Finance in Medicare | Digital Health | Merger Acquisition in Healthcare sector

Patients are the source of Revenue and a kick to a whole process in the Medicare industry. Solely from the Registration formality and insurance vendors, a margin is secured to earn a six letter word - "Profit". Taking decisions to employ that 6 letters into various costs transformation efforts like Merger Acquisition, Risk control and Digitization with the help of Finance makes this sector to run & compete with others. Next time you go to a Hospital, you will think how each individual is contributing and the source of earning post reading this summary.

We would also differentiate the meaning of Healthcare Financing vs Finance in Health care as both the words looks similar but they are not. Why not start with this itself ;)

Healthcare Financing refers to arranging working capital (money to run the business or operations) for continuity of production lines and procuring new machinery and technology whereas Finance in Healthcare works as a backbone in terms of accounting, financial risk management, controls, merger and acquisitions which helps a sector to grow.

Basic definition of financial management says that it plays a vital role in achieving organization goals to become effective & efficient. But how Financial Management helps Healthcare industry ? Let's find out :

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• Managing treatment cost -- Cost effectiveness of all the treatments is essential for Medicare by acquiring facilities to provide the services under one roof. 
• Regulatory Requirements -- Adherence of guidelines issued by regulatory body (CDSCO in India) with internal controls and risk.
• Long Term Investment Opportunities -- By analyzing revenue and expenditure, a growth plan is drafted on how investments are going to impact financial future and avoid any equipment shortages.
• Research & Development -- Raising funds to undertake preventive expensive medical conditions which can help in developing new ways to overcome any new diseases within a stipulated time.

A short take - To some extent Insurers inflates the prices for the treatment for insured patients than uninsured. According to a new study by Health care Pricing project, the prices hospital negotiate with private insurers vary considerably. A uninsured patient gets a nominal discount based on the scale of hospital and medical center whereas insured ends up paying the whole amount.
Hospitals come under a monopoly market where they carry out a "body repair shop" function which can no where be executed in the absence of physician.

There is a payment plan that you would have been aware of by seeing the word "Insurer", We all have some sort of Insurance plan(s) but never compared the benefit vs cost or exactly what percentage of amount will be refunded by the Insurance company after the treatment. Some of you are thinking about cashless payment but would that be sufficient enough to be paid on the first go. All these answers you need to find out by your own research with your providers. Else you can definitely comment below if you need a summary on this ;)

Year 2019, where we saw 155% jump in M&A. Total Value of deals were Rs.7,615 crores as per the Livemint and Business Standard reports.

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Year 2020 successfully completed one more acquisition in India in April, 2020. GlaxoSmithKline Consumer Healthcare's brand "Horlicks" was acquired by Hindustan Unilever for Rs.3,045 crores as reported by Money control & other media websites. 

[ Click here to check M&A in telecom sector ]

Many factors bring two or more organizations together. Since we are talking about Healthcare only, here are some reasons that would result in better M&A :

• Elimination of significant competition between hospitals, higher prices and diminished quality.
• Acquiring of non-profit or charity organization to ensure every patient gets a affordable treatment and it allows an institution to change lives for good.
• Discounting or negotiating with the vendors if they can waive or defer certain fees based on the accumulative purchase for whole group.
• It's about Value and getting a denial avoidance which builds up post joining the hands.

Last Lines ~

Digital Health Developments ?! This fancy term comes directly from an initiative of "Digital India". Current fintech market has a lot of information to offer via Internet. From booking a doctor appointment based on consultation models to scheduling personalized programs, all of a sudden it has become a reality of Digital health. Technology is working as a bridge between an infected patient and a life savior. Today we have health-related apps where consumers feel empower by knowing more about themselves in terms of steps counting, cardio tracker, calorie counter and much more.


Hope you had a wonderful read.
Stay classy !

DISCLAIMER :~

This is an integrated information blog to help readers to know about it collectively😉 

Co-authors - Surbhi Bhardwaj & Rahul Kumar