Max Healthcare Institute Limited has informed the Exchange about Investor Presentation
February 14, 2024
Listing Department, National Stock Exchange of India Limited Exchange Plaza, Plot C-1, Block G, Bandra Kurla Complex, Bandra (E), Mumbai – 400 051
Listing Department, BSE Limited Phiroze Jeejeebhoy Towers, Dalal Street, Mumbai – 400 001
Symbol: MAXHEALTH
Scrip Code: 543220
Sub.: Presentation for Investor Conference
Dear Sir / Madam,
This is in continuation to our earlier intimation dated February 4, 2024 wherein we had informed that the senior management of the Company will be participating in Axis Capital India Conference scheduled to be held on Thursday, February 15, 2024.
In this regard, please find enclosed herewith the investor presentation to be made during aforesaid conference.
This disclosure will also be hosted on Company's website viz. www.maxhealthcare.in.
Kindly take the same on record.
Thanking you
Yours truly, For Max Healthcare Institute Limited
Dhiraj Aroraa SVP - Company Secretary and Compliance Officer
Encl.: As above
Max Healthcare Institute Limited Corp Office: 2nd Floor, Capital Cyberscape, Sector - 59, Golf Course Extension Road, Gurugram - 122102, Haryana T: +91-124-620 7777
Max Healthcare Institute Limited Regd. Office: 401, 4th Floor, Man Excellenza, S. V. Road, Vile Parle (West), Mumbai, Maharashtra - 400 056 T: +91-22 2610 0461/62 E: secretarial@maxhealthcare.com, investors@maxhealthcare.com
www.maxhealthcare.in
(CIN: L72200MH2001PLC322854)
Investor Presentation
February 13, 2024
Disclaimer
This presentation and the accompanying slides (the “presentation”) contains selected information about the activities of Max Healthcare Institute Limited’s (“Max Healthcare”/“MHIL”/“MHC”/”Company”) as at the date of the presentation. None of MHIL, its directors, promoter, or affiliates, nor any of its or their respective employees, advisers or representatives or any other person accept any responsibility or liability whatsoever, whether arising in tort, contract or otherwise, for any errors, omissions or inaccuracies in such information or opinions or for any loss, cost or damage suffered or incurred howsoever arising, directly or indirectly, from any use of this presentation or its contents or otherwise in connection with this presentation, and makes no representation or warranty, express or implied, for the contents of this presentation including its accuracy, fairness, completeness or verification or for any other statement made or purported to be made by any of them, or on behalf of them, and nothing in this presentation or at this presentation shall be relied upon as a promise or representation in this respect, whether as to the past or the future. Past performance is not a guide for future performance.
Certain financial information contained in this presentation reflects aggregated totals of historical MHIL and Radiant Life Care Private Limited (“Radiant”), prior to their merger. These aggregated financial totals are unaudited, unreviewed and do not reflect a pro forma accounting under any accounting standards. As a result, these figures are subject to change and should not be relied upon. Furthermore, certain financial information presented herein differs from that of the audited financials of MHIL, because it includes financial information received from “Partner Healthcare Facilities”. As reflected in this presentation, this combined financial information does not meet statutory, regulatory or other audit or similar stipulated requirements of MHIL. The financial information relating to Partner Healthcare Facilities has not been verified by the Company. Accordingly, to that extent, no reliance should be placed on the financial information of such Partner Healthcare Facilities included in this presentation. MHIL may alter, modify or otherwise change in any manner the content of this presentation, without obligation to notify any person of such change or changes.
This presentation contains certain “forward looking statements” including, but without limitation, statements relating to the implementation of strategic initiatives, and other statements relating to the Company’s future business developments, results of operations and financial performance. While these forward-looking statements indicate our assessment and future expectations concerning the development of our business, a number of risks, uncertainties and other unknown factors could cause actual developments and results to differ materially from our expectations. These factors include, but are not limited to, general market conditions, macro- economic, governmental and regulatory trends, movements in currency exchange and interest rates, competitive pressures, technological developments, changes in the financial conditions of third parties dealing with us, legislative developments, and other key factors beyond the control of MHIL, such as Covid-19, that could affect our business and financial performance. The Company and or its representatives do not guarantee that the assumptions underlying such forward-looking statements or management estimates are free from errors nor do they accept any responsibility for the future accuracy of the forward-looking statements contained in this presentation or the actual occurrence of the forecasted developments. MHIL undertakes no obligation or undertaking to publicly revise any forward-looking statements to reflect future / likely events or circumstances. Given these uncertainties and other factors, viewers of this presentation are cautioned not to place undue reliance on these forward-looking statements and management estimates. Any person / party intending to provide finance / invest in the shares / businesses of MHIL shall do so after seeking their own professional advice and after carrying out their own due diligence procedure to ensure that they are making an informed decision.
This presentation is strictly confidential and may not be copied or disseminated, reproduced, re-circulated, re-distributed, published or advertised in any media, website or otherwise, in whole or in part, and in any manner or for any purpose. No person is authorised to give any information or to make any representation not contained in or inconsistent with this presentation and if given or made, such information or representation must not be relied upon as having been authorised by any person. Failure to comply with this restriction may constitute a violation of the applicable securities laws. By reviewing this presentation, you agree to be bound by the foregoing limitations.
The information contained in this presentation is for general information purposes only and does not constitute an offer or invitation to sell, directly or indirectly, in any manner, or recommendation or solicitation of an offer to subscribe to securities for or invitation to purchase any securities of MHIL. This presentation should not form the basis of, or be relied upon in any connection with any contract, commitment or investment decision whatsoever. Nothing in this presentation is intended by MHIL to be construed as financial, legal, accounting or tax advice. This presentation has not been approved and will not be reviewed or approved by any statutory or regulatory authority in India or by any stock exchange in India. This presentation is not intended to be a prospectus, a statement in lieu of a prospectus, an offering circular, an advertisement, preliminary placement document, placement document or an offer document by whatever name called under the Companies Act, 2013 as amended, or the rules made thereunder, the Securities and Exchange Board of India (Issue of Capital and Disclosure Requirements) Regulations, 2018, as amended or any other applicable law in India.
This presentation is being provided solely for the information of the attendees. The distribution of this presentation in certain jurisdictions may be restricted by law and recipients should inform themselves about and observe any such restrictions. In particular, this presentation may not be transmitted or distributed, directly or indirectly, in the United States, Canada or Japan. This document does not constitute or form part of, and should not be construed as, an offer to sell or issue or the solicitation of an offer to purchase securities of the Company or any member of the Group or an inducement to enter into investment activity, in any jurisdiction. In particular, this document and the information contained herein do not constitute or form part of any offer of securities for sale in the United States and are not for publication or distribution in the United States. No securities of the Company have been or will be registered under the U.S. Securities Act of 1933, as amended, and may not be offered or sold in the United States, except pursuant to registration or an exemption from the registration requirements of the U.S. Securities Act of 1933, as amended.
