 "Quality medical care, now in your neighbourhood")
During medical emergencies, reaching and securing admission in a hospital is a challenge. In the past few years, while corporate hospitals have catered to much of the demand for health care services, at least in metropolitan areas, neighbourhood nursing homes and clinics continue to be the first choice for those seeking urgent care. However, these facilities lack adequate infrastructure, credibility and quality.
This is the space Parvez Ahmed, former managing director and chief executive of Max Health Care, explored around a year ago. Aapka Urgicare, the company founded by Ahmed, operates through a chain of neighbourhood hospitals called Urgent Care centres. These are equipped to offer effective emergency treatment and cater to primary health care needs, emergency acute care and multi-speciality care requirements.
"The idea is to fulfil primary care needs on an urgent care basis to save time, as well as costs," says Ahmed, founder chairman of Aapka Urgicare.
"When I looked at it, I felt it was a model that would work well in India. We will put it as an immediate one-stop for patients in neighbourhoods that don't have easy access," says Ahmed, earlier a physician and director of critical care medicine at Brookdale Hospital Medical Centre in New York.
Reportedly, Ahmed, son of former President Fakhruddin Ali Ahmed, is also likely to contest the coming Lok Sabha election from Assam's Kaliabor constituency on an All India United Democratic Front ticket.
Business model
While Urgent Care centres are run out of rented spaces, the company saves on costs by outsourcing diagnostics and other critical tests. "We support the patient here in the golden hour, send them for diagnosis, if required, and if the patient requires further tertiary care, we refer them to hospitals," says Ahmed. Urgent Care, through affiliations with other hospitals and diagnostic centres, helps save time and costs. Mapping of required logistics, diagnostic chains and tertiary care hospitals in the vicinity is part of the initial planning before setting up an Urgent Care centre.
Health care consultants say Urgent Care's model works well with associated service providers such as insurance companies.
Ahmed says for the same treatment, the costs at Urgent Care are an eighth of the prices charged by large private hospitals. "Sustainable health care businesses are based on reputation," says Ahmed. He adds treatment costs can easily be reduced. For instance, instead of recommending a number of unnecessary tests, a doctor should be able to diagnose properly and prescribe the right test, he says.
Apart from catering to road and traffic accident victims and emergency acute care, Urgent Care also offers multi-speciality care, including minor operations and deliveries. The company has opted out of certain complex therapeutic segments such as cardiac, neuro and cancer surgeries. "Such therapies don't fit into the Urgent Care model, because these require huge investments in equipment and infrastructure. Urgent Care's USP (unique selling proposition) is fast treatment at low costs. The moment you enter tertiary care, these features are lost," said the promoter of a leading multi-speciality hospital.
The company plans to raise Rs 25-50 crore. "It could be private equity, preferential debt or any kind of financial tool; we are open to all kinds of tools," says Ahmed. "We can grow through joint ventures but eventually, we will look for some kind of funding such as private equity or strategic investors."
Expansion
Currently operating through three centres in Delhi, Urgent Care plans to expand to other parts of the country soon. However, as with its services, its development is also planned in a customised way. For instance, the three Urgent Care centres in Delhi (one each in East Delhi, Kalkaji and Shaheen Bagh) have 8-10 beds; now, the company plans to expand the Shaheen Bagh centre into a 30-bed facility, with more multi-speciality services, owing to the population density in that area and its requirements.
"Our first centre in East Delhi will be Ebitda (earnings before interest, tax, depreciation and amortisation)-neutral in 15-16 months of operation. Shaheen Bagh will become Ebitda-neutral in 12 months, as there, the density of population is more," Ahmed says.
He adds by the end of this month, the company plans to commission two more centres in Delhi. It aims to add at least 10 additional centres in the capital by the end of the next financial year and is considering areas such as Uttar Pradesh, Bihar, Kolkata, Punjab, Ludhiana and Jalandhar. In most places outside Delhi, it plans to opt for a hub-and-spoke model. For instance, the company is planning a hub in Moradabad, with 20-30 beds, while nearby rural areas will have units that operate for a fixed number of hours.
Rana Mehta, leader (health care), PricewaterhouseCoopers India, says, "India needs high-quality emergency care facilities in a non-hospital setting. Such facilities are quite common in the West. For instance, according to the American Academy of Urgent Care Medicine, there are 9,300 stand-alone emergency medical services providers in the US alone and their number has grown rapidly in the last decade. These specialised centres can play an important role in times of crisis. Patients are wary of going to general practitioners who are often not very well-equipped to handle such emergencies, while larger hospitals are difficult to access. These centres have an advantage over traditional hospitals in that these involve low expenditure, a shorter gestation period and the ability to gain scale and replicate operations. Therefore, the costs are not transferred to patients, making the services more accessible and affordable."
"It is estimated the market for stand-alone emergency care services in India's top seven metro cities will stand at about $1 billion by 2020," he adds.
Challenges
For Urgent Care, the biggest challenge is creating awareness. "In India, patients don't know what urgent care is. Awareness building is a challenge," Ahmed says. "Our first experience was patients were scared of coming to our centres because they thought we are very expensive, as our centres were neat and clean. Now, 55 per cent are those coming for re-visits."
The company chose Delhi to begin with, as it felt it would be easier to expand from there. "Delhi is very competitive in pricing, but I chose it because I wanted to create a brand. I could have done it elsewhere; business-wise, it would have been terrific, but wouldn't have created the brand," Ahmed says, adding price competition can be overcome by creating a differentiated quality product.
As it expands into tier-II and III cities, staff crunch is another challenge. The company, therefore, plans to partner a few educational facilities.
