Aster Dm Healthcare Ltd. · NSE:ASTERDM
Aster Dm Healthcare — Investor Day (August 2019)
67 slides from Aster Dm Healthcare's investor day presentation, Aug 26, 2019
Slide 1: Filing cover letter to stock exchanges
26 August 2019 The Secretary The Manager, Listing Department, Listing Department, BSE Limited, The National Stock Exchange of India Ltd 1st Floor, Phiroze Jeejeebhoy Towers Exchange Plaza, C-1, Block G Dalal Street, Mumbai 400001 Bandra Kurla Complex Scrip Code: 540975 Bandra (East), Mumbai 400051 S
Slide 2: Investor and Analyst Meet – 22nd Aug 2019
ASTER OM HEALTHCARE Investor and Analyst Meet – 22nd Aug 2019 www.asterdmhealthcare.com1
Slide 3: Disclaimer
I I Disclaimer This presentation has been prepared by Aster DM Healthcare Limited (the "Company"), content of which was compiled from sources believed to be reliable for informational purposes only and are based on information regarding the Company and the economic, regulatory, market and other co
Slide 4: Aster DM Healthcare – At a Glance
I I Aster DM Healthcare – At a Glance HOSPITALS One of Largest Private CAPACITY BEDS healthcare service providers GCC: 1,101 GCC: 12 4,794 25 India: 3,693 India: 13 operating in Asia (GCC & India) PATIENT VISITS – FY19 Present in 9 Countries CLINICS (UAE, Saudi Arabia, Qatar, Oman, ~18.5 mn GCC: ~16
Slide 5: Aster DM Healthcare – Evolution
I I Aster DM Healthcare – Evolution FY-1987 FY-2012 FY-2019 25 years 7 years Single clinic Geographies: 5 Geographies: 9 operation in Dubai, Units : 7 Hospitals, Units* : 25 Hospitals, UAE 36 Clinics 115 Clinics 82 Pharmacies 231 Pharmacies Revenue : INR ~1,181 Cr Revenue : INR ~7,963 Cr - : USD ~25
Slide 6: Robust Growth Over Last 5 Years
I I ROBUST GROWTH OVER LAST 5 YEARS Outpatient Count (in mn) Inpatient Count (in '000) Aster DM - Revenue from Operations (INR Cr) 8.7 7.8 218 6.7 202 7,963 5.6 158 6,721 5,931 4.2 125 5,250 3.4 104 3,876 2.2 85 2,871 2.1 2.2 52 58 2,029 1,775 - - - - - - - - - - - - FY14 FY15 FY16 FY17 FY18 FY19 FY
Slide 7: Aster – A Healthcare Ecosystem
I I Aster – A Healthcare Ecosystem PATIENT LIFE CYCLE MANAGEMANT Aster, over 30 years, has created a healthcare eco-system across two geographical regions In GCC region, Aster’s primary care clinics act as the initial touch-points in the patient i. journey, while pharmacies and hospitals / ~ con
Slide 8: Aster DM Healthcare – At a Glance
I I Aster DM Healthcare – At a Glance Revenue - FY19 Revenue - FY19 India 17% Pharmacies 27% GCC INR ~7,963 Cr -> Clinics 24% Hospitals 49% 83% EBITDA - FY19 EBITDA - FY19 India Pharmacies 14% INR ~863 Cr ._____> 21% Clinics Hospitals 49% GCC 30% 86% Note: 1. Revenue and EBITDA shown above are exclu
Slide 9: Aster – Our Vision, Values and Promise
I I ASTER – OUR VISION, VALUES AND PROMISE VALUES r,JA 1CarE · Excellence Compassion Wirth a Globa l . r io . Surpassing current benchmarks constantly by Going beyond boundaries with empathy and continually challenging our ability and skills care to take the organization to greater heights Patients
Slide 10: Aster – Strategy & Outlook (1/2)
