Health City Cayman Islands
Study on Foreign Market Penetration
Group 2
Team
It’s a Team-Effort
Members Roll No
Aditi Samanta 21BM63025
Soumajit Chail 21BM63057
Pratyush Raj 21BM63037
Soumyaneel Banik 21BM63165
Sougata Das Chakraborty 21BM63166
Syed Imroze Gowhar 21BM63053
Sandeep Yadav 21BM63031
2
Agenda
Understanding the Strategy
1. The Overview
2. Foreign Market - Key Stakeholders
3. Foreign Market – 7Ps
4. Foreign Markets - Risks & Expansion
5. Foreign Market - Strategy Analysis & Suggestions
6. The Current Status & The Road Ahead
7. Conclusion
3
The Overview
4
What's the Story?
Can the Dream
be a Reality?
Dr. Devi Shetty, with the vision to make quality healthcare
affordable to all, has set out to grow Healthcare practice, which
Foreign Expansion has already flourished in India, overseas. In his journey, he
partners with Ascension and lands on Cayman Islands. The
Strategy is Key question that needs to be answered is, will it work? Will
Caymanians buy into the dream? Is he making the right
decisions? Or is he blinded by the success?
What's the Story?
The hospital grows by leaps
and bounds to become one
of India's largest and most
prolific healthcare
institutions
2001 2005-2010 2011-2014
Narayana Hrudalaya
The hospital is accredited by the JCI and this opens the door for South
NH founded by Dr.Shetty in
Asian, Middle Eastern and African patients.
?
Bangalore
NH signs a MoU with Construction Starts on
Cayman Islands to develop Health City with Initial
Health City Cayman Planning on Pricing
Islands Strategy
2009 2012 2013
Ascension and NH sign JV
Health City to develop first phase of
Health City
Foreign Market –
Key Stakeholders
7
Key Stakeholders
Cayman Islands Government
Narayana Healthcare Ascension
Key
Stakeholders
Doctors, Nurses
and Staff Patients
Caymanians
8
Role of Stakeholders
Why are they What Role do they How are they
Who are they?
Important? have? Benefited?
Years of Experience + Strategic Needs to leverage Experience +
Dr. Shetty and Narayana He is the visionary behind the idea Know-how + Awareness of Adapt/Replicate Similar Business Business Growth + Sense of
Hrudalaya of affordable and quality healthcare Developing Economy and Model + Cater to Different Market Completion of Vision
Infrastructure Dynamics
Key Stakeholder in Shaping Key Negotiations + Balance
Economic Growth of Island +
The leader of the People's People's Opinion + Strategic Role between Industrial Investments
Cayman Islands Government Government in Developing Investment Friendly and Economic Sense +
Good Faith in Public + Developed
Healthcare System
Legislatures Employment Generation Role
An Organization focusing on health Social Influence + Economic Key Negotiations + Designing
Ascension and development of less affluent Strength + Strategic Alliance with Business Development Plan + Social Good + Economic Incentive
communities NH + Allied Business Plan Day-to-Day Operations
Local Staff, Indian Doctors and Adept with NH Business Model + Help in Fostering the Idea + Day- Employment + Quality Healthcare
Doctors, Nurses and Staff Nurses Motivated by the Cause to-Day Operations + High-Professional Workplace
Develop Trust in Brand + Spread
Patients Key Beneficiaries
Faith
Grow the Business Quality Healthcare
Experience + Spread the Good Employment + Economic Growth
Caymanians The Citizens of Cayman Islands Primary Customer Base
Word of Island + Quality Healthcare
9
Foreign Market – 7Ps
1
0
What were they doing?
Foreign Market -
Risks & Expansion
1
3
Why Cayman Islands?
Political Environmental Social Technological Economic Legal
Social Perceptions and Costing and Revenue
Government Backing
Mindset Increased Spending on Growth Opportunities Capped non-economic
+
Availability of Resources + R&D through hotel, restaurant, damages awarded in
Political Stability
+ Increase in Medical + retail and transportation medical malpractice
+
Proximity to the US Tourism due to lack of Availability to develop + +
Issuance of medical
market tertiary care newer medicine and Increased Level of Customs and Duty rates
tourism visa
+ + technology Employment +
+
Need to diversify the local Increase demand in + + Exempted from all tax
Approval of Foreign
economy prescription drugs and iKare System Business Model liabilities for 25 years
Medical Licence
Insurance Reproducibility
No Strict
Lack of Tertiary Different Regulations
Environmental
healthcare services in than in Domestic
Regulations Would create Available from
Cayman islands Market
Cayman + employment Ascension
Backed by both leader making them travel to +
Easy Availability of + +
Islands and opposition
Land and other Would create medical Available from Indian
Florida No Market Experience
+ +
resources tourism vendors
Huge market for low Partnership with
+
cost quality healthcare Ascencion
Well Connected
1
4
Foreign Market -
Strategy Analysis & Suggestions
1
5
Analyses
Segment. Target. Position
In India, they target both the affluent with premium and the mass-market with affordable healthcare, positioning it strictly as a high-quality-at-
affordable price offering.
In Cayman, HCCI plans to start off as a affordable all-round healthcare provider and slowly diversify into the premium category with a multitude of
healthcare and allied services, again positioning it strictly as a high-quality-at-affordable price offering.