2
Content
Company Overview
Key Growth Drivers
Financial Highlights
Appendix
04
14
24
31
3
Company Overview
4
Max Healthcare: India’s second largest* hospital chain in terms of revenue, EBITDA and market capitalisation
Current capacity ~3,550 beds
NCR
17 Facilities
~82% Beds in metros
~75% 9M FY24 Occupancy
402
Shalimar Bagh
516
402
BLK
Patparganj
Eqova
387
Vaishali
Panchsheel1
Dwarka
Vikrant
Lajpat Nagar1,2
521
250
Noida1
104
Saket3
Smart
Sec. 56 Gurugram
Sec. 534 Gurugram
Sec. 43 Gurugram
Outside NCR
328
220
200
219
Mumbai
Mohali1,2
Bathinda
Dehradun
Current hospitals and medical centres
Upcoming hospitals
13% Revenue CAGR^ 3 years
41% EBITDA CAGR^ 3 years
~35% 9M FY24 ROCE
Shareholding structure (as on December 31, 2023)
4.0%
11.6%
23.7%
60.7%
Abhay Soi
DIIs
FPIs and FIIs
Others
Top Public investors:
Capital Group (All funds)
• • Government of Singapore / GIC • GQG Partners (All funds) • Blackrock / iShares (All funds) • HDFC Mutual Funds • Vanguard (All funds) • •
Canara Robeco Mutual Funds SBI Mutual Funds
* Based on publicly available information for listed companies (FY23) | (1) Standalone speciality clinics with outpatient and day care services | (2) 2 facilities each at these locations| (3) 320 beds in East Block and 201 in West Block | (4) Currently the land at Sec. 53 is under litigation with HSVP | ^ CAGR is calculated for FY20 to FY23
5
Vision: To be the most well-regarded healthcare provider in India
To be the most well regarded healthcare provider in India committed to the highest standards of clinical excellence and
patient care supported by latest technology and cutting edge research
Quaternary care facilities Best-in-class clinical outcomes Patient centric approach Global best practices
Rewarded by growth Constant pursuit to strengthen management Collaborative approach
Patients
Clinicians
BEING ‘WELL REGARDED’ MEANS…
Employees
Investors
World class infrastructure State-of-the-art technology Well defined clinical protocols Focus on research and academics
Strong governance Profitable growth Healthy balance sheet Efficient operations
6
Journey so far
Dr. B L Kapur Memorial Hospital, Rajendra Place(1)
Dr. Balabhai Nanavati Hospital, Mumbai(1)
• Radiant-Max Healthcare merger
and listing on BSE and NSE
• Discontinuation of Max Multi Speciality Centre, Pitampura
Executed O&M Agreement with Muthoot Hospitals Pvt. Ltd. in Dwarka, Delhi for 300+ beds (our first asset-light model)(1)
2000
2009
2014
2020
2021
2022
2023-24
• Max Multi
Speciality Centre, Pitampura
• Max Multi
Speciality Centre, Noida
Max Super Speciality Hospital, Patparganj
Max Hospital, Gurugram
2008
Max Multi Speciality Centre, Panchsheel park
2002
2006
2004
2000
Max Super Speciality Hospital, (East Block) Saket
Max Super Speciality Hospital, (West Block) Saket
(1) Inorganic expansion
2012
2014
2016
2018
Max Institute of Cancer Care, Lajpat Nagar
2010
Max Super Speciality Hospital, Dehradun
• Max Super Speciality Hospital, Bathinda
• Max Super Speciality
Hospital, Mohali
• Max Super Speciality
Hospital, Shalimar Bagh
Max Multi Speciality Hospital, Greater Noida
Max Medcentre, Lajpat Nagar (Immigration Department)
• Max Super Speciality Hospital, Vaishali (Crosslay)(1)
• Max Smart Super
Speciality Hospital, Saket (Saket City)(1)
Acquired stake in Eqova healthcare having potential to add 400+ beds in the East Delhi(1)
• Raised INR 1,200 Cr
equity through Qualified Institutional Placement (QIP)
• Medcentre, Mohali
(Immigration Department)
• Acquired exclusive rights to aid development of a 500 bed hospital in South Delhi(1)
• Secured two prime land
parcels in Gurugram with potential to add 1,000 beds
• Acquired 100% stake in
200-bed Alexis Multispecialty Hospital, Nagpur
• Entered into an SPA for acquisition of 550-bed Sahara Hospital in Lucknow
• Commissioned and
operationalized 92-bed oncology block at Max Super Speciality Hospital, Shalimar Bagh
• Launched our proprietary omnichannel app, ‘Max MyHealth’
Discontinuation of Max Multi Speciality Hospital, Greater Noida
RADIANT LIFE CARE
MAX HEALTHCARE
7
Leading clinically comprehensive hospital chain with excellent research and academics foundation
Complex procedures performed
High end quaternary care facilities
Transplants(1)
Robotic surgeries
Cardiac procedures(2)
Neuro surgeries(3)
Orthopedic surgeries(4)
Oncology surgeries(5)
Est. Annual Count*
~1,050
~3,810
~37,910
9,800
~27,370
~12,360
including 3 JCI and 2 AACI accredited
State of the art infrastructure
Ortho & Spine Robots
Radixact TomoTherapy
TrueBeam Stx LINAC
Da Vinci Xi Robot
3.0 Tesla MRI
Digital PET CT – Discovery MI
Focus on Research and Academics
Research
• Significant strategic partnerships:
Imperial College London, Ashoka University, IIT Bombay, IIIT Delhi, IIIT-D iHub Innovation Center, IIT Delhi, BITS Pilani, Pfizer, RMIT and Deakin University – 30,000+ research participants and USD 2 million in research grants
• ~2,500 research publications in indexed journals over last 8
years including Nature with Impact Factor 69.50.
• Wellcome Trust funded Metabolic Disease biobank, with
~22,000 samples, and a BIRAC funded Oncology biobank
• Several research grants from leading organisations: CSIR, DBT, ICMR, DST iHUB, Wellcome Trust, BIRAC, INSA, DHR, NIHR, MRC, Innovate UK, etc.
• AI-enabled Radiomics project with IIIT Delhi and HKA
automation project with IIT Bombay
• 600+ clinical research projects completed to date, 120 ongoing
Academics Max Institute of Medical Excellence (MIME) is the education division of MHC for medical education & training • Signed MoU with the prestigious Royal College Of Obstetricians & Gynecologists UK, for
MRCOG training
• Only approved center in North India for hosting MRCP PACES UK exam and running the
IMT program with JRCPTB, UK at Level 3 accreditation (~50 students enrolled).
• Started (i) First time in India - Advanced Stroke Life Support Course in association with American Heart Association & Gordon Center USA (ii) Advanced Trauma Life Support Instructor course in association with American College of Surgeons, USA (iii) American Heart Association Training Centre faculty course (iv) Clinical rotations tie up with Bridgetown International University, Barbados (v) Affiliation with Lincoln American University, Guyana for MBBS students
• Masters in Emergency Medicine trainee doctors accredited through George Washington
University, USA; PhD in Health Sciences & MPH with AcSIR.
