|Deal type||Growth equity|
|Investment date||March 2012|
CARE Hospitals is the largest multi-specialty hospital chain in South and Central India, with strengths in cardiac care, neurology, nephrology and critical care. Founded in 1997, the company has 16 hospitals in nine Indian cities and ranks among India’s top five hospital chains.
India’s healthcare infrastructure remains relatively underdeveloped, despite rapid progress in other areas. As of December 2015, the country had less than one hospital bed per 1,000 people compared with the global average of 2.7, which translates into an annual shortfall of more than 50,000 beds. And, because most of India’s hospital capacity is concentrated in the major cities, many communities lack modern medical facilities.
In 2012, Advent International acquired a majority stake in CARE Hospitals with a vision of creating a regional market leader in acute care services. We were impressed by CARE’s strong footprint in South/Central India’s smaller cities and clear focus on clinical excellence and believed we could support its ambitious expansion plans based on our global experience in the healthcare sector.
“By coupling CARE’s clinical excellence and compassion with our operational expertise, we saw a tremendous opportunity to help grow the business while maintaining CARE’s strong commitment to social welfare,” said Shweta Jalan, a managing director at Advent International in Mumbai.
AND EXPANDING CAPACITY
Working with CARE’s talented founder-led management team, we have systematically implemented a plan to create value in the business by focusing on three key areas: (1) adding professional management to leverage the strong clinical leadership team, (2) improving operations and refurbishing core facilities, and (3) expanding bed capacity through new site development and acquisitions.
- Adding professional management—To enable the founders and doctors to dedicate their efforts to clinical aspects of the business, CARE has enhanced its management team by bringing in a professional CEO and adding specialized talent across functions and hospitals.
- Improving operations—Focusing on the two largest hospitals, the company has upgraded facilities and invested in marketing to increase awareness of its enhanced capabilities and expand the patient base. Across its broader network, CARE has added specialty services such as gastroenterology, general surgery, orthopedics and urology to provide comprehensive patient care.
- Expanding bed capacity—To address demand and bring quality healthcare to more people, the company is debottlenecking and increasing capacity at some of its existing hospitals, building new facilities and acquiring hospitals in current and adjacent markets. For example, a new outpatient facility in Hyderabad, the largest standalone healthcare center in India, has significantly extended the range of services available to the local population. CARE is also in advanced stages of opening new hospitals in Bhubaneswar and Hi-Tech City in Hyderabad, which, coupled with the ongoing expansion at existing sites in Raipur and Pune, will add another 660 beds by the end of 2016.
With expansion plans well underway, revenue and EBITDA are on the rise, and the prospects for continued growth are promising. When the new projects come on stream, the CARE network will have grown from 12 hospitals and 1,475 beds in seven cities at the time of Advent’s original investment to 18 hospitals and approximately 2,800 beds in nine cities.
TO ITS COMMUNITIES
Stronger performance at CARE Hospitals means the business can dedicate more resources to supporting its local communities and underwriting the CARE Foundation, which provides primary care for about 200,000 people in South India and subsidized treatment for patients with chronic kidney disease and children with congenital heart disease.
“Since the beginning,” said Dr. B. Soma Raju, co-founder, chairman and managing director of CARE Hospitals, “CARE Hospitals has been focused on clinical excellence and commitment to ethical practices and quality. Advent provides us with the resources to support the expansion of our business while maintaining our mission of providing healthcare with compassion.”