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īƒ˜ AHMC is a private US company headquartered in Washington D.C. recognized as the
leading international hospital development and management company offering clients
“individualized turn-key services and total hospital solutions.”
īƒ˜ AHMC’s 16 year track record includes successful collaboration in more than 50 hospital
projects, on 5 continents and 24 countries around the world.
īƒ˜ AHMC’s management model is based upon the very best characteristics of American
management practices and Joint Commission International (JCI) Standards.
īƒ˜ AHMC’s successful model has been adapted to the needs of clients around the world in
order to deliver enhanced operational capabilities, quality, and profitability.
īƒ˜ AHMC’s business philosophy and experience enable it to deliver global resources locally in
order to provide state-of-the-art quality medical services
īƒ˜ AHMC’s affiliated healthcare facilities are Five Star, Class “A” academic medical centers that
are committed to quality, service and long-term financial success.
īƒ˜ Unique to AHMC is its experience in the management and development of world-class
healthcare facilities that include private hospitals, Private-Public hospital Partnerships
(PPP), and academic teaching hospitals.
AHMC OVERVIEW
GLOBAL NETWORK:
īƒ˜ Hospitals and Projects: 33
īƒ˜ Operational facilities: 15
īƒ˜ Licensed Beds: 2,900
īƒ˜ Physicians: 3,000
īƒ˜ Staff/Employees: 4,500
īƒ˜ Avg. Patient satisfaction: 97%
UNIQUE EXPERIENCE:
īƒ˜ Private-Public Hospital Partnerships
īƒ˜ New hospital commissioning
īƒ˜ Academic and teaching hospital
AHMC OPERATIONS OVERVIEW
AHMC HOSPITAL FEATURES
īƒ˜ Operated at Joint Commission International standards
īƒ˜ Adoption of world class clinical guidelines
īƒ˜ Commitment to continuous quality improvement and enhanced care
īƒ˜ State-of-the-art medical technology and healthcare services
īƒ˜ Commitment to continuing medical education and employee development
through constant education and technology transfer
īƒ˜ Transparent administration and business practices for to earn investors’ trust and
in order to enhance ROI
īƒ˜ Access to AHMC’s prestigious Strategic Alliances and related resources
AHMC HOSPITAL CHARACTERISTICS
Award winning design and according to JCI Standards
AHMC HOSPITAL CHARACTERISTICS
Modern and focused on patient safety/quality and efficiency
AHMC HOSPITAL CHARACTERISTICS
Patient and family centered environments
AHMC SCOPE OF SERVICES
PHASE 1-FS/BP Development
TIMEFRAME: 2 – 3 MONTHS
īƒŧ Conduct Feasibility Study
īƒŧ Develop Business Plan
īƒŧ Develop the Financial
Projections
īƒŧ Analysis of the site and
architectural design
īƒŧ Preliminary staffing plan
īƒŧ Market analysis
PHASE 2- PROJECT
MANAGEMENT CONSULTING
TIMEFRAME: 18-24 MONTHS
īƒŧ Work with architect and
construction manager
īƒŧ Operating procedures
development
īƒŧ Equipment planning
īƒŧ HIT Selection and
implementation
īƒŧ Development of bylaws for
the board and medical staff
īƒŧ Establish governance
structure
PHASE 3- PRE-OPERATIONS &
COMMISSIONING
TIMEFRAME: 6 - 9 MONTHS
īƒŧ Staffing core operating team
īƒŧ General staffing and
recruitment
īƒŧ Physician recruitment
īƒŧ Implement operating
policies and procedures
īƒŧ Implement process design
and protocol
īƒŧ Equipment procurement
and installation
īƒŧ Establish financial controls
and measures
īƒŧ Hospital commissioning
PHASE 4- OPERATIONS
TIMEFRAME: 10-15 YEARS
īƒŧ Turnkey executive
management and control of
daily business operations
īƒŧ Implement international
mode of clinical procedures
and medical care
īƒŧ Implement quality
improvement and patient
safety framework
īƒŧ Implement AHMC best
practice financial and
operations management
īƒŧ Recruitment, training and
retention of physicians,
nurses and hospital staff
īƒŧ Selection/implementation
of HIT System
AHMC Onsite Full-TimeAHMC Consulting and Support
PHASE I: FEASIBILITY STUDY AND BUSINESS PLAN
TIMEFRAME: 2 MONTHS
SCOPE OF WORK
īƒ˜ Conduct a Feasibility Study to validate hospital project
īƒ˜ Develop the associated Business Plan and related Financial Projections
īƒ˜ Conduct site and review architectural design
īƒ˜ Conduct market analysis
DELIVERABLES
īƒ˜ Feasibility Study serves to validate the proposed hospital project's operational and financial
feasibility from a strategic perspective.
īƒ˜ Business Plan gleams information from the feasibility study to develop the proposed hospital’s
framework and a preliminary operational plan. Also serves as a prospectus grade document.
īƒŧ Hospital size, scope/breadth of hospital services
īƒŧ Address needed investments related to building, equipment, HIT and working capital needs
īƒŧ Outline space allocations
īƒŧ Preliminary employee and medical staffing plan
īƒŧ Assess and project operational costs and external service suppliers
īƒŧ Develop future strategic objectives and marketing strategies
īƒŧ 5 year financial projections including opening financial statements of operation, balance sheet, and
cash flow statement.
PHASE II: PROJECT MANAGEMENT CONSULTING
TIMEFRAME: 18-24 MONTHS
SCOPE OF WORK
īƒ˜ Work in collaboration with architect and construction manager
īƒ˜ Develop hospital operating procedures
īƒ˜ Equipment planning
īƒ˜ HIT Selection and implementation
īƒ˜ Develop bylaws for the board and medical staff
īƒ˜ Establish governance structure
DELIVERABLES
īƒ˜ Detail Room Program: AHMC works with architects to assure each room is appropriately equipped
with medical gases, electrical needs and other necessities for both clinical and diagnostic areas.
īƒ˜ Equipment Plan: AHMC will develop the list of clinical equipment, supplies and furniture necessary to
open the hospital to be approved by the Board of Directors.
īƒ˜ HIT Plan: AHMC will develop the implementation plan for selected HIT system, as well as, evaluate
the leasing and/or purchase of hardware and software relevant to the project.
