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CHAPTER III

AN OVERVIEW OF ACQUISITION AND HEALTH CARE SECTOR

Healthcare in India features a universal health care system run by the

constituent states and territories of India. The constitution charges every

state with raising the level of nutrition and the standard of living of its people

and the improvement of public health as among its primary duties.

The national health policy was endorsed by the parliament of India in 1983

and updated in 2002.

Parallel to the public health sector, and indeed more popular than it, is

the private medical sector in India. Both urban and rural Indian household

tend to use private medical sector more frequently than public sector, as

reflected in surveys.

The Indian healthcare sector is expected to reach US$ 100 billion by

2015 from the current US$ 65 billion, growing at around 20 per cent a year,

according to rating agency Fitch. Some of the major factors driving the

growth in the sector include increasing population, growing lifestyle related

health issues, cheaper costs for treatment, thrust in medical tourism,

improving health insurance penetration, increasing disposable income,

government initiatives and focus on Public Private Partnership (PPP)

models.

Further, the Indian pharmaceutical market is also set to witness

medium-term growth. The sector is expected to grow at 15.3 per cent from

2011-12 to 2013-14, according to a Barclays Capital Equity Research Report

on India Healthcare and Pharmaceuticals.

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Meanwhile, the Government of India has decided to increase health

expenditure to 2.5 per cent of Gross Domestic Product (GDP) by the end of

the twelfth five year plan (2012-17), from the existing 1.4 per cent. Prime

Minister, Dr. Manmohan Singh also emphasized the need for increased

outlay to health sector during the twelfth five year plan.

3.1. HEALTH CARE ISSUES

3.1.1. Malnutrition

Forty two per cent of India‟s children below the age of three are

malnourished, which is greater than the statistics of sub-Saharan African

region of 28 per cent. Although India‟s economy grew 50 per cent from

2001-2006, its child-malnutrition rate only dropped one per cent, lagging

behind countries of similar growth rate. Malnutrition impedes the social and

cognitive development of a child, reducing his educational attainment and

income as an adult. These irreversible damages result in lower productivity.

3.1.2. High infant mortality rate

Approximately 1.72 million children die each year before turning one.

The under five mortality and infant mortality rates have been declining, from

202 and 190 deaths per thousand live births respectively in 1970 to 64 and

50 deaths per thousand live births in 2009. However, this rate of decline is

slowing. Reduced funding for immunization leaves only 43.5 per cent of the

young fully immunized.

3.1.3. Diseases

Diseases such as dengue fever, hepatitis, tuberculosis, malaria and

pneumonia continue to plague India due to increased resistance to drugs. In

the year 2011, India developed a totally drug-resistant form of tuberculosis.

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India is ranked third among the countries with the most infected in Human

Immunodeficiency Virus (HIV). Diarrheal diseases are the primary causes of

early childhood mortality. These diseases can be attributed to poor sanitation

and inadequate safe drinking water in India.

However in 2012 India was polio free for the first time in its history.

This was achieved because of Pulse Polio Programme was started in 1995-96

by Government of India.

Indians are also at particularly high risk for atherosclerosis and

coronary artery disease. This may be attributed to a genetic predisposition to

metabolic syndrome and changes in coronary artery vasodilatation. Non

Governmental Organizations (NGOs) such as the Indian Heart Foundation

and the Medwin Foundation have been created to raise awareness about this

public health issue.

3.1.4. Poor Sanitation

As more than 122 million households have no toilets, and 33 per cent

lack access to latrines; over 50 per cent of the population (638 million)

defecates in the open. This is relatively higher than Bangladesh and Brazil (7

per cent) and China (4 per cent). Although 211 million people gained access

to improved sanitation from 1990–2008, only 31 per cent uses them. 11 per

cent of the Indian rural families dispose of stools safely whereas 80 per cent

of the population leave their stools in the open or throw them in the

garbage. Open air defecation leads to the spread of diseases and malnutrition

through parasitic and bacterial infections.

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3.1.5. Inadequate safe drinking water

Access to protected sources of drinking water has improved from 68

per cent of the population in 1990 to 88 per cent in 2008.However, only 26

per cent of the slum population has access to safe drinking water, and 25 per

cent of the total population has drinking water on their premises. This

problem is exacerbated by falling levels of groundwater caused mainly by

increasing extraction for irrigation. Insufficient maintenance of the

environment around water sources, groundwater pollution, excessive arsenic

and fluoride in drinking water pose a major threat to India's health.

3.1.6. Rural health

Rural India contains over 68 per cent of India's total population with

half of it living below poverty line, struggling for better and easy access to

health care and services. Health issues confronted by rural people are diverse

and many-from severe malaria to uncontrolled diabetes, from a badly

infected wound to cancer. Postpartum maternal morbidity is a serious

problem in resource-poor settings and contributes to maternal mortality,

particularly in rural India.

