Tag: Narayana Health

Coronavirus scare: Need to follow self-regulation to a large extent, says Sudarshan Ballal of Manipal Hospitals

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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The deadly novel coronavirus continues to wreak havoc across the country and the globe. There are 73 confirmed cases of covid-19 in India and 4 patients have recovered.

Viren Shetty, Executive Director and Group COO of Narayana Health said, “One of the first things that we have noticed in our hospital is that the minute any time a patient comes in with coughing symptoms or any sort of suspected case, immediately there is a panic situation that happens in our hospital at the emergency room, among the nurses, among the doctors because this disease is highly infectious.”

Talking about how the spread of COVID-19 be prevented, he said, “It is simple, it is what they were doing a 100 and even a 1000 years ago. Just isolate yourself. People should stay at home, avoid large gatherings, avoid travel, wash your hands frequently, don’t go to the temple, don’t go to the factory, don’t go to the department store, theater, shopping mall. You stay at home and you will be fine.”

“We have done as much as we can and I commend the government in all that they have enabled to do so far, but this is beyond the scope of that. What we are trying to do is limit the spread of infection,” he added.

Sudarshan Ballal, Chairman of Manipal Hospitals said that currently there have not been many cases of COVID-19 in their hospital. “However, looking at the trends all over the world, this could be a temporary lull before the storm. So, we have to be mentally prepared for a large number of patients coming in even though the numbers coming in so far are quite low,” he said.

Ballal further added that citizens play a major role, in addition to what the government is doing. “There has to be self-regulation to a large extent. I think this is a time where there is a lot of virus floating around and so we have to be careful about whom we meet, where we travel and common sense measures like anyone who has a cold and cough should not get into the public space like movie theatres, malls, so on and so forth,” he said.

Speaking about the shortage of masks, he said, “As far as masks are concerned, the biggest problem is misuse and hoarding of masks. You see a large number of people walking the streets of Bangalore or any other city with masks when they do not need one. The indication for a mask is very clear, care givers who are taking care of patients who have respiratory illnesses, people who have cold, cough, runny nose so on and so forth and also maybe if you are going into a large public space where you do not know what kind of people are there. But it is not for the general use and I think this hoarding has to stop.”

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KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

Limit contact, wash hands, but no masks: Coronavirus advice from Narayana Health’s Viren Shetty

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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“Limit contact, wash your hands, try and stay at home,” advises Viren Shetty, executive director and group COO of Narayana Health, on ways to combat the threat of coronavirus. “I would very strongly recommend people not to buy caps, masks and gloves,” he added, labelling the adoption of such measures as ineffective.

“To be fair we are not prepared for most things in this country. However, we have isolation wards spread out across most of hospitals, government medical colleges, private medical colleges and all of these have made themselves available to the government,” said Shetty in an interview with CNBC-TV18.

“Should it come to that, we have capacity to deal with the patients in a limited case, but should it come to the issue of a massive epidemic any health system across the world would be under tremendous amount of strain,” he added.

On directions from the government and health authorities with regards to combating the threat of coronavirus, he said, “The protocol for this is standard — as and when patient shows up and with suspected cases of COVID-19, we would isolate them, take their samples while keeping them in isolation, send the samples to the Rajiv Gandhi Institute of Chest Diseases. If it comes back positive then we immediately send them into further isolation in one of the government approved facilities or if not, we send them back home and advise them to quarantine themselves at home.”

About immediate public health steps, Shetty said, “The most important thing that anyone can do right now is to pressure your local neta (political representative) to allot more money for healthcare. The fact is that even in the best of times we are barely able to manage with the current health facility that we have.

“Limit contact, wash your hands, try and stay at home. If you have a cold, don’t be a hero and minimise all international travel as much as possible,” he added.

Debunking myths about coronavirus, Shetty said that intense summer heat in India won’t be a protection against the coronavirus.

“The fact is Singapore and Thailand, which are countries as hot as India, have seen an outbreak as well as countries like West Africa. So I wouldn’t say heat is going to protect us.

“The most plausible explanation for why it has taken a long time for the virus to catch up in India is because our supply chain is almost decoupled from China. So we don’t have close economic links with China that has caused earlier transmission in those other countries, but if I were to debunk a couple of other myths, I would very strongly recommend people not to buy caps, masks and gloves.

“The fact is hospitals need these for their health workers. There is a huge shortage in the market, there is a lot of stockpiling, it is raising the cost for hospitals who need these equipment to do the day-to-day and we are not able to get that,” Shetty added.

On the progress in combating coronavirus Shetty said that effective treatment is still some distance away.

“In China and United States there are a lot of trials going on and they managed to isolate a few genetic markers for this but the fact is we are far from identifying any effective treatments.

“A lot of plants in China have been shut down and so a lot of the active pharmaceutical ingredients (APIs) that the Indian drug industry depend on have been disrupted and so a drug that we depend on an anti-coagulant called Heparin, which we require for surgery has become hard to come by and the cost to import this has gone up at least three times.”

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KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

Pending dues from govt health care schemes hit private hospitals hard, bills worth Rs 2,000 crore yet to be cleared

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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One issue that’s drawing some attention in the healthcare space is that of pending dues of hospitals and nursing homes from government schemes. Some news reports peg the receivables of the industry at near Rs 1,000 crore, but a senior executive at a leading hospital chain who spoke on condition of anonymity pegged this number higher, at about Rs 1500-2000 crore. While pending dues on services rendered under government schemes has been a problem for hospitals for some years now, the reason for renewed attention is that the accumulation of dues has now resulted in them acquiring a significant size, especially for smaller healthcare providers. And this is starting to really hurt their cash flows.

