MANAGEMENT DISCUSSION AND ANALYSIS

Mr. Mohit Talwar

Managing Director

Mr. Dharmender Kumar

Associate Director - External Affairs

Mr. Dilbagh Singh Narang

Director - Taxation

Mr. Himanshu Tiwari

Executive Assistant to Managing Director

Mr. Jatin Khanna

Chief Financial Officer

Mr. Nitin Thakur

Director - Brand & Communications

Mr. P. Dwarakanath

Head - Group Human Capital

Mr. Prashant Hoskote

Senior Director - Quality & Service Excellence

Mr. Rishi Raj

Director - Strategy & Corporate Development

Mr. V. Krishnan

Company Secretary

Max India Limited (‘Max India’ or ‘the Company’), a part of the US$ 3 billion Max Group, operates in the Health & Allied Services space through Max Healthcare Institute Limited, Max Bupa Health Insurance Company Limited, Antara Senior Living Limited and Max Skill First Limited.

The Company was incorporated on 1st January 2015. As a result of the demerger of the erstwhile Max India Limited (now renamed as ‘Max Financial Services Limited’ or ‘MFSL’), the investments held by MFSL in Max Healthcare Institute Limited, Max Bupa Health Insurance Company Limited, Antara Senior Living Limited, Max Skill First Limited, Pharmax Corporation Limited, Max Ateev Limited and Max UK Limited stood transferred to the Company w.e.f. Appointed Date, that is, 1st April, 2015.

The Company’s key operating businesses include:
Max Healthcare Institute Limited (MHC) is an equal joint venture with Life Healthcare, South Africa’s second-largest healthcare chain. This unit provides standardised, seamless and world-class healthcare services, especially focussed on tertiary and quaternary care.

Max Bupa Health Insurance Company Limited (MBHI) is a 51:49 joint venture between Max India and Bupa Finance Plc., UK, and offers individual and family - oriented health insurance policies across all age groups.

Antara Senior Living Limited is a wholly-owned subsidiary, and offers highly differentiated, world-class senior living communities fulfilling lifestyle, wellness and health-related requirements of senior citizens.

Max Skill First Limited (Max Skill First) is a wholly-owned subsidiary. It operates as a shared service centre for providing knowledgeable learning and development solutions and training services to companies in the Max Group as well as to external clients.

Max India’s flagship entity Max Healthcare reported Gross Revenues of ₹ 2,787 crore in FY 2018 for its network of owned and managed hospitals, growing 9%.



All businesses operate in highly under-penetrated sectors with potential for rapid growth and are driven by demographic and other socio-economic factors, which have a more enduring impact than short-term economic factors.

Industry Overview

Max India’s key businesses operate in the Health & Allied Services sector. Indian healthcare is one of the fastest growing sectors, and is expected to reach ~US$ 280 billion (nearly ₹ 18 lakh crore) by FY 2020. Private healthcare in India accounts for 70% market share, 60% of total beds, 60% of inpatients, 80% of outpatients and 80% of doctors in delivery of healthcare services. The industry is expected to achieve around US$ 400 billion in sales and significantly contribute to the development of the Indian economy by FY2025. With this performance, it is poised to be amongst the top employers in the country. However, despite all the successes, 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.

Much like healthcare, the Indian health insurance sector continues to remain a fundamentally attractive industry with gross written premiums growing at a CAGR of 24% over the past 3 years. During this period, the growth of standalone health insurers has been significantly higher at 41%.

Finally, senior living as an industry category is now witnessing a growth phase with existing players developing higher value products as well as new entrants trying to launch their first senior living ventures. However, most of these projects continue to be ‘real estate’ offerings by traditional real estate players and are still sharpening their focus and world-class service standards to rank among Antara’s reputed product offering.

Financial Highlights

Max India’s flagship entity Max Healthcare Institute Limited reported Gross Revenues of ₹ 2,619 crore in FY 2018 for its network of owned and managed hospitals, growing by 7%. Owing to certain inclement circumstances, including the closure of its unit in Shalimar Bagh for about 12 days in November 2017 and its negative impact on the overall brand, the business reported a Loss before Tax of ₹ 45.6 crore during the year.

Max Bupa reported strong topline growth of 27% with Gross Written Premium (GWP) of ₹ 755 crore in FY 2018. The business also reported Profit Before Tax (PBT) of ₹ 23 crore.

The growth in revenues was primarily driven by healthy growth in new sales as well as renewals, and strong channel performance in bancassurance, coupled with proprietary channels such as agency and digital.

