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Main Story
Welcome to Wellness
Corporates are tapping the fledgling preventive healthcare
market with innovative strategies. But will that be enough to unlock the vast
potential of the market, asks Sonal Vij
 Preventive
healthcare, a relatively new kid on the block, is pacing at a growth rate of
25 per cent in the past five years. Preventive, as opposed to curative healthcare
has become the preferred option in most developed countries as it increases
the productive capability of the nation.
India's preventive healthcare market, estimated at over $800 million, has a
market potential of over 300 million clients. "As the country is witnessing
reasonable economic growth despite the global economic turmoil and as per capita
incomes rises, it is expected that consumers' demand for preventive healthcare
will rise and they will be willing to spend more on quality of care," says
Pradip Kanakia, National Head of Markets and a member of KPMG India Leadership
team.
The Key Players
Corporates are witnessing a rapid growth in preventive health
check-ups. Apollo Hospitals Group, which is the pioneer of the concept of preventive
health checkups in India today, has witnessed rapid growth in preventive healthcare
market. "We conduct around 1,000 health checkups everyday pan Apollo,"
informs Shobana Kamineni, Director, New Initiatives, Apollo Hospital, Hyderabad.
She informs that Apollo has witnessed a growth of 20 per cent overall annually.
However, the mature hospitals in the group are experiencing five per cent growth
in preventive healthcare. "Most top officials of the top 500 companies
in India spend one day at Apollo for preventive health checkups," she quips.
These checkups can even determine the probability of an occurrence of a disease.
 "Preventive
healthcare is by far the most neglected area in India"
- Pradip Kanakia
National Head of Markets
KPMG
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 "We
conduct around 1,000 health checkups everyday pan-Apollo"
- Shobana Kamineni
Director
New Initiatives
Apollo Hospital, Hyderabad
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 "We
are deploying health check based on the operational flow analysis"
- Somnath Das
COO
MCC
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Max Healthcare, which is conducting preventive health checkups
since its inception, now undertakes approximately 40 preventive health programmes
per day, pan Max. Informs Dr Sushum Sharma, Senior Consultant — Internal
Medicine and HOD-Preventive Healthcare Programme, Max Healthcare, "There
has also been a growth of 35 per cent over the last one year." Recently,
Max Healthcare has also introduced platinum health checkups. In addition to
the regular checkups, these checkups have full body MRI, stress counseling (with
a clinical psychologist) and sessions with physiotherapists. Dr Sharma shares,
"It's a fact known that 52 per cent of the executives are on some allopathic
medicines, which means that they are not ok." This is the target group
for any hospital investing in preventive healthcare.
Max also offers a holistic preventive healthcare programme.
Those who undertake this programme are provided with counselling/ advice. Dr
Sharma adds, "Without proper counselling, health checks do not translate
into any health benefit. Mapping a patient's health needs through 'pre-counselling
session', and a detailed review meeting with health counselling post the health-check
is the need."
Another player which boasts of 50 per cent growth in the
past two years is Fortis Healthcare. "The collated data of Fortis- Enterprise
stands at 375 preventive health checkups per day on an average," says Sunil
Kapur, Zonal Head Sales and Marketing, Fortis Healthcare. He adds as the group
expands, the investment in the preventive healthcare will also increase.
Manipal Hospital, Bangaluru conducts a minimum of 25 health
checkups per day. "In 2008-2009, we did approximately close to 10,000 health
checks," shares Dr Nagendra Swamy, COO, Group Medical Director, Manipal
Hospital. He adds that the hospital plans to bring in low-end (specific) packages,
like paediatric, oncology and so on. Reportedly, other major investments planned
in preventive healthcare are that of Metropolis investing Rs 50 crore and other
planned hospital projects by Fortis and Apollo with specialised focus on preventive
care.