• ~500 trainee doctors are part of DNB program, with NBE across 33 specialties; ~30,000
trainees enrolled in the last 3 years across various academic programs
(1) Transplants include kidney, heart, liver, lung, etc. | (2) Includes Cardiac Surgery, Cardiac Paed. Surgery, Vascular Surgery, Angioplasty, Angiography and Other Cardiac Procedures | (3) Includes Surgical and Spinal Surgeries | (4) Includes Joints and Other surgeries | (5) Includes Onco Surgical and bone marrow transplant (BMT) *Q3 FY24 Annualized numbers
8
Dominant presence in the most attractive markets (1/2)
Low bed density, higher per capita income, higher ARPOB and rising insurance penetration make Delhi and Mumbai attractive avenues for growth
High demand-supply gap in Delhi NCR & Mumbai…
…coupled with rising insurance penetration
Total beds per ‘000 population
Health insurance Gross Premiums (INR in Bn)
3.8
3.3
4.3
3.6
3.3
3.0
1.9
Delhi NCR
Mumbai
Chennai
Bengaluru
Hyderabad
Lucknow
WHO recommendation
37%
602
738
20% CAGR
399
518
517
562
98 FY20
86 FY21
122 FY22
27%
207
232 49 FY16
252
294 62 FY17
306
355
80 FY18
350
434
113 FY19
Govt. sponsored
Group
Individual
Health insurance penetration
Higher proportion of beds in these cities positions MHC for industry leading ARPOB on an aggregate basis
ARPOB1 (INR ‘000)
67
82%
% of bed capacity in key metro cities
54
35
52
30
37
76%
72%
• MHC has ~2,900 beds in Delhi NCR & Mumbai
– highest proportion compared to peers
•
Large metros have inherent advantages:
58%
39%
- High per capita income, high insurance penetration and propensity to pay for high end quaternary care facilities
22%
- Availability of senior/ statured clinical talent leading to
Max Healthcare
Fortis (Hospital business)
Narayana Health (India)
Apollo Hospitals
KIMS Hospitals
Aster Hospital (India)
metros becoming regional hubs
- Higher health awareness
(1) ARPOB for FY23 (excl. Covid-19 vaccination revenues); Apollo’s revenue has been grossed up for adjustment of doctor fees as per the disclosures in the last annual report of FY23 | Source: CRISIL research, IRDAI and company websites / presentations 9
Dominant presence in the most attractive markets (2/2)
Being metro-centric also positions MHC well to capitalise on medical tourism
India’s foreign medical tourism industry has been growing
Break-up of medical tourists* by major country of origin
18 company & partner-owned Patient Assistance Centres (PACs) across 15 countries, 2 more upcoming
No. of tourists in lakhs
2.3
1.8
2.4%
2.9%
~3 million medical tourists in India by 2030e
30%
5.0
4.3
7.0
6.4
6.5
Fall due to COVID-19
3.2
1.9
21.2%
Others, 8%
CIS (Eastern Europe), 3%
Afghanistan, 5%
Iraq, 7%
Africa, 8%
4.9%
4.9%
6.1%
6.4%
6.8%
10.5%
Middle East, 12%
2014
2015
2016
2017
2018 2019
2020
2021
2022
Bangladesh, 57%
Company-owned PACs
Partner-owned PACs
Upcoming PACs
Foreign tourists for medical purposes
% of total tourists
*Based on data as of 2019, since 2020 and 2021 were impacted due to COVID-19
Note: Map not to scale
MHC is well-equipped to serve medical tourists
Modern infrastructure and facilities
State-of-the-art medical equipment
Availability of senior clinical talent
Reputed for tertiary / quaternary care
High global and domestic connectivity
Source: Ministry of Tourism, CRISIL research
10
Strategy going forward
Build on Clinical Expertise
Attract best-in-class talent to focus on industry leading patient outcomes
Focus on Capital Light Adjacencies
Max Lab and Max@Home
Leverage Technology
Develop best-in-class digital ecosystem & deploy latest medical technologies
Optimise Existing Infrastructure
Payor mix, Capacity Utilisation, ALOS and Procedure Mix
Expand Bed Capacity
Brownfields and Greenfields (incl. asset light models)
Mergers & Acquisitions
Leverage expertise and balance sheet to pursue value accretive M&A
Strong free cash flow generation and Net Cash surplus on balance sheet along with brand equity, capability and track record to generate industry leading ROCEs and deliver long-term growth
11
Best in class performance parameters
ARPOB(1) (INR/OBD) (‘000)
Occupancy (%)
75
67
59
57
52
45
60
54
48
75%
76%
75%
63%
64%
65%
63%
67%
66%
Operating parameters
Max Healthcare
Apollo Hospitals
Fortis Healthcare
Max Healthcare
Apollo Hospitals
Fortis Healthcare
Pre-tax ROCE(2) (%)
Operating EBITDA per bed(3,4) (INR lakh)
Op. EBITDA Margin
27% 28%
28%
19% 20%
19%
15% 17%
17%
33%
35%
29%
Financial parameters
25%
27%
21%
10%
10%
10%
74
66
57
41
44
37
36
32
27
Max Healthcare
Apollo Hospitals
Fortis
Max Healthcare
Apollo Hospitals
Fortis Healthcare
(1) ARPOB calculated on gross revenue excluding revenue from Covid-19 vaccinations, non captive Pathology and Pharmacy; ARPOB of Apollo & Fortis is as published in their Earning’s update | (2) Indicative company level ROCE; Apollo ROCE is as published in their earning update for their consolidated financial performance; Fortis EBIT is computed from Group Consolidated P&L including share of Profits in associates and Capital employed is after adjusting for cash & bank balances assuming 85% of that are held in short term FDRs | (3) Operating EBITDA excludes exceptional items and non operating Income and non cash items | (4) Operating EBITDA per bed includes that from vaccinations in absence of information for other players and excludes that from non captive Pathology and Pharmacy; Apollo revenue & EBITDA includes Indraprastha Apollo Delhi. The revenue has been grossed up for adjustment of doctor fees as per the disclosures in the last annual report of FY22 for the calculation of operating EBITDA margin %
12
FY22
FY23
9M FY24
Distinguished Board and a dynamic management team
Distinguished Board of Directors
Mr. Abhay Soi Chairman and Managing Director
Mr. Mahendra Gumanmalji Lodha Chartered accountant & Investment Professional
Ms. Amrita Gangotra Technology Leader & Former member of Exec. Mgmt at Bharti Airtel, Vodafone Hungary
Mr. Michael Neeb Former President of HCA Healthcare
Mr. Anil Bhatnagar Senior Lawyer & Arbitrator
Mr. Narayan K. Sheshadri Non-executive Chairman of AstraZeneca Pharmaceuticals and PI Industries
Mr. Kummamuri Narasimha Murthy Chartered Accountant
Mr. Pranav Amin Managing Director Alembic Pharmaceuticals
Chairman and MD
Non-Executive Director
Independent Director
Experienced and dynamic management team
Col. HS Chehal Senior Director & COO (Cluster 2)
Mr. Umesh Gupta Senior Director – HR & Chief People Officer
Mr. N Venkatesan Director & Chief Procurement Officer
Dr. Mradul Kaushik Senior Director – Operations & Planning
Ms. Vandana Pakle Senior Director – Corporate Affairs
Mr. Prashant Singh Director – IT & Chief Information Officer
Mr. Anas Wajid Senior Director – Chief Sales and Marketing Officer
Mr. Yogesh Sareen Senior Director & Chief Financial Officer
Mr. Rakesh Kaushik Director – Legal & Regulatory Affairs
Mr. Keshav Gupta Senior Director – Growth, M&A and Business Planning
Col. Binu Sharma Senior Director – Nursing
Dr. Vinita Jha EVP – Clinical Directorate
Dr. Sandeep Buddhiraja Group Medical Director
Mr. Arjun Sharma Director & Chief Digital Officer
