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AHMC is a private US company headquartered in Washington D.C. recognized as the leading international hospital development and management company offering clients “individualized turn-key services and total hospital solutions.”
AHMC’s 16 year track record includes successful collaboration in more than 50 hospital projects, on 5 continents and 24 countries around the world.
AHMC’s management model is based upon the very best characteristics of American management practices and Joint Commission International (JCI) Standards.
AHMC’s successful model has been adapted to the needs of clients around the world in order to deliver enhanced operational capabilities, quality, and profitability.
AHMC’s business philosophy and experience enable it to deliver global resources locally in order to provide state-of-the-art quality medical services
AHMC’s affiliated healthcare facilities are Five Star, Class “A” academic medical centers that are committed to quality, service and long-term financial success.
Unique to AHMC is its experience in the management and development of world-class healthcare facilities that include private hospitals, Private-Public hospital Partnerships (PPP), and academic teaching hospitals.
AHMC OVERVIEW
GLOBAL NETWORK:
Hospitals and Projects: 33
Operational facilities: 15
Licensed Beds: 2,900
Physicians: 3,000
Staff/Employees: 4,500
Avg. Patient satisfaction: 97%
UNIQUE EXPERIENCE:
Private-Public Hospital Partnerships
New hospital commissioning
Academic and teaching hospital
AHMC OPERATIONS OVERVIEW
AHMC HOSPITAL FEATURES
Operated at Joint Commission International standards
Adoption of world class clinical guidelines
Commitment to continuous quality improvement and enhanced care
State-of-the-art medical technology and healthcare services
Commitment to continuing medical education and employee development through constant education and technology transfer
Transparent administration and business practices for to earn investors’ trust and in order to enhance ROI
Access to AHMC’s prestigious Strategic Alliances and related resources
AHMC HOSPITAL CHARACTERISTICS Award winning design and according to JCI Standards
AHMC HOSPITAL CHARACTERISTICS Modern and focused on patient safety/quality and efficiency
AHMC HOSPITAL CHARACTERISTICS Patient and family centered environments
AHMC SCOPE OF SERVICES
PHASE 1-FS/BP Development TIMEFRAME: 2 – 3 MONTHS
Conduct Feasibility Study
Develop Business Plan
Develop the Financial Projections
Analysis of the site and architectural design
Preliminary staffing plan
Market analysis
PHASE 2- PROJECT MANAGEMENT CONSULTING TIMEFRAME: 18-24 MONTHS Work with architect and
construction manager Operating procedures
development Equipment planning HIT Selection and
implementation Development of bylaws for
the board and medical staff Establish governance
structure
PHASE 3- PRE-OPERATIONS & COMMISSIONING TIMEFRAME: 6 - 9 MONTHS Staffing core operating team General staffing and
recruitment Physician recruitment Implement operating
policies and procedures Implement process design
and protocol Equipment procurement
and installation Establish financial controls
and measures Hospital commissioning
PHASE 4- OPERATIONS TIMEFRAME: 10-15 YEARS Turnkey executive
management and control of daily business operations
Implement international mode of clinical procedures and medical care
Implement quality improvement and patient safety framework
Implement AHMC best practice financial and operations management
Recruitment, training and retention of physicians, nurses and hospital staff
Selection/implementation of HIT System
AHMC Onsite Full-Time AHMC Consulting and Support
PHASE I: FEASIBILITY STUDY AND BUSINESS PLAN TIMEFRAME: 2 MONTHS
SCOPE OF WORK
Conduct a Feasibility Study to validate hospital project
Develop the associated Business Plan and related Financial Projections
Conduct site and review architectural design
Conduct market analysis
DELIVERABLES
Feasibility Study serves to validate the proposed hospital project's operational and financial
feasibility from a strategic perspective.
Business Plan gleams information from the feasibility study to develop the proposed hospital’s
framework and a preliminary operational plan. Also serves as a prospectus grade document.