HCCI mostly competes with US hospitals as Caymanians choose either Cayman hospital or US hospitals especially those in Florida
Porter’s 5 Forces
Rivalry among Bargaining Power of Bargaining Power of Threat of Substitute
Threat of New Entrants
Competitors Consumers Suppliers Services/Products
High; Medical supply is
Low; HCCI has high level
Low; One of the three fully Low; Few Options + specialized + pricing Low; High Capital
of expertise in orthopaedic
equipped hospitals + Similar Value for Money + power + If Indian requirement +
Cayman Islands Hospitals on island HCCI is of high quality suppliers fail then HCCI
and cardiac medical fields
Standardised services +
+ Island hospitals are
collaborate and low price has to resort to local good reputation
eager to work with HCCI
suppliers
High; Competitors +
High; Many Competitors + High; Existing Value High; Abundant Low; Potentially Saturated
India Low Switching Costs
Differential Value for
Chain + High Dependency Availability of Substitutes Market + Regulations
Money
The Good. The Bad.
Aspects Key Stakeholders Benefit Weakness What can go Wrong How to Improve Suggestions
Tax + Customs Waivers Exposure to Changing Tax Fiduciary Negligence + Strategic Analyses + Strict Should be Strategically
Lower Fund Drain + Increase in
& Medical Tourism Government + HCCI Revenue
Norms + Opportunity for Biasness + Do it because you Procedural Planning + leveraged to derive best results
Visa Malpractice can attitude Implementation as per growth plan
Fiduciary Negligence + Should be Strategically
Legislative Planning and Envisioning
Government + HCCI Favourable Business Environment Under-utilisation of Strategic Analyses leveraged to derive best results
Amendments Required Changes
Possibilities as per growth plan
Training Costs + Sub-Par
Abundant Labour + Local Lack of Skill and Medical Should be leveraged to win-
Local Employment HCCI + Caymanians Absorption Training
Quality Output + Different Training and Education
over Caymanian Sentiment
Employment Demands
Lower Service Rates Ascension + HCCI +
Affordability + Larger Market Potential Issues in Medial Fall-out + Higher Insurance Research Driven Pricing + Pricing should focus on market
than Contracted Insurance Providers + Potential Insurance Cost Undercutting Costs Contractual Agreements penetration and growth
Insurance Rates Patients
Mismatch with Foreign
Unawareness about Foreign Employ Indians during initial
Employing Indian Quality + Transferability of counterparts + Drain on
HCCI + Patients Medical Practices and Training and Education phase, later absorb local talent
Doctors and Nurses Operating Practices
Expectations
Expansion Scope + Demand
as well
for local Labour
Increased Costs + Loss of
Long-Term Viability + Global Develop globally resilient
Medical Equipment NH India + Government Quality + Cheaper Prices Supply Chain + Pricing of
Vendor Partnerships + Lossy De-Centralised Sourcing +
chain, but initially can leverage
Sourcing + Vendors Machines
Sourcing + Sourcing Vendor Management
existing ones
Regulations
Less Attractive to Foreign Impact on Quality and
Doctors + Nurses + Staff Regulated Comparative
Salary/Wages Gap Lower Operating Cost Talent + Open to Labour Employment + Hampers Pay as per industry norms
+ HCCI Regulations + Churn Rate Growth of HCCI
Wages
Culture and Sensitivity Requirement of continuous Sub-Par Service Delivery
Doctors + Nurses + Must have in order to grow in
Training + Medical Bridging the Gap training + Scope for Quality leading to Customer Training and Education
HCCI Normalisation Loss
foreign market
Training
The Current Status
&The Road Ahead
1
8
The Journey of HCCI
Focus on Quality Focus on Affordability Expansion & Diversification
Nurturing Local Talent to Much low priced than US Diversification to neurosurgery and
develop high skilled doctors Counterparts, which acts as orthosurgery
and nurses to deliver high the differentiator Also build a $100 million Medical
quality services Import of Equipments and Campus to train doctors and nurses so
incoming Doctors from India as to secure local high skilled workforce
CABG Procedure affordable at $50000 Plan for New Facility HCCB, New Medical Campus,
High Quality Tertiary Care & Services
compared to $120000 in US Plan of Beds Increase
Accredited by JCI, established reputation through India Custom Duty Support, Tax Support, Recognition of Indian
Operations and Successful Pilot Doctor Certification, quick visa approval support
Building up Relations
Building Trust & Scaling up with Gov and Ascension
Approval by JCI made it extremely trust Getting Tax exemptions and import duty
worthy for patients to come in for treatment. exemptions on equipments to provide low
Scaling up to HCCB, increased no. of beds cost treatment and taking help of
and departments and patients Ascension to understand local consumers
What’s awaiting for HCCI?
Existing Condition and Future Scope Problems in the Road Ahead
Scaling up is difficult
Cultural Differences
Already established trust by accreditation, quality and affordability Currently the import
Shared ICU, Common duties are less but after
and Low Skilled Nurses, $800 million imports cap,
Big Windows for patients? 22.5% duty might be
charged.
Locational Advantage and Cayman Government Support High Employee Morale,
High Working Hours and Also, bringing nurses and
Higher No. of Surgeries at doctors from India while
lower salaries? scaling is a mammoth
task
Announcement of New 70,000 sq ft facility with 110 beds – HCCB
Already in the process of Educating and Training Doctors and
Nurses through SURF Programs and other Courses
Competition
It will creep in as Medical Tourism is attractive opportunity. This might
Perfect Time for Expansion Post Covid
create difficulties by creating a dearth of good local doctors and nurses by
offering them better salaries.
Also, local doctors and nurses can create turbulences by operating
through their own clinics
Thank You