Wellness Centres
Players focused only on wellness centre are also cashing on the benefits. SRL
network, which operates 40 laboratories and 800 collection centres all over
India, started conducting preventive health checkups four years ago. Looking
at the overwhelming response, a separate wellness division SRL Wellness was
created in 2007. "The growth rate so far is 40 per cent," shares Dr
Leena Chatterjee, General Manager, Wellness Division, SRL Wellness. One of the
reasons for such a high growth rate is the availability of a good network. There
are 20 wellness centres as of now and this number is expected to reach to 50
in the next two years. Religare Wellness plans to invest Rs 50 crore over the
next two years to expand the business. A wellness centre in Dubai is also on
the cards.
A comparatively new entrant into this market is Manipal Cure and Care (MCC).
MCC, which conducts around 80 health checkups per day, is experiencing a considerable
annual growth. Shares Somnath Das, COO, MCC, "It is increasing 59 per cent
year on year, which is mainly due to the awareness of the individual for a healthy
life style and the need to prevent surprises when we fall sick." The group
has an investment of Rs 125 crore for the next three years lined up.
MCC's express packages are organ-specific packages that can
be completed in less than an hour. These packages have sub-groups like evaluation,
gynaecology and physician consultation along with advice on habits, diet, skin
and hygiene. Das explains the USP of the comprehensive health-checkups. He says,
"We are deploying the health check based on the operational flow analysis
which optimises the time that a unidirectional flow usually employed by our
competitors takes. This ensures that we complete a master health check up within
four to five hours as opposed to the eight to nine hours a healthcare institution
takes.".
Evolution
Unlocking the potential of this segment, even hospitals have started dedicating
special wings for preventive healthcare and providing additional lucrative add-ons.
For instance, Delhi-based Sir Ganga Ram Hospital will be adding an entire department
dedicated to preventive healthcare. The centre, built with an investment of
Rs three crore, will be operational by August, this year.
Max Healthcare is planning to amalgamate the concept of wellness and health
by creating a fusion of scientific and wellness measures where they will combine
spas, massages and other wellness techniques along with the regular preventive
health checkup programmes. In this new wellness division, patients will be advised
on how to live a healthy life.
SRL has also introduced a unique concept of industry-type
screening and running corporate implants wherein a wellness centre is set up
and managed by Religare on the premises of the client itself. This is important
from a strategic point of view because it gives Religare an opportunity to build
a rapport and serve the organisation on a regular basis.
Max conducts around 40 preventive health programmes per day |
Fortis conducts 375 preventive health checkups per day on an average |
Sufficient Effort?
So, are these add-ons and gimmicks enough to unlock the preventive healthcare
segment? Kanakia opines that in addition to arranging facilities, healthcare
players must invest in education. Since the awareness levels are low, healthcare
players will need to make the consumer understand the importance of routine
preventive health-checkups.
Conducting free health-checkups is also a good way to create footfall and create
loyalty. Moreover, another good strategy is that after a patient has been admitted
to IPD for a particular disease, the hospital should advise the patient on regular
follow ups and checkups. For instance, if a patient has undergone an angioplasty,
it's a good idea for the hospital to give regular check-ups and win loyalty.
"Also, enrolling the patient for future health-checkups is a good idea,"
quips Kanakia.
What's Pulling it Down?
Despite so many factors contributing to its growth, the preventive healthcare
market is not scaling up as much as it can. "Preventive healthcare is by
far the most neglected area in India," opines Kanakia. With more than half
the population below the poverty line, the major chunk is spent on food than
on healthcare.
While more than 80 per cent of American companies with 50 or more employees
have some form of preventive healthcare programmes for their employees, only
two-thirds of respondent firms in India have preventive healthcare as part of
their corporate governance strategy. However, only less than one-third make
provision for the whole range of preventive health care measures for their employees.
"From the public reforms point of view, the Government
gives tax benefits for curative healthcare, but not for preventive healthcare.