Hospital size, scope/breadth of hospital services
Address needed investments related to building, equipment, HIT and working capital needs
Outline space allocations
Preliminary employee and medical staffing plan
Assess and project operational costs and external service suppliers
Develop future strategic objectives and marketing strategies
5 year financial projections including opening financial statements of operation, balance sheet, and
cash flow statement.
PHASE II: PROJECT MANAGEMENT CONSULTING TIMEFRAME: 18-24 MONTHS
SCOPE OF WORK Work in collaboration with architect and construction manager Develop hospital operating procedures Equipment planning HIT Selection and implementation Develop bylaws for the board and medical staff Establish governance structure
DELIVERABLES Detail Room Program: AHMC works with architects to assure each room is appropriately equipped
with medical gases, electrical needs and other necessities for both clinical and diagnostic areas. Equipment Plan: AHMC will develop the list of clinical equipment, supplies and furniture necessary to
open the hospital to be approved by the Board of Directors. HIT Plan: AHMC will develop the implementation plan for selected HIT system, as well as, evaluate
the leasing and/or purchase of hardware and software relevant to the project. Bylaws for the Hospital Board and Medical Staff: Hospital Governance will conform to Accreditation
standards as well as develop a system that can be audited to ensure transparency in all transactions. General Hospital Organization (“Hierarchy of Control): To be approved by the Board of Directors.
ARCHITECTURAL DESIGN AND RELATED EXPENSES AHMC is not an architectural firm, however we work with renowned architects experienced in the design of world-class international standards hospitals worldwide. At the discretion of the owners, architects can be integrated as part of our team. Related fees and costs are billed separately from AHMC.
PHASE III: PREOPERATIONS AND COMMISSIONING TIMEFRAME: 6-9 MONTHS
SCOPE OF WORK Placement of CEO and staffing of the core operating team Recruitment of physicians and general staff Implement operating policies and procedures Equipment planning, procurement, installation and training Implementation the Health Information Technology (HIT) Develop and implement methods of procurement Establish financial controls and measures Hospital commissioning
DELIVERABLES Operating Plan and Procedures Employee Policies and Procedures Job Descriptions, Employee handbooks, and Salary/Benefit Structures Medical Equipment Planning, Procurement, Installation and Training Plan
HOSPITAL COMMISSIONING- (LAST 2 MONTHS OF PHASE III) AHMC team will conduct “practice runs” in order to insure all equipment is functioning appropriately and that all staff understand how to move patients through the system efficiently and effectively prior to hospital opening.
PHASE IV: ADMINISTRATION AND OPERATIONS TIMEFRAME: 7-15 YEARS
SCOPE OF WORK
Turnkey executive management
Management and control of daily business operations
Recruitment, training and retention of physicians, nurses and hospital staff
Implement international mode of clinical procedures and medical care
Implement quality improvement and patient safety framework
Implement AHMC’s best practice financial and operations management service
DELIVERABLES
Clinical Practice and Medical Care Model
Framework for Quality and Patient Safety Programs
Financial and Operation Management Services Plan
Hospital performance benchmark data and KPI’s
Marketing and Branding Implementation Plan
Monthly Reports: formal monthly reports prepared for Hospital Board and investors.
Reports include comparison against budget, variance analysis and benchmarks.
