“Home healthcare industry is expected to grow exponentially”

HealthCare atHOME (HCAH), is a leading home healthcare service provider in India, backed by the Burman family, the promoters of Dabur and the founders of HAH UK. HCAH has also received equity investment from Quadria Capital, one of Asia’s leading healthcare focused private equity firm. The company has 1000+ team members and caregivers’ workforce covering more than 40 cities in India. 

In an exclusive interaction with the BioVoice, Mr Vivek Srivastava, CEO and Board Member at the HealthCare atHOME shared his perspective on home based healthcare market trends, current scenario and future outlook. Read on:

How big is the market size for home based healthcare in India? What are the latest trends within this industry? 

According to recent estimates, the market for home healthcare in India is projected to reach US $6.2 Billion by 2020 at a CAGR of 18% from US $3.2 Billion in 2016. Home healthcare has presented itself as a reliable option to deliver 70% of medical procedures (done at hospital) at home.

Earlier, home-based healthcare was limited to having a nurse or attendant at home. Increased awareness among people about home healthcare, insurance companies’ increased coverage and traditional healthcare providers including doctors and hospitals’ increasing reliance on enterprises providing outpatient care have contributed to the growth of home healthcare ventures in India.

Home-based healthcare has evolved rapidly over the past 5 years. Owing to advancements in medical equipment, medical technology and high-end training of resources, now it is possible to screen and treat some serious diseases, such as cancer, and create high-end ICU setups at the comfort of patient’s home. Home ICU care is one of the game-changing innovations. It has the potential to reduce the total healthcare cost by around 40% to 60%. Patients can be discharged from hospitals and get recovery in their homes with the same quality of monitoring and treatment.

How can the standardization of healthcare regulations create affordable options for health delivery?  

One of the major challenges hampering the growth of home healthcare industry is from the unregulated players. One can count the number of established corporate working in the home healthcare industry on their fingertips. Most of the service providers are small nursing bureaus or individuals, who hardly follow any standardized protocol or norms. They are often ill-equipped to handle patient needs and do more harm than good, which results in recurrent hospital readmissions and high cost.

Standardization of healthcare regulations will create an environment of trust towards the home healthcare industry among patients as well as doctors. With the shortage of healthcare infrastructure and manpower, patients from tier II and III cities are left with the option of travelling to tier I cities for treatment. Home healthcare can make healthcare more accessible, available as well as affordable. Standardization will increase trust in the home healthcare set up more – both for patients as well as hospitals. Standardization is the first step towards inclusion in the government as well as insurance coverage. Theinclusions will act as the much-needed encouragement to doctors and patients to use these cost-effective services more often than not.  

What has been the awareness/acceptance level among Indians for home healthcare services? What are top challenges before this industry?

When we started the company, the awareness and acceptance were quite low. People were always skeptical about the concept. They will often question how can hospital-like care be possible at home. However, our continuous efforts and entry of hospital backed home healthcare companies has helped the industry. Home healthcare is already catching up with global standards of 3% to 6%.  Another challenge that we face is the availability of trained clinical staff. To manage patient complication at home, we ensure that clinical staff is effectively trained through an exhaustive induction programme, recurring on-job trainings, refresher trainings & audits. 

Continuously increasing share of home healthcare industry confirms the increased awareness and acceptance. Insurance sector, which kept itself away from the home healthcare industry for a long time, is also showing encouraging changes. Introduction of standardisation will embolden them to take home healthcare in their ambit, which will provide a huge boost to the home healthcare industry.

How do you look at the future of home healthcare in India?

The home healthcare industry is expected to, grow exponentially due to increased burden of non-communicable diseases and inadequate healthcare infrastructure. India has a hospital bed density of 0.9 beds, which is less than the one-third of world average of 3 beds per 1000 patients.  Increasing geriatric population and poor lifestyle choices have contributed heavily to surge the incidence of chronic diseases. Unfortunately, healthcare infrastructure has not seen the same surge and lags behind the needs of the population. India is well below the WHO guidelines for the doctor to patient ratio of 1:1000 population. Additionally, most of the doctors are pooled in the tier-1 cities leaving patients in tier- 2 and tier-3 cities high and dry. There are limited healthcare services in small cities and patients often travel to tier-1 cities for diagnosis as well as treatment.

Home healthcare makes it possible to deliver specialized services to such patients in the comfort of their home. Now, super-specialists can deliver their services to distant places through e-monitoring and sensitive assessment and monitoring devices, and patients can have access to super-specialist doctors without traveling. Home healthcare is the immediate and cost-effective answer to India’s healthcare woes. An already established industry in the West, it certainly is the future of healthcare in India.

How has been your company’s performance in the last few financial years? How do you look at the competition? 

HCAH has grown exponentially in past few years. We started operations with staff strength of ten in 2013. Exceptional customer experience (NPS > 70%) helped us grow from a small start-up to a 1500+ member organization that has proudly served 4,00,000+ patients across 70 + cities and delivered medicines across 200+locations through our pharmacies in 13 cities. Apart from home care services, we are the largest player in the integrated pharma services space. We work with all the top pharmaceutical companies in India to deliver patient support programs developed around their drugs.

We work with the top hospitals in the country and also work with almost all the large healthcare insurers now to deliver services. We also signed a JV with M3 Inc a listed Japanese multinational company with > USD 9 bn market cap. We have been certified as a Great Place to Work® in India by the global workplace bench-marking organization, Great Place to Work® Institute. We had successfully made sure that employees are upgraded with the latest technology and researches in the field of healthcare. One such initiative is conducting specialized training around “Physiotherapy in Painful Knee Conditions”. The training is accredited by CPD UK and CPD hours/points are globally recognized.

We don’t feel we have any direct competition in the home healthcare industry. The uniqueness of our business stems from the fact that we are working as an extension of the hospitals and our services are not merely for staffing as is exhibited by most of the players in the home healthcare business. The key challenge comes from the unorganised sector, small-time players who do not follow standards of care or maids or manservants hired as attendants for providing home care, but the introduction of standardization will wash them all. Quality and Accreditation Institute has already set benchmarks for the home healthcare industry and HCAH became first home healthcare company to receive the accreditation in 2018.