Dr. Abhaya Indrayan Chief Biostatistician, Academics & Research
13
Key Growth Drivers
14
Multiple avenues for future growth
Strong cash generation from operations
INR 924 Cr in 9M FY24
Headroom to raise debt given current leverage
Net Cash Surplus of INR 1,295 Cr as on Dec. 31, 2023
Demonstrated ability to generate high return on capital employed
~35% ROCE in 9M FY24
Long term growth potential
1
2
Optimising Existing Infrastructure
•
•
Focus on tower specialities & case mix
Increase utilization & improve process efficiencies
• Optimize payor mix
h t w o r g e r u t u f
t r o p p u s o t e
l i f o r p
l
a i c n a n i f g n o r t S
3.1
Brownfield
3.2
Asset light
• ~2,600 beds addition via brownfield expansion – ROCE
accretive
• Management contracts and long-term leases of “build-to-
suit” properties
3.3
Greenfield
• Greenfield hospitals in highly attractive and compelling
territories with attractive payback – Acquired land parcels with potential to add 1,000 beds
3.4
M&A
Strong track record of successful M&A and turnaround
• • Adequate headroom for M&A even after brownfield
capex, driven by strong free cash flows and low leverage • Robust deal pipeline - recently acquired Sahara Hospital in
Lucknow and Alexis Hospital in Nagpur
• ROCE threshold levels of 20-25% within 4-5 years post
acquisition
Significant increase in capacity
3
(~2X bed capacity in next 4-5 years)
4
5
Capital Light Adjacencies
• Non-captive pathology – Max Lab • Homecare – Max@Home
Digital Platform
•
Leverage brand, customer loyalty and data to build a
digital ecosystem
15
2
Growth opportunity in existing facilities
Optimising payor mix
Bed share
36.5%
34.2%
5.4%
2.0%
31.3%
29.2%
28.8%*
to demand from preferred channels, driven by -
• Push for reduction in institutional business in order to cater
2.8%
5.0%
5.6%
– Steady pace of organic growth in Self Pay, TPA and
corporate channels, and
– Growth
in International medical
tourism,
post
resumption of regular international travel
58.1%
63.8%
66.0%
65.8%
65.6%
– Increase in upcountry footfalls consequent to improved
FY20
FY21
FY22
FY23
9M FY24*
Institutional
International
Self Pay, TPA and Corporate
connectivity
• Given that ARPOB for institutional business is ~40% lower
than other channels, its replacement has the potential to
unlock incremental 300-400 bps in EBITDA margins
*In 9M FY24, we added 122 beds at Max Super Speciality Hospital, Shalimar Bagh and decided to ramp up occupancy on some of these beds with institutional patients. Excluding this hospital, the institutional bed share for 9M FY24 dropped to 26.7%. 16
3
Existing valuable land bank to enable addition of 4,000+ beds, with ~2,600 beds coming over next 4 years
Indicative timelines for completion of expansion projects
Dwarka, South-west Delhi Gurugram## Saket Complex (Smart) Mohali Nanavati Hospital* Saket Complex (Vikrant) Patparganj, East Delhi
3,534^
300
FY23
FY24
Bed Additions**
Estimated Capex# (INR Cr)
Brownfield
Greenfield
300
918
329 190 300
FY25
819
1,592
7,464
150 200 500
500
250 300 350 200
250
111
FY26
1,100
1,377
FY27
521*
552
FY28 & onwards potential&
Total
1,350##
To be firmed up
*160 beds need to be demolished before commencement of Phase 2 | ** No. of beds may vary slightly subject to configuration of ward beds | # Values are estimated based on EPC model of contracting and will be firmed as each project’s execution gains momentum | ## Currently, the land parcel at Sector-53 is under litigation with HSVP. May impact 500 beds potential assumed FY28 onwards | ^ Includes 122 beds added at Max Shalimar Bagh - 92 beds (added in March 2023) at the new oncology tower and 30 beds (added in June 2023) through internal reconfiguration | &Beds shown under FY28 & onwards only indicate the expansion potential. However, no plans have been formalized yet for such expansion.
17
3
Status of ongoing expansion projects
Dwarka – 300 beds
Mohali – 190 beds
Nanavati – 329 beds in Phase I
• Application of OC has been submitted in October. • Lift installation and other finishing work are in progress.
• All key functional heads are in place, middle level staff
•
being recruited. Expected commissioning by end of Q4 FY24, subject to developer obtaining the OC.
• All statutory approvals to start the construction have
been received.
• Design development is under finalization and base raft
concrete activities have started. Project is largely on schedule.
•
•
• •
Basement and ground level structures have been completed. Steel fabrication above ground floor has begun. Project is largely on schedule.
Sec. 56, GGN – 300 beds in Phase I
Saket Complex (Max Smart) – 350 beds in Phase I
Saket Complex (Vikrant) – 300 beds in Phase I
Max Smart Phase I
Vikrant
Saket (East & West)
• Approval for structural drawings has been received in
Jan 2024.
• Design development is ongoing and RCC works have
commenced. Project is largely on schedule.
•
•
•
•
Tree transplantation work is underway, with 159 trees transplanted and balance 316 trees in process. Existing structures have been demolished as per plan and shoring work for sewage & water treatment plants is ongoing. Barring the initial delay of 6-7 months the project is on schedule.
•
Building plans have been re-submitted to Municipal Corporation of Delhi (MCD) post their initial review. • Dues for water & sewer infra charges have been paid,
while Forest NOC has also been applied. Tender documents are under review for floating to the contractors. Project is largely on schedule.
•
•
18
3
Snapshot of recent inorganic transactions
Sahara Hospital, Lucknow
Alexis Hospital, Nagpur
Type of expansion
Acquisition
Bed Capacity
~550 beds (250 beds operational), 8.9L sft. BUA (G+17 floors, OC for G+8)
Acquisition
200 beds, 2.25L sft. BUA (G+6 floors)
Lucknow:
Nagpur:
Key Pointers
Largest city of UP; high pop. density (~46L), ₹96K GDP/capita Access to medical talent: 4 med. colleges + public hospitals Good connectivity: Kanpur, Allahabad, Gorakhpur, Varanasi Potential proven by peers such as Apollo, Medanta
Hospital:
Well-planned, NABH accredited tertiary care facility High quality design (Hafeez Contractor), construction (L&T) Nursing college with annual intake of ~100 students 27-acre prime land parcel: sufficient headroom for growth
Located in high-income catchment area of Gomti Nagar Potential for further ramp up via augmentation of clinical programs Since 2009, hospital has served ~2L IPD, 2L ICU, 6L OPD patients and conducted over 46,000 surgeries Current revenue run rate of ~INR 200 Cr Ample expansion scope, with option to set up a medical college on unused land parcel
3rd largest city of Maharashtra; high pop. density (~47L) High affordability, good insurance penetration Ready availability of medical talent (med. colleges, hospitals) Well connected: Amravati, Jalgaon, Bhopal, etc. Market viability proven by chains like KIMS, Wockhardt
Hospital:
Only JCI accredited facility in Nagpur Very well-built & maintained tertiary care hospital, equipped with high-end BME Enjoying good brand equity