īƒ˜ Bylaws for the Hospital Board and Medical Staff: Hospital Governance will conform to Accreditation
standards as well as develop a system that can be audited to ensure transparency in all transactions.
īƒ˜ General Hospital Organization (“Hierarchy of Control): To be approved by the Board of Directors.
ARCHITECTURAL DESIGN AND RELATED EXPENSES
AHMC is not an architectural firm, however we work with renowned architects experienced in the design
of world-class international standards hospitals worldwide. At the discretion of the owners, architects can
be integrated as part of our team. Related fees and costs are billed separately from AHMC.
PHASE III: PREOPERATIONS AND COMMISSIONING
TIMEFRAME: 6-9 MONTHS
SCOPE OF WORK
īƒ˜ Placement of CEO and staffing of the core operating team
īƒ˜ Recruitment of physicians and general staff
īƒ˜ Implement operating policies and procedures
īƒ˜ Equipment planning, procurement, installation and training
īƒ˜ Implementation the Health Information Technology (HIT)
īƒ˜ Develop and implement methods of procurement
īƒ˜ Establish financial controls and measures
īƒ˜ Hospital commissioning
DELIVERABLES
īƒ˜ Operating Plan and Procedures
īƒ˜ Employee Policies and Procedures
īƒ˜ Job Descriptions, Employee handbooks, and Salary/Benefit Structures
īƒ˜ Medical Equipment Planning, Procurement, Installation and Training Plan
HOSPITAL COMMISSIONING- (LAST 2 MONTHS OF PHASE III)
AHMC team will conduct “practice runs” in order to insure all equipment is functioning
appropriately and that all staff understand how to move patients through the system efficiently and
effectively prior to hospital opening.
PHASE IV: ADMINISTRATION AND OPERATIONS
TIMEFRAME: 7-15 YEARS
SCOPE OF WORK
īƒ˜ Turnkey executive management
īƒ˜ Management and control of daily business operations
īƒ˜ Recruitment, training and retention of physicians, nurses and hospital staff
īƒ˜ Implement international mode of clinical procedures and medical care
īƒ˜ Implement quality improvement and patient safety framework
īƒ˜ Implement AHMC’s best practice financial and operations management service
DELIVERABLES
īƒ˜ Clinical Practice and Medical Care Model
īƒ˜ Framework for Quality and Patient Safety Programs
īƒ˜ Financial and Operation Management Services Plan
īƒ˜ Hospital performance benchmark data and KPI’s
īƒ˜ Marketing and Branding Implementation Plan
īƒ˜ Monthly Reports: formal monthly reports prepared for Hospital Board and investors.
Reports include comparison against budget, variance analysis and benchmarks.
AHMC HOSPITAL NETWORK
Country Client /Project Beds
Contracted
Services
Contract
Start Date
Contract
End Date
Current Status
Honduras La Lima 180 Phase 4 2003 2008 Completed and Current investor
Ecuador Hospital Del Rio 90 Phase 2-4 2003 2010 Completed and Current Investor
Honduras Honduras Medical Center 49 Phase 3 -4 2002 2007 Completed and Current investor
Saudi Arabia Mohammed Khan Hospital 70 Phase 4 2014 Present Management/Operations
Saudi Arabia Bakhsh Hospital 120 Phase 4 2014 Present Management/Operations
India Sama Healthcare 31 Phase 4 2012 Present Management/Operations
Antigua & Barbuda Mount Saint John's Medical Center 185 Phase 3-4 2007 Present Management/Operations
Colombia Pastuer Labs NA (Lab/DX) Allaince 2004 Present Management/Operations
Panama Hospital Nacional 120 Phase 4 2000 Present Management/Operations
India Re- Hospital 120 Phase 3 - 4 2014 Present Pre-Operations
Saudi Arabia Al-Jazeera Medical Hospital 120 Phase 3 & 4 2014 Present Pre-Operations
Saudi Arabia AlQadi Specialty Hospital 140 Phase 1-4 2012 Present Pre-operations
Libya VIP Hospital 60 Phase 1, 3-4 2010 Present Pre-Operations
AHMC HOSPITAL NETWORK
AHMC HOSPITAL NETWORK
Country Client /Project Beds
Contracted
Services
Contract
Start Date
Contract
End Date
Current Status
Libya Swani Road 200 Phase 1-4 2010 Present Construction
Russia Russian American Hospital 100 Phase 1-4 2010 Present Construction
Peru Clinica Delgado 120 Phase 2-4 2009 Present Construction
Peru Torre Trecca NA (OP) Phase 2-4 2009 Present Construction
Libya Swani Road 200 Phase 1-4 2010 Present Construction
Russia Russian American Hospital 100 Phase 1-4 2010 Present Construction
Peru Clinica Delgado 120 Phase 2-4 2009 Present Construction
Peru Torre Trecca NA (OP) Phase 2-4 2009 Present Construction
Georgia American Hospital Tiblisi 120 Phase 1-5 2013 Present Financing
Libya Libyan American Hospital 120 Phase 1-4 2013 Present Financing
Nigeria Lagos American Specialty Hospital 50 Phase 1 2013 Present Financing
Nigeria Crystal Thorpe Lagos 150 Phase 1 2012 Present Financing
Nigeria Chystal Thorpe Abuja 120 Phase 2 2012 Present Financing
Nigeria Chystal Thorpe Yola 100 Phase 3 2012 Present Financing
Egypt Egyptian American Medical Center 182 Phase 1-4 2011 Present Financing
Jordan MIS Surgical Centre NA (OP) Phase 1-4 2011 Present Financing
Mexico Cancun Medical Center 100 Phase 1 2011 Present Financing
Morocco Moroccan American Hospital 182 Phase 1 2011 Present Financing
Al-Jazeera Medical Hospital
Riyadh, Kingdom of Saudi Arabia
īƒ˜ Recruiting Physicians and Staff
īƒ˜ Cath lab projected online by mid-2014
īƒ˜ Implementation of P&Ps and quality
program
īƒ˜ Develop marketing strategy
Beds: 120
Type: General Hospital
Status: Operations
Bakhsh Hospital
Jeddah, Kingdom of Saudi Arabia
īƒ˜ Recruiting Physicians, staff, and executive
team
īƒ˜ Strategic and Operational Development
īƒ˜ Implementation of P&Ps and quality
framework
Beds: 120
Type: General Hospital
Status: Operations
Dr. Mohammed Khan Hospital
Hafr-al-Batin, Kingdom of Saudi Arabia
