SUMMER TRAINING PROJECT REPORT

ON
ANALYSES OF MEDICAL SERVICES
AND BUSINESS DEVELOPMENT
MARKETED
BY
COLUMBIA ASIA HOSPITAL
FOR THE PARTIAL FULFILLMENT OF THE
REQUIREMENT
FOR THE AWARD OF
Master Of Business Administration
UNDER THE SUPERVISION OF
Mr.Abishek Singh Chauhan
SUBMITTED BY
Kailash Chandra Upadhyay

UTTARANCHAL UNIVERSITY, DEHRADUN

CERTIFICATE
This is to certify that the project work done on ANALYSES OF MEDICAL SERVICES AND
BUSINESS DEVELOPMENT MARKETED BY COLUMBIA ASIA HOSPITAL is a bonafied
work carried out by Mr. Kailash Chandra Upadhyay under my supervision and guidance. The
project report is submitted towards the partial fulfillment of 2 year , full time Master Of
Business Administration in UTTARANCHAL UNIVERSITY DEHRADUN.

This work has not been submitted anywhere else for any other degree/dimploma. The original
work was carried during 09/06/2014 to 01/08/2014 in COLUMBIA ASIA, GURGAON.

Name of industry guide

Mr. Ankita Jha
Date :
Students Name &Sign
Kailash Chandra Upadhyay

Name &Sign of faculty

Mr. Abhishek Singh Chauhan

AUTHORIZATION(To whomsoever it may concern)

This is to certify that Mr. Kailash Chandra Upadhyay, Enrolment no22051314024, student of Uttaranchal University- Dehradun, has undertaken his
Summer Internship Program (SIP) from Columbia Asia Hospital, Gurgaon from
09/06/2014 -01/08/2014 for the project titled ANALYSES OF MEDICAL
SERVICES AND BUSINESS DEVELOPMENT to understand the Business
Development Model- International Patient Services of a hospital under my
supervision.
The company will have no objection if Kailash Upadhyay:
1. Participates for IBS Alumni Federation Award (IBSAF) for Excellence in SIP2014,being conducted by IBS and shares findings of the project for academic
purposes, and
2. Uses the company name for the abstract of the above project in public domain, if
selected for the award.
We wish him well for all his future endeavors.

Ms. Rashmi Hingorani,

Manager-Marketing

ACKNOWLEDGEMENT

I am heartly thankful to my Institute(Uttaranchal University,Dehradun) &Company (Columbia

Asia Hospital) for providing me an opportunity to undertaken a very useful and interesting
project under the guidance and constant supervision of Mr.Aniket Jha (Company Guide) and
Ms. Rashmi Hingorani. I express my gratitude and thanks to them for providing necessary
skills, knowledge, and information regarding the project & also for their support in completing
the project.
A special word of thanks to my company guide, Mr. Aniket Jha for his guidance and persistent
encouragement, throughout, for the completion of this report. I am deeply indebted to him for his
invaluable supervision. Besides, I would also like to thank all the staff members of Columbia
Asia Hospital for providing me a learning environment. Without their aid & support, this project
would have been a daunting task.
I am indebted to the helping hand of my faculty guide Mr. Abhishek Singh Chauhan who by his
continuous reinforcement and best wishes pioneered me into an absolutely intense and
interesting corporate world.

Kailash Chandra Upadhyay

Uttaranchal University Dehradun

DECLARATION
This is to certify that the project titled ANALYSES OF MEDICAL SERVICES
AND BUSINESS DEVELOPMENT- To understand the Business Development
Model-International Patient Services of a hospital is a bonafide work done by
Mr. Kailash Chandra Upadhyay, Enrollment Number: 22051314024 in partial
fulfillment of the requirements of MBA Degree and submitted to Uttaranchal
University Dehradun.
I also declare that this project is a result of my own efforts and it has not been
copied from anyone. I have taken only citations from the literary resources which
are mentioned in the Bibliography section.
This work was not submitted earlier at any other university or institute for the
award of the degree.

Date- 1st Aug 2014

Place- Gurgaon

(Kailash Chandra Upadhyay)

TABLE OF CONTENT

Serial
NO.
i

CONTENTS
Authorization

ii

Acknowledgement

iii

Declaration

iv

Abstract

Introduction

Company Profile

Organization Profile

Hospital Marketing

4.1

Types Of Marketing

4.2

Referral Marketing

4.3

Institutional Marketing

International Patient Services (IPS)

PAGE
NO.

5.1

IPS Channels

5.2

International Third Party Administrators

Main Text

6.1

Country Wise analysis Of IPS at Columbia Asia

Hospital

6.2

Specialty wise analysis of IPS at Columbia Asia

Hospital

6.3

Source- wise analysis of IPS at Columbia Asia

Hospital

6.4

Pilot Research

6.5

Country Wise analysis Of IPS in Delhi/NCR

6.6

Comparative analysis of Top 10 Hospitals in

Delhi/NCR

SWOT Analysis

PEST Analysis

PORTER Five Forces Model

10

Conclusion

11

Recommendation

12

Learning from Internship

ABSTRACT
Lack of healthcare facilities for urban population and medical tourists and
economic advantages associated with it have influenced government to open the
gates for Private players to invest in the sector. Last few years have witnessed a
stiff competition in the sector creating pressure on management to sustain the
profitability. The role of Marketing in Hospitals has become crucial in keeping the
balance sheet figures positive. Today hospitals are not just about treating patients
at govt. hospitals or a few Pvt. State of the art Hospitals, today its a fight for
patients among Pvt. Hospitals. As the demand and supply in hospital sector is
achieving equilibrium in Delhi/NCR with 45 NABH accredited, 39 Govt. hospitals,
and infinite good nursing homes and referral centers, the pressure of business
development and sustainability is continuously mounting on marketing
departments of respective hospitals.
Further with the growth in the sector of medical tourism in India, the need for
global healthcare marketing has risen extremely during the past few years. The
patients and prospective patients are becoming quite aware and better educated
about the various developments taking place in the healthcare industry. They are
able to take knowledgeable decisions regarding medical services or products with
the help of professionals and internet.
The International Patient Services divisions; also known as IPS divisions of
hospitals, are competing strongly to attract these International Patients to their
respective hospitals. Big players like Apollo, Fortis, Medanta, Max, B.L Kapoor
(BLK), and others are spending a lot on marketing themselves in the arena of
Medical Tourism. The marketing in IPS is witnessing new discoveries ranging
from high commission to medical practitioners and healthcare facilitators to
referral hospitals in less developed nations. All the hospitals in India and other
Asian countries have realized the hidden potential of medical tourism; they would
like to take advantage of this opportunity before it achieves its declining stage of
Life cycle.

