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August 2009
AGENDA
Group Overview
Company Overview
Recent Acquisition
Financials
Way Forward
2
GROUP OVERVIEW
3
AGENDA
Group Overview
Company Overview
Recent Acquisition
Financials
Way Forward
4
EVOLUTION OF HEALTHCARE IN INDIA
India: Health Expenditure as a Percentage of GDP
6.0%
5.1%
4.2%
4.0% 3.8%
2.6% 3.0%
2.1%
2.0% 1.3%
0.0%
1950-51 1960-61 1970-71 1980-81 1990-91 2000-01 2005-06
Source: FICCI and Ernst & Young (2008).
55 0.6
0.4 0.6
0.86
0.80
0.71 0.70
0.54 0.55 0.59
0.51
0.46
0.35
Biha r
J&K
UP
T ripura
H a ryana
India
MP
R a ja stha n
O rissa
A ssa m
Cost of important Procedures (in US$) Source: FICCI and Ernst & Young (2008).
Percentage share of India in world health parameters Healthcare distribution across rural and urban areas
7
20%
3 3.3
8% 8% 9% 2.5
6% 1 1 1
0.8
1%
Ailments ratio Beds per '000 Physicians per Nurses per '000
Disease Beds Doctors Nurses Community Lab
'000
burden & health technicians
workers
Urban Rural
6
Source: FICCI and Ernst & Young (2008). Source: FICCI and Ernst & Young (2008).
HOSPITALS: PROXY FOR INDIA’S HEALTHCARE BOOM
The Healthcare Delivery Market in India pegged at around USD 40bn, is approximately five
times the size of the Pharmaceuticals Industry and offers a huge growth opportunity
India has 16% of the world's population, but one of the poorest healthcare infrastructures
among growing economies and the lowest spend on healthcare (~5% of GDP)
Demographic changes, improving income levels, changing lifestyles, and rising insurance
penetration etc will result in a rise in discretionary spending on healthcare
Healthcare is a difficult business with large capital outgo and long payback periods. Hence
for larger hospitals (tertiary care) India is dependant on private sector investments
Execution of new projects is key and the high cost of retaining skilled doctors remains a
constant threat to returns
In India, private sector hospital companies are well equipped to take advantage of this
large opportunity in tertiary healthcare 7
HEALTHCARE SPEND IS ON THE RISE
As India becomes a more advanced economy Growing share of urban middle class households
100% 3.3% 5.2% 7.0%
the spend on healthcare as a proportion of the
Would opt for
80%
total spend is set to rise. 44.2%
52.5%
mediclaim
60% 58.6%
20%
20% 35% 32% 29% 27%
0%
0%
1995 2005E 2015F 2025F
2001 2006 2011P 2016P 8
Food Apparel Housing, utilities
0-14 yrs 15-29 yrs 30-44 yrs 45-59 yrs 60+ yrs Household prod. Personal prod. Transportation
Communication Education Healthcare
Source: ENAM Research Source: ENAM Research
LIFESTYLE CHANGE = MORE HOSPITALIZATION
Changing disease profile Lifestyle diseases: More expensive
100% 36,000
Cancer (Rs/treatment)
30% 3,000
Cardiac – A CAGR of 11.6% Rs 2,172 bn 2,312
large Lifestyle diseases are set
20% contributor of to assume a greater share 2,000
the lifestyle Rs 1,253 bn 1,268
of the healthcare market
segment
Lifestyle diseases such as 1,000 637
10% cardiac diseases require 1,329
617 903
hospitalization and are
more expensive to treat 0
0%
hence increasing the in- 2006 2011E 2016E
2001 2012 patient revenues OPD IPD
Source: CII-McKinsey. Source: CRISIL Research ,OPD: Out-patient; IPD: In-patient. 9
Group Overview
Company Overview
Recent Acquisition
Financials
Way Forward
10
FOUNDER’S VISION
“To create a world-class integrated
healthcare delivery system in India,
entailing the finest medical skills combined
with compassionate patient care”
11
THE FORTIS EDIFICE…..
