May 14, 2021

The health-care ‘revolution’ coming to an island near you

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48516606-cayman_islands_haven_no_more-246269140_v2.530x298By Matt Clinch Assistant Producer cnbc

In late February, around 480 miles off the coast of Florida, the Cayman Islands will get ready to cater for a new kind of visitor.

On top of tourism and financial services, the islands will be home to Health City, a new health-care center costing $2 billion that caters for cardiac surgery, cardiology and orthopedics. Behind the project is Narayana Health, an Indian company that has made its name in providing care at a low cost to millions. And now it is aiming to transplant its low-cost model to the rest of the world.

Health City aims to open with a 140-bed facility expanding to 2,000 beds over the next decade – offering services at a fraction of the cost of health-care providers in the nearby U.S. and South America. It will be a joint venture with Ascension – a U.S.-based Catholic health ministry. John D. Doyle, president and CEO at Ascension Holdings believes the tie-in could inform the U.S. health-care system.

“Health care delivery in the United States needs to change and we will take the lessons learned during the HCCI (Healthcare Cayman Islands) construction, staffing and operations phases and hope to apply them in our work,” he said in a press release at a September board meeting. If the new initiative successfully demonstrates a new approach to U.S. audiences, then Ascension believe it could influence the future course of health care in the country.

Narayana is one of several Indian health-care companies, including rival Apollo Hospitals which has expanded to Mauritius and Bangladesh, with their sights set on the global stage.

These companies aren’t fully fledged hospital units, meaning capital costs are lowered. Operating in large cities in India, the huge volumes of patients means they can lower costs with a “conveyer belt” like system with one doctor working with two or more patients at a time.

A Narayana spokesperson told CNBC that cardiac bypass surgery costs 80,000 to 85,000 Indian rupees ($1,293 – $1,373) at its Mysore hospital in the southwest of India. The same procedure in the U.S. can cost over $100,000 in the U.S., according to numerous reports, however the American Heart Association has said that an exact price is hard to pin down. A spokesperson for Ascension told CNBC that the cost of the operation at HCCI is yet to be decided but the original goal of establishing pricing at 50 percent of U.S. costs remains on target.

“They are going to go global,” Anand Raman, the senior editor of the Harvard Business Review told CNBC in an interview. “I would definitely call it a revolution. India’s public health-care system can be terrible but these hospitals are showing that it is possible to bring about change and deliver world class health care affordably locally.”

Narayana enjoys an average 1.4 percent mortality rate within 30 days of coronary artery bypass graft surgery, compared to 1.9 percent in the U.S., according to the Center for Health Market Innovations (CHMI) – a research group that promotes innovations in health care which is backed by the Bill & Melinda Gates Foundation. Narayana currently operates 5,000 hospital beds across 12 cities in India and aims to grow to 30,000 beds in the next five to seven years, according to its website.

It’s not just Americans that could be ready to flock to the Caribbean, according to Raman. Martha Lagace’s book from 2007 called The Rise of Medical Tourism shows that European and South Americans could be just as likely to take a trip abroad for treatment.

“Location makes a big difference in health care; you don’t normally want to travel too far to get treatment. That’s why the Caribbean is a strategic location for health care companies that want a slice of the aging baby boomer market,” Raman said.

A Deloitte commissioned report in 2011 called Promise and Progress: Market-based solutions to poverty described Narayana as a “pared-down service that meets the basic needs of the poor at ultra-low prices and still generates positive cash flow and profits through high volume, high asset utilization and service specialization.” Bill Eggers, in his recent booked called The Solution Revolution includes Narayana in his examples of “radical innovations” that deliver public benefit.

Raman told CNBC that the only problem holding these innovators back is a bottleneck with highly trained doctors. Nonetheless, he expects further clinics and hospitals with the same ethos to open in the Bahamas, the Dominican Republic, Mexico, Panama. Added to this, he expects centers in the Middle East and some republics of the former Soviet Union such as Georgia.

“These places meet the parameters in terms of being destinations, tax-free havens, offer incentives for capital investments, and have huge catchment areas from which to draw patients,” he said.

PHOTO: David Mcfadden

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