AHMC HOSPITAL NETWORK
Country Client /Project BedsContracted
Services
Contract
Start Date
Contract
End DateCurrent Status
Honduras La Lima 180 Phase 4 2003 2008 Completed and Current investor
Ecuador Hospital Del Rio 90 Phase 2-4 2003 2010 Completed and Current Investor
Honduras Honduras Medical Center 49 Phase 3 -4 2002 2007 Completed and Current investor
Saudi Arabia Mohammed Khan Hospital 70 Phase 4 2014 Present Management/Operations
Saudi Arabia Bakhsh Hospital 120 Phase 4 2014 Present Management/Operations
India Sama Healthcare 31 Phase 4 2012 Present Management/Operations
Antigua & Barbuda Mount Saint John's Medical Center 185 Phase 3-4 2007 Present Management/Operations
Colombia Pastuer Labs NA (Lab/DX) Allaince 2004 Present Management/Operations
Panama Hospital Nacional 120 Phase 4 2000 Present Management/Operations
India Re- Hospital 120 Phase 3 - 4 2014 Present Pre-Operations
Saudi Arabia Al-Jazeera Medical Hospital 120 Phase 3 & 4 2014 Present Pre-Operations
Saudi Arabia AlQadi Specialty Hospital 140 Phase 1-4 2012 Present Pre-operations
Libya VIP Hospital 60 Phase 1, 3-4 2010 Present Pre-Operations
AHMC HOSPITAL NETWORK
AHMC HOSPITAL NETWORK
Country Client /Project BedsContracted
Services
Contract
Start Date
Contract
End DateCurrent Status
Libya Swani Road 200 Phase 1-4 2010 Present Construction
Russia Russian American Hospital 100 Phase 1-4 2010 Present Construction
Peru Clinica Delgado 120 Phase 2-4 2009 Present Construction
Peru Torre Trecca NA (OP) Phase 2-4 2009 Present Construction
Libya Swani Road 200 Phase 1-4 2010 Present Construction
Russia Russian American Hospital 100 Phase 1-4 2010 Present Construction
Peru Clinica Delgado 120 Phase 2-4 2009 Present Construction
Peru Torre Trecca NA (OP) Phase 2-4 2009 Present Construction
Georgia American Hospital Tiblisi 120 Phase 1-5 2013 Present Financing
Libya Libyan American Hospital 120 Phase 1-4 2013 Present Financing
Nigeria Lagos American Specialty Hospital 50 Phase 1 2013 Present Financing
Nigeria Crystal Thorpe Lagos 150 Phase 1 2012 Present Financing
Nigeria Chystal Thorpe Abuja 120 Phase 2 2012 Present Financing
Nigeria Chystal Thorpe Yola 100 Phase 3 2012 Present Financing
Egypt Egyptian American Medical Center 182 Phase 1-4 2011 Present Financing
Jordan MIS Surgical Centre NA (OP) Phase 1-4 2011 Present Financing
Mexico Cancun Medical Center 100 Phase 1 2011 Present Financing
Morocco Moroccan American Hospital 182 Phase 1 2011 Present Financing
Al-Jazeera Medical Hospital Riyadh, Kingdom of Saudi Arabia
Recruiting Physicians and Staff
Cath lab projected online by mid-2014
Implementation of P&Ps and quality program
Develop marketing strategy
Beds: 120 Type: General Hospital Status: Operations
Bakhsh Hospital Jeddah, Kingdom of Saudi Arabia
Recruiting Physicians, staff, and executive team
Strategic and Operational Development
Implementation of P&Ps and quality framework
Beds: 120 Type: General Hospital Status: Operations
Dr. Mohammed Khan Hospital Hafr-al-Batin, Kingdom of Saudi Arabia
Recruiting of physicians and staff
Strategic and operational planning
Implementation of P&Ps and quality framework
Beds: 70 Type: General Hospital Status: Operations
AlQadi Specialty Hospital Najran, Kingdom of Saudi Arabia
Construction in final stages
Staffing imminent
Equipment procurement underway
Financing
Beds: 140 Type: Specialty Hospital
Status: Pre-Operations
Memorial Souad Kafafi Medical Center 6th of October, Egypt
Moved into Extension with new ED, OR & Cath Lab
CCU, NICU, ICU, OB
Remodeling of Old Building
Transition to Fee for Service Model
Beds: 140
Type: General Hospital
Status: Operations (Completed April 2014)
Hospital Nacional Panama City, Panama
Kidney Transplant Program
Da Vinci Robotic Surgery
Radiation Oncology Center
Expansion ICU, Surgery and ED
Beds: 100 Type: General Hospital Status: Operations
Mount Saint John’s Medical Center St. John’s, Antigua & Barbuda
New Executive Team & Board
Updating Strategic Plan
GPO Pilot Program
Teaching Accreditation
Cancer Centre of Eastern Caribbean
Beds: 185 Type: General Hospital Status: Operations
AHMC HOSPITAL NETWORK Hospitals Under Development (continued)
