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A Novice’s Experiment With
Affordable Healthcare
V. Renganathan
Co-Founder, Vaatsalya Healthcare Solutions

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Enabling access to affordable healthcare

Vaatsalya Healthcare Solutions
Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Indian Healthcare Expenditures
Year
2008
2012
2017

•
•
•
•
•

HC Expenditure ($)
45 B
79 B
158 B

Annual Growth rate: 15%
Increasing income
Insurance availability
Availability of good hospitals
Availability of highly skilled doctors
Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Healthcare Services Distribution
Indian Population: 30% Urban & 70% Rural

Hospitals: Mostly Urban & Tertiary Care
Demand: Mostly Primary & Secondary care
Semi-urban & Rural areas lack healthcare facilities &
when available may not be of good quality

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
About Vaatsalya
• Mission: Create a network of for-profit
hospitals providing customer-oriented, ethical,
affordable, and efficient healthcare services in
semi-urban and rural areas
• Number of hospital units operational: 15
• “Accessible, affordable, human-touch, &
respect”

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Vaatsalya Business Model
• Location: Tier II and III cities with 200K
population
• 50-100 bed hospitals
• Specialties: General medicine, Gynecology,
Pediatrics, and General Surgery
• Offer 70% of needed healthcare services
• Other Specialties: Nephrology, Urology,
Pediatric Surgery
Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Founders/Management Team
Dr. Ashwin Naik, Co-Founder & CEO
• Physician, scientist, and entrepreneur
- VP of Business Development at Triesta Sciences
- Human Genome Project, Celera Genomics, USA

Dr. Veerendra Hiremath, Co-Founder & VP, Projects
• Physician & Hospital admin
- Vivus Group Hospitals, and Asia Heart Foundation

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Founders/Management Team

Dr. Renganathan V

VP Alliances

Scientist turned manager
- Asso. Prof, Biochemistry at Oregon Graduate Institute, Portland, USA
- 40 publications & 6 PhDs
- Program manager, Intel, Portland, Oregon, USA
- PhD from Indian Inst. Of Science, Bangalore
- MBA from Portland State University, Portland, Oregon, USA
•.
-

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Vaatsalya Hospitals (12)
Karnataka

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Vaatsalya Hospitals (4) – A.P.

Rajmundhry

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Facilities

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Vaatsalya Hospital, Hassan
Bharathi Healthcare Complex, Opp to Sandalkote

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Vaatsalya Hospital, Hubli
IMZ Plaza, Next to New Bus Stand

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Vaatsalya Hospital, Mandya
Pragathi Healthcare Complex, G. H. Road

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Reception, Shimoga

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Neonatal ICU, Gadag

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
NICU – Vizianagaram, AP

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
ICU, Gulbarga

NICU, Gulbarga

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Awards & Accolades


Top 100 startups – TATA NEN Hottest Startup 2008



Sankalp Award for Social Enterprise 2009



Rashtriya Samman Puraskar 2009



Frost & Sullivan India, Excellence In Healthcare Award 2010



India Fast Growth 25 (# 5 Ranking) 2010



Ashwin Naik selected as a global Young Leader by WEF (2012)



Porter Prize for Value Based Healthcare (2012)

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Affordability in a Hospital Context
•
•
•
•
•

Affordability depends on target segment
Target segment for Vaatsalya: Rs 36 – 120K/year
BPL income: 17K a year
Our customer earns 2x – 7x that of a BPL family
Vaatsalya is affordable by APL segments

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Understand Healthcare Service Costs
Service Price =
Total Cost

=

Total cost of operations + Provider profits
Fixed Cost + Variable Cost + Indirect Cost

Fixed costs: Professionals, Mortgage/Rent, Depreciation
Variable costs: Medicines, Consumables
Indirect Costs: Water, electricity, Corporate expenses
(Expected) Provider Profits α Investments