In the new world of healthcare, healthcare practitioners and healthcare marketing

agents first identify the needs and requirements of the patients. Post recognition is
very important in this field as they work on the marketing plan that will be the next
to their vision and the extent to which they want their services and products
recognized and made popular. A diverse range of marketing tools is used to make a
strong image of a brand or strengthen it.
According to medical marketing professionals, cost and quality are not the only
influential factors for patients opting for a medical tourism destination. It also
includes factors, such as destination and culture proximity, infrastructure,
environment. Cost of treatment and risk are major in deciding on a destination to
avail medical services in foreign country.
Medical tourists will only opt for a destination, which is easily accessible, wellmarketed, has advanced technology and caters to all their needs in a satisfactory
manner. Medical tourism marketing advisors therefore, are driven to follow a
deliberate approach to attract more medical tourist. They do so by recognizing a
target group and hereafter forming their marketing strategies according to the
targets interest.
The main factors contributing to this phenomenon include long waiting list for
surgeries, costly healthcare in industrialized countries, No or minimal insurance
coverage in many developed countries, anonymity of medical surgeries in other
countries, powerful communication between the various nations and states in the
world, having natural resources in many developing and Asian countries for
offering complementary and traditional medicine has led to the recent natural
progression within health and medical from developed to developing countries.*
In India cost benefit is approximate 50% - 80% which favors the International
Patient services in India up to great extent. The most common treatments and
Surgeries for which India is gaining popularity are Cochlear Implant, heart surgery,
knee Replacement, Hip Replacement, cosmetic surgery, hair Transplant, Eye
surgery and dental implants/ surgery. Healthcare packages are varied and so are the
cost of treatment involved but in any way people have to pay a fraction or 1/10th
or 30-40% less cost of the total cost that they are supposed to invest in their
countries.
This project was undertaken to understand the basics of hospital marketing and
business development with a special focus on IPS division. The process included

the identification of loopholes responsible for decreasing counts and revenue

generated from IPS section of Columbia Asia Hospital, Gurgaon.

INTRODUCTION

HEALTHCARE INDUSTRY AT A GLANCE

The health care industry is one of the world's largest and fastest-growing
industries. Consuming over 10 percent of gross domestic product (GDP) of most
developed nations, health care can form an enormous part of a country's economy.
MARKET SIZE
The domestic health care sector is poised to touch US$ 100 billion by 2015 and
US$ 275.6 billion by 2020, according to industry estimates. In 2013, healthcare
and life sciences emerged as the second favorite destination for venture capitalists
after technology, attracting 27 investments worth US$ 181 million, according to
research firm Venture Intelligence.
The hospital and diagnostics center in India received foreign direct investment
(FDI) worth US$ 2,191.91 million, while drugs & pharmaceutical and medical &
surgical appliances industry registered FDI worth US$ 11,583.69 million and US$
741.80 million, respectively during April 2000 to December 2013, according to
data provided by Department of Industrial Policy and Promotion (DIPP).

MARKET SEGMENTS
Of the total healthcare revenue in the country, hospitals account for 71 per cent.

There is a very large market potential in India. Only 20% of this industry potential
has been tapped so far. The government cannot afford to spend the necessary
amount and hence it opens up a large area for private investors. The factors for the
boom of this industry are more options in healthcare financing, growing economy,
saturation of other sectors like IT and retail and the different models of healthcare
delivery. The key players of this industry (on basis of number of beds) are
Columbia Asia Hospitals, Artemis Healthcare, Medanta, Apollo, Fortis, Arvind
Eye care, Max Hospitals etc. The regulators of this industry are Government of
India, Directory of Health and Family Welfare, Ministry of Health and Family
Welfare, Indian Council of Medical Research, Central drug Standard Control of
Organization.
The growing population with a much deeper pockets and low government
participation has led to higher demands where people are willing to pay high costs
for proper medical care. Indias unmet demand for healthcare facilities, rapidly
changing demographics, increasing private spending on healthcare, and a readily
available intellectual pool are fuelling the growth of the healthcare industry and
making it highly attractive for investors.

THE ROAD AHEAD

India is a land full of opportunities for players in the medical devices industry. The
country has also become one of the leading destinations for high-end diagnostic
services with tremendous capital investment for advanced diagnostic facilities, thus
catering to a greater proportion of population. Besides, Indian medical service
consumers have become more conscious towards their healthcare upkeep.
India is not just a great emerging power, in medicine it is a well-established
leader, and we have a lot to learn from this success, highlighted Mr. Alexander
Kadakin, Russian Ambassador to India.

COMPANY PROFILE-COLUMBIA ASIA HOSPITALS PVT.

LTD
Columbia Asia is an international healthcare group operating a chain of modern
hospitals across Asia. Columbia Asia Hospitals Pvt. Ltd.is one of the first
healthcare companies to enter India through 100% foreign direct investment (FDI)
route. The Columbia Asia Group is owned by more than 150 private equity
companies, fund management organizations and individual investors.

Columbia Asia hospitals are clean, efficient, affordable and accessible. The
innovative design of the hospitals, from their manageable size to their advanced
technology, is focused on creating positive experience for patients.
The first hospital in India commenced operations in 2005 in Hebbal - Bangalore.
Currently Columbia Asia operates seven multispecialty hospitals, one referral
hospital and a clinic. The group has presence in Bangalore, Mysore, Kolkata,
Gurgaon, Ghaziabad, Patiala and Pune.
Mission
Columbia asia is pledge to deliver effective and affordable medical services in a
clean and caring environment
VISION
To build the best managed healthcare company in Asia.

MOTO
Costomer First
PEOPLE
We hire the best from healthcare and other industries, invest in training the
employees and have numerous rewards and recognitions for them

PATIENT CENTERED CARE

Columbia Asia prides itself on its service standards, the people working with them
and the clinical expertise extended to patients. The companys mission is to
provide effective and affordable care in a clean and caring environment.
The company has a hospitality-based approach wherein the patients are treated as
guests. The processes are technology-driven, making it convenient for patients to
use their services. All of the medical programs are underpinned by an
uncompromising belief and practice of ethics, excellence and strict clinical
governance.

INFRASTRUCTURE AND SERVICES

Columbia Asia today serves more than one million patients every year. The
hospitals offer comprehensive clinical programs that are supported by a list of
ancillary services (ICU, NICU, physiotherapy, referral lab,
teleradiology/telemedicine, pharmacy and imaging facilities).
A comprehensive electronic medical records system forms the core of the hospital
information system (HIS) that supports clinical decision making. While four of the
hospitals are already accredited by NABH, the rest are under process. The
company caters to healthcare needs of international patients from developed and
developing countries.

ORGANIZATION PROFILE
Columbia Asia Hospital Palam Vihar, Gurgaon, is a 90 bed multi-specialty
facility situated in an upscale locality of the National Capital Region. The hospital

began its services in July 2008 and has already become a preferred healthcare
service provider for the residents and corporate entities of Gurgaon.
The hospital offers a wide range of clinical services such as Obstetrics &
Gynecology, Internal Medicine, General Surgery, Pediatrics, Ophthalmology, Ear,
Nose & Throat, Urology, Gastroenterology, Dermatology, Orthopedics and Plastic
Surgery, Cardiology, Orthopedics, Neuro & spine surgery, Pulmonology. Qualified
and experienced medical personnel and technicians ensure healthcare delivery of
the highest standards.
Columbia Asia Hospital Palam Vihar is today considered as one of the best
hospitals in Gurgaon. The hospital has international standard infrastructure and
follows globally benchmarked standards of medical, nursing and operating
protocols and is rapidly becoming the preferred healthcare destination for
International Patients.

STRENGTHS

-designed room

SERVICES
24-Hour services

SPECIAL CLINICS

linic

PREVENTIVE HEALTHCARE
- between 30 to 40 years
- above 40 years
- Senior Citizens

screening

- below 30 years

OTHER SERVICES

Audiology

BUSINESS MODEL OF COLUMBIA ASIA HOSPITAL

Columbia Asia Hospital follows both B2B and B2C business models.

-to-Business (B2B):
B2B model describes commerce transactions between businesses. Columbia Asia
Hospital follows this business to business transaction. Under this comes the
following:

Stakeholders Those who are the partners of the organization.

: Third Party Administration that includes the third party workers.

