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Capio France
Presentation to investors at Capio Clinique de Domont, Paris
March 22, 2017
Philippe Durand, Head of Capio France
2
The company
The market
The strategy
Agenda
3
• Mostly DRG payment since 2005
• Self employed doctors
This is Capio in FranceA significant proportion of Capio
This is Capio in FranceCoherent clusters in key regions
4
Capio France
Sales of 561 MEUR
22 units, mostly MSO :
- 8 emergency hospitals
- 10 local hospitals
- 3 specialist clinics
- 1 day surgery center
734.5 no. of patients out of which
more than 81% are outpatients
>25% market share in surgery
in almost every local market
5
A leadership recognized by our peers
This is Capio in FranceRecognized as most advanced in Modern Medicine
6
An ambitious training program recognized by industry peers
This is Capio in FranceRecognized as most advanced in Modern Management
2017-03-2120170322 – Investors meeting 7
The company
The market
The strategy
Agenda
Market growth and fundingA solid public financing basis
• Market growth >3% in volumes
but managed c.2% through strong
regulation
• Spendings level is decided
annually by the government and
approved by Parliament
• Public financing remains strong at
78% and stable over time
8
Split of healthcare expenditures (%)
A growing market due to new patients needs
Market growth (%)
9
Total spending on French healthcare expenditure, 20122
EUR bn
Private care
Public care64
48
21
174
GPs and
specialists2
47
47
Medicine,
Surgery,
and Obstetrics
(MSO)
16
Total
healthcare
132
65
67
Rehab.,
post
-acute and
psychiatry
Hospital care
Relevant healthcare market for Capio
GPs and
specialists3
• Private provision
represents c.50% of total
• Relevant market (acute
care) for Capio
represents c. € 20 billion
• Split fairly stable along
the years
The private market leads the change in the industry
Market size and private provisionThe largest private market in Europe
10
• To avoid higher
deficits, Government
keeps healthcare
spendings growth as
close as possible from
GDP growth
• Considering volumes
growth higher than
GDP, this drives price
decrease
Healthcare expenditures & GDP
Healthcare environment – price trendsUnder tension to protect deficits
11
Annual % of increase (decrease) 2017
ONDAM - national healthcare spendings target 2,10
Volumes regulation & government cost-cutting plan -3,00
Take back of tax and social cuts (only for private providers) -0,49
Prudential coefficient (*) -0,70
Total price increase (decrease) -2,09
(*) Applicable in case ONDAM target is exceeded
• The Government sets
ONDAM target for the
year
• It then sets tariffs after
taking into
consideration natural
volumes increase and
some cost-cuttings
requests to the
providers
Tariff constructionApplication to March 2017 tariffs
• A market mostly publicly financed but largely privately run
• Fundamental demographic and social trends sustain market
growth
• A strong public regulation seeking for efficiency of the system
and pushing the shift from inpatients to outpatients
• Top private providers focused on quality and productivity have
room to benefit
Capio well positioned due to systematic implementation of Modern Medicine
France – Market summaryConclusion
2017-03-2120170322 – Investors meeting 13
The company
The market
The strategy
Agenda
14
• Increased focus on patient needs
• Mobilize patients through deeper involvement
• Monitor process all along the care chain
• Measure results
The strategyA systematic approach to quality
15
Our 2 strategic pillars have positive effects on performance!
Modern Medicine and Modern ManagementQuality drives productivity
Modern Medicine and Modern ManagementFocus on AVLOS reduction
Still room for improvement compared to Swedish practices!
Modern Medicine and Modern ManagementCapio ahead of the market
Source: ATIH and company data
2017-03-2118
From 31 % to 100% depending on the
units!
From 38 % to 92 % on cruciate
ligamentoplasty
The transfers to ambulatory will continue!
Modern Medicine and Modern ManagementAmbulatory is the future of the market
Ambulatory is the future of hospitalization!