3.1.7. Female Health Issues

a. Malnutrition

According to tradition in India, women requires to eat last, even

during pregnancy and lactating period, which is the main cause of female

malnutrition.

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b. Breast Cancer

One of the most growing problems among women causing an

increased number of mortality rates in India.

c. Polycystic Ovarian Disease (PCOD)

The Polycystic ovarian disease (PCOD) is another issue causing

increase in infertility rate in females. It is a condition in which there are

many small cysts in the ovaries, which can affect a woman's ability to

conceive.

d. Maternal Mortality

Indian maternal mortality rates in rural areas are highest amongst the

world.

3.2. National Rural Health Mission (NRHM)

The National Rural Health Mission (NRHM) was launched in April

2005 by the government of India. The goal of the national rural health

mission was to provide effective healthcare to rural people with a focus on

18 states which have poor public health indicators and/or weak

infrastructure.

3.3. Steps of Mergers and Acquisition Process

The process of mergers and acquisition has the following steps:

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3.3.1. Market Valuation

Before going for any merger and acquisition, it is almost important

that we must know the present market value of the organization as well as its

estimated future financial performance. The information about organization,

its history, products and services, facilities and ownerships are reviewed.

Sales organization and marketing approaches are also taken into

consideration.

3.3.2. Exit Planning

The decision to sell business largely depends upon the plan of the

organization-what does it target to achieve and how it is going to handle the

wealth and so on. Various issues like estate planning, continuing business

involvement, debt resolution and so on. As well as tax issues and business

issues are considered before making exit planning. The structure of the deal

largely depends upon the available options. The form of compensation (such

as cash, secured notes, stock, convertible bonds, royalties, future earnings

share, consulting agreements, or buy back opportunities etc.) also plays a

vital role here in determining the exit planning.

3.3.3. Structured Marketing Process

This merger and acquisition process involves marketing of the

business entity. While marketing, selling price is never divulged to the

potential buyers. Serious buyers are also identified and then encouraged

during the process.

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3.4. Mergers and Acquisitions in different Sectors in India

Sector wise, large volumes of the mergers and acquisitions in India

have occurred in finance, telecom, Fast Moving Consumer Goods (FMCG),

construction materials, automotives and metals. In 2005, finance topped the

list with 20 per cent of total value of mergers and acquisitions in India taking

place in this sector. Telecom accounted for 16 per cent, while FMCG and

construction material accounted for 13 percent and 10 percent respectively.

In the telecom sector, an increase of stakes by Sing Tel from 26.96 per

cent to 32.8 per cent in Bharti Telecom worth $ 252 million ( Rs.10.9 billion

in Indian currency). In the Foods and FMCG sector a controlling stake of

Shaw Wallace and Company was acquired by United Breweries Group

owned by Vijay Mallya. This deal was worth $ 371.6 million (Rs. 16.2

billion in Indian currency). Another important one in this sector, worth $

48.2 million (Rs. 2.1 billion in Indian currency) was the acquisition of 90

percent stake in Williamson Tea Assam by McLeod Russell India. In

construction materials 67 per cent stake in Ambuja Cement India Limited

was acquired by Holcim, a Swiss company for $ 634.9 million (Rs 27.3

billion in Indian currency).

3.5. Concepts and Operational Definitions

Mergers, acquisitions and takeovers have been a part of the business

world for centuries. In today‟s dynamic economic environment, companies

are often faced with decisions concerning these actions-after all; the job of

management is to maximize shareholder value. Through mergers and

acquisitions, a company can develop a competitive advantage and ultimately

increase shareholder value. The above terms stated by layman may seem

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alike but in legal and corporate terminology, they can be distinguished from

each other.

3.5.1. Merger

A full joining together of two previously separate corporations. A true

merger in the legal sense occurs when both business dissolve and fold their

assets and liabilities into a newly created third entity. This entails the

creation of a new corporation.

3.5.2. Acquisition

Taking possession of another business. Which is also called a takeover

or buyout. It may be share purchase the buyers buys the shares of the target

company from the shareholders of the respective target company. The buyer

will take on the company with all its assets and liabilities or asset purchase

(buyer buys the assets of the target company from the target company).

3.5.3. Joint Venture

Two or more business concerns joining together under a contractual

agreement to conduct a specific business enterprise with both parties sharing

the profits and losses. The venture is only for one specific project only,

rather than for a continuing business relationship as in a strategic alliance.

3.5.4. Strategic Alliance

A partnership firm with another business firm in which the combine

efforts in a business, involving anything from getting a better price for goods

by buying in bulk together to seeking a business together for providing a part

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of the product. The basic idea behind alliances is to minimize risk while

maximizing the leverage.