Vendors: Who are the suppliers those contribute in the supply chain of the
enterprise.

Consultants: Who are the professionals (Doctors) those provide the expert
advice in a particular domain.

-to-Consumer(B2C):
B2C (sometimes also called Business-to-Customer) describes activities of
businesses serving end consumers with products and/or services. Columbia Asia
Hospital serves the patients and maximizes the value of the transaction. It has
created a brand identity through repetition and imagery.

Community HospitalAs of now , all its

existing hospitals are
community
hospitals,except the
one at yes one
yashwantpura
(Bangalore), which is
a 200 bed tertiary
care referral hospital.
Community ensure
focused care,are more
commited to patient
and well being nd
improves clinical
outcomes

The criteria for

choosing a city, most
of which are tier II, is
inadequacys of
healthcare services in
these cities and
presence of an
affordable class ready
to payfor good
medical care.

Columbia asia
Hospitals USP has
always been evidence
based medicine- the
conscientious, explicit
and judicious use of
current best evidence
in making decisions
about the care of
individual patient

HOSPITAL MARKETING
Hospital marketing this term usually earns criticism of non-marketers who relate
it with the negative aspects of marketing vis--vis selling of the most basic
necessity of 21st century i.e. Healthcare, but an insight into the requirements
dilutes the doubts.
In this highly globalized and competitive environment, any organization,
irrespective of its principles, motives, and goals, cannot survive without marketing.
Today, healthcare is not confined to stethoscopes, medicines and injections only; it
has emerged into an experience.
Today, when we are ill, we want to know that we have a doctor whose technical
knowledge and skills we can be sure of, on whose honesty we can rely and who
will treat us empathetically with the respect and courtesy to which we are entitled.
We need to be sure that the hospital or primary care team to which our doctor
belongs works effectively and safely, so we can be assured that we are getting
good quality care. And we need good access to care. So stated Sir Donald Irvine
President GMC (General Medical Council, UK) in 2003
With such advancements in patients expectations, it becomes inevitable for
Hospitals to acquaint seekers regarding their services and how different and
beneficial they are from the existing and other players. Product differentiation,
Segmentation, and Positioning of Hospitals play a major strategic role. Over and
above, when we are dealing with the MTV generation, who want everything
colorful and catchy, we cannot ignore modern marketing strategies like Integrated
Marketing Communication.

HOSPITAL MARKETING: DEFINITION

Hospital Marketing is a specialized field that deals with connecting patients,
physicians and hospitals in mutual relationships.
With these ingredients there is clearly a need for analysis, strategy and
communication to make the most of limited resources while providing
compassionate health care. This is what hospital marketing does

TYPES OF MARKETING AT COLUMBIA ASIA HOSPITAL,

PALAM VIHAR
1. INTERNAL MARKETING
2. EXTERNAL MARKETING

INTERNAL MARKETINGInternal marketing provides all information which is important for the patient
inside the hospital. Brochures and leaflets play key role in presentation of the
hospital information and the customer care help desk is again an important role to
guide the patient and attendants to information of treatment and expertise of
doctors treatment. Hospital services like House-keeping, nursing care also play
important role to increase the business through their best customer care services to
the patients which is responsible for word of mouth publicity.
Internal Marketing is a process which occurs within a company or organization
whereby the functional process aligns motivates and empowers employees at all
management levels to deliver a satisfying customer experience.
EXTERNAL MARKETING
It is all about marketing, the hospital does to outsiders, the various target
audiences, through strategies like International Medical Camps, Continuous
Medical Education (CMEs) for referral doctors, health camps for general public or
tie-ups with corporate. Mostly, Hospitals concentrate on marketing to sustain the
business and make it visible to people with medical needs and requirements. It
includes Visibility in community, Insurances and TPAs (Third Party
Administrators), Corporate Associations, Medical Marketing, and International
Business.

HOSPITAL MARKETING AT COLUMBIA ASIA

Hospital Marketing at Columbia Asia is classified into three major segments

HOSPITAL
MARKETING

REFERRAL

INTERNATIONAL
INSTITUTIONAL

PATIENT
SERVICES

HEALTHCARE
FACILITATORS

HEALTHCARE
MEDIATORS Individuals

INTERNATIONAL
TPAs

CORPORATE

(General
Physicians)

TPAs

REFERRAL MARKETING
70-80% of all patients follow their GPs [General Physicians] suggestion directly or
indirectly while choosing a hospital and up to 50% of all hospital admissions are due to a referral
of regional doctors. Direct referral marketing is a key to long term success for private hospitals.
GPs already referring patients to a hospital as well as potential new doctors have to be, and stay
convinced of the good performance of the hospital.
There are four criteria which mainly influence a doctor to choose a particular hospital: his
or her experience with the hospital so far, personal contacts, the reputation of the doctor treating
the patient and finally the communication and organization between hospital and GP. At the
same time, doctors want to be appreciated as important customers for the hospital and treated
accordingly, sometimes hospitals often neglected to take into consideration in the past.
Consequently, this means excellent prospects to acquire, keep and manage new referral networks
by direct marketing.

INSTITUTIONAL MARKETING
THIRD PARTY ADMINISTRATORS
TPAs are representatives of health insurance companies who approve
requests and settle claims (cashless & reimbursement).
Third Party administrators (TPAs), as the name suggests act as third party
facilitators and managers for the health insurance policies. They are the
administrators that function between the insurer (insurance company) and the
insured (who buys the policy). The TPAs role is very crucial as it functions as a
gatekeeper for the incoming of applications, claim, etc. and outgoing of privileges,
claim settlement, etc.
CORPORATE
Corporate marketing can be seen as more of a guiding philosophy than a function
at any department. It can be used as an overarching or umbrella term covering the
interrelating activities associated with managing various corporate level concepts
including organizational identity, corporate identity, corporate branding, corporate
reputation, corporate communication and corporate image spanning and
encompassing the whole corporation and its various stakeholders. Corporate
marketing also has a general applicability to entities, including corporations,
business alliances cities, government bodies etc.
Objectives of Corporate marketing: - Targeting the corporates, providing the
services at a reasonable cost, promoting the hospital services to the corporate, and
generate the revenue of the hospital
MARKETING RESEARCH FOR CORPORATE MARKETING
The purpose of marketing feasibility study is to assist a hospital in identifying
market competition, potential markets, and analysis to assess a business idea. It
needs both primary and secondary data to evaluate the local market conditions.
CORPORATE NEED
Corporate basically need to focus more about providing better healthcare services
to their employee in a reasonable costs. Thats why whenever any Corporate tie up
happens with any healthcare organization, corporate needs more discount in
Inpatient services along with Out- patient services. They want Basic health
cam, BIS (basic life support) training.

INTERNATIONAL PATIENT SERVICES

INTERNATIONAL PATIENT SERVICES (IPS)

International Patient Services (also known as Medical Tourism, Health Tourism,
and Medical Travel) are services rendered to patients seeking medical treatment
abroad. It involves the benefit of cost effective treatment, private medical care in
collaboration with the tourism industry. The main Factors contributing to this
phenomenon include long waiting list for surgeries, costly healthcare in
industrialized countries, No or minimal insurance coverage in many developed
countries, anonymity of medical surgeries in other countries, powerful
communication between the various nations and states in the world, having natural
resources in many developing and Asian countries for offering complementary and
traditional medicine has led to the recent natural progression within health and
medical from developed to developing countries (Jabbari, 2007)
In India cost benefit is approximate 50% to 80% which favors the International
Patient services In India up to great extent. The most common treatments and
Surgeries for which India is gaining popularity are heart surgery, knee
Replacement, Hip Replacement, cosmetic surgery, hair Transplant, Eye surgery
and dental implants/ surgery. Healthcare packages are varied and so are the cost of
treatment involved but in any way people have to pay a fraction or 1/10th or 3040% less cost of the total cost that they are supposed to invest in their countries.

