BUSINESS PLAN : RSU INTERNATIONAL HOSPITAL NARONG SIRIWATHANAWIROTH 1

291 BUSINESS PLAN : RSU INTERNATIONAL HOSPITAL NARONG SIRIWATHANAWIROTH 1 ------------------------------------------------------- Executive Summary RSU International Hospital is a subsidized project of Rangsit University, Thailand s best private university ranked by www.webometrics.com in 2016. The private hospital and medical center aims to be a leading provider of high-quality and world-class healthcare in Thailand. Its 26-floor building with a capacity of 150 beds for inpatients and 3,000 outpatients per day is expected to be located in an area of 2.76 acres on Vibhavadi Rangsit Road in northern Bangkok, Thailand. RSU international Hospital also has 30 specialized clinics. Its state-of-the-art medical equipment contributes the validity of the early detection of diseases and comprehensive investigation including Cancer X-Ray which can detect specialized areas of cancer. Expected to serve high-end locals and medical tourists, especially from the Middle East, Russia and Myanmar, the hospital will provide patient-focused service mentality incorporating greater patient concern, level of service and compassion. The total project investment is Baht 4 Billion. The Net Present Value (NPV) of the project at the first year would be Baht 265 million, and the Internal Rate of Return (IRR) would be 23%. The project payback period is expected to be 3.7 years from the first year of operation. KEYWORDS : RANGSIT UNIVERSITY INTERNATIONAL HOSPITAL, RSU INTERNATIONAL HOSPITAL, PRIVATE HOSPITAL 1 ก ก ก ก ก ก ก ก ก

292 Introduction Vision / Mission / Objective The mission of Rangsit University International Hospital is to become a Thailand s world-class quality and integrated private hospital and medical center with a combination of conventional and oriental medicine. As the first private university establishing a medical school in Thailand, RSU International Hospital will also be able to make use of substantial knowledge supported by College of Medicine, Rangsit University. The hospital s vision is to become a leading international and integrated healthcare provider. This hospital will have the most comprehensive, highly specialized medical equipment and well-known medical staffs, human capital, management expertise and system in the world. Patients will be treated compassionately through its holistic, patient-orientated approach in an environment clearly superior to that being offered today in Asia. Its multi-disciplinary specialty centers would enable patients to receive coordinated care from a variety of experts. By bringing services together under one roof, patients will gain advantages, staying in one location to receive all health care services including counseling, tests, and imaging. Moreover, its medical staffs will be well-trained to be able to communicate in English, Chinese, Russian, and Arabic. The company s target group is foreign patients, especially ASEAN and local high-end patients. Nevertheless, effort will also be made to attract international patients from other countries and medical tourists who require medical services in Thailand. To build the strongest competitive network of integrated medicine (a combination of conventional and oriental medicine) in the region, RSU International Hospital will form multiple strategic alliances and collaborative operating models with leading healthcare providers in each prospective country. The hospital will consist of local, regional, and international capabilities, exclusively focusing on the area of integrated medicine, significant long-term market potential, stage of growth and experience of its management in the field. In the future, the hospital will establish medical centers in prospective countries for counseling and sending patients to hospitals in abroad.

293 Through its local, regional and international affiliation to leading healthcare institutions and aiming to offer medical services which are superior to those currently being offered to patients in other hospitals, RSU International Hospital has set up its objectives as follows; - To provide world-class healthcare services on the basis of conventional and oriental medicines with high quality and well-maintained equipment, well-trained doctors, and clinical expertise from leading medical centers. - To be a world-class nursing care due to superior training, development and potential of nurses in ASEAN - To provide dietary and counseling services which have always been neglected so far in many Asian countries and to pay greater attention to important social, economic and dietary difficulties patients and their families encounter - To improve medical facilities designed for both patients comfort and medical effectiveness. Efforts focused on better floor plan designs for high-end, elders and disabled patients, more patient amenities and improved center ambience. - To enhance patient-oriented service mentality incorporating greater patients concern about level of services and compassion and to boost up education, training, activities and support to patients afflicted with chronic or intractable illnesses. Scope of Business Rangsit University International Hospital is a private hospital and medical center, located on Vibhavadi Road in northern Bangkok, Thailand. Its 26-floor building is going to be located in an area of 2.76 acres. RSU INTERNATIONAL HOSPITAL has been initiated by Dr. Arthit Ourairat, President of Rangsit University (RSU) and of RSU Healthcare. He has 35 years of experience in operating Phyathai Hospital Group, a major international hospital operator in Thailand. RSU International Hospital plans to have 400 medical professionals including general doctors, specialized doctors, sub-specialized doctors, full-time and part-time doctors, special counselors as well as 600 nurses and para-medical staff and 250 supporting staff including well-trained multi-lingual staff who can communicate in English, Arabic, Chinese, Russian, and Japanese. The hospital is expected to have a