Many mergers are in fact acquisitions. One business actually buys

another and incorporates it into an own business model. Because of this

misuse of the term merger, many statistics on mergers are presented for the

combined mergers and acquisition that are occurring. This gives a broader

and more accurate view of the merger market.

3.6. Impact of Mergers and Acquisitions

Have a look at the impact of mergers and acquisitions on different

segments of the business.

3.6.1. Impact on Employees

Mergers and acquisitions may have great economic impact on the

employees of the organization. In fact, mergers and acquisitions could be

pretty difficult for the employees as there could always be the possibility of

layoffs of any post merger or acquisition. If the merged company is pretty

sufficient in terms of business capabilities, it does not need the same

quantum of employees that it previously had to do the same amount of

employees that it previously had to do the same amount of business. As a

result, layoffs are quite inevitable. Besides, those who are working would

also see some changes in the corporate culture. Due to the changes in the

operating environment and business procedures, employees may also suffer

from emotional and physical problems.

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3.6.2. Impact on Management

The percentage of job loss may be higher in the management level

than the general employees. The reason in behind this aspect is the corporate

culture clash. Due to change in corporate culture of the organization, many

managerial level professionals, on behalf of their superiors, need to

implement the corporate policies that they might not agree with. It involves

high level of stress.

3.6.3. Impact of Shareholders

Impact of mergers and acquisitions also include some economic

impact on the shareholders. If the purchase is taking place the shareholders

of the acquired company enjoys most of the benefit from the acquisition as

the acquiring company pays a hefty amount for the acquisition. On the other

hand, the shareholders of the acquiring company suffer some losses after the

completion of acquisition process due to the acquisition premium and

augmented debt load.

3.6.4. Impact on Competition

Mergers and acquisitions have different impact as far as market

competitions are concerned. Different industry has different level of

competitions after the mergers and acquisitions. For example, the

competition in the financial services industry is relatively constant. On the

other hand, change of powers can also be observed and wanted among the

market players.

Mergers and acquisitions are parts of corporate strategies that deal

with buying and selling or combining of business entities, which in turn, help

a company to grow very fastly. However, merger and acquisition process is

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quite a complex process that consists of a few steps. Before going for any

merger and acquisition, both the companies need to consider a few points

and also need to go through some distinct steps. The merger and acquisition

process is also a high point of concern for the companies which are involved

in the deal, as the process could be full of risk and uncertainly. However,

prior effective planning and research could make the process easy and

simple.

3.7. Profile of the Select Hospitals in India

3.7.1. Profile of Apollo Hospitals Enterprise Limited

In 1983, Dr.Prathap C Reddy, the architect of Indian healthcare,

launched the first corporate hospital in India, Apollo Hospitals Chennai.

Over the years, the Apollo Hospitals group has grown to become one of

Asia‟s largest integrated healthcare organizations with over 8,500 beds

across 54 hospitals, more than 1200 pharmacies and over 100 diagnostic

clinics.

The group also offers medical business process outsourcing services,

health insurance services and clinical research divisions with a focus on

epidemiological studies, stem cell research and genetic research. To develop

talent for the burgeoning need of superior healthcare delivery, the Apollo

hospitals group has 11 nursing and hospital management colleges. These

achievements have earned Apollo hospitals group several accolades,

including the centre of excellence from the government of India and

recognition from the Joint Commission International (JCI).

In a rare honor, the government of India issued a commemorative

stamp in recognition of Apollo‟s contribution, the first for a healthcare

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organization. The Apollo hospitals Chairman, Dr Prathap C Reddy, were

conferred with the prestigious Padma Vibhushan award, in 2010. The Apollo

hospitals group, for over 28 years, has continuously excelled and maintained

leadership in medical innovation, world-class clinical services and cutting-

edge technology. The hospitals are consistently ranked amongst the best

hospitals globally for advanced medical services and research.

The dream nurtured and grew within Dr. Prathap C Reddy, the

founder Chairman of Apollo hospitals, until the point of inflection happened

in 1983. A young man succumbing to an ailing heart was what it took to

ignite Dr. Reddy's vision into a reality where quality healthcare was given,

where the pursuit of clinical excellence was daily endeavor, India a hub in

the medical tourism map and where the Apollo family touches and enriches

lives every minute, every day. Today, with over 8500 beds across 54

hospitals, and a significant presence at every touch-point of the medical

value chain, Apollo hospitals is one of Asia‟s largest healthcare groups.

Commenced as a 150 bed hospital, today the group has grown exponentially

both in India and overseas. Its growth is often said to be synonymous with

India emerging as a major hub in global healthcare.