5 As FACTORS OF INTERNATIONAL PATIENT SERVICES

ACCESSIBILITY
Accessability applies more particularly to patients from countries where the
waiting list is long, particularly to national health service patients in the UK and in
Canada. In the UK, private health care may be available locally, but is expensive.
AFFORDABILITY
Affordability is probably the major reason and this is particularly true for patients
from the well-off, developed countries like America and UK, where private health
care is expensive, and some surgeries are not covered by their insurances
AVAILABILTY
Availability is often because the medical treatment they need is not available in
their local areas or not trusted by the patients, as is often the case with Omani
patients.
ACCEPTABILITY
Acceptable applies to services, which may be affordable, available, and
accessible, but they are not acceptable in the patients own country for religious,
political reasons or other social reasons.
ADDITIONAL
Additional refers to the availability of better care, perhaps better technology, or a
better specialist, or simply better service and personalised care abroad compared to
care in the home country.

INTERNATIONAL PATIENT SERVICES PROVIDED AT

COLUMBIA ASIA HOSPITALS
International insurance facility
Travel arrangements
Airport pick-up and drop
Forex support
Web access

International conferencing facility

Coordinating doctors appointments
Arrangement with leading resorts chains for post-operative recuperation
Accommodations for relatives and attendants
Locker facilities
A choice of cuisine (kitchen)
Ensuring high quality healthcare
PAPERWORK TO BE COMPLETED FOR INTERNATIONAL PATIENTS
Previous medical records
Information about the treatment & package taken by the patient
Passport & visa
Letter of invitation
Resident permit
Consent form
Registration of foreign patient
Legal formalities for transplant
International patient referral information

INTERNATIONAL MARKETING STRATEGIES

Aggressive marketing and awareness programs globally
PUBLISH- Details of hospital and its core competencies- e.g. Joint Replacement
surgery, Bypass surgery, Cochlear implant, liver transplant, etc.
ADVERTISE- in international magazines, journals and newspapers and T.V
channels

WEB-SITES list, details, telephone numbers and email ID of Hospital and

concerned executives of IPS division.
SOCIAL MEDIA -Create presence in social media Facebook, twitter, LinkedIn,
etc.
BROCHURES- giving details and pictures of the hospital and its specialties,
consultants details, procedures, rates, special attractive treatment, travel and
tourism packages- if required.
TIE-UPS with insurance companies for health insurance for treatment in India
and Third Party Administrators (TPAs) and Health Care Facilitators (HCFs).
INTERNATIONAL PATIENT SERVICES -CHANNELS
Apart from a Hospitals official website, there are three other channels by which an
International Patient comes to know about the healthcare services in India and

Healthcare
Facilitators

IPS
Channels
International

Healthcare

TPAs

Referrals

comes for treatment.

HEALTHCARE FACILITATORS
Healthcare Facilitator (HCF) is an agency with the team of professionals offering a
seamless combination of complicated arrangements within medical tourism.

QUERIES HANDLING PROCESS FOR INTERNATIONAL

HEALTHCARE FACILITATORS
Medical queries are received by case manager. All the queries are forwarded to the
IPS manager of hospital, nearest to patients country. The queries are replied by
the medical coordinator on following lines:

PROCESS FOR INTERNATIONAL HCFs

Patient approaches HCFs - Direct/Online

HCFs mail the queries and medical records to IPS division of Colombia Asia Hospital

consultation with the appropriate doctor followed by revertfrom IPS manager

Reply by HCF about the rates and other queries to patient

all the treatment plan and costs are sent to patients

if the rates are approved, dates are decided & invitation letter is sent to patient

the patient informs about the date of her visit

The presence of International Accreditation for a medical facilitator helps them to

be better prepared in the field of healthcare protocols- patient protocols, preoperative and post-operative protocols, communication protocols and legal
liabilities to protect organizations; in addition to receiving continuous education on
latest trends in quality management practices. Accreditation, not only helps to
improve quality of service, it also creates confidence, trust and creates credibility
for facilitator in the eyes of patients.
INTERNATIONAL THIRD PARTY ADMINISTRATORS
TPAs are representatives of health insurance companies who approve requests
and settle claims (cashless & reimbursement).
Third Party Administrators (TPAs), as the name suggests act as third party
facilitators and managers for the health insurance policies. They are the
administrators that function between the insurer (insurance company) and the
insured (who buys the policy). The TPAs role is very crucial as it functions as a
gatekeeper for the incoming of applications, claim, etc. and outgoing of privileges,
claim settlement, etc.
ROLES OF TPAs
They act as back office and collect all the applications and process them for the
approval of the insurance companies.
network hospitals, etc. to the insured.
nd provide complete support to them
in resolving their queries and other related concerns. They also provide support
about the guidelines related to sending any intimation or any specific criteria that
the insured needs to meet in order to avail the medical insurance benefits.
network hospitals.
-network hospitals, they provide full support to the insured as
regards the norms, procedure of application, filing for claim settlement, etc.
insured for claim settlement, underwriting services, assessing the eligibility as per

the policy, managing exclusions, deducting any amount as per the policy
guidelines, etc.
by the insurance company and thereafter the claim amount is released via the TPA.

SOME MAJOR INTERNATIONAL MEDICAL INSURANCE

COMPANIES

AETNA HEALTH SERVICES FZ LLC.

ALLIANZ WORLDWIDE CARE
DUBAI

BUPA INTERNATIONAL

CIGNA INTERNATIONAL

GMC SERVICES
PARIS

IHI
Denmark
INTE

INTERNATIONAL SOS

PRESTIGE INTERNATIONAL
SINGAPORE

MEERA RESCUE PVT. LTD.

(CEGA INTERNATIONAL)

SEVEN CORNERS INC.

USA

USA

VANBREDA INTERNATIONAL
BELGIUM

INTERNATIONAL REFERRAL MARKETING (International Medical

Referrals)
It falls under direct marketing and involves associate physicians, holding MD/
MS/ DM Qualification with good reputation and patient load. These physicians
refer patients to associated hospitals abroad and charge some fee for the same.
Hospitals conduct Continuous Medical Education (CMEs) and regular training
seminars in these physicians respective countries, for a well-coordinated network.
CRITERIA FOR SELECTION OF ASSOCIATE PHYSICIANS FOR IPS
hospitals

per month)

l from the doctor.

OBJECTIVES:
To study the services provided to the patient by Columbia asia.
To analyse the demographic project of clients of Columbia asia.
Promoting the hospital services to corporate and referral marketing by
Columbia asia.

RESEARCH METHODOLOGY:
SIGNIFICANCE FOR THE RESEACHER
To facilitate and provide all the useful information of the referrals doctors to the Columbia asia
hospital.

RESERCHER DESIGN

EXPLORATORY & DESCRIPTIVE EXPERIMENTAL RESEARCH

The researcher is primarily both exploratory as well as descriptive in nature. The sources of
information are both primary & secondary.
A well-structured questionnaire was prepared and personal interviews were conducted to collect
the doctors perception, through this questionnaire.

