India offers a huge opportunity to healthcare at home business!

New Delhi: A cancer patient, Rakesh Kumar (name changed) has been struggling with his medical treatment despite being admitted to a premier hospital. A well to do business man by profession who worked hard all his life to earn his fortune, he wants to spend the days of bad health in a quiet environment at his home, among his family members. His acquaintances tried all measures to fulfill his wish until they came across one healthcare to home company which had just arrived in their city. A year on, the family members are happy with the comprehensive healthcare services at home including visits by reputed doctors, therapists and qualified nurses. The patient has gained good health due to the positive environment and is recovering fast.

While in this case, it was the patient himself who wished it, the most of the cases fit for home healthcare include situations where family members of the patient are too busy or they want to save the repeated waste of time due to hospital visits. Also, the personalized attention for the best outcome that could be monitored at home is also one of the reasons.

Whatever be the reasons, the ‘Healthcare at Home’ model of healthcare delivery is fast catching up in India with gradual social acceptance. The companies in the space have developed their own specialised protocols for management of patients with strokes, COPD, Congestive heart failure, diabetic wounds and musculoskeletal issues.

“With pressure on the family who already lead a busy and in a lot of cases a stressful life, informal support systems are collapsing. At the same time, mature and professional services for Home healthcare are proving to be a catalyst for increased traction,” says Mr Rajiv Mathur, Founder, Critical Care Unified, that is fast emerging as a solid player in this market.

Elaborating further Rajiv remarked: “For a large number of ailments, it is not necessary to either visit or get admitted in a hospital. Today, most facilities, including sophisticated ICU type set-up can be made operational in the home. Post-surgery and trauma treatments can be implemented in the home as relevant medical equipment and medical expertise can be made available in the home. For long term chronic ailments, home healthcare is most appropriate. Even psychologically, patients tend to recover faster in familiar surroundings and near loved ones.”

As per Dr Gaurav Thukral, Executive Vice President and Chief Operating Officer-Services, HealhCare atHOME, there have been new paradigm shifts in the home healthcare business. Speaking at an event in the Pune, Dr Thukral remarked, “Rapid response and step-down care which is available due to home healthcare services have made a difference to a larger section of society. And it is there to stay and grow.”

Mr Vishal Bali, Co-founder & Chairman, Medwell Ventures that owns
Nightingales Home Health Services also shares the similar views when he says that India is going through a transformation in its healthcare delivery ecosystem and speciality led home healthcare services with a focus on chronic diseases will play a key role in this transformation. “Heart diseases, COPD, Strokes, Cancers and Diabetes are 60% cause of mortality in the country. Non Communicable Disease’s (NCD’s) scale to become chronic diseases and currently account for 40% of all hospital stays and 35% of OPD visits,” he says.

Huge market potential

Globally home healthcare market is expected to grow from $252.95 billion in 2016 to reach $494.78 billion by 2023 with a CAGR of 10.1%. There are a significant number of opportunities in India; already existing and emerging. Providing Critical Care at Home is a huge need as there are just not enough ICU beds available in the country. More so, in towns outside metro locations, the facilities for Critical Care at Home are near non-existent.

Rajiv Mathur, Founder of Critical Care Unified believes that globally, home healthcare is different to India in some ways. He says: “With strong social care systems and facilities in mature geographies,  people tend to move into hospices or homes for the aged where medical facilities are also available.”

As per experts, the NCD’s and neuro health issues will cost India $4.58 trillion by 2030 and will cause huge health affordability issues. At the same time, with appropriate use of technology, the quality and reach of homecare can be improved dramatically. The patients with chronic diseases can be made feel better by devising personalised care plans for their management at home.

Companies expanding in major cities

HealthCare atHome (HCAH) is a leading home healthcare service provider in India. It is backed by Burman family, the promoters of Dabur. The company has received equity investment from Quadria Capital, one of Asia’s leading healthcare focused private equity firms. As per HCAH, it has served 4 lakh patients with its 1000 plus team members covering 40 cities in India.

Nightingales Home Health Services, a Medwell Ventures company, which has pioneered the speciality-led home healthcare service delivery, announced its entry into Chennai. After successfully establishing a deep presence in Bengaluru, Mumbai, Pune and Hyderabad markets, Nightingales has established its first branch in the centrally located area of Adyar in Chennai. Its business has grown from a single branch in Bengaluru in 2014 to 16 branches across 5 cities with a full-time team of over 1,000 medical, paramedical, and healthcare professionals.

CCU is on a rapid expansion plan for the next 12 months, both within India and overseas. The areas of expansion and critical activities are: Growing vertically into other areas of Critical Care that can be delivered at home Expansion into 3 territories within India Expansion within one geography overseas, Raising external capital for growth, Growing the existing business in Delhi/NCR by 250 percent.

Other players in the market include Philips Healthcare@home, Care24, Portea Healthcare, Apple Healthcare. Out of these Philips Healthcare@home is a 100 percent subsidiary of Philips India Limited, one of the leading health technology company. It offers a variety of home based healthcare solutions with its own sophisticated high end medical technology devices.

Challenges

The two major challenges for home healthcare in India shortage of trained and skilled manpower to provide healthcare services in the home and lack of insurance coverage for treatment at home.

Sharing his experiences, Rajiv Mathur says “There have been a variety of cases, both in critical and semi-critical areas that have been serviced by CCU in the last 16 months in Delhi/NCR. Each case is different in terms of the nature of ailment and the level of complication and complexity. However, some common threads have been noticed: he patients, after a stay in the hospital, are eager to go home and carry on with the treatment. In a lot of cases, one sees effectiveness of the treatment enhanced once the patient is home and in familiar surroundings. In most cases, with a controlled and disinfected environment at home, the incidence of infections reduces.”

While India struggles with the primary healthcare facilities in tier-2,3 cities and rural areas, there is a growing focus on the innovative means to reach out. Among these are the telemedicine and remote e-clinics. The secondary and tertiary healthcare is majorly dominated by the private players. In this backdrop, the healthcare delivery at doorsteps will surely be a good idea for the future when the medical insurance is fast emerging as an integral part of human existence.

Despite challenges, the companies have found innovative ways to connect with the wider sections of the population while keeping their economic compulsions under consideration. One of them is the payment through EMI which definitely opens the potential clients for availing the facility and more importantly eases the financial stress. Another is the personalized and customized diagnostic and treatment packages.

The home healthcare is a promising industry in making. Will have to keep watching this space for more interesting trends in the days to come.