īƒ˜ Recruiting of physicians and staff
īƒ˜ Strategic and operational planning
īƒ˜ Implementation of P&Ps and quality
framework
Beds: 70
Type: General Hospital
Status: Operations
AlQadi Specialty Hospital
Najran, Kingdom of Saudi Arabia
īƒ˜ Construction in final stages
īƒ˜ Staffing imminent
īƒ˜ Equipment procurement underway
īƒ˜ Financing
Beds: 140
Type: Specialty Hospital
Status: Pre-Operations
Memorial Souad Kafafi Medical Center
6th of October, Egypt
īƒ˜ Moved into Extension with new ED,
OR & Cath Lab
īƒ˜ CCU, NICU, ICU, OB
īƒ˜ Remodeling of Old Building
īƒ˜ Transition to Fee for Service Model
Beds: 140
Type: General Hospital
Status: Operations
(Completed April 2014)
Hospital Nacional
Panama City, Panama
īƒ˜ Kidney Transplant Program
īƒ˜ Da Vinci Robotic Surgery
īƒ˜ Radiation Oncology Center
īƒ˜ Expansion ICU, Surgery and ED
Beds: 100
Type: General Hospital
Status: Operations
Mount Saint John’s Medical Center
St. John’s, Antigua & Barbuda
īƒ˜ New Executive Team & Board
īƒ˜ Updating Strategic Plan
īƒ˜ GPO Pilot Program
īƒ˜ Teaching Accreditation
īƒ˜ Cancer Centre of Eastern Caribbean
Beds: 185
Type: General Hospital
Status: Operations
AHMC HOSPITAL NETWORK
Hospitals Under Development (continued)
īƒ˜VIP Hospital
Tripoli, Libya
60 Beds
Status: Construction (Pending)
īƒ˜Swani Road
Tripoli, Libya
200 Beds
Status: Pre-Operations (Pending)
īƒ˜Tripoli American Hospital
Tripoli, Libya
120 Beds
Status: Design and Capitalization
AHMC HOSPITAL NETWORK
Hospitals Under Development (continued)
īƒ˜Moroccan American Medical Center
Casablanca, Morocco
110 beds
Status: Design and Capitalization
īƒ˜Egyptian American Medical Center
Cairo, Egypt
180 beds
Status: Design and Capitalization
īƒ˜Minimally Invasive Surgery Center
Amman, Jordan
Status: Design and Capitalization
AHMC HOSPITAL NETWORK
Hospitals Under Development (continued)
īƒ˜Lagos American Medical Center
Lagos, Nigeria
50 Beds
Status: Design and Capitalization
īƒ˜Crystal Thorpe (3 hospitals)
Yola, Abuja and Lagos, Nigeria
100, 120 and 150 Beds
Status: Design and Capitalization
īƒ˜R&H Specialty Hospital
Accra, Ghana
100 Beds
Status: Design and Capitalization
AHMC HOSPITAL NETWORK
Hospitals Under Development (continued)
īƒ˜Russian American Medical Center
Tver, Russia
120 beds
Status: Design and Capitalization
īƒ˜American Hospital Tbilisi
Tbilisi, Republic of Georgia
120 beds
Status: Design and Capitalization
AHMC HOSPITAL NETWORK
Hospitals Under Development (continued)
īƒ˜Clínica Delgado
Lima, Peru
120 Beds
Status: Phase 2 Construction
īƒ˜Torre Trecca
Lima, Peru
Ambulatory and Urgent Care Center
Status: Phase 2 Construction
īƒ˜Hospital Solaris
Guayaquil, Ecuador
100 Beds
Status: Phase 2 Construction
AHMC HOSPITAL NETWORK
Completed and Current Investor
īƒ˜Honduras Medical Center
Tegucigalpa, Honduras
Status: Commissioned, Operated
and own equity in Hospital
īƒ˜La Lima Medical Center
Tegucigalpa, Honduras
Status: Renovated, Operated,
and own equity in Hospital
īƒ˜Hospital Del Rio
Cuenca, Ecuador
Status: Business Plan, Commissioned,
Operated and own equity in Hospital
6/6/2014 FAMILY HOSPITAL GROUP 29
INVESTING IN HEALTHCARE
īƒ˜ Hospitals are complex
businesses
īƒ˜ Business of “people”
īƒ˜ High technical skills
required
īƒ˜ Long-term perspective and
dedication required
īƒ˜ Significant ROI is possible
6/6/2014 FAMILY HOSPITAL GROUP 30
HEALTH MARKET TRENDS
īƒ˜ Scarcity of Capital
īƒŧ Human
īƒŧ Financial
īƒ˜ Increased Complexity
īƒ˜ Capital Markets and
Investor Expectations
īƒ˜ Quality & the Patient
Experience
īƒ˜ Cost Pressures
6/6/2014 FAMILY HOSPITAL GROUP 31
HEALTH MARKET TRENDS
īƒ˜ Transitions:
īƒŧ Financial Markets
īƒŧ Reimbursement
īƒŧ Aging Hospitals
īƒŧ Younger Populations
īƒŧ New Technology
īƒ˜ Increased Complexity
6/6/2014 FAMILY HOSPITAL GROUP 32
BUSINESS MODELS
Classic:
īƒ˜ Public
īƒ˜ Public Private Partnerships
īƒ˜ Private:
īƒŧ Foundation
īƒŧ Family Owned
īƒŧ Doctor Owned
īƒŧ Investor Owned
Alternative:
īƒ˜ Hospital within a Hospital
īƒ˜ Doctor – Investor Hybrid
īƒ˜ Joint Ventures
īƒ˜ Collaboration with
Insurance Companies
īƒ˜ Tenant Hospitals
īƒ˜ Concession of Services
6/6/2014 FAMILY HOSPITAL GROUP 33
CHARACTERISTICS OF SUCCESS
īƒ˜ Focused Business Plan – Clear investment objectives
īƒ˜ Clearly identified and sustainable local market
īƒ˜ Socio-economic levels of patients are top “informed” 40%
īƒ˜ Class “A” tertiary care with quality and economic volumes
īƒ˜ Class “B” volume and service focused 1 and 2 level care
īƒ˜ Aligned, well-trained and multi-specialty medical staffs
īƒ˜ Operated to International Standards (ISO9000/HQS/JCAHO)
īƒ˜ Emphasis on “value” technology as a clinical and business tool
īƒ˜ Clinical benchmarking and measuring of outcomes
īƒ˜ Ability to understand the relationship and implications between clinical
care and financial performance
6/6/2014 FAMILY HOSPITAL GROUP 34
CHARACTERISTICS OF FAILURE
īƒ˜ Over reliance on the government for patients & revenue
īƒ˜ Alienating the physicians or insurance companies
īƒ˜ Poor quality and patient experience
īƒ˜ Lack of clear strategic plan and/or poor implementation
īƒ˜ Ineffective leadership and lack of accountability
īƒ˜ Wrong or incompatible investor expectations
īƒ˜ Focusing on the socio-economic levels of patients in the top 5% to 10% or
the bottom 50%
īƒ˜ Too many hospitals/beds in market, lack of differentiation
īƒ˜ Too much technology or too little technology
īƒ˜ Lack of resources: financial and human capital
īƒ˜ If you build it, they will come
6/6/2014 FAMILY HOSPITAL GROUP 35
CRITICAL INVESTMENT QUESTIONS
īƒ˜ Why are you investing?