I I ASTER – Strategy & Outlook (1/2) Strengthening of hub and spoke model in GCC Specialized, asset-light growth in India Cost Optimization – HR & material cost focus Profitability growth & brand positioning using product-mix and technology 9
Slide 11: Aster – Strategy & Outlook (2/2)
I I ASTER – Strategy & Outlook (2/2) Scalable systems implementation, tightly integrated with market requirements A comprehensive human resource strategy utilizing our geographical diversity Strengthening of our medical tourism network Establishing new related business lines 10
Slide 12: Aster – Leadership Team
I I Aster – Leadership Team , Chairman & Managing Director ' Dr. Azad Moopen \... I ,, r r ] F 'I [ 'I CEO CEO Exec. Director & Group Head Group Chief Medical and Deputy Managing Director Aster Primary Care Aster Hosp. & Clinics India - Gov. & Corp Affairs ~ ~ Quality Officer Alisha Moopen Jobilal V
Slide 13: Aster – GCC
Aster – GCC 9
Slide 14: GCC – Macro Economic Overview
I I GCC – Macro Economic Overview Population (in mn) GDP per Capita - Nominal (USD) 33.7 69,000 • GCC Countries have a high per capita GDP even compared to USA (USD 43,000 ~63,000) and UK (USD ~43,000) 34,200 10.0 23,200 24,100 • Higher per capita income makes high I I-I 9.6 16,400 healthcare servic
Slide 15: GCC – Macro Economic Overview: Healthcare Expenditure
I I GCC – Macro Economic Overview Healthcare Expenditure (USD bn) Beds / 1000 Population 45 • GCC Countries, especially UAE, Oman 2.9 2.8 2.7 and Qatar have room for growth in 2.0 2.0 terms of healthcare expenditure (% of 1.6 GDP), Beds / 1000 and Physicians / 1.4 1000 - - ■ 111 15 1.2 1.2 I •• UAE
Slide 16: GCC Healthcare – Unique Traits
I I GCC Healthcare – Unique Traits Population (mn) Prevalence of Primary and Secondary Healthcare Expat% -> ~80% ~70% ~45% ~30% 32.0 Facilities (Private Sector) 9.3 Due to lack of support systems (family, relatives, etc.) 2.6 4.4 expat community travel back to their home countries for UAE Qatar
Slide 17: GCC Healthcare – Chronic Disease Prevalence (Dubai)
I I GCC Healthcare – Chronic Disease Prevalence (Dubai) Mortality rate due to cardiovascular diseases (~148 per 10K) – 3x compared to UK or Australia Diabetes prevalence ratio 17.3% (age 20-79) – 2x to 4x compared to UK or Australia Overweight prevalence ratio 34.5%– 5x to 10x compared to Sing
Slide 18: Aster GCC – Business Split
I I Aster GCC – Business Split REVENUE - FY19 Saudi Arabia Others Qatar 5% 6% 2% UAE: 7 Hospitals, 85 Clinics, 198 Pharmacies Oman 6% UAE Oman: 3 Hospitals, 7 Clinics, 7 Pharmacies 81% Qatar: 1 Hospital, 8 Clinics, 6 Pharmacies GCC Revenue FY19: INR ~6,649 Saudi Arabia: 1 Hospital • ~81% of Aster -
Slide 19: Aster UAE – Overview
I I Aster UAE –Overview Brands/Segments Hospitals Clinics Pharmacies Count: 4 Count: 17 Premium Installed Beds: 335 Avg Daily Patient Visits:~1,300 Avg Daily Patient Visits: ~1,480 Count: 3 Count: 47 Count: 198 Aster Installed Beds: 297 Avg Daily Patient Visits:~650 Avg Daily Patient Visits: ~8,900
Slide 20: Aster UAE – Facilities