This is the space Parvez Ahmed, former managing director and chief executive of Max Health Care, explored around a year ago. Aapka Urgicare, the company founded by Ahmed, operates through a chain of neighbourhood hospitals called Urgent Care centres. These are equipped to offer effective emergency treatment and cater to primary health care needs, emergency acute care and multi-speciality care requirements.
"The idea is to fulfil primary care needs on an urgent care basis to save time, as well as costs," says Ahmed, founder chairman of Aapka Urgicare.
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Experts say the Urgent Care concept is unique to India, as it seeks to cash in on the huge void between local clinics and well-equipped hospitals. Local clinics and nursing homes are either incapable of handling emergencies and delivering multi-speciality care or cannot be trusted for quality. And, at high-end tertiary care hospitals, access to primary care is not only expensive but is mostly through appointments.
"When I looked at it, I felt it was a model that would work well in India. We will put it as an immediate one-stop for patients in neighbourhoods that don't have easy access," says Ahmed, earlier a physician and director of critical care medicine at Brookdale Hospital Medical Centre in New York.
Reportedly, Ahmed, son of former President Fakhruddin Ali Ahmed, is also likely to contest the coming Lok Sabha election from Assam's Kaliabor constituency on an All India United Democratic Front ticket.
Business model
While Urgent Care centres are run out of rented spaces, the company saves on costs by outsourcing diagnostics and other critical tests. "We support the patient here in the golden hour, send them for diagnosis, if required, and if the patient requires further tertiary care, we refer them to hospitals," says Ahmed. Urgent Care, through affiliations with other hospitals and diagnostic centres, helps save time and costs. Mapping of required logistics, diagnostic chains and tertiary care hospitals in the vicinity is part of the initial planning before setting up an Urgent Care centre.
Health care consultants say Urgent Care's model works well with associated service providers such as insurance companies.
Ahmed says for the same treatment, the costs at Urgent Care are an eighth of the prices charged by large private hospitals. "Sustainable health care businesses are based on reputation," says Ahmed. He adds treatment costs can easily be reduced. For instance, instead of recommending a number of unnecessary tests, a doctor should be able to diagnose properly and prescribe the right test, he says.
Apart from catering to road and traffic accident victims and emergency acute care, Urgent Care also offers multi-speciality care, including minor operations and deliveries. The company has opted out of certain complex therapeutic segments such as cardiac, neuro and cancer surgeries. "Such therapies don't fit into the Urgent Care model, because these require huge investments in equipment and infrastructure. Urgent Care's USP (unique selling proposition) is fast treatment at low costs. The moment you enter tertiary care, these features are lost," said the promoter of a leading multi-speciality hospital.
The company plans to raise Rs 25-50 crore. "It could be private equity, preferential debt or any kind of financial tool; we are open to all kinds of tools," says Ahmed. "We can grow through joint ventures but eventually, we will look for some kind of funding such as private equity or strategic investors."
Expansion
Currently operating through three centres in Delhi, Urgent Care plans to expand to other parts of the country soon. However, as with its services, its development is also planned in a customised way. For instance, the three Urgent Care centres in Delhi (one each in East Delhi, Kalkaji and Shaheen Bagh) have 8-10 beds; now, the company plans to expand the Shaheen Bagh centre into a 30-bed facility, with more multi-speciality services, owing to the population density in that area and its requirements.
"Our first centre in East Delhi will be Ebitda (earnings before interest, tax, depreciation and amortisation)-neutral in 15-16 months of operation. Shaheen Bagh will become Ebitda-neutral in 12 months, as there, the density of population is more," Ahmed says.
He adds by the end of this month, the company plans to commission two more centres in Delhi. It aims to add at least 10 additional centres in the capital by the end of the next financial year and is considering areas such as Uttar Pradesh, Bihar, Kolkata, Punjab, Ludhiana and Jalandhar. In most places outside Delhi, it plans to opt for a hub-and-spoke model. For instance, the company is planning a hub in Moradabad, with 20-30 beds, while nearby rural areas will have units that operate for a fixed number of hours.
Rana Mehta, leader (health care), PricewaterhouseCoopers India, says, "India needs high-quality emergency care facilities in a non-hospital setting. Such facilities are quite common in the West. For instance, according to the American Academy of Urgent Care Medicine, there are 9,300 stand-alone emergency medical services providers in the US alone and their number has grown rapidly in the last decade. These specialised centres can play an important role in times of crisis. Patients are wary of going to general practitioners who are often not very well-equipped to handle such emergencies, while larger hospitals are difficult to access. These centres have an advantage over traditional hospitals in that these involve low expenditure, a shorter gestation period and the ability to gain scale and replicate operations. Therefore, the costs are not transferred to patients, making the services more accessible and affordable."
"It is estimated the market for stand-alone emergency care services in India's top seven metro cities will stand at about $1 billion by 2020," he adds.
Challenges
For Urgent Care, the biggest challenge is creating awareness. "In India, patients don't know what urgent care is. Awareness building is a challenge," Ahmed says. "Our first experience was patients were scared of coming to our centres because they thought we are very expensive, as our centres were neat and clean. Now, 55 per cent are those coming for re-visits."
The company chose Delhi to begin with, as it felt it would be easier to expand from there. "Delhi is very competitive in pricing, but I chose it because I wanted to create a brand. I could have done it elsewhere; business-wise, it would have been terrific, but wouldn't have created the brand," Ahmed says, adding price competition can be overcome by creating a differentiated quality product.
As it expands into tier-II and III cities, staff crunch is another challenge. The company, therefore, plans to partner a few educational facilities.