294 capacity of 150 beds for inpatients and 3,000 outpatients per day. Moreover, RSU International Hospital is planned to have 30 specialized clinics. RSU International Hospital is expected to serve residents in districts on Vibhavadi Road, including Phya Thai, Chatuchak, Lak Si, and Don Mueang and on Phahonyothin Road (Thailand Route 1) including Khu Khot Subdistrict and Lam Luk Ka District, Pathum Thani Province. These roads are considered as business and logistic routes. RSU International Hospital will prominently be situated in Phatumthani and Bangkok which are approximately 10 minutes by car from Don Mueang International Airport. With its accessibility by public transport and SRT Dark Red Line, The location is in an area of high-end housing and high density resident zone with approximately 525 houses and a population of 1,079,646 in Phatumthani (stat.dopa.go.th, 2015). Logo and Slogan Slogan The Pleasure of Healthy Life Key Success Factors Rangsit University International Hospital (RSU INTERNATIONAL HOSPITAL) has analyzed the key factors for success and attempted to define them as follows: 1) Management of development of medical staffs: RSU INTERNATIONAL HOSPITAL has a capability to supply the hospital itself with the medical staffs graduating from the College of Medical Sciences and Health, Rangsit University. Through this plan, the hospital can make use of the graduates skills and knowledge in their fields of study to integrate with its business focus. 2) Strategic focus: RSU INTERNATIONAL HOSPITAL has a competitive advantage in worldclass conventional and complimentary-alternative medical approaches to offer complementary therapies to their patients to improve their quality of life and to meet their needs.

295 3) Effective operations management: RSU INTERNATIONAL HOSPITAL has extensive experience in managing Phyathai Hospital Group, a large chain of private hospitals in Thailand which includes RSU Healthcare Group, a specialized center comprising five medical centers: RSU Medical, Dental, Eye, Vision, and Skin and Beauty Center (Pimtara Estetica). In addition, RSU INTERNATIONAL HOSPITAL will be led by a medical staffs with expertise from each center. 4) Physical resources: RSU INTERNATIONAL HOSPITAL is a subsidiary of Rangsit University, the first private university establishing a medical school in Thailand which annually admits more than 5,000 freshmen (as of December 2014). As mentioned, RSU INTERNATIONAL HOSPITAL is considered earning a good reputation and financially subsidized by well-known companies. 5) Customer relations: RSU INTERNATIONAL HOSPITAL will focus on patients needs and will offer services superior to those currently being offered to patients in other hospitals. Its services will become excellent due to contributing factors including academy and education, training and development, and empowerment. RSU INTERNATIONAL HOSPITAL believes these improvements enable it to build their own company s culture and can satisfy their patients so that they will remain loyal to the hospital. Situational Analysis Porter s Five Force Analysis The model of pure competition implies that risk-adjusted rates of return should be constant across firms and industries. However, numerous economic studies have affirmed that different industries can sustain different levels of profitability; part of this difference is explained by the industry structure. Michael Porter provided a framework that models an industry as being influenced by five forces. The strategic business manager seeking to develop an edge over rival firms can use this model to better understand the industry context in which the firm operates. a) Competitive Rivalry and Industry Growth

296 At the end of 2013, there were 327 private hospitals and more than 1,050 public hospitals in Thailand. In term of positioning and group targeting, hospitals may be categorized into four segments as follows: i. Premium market : e.g. Bumrungrad, Samitivej, Bangkok Hospital and BNH ii. Upper-mid tier market : e.g. Phyathai, Piyavej, Vejthani, Vibhavadi, Ramkamhaeng and Vichaiyut iii. Mid-tier market : e.g. Paolo, Kasermrad, and Chularat iv. None-profit hospitals : e.g. Siriraj, Ramathibodi, and King Chulalongkorn Memorial RSU INTERNATIONAL HOSPITAL positions itself among world-class quality integrated hospitals that combine between conventional and oriental medicines and aims to serve the upper-mid tier market in Thailand. RSU INTERNATIONAL HOSPITAL also focuses on foreign patients to correspond to the growth of medical tourism in Thailand and prepare for the Asian Economic Community (AEC). Nowadays, Thailand is the world s largest medical tourism market, with an increasing number of international patients. In 2012, Thailand welcomed more than 2.5 million international patients, a 14% increase from 2011. Thailand s revenue gained from medical tourism in 2012 was approximately US$ 4.7 billion, increasing from US$ 3.2 billion in 2011. There are other factors that contribute the expansion of Thailand s healthcare market such as a growth rate of aging population, an increase of middle-class income, lack of facilities in public hospitals, higher insurance coverage, and growing competitiveness of neighboring countries such as Myanmar, Cambodia, and other countries in AEC. b) Threats of New Entrants and High Entry Barriers The barrier to entry to a hospital business is fairly high because there are three important threats for new comers: high investment, land availability, and limited human resources. High investment is the first barrier to entry because a capital investment of a private hospital with 200 beds typically is between THB 6,000-8,000 million in Bangkok