I I Aster UAE – Facilities Beds : Capacity – 64, Operational - 55 Beds : Capacity – 126, Operational - 108 Operation Commencement Year: FY07 Operation Commencement Year: FY16 City: Dubai City: Dubai Beds : Capacity – 108, Operational - 91 Beds : Capacity – 154, Operational - 120 Operation Commenceme
Slide 21: Aster Oman
I I Aster Oman ASTER e · ---- ·iii Beds : Capacity – 85, Operational - 72 Beds : Capacity – 74, Operational - 64 Operation Commencement Year: FY09 Operation Commencement Year: FY10 City: Muscat City: Sohar • Oman GDP has been growing at a steady ~2.7% from 2013 to 2018 with a relatively high populat
Slide 22: Aster Qatar
I I Aster Qatar Beds : Capacity – 61, Operational - 41 Operation Commencement Year: FY18 City: Doha • Qatar GDP has been growing at ~2.6% from 2013 to 2018 with a population growth of ~3.5% • Aster has been present in Qatar since 2003 and currently has 1 hospitals, 8 clinics and 6 pharmacies Source:
Slide 23: Aster – Saudi Arabia
I I Aster - Saudi Arabia Sanad Hospital – An Overview Sanad Hospital – Snapshot FY 2018-2019 CAPACITY BEDS: 218 t DOCTORS: ~150 @ PATIENT VISITS: 200,000+ t NURSES: ~240 t OTHER HR: ~450 Sanad Hospital – Centres of Excellence Aster Sanad Hospital started its operation as “Dr. Ahmad Abanamy Hospita
Slide 24: Aster – Six Strategic Pillars
I I Aster – Six Strategic Pillars Clinical Excellence Service Innovation Excellence Business Talent Growth Management Community Connect • All stages of strategic actions – planning, execution and measurement – is directed by the six strategic pillars 23
Slide 25: Aster Primary Care
Aster RIMARY CARE DELIVERING GOOD HEALTH & HAPPINESS •••
Slide 26: Aster Primary Care – The Comprehensive Healthcare Offering
Aster Primary Care - The Comprehensive Healthcare Offering Aster - - (IQ0PT1cs - - Aster nline&- - PHARMACY Aster PRIMARY CARE .J ~ ■ ------~ L Aster CLINIC Aster DIAGNOSTIC Integrated Service Offerings Seamless Customer Journey Appointment Booking ~ , - - - -<1 Contact Centre n----+-------.. ,-----
Slide 27: Business Philosophy
Buisness Philosophy ~- ~- .... The Positioning . The Promise The Bonding Emotions Create a Happier, Affordable We will treat Pride Innovation Healthier Society Healthcare made you well Excellence Accessible Patient-Centricity Aster PRIMARY CARE
Slide 28: Aster Primary Care – Organogram
Aster Primary Care - Organogram CEO-APC Head- Marketing Aster PRIMARY CARE
Slide 29: Meet the CEO of Aster Primary Care
Meet the CEO of Aster Primary Care Mr. Jobilal M Vavachan Jobilal is the influential thought-leader of Aster Primary Care who sits at the helm of re-shaping the model of healthcare across the GCC. Renowned within the healthcare industry, Jobilal brings over 20 years of experience built on a strong f
Slide 30: Market Size & Growth
Market Size & Growth Dubai population & concentration of economic segment 10 9.62 Dubai Population 8 Total population of Dubai 2.7m ___________ Dubai __ [ _______ , EBP plan enrolment - 60\ 1.3m Northern Emirates Population C 6 I Fam1hes with EBP- 0.2m :E SharJah 17m .5 : 4.3 Total Market - EBP - 1.