SAMPLING METHODOLOGY
Sampling Technique: Initially, a rough draft was prepared keeping in mind the objective of
the research. A study was done in order to know the accuracy of the questionnaire. The final
questionnaire was arrived only after certain important changes were done. Thus my sampling
came out to be judgemental and convenient.

Sampling Unit:
The respondents who were asked to fill out questionnaire are the sampling units.

Sample Size:
The sampling size was restricted to only 50, which comprised of mainly doctors from different
specialty, of palam vihar gurgaon due to time constraints.

Sampling area:
The area of the research was palam vihar gurgaon, india.

MAIN TEXT -

Apparently International Patient Services division looks very straight and

organized, but as one dwells on the topic eventually it is found to be a complex,
delicate, onerous and perplexing business. Since more and more players are
identifying the potential vested with the Medical Tourism, competition is
increasing vastly. Some hospitals and medical facilitators have even started unfair
practices like lobbying, picking-up patients from airports- actually headed for some
other hospitals, and bribing referral doctors at other countries.
I would like to show my immense respect towards Columbia Asia Hospitals for
their fair practices and commitment towards International Patients by providing
them world-class Medical facilities at affordable prices.

An analysis of business from International Patient Services from different

specialties and channels was performed to identify the loopholes and strengths of
the division at Columbia Asia Hospital, Palam Vihar, Gurgaon. To analyze, three
financial years were considered including FY 12, FY 13, and FY 14.
The findings of the analysis were also used in forecasting the FY 15 budget and
lining up the required marketing strategies and promoting the relevant specialities.

FINDINGS

AREAS OF CONCERN
1. It can easily be inferred from the data that out of top ten countries (count-wise),
there is not even a single country from where revenue has increased as compared
to FY 12 (except Zambia and Pakistan, for there was no business from these
countries in FY 12).
2. Business has drastically dropped from countries like Iraq, U.S, Afghanistan and
Oman. Iraq a potential for some major hospitals like Apollo, Max, Artemis, and
B.L Kapoor; has dropped by 73.33 % as compared to FY 12. Afghanistan is even
worse with a 100% decrease in patients.
KEY AREAS TO FOCUS
1. Nigeria with a total of 131 International patients is obviously the key area to
focus but there also the figures are falling. There is a huge potential to tap and
capitalize into.
2. From just 1 patient from Iraq in FY 13 to 4 in FY 14 -shows that there are
patients in Iraq who are willing to come to Columbia Asia Hospital.

ZEITHAML CUSTOMER PYRAMID FOR COLUMBIA ASIA HOSPITAL,

GURGAON, IPS DIVISION

PLATINUM
Nigeria*
Kenya
Iraq
LEAD
U.S
European
Specialty-wise analysis

GOLD
Afghanistan

IRON
Oman
Uzbekistan

AREAS OF CONCERN
1. ENT/ Head and Neck: - Despite of growing demand for Cochlear implants and
other specialty associated treatments, the figures have slumped for the specialty.
2. Neurology: - The Company recently organized a camp for Neurosurgery in Nigeria.
The specialty carries a lot of potential and should be promoted.

OPPORTUNITIES
1.ORTHOPEDIC in Nigeria

Age structure: 0-14 years: 43.8% (male 39,127,615/female 37,334,281)

15-24 years: 19.3% (male 17,201,067/female 16,451,357)
25-54 years: 30.1% (male 25,842,967/female 26,699,432)
55-64 years: 3.8% (male 3,016,896/female 3,603,048)
65 years and over: 3% (male 2,390,154/female 2,840,722)
This shows that there are around 64,393,219 people in the age bracket of 25 and above
who would be requiring orthopedic attention either today or nearest future. The country
has low spending power but even the smallest fraction of population would be a
considerable and potential market to tap.
Further Sr. Consultant for Orthopedics at Columbia Asia, Gurgaon, Dr. Jayant Arora
has earned a good name among patients and medical facilitators which makes the task
a bit easier and convenient.

Channels/Sources: analysis

AREAS OF CONCERN
1. Patient count and revenue from High Beam Global, a medical facilitator is
decreasing drastically. Their increasing involvement with other hospitals like
Artemis, Nova, BLK, and others should be a major concern for Columbia
Asia.
2. Patient count and revenue from Sahara are also decreasing by a major
fraction.

OPPORTUNITIES
1. Safe Med Trips revenue share is increasing, although the count figures are same.
The company must maintain good relations with Safe Med Trip (SMT) in order to
sustain the business.
2. Dr. Ashoks share has seen a tremendous growth, from just 1 patient in 2011-12 to
11 patients in 2013-14 the revenue share has also increased by INR 21,91,628

PILOT RESEARCH:
To analyze the factors attracting International Patients to India for medical treatment a
questionnaire was prepared to be filled up by top hospitals in Delhi/NCR which are
providing Medical facilities to International Patients opting India as a destination. The
participating Hospitals were:

1. Columbia Asia Hospital, Gurgaon

2. BLK Super Specialty Hospital, New Delhi
3. Max Healthcare Hospital, New Delhi
4. Nova Specialty Hospitals, New Delhi
5. Rockland Hospital, New Delhi
6. Indraprastha Apollo Hospital, New Delhi
7. Fortis Healthcare, Shalimar Bagh, New Delhi
8. Metro Heart Hospital, Lajpat Nagar, New Delhi

FINDINGS
The main factors which these hospitals find for attracting International Patients to India are
namely:
Availability - lack of medical specialties in their patients own countries
Affordability- Expensive treatment in patients own countries
Competency- Competent doctors in India
Quality- World-class medical facilities in India
When Hospitals were asked to rank the factors responsible for attracting International
Patients to India, 75% agreed strongly that these patients come to India for treatment due to
non-availability or lack of medical specialties in their own countries. E.g. there is only one
1.5 tesla MRI machine in Nigeria (at PRIMUS International Super Specialty Hospital,
Lagos, Nigeria). In Nigeria only 51 open Heart Surgery procedures were done between
August 2004 and December 2011 which makes it around 9 surgeries annually, that too with
little success rate whereas in India around 80,000 open heart surgeries are performed
annually in 175 centers and that too at comparatively affordable prices.
Similarly, up to 75% also agreed that these patients come to India due to expensive
treatment in their home countries. A cross country comparison of treatment costs in U.S
dollars should make it clear :-

Comparative competency and fair practices of Indian Doctors are other factors for attracting
these patients to India.
Lets get it clear from a story published in Deutsche Welle (DW):"The Afghan doctors
diagnosed a tumor and operated right away," said Mohammad Nabi from his bed at a hospital in
Delhi, pointing to a scar on his neck. After the operation, friends had advised the 56-year-old
from Balkh in northern Afghanistan to seek treatment in India. Doctors at the hospital in Delhi
told him that he never had a tumor, instead merely swollen lymph nodes. "I was tricked.
Unfortunately, that's common practice in Afghanistan," Nabi said, visibly upset.
The CT imagines clearly manifests the shadows that are created by a tumor and a tumor can be
differentiated from a plain swelling of the lymph nodes. Unfortunately, Afghanistan does not
have competitive and qualified radiologist to read CT scan as well as Magnetic Resonance
Imaging (MRI) to count on them.