Attracts patients from MP & Chhattisgarh due to its strategic location in the affluent area of Mankapur (North Nagpur) Run rate of Revenue & EBITDA is INR ~150 Cr & ~25 Cr Potential for further ramp up via augmentation of clinical programs Can be expanded by ~140 beds due to FAR availability and internal reconfiguration
19
3
Strong track record of successful acquisitions
• Management team has done multiple successful acquisitions including BLK, Nanavati and Max Healthcare • Adequate headroom driven by strong free cash flows and low leverage to pursue M&A even after spend on brownfield and greenfield
expansions
Case study on Max acquisition and turnaround
EBITDA* (INR Cr)
436
EBITDA Margin
ROCE*
1,636
27.7%
33.1%
1,305
26.2%
28.8%
636
Merger of Max Healthcare and Radiant effective from June 2020
590
Demonstrated EBITDA margins of 19.2% in Q4 (excl. last 10 days of March due to COVID)
348
17.5%
14.3%
14.7%
11.1%
9.7%
5.4%
FY23
FY22
FY21
FY20
FY19
Performance improvement from FY19 to FY23 largely driven by: •
~INR 330 Cr impact on EBITDA driven by structural cost initiatives as well as merger synergies, with ~INR 140 Cr flowing in EBITDA in FY20, ~INR 73 Cr flowing in EBITDA in FY21 and balance in FY22 Significant growth in high-end tertiary and quaternary procedures with hiring of new senior clinical teams and deployment of latest medical technology across our Network, including 17 robotic systems
•
*Combined performance of Max Healthcare and Radiant; Excludes COVID-19 vaccination & related antibody tests EBITDA
20
4
Develop asset light adjacencies: Max Lab – Non-captive pathology SBU
Organised diagnostics players to grow faster than overall Diagnostic industry
India Diagnostic market to see steady growth (INR Bn)
Indian Diagnostic Industry mix by type of providers
1,360
35-40%
Standalone
Multi-regional chains
6%
11%
Regional chains
46%
12-17%
472
596
684
710
37%
45-50%
Hospital based
FY17
FY18
FY20
FY21
FY26E
Source: Axis Capital, Investec reports
Shift to organised diagnostics centers driven by preference for higher quality and brands
Investing for growth, 68% CAGR since FY17
Net revenue (INR Cr)
EBITDA* (INR Cr)
112
4
106
1
108
105
104
32
72
+68%
41
66
27
39
24
13
5
FY17
FY18
FY19
FY20
FY21
FY22
FY23
9M FY24
5.0
3.0
1.0
-1.0
-3.0
-5.0
12.4%
4.7
5.5%
1.8
4.3%
1.4
1.0%
0.3
-0.9
-3.1%
-0.1
-0.5%
Q2 FY23
Q3 FY23
Q4 FY23
Q1 FY24
Q2 FY24
Q3 FY24
15%
9%
3%
-3%
-9%
-15%
Non-COVID
COVID-19
EBITDA
EBITDA margin (%)
Operational footprint (as of Dec. 31, 2023)
525+
Partner-run collection centres
23 Company owned collection centres (CoCC)
~160 Phlebotomist At Site (PAS)
275+ Pick-Up Points (PUPs)
44 HLMs & OLMs
41
Cities of operations
1,070+ Active Partners
Note: COVID-19 and related tests include RTPCR, Antigen, Antibody, CBNAAT, IL-6, D-Dimer, Ferritin, CRP, LDH, Procalcitonin * Margin computed on net revenue, using arm length revenue share between Max Lab and hospitals (60:40 from FY23 onwards) for samples tested in hospital labs
21
4
Develop asset light adjacencies: Max@Home – Amongst one of the largest homecare providers in the country
Indian home healthcare is under-penetrated with only ~3.6% of total health spending on home healthcare vis-à-vis ~8.3% in the US
Growth Drivers
Indian home healthcare market expected to grow ~2.5 times by 2025...
…with organized healthcare contributing ~USD 480 Mn by 2025 and a significant headroom to grow
USD Bn
Has potential to create ~3.1 Mn jobs
% of total Home healthcare market
30%
14.1
19.9
5.4
2020
2023
2025
52%
2.4%
1.1%
2020
2025
Max@Home: Investing in Growth, over 56% CAGR
Home healthcare solutions ~40% less costly compared to hospitals with added convenience
Rising doctor’s acceptance of home healthcare post pandemic
Increase in the size of aging population and prevalence of chronic ailments
Insurance policies covering home healthcare expenses
Extension of services / scale through digital products
Gross revenue (INR Cr)
Rapid growth through scale up of direct-to- customer services
14 specialized
services
3,000+ daily billed
transactions
1,250+ strong QAI Quality & Accreditation Institute
(ISQua member) accredited
team*
24x7 customer
support
+56%
Max@Home’s comprehensive and round the clock service offerings
63
77
70
28
112
139
126
Critical Care | Nursing Care | Patient Attendants | X-ray at home | ECG/Holter at home | Dialysis | Physiotherapy | Medical rooms | Doctor Visits | Sleep Studies | Pathology | Pharmacy | Medical Equipment | Immunization
9M FY24
*Manpower incl. support & outsourced teams as of December 31, 2023
22
10 FY17
FY18
FY19
FY20
FY21
FY22
FY23
Source: NatHealth – Indian Home Healthcare 2.0
5
Max MyHealth – Proprietary digital platform enabling best-in- class omnichannel healthcare experience
‘Max MyHealth’ offering new age experience for patients and doctors
Monthly Active Users ('000s)
~4.5 lac Patient registrations till date
10.9
70.9
Over 5X growth
70,000+ Monthly Active Users
Deployed BOSS - our home grown appointment management system, across all units
• Single app for all types of consults (physical and virtual) & Max@Home
services; instant consults with a general practitioner within 10 minutes of
booking an appointment
• Track in-patient admission progress and make payments directly through
app; link and view family members, book appointments and view health
records for all
• Quick access to Emergency and Ambulance services across Max network
• Pre-consult document quality checks and case summary preparation
• Enhanced patient experience through intelligent lead management and
patient engagement platform (PEP)
Digital revenue through online marketing activities and web-based appointments accounted for ~22% of overall revenue in 9M FY24
Leverage Max Healthcare’s strong brand, customer base, clinical expertise, doctor network and data to provide existing and new customers with a seamless and best-in-class omnichannel healthcare experience
23
Financial Highlights
24
Network P&L Statement: Q3 FY24
Gross revenue
Net revenue Direct costs1
Contribution Indirect overheads2
Figs in INR Cr
Q3 FY23
Q2 FY24
Q3 FY24
Amount
% NR
Amount
% NR
Amount
% NR
1,559
1,478
573
905
486
100.0%
38.8%
61.2%
32.9%
1,827
1,732
667
1,065
567
100.0%
38.5%
61.5%
32.8%
1,779
1,689
650
1,038
567
100.0%
38.5%
61.5%
33.6%
Operating EBITDA (post Ind AS-116)
419
28.3%
497
28.7%
471
27.9%
ESOP (Equity-settled scheme)
Movement in fair value of contingent consideration payable and amortisation of contract assets3
Reported EBITDA Finance cost (net)4
Depreciation and amortisation
Profit before tax Tax5
Profit after tax
12
6
0.8%
0.4%
401
27.1%
7
63
331
61
269
0.5%
4.3%
22.4%
4.2%
18.2%
12
7
478
(17)
66
429
91
338
0.7%
0.4%
27.6%
(1.0%)
3.8%
24.8%
5.3%
19.5%
12
(8)
467
(14)
70
411
73
338
0.7%
(0.5%)
27.7%
(0.8%)
4.1%
24.3%
4.3%
20.0%
1. Direct costs include material cost, F&B and Clinician’s cost, etc. 2. 3. This is a non-cash item representing change in fair value of contingent consideration payable to Trust/Society over the balance period (~19 to 30 years) under O&M Contracts and
Indirect overheads include personnel cost and other indirect overheads.