Slide 31: Clinics – Growth Drivers
Clinics - Growth Drivers APC Clinics 75 75 61 63 65 49 31 FY14 FY15 FY16 FY17 FY18 FY19 FY20_Q1 Relocation and expansion of existing clinics give immediate benefits in Margin the form of revenue and margin growth with a lower operating cost base Pipeline (committed projects): 13 units* Business Grow
Slide 32: Retail – Growth Drivers
Retail - Growth Drivers APC Retail 98 155 170 190 194 205 217 • COO & Industry veteran Mr. Bala on board in FY18-19 • New brand additions & foray into generics • Rx Generation for brands/products • Replacing locally sourced products & capturing distributor margin FY14 FY15 FY16 FY17 FY18 FY19 FY20_Q
Slide 33: Competitive Advantage
Competitive Advantage 01 l Full spectrum of healthcare services I Largest network of pharmacies & clinics VALUE ADDED SERVICES: E-commerce 02 Presence in key commercial and res1dent1al areas Home care nursing Doctor-on-call facility Aster Secure 03 Strong brand equity I Loyalty program with over hal
Slide 34: Health & Wellness Service Provider
We are the UAE's most awarded and loved Health & Wellness Service Provider 0 .. Shar.1ah Top 10 Business Excellence Award 2017 .. UAE Innovation Award 2017 Dubai Human Development Appreciation-Award 2018 . -- Dubai Quality Appreciation Award For Aster Clinic 2019 Aster PR I MARY CARE
Slide 35: Affordable Healthcare Made Accessible
Affordable Healthcare Made Accessible 195 4000 18 Pharmacies Employees Optical Stores 71 4 4 Aster Clinics Diagonostic Nutrition Online Centers Stores Note: The above unit counts excludes clinics & pharmacies in Qatar, Oman, medcare clinics(UAE). Diagnostics are generally classified under clinics; N
Slide 36: Hospitals
ITAL
Slide 37: Dr. Sherbaz Bichu – CEO, Aster Hospitals & Clinics, UAE
Dr. Sherbaz Bichu – CEO, Aster Hospitals & Clinics, UAE Overview Dr. Sherbaz Bichu is Chief Executive Officer and Specialist in Anesthesia at Aster Hospitals, UAE. Having worked in the field of Anesthesia as well as Hospital administration, Dr. Sherbaz Bichu is well versed with the medical as well a
Slide 38: Aster Hospital UAE Growth Curve
Aster Hospital UAE Growth Curve Aster Hospital Sharjah 2020 - 418 BEDS Aster Hospital Muhaisnah 2019 - 338 BEDS Aster cedars Hospital 2019 - 297 BEDS Unit Beds Aster Hospital Qusais 2018 - 280 BEDS Al Rafa 14 Aster Hospital, Mankhool 126 Aster Hospital Mankhool Aster Hospital, Qusais 154 2014 -126 B
Slide 39: Recent changes in Healthcare sector
Recent changes in Healthcare sector • Ease of licensing - Prometric • Mandatory Insurance in place • Focus on Health Tourism - 326,000 Health tourists were welcomed in Dubai in 2016, DHA aim is to reach 500,000 by 2020. • Focus on e-prescription and electronic data interchange.