Mission: To have a network of more than 40 hospitals and over 6,000 beds by 2012.
Globally respected
Responsibility
“Achieved by” Talented people Strong value system Efficient systems towards stakeholders
12 12
“Foundation”
Built on Trust
HOSPITALS: BENEFITS TO ACCRUE IN LONG TERM
Set-up cost Operating Profit
Operating Metrics
Buildup
Indicative Hospital Operating Model
(%)
Book Breakeven
Land 12 500 (%)
Other 4x
10 Year 5
Equip 400 Cash Breakeven
30%
300 2.8x
EBITDA Breakeven
2.1x
Revenues
21%
Medical 40 200 1.6x 24%
21%
Equip 1x 26%
31%
25%
100 35% 28%
34%
38% 28%
36% 32% 29%
43%
0 22% Year 4
Building
26 (100)
Year 1 Year 2 Year 3 Year 4 Year 5
14%
Cash Direct Personnel Other Costs EBIDTA Year 3
losses 12
13
30% Occupancy 85% EBITDA Flow
Fixed Cost Structure
KEY DIFFERENTIATORS :
Core Competence Strengths
Providing Tertiary and Quaternary care on Centre of o Focus on Medical and service excellence.
Excellence in the areas of:
o In-house project execution capabilities on QTC
Cardiac Sciences parameters
Boutique facility for women and child care o Experienced, dedicated and financially sound
promoter group.
State of the art accredited facilities.
FIELD: FOS:
1. Building employee capability to drive 1. To minimize lead time in patient related
operations efficiency operations
2. Developing distinctive capabilities at 2. To embed best practices in operations to
various levels yield bottom line impact
3. Generating talent pipeline to support 3. High level of patient care; and
growing business needs 4. To create next generation leaders
Patient
Centricity
TRM:
PSM:
1. Increase revenue through systematic
intervention and create a sustainable 1. Consolidate and optimize purchase and
platform going forward supply chain operations
2. Enabling cross sharing of information 2. Achieve internal process efficiencies
across different units 3. Standardization of items
15
3. Develop a common approach for revenue 4. Price equalisation
management
KEY DIFFERENTIATOR - ACCREDITATIONS, FACILITIES AND DOCTORS
JCI
Greenfield
• On Payrolls of the company
Brownfield Doctors on • Center of Excellence under
Rolls Super Specialty
O&M
Fortis
FINANCIALS: A SNAPSHOT: NETWORK REVENUES
Rs. In Crores
900
800 772
Owned Managed 17
STRATEGIC PLAN – MISSION 2012
Fortis aspires to . . .
Group Overview
Company Overview
Recent Acquisition
Financials
Way Forward
19
ABOUT WOCKHARDT
Proven track record in setting up green field hospitals and delivering compassionate
and quality healthcare in a cost effective manner
Provide super speciality care in Cardiac, Neuro, Ortho, and, Minimal Access Surgery
and Women Care
Hospitals in Bengaluru and Mumbai have received the highly coveted JCI
accreditation
Came up with IPO @ Market Capt of Rs. 2,850 – 3,150 Crore ( $ 600 – 675 million) –
Reduced size to Rs. 2,300 – 2,600 Crore ($ 475 – 550 million) after lukewarm
20
response from market
THE DEAL
2 new hospitals at Yeshwantpur, Bengaluru (120 beds) and Anandpur, Kolkata (414
beds), under construction, to be operational in next 12-15 months.