The Apollo hospital is driven by a single thrust, to provide the best

standards of patient care. It is this passion that has lead to the development

of unique centers of excellence across medical disciplines, within the Apollo

hospitals network. An Apollo hospital has Joint Commission International

(JCI) accreditations for seven of its hospitals, the largest by any hospital

group in the region. True to its founding principles, the group has made

quality healthcare accessible to the people of India, and even overseas. It has

become an institution of trust, and a beacon of hope to so many searching for

a cure for their ailments.

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The legacy of touching and enriching lives stems from the pillars of

the Apollo philosophy-experience, excellence, expertise and research. We

pride ourselves for constantly being on the cutting edge, and going the extra

mile to stay relevant and revolutionary. The Apollo hospitals group is the

pioneer of integrated healthcare delivery in India. This vision led the group

to earmark time and resources to strengthen each vital cog in the process of

healthcare delivery. As a result of these efforts, the group today is in a

unique position to exponentially increase its healthcare cover. This will be

critical in order to meet future requirements.

The Apollo hospitals group, today, is an integrated healthcare

organization with owned and managed hospitals, diagnostic clinics,

dispensing pharmacies and consultancy services. In addition, the group‟s

service offerings include healthcare at the patient‟s doorstep, clinical and

diagnostic services, medical business process outsourcing, third party

administration services and health insurance. In order to enhance

performance and service to customers, the company also makes available the

services to support business, telemedicine services, education, training

programs and research services and a host of other non-profit projects.

3.7.2. Profile of Fortis Healthcare Limited

The Fortis healthcare has been established with a vision to become a

global leader in the field of integrated healthcare. It is one of the fastest

growing integrated healthcare providers with multi-vertical presence that

touches millions of lives across 10 countries including Australia, Canada,

Dubai, Hong Kong, India, Mauritius, New Zealand, Singapore, Sri Lanka

and Vietnam.

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The Fortis healthcare has multi-vertical presence in emerging markets

in different healthcare verticals ranging from primary healthcare, day care

specialty healthcare, hospitals, dental clinics and diagnostics. Today, its

combined network comprises over 75 hospitals with more than 12,000 beds,

580 primary care centers, 188 day care specialty centers, 190 diagnostic

centers and a talent pool of over 4,000 doctors and 23,000 employees

making it amongst the largest integrated healthcare delivery networks in

Asia Pacific. Among its assets, Fortis healthcare international owns Quality

Healthcare Limited, the largest primary care network in Hong Kong; Dental

Corporation Private Limited, the largest dental care network in Australia and

New Zealand; Fortis Specialty Hospital, an under construction specialty

hospital in Singapore; a stake in 350 bed Lanka Hospitals Corporation, Sri

Lanka‟s largest super specialty hospital, and the largest private pathology

diagnostics laboratory in United Arab Emirates (UAE); and holds majority

stake in Hoan My Medical Corporation, one of Vietnam‟s largest private

healthcare provider groups.

This integration will unlock multiple synergies in growth, talent,

medical verticals and cost efficiencies. Its ability to service a wider spectrum

of patient population will also give it a unique proposition as a healthcare

provider of choice in the region. Its large pool of experienced clinical and

managerial talent, under the guidance of a strong global management team,

will help to cross-pollinate knowledge and capabilities across the enterprise.

a. Healthcare Services

The Fortis healthcare (India) is engaged in providing the latest in

internationally recognized medical care to patients with a variety of ailments

and medical conditions. The network consists of super specialty hospital

hubs that concentrate on one or more specialties. These hospitals are

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interconnected to a larger network of multi-specialty hospitals that ensures

patient access to expert care for any specialty. This unique network

architecture provides expert care to our patients and a level of confidence in

receiving the latest medicine has to offer.

b. Telemedicine

The Fortis healthcare (India) has built a tele-medicine network, which

connects each of its facilities, so expert care is never out of reach. In

addition, the Fortis healthcare (India) facilities are also working with both

private and public partners in the Indian healthcare industry to provide super

specialty and quality healthcare services. It provides services covering

Intensive Care Unit (ICU) Management, Emergency Resource Management,

Out Patient Department (OPD) Management, Radiology Reporting,

Pathology Reporting as well as Training and Education Opportunities.

Utilizing the strong Healthcare Infection Society (HIS) backbone,

and Picture Archiving Communication System (PACS) technology, this is

able to seamlessly transmit patient information in a secure and confidential

environment. The use of tele-medicine has provided a much-needed boost to

the Indian healthcare sector. It has also allowed our network to expand its

presence by extending quality healthcare treatment to the remote areas of

northern India as well as overseas.

c. Research

The Fortis healthcare (India), it believes in continuous learning,

innovation and improvement. It encourages medical practitioners and

healthcare experts for medical research and studies. For years, the Fortis

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healthcare has been involved in several healthcare and medicinal study

projects and offers societal rewards and benefits to researchers.

d. Corporate Services

Healthy employees contribute to a healthy business. The healthcare

delivery services in the top hospitals are specially designed to suit employee

needs. All patient records are accessible at all our hospitals across India so

that employee can access healthcare services at the centre most convenient to

them, choosing from a wide network of the group hospitals.