297 and THB 700-1,000 million in rural areas. The start-up operation cost is about THB 20 million. The biggest variable is land cost assuming availability. Suitable land sites are scarcely found in crowded cities especially in Bangkok, Chiang Mai, or Hua Hin. Therefore, some hospitals plan to expand to border cities such as Phatumthani, Samut Prakan. The last barrier is the availability of qualified and experienced doctors, nurses, and medical specialists. In addition, due to the approach of AEC, Thailand will encounter the language barriers as compared with the regional competitors such as Singapore, and Malaysia. c) Threat of High Substitutes Private hospitals have to encounter threat of substitutes. Patient can choose to go to public hospitals, quasi-public hospitals, or medical centers as they can also provide a range of treatments. There is a growing trend of opening after-hour clinics that share facilities and experienced doctors in well-known quasi-public hospitals such as Siriraj, Ramathibodi, King Chulalongkorn Memorial hospitals. Even though prices of treatment are a bit higher than public hospital, many patients still want to have their own private hospitals which provide them with treatment and satisfactory service at their comfort and highly qualified doctors. This phenomenon leads to the growth and expansion of private hospital business. d) Bargaining Power of Medium Buyers In 2012, the growth of private hospital business is still higher than that of public hospital business due to more complex treatments being sought by patients and growing preference for better service. The data show that this trend will grow continuously over the next five years as an increase of and insurance coverage becomes more prevalent. However, many organizations plan to offer a variety of health insurance packages, and patients consider hospital facilities and medical centers rather than doctors reputation. Patients, therefore, switch to hospitals with low treatment cost. e) Bargaining power of supplier Pharmaceutical products and medical equipment have enjoyed a good growth rate due to an increase in demand. Overall, the competition amongst local pharmaceutical and medical manufacturers is becoming high involving over 100 companies. Many

298 private hospitals establish their own companies to purchase drugs and medical equipments such as Bangkok Dusit Medical Services, BGH. f) Dynamic Nature of Industry Rivalry In term of beds, BGH was found possessing the largest market share with about 18% in 2012 (a total of 30,880 beds). In term of market size, BGH was also found the largest market size with a revenue of 40.9% in 2012 (THB 119.5 billion). SWOT Analysis Strengths, weaknesses, opportunities and threats of Rangsit International Hospital were analyzed as follows: Strengths 1) Management teams have experience for over 40 years in managing Phyathai Group. 2) Connection with highly experienced doctors, specialists, technicians, nurses and etc. from the past experience during their working with Phayathai Group. 3) Co-operation with Havard Medical School, an international institute of healthcare. 4) Collaboration with Rangsit University with a capacity to groom new graduates to work in the hospital as doctors, specialists, technicians, nurses and translators. 5) The first hospital in Thailand, RSU INTERNATIONAL HOSPITAL, with an integration of Thai conventional and oriental medicine 6) Prime location in economic growth area. Weaknesses 1) Late arrival in healthcare market 2) Intense competition in the private hospital business section. 3) Shortage of medical staff who can communicate in other languages 4) High switching cost 5) High expenses for doctor and specialist wages