Industry sources in private also confess that they aren’t hopeful of any payments for at least another two months. Indications are that payments will come through, perhaps, only later in January, following fresh fund allocations to the key healthcare schemes.

Average delay is 4 to 6 months

Along with Ayushman Bharat there are mainly three government schemes that hospitals and nursing homes cover. The Central Government Health Scheme or CGHS, the Ex-Serviceman Contributory Health Scheme or ECHS and the Employee State Insurance or the ESI. The CGHS covers government employees and pensioners, the ECHS covers ex-service personnel and the ESI covers those working in factories, etc. The CGHS scheme presently covers about 3.5 million people while ECHS covers 5.5 million ex-servicemen. The delays according to Healthcare Global, the cancer hospital chain, are seen mostly from the ECI scheme, which despite being flushed for funds delays payments. Some industry observers say the biggest problem is from the ECHS scheme which is awaiting more funds from the government.

According to the CGHS scheme, dues have to be cleared in 45 days, 70 percent of payments have to be cleared in five working days after submission of a bill and the balance in the remaining 30 days. Currently, the average delay in payments is 4 to 6 months, with the trend having only worsened in recent times. Stalling of payment processing ahead of the elections and the addition of a large number of hospitals under the schemes are cited as two reasons for the high accumulation. And this is making some hospitals wary of joining government schemes.

Narayana Health, Apollo, Fortis, Max and HCG are a few of the listed private hospital companies with pending government dues. Narayana’s dues are to the tune of Rs 170 crore, about Rs 20 crore and another Rs 20-30 crore pending from CGHS, ECHS and ESI, respectively. Healthcare Global, the cancer-focused hospital chain, awaits settlement of about Rs 200 crore in dues, while for Delhi-based Max Health the outstanding amounts to about Rs 150 crore. Even Fortis, which is mired in a legal battle, is yet to receive about Rs 60 crore, as of end-July. For Apollo Hospitals, though, the impact is limited as only 5 percent of its customer base comprises patients covered under government schemes.

The impact is most severe for small hospitals and nursing homes who cater to a large share of customers covered under these schemes. One of the reasons is because smaller healthcare facilities conduct more routine operations, which are covered under these schemes. Large private hospitals, on the other hand, prefer to focus on high-end procedures. According to a senior executive with a large healthcare provider, who wished not to be quoted, the cash crunch faced by smaller facilities is so severe that many are shutting down, scaling back operations or even putting themselves on the block, despite high occupancies.

Impact on cash flow

Treating patients under a government scheme is a choice that healthcare facilities have. They can choose not to treat patients under government schemes. Then why do they do it? Besides a moral obligation, not treating patients would result in losing out on a bulk of customers, especially if your hospital is located in an area with a large beneficiary population. An industry veteran cites the example of Delhi, where a large pool of patients are those with government jobs.

To address the cash flow impact, industry has proposed emergency solutions. One such proposal is to stop cashless payments till the earlier dues are paid. This means that a patient pays the hospital or nursing home and is later reimbursed by the government. But stopping cashless payments can impact patients, as many do not have the required liquidity to pay high medical bills for procedures. What also makes this proposal difficult to implement is that hospitals are clamouring for a revision in rates for their services. Industry players point out that CGHS scheme rates, for instance, have not seen rates revised since 2014.

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KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

Massive shift happening for “economics of hospitals” in India, says Narayana Health

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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There is a massive shift happening for the “economics of hospitals” in India, said Viren Shetty, executive director and group COO, Narayana Health. “We are seeing that there is going to be a lot more price control not just in drugs, in consumables but also across margin control for every input cost of ours,” he said in an interview with CNBC-TV18.

CNBC-TV18’s ‘Riders in the Storm’ identifies companies that are bucking the slowdown trend and Narayana Health is the company that is weathering the storm in the healthcare sector.

“Fortunately, our numbers have been looking good and the year does look quite positive for us. There does exist seasonal variations. Generally, Q3 is a depressed quarter for most healthcare companies given that it coincides with both Diwali and Eid but we believe it will pick up in Q4. So we are quite positive for the rest of the year,” said Shetty.

“For the next year at least, we aren’t looking at expanding any more. We recently commissioned three hospitals, two in Delhi and one in Bombay. We have enough latent capacity within the group. We have 6,000 operational beds but we also have 7,000 capacity beds. So a lot of our efforts will go towards operationalising those beds,” Shetty added.

However, he did not rule out the expansion plans going forward.

On the expansion front, he said, “We are taking this pause to look at our operations and focus a lot more on additional transformation so that we are able to run things more efficiently within the existing infrastructure. Once we feel confident that this is something that is replicable is when we would be more confident about scaling because, at this point, a greenfield hospital simply is not able to generate an adequate return on capital.”

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Thursday’s filing dispelled some doubts, though Musk still has work to do. He and his advisers will spend the coming days vetting potential investors for the equity portion of his offer, according to people familiar with the matter

KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow

Quality of healthcare more vital than cost, says Devi Shetty

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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Dr Devi Shetty, chairman of Narayana Health, says “Low cost medicines are important. But quality is more important than the cost is.”

Speaking to CNBC-TV18, he saidearly response has been good after the commissioning of 210 bed hospital in Gurugram, Haryana.

Talking about the  KPME (Amendment) Bill 2017, he was of the view that nobody can accept the rules put forth by the Karnataka Government.

“Doctors give opinion based on the data that they have been provided and the similar data getting presented to different doctors can come up with different opinions. So subjecting the doctors under legal scrutiny with severe punishment is not good for the industry,” he said.

Senior politicians has the wisdom to accept our concern and they removed those clause, added Dr Shetty.

“India is a low cost healthcare destination and Indian medicines are the cheapest in the world. There is a limit to which one can push the price of a medicine,” he added.

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KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow