be structured according to the prices provided by the transaction advisors and bidders
National Dialysis Project
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Details or source documentInformationCategory
Project details
Specificadvantages
Businesscase
Location/ Capacity
Purpose/ Idea
Other details
Infrastructure & Resources
Other advantage/ incentives
Timeline
Investment
Returns
Revenue model
Overview
PRO
JECT
/ DEA
L LE
VEL
Minimum requirement Optional information
▪ 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
▪ Ability to have a commercial investment within the property as well as benefits such as land utilization, credit support, low tax and material exemptions
▪ 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 800 Million U.S Dollar)
▪ The expected IRR is depending on the financial model and bidders prices
▪ PPP project that is based on guaranteed offtake agreement which will be structured according to the prices provided by the transaction advisors and bidders
National Air Ambulance Project
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Extended Care Details or source documentInformationCategory
Project details
Specificadvantages
Businesscase
Location options
Purpose/ Idea
Infrastructure & Resources
Other advantage/ incentives
Timeline
Investment
Returns
Revenue model
Overview
PRO
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/ DEA
L LE
VEL
Minimum requirement Optional information
▪ 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)
▪ Ability to have a commercial investment within the property as well as benefits such as land utilization, credit support, low tax and material exemptions
▪ 12-18 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
▪ The expected IRR is depending on the financial model and bidders prices
▪ PPP project that is based on guaranteed offtake agreement which will be structured according to the prices provided by the transaction advisors and bidders