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Buurtzorg Edugreen Neighborhood India Care Private Limited || India www.buurtzorgindia.com

BUURTZORG IndiaBetter care at lower costInvesting in the India roll-out of the most successful European

home nursing model

Investment Teaser


Buurtzorg is a pioneering

healthcare organisation

established 12 years ago

with a nurse-led model of

holistic care that

revolutionised

community care in the

Netherlands.

Client satisfaction rates are

the highest of any health

care organisation, staff

commitment and

contentedness is reflected in

Buurtzorg’s title of Best

Employer (4 out of the last 5

years).

Highlights

Buurtzorg Edugreen

JV

Summary: Buurtzorg Edugreen Neighborhood Care India Private Ltd., Kolkata

• Private-pay market. Market opened due to Uber-type of platforms (e.g. Portea,

Nightingale) who created market for homecare but fail to deliver quality care

• Proof of concept in 2017/18: 6 months pilot project in Kolkata

• 1/2019 co-founding Buurtzorg Edugreen Neighborhood Care Ltd, Kolkata

• Key Figures: Meanwhile 4 teams in 3 cities, ~80 nurses and care workers, 40 patients

• Business Model: High quality full time nurse attendance model (current market practice);

only few aspects of Buurtzorg model implemented so far. Stepwise transformation over

the next 5 years to full Buurtzorg model

• 24/7 or 12/7 shifts. 3 nurses and 9 nurse attendants per team; 1 doctor per 3-4 teams.

Differentiation is quality of care, continuity of care and medical supervision of care

workers

• Edugreen (JV partner) is specialized on skilling young people from rural areas and thus

provides a continuous inflow of well trained, motivated staff (captive employment model)

• Revenue model: 100% private pay

• Financials: Breakeven on team level in all cities

• Target for 12/2019: 10 teams, 140 nurses/care workers, 100 patients

Buurtzorg Edugreen Neighborhood India Care Private Limited || India www.buurtzorgindia.comBuurtzorg Edugreen Neighborhood Care India Private Limited || India www.buurtzorgindia.com

Why investing in Buurtzorg India: Investment Theses

Huge need at the verge to become a market with

huge growth outlook with lack of sophisticated

players who can deliver quality care

Multiply awarded, proven, successful biz model

in Western World, adaptability to India needs and

situation proven by successful pilot projects in 3

cities in India

Differentiated market positioning with long-term

competitive advantages for clients and resources

(nurses/nurse attendants)

Only foreign player in community care in India.

Founders well established with strong and long term

relationships in Indian & International care market

and with government.

Seasoned, committed management with proven track

record in India

Proprietary best-in-class ICT solution

Highly efficient business model with lowest overhead

and highest nurse productivity

Elderly care segment receives ever more growing

interest from investors, hence good opportunities for

future exits

Social enterprise, empowering local communities

and nurses

Buurtzorg Edugreen Neighborhood India Care Private Limited || India www.buurtzorgindia.com4/12/2020 Copyrights 2018 Edugreen 5

Providing quality home health care in communities

10

Total No. of cities

Professional quality Home Healthcare focused on Critical patients

4368

Total No. of staff

Crore140

Total Revenue Projected

14 Crore

Accumulated Profits

Copyrights 2018 Edugreen

Buurtzorg Edugreen JV in 5 years (Projection)

Buurtzorg Asia | Hongkong/Shanghai | www.buurtzorg.com

BP India (JV Buurtzorg Edugreen)

6

Based on existing BP of Buurtzorg Edugreen India (2019). With more capital speed of growth/impact can be increased as of 2021

Key Business Metrics 2019-20 2020-21 2021-22 2022-23 2023-25

Number of Nursing Stations 4 7 29 57 87

People 180 358 1,462 2,866 4,368

Income Statement- Amount in Indian Rupees 2019-20 2020-21 2021-22 2022-23 2023-25

Revenue from Operations 1,08,34,560 3,38,34,240 15,14,55,744 40,72,88,218 79,61,82,774

Total Revenue 1,08,34,560 3,38,34,240 15,14,55,744 40,72,88,218 79,61,82,774

Royalty Expenses 0 0 0 0 0

People Cost 1,39,77,600 3,53,00,160 15,96,00,105 36,18,31,901 61,00,40,708

Marketing Expenses 15,00,000 19,84,500 41,01,300 78,48,698 1,25,44,025

Premises Expenses 10,80,000 19,12,050 58,41,045 1,28,63,529 2,16,82,200

Other Operating Expenses 8,40,000 8,82,000 9,26,100 9,72,405 10,21,025

Total Operating Expenses 1,73,97,600 4,00,78,710 17,04,68,550 38,35,16,532 64,52,87,958

