This past year has been eventful and a defining one for your Company. Max India’s shares started trading on the Exchanges in July 2016 and the stock has since maintained its strength. The Company’s stock is currently trading at ₹ 144 per share which implies a market cap of around ₹ 3,900 crore.
All our operating companies have gained a strong momentum and are set for a path towards profitability. I am pleased to report that Max Healthcare (MHC), Max India’s flagship operating company, achieved robust growth in revenues and profits, despite regulatory headwinds.
It is heartening to note that this success is based on the confluence of Max Healthcare’s superior clinical expertise, advanced medical practices and technologies, patient-centric and customer-focussed processes, relentless focus on service quality and reliable infrastructure.
During the year, MHC successfully completed the integration of its newly acquired hospitals – Max Smart Super Speciality Hospital (formerly Saket City Hospital) in South Delhi, and Max Vaishali (formerly Pushpanjali Crosslay Hospital) in East Delhi.We have made concerted efforts to hire and retain key talent in these hospitals, implement clear Management Information Systems (MIS) and reporting systems, fulfil critical compliance obligations and have synergised elements with other hospitals in the Max Network in line with key strategic objectives of these acquisitions. The performance of both these hospitals has displayed considerable improvement since their acquisition, both in terms of revenues and profits. Some of our other new hospitals, such as the ones in Bathinda and Dehradun have alsodemonstrated a remarkable turnaround in profits, becoming EBITDA-positive for the first time.
In the coming months, we will increase focus on the Company’s new business initiatives including Max@Home, our new patient homecare initiative; Max Labs, our pathology business and Oncology Day Care Centres – all of which have the management’s and the Board’s strong support.
I am pleased to share that this year also marked MHC’s firstever accreditation by the Joint Commission International(JCI), the world’s premier body for accrediting healthcare organisations. The accreditation was conferred on Max Super Speciality Hospital, Saket and is a testimony to the high-quality processes and practices at the hospital, as well as the passion and perseverance of the hospital’s doctors, nurses, paramedical and support staff.
Our health insurance joint venture, Max Bupa, witnessed significant milestones during the year. The business has over two million customers across urban and rural India, with more than one million of these being retail customers. This is a testimony of Max Bupa’s relentless focus on serving the B2C space. In another major development, Max Bupa struck a new bancassurance alliance with Bank of Baroda, one of India’s largest public sector banks. This partnership is already performing well and gives Max Bupa the opportunity to penetrate the bank’s network of 5,400 domestic branches and 60 million customers in India.
Adding this to the existing bancassurance partnerships that Max Bupa has with Federal Bank, Standard Chartered Bank, RBL Bank, and Deutsche Bank creates a solid external distribution capability for Max Bupa beyond its own strong agency force.
In line with its medium-term agenda of ‘Getting Fit for Growth’, the business has also made successful efforts to improve the productivity of its agency channel, posting a 25% productivity-led growth in sales in FY 2017.
Finally, our youngest business, Antara Senior Living, proudly launched its first senior living community near Dehradun, Uttarakhand, in April this year. As a Group, we have always had immense confidence in Antara’s unique proposition of ‘Lifestyle with Lifecare’ and I am pleased to say that the unwavering efforts of Team Antara have led to an offering that makes us all proud. I have no doubt that Antara will earn a deserved reputation of being a quintessential brand that epitomises the highest quality of senior living services in India. The successful commissioning of its first community now allows the energetic team at Antara to start scouting locations and business models for its next community.
As the flag bearers for a robust and modern healthcare ecosystem, it is important for us to take a step back and review the current environment of the health and allied businesses in India. The Indian healthcare ecosystem is growing at an unprecedented pace and has made significant strides, specifically over the past few years, in terms of improving standards.
While we have fared well on the Millennium Development Goals set by the WHO, the delivery of public health under the National Rural Health Mission has also been expanded significantly. Access to hospitalisation services via public-financed health insurance schemes has increased from 55 million people in FY 2004 to 370 million people in FY 2014. We are also seeing a growth in medical, nursing and technical education.
India has further established its position in the world as a leading destination for top-quality care at relatively low cost. The industry is expected to reach around US$ 400 billion in sales and significantly contribute to the development of the Indian economy by FY 2025 as well as be amongst the top employers in the country. A large part of this growth will be driven by the private sector. Private providers have a major role to play in delivering secondary and tertiary healthcare services in India and already account for 70% of the healthcare market.
Despite the successes, however, the Indian healthcare system continues to grapple with myriad challenges. Some primary areas of concern include disparities in health outcomes across India, the focus on curative rather than preventive healthcare, lack of healthcare financing, the significant trust deficit between patients and institutions, regulatory uncertainty and limited skilled manpower.