VIP Hospital Tripoli, Libya 60 Beds Status: Construction (Pending)
Swani Road Tripoli, Libya 200 Beds Status: Pre-Operations (Pending)
Tripoli American Hospital Tripoli, Libya 120 Beds Status: Design and Capitalization
AHMC HOSPITAL NETWORK Hospitals Under Development (continued)
Moroccan American Medical Center Casablanca, Morocco 110 beds Status: Design and Capitalization
Egyptian American Medical Center Cairo, Egypt 180 beds Status: Design and Capitalization
Minimally Invasive Surgery Center Amman, Jordan Status: Design and Capitalization
AHMC HOSPITAL NETWORK Hospitals Under Development (continued)
Lagos American Medical Center Lagos, Nigeria 50 Beds Status: Design and Capitalization
Crystal Thorpe (3 hospitals) Yola, Abuja and Lagos, Nigeria 100, 120 and 150 Beds Status: Design and Capitalization
R&H Specialty Hospital Accra, Ghana 100 Beds Status: Design and Capitalization
AHMC HOSPITAL NETWORK Hospitals Under Development (continued)
Russian American Medical Center Tver, Russia 120 beds Status: Design and Capitalization
American Hospital Tbilisi Tbilisi, Republic of Georgia 120 beds Status: Design and Capitalization
AHMC HOSPITAL NETWORK Hospitals Under Development (continued)
Clínica Delgado Lima, Peru 120 Beds Status: Phase 2 Construction
Torre Trecca Lima, Peru Ambulatory and Urgent Care Center Status: Phase 2 Construction
Hospital Solaris Guayaquil, Ecuador 100 Beds Status: Phase 2 Construction
AHMC HOSPITAL NETWORK Completed and Current Investor
Honduras Medical Center Tegucigalpa, Honduras Status: Commissioned, Operated and own equity in Hospital
La Lima Medical Center Tegucigalpa, Honduras Status: Renovated, Operated, and own equity in Hospital
Hospital Del Rio Cuenca, Ecuador Status: Business Plan, Commissioned, Operated and own equity in Hospital
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INVESTING IN HEALTHCARE
Hospitals are complex businesses
Business of “people”
High technical skills required
Long-term perspective and dedication required
Significant ROI is possible
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HEALTH MARKET TRENDS
Scarcity of Capital Human
Financial
Increased Complexity
Capital Markets and Investor Expectations
Quality & the Patient Experience
Cost Pressures
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HEALTH MARKET TRENDS
Transitions:
Financial Markets
Reimbursement
Aging Hospitals
Younger Populations
New Technology
Increased Complexity
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BUSINESS MODELS
Classic:
Public
Public Private Partnerships
Private: Foundation
Family Owned
Doctor Owned
Investor Owned
Alternative:
Hospital within a Hospital
Doctor – Investor Hybrid
Joint Ventures
Collaboration with Insurance Companies
Tenant Hospitals
Concession of Services
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CHARACTERISTICS OF SUCCESS Focused Business Plan – Clear investment objectives
Clearly identified and sustainable local market
Socio-economic levels of patients are top “informed” 40%
Class “A” tertiary care with quality and economic volumes
Class “B” volume and service focused 1 and 2 level care
Aligned, well-trained and multi-specialty medical staffs
Operated to International Standards (ISO9000/HQS/JCAHO)
Emphasis on “value” technology as a clinical and business tool
Clinical benchmarking and measuring of outcomes
Ability to understand the relationship and implications between clinical care and financial performance
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CHARACTERISTICS OF FAILURE Over reliance on the government for patients & revenue
Alienating the physicians or insurance companies
Poor quality and patient experience
Lack of clear strategic plan and/or poor implementation
Ineffective leadership and lack of accountability
Wrong or incompatible investor expectations
Focusing on the socio-economic levels of patients in the top 5% to 10% or the bottom 50%
Too many hospitals/beds in market, lack of differentiation
Too much technology or too little technology
Lack of resources: financial and human capital
If you build it, they will come
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CRITICAL INVESTMENT QUESTIONS
Why are you investing?