The major specialties attracting these International patients to respective

hospitals are as follows:

HOSPITAL

SPECIALTY
1

SPECIALTY
2

SPECIALTY
3

SPECIALTY
4

Columbia
Asia
Hospital,
Gurgaon

Orthopedics

Plastic/
Reconstructive

Obstetrics

ENT/ Head/
Neck

Neurosurgery

Spine and
Neurosurgery

Oncology

Cardiac

Spine

Orthopedics
(Knee)

Oncology

Gastroenter
ology

BLK
Super
Specialty
Hospital,
New Delhi

Bone Marrow
Transplant

Max
Healthcare
Hospital,
New Delhi

Brain

Orthopedics

Nova
Specialty
Hospitals,
New Delhi

Orthopedics

IVF

Urology

Laparoscopy

Rockland
Hospital,
New Delhi

Orthopedics

Cardiac

Oncology

Urology
And
Nephrology

Indraprast
ha Apollo
Hospital,
New Delhi

Cardiac

Fortis
Healthcare
Shalimar
Bagh, New
Delhi

Orthopedics
(Arthroscopy)
(KneeTransplant)

Metro
Heart
Hospital,
Lajpat
Nagar,
New Delhi

Interventional
Cardiology

Orthopedics

Brain and
Spine surgery

NonInterventional
Cardiology

Spine
And
Neurosurgery

SPECIALTY
5

Ophthalmology

Gynecology
And
Obstetrics

Gastroentero
logy

Oncology,
Nephrology,
Urology

Renal
Transplant

Cardiac

Oncology

Gastroenterology

Neurology

Pulmonary

COUNTRY WISE ANALYSIS OF MEDICAL TOURISM IN DELHI/NCR

Most of the International Patients in Delhi/NCR belong to Afghanistan, Iraq, and Nigeria, due to
the following respective factors.

AFGHANISTAN
Many Afghans are opting to get treated in India nowadays owing to the poor health care facilities
and services in their own country. Many cite that while Afghanistan has some big hospitals, the
medicines used for treatments are, in most cases, fake.
A report published by the international charity Medicines Sans Frontiers revealed that out of
every 5 Afghan patients who were interviewed had a close friend or family member who died
due to improper medical care in Afghan over the last one year alone.
These factors would probably explain the increasing numbers of Afghan medical tourists
arriving in India over the past few years, with numbers rising to nearly 32200 in 2013 from
26500 in 2012.
IRAQ
Years of war have literally destroyed Iraqi's once world-renowned healthcare system. The Iraqi
healthcare system used to be considered one of the best in the region, but today, millions of
Iraqis suffer from respiratory infections, formerly preventable diseases such as measles, and
malnutrition.
The basics are missing from Iraqi's healthcare facilities and hospitals these days, from
vaccinations to cardiac defibrillators. Meningitis, dysentery, and malaria have become the norm.
Hospital labs can't perform tests, and lack of drugs and basic supplies severely hamper
physician's efforts to cure patients. Medicine, syringes and IV fluids are often only available
through the black market.
Because of the dire situation in Iraq, millions of Iraqis are scrambling and saving to travel to
foreign destinations for quality and affordable medical care. One of the most popular
destinations for Iraqis is India. Iraqis are patient as possible while they wait for passports and
travel permits to venture beyond their war-ravaged borders for healthcare. Children and adults
requiring surgeries are able to receive affordable care in India for conditions in cardiac,
orthopedic, vision and dental care, making any and all sacrifices more than worth the effort.
NIGERIA
It has been realized by Nigerians who can afford to seek medical treatment abroad, that India
offers them cheaper and more qualitative treatment. For instance, the cost of surgery can be
onetenth of what is in the United States or Western Europe, and sometimes even less. A heartvalve replacement that would cost $200,000 or more in the US, for example, goes for $10,000 in
India- and that includes round-trip airfare and a brief vacation package. Similarly, a metal- free
dental bridge worth $5,500 in the US costs $500 in India. Cosmetic surgery savings are even
greater: A full facelift that would cost $20,000 in the US cost about $1,250 in India. The most
popular treatments sought in India by Nigerian medical tourists are alternative medicine, bonemarrow transplant, cardiac bypass surgery, eye surgery and orthopedic surgery. India is known

in particular for heart surgery, hip resurfacing and other areas of advanced medicine. To this end,
Government of India has introduced a medical visa for foreigners who come to India for
medical treatment and are willing to be there for extended period. The medical visa would be
admissible to all foreigners seeking Medicare in recognized specialty hospitals or treatment
centers. The initial period of such a visa will be one year or for the period of treatment,
whichever is less.

JCI ACCREDITED HOSPITALS IN DELHI/NCR

Joint Commission International (JCI) was founded in the late 1990s to survey hospitals outside
of the United States. JCI accreditation is authorized by the Joint Commission International, the
international arm of the Joint Commission (the United States largest accreditor of health care
organizations.) JCI is wholly non-profit and exists to provide leadership, quality and credibility
in the field of international health care. Key functions include meeting the international goals of
patient safety, access to care, assessment and care processes, infection control, education,
information management and human resources, facility management, leadership and
management. The JCI has a total of six accreditation programs and one certification program.
The accreditations include Hospitals, Ambulatory Care, Clinical Laboratories, Care Continuum,
Primary Care Centers and Medical Transport Organizations.
1.
2.
3.
4.

Artemis Health Institute, Gurgaon

Fortis Escorts Heart Institute, New Delhi
Indraprastha Apollo Hospital, New Delhi
Moolchand Hospital, New Delhi

NABHACCREDITED HOSPITALS IN DELHI/NCR

NABH is an acronym for National Accreditation Board for Hospitals & Healthcare Providers is a
constituent board of Quality Council of India, set up to establish and operate accreditation
programme for healthcare organizations. NABH was established in year 2006.
GURGAON
1.
2.
3.
4.
5.
6.
7.

Alchemist Hospital, Gurgaon

Artemis Health Institute, Gurgaon
Columbia Asia Hospital, Gurgaon
Fortis Hospital, Gurgaon
Max Super Specialty, Gurgaon
Medanta The Medicity, Gurgaon
Paras Hospital, Gurgaon

DELHI
1. Action Cancer Hospital, New Delhi
2. B.L Kapur Memorial Hospital, New Delhi
3. Batra Hospital, New Delhi
4. Bhagwati Hospital, Delhi
5. Chacha Nehru Bal Chikitsalaya, New Delhi
6. Dharamshila hospital and Research Center, New Delhi
7. Escorts heart institute and Research center, New Delhi
8. Fortis Hospital, Shalimar Bagh, New Delhi
9. Holy Family Hospital, New Delhi
10. Indian Spinal Injuries Center, New Delhi
11. Indian Spinal Injuries Center, New Delhi
12. Institute of Human Behavior & Allied Sciences (IHBAS), New Delhi
13. Institute of Liver and Biliary Sciences, New Delhi
14. Jeewan Anmol Hospital, New Delhi
15. Jeewan Mala Hospital, New Delhi
16. Khandelwal Hospital & Urology Centre, New Delhi
17. Max Super Specialty Hospital, New Delhi
18. Max Superspeciality Hospital, Shalimar Bagh, New Delhi
19. Metro Heart and Cancer Institute, New Delhi
20. Metro Heart Institute with Multispecialty, Faridabad
21. Metro Hospital & Heart Institute, Lajpat Nagar, New Delhi
22. Moolchand Hospital, New Delhi
23. National Heart Institute, New Delhi
24. Park Hospital, New Delhi
25. Primus Super Specialty Hospital, New Delhi
26. Pushpawati Singhania Research Institute, New Delhi
27. R G Stone Urology & Laparoscopy Hospital, Kailash Colony, New Delhi
28. Rajiv Gandhi Cancer Institute & Research Centre, New Delhi
29. RLKC Hospital, Metro Heart Institute, New Delhi
30. Rockland Hospital, New Delhi
31. Saket City Hospital, New Delhi
32. Saroj Hospital & Heart Institute, Delhi
33. Sir Ganga Ram Hospital, New Delhi
NOIDA
1. Apollo Hospitals, Noida
2. Delhi Heart and Lung Institute, Noida
3. Escorts Hospital and Research Center, Noida
4. Fortis Hospital, Noida
5. Kailash Hospital and Heart Institute, Noida
6. Metro Hospital and Heart Institute, Noida