mainly represents impact of changes in the time value of discounted liability
4. Net of interest income on deposits, capitalisation of projects underway and tax refunds, and includes forex gain/loss, etc. 5. Effective tax rate in Q3 FY24 stood at 17.7% compared to 18.6% in Q3 FY23
25
Network P&L Statement: 9M FY24
Gross revenue1 Net revenue Direct costs Contribution Indirect overheads
Operating EBITDA1
Figs in INR Cr
FY21
FY22
FY23
9M FY24
Amount 3,881
3,629
1,508
2,121
1,485
% NR
100.0%
41.6%
58.4%
40.9%
Amount 5,509
5,218
2,103
3,115
1,725
% NR
100.0%
40.3%
59.7%
33.1%
Amount 6,236
5,904
2,304
3,600
1,964
% NR
100.0%
39.0%
61.0%
33.3%
Amount 5,325
5,049
1,968
3,081
1,677
% NR
100.0%
39.0%
61.0%
33.2%
636
17.5%
1,390
26.6%
1,636
27.7%
1,404
27.8%
ESOP (Equity-settled scheme) Movement in fair value of contingent consideration payable and amortisation of contract assets3 Transaction cost including QIP related cost & Loss on fair valuation of pre-merger holding of Radiant under Ind AS 103
Exceptional item: Payment to employees under VRS Reported EBITDA Finance costs (net) Depreciation and amortisation Profit / (Loss) before tax Tax4 Profit / (Loss) after tax
27
1
0.7 %
0.0%
34
7
0.7%
0.1%
249
6.9%
-
-
-
359
187
216
(45)
50
(95)
-
9.9%
5.2%
6.0%
(1.2%)
1.4%
(2.6%)
9
1,340
112
248
979
143
837
0.2%
25.7%
2.2%
4.8%
18.8%
2.7%
16.0%
34
4
-
-
1,597
39
260
1,298
(30)
1,328
0.6%
0.1%
-
-
27.1%
0.7%
4.4%
22.0%
(0.5%)
22.5%
36
6
-
-
1,362
(34)
200
1,196
229
966
0.7%
0.1%
-
-
27.0%
(0.7%)
4.0%
23.7%
4.5%
19.1%
Note: The numbers for the previous period have been re-casted and re-grouped to make them comparable with the disclosures in the current period 1. 2. Non-cash item represents the change in fair value of contingent consideration payable to Trust/Society over the balance period (~19 to 30 years) under O&M Contracts and represents
FY22 includes gross revenue of INR 236 Cr and EBITDA of INR 85 Cr from Covid-19 vaccination & related antibody tests compared to INR 2 Cr revenue in FY23
change in the WACC, time value of discounted liability and impact of changes in future business plan projections Includes impact of one time reversal of INR 244 Cr deferred tax liability (net of capital gains tax) in FY23 pursuant to voluntary liquidation of a subsidiary
3.
26
Memorandum Consolidation of Network P&L: 9M FY24
MHIL & its subsidiaries & Silos
Ind AS Unaudited
Partner Healthcare Facilities ("PHF") Financials
(IGAAP Unaudited)*
Balaji Society
GM Modi Society
Devki Devi Society
IND AS Adjustment(1)
Eliminations & Adjustment (2)
Revenue from operations Other income(3) Total operating income Pharmacy, drugs, consumables & other direct costs Employee benefits expense(4) Other expenses(5) Total expenses Operating EBITDA
Less: non-operating expenses
3,983
15
3,998
823
663
1,351
2,837
1,161
469
2
472
95
62
239
396
76
324
8
332
70
40
167
278
55
589
18
607
162
59
289
510
97
-
-
-
-
-
(5)
(5)
5
(343)
(17)
(360)
51
193
(615)
(371)
11
Figs in INR Cr
MHC Network (Consolidated) (Certified by an ICA)
5,023
26
5,049
1,202
1,016
1,427
3,645
1,404
-
-
6
36
ESOP (Equity-settled Scheme) Movement in fair value of contingent consideration payable and amortisation of contract assets Reported EBITDA Finance costs (Net) Depreciation & Amortisation Profit / (Loss) before tax Tax Profit / (Loss) after tax New PHFs i.e. Vikrant Children’s Foundation and Nirogi Charitable and Medical Research Trust have not been reflected separately and included in the Eliminations & Adjustments due to negligible values
1,196
1,362
1,119
1,023
800
175
223
229
966
200
(20)
(79)
(34)
14
66
66
15
68
20
19
12
68
20
76
21
97
14
14
55
36
12
11
(4)
3
7
6
2
5
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1) Mainly IND AS 116 (Accounting for Leases) at PHFs | (2) Eliminations relate to revenue from PHFs and intra-network sale/purchase. Also includes consequential impact on amortisation due to reversal of intangible assets recognized at MHIL & its subsidiaries for contracts with PHFs. The net present value of the amount payable by a PHF to unconsolidated part of the other Society over the contract period was accrued during PPA and payment made for the year there against in Q3 FY24 has been knocked off against the liability so created. Further, cost of non-treating doctors on retainership, forex gain/loss etc. have been reclassified under Employee benefits expense & Finance costs resp.| (3) Other Income includes income from EPCG, unclaimed balances written back, donations & contributions, scrap sale, income from outlets/in hospital displays etc. | (4) Includes non-clinical doctors on retainership & movement in OCI for actuarial valuation impact but excludes ESOP expenses | (5) Includes cost of admitting doctors, net provision for doubtful debts & excludes movement in fair value of contingent consideration and amortisation of contract assets that is reflected below operating EBITDA
27
Network Balance Sheet1 (Includes Managed and Partner Healthcare Facilities)
Sep 2022
Particulars
Mar 2023
Sep 2023
Figs in INR Cr
7,462
Shareholders' Equity
815
446
144
137
(72)
Gross Debt Deferred / Contingent Consideration Payable2 Put Option Liability3
Lease Liabilities (Ind AS 116)
Deferred Tax Liability / (Deferred Tax Asset)
8,932
Total Liabilities
3,773
3,260
680
205
1,000
452
84
2
(524)
8,932
Goodwill
Net tangible Assets (incl. CWIP)
Intangible Assets (incl. brand and O&M rights)
Right to Use Assets (Ind AS 116)
Cash & Bank balance Trade Receivables (Net)4
Inventories
Investments
Net Current & Non-Current Assets / (Liabilities)5
Total Assets
8,070
682
440
150
139
(50) 9,430
3,773 3,458
681
203
1,565
434
104
2
(789)
9,430
8,623
606
463
84
147
(16)
9,907
3,773 3,552
692
206
1,993
546
98
2
(955)
9,907
1. The intra-network dues and intangible assets on account of medical services agreements with PHFs are eliminated and fair value of assets & liabilities of PHFs (as on June
1, 2020) are recognised, with balance reflected under Goodwill
2. Represents fair value of long-term liabilities towards fees / revenue share payable to Trust / Societies over the remaining contract period ranging from 20 to 82 years 3. Put Option Liability at the end of Sep. 2023 is for the purchase of balance stake (40%) in Eqova Healthcare Pvt. Ltd. 4. Represents DSO of 61 days. Increase is attributed to growth in revenue from insurance and institutional patients 5. Mainly represents tax refunds receivable, capital advances, provisions for retiral benefits and unfavorable lease liability recognized, PPA, dividend payable to MHIL shareholders and includes Trade payable of INR 792 Cr at the end of Sep 2023 compared to INR 719 Cr at the end of Mar 2023 and INR 661 Cr at the end of Sep 2022
28
Notes to Network Consolidated Financials
1. Max Healthcare Institute Limited (“MHIL”), its subsidiaries and deemed separate entities (i.e. silos for managed healthcare facilities) constitute MHIL Group under IND AS 110. MHIL Group also has long term contracts with certain societies, who own and operate hospitals and act in concert with other Max Hospitals to provide high end medical care to the communities. MHIL Group carries significant financial exposure and control medical operations of these hospitals through Hospital Management Committee structure or otherwise. These hospitals are treated as Partner Healthcare Facilities (“PHF”) and form part of Max Network of Hospitals. Given the financial exposure and operating model, it is considered appropriate by MHIL management to disclose the financial performance of the Network Hospitals as a whole, by way of a certified memorandum consolidation of financial results of operations of MHIL, its subsidiaries, managed healthcare facilities and PHFs (all these entities combined together are referred as “Network”), which have been subjected to review by their statutory auditors.
2. The Consolidated financial information contained in this presentation is thus different from that of the MHIL Group since the financials of Partner Healthcare Facilities (PHFs) are also included. The information is drawn up based on the management consolidation of the unaudited financials of the Company, its subsidiaries, managed healthcare facilities and those of the PHFs (prepared under IGAAP), duly adjusted for intra-network eliminations and IND AS related adjustments. The Consolidated financial information post IND AS adjustments, is certified by an independent firm of chartered accountants.
3. Healthcare undertaking of Radiant Life Care Private Limited (“Radiant”) and residual business of erstwhile Max India Limited merged into Max Healthcare Institute Limited (“MHIL” or “the Company”) through a NCLT approved Composite Scheme of Amalgamation and Arrangement on June 1, 2020. The Group, while accounting for the Business Combination in June 2020 has carried out a fair valuation exercise, whereby the assets and liabilities of the acquired entity (i.e. MHIL) & its subsidiaries and effects thereof were captured in the financials of the Company. The fair valuation exercise has led to an increase in the tangible and intangible assets of the Network by INR 3,662 Cr, which includes INR 252 Cr towards the Partner Healthcare Facilities. Further, the Company acquired a step-down subsidiary during Q2 FY22 and the purchase price allocation (“PPA”) of this acquisition led to incremental change in tangible and intangible assets by INR 107 Cr beyond the investment value.
4. The Profit & Loss statement in the earnings update is prepared after line-by-line consolidation of the financials of MHIL, its subsidiaries, deemed separate
entities/silos and PHFs, after eliminating intra Network transactions, in an investor friendly format.
5.
In order to better explain the financial results, the exceptional items and material items which don’t truly represent the operating income/expenditure and are non-cash in nature have been identified and reported separately, to reflect the Operating EBITDA performance of the Network. The numbers are regrouped to meet industry specific information requirement of investors. Further, the Profit after tax includes the impact of change in other comprehensive income and thus reflects Total Comprehensive income for the period.
29
Thank you
30
Appendix
1. ESG & CSR Updates
2. Network Structure, IT & HR
31
Appendix 1
ESG Highlights
CSR Initiatives
32
ESG Highlights
Environment
33.3% share of renewable energy in total energy mix
39% water recycled out of total water consumption in FY 2023, up from 35.9% in FY 2022
Water consumption decreased to 0.98 kilolitres per bed in FY 2023 from 1.08 kilolitres per bed in FY 2022
ISO 14001 certification received for eight hospitals
> 50% of our waste being disposed through authorized recyclers
100% water neutrality goal by 2025
Social
Employees
• 49% women employees • 9.95 lakh hours of upskilling programmes • Certified Great Place to Work® by
Great Place to Work institute
Patients
Community
• 363K needy patients treated free in FY
• Nutrition support to ~2,300 TB patients
2023
• USD ~25 Mn worth of free medical
•
treatment to the underprivileged Introduced ‘MaxCel’ platform that aids in comparison of clinical outcomes to enhance patient care
for better recovery
• ~3,600 physical outreach OPDs in
upcountry
• More than 6,000 community engagement
activities conducted
Governance
Implementing policies benchmarked against global best practices
Ensuring diversity in the boardroom • Five out of eight directors on the board are independent including one woman director
Risk management with a framework that identifies, analyses and mitigates potential threats
Instilling ethical conduct by sustaining a culture of accountability
33
CSR Initiatives
Initiatives undertaken on Education
CMD and DG Delhi Prisons inaugurating the Max Skill Training for Sustainable Livelihoods at Tihar Jail
Press coverage in Times of India & Dainik Jagran
Media coverage on AajTak news channel
Focus areas for CSR: Education and Water Sustainability
Education
Water Sustainability
I. Max Healthcare Scholarships
II. Skill Training for Sustainable Livelihood
Address the gap of trained healthcare professionals by enabling meritorious students from financially disadvantaged sections of society fulfil their aspirations of a career in medicine
Max Healthcare Skill Training being conducted at Tihar Jail is considered India’s largest and 1st ever instance of a corporate sector partnership for correctional reforms in India. Under this initiative, 1200 undertrials are learning new skills to forge a new future for themselves upon release and re-integrate into society.
III. Water Rejuvenation
Construction of water recharge structures e.g. ponds in the vicinity of our operations, in line with our stated ESG goal of water neutrality by FY25
34
Appendix 2
Network structure
IT Infrastructure
HR Initiatives
35
Network Holding Structure (as of February 12, 2024)
Max Shalimar Bagh Max Dehradun Max Panchsheel Immigration centre (Lajpat Nagar) Max Saket (West) SBUs (MIME, Max@Home) Immigration centre (Mohali)
Max Healthcare Institute Limited (MHIL)
Medical Service Agreement
Balaji Society (Max Patparganj)
Valid till 2065
Devki Devi Society (Max Saket East, Onco Daycare Centre)
Valid till 2064
100%
100%
100%
100%
100%
100%
100%
Shareholding: 60%, Option rights: 40%
Max Lab Limited
HBPL (Max Bathinda) (Max Mohali)
Medical Services contain specific specialities & pathology / radiology services, as may be the case
Alps Hospital Ltd.# (Max Gurugram)
100%
ET Planners Pvt. Ltd.
Medical Service Agreement
Vikrant Children’s Foundation & Research Centre Valid till 2111
CRL (Max Vaishali) (Max Noida)
Max Healthcare FZ-LLC (Dubai)
MHC Global Healthcare Nigeria Ltd.
Max Hospitals and Allied Services Ltd.#
Eqova Healthcare Pvt. Ltd.^
Medical Service Agreement
O&M / Medical Service Agreement
O&M / Medical Service Agreement
O&M / Medical Service Agreement
Medical Service Agreement
Gujarmal Modi Society (Max Smart)
Valid till 2105
BLK-Max Hospital
Max Hospital Dwarka
Nanavati Max Hospital
Valid till 2054
Valid till 2082
Valid till 2043
Nirogi Charitable & Medical Research Trust
Valid till 2112
Owned
Partner Healthcare Facilities
Managed Healthcare Facilities
99.9%
Alexis Multi- speciality Hospital Pvt. Ltd.
# The Boards of Alps Hospitals Ltd. and Max Hospitals and Allied Services Ltd. have approved a scheme of amalgamation of the two entities and the same is yet to be approved by Hon’ble NCLT, Mumbai Bench | Saket City Hospital Ltd., a WOS is under voluntary liquidation and its business undertaking has been distributed by the liquidator on Aug 31, 2022 to MHIL | ^ MHIL holds & has exercised the right to appoint majority directors in Eqova Healthcare | MHIL – Max Healthcare Institute Limited; CRL – Crosslay Remedies Limited; HBPL – Hometrail Buildtech Private Limited | Validity includes extensions available under the contract
36
Our Digital Backbone
Modernization of IT infra
▪ Modernisation of Core HIS, EMR and
other apps
▪ Implementation of SDWAN for better user experience and cost optimization
▪ Enhancement of BCP for improved
RPO/RTO
▪ Cloud journey started with Data Lake,
Patient Mobile App, Doctor App
▪ Adoption of best-in-class Alternative
Payment Model (APM)
Cyber Security
▪ Implementation of robust cyber security framework incl. EDR, SOC, WAF, etc., along with cyber insurance coverage ▪ ISO 27001 underway with revamp of
policies
▪ Digital Personal Data Protection Act 2023 implementation underway
▪ Network segmentation and adoption of Cyber Resilience program in progress ▪ Augmentation of in-house SOC team
01
02
04
03
Digitization & AI
▪ Multiple AI projects running in radiology (Qure AI, Predible’s LungIQ, Zebra’s, etc.) + few pilot projects for disease prediction
▪ Use of Low Code tech for faster delivery – 40 apps developed till date, more in pipeline
▪ Gen AI, LLM being evaluated for case summarization, speech-to-text, etc. ▪ IoT being leveraged for optimizing patient workflows such as porter mgmt., PHP, ambulance, etc.
Data Analytics
▪ Comprehensive data lake developed for
use in analytics and clinical research ▪ Enhancement of analytics platform for
Predictive Analysis
▪ Command Centre under evaluation for enhanced patient safety and experience
▪ IoT based continuous patient
monitoring to be initiated for better clinical decision-making
37
Our people help us – to serve, to excel
COMPASSION
EXCELLENCE
EFFICIENCY
CONSISTENCY
▪ Travel tickets ‘to and fro’ home
▪ ~1 Mn hours of upskilling
to our nurses once a year
▪ 100% off on consultations for
our employees and their immediate families
▪ 1-4 weeks of leave for parents
with adopted kids
programme through capability development initiatives
▪ Curated Functional Upskilling Programme for Excellence (FUPE) for functional expertise and Hospital Operations Programme for Excellence (HOPE) for aspiring leaders
▪ Differentiated reward strategy for medical and non-medical staff to drive targeted outcomes
▪ Internal Job Posting Policy to provide diversified career opportunities for employees
▪ Technology driven HR
processes to enhance user experience and engagement
▪ Received Great Place To Work
certification for two consecutive years, through consistently prioritizing employee well-being and development
▪ Notable increase in employee
engagement scores from 72% to 79%
IIM Ahmedabad & IIM Kashipur First of its kind Max Talent Development Programme curated by Premier B schools
UMANG – Pride within our employee recognition platform, wherein 1 employee was rewarded every 41 mins
5,000+ apprentices upskilled in our hospitals under the guidance of Ministry of Skill Development
1 crore+ ESOPs approved under ESOP Scheme 2022 for non- medical as well as medical staff. Vesting b/w year 1 and 5, linked to individual & org. performance
27,000+ employee lives touched through medical benefits programme
38
List of Network Healthcare Facilities
Name
Location
Description
Max Super Speciality Hospital, (West Block) Saket
Max Super Speciality Hospital, (East Block) Saket
Max Smart Super Speciality Hospital, Saket
BLK-Max Super Speciality Hospital, Rajendra Place
Nanavati Max Hospital, Mumbai
Max Hospital, Gurugram
Max Super Speciality Hospital, Patparganj
Max Super Speciality Hospital, Vaishali
Max Super Speciality Hospital, Shalimar Bagh
Max Super Speciality Hospital, Mohali
Max Super Speciality Hospital, Bhatinda
Max Super Speciality Hospital, Dehradun
Max Multi Speciality Centre, Panchsheel Park
Max MedCentre, Lajpat Nagar (Immigration Department)
Max Institute of Cancer Care, Lajpat Nagar
Max Multi Speciality Centre, Noida
Max MedCentre, Mohali
Delhi
Delhi
Delhi
Delhi
Mumbai
Gurugram
Delhi
Ghaziabad
Delhi
Mohali
Bathinda
Dehradun
Delhi
Delhi
Delhi
Noida
Mohali
Hospital
Hospital
Hospital
Hospital
Hospital
Hospital
Hospital
Hospital
Hospital
Hospital
Hospital
Hospital
Medical centre
Medical centre
Medical centre
Medical centre
Medical centre
In addition to the above, there are 6 new upcoming Network facilities – one each in South Delhi (Saket Complex – Vikrant), East Delhi (Patparganj), North West Delhi (Dwarka), Gurugram (Sector 56), Lucknow (Gomti Nagar) and Nagpur (Mankapur)
As on February 12, 2024
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Definitions
Term
ALOS
ARPOB
Average Length of Stay: discharged patients stay in the hospital, basis admission and discharge time
Description
Average Revenue per Occupied Bed; Gross revenue divided by the occupied bed days; excludes revenue from Covid-19 vaccination & related antibody tests and Max Lab operations
Cash from operations
Represents cash generated from operations after amount deployed for routine capex, finance cost and working capital changes relating to operations
Contribution
CTI
EBITDA per bed
Gross Revenue
Net revenue minus material cost, F&B cost and salary/professional fess paid to clinicians credentialed for OPD consultations and IPD admissions
Represents self pay, private insurance & international patient segments where hospital tariff is the basis for billing / contract
Operating EBITDA divided by occupied bed days, annualised. Excludes incremental EBITDA from Covid-19 vaccination & related antibody tests and Max Lab operations
Amount billed to the patients/customers as per contracted/rack rates, as applicable, including the patients from the economically weaker section (EWS) on discharge basis; Also includes movement in unbilled revenue at the end of the period for patients admitted in the hospital on reporting date and other operating income such as SEIS income, EPCG income, unclaimed balances written back, etc.
Indirect overheads
Major costs include – Personnel costs (excl. clinicians credentialed for OPD consultations and IPD admissions), hospital services, admin, provision for doubtful debts, advertisement and allied costs, power and utilities, repair and maintenance
Net Revenue
Gross revenue minus management discounts, amount billed to EWS patients, employee discounts, marketing discounts and allowance for deductions for expected credit loss
OBD
Occupied Bed Days
Operating EBITDA
Contribution minus indirect overheads, excluding one-off expenses, extraordinary expenses and specific non-cash expenses (itemised separately) which are accrued due to IND AS requirements, but are not operating in nature;
Greenfield / Brownfield expansion
Greenfield expansion denotes capacity addition at a new hospital in a new location; Brownfield expansion implies bed addition at or within 1 km of existing, operational Max hospital
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About Us
Max Healthcare Institute Limited (MHIL) is India’s leading provider of healthcare services.
It is committed to the highest standards of medical and service excellence, patient care,
scientific and medical education.
For further information, please visit
www.maxhealthcare.in
MHIL has major concentration in north India consisting of a network of 17 healthcare
Contact:
facilities. Out of the total network, eight hospitals and four medical centres are located in
Aakrati Porwal
Delhi and the NCR and the others are located in the cities of Mumbai, Mohali, Bathinda
and Dehradun. The Max network includes all the hospitals and medical centres owned,
operated and managed by the Company and its subsidiaries, and partner healthcare
facilities. These include state-of-the-art tertiary and quaternary care hospitals at Saket,
Patparganj, Vaishali, Rajendra Place, and Shalimar Bagh in NCR Delhi and one each in
Mumbai, Mohali, Bathinda and Dehradun, secondary care hospital in Gurgaon and Day
Max Healthcare Institute Ltd.
Tel: +91 9920 409393
Email: aakrati.porwal@maxhealthcare.com
Anoop Poojari / Suraj Digawalekar
Care Centres at Noida, Lajpat Nagar and Panchsheel Park in NCR Delhi and one in Mohali,
CDR India
Punjab. The hospitals in Mohali and Bathinda are under PPP arrangement with the
Tel: +91 98330 90434 / 98211 94418
Government of Punjab.
Email: anoop@cdr-india.com, suraj@cdr-india.com
In addition to its core hospital business, MHIL has two SBUs - Max@Home and MaxLab.
Max@Home is a platform that provides health and wellness services at home and
MaxLab offers diagnostic services to patients outside its network.
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