īƒ˜ What is the expected
ROI?
īƒ˜ What are the incentives?
īƒ˜ Understand how all
investors will make
money
īƒ˜ Who is in charge and
who is accountable?
6/6/2014 FAMILY HOSPITAL GROUP 36
KEYS TO SUCCESS
īƒ˜ Demand in market – priced for the market
īƒ˜ Diversified referral base of patients
īƒ˜ Clear focus of the business and strategic plan and
objectives of the hospital
īƒ˜ Service selection – Cannot be all things to all people: Ok
to be a Wal-Mart and ok to be a Saks 5th Avenue, you just
cannot be both
īƒ˜ Realize the uniqueness of the hospital business and the
uniqueness of the customers
6/6/2014 FAMILY HOSPITAL GROUP 37
THE PHYSICIAN KEY
Working in partnership with
the medical staff:
īƒ˜ Doctors are unique
customers
īƒ˜ Doctors bring patients
īƒ˜ Doctors spend the money
īƒ˜ The Doctor Workshop
6/6/2014 FAMILY HOSPITAL GROUP 38
THE PATIENT EXPERIENCE
īƒ˜ Differentiating and
understanding quality care
and quality service:
īƒŧ The patients and families’
expectations
īƒŧ The patient experience
īƒŧ The “little things” of service
īƒŧ Voting with their feet
6/6/2014 FAMILY HOSPITAL GROUP 39
ALIGNMENT OF INCENTIVES
īƒ˜ Owners / Investors
īƒ˜ Doctors that Bring Patients
īƒ˜ Insurance Companies
īƒ˜ Other Hospitals
6/6/2014 FAMILY HOSPITAL GROUP 40
MAXIMIZING PROFITS
īƒ˜ Programs – not “Bricks and Sticks”
īƒ˜ Day to Day control of money and information
īƒŧ Understanding the true and the incremental costs of care
īƒ˜ Productivity and flexibility
īƒ˜ Appropriate and sufficient capitalization – with reality based
financing
īƒ˜ Accountability, transparency and long-term relationships
6/6/2014 FAMILY HOSPITAL GROUP 41
MAXIMIZING PROFITS
īƒ˜ Best practices and standardization
īƒ˜ Clear strategic plan for insurance and third party
contracting of local domestic patient referrals:
Healthcare is local
īƒ˜ Share the risk – share the rewards
īƒŧ Doctors
īƒŧ Insurance companies
īƒŧ Competing hospitals
īƒŧ Clinical partners
6/6/2014 FAMILY HOSPITAL GROUP 42
REDUCING THE RISK
īƒ˜ Not Re-Inventing the
Wheel:
īƒŧ Learn from Others
īƒŧ Clinical Partners
īƒŧ Best Practices
īƒ˜ Invest in Human
Capital:
īƒŧ Professional
Management
īƒŧ Technical Training
CASE STUDY
Mount St. John’s Medical Centre is a state-of-the-art hospital facility centrally-located
on the island of Antigua and has been prepared to be the premier hospital of the
Eastern Caribbean region.
OVERVIEW
īƒ˜ 185 bed hospital structured as a
Public Private Partnership
ownership model.
īƒ˜ The Hospital is professionally
managed and operated as a
modern, private enterprise by
American Hospital Management
Company that ensures the
effective management of all
business operations
īƒ˜ The hospital provides
comprehensive medical services
to the public and private patients
īƒ˜ Regional demand for quality
healthcare services is growing with
lack of adequate private facilities in
the region
īƒ˜ Private, insurance and for tertiary
level government patients,
reimbursement is under fee for service
īƒ˜ Primary and secondary services for
government sponsored patients are
reimbursed under a capitation
agreement with he Government of
Antigua and Barbuda on a monthly
basis
īƒ˜ Antigua and Barbuda is centrally
located within the Eastern Caribbean
Economic Market and a major
transportation hub
SERVICES
īƒ˜ Medical / Surgical
īƒŧ Suites
īƒŧ Private Rooms
īƒŧ Semi-Private Rooms
īƒ˜ Intensive Care
īƒ˜ Maternity
īƒ˜ Nursery
īƒ˜ Neonatal Intensive Care
īƒ˜ Operating Theaters
īƒ˜ Radiology
īƒŧ MRI
īƒŧ CT-Scan
īƒŧ Fluoroscopy
īƒŧ Ultrasound
īƒ˜ Full Clinical Laboratory
īƒ˜ Rehabilitation
īƒ˜ Emergency Room
īƒ˜ 20 Medical Offices
īƒ˜ Helicopter Landing Pad
6/6/2014 FAMILY HOSPITAL GROUP 46
SUMMARY
īƒ˜ Significant new opportunities exist
īƒ˜ Know who you are and know your market
īƒ˜ Everyone must understand why they are going into business
and the expectations
īƒ˜ Align your incentives with the doctors
īƒ˜ Focus on quality and the patient experience
īƒ˜ Human capital and resources
īƒ˜ Maintain the optimal mix of technology and financial
resources
CONTACT INFORMATION

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Ahmc presentation june 2014 for healthcare private investment conference

  • 1.