They offer a wide range of products and services to suit the company's

needs.

1. Outpatient Department Services - The network of top hospitals in

North India offer special packages to corporate employees and their

dependants on the outpatient department facilities listed below:

Doctor consultations

Pathological investigations

Radiological diagnostics such as X-Rays, Computed

Tomography (CT) Scan, Magnetic Resonance Imaging (MRI),

Ultrasound, Mammography

Non-invasive cardiology like Electrocardiography (ECG), Echo,

Tread Mill Test (TMT), Holter etc.

Neurology investigations such as Electroencephalogram (EEG),

Electromyography (EMG) etc.

Physiotherapy

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2. Inpatient Department offers certain services - Employees of

empanelled corporate are given special offers on all multi specialty

procedures and surgeries and on room rent.

3. Ambulance Facility - This facility can be availed of in times of

emergency. Dependants of members may also be eligible for these

facilities.

4. Health Awareness Lectures/ Workshops – Awareness workshops and

sessions are organized by eminent faculty members on diverse topics

at various hospital units as well as the corporate premises with the

intention of promoting a sense of well-being and fitness among

corporate personnel.

e. List of Empanelled Institutions

The Fortis group is empanelled with a number of top corporate and

Multi National Companies (MNCs), Public Sector Units (PSUs),

Government Bodies and Institutions, Ministries under the government of

India, Insurance Companies and Third Party Administrators (TPAs). Many

of these clients have chosen Fortis hospitals has their preferred healthcare

provider. The employees of these empanelled clients are given special offers

on preventive health check-up programmes, multi-specialty

procedures/surgeries and medical management services. This facility can be

availed of in times of emergency wherever and whenever needed. All

dependants of employees at the empanelled organization may also be eligible

for these facilities.

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3.7.3. Profile of the Kovai Medical Center and Hospital Limited

The Kovai Medical Center and Hospital (KMCH), the 657-bed Multi-

disciplinary advanced super specialty hospital located in a clean, serene 20

acre plot in Coimbatore offers total and comprehensive health solution for

various diseases. Comprehensive infrastructure, cutting edge technology,

latest hi-tech medical equipments in all specializations and committed

medical experts make KMCH trusted brand. The hospital has pioneered

several techniques like the steroid free kidney transplantation, Guglielmi

Detachable Coil (GDC) coiling and clipping for brain aneurysms which save

lives, improve patient comfort and minimize side effects.

The hospital has 20 operation theatres and modern equipments

including state of the art Varian Trilogy Linear Accelerator, world‟s most

advanced Positron Emission Tomography-Computed Tomography (PET-

CT) Scan, 3T Magnetic Resonance Imaging (MRI), 500 slice volume

Computed Tomography (CT) scanner, Endo Bronchial Ultra sound (EBUS),

4D Ultra Sound Scanner, Flat Panel Cath Lab, Cardiac Electro-physiology

Lab, Bone Mineral Densitometer, Mammography, Laser equipments, Video

Endoscope, Operating Microscope, Auto analyzer, Computer Assisted

Navigation for hip and knee replacements, Extracorporeal Shock Wave

Lithotripsy (ESWL) for the removal of urinary stones.

Super specialty procedures like open heart surgeries, Valve

replacements, Kidney transplants, Hip and knee replacements, Complex

brain surgeries and advanced spine surgeries are done regularly at the

hospital. At KMCH, the latest edition has been the state of the art

comprehensive cancer center. The hospital offers 24 hrs end to end services

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in cancer care from prevention to early detection, comprehensive treatment

to palliative care under one roof.

The Comprehensive Cancer center equipped with the world‟s most

advanced Positron Emission Tomography-Computed Tomography (PET-

CT) Scanner-True-point enabled Siemens Bio graph 6 for the first time in

Coimbatore and Western Tamil Nadu. This unique instrument; Positron

Emission Tomography-Computed Tomography (PET-CT) Scanner makes

KMCH one of the few centers in the world to provide this form of cutting

edge technology for cancer care. Cancer treatment requires accurate staging

of the disease by demonstrating its spread in the human body. The therapies

of cancer differ from patient to patient and cure is possible only with perfect

staging. World over the whole body Positron Emission Tomography-

Computed Tomography (PET-CT) is the gold Standard for cancer staging. A

Positron Emission Tomography-Computed Tomography (PET-CT) not only

stages cancer but it is the current choice for evaluating treatment response

and disease recurrence in oncology.

Highly qualified and experienced team of professionals in KMCH

offers advanced radiation treatment for cancer control and cure. This hospital

provides rapid arc therapy with Intensity Modulated Radiation Therapy

(IMRT), image Guided Radio Therapy, Stereotactic Surgery (SR), 4D gated

Radiotherapy and Stereotactic Body Radiation Therapy (SBRT). The

hospital is very actively involved in preventive health checkup Programmes.

There are various preventive health checkup programmes such as premium

master health checkup with Cardiac Computed Tomography (CT) Angio and

Conventional Angio, Executive Master Health Checkup, KMCH Cancer

Screening programme with whole body positron emission Tomography-

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Computed Tomography (PET CT) and Tumor markers, routine and pre-

employment health checkups.

At the hospital emphasis is on a patient centric culture. All the

systems, people and processes are geared towards delivering total care to

each individual patient. This philosophy cuts across every level of service

from the doctors and nurses to the administrative and support staff.

The hospital has over 150 internationally renowned full time specialists and

over 250 post graduate medical professionals assisting them. With more than

1500 medical, paramedical, patient relations and administrative staff, the

hospital offers total care for patients.

Continuing medical education programs update skill sets of the

doctors and paramedical staff and keep them abreast of the latest

developments in their field. The services are integrated by a state of the art

hospital management system to provide effortless patient movement.

Hospital is recognized for diplomat of national board (Post Graduate

Programmes) in departments like general surgery, Anesthesiology,

Cardiology, Cardiothoracic surgery and obstetrics and gynecology. Hospital

is recognized for training doctors in Fellowship of the ROYAL COLLEGE

of Surgeons (FRCS) programme in general surgery.

KMCH is recognized for the following schemes:

Income tax Act under Section 17(2) B

Employee‟s State Insurance (ESI)

Tamilnadu Government employees new health insurance scheme

managed by star health insurance company

Tamilnadu Government pensioner‟s health fund scheme

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Unit Trust of India senior citizen plan

Prime Minister‟s National Relief Fund

Chief Minister‟s Relief Fund

Ministry of health and family welfare-discretionary grant

Kerala Government servants medical attendance rules-1960

Approves Third Party Administrators (TPAs) and insurance

companies for cashless treatment:

Bajaj Allianz General insurance

Cholamandalam General Insurance

Apollo DKV

ICICI Lombard General Insurance

Medicare

Star Health and Allied Insurance Company Limited

E-Meditek Solutions Limited

Future General

Religare

Medi Assist

Heritage health third party administrator (TPA)

Good Health Plan Limited

Tiruvellore Thattai Krishnamachari (TTK) Healthcare

3.7.4. Profile of the KMC Specialty Hospital (India) Limited

The KMC specialty hospital India limited in its decennial year of

operations has added numerous feathers to its cap. From a humble beginning

of 30 beds in 1999 it has come a long way to 200 beds by acquiring Seahorse

Hospital. The number of doctors in this hospital has grown from 10 to 100

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and the staff members have grown over 1000. Seahorse hospital Limited

management has been taken over by KMC by in the year 2007. Now all the

procedural formalities have been completed and hence forth it will be known

as the KMC specialty hospital India Limited.

To reaffirm the high level of healthcare which we are providing‚ we

have started the accreditation process for National Accreditation Board for

Hospital (NABH) and for National Accreditation Board for

Laboratories (NABL). The KMC Specialty hospital India limited has been

striving hard to provide quality healthcare to the patients at par with KMC

by conducting training programmes for the employees on patient care‚

patient relations and management in a planned way. The hospital has full

time consultants in all the basic specialties. Especially Obstetrics and

Gynecology‚ Pediatrics‚ Cardiology‚ Ear, Nose and Throat (ENT)‚ Dental‚

Joint Replacement‚ Plastic Surgery‚ Neurology‚ diabetology‚ etc.

a. Service in Quality Patient Care

They have ensured that the hospital are able to offer quality care to the

patients, adopted systematic and comprehensive clinical standards in patient

handling, operating theaters, intensive care unit management and emergency

care. The layouts at the facilities minimize inpatient movement, with

outpatient facilities located near diagnostic facilities within the hospital. The

hospital staff is continually trained to care for patients with techniques

utilized in the hospitality industry, which helps more comfortable experience

for patients. Also emphasize high quality maintenance of the facilities.

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b. Specialty Focus

Their specific focus on clinical areas such as Neurosurgery,

Cardiovascular and thoracic surgery, Orthopedics, Plastic and

Reconstructive Surgery, Gynecology, Neonatology and Nephrology

(including renal transplants). Investing significantly in the technology,

equipment and infrastructure required to perform the most advanced

procedures. To extend, support and strengthen the specialty focus, have

established and intend to expand the network of regional specialty Intensive

Care Unit (ICU) hospitals, which can refer patients to the super-specialty

hospital.

c. Experienced Management

The operations are led by an experienced management group that

functions well as a team, and that has the expertise and vision to continue to

expand the business. The management of the company was taken over by the

present promoter Sri Kavery Medical Care (Trichy) Limited, during the year

2007. The Managing Director Dr. S. Chandrakumar is well experienced in

clinical as well as administrative activities. It have dedicated and

experienced management teams from the healthcare and other service

sectors, as well as doctors with both clinical and administrative experience.

The senior managers are well experienced in managing the healthcare

services industry. It believes that the combination of a professionally

managed administration with a commitment to patient care and high ethical

standards enables us to operate the facilities more efficiently.

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d. Brand Equity

It believes that the KMC brand is widely recognized in the region

where the hospital facility is located by both healthcare professionals and

patients in specialty areas, such as cardiac care, orthopedics, neurosciences,

oncology, renal care, metabolic diseases and mother and child care. It

believes that the reputation helps to attract not only patients, but also well-

known doctors and other healthcare professionals, who in turn draw

additional patients to the facilities.

e. Business Strategies

i. Focus on High-Growth Segment

The increase in standard of living and purchasing power of people, an

increase in awareness about health and healthcare, a growing medical value

travel market and an increase in lifestyle-related diseases such as heart

disease, has created a new and expanding group of patients. This group is

increasingly demanding higher levels of quality medical services. It believes

that we are well-positioned to serve the increasing demand for sophisticated

clinical care.

ii. Improve Profitability and Occupancy Rates

It intends to improve profitability at the hospitals by increasing

average income per bed and decreasing average length of stay. It plan to

focus on the case mix and increase the ratio of surgical to medical

procedures, and also improve the utilization rates in order to increase

average income per bed.

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iii. Attract and Retain Prominent and Skilled Doctors

It believes that have been successful in attracting and retaining doctors

who have over a period of time achieved clinical excellence in their fields at

the hospitals. It believes that hiring surgeons and other physicians who have

established reputations for clinical excellence in their communities is key to

the successful implementation of the strategy.

iv. Training to the Administration with Leadership Skills

It believes that well trained and skilled staff is required to carry out the

smooth operation of the organization. The respective hospital provides

training to the administrative staff to attract sustained management talent to

support emerging business needs and develop and train employees

appropriately for each level of the management hierarchy to drive results

efficiently.

v. Steps Taken to Deal with the Competition

The company has adopted aggressive marketing strategies

Enlisting and tie ups with new corporate clients

Conduct free medical camps to create health awareness in rural areas

Revision of tariffs to suit the economic status of the patients and

offering loyalty discounts and concessions wherever necessary

Brand building by offering best of services and adopting corporate

social responsibility

A number of obsolete equipments have been replaced by state of art

equipments

Number of new departments with latest equipments has been

commissioned

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3.7.5. Profile of the Lotus Eye Care Hospital

The Lotus Eye Care Hospital is the state of art eye care hospital group

successfully functioning in South India with specialization in super-specialty

service related to eye care. It have network of four eye care hospitals based

at Coimbatore (2), Salem (1), Tirupur (1). These hospitals have hi-tech eye

care equipments and ophthalmic experts backed by well-trained paramedical

and administrative team. All the centers have fully computerized modern

setup manned by medical and administrative staff. The networks of eye care

hospitals have 9 operation theatres and 3 lakhs laser equipments. Most of the

eye operations are performed as a day care procedure and therefore the

numbers of beds maintained by us are optimum number required. The total

bed strength of all the centers is 120 beds excluding eye camp beds. The

Lotus has two centers in Coimbatore, one in down town and another in civil

aerodrome. The Salem center is located in the heart of the city. The Tirupur

center is also functioning in prime location in the city. The Lotus eye care

hospital is a hi-tech super specialty eye care hospital catering its value added

service to the society since 1993. Dr.SK.Sundaramoorthy and his team of

ophthalmic experts, who have highly qualified with vast experience in each

specialty, render comprehensive eye care to hundreds of patients daily at

their state of the art eye hospitals in Coimbatore, Tirupur and Salem in South

India.

The Lotus eye care hospitals introduced Multi Scan Lasik Wave front

based Esiris Custom Lasik for the first time in India. Lotus was the first Eye

hospital in South East Asia to have Epilasik. The Lotus eye care hospitals

introduced the most advanced technology of Zyoptix and combined two

superior technologies Epilasik and Zyoptix known as Zyoptix Integrated

Epilasik to achieve supervision. During the calendar year 2007, it performed

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over 4200 numbers of various surgeries as cataract, Lasik and Epilasik,

corneal, vitreo-retinal, squint, oculoplastic and orbital.