This is a short sighted view, as it does not recognise the contribution that
enhancement in preventive healthcare can have on reducing the burden of curative
healthcare in the country," shares Kanakia.
- Almost a quarter of respondent firms lose
approximately 14 per cent of their annual working days due to sickness.
- In a highly competitive corporate environment,
companies cannot afford the absence of their employees due to sickness,
etc, or a poor performance at the workplace due to poor health.
- Preventive healthcare is the most cost-effective
strategy not only for a country with scarce financial resources, but
also for resource-rich companies whose rising health spending is affecting
their business results and competitiveness.
- 82 per cent of respondent firms agree that
preventive health care measures increase a firm's productivity and profitability.
- 91 per cent of respondent employees want
employers to offer preventive healthcare vouchers to them.
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Awareness is Low
Less inclination amongst the population in investing in preventive
healthcare is a big hindrance to the growth of this market. There is a general
lack of awareness on health and the impact that it can have on ones' physical
and financial status, particularly amongst poorer masses. For example, Indians
are genetically more prone to cardiac disorders but since there is very little
awareness about this fact, very little is done to prevent cardiac disorders.
Also, if the insurance companies start reimbursing for the
preventive healthcare checkups too, the preventive healthcare market will grow
at a much faster pace. "Ultimately, it is the insurance company who will
pay for the treatment, so it is going to be ultimately beneficial for them to
nip the problem at its bud," opines Dr BK Rao, Chairman, Board of Management,
Sir Ganga Ram Hospital.
| So, what's driving this market? Consumers are aspiring
for greater fitness and well-being as they move up the income ladder. In
2008, the richest 30 per cent of the population accounted for 75 per cent
of the total private health expenditure.
Further, as the disease profile shifts from infectious
to lifestyle diseases, healthcare expenditures on preventive care will
raise further. Well-designed employee wellness programmes create 25 per
cent reduction in health-plan costs, sick leave, disability pay and workers'
compensation.
Of the spending on healthcare, nearly all of it
is spent on the curative healthcare. The cost, obviously, is the major
hurdle in the growth of the Indian preventive healthcare market. This
is directly linked to the GDP. The middle class spends the maximum on
healthcare. It's estimated that out of every Rs 100 spent, Rs 20 is spent
on healthcare. Also, globally, for every one per cent increase in GDP,
the healthcare spending increases by one percent. However, in India, for
every one per cent increase in GDP, the healthcare spending increases
by 1.5 per cent. This is because the Indian society is moving from poor
to middle class. So, as the GDP increases, there will be an increase in
the middle class, who will be much more willing to spend on the preventive
healthcare. This will definitely drive the market further.
Also, as per the report 'Indian Council for Research
on International Economic Relations', reducing just one health risk increases
an employee's on-the-job productivity by nine per cent and cuts absenteeism
by two per cent. The report also states that 98 per cent of respondent
employees who have undergone preventive health check-ups felt that these
were beneficial in terms of a better quality of life and performance at
work. Even those who did not undergo such check-ups felt that such benefits
accrue.
Also, the educated middle class is increasingly
seeking annual health check- ups. Previously, what was thought to be the
privilege of corporate executives in the recent past is now seeping into
the lives of the growing Indian middle class. The companies are now paying
greater attention to executives' health.
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Economy Depends on Healthy People
If the preventive healthcare market picks up, it can drive the GDP to greater
heights. It has been estimated that a five-year increase in the life expectancy
can lead to an increase in the growth rate of up to 0.5 per cent of the GDP.
(See Box- Driving Factors). "On the other hand, poor preventive healthcare
can adversely affect the economic growth. The loss on account of cardiac ailments
and diabetes alone is estimated at about $236 billion over the next 10 years,"
shares Kanakia.
Needless to say, that there is a need for reforms which favour preventive healthcare.
Though the potential is huge, it is going to be a while before the market really
picks up. But once it does, then there is no looking back!
sonal.vij@expressindia.com
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