  • 2. īƒ˜ AHMC is a private US company headquartered in Washington D.C. recognized as the leading international hospital development and management company offering clients “individualized turn-key services and total hospital solutions.” īƒ˜ AHMC’s 16 year track record includes successful collaboration in more than 50 hospital projects, on 5 continents and 24 countries around the world. īƒ˜ AHMC’s management model is based upon the very best characteristics of American management practices and Joint Commission International (JCI) Standards. īƒ˜ AHMC’s successful model has been adapted to the needs of clients around the world in order to deliver enhanced operational capabilities, quality, and profitability. īƒ˜ AHMC’s business philosophy and experience enable it to deliver global resources locally in order to provide state-of-the-art quality medical services īƒ˜ AHMC’s affiliated healthcare facilities are Five Star, Class “A” academic medical centers that are committed to quality, service and long-term financial success. īƒ˜ Unique to AHMC is its experience in the management and development of world-class healthcare facilities that include private hospitals, Private-Public hospital Partnerships (PPP), and academic teaching hospitals. AHMC OVERVIEW
  • 3. GLOBAL NETWORK: īƒ˜ Hospitals and Projects: 33 īƒ˜ Operational facilities: 15 īƒ˜ Licensed Beds: 2,900 īƒ˜ Physicians: 3,000 īƒ˜ Staff/Employees: 4,500 īƒ˜ Avg. Patient satisfaction: 97% UNIQUE EXPERIENCE: īƒ˜ Private-Public Hospital Partnerships īƒ˜ New hospital commissioning īƒ˜ Academic and teaching hospital AHMC OPERATIONS OVERVIEW
  • 4. AHMC HOSPITAL FEATURES īƒ˜ Operated at Joint Commission International standards īƒ˜ Adoption of world class clinical guidelines īƒ˜ Commitment to continuous quality improvement and enhanced care īƒ˜ State-of-the-art medical technology and healthcare services īƒ˜ Commitment to continuing medical education and employee development through constant education and technology transfer īƒ˜ Transparent administration and business practices for to earn investors’ trust and in order to enhance ROI īƒ˜ Access to AHMC’s prestigious Strategic Alliances and related resources
  • 5. AHMC HOSPITAL CHARACTERISTICS Award winning design and according to JCI Standards
  • 6. AHMC HOSPITAL CHARACTERISTICS Modern and focused on patient safety/quality and efficiency
  • 7. AHMC HOSPITAL CHARACTERISTICS Patient and family centered environments
  • 8. AHMC SCOPE OF SERVICES PHASE 1-FS/BP Development TIMEFRAME: 2 – 3 MONTHS īƒŧ Conduct Feasibility Study īƒŧ Develop Business Plan īƒŧ Develop the Financial Projections īƒŧ Analysis of the site and architectural design īƒŧ Preliminary staffing plan īƒŧ Market analysis PHASE 2- PROJECT MANAGEMENT CONSULTING TIMEFRAME: 18-24 MONTHS īƒŧ Work with architect and construction manager īƒŧ Operating procedures development īƒŧ Equipment planning īƒŧ HIT Selection and implementation īƒŧ Development of bylaws for the board and medical staff īƒŧ Establish governance structure PHASE 3- PRE-OPERATIONS & COMMISSIONING TIMEFRAME: 6 - 9 MONTHS īƒŧ Staffing core operating team īƒŧ General staffing and recruitment īƒŧ Physician recruitment īƒŧ Implement operating policies and procedures īƒŧ Implement process design and protocol īƒŧ Equipment procurement and installation īƒŧ Establish financial controls and measures īƒŧ Hospital commissioning PHASE 4- OPERATIONS TIMEFRAME: 10-15 YEARS īƒŧ Turnkey executive management and control of daily business operations īƒŧ Implement international mode of clinical procedures and medical care īƒŧ Implement quality improvement and patient safety framework īƒŧ Implement AHMC best practice financial and operations management īƒŧ Recruitment, training and retention of physicians, nurses and hospital staff īƒŧ Selection/implementation of HIT System AHMC Onsite Full-TimeAHMC Consulting and Support
  • 9. PHASE I: FEASIBILITY STUDY AND BUSINESS PLAN TIMEFRAME: 2 MONTHS SCOPE OF WORK īƒ˜ Conduct a Feasibility Study to validate hospital project īƒ˜ Develop the associated Business Plan and related Financial Projections īƒ˜ Conduct site and review architectural design īƒ˜ Conduct market analysis DELIVERABLES īƒ˜ Feasibility Study serves to validate the proposed hospital project's operational and financial feasibility from a strategic perspective. īƒ˜ Business Plan gleams information from the feasibility study to develop the proposed hospital’s framework and a preliminary operational plan. Also serves as a prospectus grade document. īƒŧ Hospital size, scope/breadth of hospital services īƒŧ Address needed investments related to building, equipment, HIT and working capital needs īƒŧ Outline space allocations īƒŧ Preliminary employee and medical staffing plan īƒŧ Assess and project operational costs and external service suppliers īƒŧ Develop future strategic objectives and marketing strategies īƒŧ 5 year financial projections including opening financial statements of operation, balance sheet, and cash flow statement.