Slide 40: Aster Hospital
Aster HOSPITAL We'll Treat You Well Aster Hospital, Al Mankhool, Aster Hospital, Al Qusais Aster Cedars Hospital, Kuwait Road, Bur Dubai, 9th Beirut Street, Street No 2 (Outside Gate No 2) Dubai - UAE Al Qusais, Dubai - UAE Dubai - UAE
Slide 41: Aster Hospital footprint in UAE
Aster Hospital footprint in UAE ........ SAIF ZONE .,.,,,. . __,, .,Uii..i•.,N, ....... UNNERSITY cm ....... Duba, A International Y Airport ALIWIAMA ~> .,Lb.o ..,,sJI _,J.,_,JI AL KHAWANEEJ o-,1.,JI DUBAI Ft:$TIVAL CITY MIADfF ...... ,......... J,,. Dubai Jebel Ali ~::, Al Aweer _.JI INT£ANATIONAL
Slide 42: Business Model
Business Model Q Aster based clinic • • Community Clinic ···• ···• . .-,., . ... . . . . . n Q Banking on tertiary ··········Y • • and quaternary case Visiting doctors from India
Slide 43: Differentiator – Our Uniqueness (Aster Hospital, Mankhool, Dubai)
Differentiator – Our Uniqueness (Aster Hospital, Mankhool, Dubai) Clinical • USB: Critical Care, Interventional Cardiology • Center of Excellence – NICU • Royal college of Physicians, London Accredited. Operational • Sustained occupancy rate > 90% • OT Utilization 100% • Radiology Utilization 92% •
Slide 44: Key Focus Area
Key Focus Area Diagnostic Health and Electronic HUB to remote manage monitoring Center of Excellence Insurances NICU/ Cardiology Home care Transplants Complex surgical/ Obstetric cases
Slide 45: Medcare Hospitals & Medical Centres
Medcare Hospitals & Medical Centres
Slide 46: Medcare Hospitals & Medical Centres
Innovation Marketing Operations Digitalization Strategy • 26 Years of Experience Regionally & Internationally Strategic Partnerships Design ANDRE DAOUD Healthcare Ecosystems e-business • Business 15 Years Experience in Healthcare Development Medcare Hospitals & Medical Centres International Network
Slide 47: Growth Story
GROWTH STORY • Medcare Hospital • Medcare Orthopaedics • Medcare Hospital • Medea re Women & & Spine Hospital Children Hospital • Medcare Women & Children Hospital • Medcare Orthopaedics • Medcare Hospital Sharjah • Medcare Hospital Sharjah & Spine Hospital 1.1+ MILLION 400+ 2,000+
Slide 48: Clinical Excellence
Clinical Excellence Patient safety and well being to be priority number one Apply international Standards treat patients with Empathy and Attention Patient Experience Understand and create Patient needs Disrupt industry through a seamless, unique and digital patient experience from start to end Sust
Slide 49: Revenues / Savings, Brand, Quality, Engagement, Digitalization
Revenues / Savings BRAND Quality Engagement Digitalization Referral system / CBD Brand position / Ambition Introduce tier 1 HIS Map patient journey Engage & Enable Disease management Digital focused strategy Increase online revenues Center of Excellence Talent Development Sustainable insurance model
Slide 50: Aster – India
Aster – India 9
Slide 51: Aster India Leadership Team
Aster India Leadership Team Aster India Leadership Team Dr. Harish Pillai Dr. Nitish Shetty Jayaprakash KR CEO – Aster India CEO – Aster Hospitals COO – Aster Labs & Clinics, Bengaluru Kalappa K B Bindu Nambisan Sunil Kumar M R Head HR - Aster India Head – L&OD, Head Finance – Aster India Aster Indi
Slide 52: Geographical Footprint of Aster India
Geographical Footprint of Aster India Footprint in India Kerala 5 Aster Medcity Hospitals - 13 Clinics - 8 INDIA Aster MIMS Calicut Aster MIMS Kottakal Aster MIMS Kannur ASSH Wayanad Karnataka 2 Aster CMI Hospital Aster RV Hospital Clinics [4] Maharastra 1 Aster Aadhar Hospital Telangana 1 Aster Pri
Slide 53: Aster India @ Glance
