Quality Health Care and Affordability

An Outcome of Compassionate Heart and Business Mind

Presented by:
Abhilash Chauhan
Amarjeet Singh
Asim Abinash
Krishna Bollojula

CHALLENGES: HEALTH CARE IN INDIA
In India, the dual pressures of poverty and a large population
make effective healthcare delivery especially challenging.
There is no national health system and health spending
accounts for 4.2 per cent of GDP, compared to 9.8 per cent of
GDP in the UK
Although 72 per cent of Indias population lives in rural
areas, 80 per cent of doctors, 75 per cent of dispensaries and
60 per cent of hospitals are in urban areas.
Increasing the health resources of the nation requires
substantial investment. To achieve the target of two beds per
1,000 population by 2025, an additional 1.75 million beds are
needed.
To reach a ratio of one medical doctor per 1,000 individuals
by 2025, an additional 700,000 doctors will be required
NARAYANA HEALTH
Narayana Health, a private multi-
specialty hospital chain in India,
headquartered in Bangalore.

Founded in the Y ear 2001, by Dr.
Devi Shetty.

Known for low cost and high
quality Indian healthcare service
provider because of its ability to
reconcile quality, affordability and
scale.
HOW QUALITY & AFFORDABLE HEALTH CARE IS PROVIDED
IN NH ?
In 1990 the cost of cardiac
surgery usually costed Rs
1.50 lakh. Most of the people,
in need of cardiac surgery
couldnt afford it
NH brought the cost of
surgery down to $1500
compared to $1,44,000 in US
and $27,000 in Mexico.
They proved that Poor can
access quality health care
from world renowned
doctors.

BRIEF ABOUT HOW IT ALL STARTED ??

Dr. Devi Prasad Shetty, when working with Birla Heart Research Foundation in
1990's, he would see over 100 heart patients daily.
Most needed surgery but never came back for it. This intrigued him.
He soon found out that the high cost of cardiac surgery (Rs 1.50 lakh then) was the
reason.
"It was clear costs had to come down," says Dr Shetty. And he says "I was certain of
one thing though - charity is not scalable while a sound business model is"
The world renowned surgeon then started Narayana Hrudayalaya at Bangalore in
2001 with 280 beds.
Now, they grown upto a 26-hospital network with 6,900 beds across 16 cities
employing 13,000 people and 1,500 doctors.
ABOUT THE HOSPITAL

It is called as "Gods Compassionate
Home".
Founded by World Renowned Heart
Surgeon Dr. Devi Prasad Shetty.
Situated in Bangalore, Karnataka
Aims to provide Affordable and quality
health care to the poor.
Dr. Shetty has transformed open heart
surgery to mass production using industrial
organization's execution playbook.
Took machines on monthly rent and paid
for reagents used to run the machines.
Minimum inventory and quick processing
of tests.
Spent only 22%of total revenue for staff
salaries.



Dr. Devi Shetty
Source: Economic Times
INTENSIVE WORK AT NH

Increasing Production
It has so far performed over 100,000
cardiac surgeries and 250,000 cath lab
procedures.
The group performs 150 major surgeries
(including 44 cardiac surgeries) daily.
NH says about 12 per cent of all cardiac
surgeries done in the country are
performed at its hospitals and 50 per cent
of its patients are from the economically-
weaker sections.
Affordable Prices
NH's average cost of a bypass surgery is
$1,500 (Rs 90,000) compared to
$1,44,000 in the US, $27,000 in Mexico
and $14,800 in Colombia. Interestingly,
NH's cost of cardiac surgery is
significantly lower than what it was in
India 13 years ago.
Quality Healthcare
The lower cost has not come at the expense of
quality. Incidence of bedsores after a cardiac
surgery is globally anywhere between eight
and 40 per cent. At NH, it has been almost zero
in the last four years.
By the way, when you perform open heart
surgery on an assembly line, not only does the
cost go down but quality goes up. Performing a
medical procedure repeatedly improves a
doctor's skill and reduces errors.

Financially Strong
The focus on both cost and quality has not hurt
NH's financials either. While NH's revenues
grew by over 200 per cent in the last five years
to Rs 827.35 crore in 2012/13. Private equity
funds JPMorgan and Pine Bridge have picked
up a 24 percent stake in NH. They clearly
believe NH is creating long-term value for
investors.

MICRO INSURANCE: YESHASWINI
"Yeshaswini scheme
launched in 2002 in association
with the Karnataka state
government
Covering more than 3 million
farmers
Premium: 18 rupees per month
from Rs 5 at inception
Government infrastructure like
post offices collect monthly
premiums, track payments and
issue health insurance cards

85,000 farmers had free
medical treatment
22,000 farmers had free
surgeries
1400 farmers had heart
surgeries

About Yeshaswini: Yeshaswini in 20 months:
TELEMEDICINE
Collaboration with ISRO
One of the largest telemedicine
centers in the world
Extends to 19 countries
Leveraging technology to reach
out to masses through 22
centers
Treated over 53,000 heart
patients in remote locations of
India

Telemedicine being practiced at
Narayana Hrudayalaya, Bangalore

Telemedicine center with
CCU at Agartala, Tripura

Source: NH
Trans Telephonic
ECG Network

Mobile Diagnostic
Lab
MEDICAL TOURISM:
VISION OF NHTO PROVIDE AFFORDABLE HEALTHCARE
WORLDWIDE
Medical tourism: Provision of cost effective private medical care in
collaboration with the tourism industry.
Certified by National Accreditation Board for Hospitals & Health
care Providers (NABH)
Set up a center for excellence: medical tourism facility of NH in the
Cayman Islands, a British Overseas Territory
The hospital, Health City Cayman Islands, has opened with a 104-bed
tertiary-care hospital in Grand Cayman, providing services in cardiac
surgery, cardiology and orthopedics
Future Plans: Expand to a 2,000-bed facility, and is expected to provide a
broader array of services including neurology, oncology and other cutting
edge tertiary care services
A medical school is also planned to be built on the site


Innovative factors that have contributed to NH
Unique Health City Model
Telemedicine
Yeshaswini
Low Cost Surgical Hospital Model
Increasing life span of medical equipment
Daily Profit and Loss tracking
Cloud ERP system
Staff and Patient feedback system
Scholarship for Medical studies
Investment towards training and development
Asset Light Strategy
THANK-YOU
NARAYANA HRUDALAYA, BANGALORE