  • 10. PHASE II: PROJECT MANAGEMENT CONSULTING TIMEFRAME: 18-24 MONTHS SCOPE OF WORK īƒ˜ Work in collaboration with architect and construction manager īƒ˜ Develop hospital operating procedures īƒ˜ Equipment planning īƒ˜ HIT Selection and implementation īƒ˜ Develop bylaws for the board and medical staff īƒ˜ Establish governance structure DELIVERABLES īƒ˜ Detail Room Program: AHMC works with architects to assure each room is appropriately equipped with medical gases, electrical needs and other necessities for both clinical and diagnostic areas. īƒ˜ Equipment Plan: AHMC will develop the list of clinical equipment, supplies and furniture necessary to open the hospital to be approved by the Board of Directors. īƒ˜ HIT Plan: AHMC will develop the implementation plan for selected HIT system, as well as, evaluate the leasing and/or purchase of hardware and software relevant to the project. īƒ˜ Bylaws for the Hospital Board and Medical Staff: Hospital Governance will conform to Accreditation standards as well as develop a system that can be audited to ensure transparency in all transactions. īƒ˜ General Hospital Organization (“Hierarchy of Control): To be approved by the Board of Directors. ARCHITECTURAL DESIGN AND RELATED EXPENSES AHMC is not an architectural firm, however we work with renowned architects experienced in the design of world-class international standards hospitals worldwide. At the discretion of the owners, architects can be integrated as part of our team. Related fees and costs are billed separately from AHMC.
  • 11. PHASE III: PREOPERATIONS AND COMMISSIONING TIMEFRAME: 6-9 MONTHS SCOPE OF WORK īƒ˜ Placement of CEO and staffing of the core operating team īƒ˜ Recruitment of physicians and general staff īƒ˜ Implement operating policies and procedures īƒ˜ Equipment planning, procurement, installation and training īƒ˜ Implementation the Health Information Technology (HIT) īƒ˜ Develop and implement methods of procurement īƒ˜ Establish financial controls and measures īƒ˜ Hospital commissioning DELIVERABLES īƒ˜ Operating Plan and Procedures īƒ˜ Employee Policies and Procedures īƒ˜ Job Descriptions, Employee handbooks, and Salary/Benefit Structures īƒ˜ Medical Equipment Planning, Procurement, Installation and Training Plan HOSPITAL COMMISSIONING- (LAST 2 MONTHS OF PHASE III) AHMC team will conduct “practice runs” in order to insure all equipment is functioning appropriately and that all staff understand how to move patients through the system efficiently and effectively prior to hospital opening.
  • 12. PHASE IV: ADMINISTRATION AND OPERATIONS TIMEFRAME: 7-15 YEARS SCOPE OF WORK īƒ˜ Turnkey executive management īƒ˜ Management and control of daily business operations īƒ˜ Recruitment, training and retention of physicians, nurses and hospital staff īƒ˜ Implement international mode of clinical procedures and medical care īƒ˜ Implement quality improvement and patient safety framework īƒ˜ Implement AHMC’s best practice financial and operations management service DELIVERABLES īƒ˜ Clinical Practice and Medical Care Model īƒ˜ Framework for Quality and Patient Safety Programs īƒ˜ Financial and Operation Management Services Plan īƒ˜ Hospital performance benchmark data and KPI’s īƒ˜ Marketing and Branding Implementation Plan īƒ˜ Monthly Reports: formal monthly reports prepared for Hospital Board and investors. Reports include comparison against budget, variance analysis and benchmarks.
  • 14. Country Client /Project Beds Contracted Services Contract Start Date Contract End Date Current Status Honduras La Lima 180 Phase 4 2003 2008 Completed and Current investor Ecuador Hospital Del Rio 90 Phase 2-4 2003 2010 Completed and Current Investor Honduras Honduras Medical Center 49 Phase 3 -4 2002 2007 Completed and Current investor Saudi Arabia Mohammed Khan Hospital 70 Phase 4 2014 Present Management/Operations Saudi Arabia Bakhsh Hospital 120 Phase 4 2014 Present Management/Operations India Sama Healthcare 31 Phase 4 2012 Present Management/Operations Antigua & Barbuda Mount Saint John's Medical Center 185 Phase 3-4 2007 Present Management/Operations Colombia Pastuer Labs NA (Lab/DX) Allaince 2004 Present Management/Operations Panama Hospital Nacional 120 Phase 4 2000 Present Management/Operations India Re- Hospital 120 Phase 3 - 4 2014 Present Pre-Operations Saudi Arabia Al-Jazeera Medical Hospital 120 Phase 3 & 4 2014 Present Pre-Operations Saudi Arabia AlQadi Specialty Hospital 140 Phase 1-4 2012 Present Pre-operations Libya VIP Hospital 60 Phase 1, 3-4 2010 Present Pre-Operations AHMC HOSPITAL NETWORK
  • 15. AHMC HOSPITAL NETWORK Country Client /Project Beds Contracted Services Contract Start Date Contract End Date Current Status Libya Swani Road 200 Phase 1-4 2010 Present Construction Russia Russian American Hospital 100 Phase 1-4 2010 Present Construction Peru Clinica Delgado 120 Phase 2-4 2009 Present Construction Peru Torre Trecca NA (OP) Phase 2-4 2009 Present Construction Libya Swani Road 200 Phase 1-4 2010 Present Construction Russia Russian American Hospital 100 Phase 1-4 2010 Present Construction Peru Clinica Delgado 120 Phase 2-4 2009 Present Construction Peru Torre Trecca NA (OP) Phase 2-4 2009 Present Construction Georgia American Hospital Tiblisi 120 Phase 1-5 2013 Present Financing Libya Libyan American Hospital 120 Phase 1-4 2013 Present Financing Nigeria Lagos American Specialty Hospital 50 Phase 1 2013 Present Financing Nigeria Crystal Thorpe Lagos 150 Phase 1 2012 Present Financing Nigeria Chystal Thorpe Abuja 120 Phase 2 2012 Present Financing Nigeria Chystal Thorpe Yola 100 Phase 3 2012 Present Financing Egypt Egyptian American Medical Center 182 Phase 1-4 2011 Present Financing Jordan MIS Surgical Centre NA (OP) Phase 1-4 2011 Present Financing Mexico Cancun Medical Center 100 Phase 1 2011 Present Financing Morocco Moroccan American Hospital 182 Phase 1 2011 Present Financing
  • 16. Al-Jazeera Medical Hospital Riyadh, Kingdom of Saudi Arabia īƒ˜ Recruiting Physicians and Staff īƒ˜ Cath lab projected online by mid-2014 īƒ˜ Implementation of P&Ps and quality program īƒ˜ Develop marketing strategy Beds: 120 Type: General Hospital Status: Operations