Aster India @ Glance Human Resource Cluster wise Revenue Mix Total Hospitals : 13 Total Clinics : 8 26% 53% Kerala Cluster Capacity Beds : 3693 Doctors Nurses Others Bangalore Cluster Operational Beds : 2461 10,526 1,570 4,033 4,923 21% Others Payer Mix % Speciality Mix % CARDIAC SCIENCES MU
Slide 54: Key Financial Ratios
KEY FINANCIAL RATIOS Calicut, Kottakal & Vijayawada, Guntur & 670 Beds 509 beds 250 beds 175 beds 150 beds Kannur ~ 1209 Beds Ongole ~740 Beds JCI Accredited 1st NABH Hospital in India NABH Accredited NABH Accredited NABH & NABL Accredited NABL & NABH Accredited - Da Vinci Surgical Robot - Da Vinci
Slide 55: Aster India Clinical Volumes & Case Mix
Aster India Clinical Volumes & Case Mix 1,35,500+ 1,790+ IP Discharges Cardiovascular Surgeries 6,470+ 50+ General Surgeries Bariatric Surgeries 570+ 1,180+ Spine Surgeries Joint Replacements 4,260+ 280+ Urology Cases Transplants* 8,500+ 2,700+ Deliveries Neurosurgery 2,950+ 1,390+ Gastro-Intestinal
Slide 56: Aster India Growth Trending
Aster India Growth Trending Operational Trending Revenue from Operations 1,400 1,314 1,200 1,167 1,000 950 800 632 600 428 400 295 200 - FY14 FY15 FY16 FY17 FY18 FY19 • Aster India CAGR is higher than the Industry CAGR. 55
Slide 57: Aster India Operational Nos Trending
Aster India Operational Nos Trending Operational Trending Capacity Beds Operational Beds ARPOB 3460 2179 26100 2038 1979 23700 3071 3007 22175 2548 19052 1436 2007 1306 15936 CAGR : 27% 12,643 CAGR : 16% 917 CAGR : 19% 1,036 FY14 FY15 FY16 FY17 FY18 FY19 FY14 FY15 FY16 FY17 FY18 FY19 FY14 FY15 FY16
Slide 58: India Strategy – Way Forward – Hospitals
India Strategy – WayGROWTH BUSINESS Forward – HOSPITALS Locations for Flagship Units in Tier 1 cities and Metros Manpower estimate for FY 2025 – 20,000 57
Slide 59: India Strategy
India Strategy Long-term India Strategy lease or an O&M model to Focus on hospital enable better driven operating ROCEs model vs India is ‘Superstar doctor’ geographically driven operating The Pradhan Mantri Jan Arogya Yojana well positioned for model (PM-JAY) will cover around 500 million medical t
Slide 60: Aster Chennai – Business Growth – Hospitals
Aster Chennai BUSINESS GROWTH – HOSPITALS • 500 beds • Gastroenterology, • Oncology, • Nephrology, • Urology, • Pulmonology, • Women & Child Health Manpower estimate for FY 2025 – 20,000 59
Slide 61: Aster Labs – Focus on Bengaluru
Aster Labs FOCUS ON BENGALURU 60
Slide 62: Aster Bangalore
Aster Bangalore To be a dominant health care provider in Bangalore 61
Slide 63: Advantage – Bangalore
Advantage - Bangalore Bangalore is one of fastest growing market in India, which has highest growth rate Strong Demand compared to other cities. Bangalore market expected to grow with high CAGR compared to other cities in India Demographic • Growing population and rising life expectancies – Part
Slide 64: Population growth (In Mn)
Population growth (In Mn) Bangalore Delhi 34.6 20 40 14.39 29.3 30.2 15 12.33 30 25.8 11.88 10.1 21.9 10 8.2 20 5 10 0 0 2010 2015 2019 2020 2025 2010 2015 2019 2020 2025 Population Population Mumbai Chennai 25.0 14.0 12.3 22.0 20.2 20.4 12.0 10.7 11.0 19.3 9.6 20.0 18.2 10.0 8.5 8.0 15.0 6.0 4.0 10
Slide 65: Delivering Ethical and Affordable Medical Care
“DELIVERING ETHICAL AND • 509 beds MEDICAL AFFORDABLE CARE” • NABH Accredited • da Vinci Surgical Robot • DNB Training Programs
Slide 66: Delivering Ethical and Affordable Medical Care
“DELIVERING ETHICAL AND • ~250 bedsMEDICAL AFFORDABLE CARE” • Intra Operative MRI • da Vinci Surgical Robot • Bi-Plane Hybrid Cathlab with Neuro Navigation system
Slide 67: Thank You
Thank You 9