EBITDA -65,63,040 -62,44,470 -1,90,12,806 2,37,71,686 15,08,94,816

Depreciation and Amortisation 16,64,267 16,64,267 16,64,267 17,81,867 17,81,867

EBIT -82,27,307 -79,08,737 -2,06,77,073 2,19,89,819 14,91,12,949


• Better care at lower

cost

• Happy Nurses –

happy patients

• ~410 mn € revenue,

EBIT 3-5%, ROCE

~40%

Key elements

Unique care model

Empowerment

Cost efficiency

• Neighbourhood-based; leveraging

community-resources

• Tailored care instead of standard care

• Promoting self-care/independence

• ~1.400 self-steering, decentral teams (~10.000

nurses, ~4.200 care workers)

• Empowered nurses & care workers, no

managers, flexible working models

• Proprietary ICT-solution

• Only 50 backoffice FTE for 14.200 staff

• 8% overhead (vs 25% market standard)

• Low travel times

• 35% less service hours per client than market

standard (KMPG study)

Buurtzorg’s success in Holland: From 4 to 14,200 staff in 12 years

India Industry Analysis & Trends

4551.7

59.568.4 72.8 76.4 81.3

104 110

160

280

0

50

100

150

200

250

300

Healthcare Sector Growth Trend in USD Billion

Healthcare is one of India's largest sectors both in terms of

revenue and employment. Will attract largest resource

mobilization POST COVID-19 Scenario.

The industry is growing at a tremendous pace owing to its

strengthening coverage, services and increasing expenditure by

public as well private players.

The total industry size is expected to touch US$ 160 billion by

2017and US$ 280 billion by 2020.

According to WHO, the doctor patient ratio in India is 1:1674

which is way below the WHO’s prescribed ratio of 1:1000.India

spends about 1.4% of GDP on healthcare which is half than

China and nearly one-eighth of the developed nations such as

Britain

Globally, home healthcare segment is 3-6% of the total

healthcare market. Currently, the home healthcare services

market in India around $5-$7 billion and is expected to rise to

$10-$15 billion by 2020. Clearly, start-ups catering to this domain

want to garb a piece of the growing pie.

HOME Healthcare would be largest growth sector POST

COVID-19 scenario

India’s Home Healthcare sector is USD 3.6 Billion

growing at CAGR of 20%


4/12/2020 9

Porter “Five Forces Analysis”-HOME Healthcare

Bargaining power of Suppliers

Low

1. Suppliers are largely fragmented

with few large organized players

2. Aggregators add significant value

by generating additional revenue

for supplier. But they have to be

quality focused and accountable

1

Threat of SubstitutesLow

1. People are looking for quality and

personal care in Homecare rather

than an alternative

2. Technology can only be enabler but

not replace quality and personal

care

2Intensity of Rivalry

Medium1. In India the market is nascent and

catching up significance both from

Aggregators as well as Full-fledged

Healthcare Institutions.

2. Most aggregators are focused either on

just connecting the people to the

provider and not taking responsibility

3

Bargaining power of BuyersHigh

1. While patients consider pricing to be similar or

just above clinical care, competition in the

business is creating Bargaining from patients

and their relatives

2. Diverse needs and personnel intensive makes

pricing differentiation for different services

difficult since touch point is patient

3. Aggregators provide value by offering wide range

of choices across E&A categories catering to

every segment

4

1. Market is growing rapidly and potential threat

from International players as the opportunity

in India is attractive to new entrants

2. Existing Healthcare delivery may try to enter

this attractive market

3. Easy availability of capital as Investor

perception is positive

Threat of New EntrantsHigh5

Trained service providers key to both institutional

as well as home healthcare solutions



10

16.000

Hrs

/month

Key elements

Business model

Cities/basis and

models for home care

USP

• Mainly B2C

• Private paying clients

• Kolkata:

• Bhubaneswar:

• Cuttack:

• Varanasi

• Proven, best practice care model with

cultural fit (care at home, filial care)