In April 2017, Antara Senior Living commenced operations at its first community of 200 apartments near Dehradun, Uttarakhand. Over the course of the year, Antara improved collections to ₹ 250 crore, compared to ₹ 131 crore in the previous year.

In FY 2018, Max SkillFirst reported revenues of ₹ 44.9 crore, with profits of ₹ 1.9 crore. During the year, the business imparted over 4.3 lakh hours of engaged training delivering big results to more than 1 lakh trainees over more than 90,000 sessions.

Human Resources

Number of permanent employees in Max India Ltd. as on 31st March 2018 is 51.

Sevabhav, Credibility and Excellence continue to be the key HR pillars, intertwined across all the talent and performance measures. The organisation has stressed throughout the entire year its spotlight on building effective corporate governance, fostering an inclusive work culture, enhancing talent capabilities to drive performance. and leveraging progressive ways of employee learning and development.

The Company is committed to developing and sustaining its talent pipeline by attracting and retaining the right talent and investing in capability enhancement of employees. Concerted efforts have been directed towards multiple talent management interventions, in-house training programmes as well as sponsoring employees to attend suitable external training and career development programmes for improving their functional and managerial effectiveness. Additionally, the power of Digital HR has being harnessed to multiskill the workforce and to enrich the overall employee experience.

The Company has established an organisational structure which is agile and fluid, focussed on delivering results and perform effectively in a dynamic business environment. The business strongly believes in focussing on overall employee wellness and striving to create effective communication channels for employees such that all are aligned to the common business goals and strategy.

Opportunities and Threats

Each of Max India’s businesses presents its unique challenges and opportunities. Over the past few years, Max Healthcare has invested in three alternative business lines, namely Max Labs, a pathology vertical focussed on B2B and in-hospital labs, Max@Home, a vertical providing high-quality medical care at home and Oncology Day Care, under which the first unit has been set up in a prime South Delhi locality. These verticals are expected to add to revenues and profitability in the years to come, but more importantly, will increase the depth and width of MHC’s coverage and offerings. Each of these new verticals has shown great promise with revenues growing 2.5-3x in each. MHC is also planning to launch two additional Oncology Day care centres in Gurugram and Noida.

Further, both Max Healthcare Institute Limited and Max Bupa have made noteworthy progress in building digital capabilities and enabling an end-to-end digital journey for their customers. Some key innovations at Max Bupa include a new product called GoActive, which was launched earlier this year. Its performance has been outstanding, as is evident, with its recognition as the Health Insurance Product of the Year by ‘Consumer Survey of Product Innovation’.

The primary challenges for the Company at this juncture are the growing regulatory headwinds in the healthcare sector. The Company and the healthcare sector faced multiple regulatory hurdles during the year. These include price capping on products such as keen implants and stents, margin capping on consumables and as well as ongoing concerns such as reduction on inpatient tariff and medical device price control. The burgeoning regulatory interventions necessitate frequent adjustments to business plans and projections, thereby impacting timelines and limitations.

In the health insurance sector as well, the Government’s National Health Protection Scheme (NHPS), which aims to provide medical insurance cover of up to ₹ 5 lakh for over 10 crore eligible families across India, though an encouraging opportunity, presents its own challenges. The scheme entails reverse auction between the lowest 3 bidders to select the insurer, thereby putting additional strain on pricing, especially for private players. With state-level contracts, it will be testing to compete with PSUs and other large insurers owing to differences in capacity and operational capabilities. NHPS is expected to create pricing pressures on private healthcare providers as well.

The organisation has continued through the entire year of its focus on building effective corporate governance, fostering an inclusive work culture, enhancing talent capabilities to drive performance and leveraging progressive ways of employee learning and development.

Outlook

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 ameliorate the unintended consequences of major policy interventions. The Company continues to sustain its advocacy efforts through the year with the Ministry of Health & Family Welfare, the Delhi State Government, industry bodies and other key stakeholders.

In addition, each of the businesses will continue to focus on their respective priorities with MHC and Max Bupa building greater efficiencies across cost, revenue and process dimensions led by changes in technology. Specifically, with respect to improving financial performance, MHC has drawn up a holistic plan to achieve financial stability over the next year with specific deliverables. Antara will continue to focus on superior service delivery, which is at the core of its brand proposition, while exploring low-risk capital-light opportunities based on an Operator model in Delhi-NCR and Mohali region.