In light of these challenges, it is indeed encouraging to see the healthcare-centric focus of the current Government and its willingness to engage positively with the private sector. The key objectives and policy thrust set out in the National Health Policy 2017 (NHP) address challenges such as reinforcing trust in the public healthcare system, ensuring adequate investment, preventive health checks, achieving defined outcomes related to health status and programme impact, organisation of public healthcare delivery and perhaps, most importantly, aligning growth of the private healthcare sector with public goals.
While we deeply appreciate the Government’s recognition of the private sector’s role, it is imperative for the two to collaborate constructively towards achieving the NHP’s desired objectives, such as developing a common understanding of the economics of the healthcare model to set pricing for delivering affordable quality care, developing effective public-private partnership(PPP) models and to ensure provision of low-cost healthcare financing. The industry also needs to co-fund the establishment of a public body responsible for authorising, monitoring and regulating public health delivery, perhaps an Indian equivalent of the UK’s National Health Scheme (NHS) Monitor. This would aid in curbing unethical practices in healthcare by setting up a process to levy punitive actions.
Much like healthcare, the Indian health insurance sector continues to remain a fundamentally attractive industry as less than 30% of the country’s population currently has any kind of health coverage. Gross written premiums are growing at a rapid CAGR of 26% and the market is likely to touch ₹ 50,000 crore by FY 2020.
Senior living is a sunrise sector and Antara is, arguably, the only serious quality provider in this sector at the moment. While there are some players who have launched their respective versions of ‘senior living’ projects, most of them continue to be physical infrastructure-led offerings by traditional real-estate players and lack the sharp focus and top-quality service standards of Antara’s range of product offerings
Shifting focus now to some key financial highlights of your Company’s operating businesses, I am pleased to share with you that all the three businesses reported strong growth in the past year.
Max Healthcare reported Gross Revenues of ₹ 2,567 crore in FY 2017 for its network of owned and managed hospitals, a jump of 18% over the previous year. The Company also reported a robust 31% increase in EBITDA for its network of hospitals to ₹ 281 crore in FY 2017.
Max Bupa posted strong growth in its topline with Gross Written Premium (GWP) of ₹ 594 crore in FY 2017, an increase of 25% over FY 2016. The Company has grown consistently and rapidly by more than doubling its retail customer base over the past four years and is within striking distance of achieving financial breakeven.
Finally, Antara Senior Living has been progressing from strength to strength over the past 4 years. The Company has already sold around 50% of its units in Dehradun and will continue to focus on accelerating sales in the coming months while leveraging its biggest strength – the Dehradun community, which now stands testament to Antara’s premium service standards.
As we look ahead, we will continue to focus on our existing operating areas, building scale and profitability, while also exploring newer avenues of growth in all our businesses.
In June this year, Max Group’s Founder and Chairman Emeritus Mr. Analjit Singh committed to increase his stake in the Company to 45.12% by investing ₹ 300 crore through issuance of share warrants. A portion of the proceeds from this transaction was utilised by Max India to acquire half of International Finance Corporation’s stake in MHC (the other half was acquired by Max India’s JV partner Life Healthcare). The increase in the Sponsors’ shareholding represents their unwavering commitment to the Company, and more specifically, their confidence in the immense growth prospects of the underlying healthcare, health insurance, and senior-living businesses.
In addition, our businesses have identified efficiencies across cost, revenue and process dimensions led by changes in technology. Over the past few years, both Max Healthcare and Max Bupa have made significant progress in building digital capabilities and enabling an end-to-end digital journey for our customers across the spectrum. These efforts will continue to be a priority for these businesses over the coming years.
I should note that we have a great appreciation for the Government’s explicit recognition of the need to engage with the private sector to achieve the goals set out in the National Health Policy. However, I must temper my enthusiasm in lig of recent concerns regarding the poor overall financial position of healthcare providers in India. The recently introduced pricing cap regulations are a relevant example of well-intentioned policy-making leading to unintended consequences such as worsening the financial position of providers. Such a turn of events can be avoided going forward through a process of structured engagement, the inclusion of appropriate expertise and reliance on comprehensive data. We have also underlined that the lack of any attempt to apply a scientific framework to determine treatment costs will lead to inappropriate decisions,ambiguity and lack of trust amongst stakeholders.
Max India has been at the forefront of advocacy initiatives, in collaboration with industry partners such as NatHealth and FICCI, to engage with the Government and arrive at mutually agreeable solutions to some of these pressing issues. We will sustain our intense advocacy efforts through the year with the Ministry of Health & Family Welfare, the Delhi State Government, industry bodies and other key stakeholders.
Max India will continue to drive forward in its endeavour to deliver value for all its stakeholders, just as it has in the past, and our businesses will continue to set the pace in their respective industries. With your ongoing support and commitment, we hope to keep delivering strong results on all performance parameters in the coming years.
Chairman, Max India Limited