• Nurse education, integrated with

Edugreen skilling practice

• Localised, unique ICT-solution

• Foreign trusted brand

Buurtzorg in India: Adapting and rolling out the Dutch success model

Buurtzorg China | Shanghai | www.buurtzorg.com.cn

4 cities

1 model

~ 1 Cr

annually

Key Figures

5 Lac

Hrs/month

>15 cities

3 models

~ 25 Cr

annually

2019* 2025**

Service hours

Cities

Biz models

Revenue


2018/2019 Proof of Concept

Details No. of Patients

Patient Got Cured 37

Patient Expired 19

Discontinued Due to

Financial Problem21

Patient Hospitalised 8

Patient Not Satiafied with

Services3

Services continuing 31

Total 119

PATIENT STATUS

Location No. Of Patient

Kolkata 56

Bhubaneswar 34

Varanasi 29

Total 119

LOCATIONWISE PATIENT

Gender Number

Male 81

Female 38

Total 119

GENDERWISE SEGREGATION

Service Nature No.of Patient

Baby Care 8

Companionship 29

Critical Care 19

Elder Care 16

Highly Critical Care 25

Semi Critical Care 22

Total 119

NATURE OF SERVICE


Buurtzorg India – Patient Case Studies

62 yrs.old gentle man, was suffering from

Hypertension and CVA associated with DM-

II. Mr. Pradip is also suffering from

Hemiplegia. The criticalities are over now and

his health condition has improved

considerably.

Chief complaints

High BP with Cerebrovascular Accident

(CVA) associated with Diabetes Mellitus ii

Relevant Past history

Cerebrovascular Accident (CVA)

Diagnosis

Diabetes Mellitus ii with High BP

65 years old with front-temporal dementia,

known case of Hypothyroidism and DM.

Sever breathing difficulty for which

Tracheostomy was performed. Patient is

on oral hypoglycemic agent

Chief complaints

convulsive inspiration, attended by contrac

tion of the diaphragm and spasmodic

closure of the glottis


Tracheostomy

Diagnosis

Dementia,Lower respiratory tract infection,

Hypothyroidism, DM

She is 76 yrs. old highly obese patient whose

mobility is restricted after knee surgery.

Chief complaints

Obesity, Diabetes Mellitus with Hemiplegia.


Knee replacement

Diagnosis

Obesity Non mobile


13c

Experienced Founder and Management Team

Dr. Stephan

Dyckerhoff

Founder(Shanghai)

• MbA/PHD (Business)

• 14 years in China

• 13 years consulting

experience with Cap

Gemini Group

• Former President

North Asia of Swedish

consumer goods &

elderly care company

SCA (Shanghai)

• Founded first home

nursing company ever

in China in 2011

• Started up Buurtzorg

Asia in 2014

Jos de Blok

Director/Board(Almelo/NL)

• Bachelor in Nursing

and MbA

• +15 yrs nursing expe-

rience (hospitals/

community nursing)

• Founder and CEO of

Buurtzorg Nederlands

• Albert Medal of Royal

Society of Arts (RSA)

in London for break

through innovating

home nursing.

• Started up Buurtzorg

Asia in 2014

Investment would be in Buurtzorg Edugreen Neighborhood Care India Private Limited

Dr. Sharda NandramDirector

(Amsterdam, NL)

• Sharda is Associate

Professor

at Nyenrode Business

Universityand founder

of Praan Solutions for

alternative economic

practices.

• She has earned two

bachelors and two

masters (both at the

University of

Amsterdam). She has

also earned her PhD

in Social Sciences at

the Vrije University at

Amsterdam.

Devjit Sarkar

Director CEO(Kolkata India)

• Founder of

Edugreen,

Buurtzorg India

• Alumni of NIIT,

Centum Learning)

and GLOCAL

Healthcare,

• Core expertise in

developing and

implementing

business model in

the education and

training sector.

• Has been involved

in implanting

skilling projects in

33 countries.

Gopinath Banerjee

Operations Head(Kolkata India)

• A dynamic leader

comes with widespread

experience in sales &

business development,

operations, general

administration in

Educational Sector.

• A keen planner,

strategist &

implementer

• He leads Buurtzorg

India’s overall business

operations &

compliances.

