It is not about Size & Beds but governance in Private Hospitals in India. Indian Hospitals need a major makeover

It is not about Size & Beds but governance in Private Hospitals in India. Indian Hospitals need a major makeover

Cost Reduction, improving quality of care and access for patients are challenges as Global Hospitals, Apollo Hospitals Group, Fortis Healthcare, Care Hospitals & Manipal Hospitals compete to win coveted India’s Most Best Managed Healthcare Chain 2013

Saturday, November 23, 2013, Mumbai, Maharashtra : India’s medical tourism boom—a $1 billion business that is growing by 30% a year is being regarded by the analysts & experts as one of the fastest & growing sector in healthcare services worldwide as india’s top private hospitals have expanded their healthcare services remarkably both in size & geographies. Health services in India have to be affordable because their patients are poor and typically pay 60 percent of their medical costs out of pocket & without healthcare insurance in place, Indian Hospital majors are facing the heat of price reduction & globalizing healthcare standards. As Healthcare Industry in india mainly the hospital chains are beginning to change their approach, Pharmaleaders ( www.pharmaleaders.tv ), Asia’s most analytical news media in healthcare has nominated top five hospitals in india such as Global Hospitals, Apollo Hospitals Group, Fortis Healthcare, Care Hospitals & Manipal Hospitals for public voting to determine who has the edge in corporate HR & Managed Healthcare in the category of “India’s Most Best Managed Healthcare Chain 2013” at the historic sixth edition of Pharmaceutical Leadership Summit & Business Leadership Awards 2013 ( www.pharmaleaders2013.com ). This widely acclaimed meet is held annually to recognize the best amongst the best based on their yearly performances.

The experience of a few innovative Indian hospitals may point the way forward. India’s health care system as a whole has many problems, mainly on the issue of governance & affordable medical care. The quality of doctors, equipment and infrastructure has been the hallmark of healthcare excellence in Indian hospital industry & The Indian experience shows that costs can be dramatically reduced and access can be expanded even as quality is improved.

The study point out that  private hospitals deliver medical outcomes comparable to that of good U.S. hospitals, as measured by medical complication rates or post-treatment survival rates. Furthermore, they're profitable. Even if Indian hospitals paid U.S.-level salaries for all health-care staff, which are as much as 20 times higher, their prices would be one-fifth of U.S. levels. By contrast, hospitals in the United States are uncoordinated, duplicating specialized care without enough volume in most of them to make procedures affordable. Even when hospitals consolidate, the motive is often to gain pricing power over insurance companies rather than to lower costs.The second innovation is shifting responsibility for routine tasks to lower-skilled workers. This leaves doctors free to focus on complicated procedures. Several hospitals have created a tier of paramedic workers with two years of training after high school to perform routine medical jobs. As a result, surgeons, for instance, can perform two to three times as many surgeries as their U.S. counterparts. Compare that with the United States, where hospitals reduce costs by laying off support staff, which shifts mundane tasks such as billing to doctors, who are overqualified for such duties.Finally, the Indian hospitals save money through old-fashioned frugality. They shepherd resources by building hospitals at a fraction of the cost spent in the United States, replacing imported devices with local equivalents costing a fraction of the price or, for example, sterilizing and reusing clamps for open-heart surgery that are routinely discarded after one use in the United States. In contrast to the American fee-for-service model, they often pay their doctors a fixed salary. One hospital sends a daily message to all doctors with the previous day's financial results, encouraging them to consider the cost-effectiveness of their medical choices. In contrast, U.S. hospitals often resemble luxury hotels, with much wasted space and underutilized equipment. Their doctors, and sometimes even their chief financial officers, are unaware of how much procedures cost.How realistic is it that U.S. hospitals will adopt the Indian model? U.S. hospitals are constrained by regulations and norms unlike those in India. Nevertheless, some progressive U.S. hospitals are adopting some of the practices of our Indian exemplars, and more should follow their example.

India might be the last place on earth where you’d expect to find health care innovation. Government programs have finally brought some infectious diseases under control, but the nation’s ability to meet the basic medical needs of its citizens remains abysmal. Despite robust economic growth over the past two decades, the infant mortality rate is three times higher than China’s and seven times greater than that of the U.S. Of the 2 million Indians in need of heart surgery, fewer than 5% get it. The majority of the country’s estimated 63 million diabetics and 2.5 million cancer sufferers haven’t been diagnosed, let alone treated. Seventy percent of India’s 12 million blind people could be cured by a simple surgery—if it were available to them.

Although India boasts 750,000 doctors and 1.1 million nurses, practitioner density is about one-fourth what it is in the U.S. and less than half that of China. Hospital beds are in short supply, and most medical facilities are dated, cramped, and often unhygienic. In a country where the nominal per capita income is only $1,500 a year, patients typically have to pay 60% of health care expenses from their own pockets. Still, Indians believe that good medical treatment is something everyone should have access to regardless of their ability to pay.

Necessity spawns innovation. Despite the pressing demand and constrained supply, a few relatively new Indian hospitals have devised ways of providing world-class health care affordably—and to scale. These hospitals target well-off patients, which forces them to provide care that meets global quality standards. But their purpose is to serve everyone, including patients with very low incomes, which puts pressure on the organizations to lower costs dramatically. Such a business model scales because the low costs of these hospitals attract large volumes of patients and allow the overall enterprise to be profitable. As a result, the hospitals are able to sustain their operations not through the usual government subsidies, charitable donations, or insurance reimbursements but through their revenues.

The Indian hospitals we studied treat medical conditions that range from problems of the eye, heart, and kidney to maternity care, orthopedics, and cancer. Their charges for most procedures are as much as 95% lower than those at U.S. hospitals. How are some Indian hospitals able to provide such high-quality health care at ultralow prices? The obvious answer—the differential in the cost of labor—does play a role: Cardiothoracic surgeons, nephrologists, ophthalmologists, and oncologists in India earn anywhere from 20% to 74% of what their American counterparts do.

These Five Hospitals put together would constitute more than 30,000 Beds & will excel in healthcare services & the competition is intense as the prices of services of the consultants are increasing posing a challenge to meet the budget of the patients.

As india votes to select the coveted India’s Most Best Managed Healthcare Chain 2013 by public voting, it will be a challenge to crown the one of the five to be declared on 27^th December 2013 at Mumbai at Pharmaleaders Incredible Pharmaleaders 2013 Meet where more than 250 healthcare leaders will assemble to discuss healthcare reforms.