  • 17. Bakhsh Hospital Jeddah, Kingdom of Saudi Arabia īƒ˜ Recruiting Physicians, staff, and executive team īƒ˜ Strategic and Operational Development īƒ˜ Implementation of P&Ps and quality framework Beds: 120 Type: General Hospital Status: Operations
  • 18. Dr. Mohammed Khan Hospital Hafr-al-Batin, Kingdom of Saudi Arabia īƒ˜ Recruiting of physicians and staff īƒ˜ Strategic and operational planning īƒ˜ Implementation of P&Ps and quality framework Beds: 70 Type: General Hospital Status: Operations
  • 19. AlQadi Specialty Hospital Najran, Kingdom of Saudi Arabia īƒ˜ Construction in final stages īƒ˜ Staffing imminent īƒ˜ Equipment procurement underway īƒ˜ Financing Beds: 140 Type: Specialty Hospital Status: Pre-Operations
  • 20. Memorial Souad Kafafi Medical Center 6th of October, Egypt īƒ˜ Moved into Extension with new ED, OR & Cath Lab īƒ˜ CCU, NICU, ICU, OB īƒ˜ Remodeling of Old Building īƒ˜ Transition to Fee for Service Model Beds: 140 Type: General Hospital Status: Operations (Completed April 2014)
  • 21. Hospital Nacional Panama City, Panama īƒ˜ Kidney Transplant Program īƒ˜ Da Vinci Robotic Surgery īƒ˜ Radiation Oncology Center īƒ˜ Expansion ICU, Surgery and ED Beds: 100 Type: General Hospital Status: Operations
  • 22. Mount Saint John’s Medical Center St. John’s, Antigua & Barbuda īƒ˜ New Executive Team & Board īƒ˜ Updating Strategic Plan īƒ˜ GPO Pilot Program īƒ˜ Teaching Accreditation īƒ˜ Cancer Centre of Eastern Caribbean Beds: 185 Type: General Hospital Status: Operations
  • 23. AHMC HOSPITAL NETWORK Hospitals Under Development (continued) īƒ˜VIP Hospital Tripoli, Libya 60 Beds Status: Construction (Pending) īƒ˜Swani Road Tripoli, Libya 200 Beds Status: Pre-Operations (Pending) īƒ˜Tripoli American Hospital Tripoli, Libya 120 Beds Status: Design and Capitalization
  • 24. AHMC HOSPITAL NETWORK Hospitals Under Development (continued) īƒ˜Moroccan American Medical Center Casablanca, Morocco 110 beds Status: Design and Capitalization īƒ˜Egyptian American Medical Center Cairo, Egypt 180 beds Status: Design and Capitalization īƒ˜Minimally Invasive Surgery Center Amman, Jordan Status: Design and Capitalization
  • 25. AHMC HOSPITAL NETWORK Hospitals Under Development (continued) īƒ˜Lagos American Medical Center Lagos, Nigeria 50 Beds Status: Design and Capitalization īƒ˜Crystal Thorpe (3 hospitals) Yola, Abuja and Lagos, Nigeria 100, 120 and 150 Beds Status: Design and Capitalization īƒ˜R&H Specialty Hospital Accra, Ghana 100 Beds Status: Design and Capitalization
  • 26. AHMC HOSPITAL NETWORK Hospitals Under Development (continued) īƒ˜Russian American Medical Center Tver, Russia 120 beds Status: Design and Capitalization īƒ˜American Hospital Tbilisi Tbilisi, Republic of Georgia 120 beds Status: Design and Capitalization
  • 27. AHMC HOSPITAL NETWORK Hospitals Under Development (continued) īƒ˜Clínica Delgado Lima, Peru 120 Beds Status: Phase 2 Construction īƒ˜Torre Trecca Lima, Peru Ambulatory and Urgent Care Center Status: Phase 2 Construction īƒ˜Hospital Solaris Guayaquil, Ecuador 100 Beds Status: Phase 2 Construction
  • 28. AHMC HOSPITAL NETWORK Completed and Current Investor īƒ˜Honduras Medical Center Tegucigalpa, Honduras Status: Commissioned, Operated and own equity in Hospital īƒ˜La Lima Medical Center Tegucigalpa, Honduras Status: Renovated, Operated, and own equity in Hospital īƒ˜Hospital Del Rio Cuenca, Ecuador Status: Business Plan, Commissioned, Operated and own equity in Hospital
  • 29. 6/6/2014 FAMILY HOSPITAL GROUP 29 INVESTING IN HEALTHCARE īƒ˜ Hospitals are complex businesses īƒ˜ Business of “people” īƒ˜ High technical skills required īƒ˜ Long-term perspective and dedication required īƒ˜ Significant ROI is possible
  • 30. 6/6/2014 FAMILY HOSPITAL GROUP 30 HEALTH MARKET TRENDS īƒ˜ Scarcity of Capital īƒŧ Human īƒŧ Financial īƒ˜ Increased Complexity īƒ˜ Capital Markets and Investor Expectations īƒ˜ Quality & the Patient Experience īƒ˜ Cost Pressures
  • 31. 6/6/2014 FAMILY HOSPITAL GROUP 31 HEALTH MARKET TRENDS īƒ˜ Transitions: īƒŧ Financial Markets īƒŧ Reimbursement īƒŧ Aging Hospitals īƒŧ Younger Populations īƒŧ New Technology īƒ˜ Increased Complexity
  • 32. 6/6/2014 FAMILY HOSPITAL GROUP 32 BUSINESS MODELS Classic: īƒ˜ Public īƒ˜ Public Private Partnerships īƒ˜ Private: īƒŧ Foundation īƒŧ Family Owned īƒŧ Doctor Owned īƒŧ Investor Owned Alternative: īƒ˜ Hospital within a Hospital īƒ˜ Doctor – Investor Hybrid īƒ˜ Joint Ventures īƒ˜ Collaboration with Insurance Companies īƒ˜ Tenant Hospitals īƒ˜ Concession of Services
  • 33. 6/6/2014 FAMILY HOSPITAL GROUP 33 CHARACTERISTICS OF SUCCESS īƒ˜ Focused Business Plan – Clear investment objectives īƒ˜ Clearly identified and sustainable local market īƒ˜ Socio-economic levels of patients are top “informed” 40% īƒ˜ Class “A” tertiary care with quality and economic volumes īƒ˜ Class “B” volume and service focused 1 and 2 level care īƒ˜ Aligned, well-trained and multi-specialty medical staffs īƒ˜ Operated to International Standards (ISO9000/HQS/JCAHO) īƒ˜ Emphasis on “value” technology as a clinical and business tool īƒ˜ Clinical benchmarking and measuring of outcomes īƒ˜ Ability to understand the relationship and implications between clinical care and financial performance
  • 34. 6/6/2014 FAMILY HOSPITAL GROUP 34 CHARACTERISTICS OF FAILURE īƒ˜ Over reliance on the government for patients & revenue īƒ˜ Alienating the physicians or insurance companies īƒ˜ Poor quality and patient experience īƒ˜ Lack of clear strategic plan and/or poor implementation īƒ˜ Ineffective leadership and lack of accountability īƒ˜ Wrong or incompatible investor expectations īƒ˜ Focusing on the socio-economic levels of patients in the top 5% to 10% or the bottom 50% īƒ˜ Too many hospitals/beds in market, lack of differentiation īƒ˜ Too much technology or too little technology īƒ˜ Lack of resources: financial and human capital īƒ˜ If you build it, they will come
  • 35. 6/6/2014 FAMILY HOSPITAL GROUP 35 CRITICAL INVESTMENT QUESTIONS īƒ˜ Why are you investing? īƒ˜ What is the expected ROI? īƒ˜ What are the incentives? īƒ˜ Understand how all investors will make money īƒ˜ Who is in charge and who is accountable?