299 Opportunities 1) An increase in the middle to high income population 2) An increase in corporate and private health insurance 3) Dramatic growth rate in medical tourism. 4) The approach of AEC, location close to Don Mueang Airport (transportation convenience by air plane from other countries) 5) Accessibility: car, public transport, SRT dark red line project, etc. Threats 1) High competition in Thai healthcare market, especially with the largest chain: BGH and BH 2) High competition from other countries in the region such as Singapore, Malaysia, etc. 3) Opening of specialty clinics in non-profit hospitals 4) Human capital flight and Shortage of professional staff and administrators. 5) Political instability Customer Behavior In term of customer behaviors, RSU INTERNATIONAL HOSPITAL analyzed the causes of patients trends. There are four causes as follows; 1) Aging population: Thailand is now entering the age of aging population. In 2012, 7.88% of its population was aged over 65, the second highest in Southeast Asia. The number of old population increased to 8.5% in 2015 (5.9 million) and is estimated to reach 10% in 2020 (7.1 million). Demand for healthcare services is expected to increase not only in frequency but also in term of duration of treatments and hospital stay. 2) Growing middle-class: There is a growing number of middle to high income population. The top 40% of household income increased from 31.1% in 2008 to 37.2 in 2012 while the bottom 40% of income decreased from 44.9% in 2008 to 34.4% in 2012. With growing affluence, more patients switch to private hospitals seeking for treatment. 3) Better affordability: Private health insurance in Thailand is the fastest growing source of healthcare funding. Numbers of insurance policies and direct premiums was recorded double during 2007-2012. Patients with insurance coverage were more likely to visit private hospitals rather than public hospitals. As a result, the higher

300 penetration rate and growth in health insurance coverage is expected to increase demand for service of private hospitals. 4) Medical tourism: Singapore and Malaysia are destinations for medical tourists from Asia while Thailand attracts patients from East Europe and Middle East. The patients financial capabilities, reputation of doctors, and connectivity to countries of treatment are key factors on the decision of medical travelers seeking treatment overseas, and this is gauged by international accreditation. Competitor Analysis The competition in Thai private hospital market appears to be getting intense as the market is shared among more than 327 private hospitals. However, the largest 24 private hospitals such as Bangkok Dusit Medical Services, Bumrungrad Hospital, Vibhavadi Hospital, and Phyathai Hospital dominate the market with a 75% combined market share. According to RSU INTERNATIONAL HOSPITAL s position as an upper-mid tier hospital, RSU INTERNATIONAL HOSPITAL captured the competitors by positioning and market share by segment as below figures. For this upper-mid tier segment, Phayathai Hospital (PYT) is the leader by with a 33% of market share. PYT Group first started PYT 1 with only 157 beds in 1976. Now PYT owns 3 hospitals with 1,270 beds in Bangkok and 1 hospital with 257 beds in Chonburi Province to serve patients in the east of Thailand. PYT was fully merged by Bangkok Medical Services in 2010. Now PYT Group is a subsidiary of the largest hospital chain in Thailand. On the other hand, Vibhavadi Hospital (VH) first started with only 230 beds by a handful of medical practitioners and financiers in 1986. Now VH owns 4 hospital and 990 beds across Thailand. In addition, VH Group also has a hospital with 610 beds in Chaing mai Province in the north of Thailand. In the field of medical tourism investment, PYT has attracted much more foreign interest than VH because PYT stated itself as international hospital. PYT also emphasizes international standard quality of clinical services and service excellence. PYT has targeted at international market such as Middle East countries. Besides, VH focuses on Thai patients who live around the north of Bangkok, corporate contractors, and insurance

301 whereas the growth of VH is slow as it focuses on patients from the regional countries such as Myanmar. Marketing Plan Marketing Objective One of RSU INTERNATIONAL HOSPITAL s marketing objectives includes attracting patients through it facilities in an increasing competitive filed. One of the most important goals of marketing for healthcare business is driving business and increasing sales. Not only the operational results, the hospital also aims to educate and prevent the patients to prevent themselves from illnesses. a) To educate patients about serious health conditions. b) To build brand awareness of RSU INTERNATIONAL HOSPITAL and its medical services c) To increase its sales by 25 percent in the first year of operation d) To reach a 5 percent growth in overall market in 2018 STP Analysis RSU INTERNATIONAL HOSPITAL has analyzed the overall markets and created its own value by marketing segmentation, target market selection, and product and service positioning as follow: Marketing Segmentation As of August 2014, there were 327 private hospitals and more than 1,050 public hospitals in Thailand (MKE-ISR, 2014). 108 hospitals had 51 100 beds, or a 33.6%, and the remaining of hospitals had more than 100 beds, or a 66.4%. In term of patients, there were 46.3 million patients who received services in private hospitals in Thailand. 44.1 million or 95.3% were OPD patients while 2.2 million or 4.7% were IPD patients. There were approximately 144,346 OPD patients and 6,781 IPD patients per day per hospital. In terms of international patients, there were 3 million patients who received services in private hospitals in Thailand. About 2,856,000 or 95.2% were international OPD patients and about 144,000 or 4.8% were international IPD patients.