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Vaatsalya Approach to Cost Control &
Profit Optimization
Strategy

Impact

Don’t own but lease building

Low investment requirement

Buy only reliable Indian made
equipment

Lowered capital expenditure

Negotiate volume discount

Lowered capital & variable
expenditure

No costly equipment (eg; MRI)

Lowered capital expenditure

Doctors on revenue share

Lower fixed expenditure

Control corporate expenditure

Lower operational expenses

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
User Challenge to Provider
•

1. Offer good quality accessible services at
affordable prices
2. That offer should be available wherever I move in
my community – That means scalable

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
User Expectations: Healthcare Service
Cost as low as possible
High Quality
Home

Hospital

Easy Accessibility
User’s Street
Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
What is Quality?
User yardsticks of Quality
• Cure rate or how fast I got cured
• Clinical Diagnosis Skills
• Hospital Cleanliness

A quality provider follows recommended
guidelines of diagnosis & treatment
What are the impact of quality measures on cost?

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Accessibility to Services
• Physical

as well as services accessibility

• Physical accessibility means hospital in the neighborhood
itself or if transportation is available easy access through roads
How does accessibility impact costs ?
Closer the healthcare facility to the user higher the costs

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan
Urban Health
Issues

Communicable/Infectious
diseases

Prevention

Acute Care

•Long-term
•No significant
role for Provider

•Short-term
•Predominant
role for Provider
• OP & IP care

Non-Communicable

Prevention
•Long-term
•Significant role
for Provider
• OP care
• Diagnostics

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan

Chronic Care
•Long-term
•Significant role
for Provider
• OP & IP
• Diagnostics
Urban Healthcare Delivery Model
Peri-urban
Spaces

Full fledged
secondary care
hospitals with OP &
IP care

• Low-cost clinics
• 1-2 docs, ANM, Nurses
• Clinics with OP care
• Diagnostics
• Medical management
• Diet/exercise consultation
• OP chronic care treatments

Presented at Lounge47.in on 1st February 2014
Copyright © Mr. Dr. V Renganathan

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A Novice’s Experiment with Affordable Healthcare