The Lotus eye care hospital is known for its excellence in ophthalmic

services with personalized care. It is committed pioneering in the

technological revolution in eye care and rendering service to thousands of

patients from across the globe to see the world better than ever before. The

main hospital is built on 1.2 acres of land in prime location at Peelamedu

(Coimbatore) in the state of Tamilnadu. This facility is beneficial to the

patients of Western and Northern districts in Tamilnadu, Kerala and

Karnataka state. The other three network hospitals are located at Tirupur,

Salem and R.S.Purum (Coimbatore). These hospitals are located at

convenient place to serve the people in Salem, Dharmapuri, Krishnagiri,

Namakal, North Arcot, Tirupur, Dindugal, Madurai, Trichy districts in

Tamilnadu, Southern districts of Karnataka and Andhra Pradesh.

All imported hi-end surgical equipments with latest laser technology is

used in all the units. The Lotus eye care hospital is affiliated to National

Board of Examination (NBE) a government body for post-graduate training

in ophthalmology. The Lotus group has been authorized to educate and train

4 candidates in a year for postgraduate ophthalmology. It also offers

fellowship-training programme for fresh and practicing ophthalmology in

cataract with Intraocular Lenses (IOL) surgery, Lasik and Epilasik surgery,

vitro-retinal surgery, Pediatric ophthalmology and corneal surgery. It has

entered into Limca book of records for conducting international ophthalmic

conference in high seas for the first time in the world.

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a. Technology

The Eye Care Centers aim at providing comprehensive eye-care

services using the world class technology and skills. Besides delivering the

regular eye-care services, the hospitals are providing advanced level of

diagnostic and therapeutic services in the field of vitreous and retinal

diseases, Phacoemulsification surgery for cataract and customized wave

front Lasik laser for glass free vision.

b. Experienced Promoter

The promoter Dr. S.K.Sundaramurthy is a leading eye surgeon known

and acknowledged worldwide. He has more than 25 years of experience in

the fields of eye surgery. His experience and knowledge have fetched rich

dividends to the company.

c. Strategy

It has an innovative service model to eye patients and the society. The

eye care services consist of primary, secondary and tertiary eye care.

d. Primary Eye Care

This units focusing on patients coming in directly for eye treatment

such as refractive error, change of glasses, contact lens and other ailments

such as infection, inflammation, diabetic eye disease, cataract, glaucoma etc.

The unit will provide state of the art equipments and manpower for

examination, dispensing medicines and optical. Patient will also be

examined by an ophthalmologist to rule out condition like glaucoma,

cataract, and diabetic eye disease. It proposes to set up three-eye care

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centers, out of which two in Bangalore and another one in Chennai through

the present issue. It also intends to setup more number of eye care centers in

different parts of the country.

e. Secondary Eye Care

Secondary eye care would be setup in second or third tier cities and

these centers will have walk in patients and patients referred by individual

practioners and its own primary eye care centers. The unit will have latest

eye care equipments and skilled specialist doctors. It have currently two-eye

care secondary centers one at Tirupur and another at R.S. Puram. After

completion of new building, which is in progress, the R.S.Purum center will

function as full-fledged secondary eye care unit. It propose additional

secondary eye care center at Karur through the proceeds of the present issue.

Each secondary center will provide service like Lasik laser treatment for

glass free vision, a cataract surgery with Intraocular Lens (IOL)

implantation, squint surgeries for squint eye, diabetes eye disease, glaucoma

and myopic (short sight) treatments.

f. Tertiary Eye Care

Tertiary eye care units will function at Peelamedu, Coimbatore and

Salem to handle complicated eye diseases. The center will function as one

stop solution with necessary infrastructure and latest equipments and support

by large team of specialized doctors. The patients for the tertiary care include

walk-in patients, patients referred by primary and secondary eye care units.

The tertiary eye care will provide state of the art Lasik and Epilasik, cataract

with Intraocular Lens (IOL) surgery, glaucoma, diagnosis treatment,

comprehensive care of pediatric disease, myopic eye diseases, diabetic eye

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disease, advanced vitreo retinal surgical facility, orbital treatment for orbital

diseases, oculoplastic and cosmetic treatments, neuro (nerve related eye

disease) ophthalmology, uveal diseases, full-fledged laboratory services and

clinical and basic science research.

The hospital has a vision of empowering eyes to illuminate lives. Its

Eye Care group is marching towards its vision of becoming India‟s best

corporate hospital with branches in strategic locations where quality eye care

is in need, and render world class eye care service to the society. The

company was originally incorporated as Kalaivani health centre private

limited on 14th

March 1997 under the companies Act, 1956 vide Certificate

of incorporation issued by the registrar of companies, Tamil Nadu,

Coimbatore. The name of the company was changed to Lotus Eye Care

Hospital Private Limited on 23rd

January 2007.