Barunansu Sarkar

Delivery Head(Kolkata India)

• A seasoned

professional with more

than 27 years years of

managerial

experience in Sales,

Business

Development,

Operation

Management,

• He leads Buurtzorg’’s

Delivery and Quality

Assurance part

• A perfectionist he also

is the creative brain

for Bz India and is

involved in corporate

communication

Buurtzorg Edugreen Neighborhood India Care Private Limited || India www.buurtzorgindia.comBuurtzorg Edugreen Neighborhood Care India Private Limited || India www.buurtzorgindia.com14

For Investment Deck Contact :Devjit Sarkar

Director & CEO, Buurtzorg IndiaPS Srijan Corporate Park, Tower 2

Sector V, Salt Lake City , Kolkata -91Phone : 9830486301

Email : [email protected]


Appendix

Buurtzorg’s home nursing model : Acknowledged as the most innovative

community care model in the Western World

Many Publications all around the world explaining the Buurtzorg Principle

Buurtzorg Edugreen Neighborhood India Care Private Limited || India www.buurtzorgindia.com16

Buurtzorg in Holland

Established in 2006 in Holland, Buurtzorg Nederland is the leading community-based home

nursing provider which has attracted international attention for its innovative use of

independent nurse teams in delivering high-quality, relatively low-cost care at homes

Buurtzorg Nederland provides medical and non-medical care for patients in their homes and

continuously innovates care models with the objective to keep patients at home and to support

them in re-gaining as much as possible independence.

The majority of the operational business is in a foundation (“Buurtzorg Stichting”). In 2018

Buurtzorg Stichting achieved revenue of around 410m Euro at 3-4% operational EBIT. ROCE

(adjusted) has been >42% over the past 6 years.

Employees: ~ 14.200 staff comprising of ~ 10.000 nurses, ~ 4.200 caregivers and ~ 50 back

office staff

Patients: ~80,000 in 2016; over 500,000 patients in total since Buurtzorg was founded

Key Facts & Statistics

Revenue: 410 million EUR (2018)

EBIT: 3%~5%

ROCE: 42% in average

Market share in Holland (community care) : 60%

Operational in Sweden, Germany, England, France, Japan,

China/Taiwan, India (and projects in 25+ other countries)

In November 2014, the founder of Buurtzorg, Jos de Blok received the Albert Medal as the

first Dutch ever for innovating home care; The impressive list of Albert Medal awardees

comprises names like Michael Faraday, Thomas Edison, Marie Curie, and Alexander

Graham Bell

Key Success Factors

Patient-

centricity

Leveraging

networks

Lean

management

Self-steering

teams

Smart IT

Neighborhood

focused

Local for local

Care tailored to patient’s needs instead of standard services. Nurses focus on patient

thanks to smart ICT system and efficient back office support.

Leveraging informal networks, family, volunteers to support patients to regain

independence and minimize expensive nurse hours

Nurses are organized into self-steering teams, work independently and autonomously.

Rigorous standardization of non client-facing processes. Minimal back office staff.

Nurse teams organize themselves, are responsible for recruiting, marketing,

operations, quality - nurse stations grow organically and exponentially

Mobile device (tablet or phone) as key working tool with proprietary software for care

process, scheduling, communication, eLearning, billing, business KPIs, eHR etc.

Strict focus on designated areas, low travel times, deep understanding of the

neighborhood structures and specifics, working closely with local neighborhood

Strive to recruit nurses from local neighborhoods

Nurse-centricityLifting up the image of nursing work, provide training, education, and flexibility to

nurses

Buurtzorg’s home nursing model : Acknowledged as the most

innovative community care model in the Western World


Frederic Laloux: ‘Reinventing

organizations’

Sharda Nandram: ‘organizational innovation by integrating

simplification’

Many Publications all around the world explaining

the Buurtzorg Principle

Buurtzorg: The Dutch word that could revolutionize healthcare | World Economic Forumhttps://www.weforum.org/agenda/2017/06/the-dutch-community-care-revolution/?utm_content=buffere9b2b&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer&from=singlemessage&isappinstalled=0What a group of Dutch nurses can teach Silicon Valley about the future of work https://www.linkedin.com/pulse/what-group-dutch-nurses-can-teach-silicon-valley-future-heimans/?published=t

Jos de Blok @ TedTalk http://tedxtalks.ted.com/video/Healthcare-humanity-above-bureaJos de Blok presentation when receiving the Albert medal: https://www.thersa.org/discover/videos/event-videos/2014/11/Jos-de-Blok-on-Organizational-Structures

And many more articles, TV reports, conferences …

https://www.weforum.org/agenda/2017/06/the-dutch-community-care-revolution/?utm_content=buffere9b2b&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer&from=singlemessage&isappinstalled=0

https://www.linkedin.com/pulse/what-group-dutch-nurses-can-teach-silicon-valley-future-heimans/?published=t

http://tedxtalks.ted.com/video/Healthcare-humanity-above-burea

https://www.thersa.org/discover/videos/event-videos/2014/11/Jos-de-Blok-on-Organizational-Structures

powerpoint presentation teaser - bz india... · title: powerpoint presentation author: devjit...

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