What is the expected ROI?
What are the incentives?
Understand how all investors will make money
Who is in charge and who is accountable?
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KEYS TO SUCCESS
Demand in market – priced for the market
Diversified referral base of patients
Clear focus of the business and strategic plan and objectives of the hospital
Service selection – Cannot be all things to all people: Ok to be a Wal-Mart and ok to be a Saks 5th Avenue, you just cannot be both
Realize the uniqueness of the hospital business and the uniqueness of the customers
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THE PHYSICIAN KEY
Working in partnership with the medical staff:
Doctors are unique customers
Doctors bring patients
Doctors spend the money
The Doctor Workshop
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THE PATIENT EXPERIENCE
Differentiating and understanding quality care and quality service:
The patients and families’ expectations
The patient experience
The “little things” of service
Voting with their feet
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ALIGNMENT OF INCENTIVES
Owners / Investors
Doctors that Bring Patients
Insurance Companies
Other Hospitals
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MAXIMIZING PROFITS
Programs – not “Bricks and Sticks”
Day to Day control of money and information
Understanding the true and the incremental costs of care
Productivity and flexibility
Appropriate and sufficient capitalization – with reality based financing
Accountability, transparency and long-term relationships
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MAXIMIZING PROFITS
Best practices and standardization
Clear strategic plan for insurance and third party contracting of local domestic patient referrals: Healthcare is local
Share the risk – share the rewards
Doctors
Insurance companies
Competing hospitals
Clinical partners
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REDUCING THE RISK
Not Re-Inventing the Wheel: Learn from Others
Clinical Partners
Best Practices
Invest in Human Capital: Professional
Management
Technical Training
CASE STUDY
Mount St. John’s Medical Centre is a state-of-the-art hospital facility centrally-located
on the island of Antigua and has been prepared to be the premier hospital of the
Eastern Caribbean region.
OVERVIEW
185 bed hospital structured as a Public Private Partnership ownership model.
The Hospital is professionally managed and operated as a modern, private enterprise by American Hospital Management Company that ensures the effective management of all business operations
The hospital provides comprehensive medical services to the public and private patients
Regional demand for quality healthcare services is growing with lack of adequate private facilities in the region
Private, insurance and for tertiary level government patients, reimbursement is under fee for service
Primary and secondary services for government sponsored patients are reimbursed under a capitation agreement with he Government of Antigua and Barbuda on a monthly basis
Antigua and Barbuda is centrally located within the Eastern Caribbean Economic Market and a major transportation hub
SERVICES
Medical / Surgical Suites
Private Rooms
Semi-Private Rooms
Intensive Care
Maternity
Nursery
Neonatal Intensive Care
Operating Theaters
Radiology MRI
CT-Scan
Fluoroscopy
Ultrasound
Full Clinical Laboratory
Rehabilitation
Emergency Room
20 Medical Offices
Helicopter Landing Pad
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SUMMARY Significant new opportunities exist
Know who you are and know your market
Everyone must understand why they are going into business and the expectations
Align your incentives with the doctors
Focus on quality and the patient experience
Human capital and resources
Maintain the optimal mix of technology and financial resources
CONTACT INFORMATION