  • 1. A Novice’s Experiment With Affordable Healthcare V. Renganathan Co-Founder, Vaatsalya Healthcare Solutions Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 2. Enabling access to affordable healthcare Vaatsalya Healthcare Solutions Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 3. Indian Healthcare Expenditures Year 2008 2012 2017 • • • • • HC Expenditure ($) 45 B 79 B 158 B Annual Growth rate: 15% Increasing income Insurance availability Availability of good hospitals Availability of highly skilled doctors Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 4. Healthcare Services Distribution Indian Population: 30% Urban & 70% Rural Hospitals: Mostly Urban & Tertiary Care Demand: Mostly Primary & Secondary care Semi-urban & Rural areas lack healthcare facilities & when available may not be of good quality Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 5. About Vaatsalya • Mission: Create a network of for-profit hospitals providing customer-oriented, ethical, affordable, and efficient healthcare services in semi-urban and rural areas • Number of hospital units operational: 15 • “Accessible, affordable, human-touch, & respect” Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 6. Vaatsalya Business Model • Location: Tier II and III cities with 200K population • 50-100 bed hospitals • Specialties: General medicine, Gynecology, Pediatrics, and General Surgery • Offer 70% of needed healthcare services • Other Specialties: Nephrology, Urology, Pediatric Surgery Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 7. Founders/Management Team Dr. Ashwin Naik, Co-Founder & CEO • Physician, scientist, and entrepreneur - VP of Business Development at Triesta Sciences - Human Genome Project, Celera Genomics, USA Dr. Veerendra Hiremath, Co-Founder & VP, Projects • Physician & Hospital admin - Vivus Group Hospitals, and Asia Heart Foundation Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 8. Founders/Management Team Dr. Renganathan V VP Alliances Scientist turned manager - Asso. Prof, Biochemistry at Oregon Graduate Institute, Portland, USA - 40 publications & 6 PhDs - Program manager, Intel, Portland, Oregon, USA - PhD from Indian Inst. Of Science, Bangalore - MBA from Portland State University, Portland, Oregon, USA •. - Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 9. Vaatsalya Hospitals (12) Karnataka Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 10. Vaatsalya Hospitals (4) – A.P. Rajmundhry Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 11. Facilities Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 12. Vaatsalya Hospital, Hassan Bharathi Healthcare Complex, Opp to Sandalkote Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 13. Vaatsalya Hospital, Hubli IMZ Plaza, Next to New Bus Stand Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 14. Vaatsalya Hospital, Mandya Pragathi Healthcare Complex, G. H. Road Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 15. Reception, Shimoga Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 16. Neonatal ICU, Gadag Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 17. NICU – Vizianagaram, AP Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 18. ICU, Gulbarga NICU, Gulbarga Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 19. Awards & Accolades  Top 100 startups – TATA NEN Hottest Startup 2008  Sankalp Award for Social Enterprise 2009  Rashtriya Samman Puraskar 2009  Frost & Sullivan India, Excellence In Healthcare Award 2010  India Fast Growth 25 (# 5 Ranking) 2010  Ashwin Naik selected as a global Young Leader by WEF (2012)  Porter Prize for Value Based Healthcare (2012) Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 20. Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 21. Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 22. Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 23. Affordability in a Hospital Context • • • • • Affordability depends on target segment Target segment for Vaatsalya: Rs 36 – 120K/year BPL income: 17K a year Our customer earns 2x – 7x that of a BPL family Vaatsalya is affordable by APL segments Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 24. Understand Healthcare Service Costs Service Price = Total Cost = Total cost of operations + Provider profits Fixed Cost + Variable Cost + Indirect Cost Fixed costs: Professionals, Mortgage/Rent, Depreciation Variable costs: Medicines, Consumables Indirect Costs: Water, electricity, Corporate expenses (Expected) Provider Profits α Investments Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 25. Vaatsalya Approach to Cost Control & Profit Optimization Strategy Impact Don’t own but lease building Low investment requirement Buy only reliable Indian made equipment Lowered capital expenditure Negotiate volume discount Lowered capital & variable expenditure No costly equipment (eg; MRI) Lowered capital expenditure Doctors on revenue share Lower fixed expenditure Control corporate expenditure Lower operational expenses Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 26. User Challenge to Provider • 1. Offer good quality accessible services at affordable prices 2. That offer should be available wherever I move in my community – That means scalable Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 27. User Expectations: Healthcare Service Cost as low as possible High Quality Home Hospital Easy Accessibility User’s Street Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 28. What is Quality? User yardsticks of Quality • Cure rate or how fast I got cured • Clinical Diagnosis Skills • Hospital Cleanliness A quality provider follows recommended guidelines of diagnosis & treatment What are the impact of quality measures on cost? Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 29. Accessibility to Services • Physical as well as services accessibility • Physical accessibility means hospital in the neighborhood itself or if transportation is available easy access through roads How does accessibility impact costs ? Closer the healthcare facility to the user higher the costs Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan
  • 30. Urban Health Issues Communicable/Infectious diseases Prevention Acute Care •Long-term •No significant role for Provider •Short-term •Predominant role for Provider • OP & IP care Non-Communicable Prevention •Long-term •Significant role for Provider • OP care • Diagnostics Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan Chronic Care •Long-term •Significant role for Provider • OP & IP • Diagnostics
  • 31. Urban Healthcare Delivery Model Peri-urban Spaces Full fledged secondary care hospitals with OP & IP care • Low-cost clinics • 1-2 docs, ANM, Nurses • Clinics with OP care • Diagnostics • Medical management • Diet/exercise consultation • OP chronic care treatments Presented at Lounge47.in on 1st February 2014 Copyright © Mr. Dr. V Renganathan