Modern Medicine and Modern ManagementCapio is leading the ambulatory trend
Source: ATIH and company data
PURCHASING
ORGANISATION – PROD SUPPORT
HUMAN RESOURCES
IT
MEDICAL PRESCRIPTION
MODERN MEDICINE
MARKETING
Medical protocols drive 80% of our processes and costs
Modern Medicine and Modern ManagementHow do we achieve this?
Modern Medicine and Modern ManagementConsolidation and star network strategy
2007: Importing of Capio
Model to France
Future: Integrated regional hubs
structured along a star networkToday: Strong
regional hubs
Increasing
productivity Closing beds Merging
Consolidation strategy
• A “star network” is a physical and virtual
network around main units
• Modern “main units” with a large set of
activities attracting both patients and doctors
• Several small specialized units (e.g., day
care center, rehabilitation and post-acute,
psychiatry)
• Individual medical practices, consultations
and homecare in areas surrounding Capio’s
clinics
Star network
• Regroup existing facilities into new
facilities
• Optimize flows and cost of
operations
• Attract new doctors and patients
Surgery
Daycare
Consultancies
Maternity
Medicine
Emergencies
Capio clinic
General
practitioners
Proximity care
centres
Day care
centres
Rehab
Specialists
Homecare
Health
Insurance/
Regional Health
Authority
Compli-mentary
Insurances
• Dedicate doctors to
local points of care
• Improve accessibility for
patients
• Attract new patients
Consolidation strategyRegroup facilities to improve leverage
22
Increasing
productivity Closing beds Merging
BELHARRA :
Regroup 3 existing clinics
Into a new building
ST VINCENT :
Regroup Orangerie rehab
beds into St Vincent clinic
ORANGE :
Regroupe Provence clinic
on Orange clinic
ATLANTIQUE :
Regroup Mail clinic onto
Atlantique clinic
DOMONT –
Dedicated daycare centre
QUINT FONSEGRIVES:
Regroup 2 existing clinics
in a new building
MEDIPOLE:
Regroup 2 existing clinics
+ 4 clinics from Mutualité
into a new building
Done
To come by 2018
Increased synergies – lower fixed costs – nicer environment
3 programs were sponsored by Regional Health Authorities
2017-03-2123
• Belharra : core unit with
emergency, ICU,
maternity, …
• Aguilera : moving from
surgery to geriatric
medicine; dedicated to
expand our offer in the
South West of the area
• Jean Le Bon : mostly
ambulatory, dedicated to
expand our offer in the
North of the area
• Cardio center : focused
factory, JV with the
public hospital (75%
Capio)
Offer the best medical service to the population through
focused and coordinated centers
1
1
2
2
3
3
4
4
Consolidation and star networkA clear regional footprint: example of the Bayonne area
Capio’s star network in the Val d’Oise region
24
- 3
1
1
2
Ermont3
2
The development of Capio in Val d’Oise region is a good example of the implementation of the “star
network”, which saves the healthcare offer by favoring the efficiency of technical equipment, thus
increasing added value for the patient.
3
CCB : Core unit with
emergencies, ICU,
maternity,…
Domont : Dedicated
daycare centre
Cormeilles : Short
stay medical &
surgical center
25
• Very strong demand from
GPs
• Can add-on up to 1%
organic growth annually
Completed In Progress
Additional initiativesDevelop the geriatric business
• Strengthening of our actions in
FY17
• European & French levels –
leverage on volumes
• Suppliers should become partners
of modern medicine
• Short-term and long-term actions
2017-03-2126
Additional initiativesStrengthened procurement strategy
27
• Connect the patient to
us before and after
treatment
• Before : improved
patient preparation
• After : secures patient
follow-up
Overall improves:
- Service level
- Productivity
- Quality data capture
- Long-term connection to the
patient and GP
Already sponsored by 2 Regional Health Authorities
Additional initiativesDigitalization : the E-Fitback tool
Prices decrease, BUT:
Operating model is designed to drive productivity
Strategy is supported by Health Authorities
Strong local implementations to attract best medical teams
New perspectives for sales development and productivity
(geriatry, digital, procurement)
28
A strong asset within Capio
ConclusionStrengthened procurement strategy