COMPARATIVE ANALYSIS OF TOP HOSPITALS IN DELHI/NCR AVAILABLE FOR

IPS As per Study

COMPANY BACKGROUND

Name

Columbia Asia Hospital, Palam Vihar, Gurgaon

Division

International Patient Services Division

Geographic Areas
Served
Revenue FY 2014

International Patients worldwide

Special Focus on SAARC and African Nations

No. of International
Patients
Employees

55 (app. 5 patients per month)

Main Competitors

Indraprastha Apollo Hospital, Fortis healthcare, BLK

super specialty Hospital, Artemis Hospital, Nova super
specialty, Medanta Medicity, Rockland Hospitals, Max
Healthcare, Metro Hospitals

INR 1,34,63,666

(IPS-In Patients)

1+1

From revenue of INR 26,379,330 from 109 International Patients in FY 2012 the figures have
declined to INR 13,463,666 from 55 International Patients in FY 2014. This describes a slump
of 48.96% in Revenue and 49.54% in Patients count, from FY 2012 to FY 2014.
With strong marketing campaigns and govt. lobbying by financially strong hospitals like
Medanta, Apollo, Fortis and Max Healthcare, It has become really tough for 100 bedded
hospitals, like Columbia Asia Hospital, in Delhi/NCR to attract patients from other countries.
Over and above, being financially strong and with more manpower these hospitals manage to
maintain good relationships with Healthcare Facilitators, Healthcare Mediators, and
Consultants.

SWOT ANALYSIS, COLUMBIA ASIA HOSPITAL, IPS DIVISION

STRENGHTHS (Moderate)

1. Lower rates of treatments, as compared

to other competitors in Delhi/NCR.
2. Skilled and well qualified Consultants
and Surgeons.
3. Global Brand.
4. Close proximity to International
Airport.
5. International standards of cleanliness
and hygiene.

OPPORTUNITIES (High)

1. High demand of Medical Treatments in

India especially Delhi/NCR.
2. Increasing demand for Knee
replacement and cochlear implant.
3. Increasing number of Patients from
SAARC and African region (8%-10%)
4. Soon to be introduced Renal Transplant
carries a lot of potential and
opportunities for the hospital.

WEAKNESSES (High)

1. Financial constraints Marketing

Constrains
2. Manpower
3. Client Relationship
4. Absence of International Patients
Lounge.
5. Absence of a few treatments like liver
transplant (though, available at
Columbia Asia, Yeshwanthpur, Blr).
6. Main focus on Corporate and Referral
Marketing.
7. Inability in promoting potential
specialties and treatments: Promotion
Sales driven rather brand building.
THREATS (High)

1. Competitors strong move in

International Patient Services.
2. Decreasing Market Share
3. Dispersion of International Patients to
other countries like Malaysia, Thailand,
Turkey, and Singapore.

PESTanalysis for Columbia Asia Hospital, International Patients Services division covers the
political, economic, social, and technological. The overall analysis helps the organization to cater
its clients/patients accordingly.

The analysis also prepares a theoretical map to face the challenges in order to grow.
P-Political
E-Economical
S-Socio-Cultural
T-Technological
Political:
1.Legislation for Accreditation of Healthcare institutions like NABH to make them on par
with International standards
2. Extension of Visa period for International Patients.
To encourage International Patients in India Govt. has extended the time limit of
Medical Visas to 1 year; previously it used to be 3 months. This is further extendable by
another 1 year
3. Regulatory and Tax reforms.
The Govt. is providing a variety of incentives, including lower import duties and higher
depreciation rates on medical equipment, as well as expedited visas for International
Patients.
4.Since 2001 there has been a 100% FDI in Healthcare Sector.
5.Govt. encourages Public-Private Partnerships (PPP) in healthcare sector.
Economic Environment:
1.Lack of Govt. Spending.
Since the Govt. is struggling to provide basic health services to rural and semi-urban
population, there is a vast room for private healthcare investors to attract domestic and
International Patients seeking world-class facilities.
Extensive marketing by Private hospitals attract International Patients and Govt.
hospitals fail to play a major role in Medical tourism.

Socio-Cultural Environment:
1. Increasing elderly population
A growing population of elderly people in Nigeria can be credited for a huge number of
Hip and Total knee replacement and Spinal disorders surgeries in Indian Hospitals.
Similarly with increasing number of elderly people in Europe, figures for Cardiac
surgeries performed on International Patients in India are also increasing.

2. Geographical reach
3. Increasing demands for specialty services
Technological Environment:
1. Use of Information Technology
2. Role of Telemedicine
Telemedicine is the use of telecommunication and information technologies in order to
provide clinical health care at a distance. It helps eliminate distance barriers and can
improve access to medical services that would often not be consistently available in
distant rural communities. It is also used to save lives in critical care and emergency
situations.
3. Pre and Post Treatment Consultation using apps like Skype Conversation with
International Patients.
4. If India is attracting so many International Patients, an important reason for that is
technological advancement and affordability of the same. In Nigeria there is just one 1.5
tesla CT-scan machine, imagine a nation of 168.8 million (2012 statistics) with just one
advanced CT-scan machine. This is the reason Medical treatments in other countries are
so expensive.

PORTER FIVE FORCES MODEL FOR INDUSTRY ANALYSIS

THREAT OF NEW
ENTRANTS (-)
Each of the industry
players has to face competition
from new entrants.
Hospitals like Nova,
Paras have been chucking out
some beds for International
Patients.
Possible entry of new
Hospitals like QRG (Havells)
due to high efficiency ratio.

BARGAINING POWER OF
CUSTOMERS (+)
-Due to very little price
sensitivity and lesser number
of substitutes (existing), Power
of driving down the prices
does not vest with the patients.

COMPETITIVE RIVALRY
THE INDUSTRY
-)
WITHIN
(
Competitive Rivalry is extremely
high which exerts downward
pressure on prices. If Hospital
increases prices it is easily robbed
of Patients count.
Corporate lobbying by financially
well off organizations makes
business tougher for smaller
organizations.

BARGAINING POWER OF
SUPPLIERS (-)
-Large number of Hospitals
offering International Patient
services makes it tougher for
hospitals to drive up prices. The USP of International
Patient
Services in India stands for
AFFORDABILITY, so driving
up prices too much doesnt
make sense.
-For specialties like Renal &
Liver
transplant,
Incisive
Cardiology
Hospitals may drive up the
prices.

THREAT OF
SUBSTITUTES (-)
-International Patients are
shifting towards Homeopathy,
Ayurveda, and Herbal
treatments due to safety factors.
-Countries like Malaysia,
Singapore, Turkey, and
Vietnam have also identified
the potential of Medical tourism
and begun the practice of
providing specialties at
competitive prices.