  • 36. 6/6/2014 FAMILY HOSPITAL GROUP 36 KEYS TO SUCCESS īƒ˜ Demand in market – priced for the market īƒ˜ Diversified referral base of patients īƒ˜ Clear focus of the business and strategic plan and objectives of the hospital īƒ˜ Service selection – Cannot be all things to all people: Ok to be a Wal-Mart and ok to be a Saks 5th Avenue, you just cannot be both īƒ˜ Realize the uniqueness of the hospital business and the uniqueness of the customers
  • 37. 6/6/2014 FAMILY HOSPITAL GROUP 37 THE PHYSICIAN KEY Working in partnership with the medical staff: īƒ˜ Doctors are unique customers īƒ˜ Doctors bring patients īƒ˜ Doctors spend the money īƒ˜ The Doctor Workshop
  • 38. 6/6/2014 FAMILY HOSPITAL GROUP 38 THE PATIENT EXPERIENCE īƒ˜ Differentiating and understanding quality care and quality service: īƒŧ The patients and families’ expectations īƒŧ The patient experience īƒŧ The “little things” of service īƒŧ Voting with their feet
  • 39. 6/6/2014 FAMILY HOSPITAL GROUP 39 ALIGNMENT OF INCENTIVES īƒ˜ Owners / Investors īƒ˜ Doctors that Bring Patients īƒ˜ Insurance Companies īƒ˜ Other Hospitals
  • 40. 6/6/2014 FAMILY HOSPITAL GROUP 40 MAXIMIZING PROFITS īƒ˜ Programs – not “Bricks and Sticks” īƒ˜ Day to Day control of money and information īƒŧ Understanding the true and the incremental costs of care īƒ˜ Productivity and flexibility īƒ˜ Appropriate and sufficient capitalization – with reality based financing īƒ˜ Accountability, transparency and long-term relationships
  • 41. 6/6/2014 FAMILY HOSPITAL GROUP 41 MAXIMIZING PROFITS īƒ˜ Best practices and standardization īƒ˜ Clear strategic plan for insurance and third party contracting of local domestic patient referrals: Healthcare is local īƒ˜ Share the risk – share the rewards īƒŧ Doctors īƒŧ Insurance companies īƒŧ Competing hospitals īƒŧ Clinical partners
  • 42. 6/6/2014 FAMILY HOSPITAL GROUP 42 REDUCING THE RISK īƒ˜ Not Re-Inventing the Wheel: īƒŧ Learn from Others īƒŧ Clinical Partners īƒŧ Best Practices īƒ˜ Invest in Human Capital: īƒŧ Professional Management īƒŧ Technical Training
  • 43. CASE STUDY Mount St. John’s Medical Centre is a state-of-the-art hospital facility centrally-located on the island of Antigua and has been prepared to be the premier hospital of the Eastern Caribbean region.
  • 44. OVERVIEW īƒ˜ 185 bed hospital structured as a Public Private Partnership ownership model. īƒ˜ The Hospital is professionally managed and operated as a modern, private enterprise by American Hospital Management Company that ensures the effective management of all business operations īƒ˜ The hospital provides comprehensive medical services to the public and private patients īƒ˜ Regional demand for quality healthcare services is growing with lack of adequate private facilities in the region īƒ˜ Private, insurance and for tertiary level government patients, reimbursement is under fee for service īƒ˜ Primary and secondary services for government sponsored patients are reimbursed under a capitation agreement with he Government of Antigua and Barbuda on a monthly basis īƒ˜ Antigua and Barbuda is centrally located within the Eastern Caribbean Economic Market and a major transportation hub
  • 45. SERVICES īƒ˜ Medical / Surgical īƒŧ Suites īƒŧ Private Rooms īƒŧ Semi-Private Rooms īƒ˜ Intensive Care īƒ˜ Maternity īƒ˜ Nursery īƒ˜ Neonatal Intensive Care īƒ˜ Operating Theaters īƒ˜ Radiology īƒŧ MRI īƒŧ CT-Scan īƒŧ Fluoroscopy īƒŧ Ultrasound īƒ˜ Full Clinical Laboratory īƒ˜ Rehabilitation īƒ˜ Emergency Room īƒ˜ 20 Medical Offices īƒ˜ Helicopter Landing Pad
  • 46. 6/6/2014 FAMILY HOSPITAL GROUP 46 SUMMARY īƒ˜ Significant new opportunities exist īƒ˜ Know who you are and know your market īƒ˜ Everyone must understand why they are going into business and the expectations īƒ˜ Align your incentives with the doctors īƒ˜ Focus on quality and the patient experience īƒ˜ Human capital and resources īƒ˜ Maintain the optimal mix of technology and financial resources