Académique Documents
Professionnel Documents
Culture Documents
P
a
t
i
e
n
t
s
Patients are
enrolled under
different benefit
schemes
Insurance cost
reduces
There is no
deductible for the
patient
Ease of payment,
cashless facilities
in network
hospitals
P
a
y
e
r
I
n
s
u
r
a
n
c
e
Insurance players
get customers
Concept of Self
Funding Insurance
especially for
corporates is
lucrative business
Good healthcare =
Low Insurance cost
P
r
o
v
i
d
e
r
H
o
s
p
i
t
a
l
s
Makes expensive
world class
facilities available
to the middle class
Insurance
empowers
customers and
ensures regular
check-ups
Profitable for the
hospitals as
services are
provided as per
coverage and
benefits
12
Proposed Model for Competitive Advantage
12
Primary
Provider
Subscribers
Pharmacy Hospital (Secondary Provider)
Enrollee
Payer (Insurance Agencies)
Pro Bono
13
Proposed Model for Competitive Advantage
This model enables the hospital to cater to the middle classes as well as the
rich who can afford the world class treatment
It is a win win situation for the Hospital Patients Insurance Companies
The entire value web is optimized. Competitors in the NCR region are not
modeled in this way i.e. The Hospital Insurance nexus is not leveraged
Patients are empowered as they can choose exactly what benefits and
coverage they want and pay the insurer accordingly
Patients subscribers have many distinct advantages over traditional hospitals:
Reduced risk as compared to conventional insurance
Reduced premiums
Reduced co-payments
No deductibles or annual maximums
The hospital can exploit an edge over its competitors on the following factors:
World class facilities and equipment with multi super specialty
Insurance coverage ensuring affordability in patients time of need
Self Funding schemes for corporates, hospice and palliative care model can
also give this hospital an edge.
14
Financials
Assumptions
Number of Beds: 150
Average In patient stay: 4 days
Average daily out patients = 200
Uniform salary of interns,
residents, attending and
department heads
Salary assumed at 3 lacs per
month
Lab, claims, overheads, etc. have
not been factored
Set up cost and capital structure
will determine break even
Number and depth of specialties
will determine initial costs
Year 1
Number of
visits
Average
Sales
Inpatient 13688 35000 479080000
OutPatient 73000 700 51100000
Gross revenue 53,01,80,000
Allowance percentage 5
Net revenue 50,36,71,000
Salaries and wages -
Doctors 10,80,00,000
Salaries and wages - Staff 1,00,00,000
Malpractice insurance 1,00,00,000
Travel and education 10,00,000
General insurance 1,50,00,000
Subscriptions 5,00,000
Medical Supplies 12,00,00,000
Electricity 30,00,000
Water 2,00,000
Equipment rental 8,00,00,000
Building lease 5,00,00,000
Other operating expenses 1,03,779
Total operating expenses 39,78,03,779
Net profit (loss) 10,58,67,221
Gross margin (%) 21.0%
15
References
What's the Secret?: To Providing a World-class Customer Experience, John Wiley & Sons, DiJulius,
John R., (2008)
Managing Services: Using Technology to Create Value, McGraw-Hill, Boston, Davis, Mark M. and
Janelle Heineke, (2003)
Service operations management: Improving service delivery, Robert Johnston and Graham Clark
Service management and operations, Cengiz Haksever, Barry Render and Roberta S. Russell
The management of service operations, J. Nevan Wright and Peter Race
Service operations Management: Strategy, design, and delivery, Christine Hope and Alan
Mhlemann
Successful service operations management, Richard Metters, Kathryn King-Metters and Madeleine
Pullman
MANAGING A MODERN HOSPITAL, 2E: edited by: A V Srinivasan, Corporate Planner-Indian
Network, Hyderabad
HOSPITAL MANAGEMENT: An Evaluation, A.K. Malhotra
Hospital Management, Dr S M Jha
The Rise And Fall Of HMOs: Jan Coombs
Then Why Does it Still Hurt? Jack Schroder (2000)
Process flow designs and models are original work.
16
Thank you!!!