302 In terms of market share in upper-mid tier market, Phayathai holds about 33%, and Vibhavadi holds about 15%. Target Market Selection RSU INTERNATIONAL HOSPITAL aims to target the domestic market divided into two types: upper-middle class people and the expatriate community in Thailand. The international market reflects primarily medical tourism from countries where there are issues with quality, accessibility, and affordability for healthcare services, especially Middle East, Myanmar, and Chinese. In addition, RSU INTERNATIONAL HOSPITAL will also target patients from corporate contracts, insurance companies, and referral patients both in Thailand and aboard. Product and Service Positions In term of positioning and target group hospitals may be categorized into four segments as follows; I Premium market such as Bumrungard, Samitivej, Bangkok Hospital and BNH, II Upper-mid tier market such as Phyathai, Piyavej, Vejthani, Vibhavadi, Ramkamhaeng and Vichaiyut, III Mid-tier market such Paolo, Kasemrad, and Chularat IV Not-for-profit hospitals such as Siriraj, Ramathibodi, and King Chulalongkorn Memorial Marketing Mix (7P) RSU INTERNATIONAL HOSPITAL uses the marketing mix as a tool to determine its services and brand offering. However, the hospital s services cannot be analyzed through the 4Ps due to its additional services. Therefore, three has been added as 7Ps which are analyzed as follows: Product RSU INTERNATIONAL HOSPITAL would provide services what patients wish to treat their health problems and what they expect to get.

303 Place RSU INTERNATIONAL HOSPITAL is located on Petchaburi Road in central Bangkok. Therefore, patients easily access the location by their own cars, MRT, or public transportation. Price RSU INTERNATIONAL HOSPITAL is always seen representing good value for every service because it would capture the upper-mid tire market. It is not necessary for the patients to pay the cheapest price, but they are willing to pay a little more for tailor-made services that really satisfy them. Promotion RSU INTERNATIONAL HOSPITAL is a new comer in healthcare business. Therefore, the hospital would integrate advertising, public relations, sales promotions, sales representatives in their marketing strategies, and these tools would be used to put across the hospital s key message to the target audience. In addition, RSU INTERNATIONAL HOSPITAL would attract the patients by the use of new media to such as social media, online application, an etc. The above 4Ps were extended into 7Ps for RSU INTERNATIONAL HOSPITAL s marketing mix to include all service elements, not just physical things. People RSU INTERNATIONAL HOSPITAL will include nurses, doctors, and all staffs, the pride of the hospital. RSU INTERNATIONAL HOSPITAL is also supported by Rangsit University, which can groom medical staff with not only academic knowledge but also professional skills for service excellence. Process RSU INTERNATIONAL HOSPITAL will design a simple process in which patients necessary data and profiles are linked through an application of the latest intellectual technology. Physical Evidence RSU INTERNATIONAL HOSPITAL s premise will be designed in a modern and luxury style. This element of physical evidence will distinguish the company from its

304 competitors to meet their patients affordability for premium services and establish a positive experience superior to other competitors. Operational Plan Aiming to reach a standard maintained by Hospital Process Orientation (HPO), RSU INTERNATIONAL HOSPITAL has implemented hospital practice from World Health Organization. The HPO can lead to no more process orientation or even patient focus. The RSU INTERNATIONAL HOSPITAL operation map can be explained as follows: 1. Reception and Registration Stage (the first stage): A customer accesses to care. 2. Admit (the second stage): A customers is admitted to the hospital. 3. Records (the third stage): If a customer becomes a new patient for the hospital, this process will be ignored. However, when they come back next time, their medical record would be shown at the Reception and Registration stage. 4. Delivery of Care and Diagnostic Services (the fourth stage): a customer receives diagnostic or treatment services and is separated into In-patient or Out-patient department. In this stage, the patient passes each department depending on their illnesses. 5. Pharmacy (the fifth stage): After a patient receives diagnostic or treatment services, he or she is prescribed medicines and recommended medical instructions. 6. Discharge (the sixth stage): A patient is accounted for his/ her care. This stage includes costs, billing, and collection. 7. Post Hospital Care (the last stage): A patient whose doctor needs to follow up or provide further treatments comes back to the hospital to start the first stage again. Financial Plan The total project investment is Baht 4 billion. The Net Present Value (NPV) of the project in the first year would be Baht 265 million. The Internal Rate of Return (IRR) to the project would be 23%. Project payback period is expected to be 3.7 years from the first year of operation.