CONCLUSION
1. Columbia Asia Hospital, Gurgaon is facing immense competition from hospitals in
Delhi/NCR. Growing popularity of Artemis Health Institute Gurgaon, Medanta the
Medicity, Fortis Gurgaon, and Paras Hospital is dividing the market share into smaller
fragments.
2. The main factors attracting International Patients to Columbia Asia and other hospitals in
Delhi/NCR are Affordability, Availability, Competency, and Quality of Medical
facilities.
3. Medical facilitators are increasing in number in Delhi/NCR region so the network is also
spreading; as a result there has been an overall increase in number of potential medical
queries from International Patients.
4. Columbia Asia Hospital, Gurgaon is facing both internal and external competition. While
there has been a dispersion of International Patients to other hospitals, there have been
cases where patients opted for Columbia Asia, Bangalore as their preferred destination.
5. Revenue from international patients (In-Patients) has gone down by 48.96% as compared
to FY 2012 with an overall slump of 49.56% in total International Patients count.
6. Specialties like Plastic/ reconstructive and Neurology are losing counts and revenues
need to be pushed.
7. Orthopedics enjoys a major share of total revenue and count: approx. 26.61% of total
International Patient count and 35.72% of total revenue.
8. SAFE MED TRIP, a Delhi based Medical facilitating company is alone providing
patients worth 20.01% of total revenue.
9. High Beam Global, a Gurgaon based firm needs special attention, for the company has
good network in African countries, Iraq and Uzbekistan. HBGs contribution in overall
count and revenue is decreasing constantly and needs to be pushed.
10. Queries for treatments like TKR (Total Knee Replacement), Hip Replacement,
Neurosurgery and spinal, and Cochlear implant are increasing.

RECOMMENDATIONS
SCAMPER ANALYSIS: SCAMPER is a six sigma tool, which stands for:

Substitute.
Combine.
Adapt.
Modify.
Put to other purposes.
Eliminate.
Reverse.
We can use the tool by asking questions about existing products/ services / people/ processes,
using each of the seven prompts above. These questions help us come up with creative ideas
for developing new products / services / people/ processes and for improving current ones.
In order to improve the existing, slumping, International Patients Division of Columbia Asia
Hospitals, I would like to use SCAMPER tools to identify the existing loopholes and improve or
improvise the concerned factors.

Substitute
Highlight the existing non-potential specialties with the potential ones.
If one looks at the figures, the trends show that the number of patients opting for Plastic/
reconstructive and gynecology are falling whereas specialties like Hip Replacement, Total Knee
Replacement, and Cochlear Implant are growing constantly. These specialties should be
promoted in potential countries at affordable and competitive prices.

Combine
Combine Corporate with International Patient Services; with Corporate MNCs having a
worldwide network of stakeholders and shareholders, a good relationship on that front can fetch
great business.
An understanding with Hospitality Corporates business model of Trident and Hyatt would get
some potential queries for IPS.

Adapt
Hospitals like Max, BLK (former B.L Kapoor Memorial Hospital), Fortis, Apollo etc. are
spending a lot on brand awareness in other countries like Iraq, Nigeria, Uzbekistan,
Afghanistan, Kenya as a result Columbia Asia faces immense threat and will have to increase
brand awareness and adapt to this situation. It should go beyond sales promotion to core brand
visibility.

With growing players in the field, Client Relationship with Healthcare Facilitators and Mediators
is also deteriorating, for they now demand more attention and engagement, physically as well as
financially.

Modify
In order to create more Value to International Patients following modifications to the existing
model are recommended.
a. Introduce a Lounge & Cuisines for International Patients Services Patients
feel more comfortable when they are surrounded with other International
Patients.
This helps in building word of mouth publicity, once they move back to their
countries and transparency in the process and consultation.
b. Increase the manpower from 1 IPS executive to 3 (2 executives + 1 Assistant
Manager) as Delhi/NCR has a strong potential for Medical Tourism and being
the only Columbia Asia Hospital in North India offering International Patient
Services, it deserves a strong attention.
For the increasing competition and slumping figures, the current hierarchy and
man power is not sufficient.

Put to other purposes

Once the Renal Transplant facility is introduced successfully, the hospital can tap an
increasing market demand for renal transplant. The hospitals providing Renal Transplant in
Delhi/NCR are all big hospitals and charge a huge amount because of complications involved
in the surgery. The same treatment can be offered at a relatively lower prices and hospital can
be promoted as a specialized center for Renal Transplant. Ex 12000 USD (as majority of
competitors offer between 11000 USD 15000 USD).

Eliminate
Eliminate the non-competitive referral tools as they are not up to market standards.

Reverse
More emphasis on Research and Development, and branding is required. R&D and Branding
should be started afresh considering trending concepts and eliminating the have become
histories concepts: Target New markets, smaller markets by focusing on trending specialties.

LEARNING FROM INTERNSHIP

1. An insight into the basic functioning of Hospital Marketing
2. Customer and Client Relationship Management
3. Database Management and Data Mining
4. Event Management
5. Forecasting and Business Development
6. Identification of service gaps
7. International Patients- Channels functionality and processes
8. Market Research
9. Query handling and conversion
10.Query Tracking of International Patients

BIBLIOGRAPHY
Web Pages:
www.columbiaasia.com
www.indexmundi.com

Research Papers:
K.R Shanmugam (Madras School of Economics)
India Healthcare (McKinsey and Co.)
Medical tourism and role of TPAs (Dr. Prem Jagyasi)

Other References:

Company guide and Head of Department (Marketing)

Faculty guide
Data from the hospital
Company handbook Abhik Moitra HBG

Shalini Mediconnect India

Nirmal Jeet Singh BL Kapoor Hospital
Amit Singh BL Kapoor
Executive Fortis Hospital
Dr. Soheila Mustafavi Metro Hospital
Anshu Arora Nova Hospital
Govind Safe Med Trip
Adeeb Columbia Asia Hospital, Bangalore

FOR OFFICIAL USE

Questionnaire No :
___________________
Date of the interview : ____________________
Name of
interviewer

Name Of the
Supervisor

Profile of the doctor

a. Name of the
doctor:__________________________________________
b. Sex (Code: Male-1, Female-2) :
______________________________________
c. Speciality:____________________________________________

_______
d. Practicing since (Total practice)___________________(Year)
e. Average Consultation
fees:________________________________________
f. Address:___________________________________________________
________

Q.1. Do u run a private clinic?

1.Yes..

2. No

Q.2. If answered yes to the above question; please ask the number of clinic
currently run by
the doctor along with the address.
No. of Clinic:___________________

Address: 1.___________________
2.___________________
3.___________________

Q.3. Are you also visiting some of the hospitals in the city?
1.Yes..

2. No

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Q.4. If answered yes in the above question; please ask the name of
the hospitals visited by the doctor.
Hospital Name :
___________________________________________________

Hospital Name :
____________________________________________________
Hospital Name :
____________________________________________________
Q.5. How many admissions (hospitalization), on an average, do
you refer in a given month?

____________________________________________________________
___
Q.6. Could you share with us the main 3 factors considered by you
for suggesting a hospitals (for hospitalization cases) to patients.
1.
_______________________________________________________
_________
2.
_______________________________________________________
_________
3.
_______________________________________________________
_________
Q.7. Kindly share with us the kind of Healthcare cases you usually
receive. (please tick mark the oppopraite columns in the table
mentioned below).Also, please share with us the name of doctors /
hospitals to whom you refers these cases.

S.no.

Health concerns

1.

Orthopedics

2.

Gynecology

3.

Respiratory

4.

Neurology

Do you get the

helth cases
mentioned in
the left
column? (tick)

Doctors
/Hospitals (to
whom you
refers cases)

5.

Nephrology(kidney)

6.

Cardiology

7.

Pediatrics(infants &
children)

8.

Advanced text (MRI etc..)

9.

Others