Includes 3 nursing colleges (total – 450 candidates) linked to operating hospitals, for
availability of trained nursing staff 21
HOSPITALS UNDER ACQUISITION
Nos. City Location Total Beds Start Remarks
Year
1 Mumbai Mulund 567 2002 JCI accredited
2 Mumbai Kalyan 60 2008
3 Bengaluru BG Road 451 2006 JCI accredited
4 Bengaluru Cunningam Road 128 1991
5 Bengaluru Chord Road 40 2007
6 Bengaluru NagarBhavi 55 2007
7 Kolkata Rashbehari Avenue 67 1993
8 Kolkata Sarat Bose Road - 1990 Daycare centre
1,368
Greenfield
9 Bengaluru Yeshwantpura 120 - New Project
10 Kolkata Anandpur 414 - New Project
1,902
Quality assets at premium locations, with clinical competence and strong reputation 22
Total beds include expansion opportunity in 2 facilities
STRATEGIC RATIONALE
Centre of Excellence in Cardiac, Neuro, and Ortho, further strengthens dominant position :
3 top specialities account for 54% - 58% of total revenue
Largest cardiac care and Joint replacement programs across India
Improved Purchase and Supply Management :
Expect a significant reduction in cost of Bought-out Items resulting in benefits in combined network
Integrated marketing and customer acquisition
Synergize regions for more efficient play and management efficiencies
Significant savings in the employee costs
Mumbai, Bengaluru allow leveraging combined network for Doctor productivity maximization
Wockhardt
MAS/Renal Critical
10% Care/Other
18%
Neuro
6%
Ortho OPD
10% Other 15%
18%
Cardiac Pharma
38% 3%
23
% Revenues
STRATEGIC RATIONALE
Geographical Complementarities
Supports ‘Deep’ strategy for each region, with hospitals located in metros (Mumbai,
Bengaluru, and Kolkata)
Shared Value system
Enhances depth and width of talent and medical competence of the group for
supporting future growth plans
Adds talent pool of 650+ doctors, ~1300 Nurses/Para-medics, +650 other staff.
Bed North Zone West & Central South Zone East Zone
Capacity (NCR, Punjab, (Maharashtra, Gujarat, (AP, TN, Karnataka, (West Bengal)
Rajasthan) Chhattisgarh) Kerala)
998
3500
3000
2,472
2500
725
2000
1,586
1500 3123
674 1,064
1000 295 1747
0
Doctors Nurses Paramedical Executives & Staff
Fortis Wockhardt
25
Arneja Hospital,
Nagpur(2006)
Bengaluru – 5 Hospitals
27
Fortis Network Hospitals
Acquired Hospitals
COMBINED FINANCIALS (FY 2008-09)
Group Overview
Company Overview
Recent Acquisition
Financials
Way Forward
29
FY 2009
30
SNAPSHOT – EXECUTIVE SUMMARY FY-2009
Key Performance Indices:
Revenue across network crosses more than
Rs. 200 Crores mark for Quarter – IV
600.00
548.00
500.00
Rs. Crores
400.00
300.00
Maiden profits
for the company
200.00 85%
114.25
100.00 61.75
20.82
0.00
Operating Revenue EBIDTA PAT
33
(100.00) (55.48)
FY08 FY09E
Q1FY-2010
34
Snapshot – Executive Summary
Q1 FY 10 - Consolidated
Rs. in Crores +45%
Operating Revenue - Rs. 185 Cr 33%
EBITDA - Rs. 31 Cr 34%
+27%
Net Profit - Rs. 7.6 Cr 7x
Q1 FY 09 Q1 FY 10
Total Income
EBITDA & PAT (CONSOLIDATED)
Rs. in Crores
Q1 FY 09 Q1 FY 10
+7x
+34%
36
Operating EBITDA as a percentage of Operating income grows 490 bps over corresponding period last year
CONSOLIDATED PROFIT AND LOSS – Q1FY10
Q1FY10 Q1FY09 Q-o-Q
Particulars % %
(Rs. Crores) (Rs. Crores) Growth
Operating Revenue 185.4 100% 139.4 100% 33%
Other Income 3.1 2% 9.0 6% -66%
Total Income 188.5 148.4
Direct Costs 54.3 29% 41.9 30% 30%
Employee Costs 42.5 23% 36.0 26% 18%
Other Costs 60.6 33% 47.3 34% 28%
EBITDA 31.2 17% 23.2 17% 35%
Finance Costs 10.4 6% 10.9 8% -5%
Depreciation &
11.4 6% 11.7 8% -3%
Amortization
PAT 7.6 4% 0.9 1% 7x
Indian Corporates
9.65%
Retail Investors
11.13%
As on 31st July 09 38
AGENDA
Group Overview
Company Overview
Recent Acquisition
Financials
Way Forward
39
AGGRESSIVE GROWTH PLAN
Pan India Rollout plan:
Geographical:
Northern India
NCR
Western
Southern
Eastern
Metros & Tier-2 towns
DEEP strategy
Mix of Greenfield, O&M and Acquisitions
Super
Religare
By FY 2012, Fortis plans to Fortis
Healthworld
Fortis
reach Clinical
Research Fortis
40 Hospitals Healthcare
$ 575 Million
Religare
6000 Beds Technova Religare
Enterprises 40
Global Presence
Business under discussion
CURRENT PROJECTS
Shalimar Bagh
Construction started in August ’07.
Expected commissioning in Q IV – 2009
Gurgaon
Excavation completed, shell of the building expected to be completed soon
Expect commissioning by early Q – I, 2011 – 350 beds.
Other Projects
Expansion of Mulund Hospital, Mumbai – 316 beds
Expansion of Bengaluru Hospital – 196 beds
41
2 Greenfields at Bengaluru and Kolkata – 534 beds
PEERS REVIEW
42
APOLLO AND MAX
Apollo Max
3000 700 20%
18.0%
2535 601
16.0% 600 17%
2500
28%
2094 14.0% 484 15%
500
2000
12.0% 423
1614 400 372
Rs. Crores
10.0%
1500 10%
1214
8.0% 300
1000 6.0%
200
5%
4.0%
500
100
2.0%
0 0.0% 0 0%
FY08 FY09 FY10E FY11E FY08 FY09 FY10E FY11E
43
Revenues EBIDTA PAT Revenues EBIDTA
Centrum Broking Estimates B&K Estimates
KEY DIFFERENTIATOR – SUCCESS DRIVERS :
Strong IT system
Pan India
Presence, Differential Model –
Doctor engagement,
leveraging costs - Deep penetration
Revenue and Strategy
Capital
Business
Model
Bandwidth for
future Growth,
Operational
managed through Synergies – FOS,
team of TRM, PSM
Professionals
Stress on Quality,
Patient Centricity
44
SAFE HARBOR
Except for the historical information contained herein, statements in this presentation and the subsequent discussions, which include words or phrases such as “will”,
“aim”, “will likely result”, “would”, “believe”, “may”, “expect”, “will continue”, “anticipate”, “estimate”, “intend”, “plan”, “contemplate”, “seek to”, “future”,
“objective”, “goal”, “likely”, “project”, “should”, “potential”, “will pursue” and similar expressions or variations of such expressions may constitute "forward-looking
statements". These forward-looking statements involve a number of risks, uncertainties and other factors that could cause actual results to differ materially from those
suggested by the forward-looking statements. These risks and uncertainties include, but are not limited to our ability to successfully implement our strategy, our growth
and expansion plans, obtain regulatory approvals, our provisioning policies, technological changes, investment and business income, cash flow projections, our
exposure to market risks as well as other risks. Fortis does not undertake any obligation to update forward-looking statements to reflect events or circumstances after the
date thereof.
“Fortis Healthcare Limited is proposing, subject to receipt of requisite approvals, market conditions and other considerations, a rights issue of its equity shares with
warrants and to file a Draft Letter of Offer with SEBI.” This presentation is not and should not be construed as an offer for sale within the United States of any rights,
warrants, equity shares or any other security of Fortis Healthcare Limited or as a solicitation of an offer to buy any of such rights, warrants, equity shares or other
securities. Securities of Fortis Healthcare Limited, including any offering of its rights, warrants, equity shares or any other security, may not be offered, sold, resold or
otherwise transferred within the United States absent registration under U.S securities laws or unless exempt from registration under such laws. The offering of the
securities of Fortis Healthcare Limited described in this advertisement has not been and will not be registered under U.S securities laws, and accordingly, any offer or
sale of these securities may be made only in a transaction exempt from registration.
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THANK YOU…
46
Fortis Healthcare Limited
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