Under the general trend of the reform of the national medical and health system, is the non-public medical market really ushered in?
Since 2009, China has started to comprehensively reform the medical and health system. One of the main lines of reform is to promote the reform of public hospitals, encourage, support, and guide social capital into the medical service field, and form a diversified medical treatment pattern. The Central Committee of the Communist Party of China and the State Council have issued many guidelines and notices on deepening the reform of the medical and health system. Among them, the main policy contents of social capital holding medical institutions are:
1. Encourage and guide social capital to develop medical and health undertakings, actively promote the development of non-public medical and health institutions; encourage and support social capital to organize various medical institutions; encourage social capital to participate in the reform of public hospitals, and give priority to having medical experience and good social reputation. Non-public medical institutions participate in the restructuring of public hospitals.
2. Social capital may independently apply for for-profit or non-profit medical institutions in accordance with business purposes; encourage social capital to hold non-profit medical institutions and support the organization of for-profit medical institutions.
3. Adjusting and adding medical and health resources prioritize social capital; when it is necessary to adjust and add medical and health resources, priority should be given to organizing medical institutions by social capital under the conditions of meeting the access standards.
4. The health department is responsible for reviewing the scope of practice of non-public medical institutions, medical subjects, beds, etc., and does not limit the scope of non-public medical institutions' practice.
5. Accelerate the formation of a multi-disciplinary medical system; encourage enterprises, charities, foundations, commercial insurance institutions, etc. to invest in the medical service industry in various forms such as capital contribution, participation in restructuring, custody, and public private.
Under the guidance of the above policies, the number of public hospitals has shown a downward trend in recent years. In contrast, the number of private hospitals has increased rapidly. By the end of November 2016, the number of private hospitals has exceeded the number of public hospitals. Private capital enters the field of medical services, and will form a multi-medical service pattern with public medical institutions as the main body and private medical institutions as supplements, and promote the healthy development of the medical service industry by introducing competition.
Of course, in addition to the reform dividend, investment M&A activity within medical services has also begun to take off fiercely. The billion euro think tank counts the top 10 projects in the domestic non-public medical field in May 2017-2018. The total financing amount is nearly 11 billion yuan. The financing amount of each project exceeds 200 million yuan, mainly distributed in Internet hospitals and private hospitals. ,clinic.
In order to analyze the status quo of domestic non-public medical service industry, Yiou Great Health has compiled 39 listed companies involved in medical services, trying to fully express the development status and laws of each enterprise for the exchange of industry participants.
Macro analysis: transformation time, city where the headquarters is located and main business
Tracing the reform process of China's medical and health system, 2009, 2010 and 2015 are undoubtedly the three important time nodes for industrial development. In 2009, China implemented a comprehensive health system reform. In November 2010, the “Opinions on Further Encouraging and Guiding Social Capital to Organize Medical Institutions†proposed a number of measures and preferential policies, and relaxed the scope of social capital to organize medical institutions. These policies provide policy guarantees for private capital to enter the medical service industry, and the proportion of private medical institutions continues to increase. In 2015, the Notice of the General Office of the State Council on Printing and Distributing the Outline of the National Medical and Health Service System (2015-2020) clearly stated that the scale of public hospitals should be strictly controlled. The 39 listed companies in the above statistics have been involved in the medical service sector since 2009.
In terms of time dimension, there were only 9 listed companies that started to get involved in medical services in 2009, and as many as 30 companies started to enter after 2009, with the strongest growth rate in 2015. It can be seen that the full implementation of the medical and health system reform in 2009 and the strict control of the scale of public hospitals in 2015 have undoubtedly accelerated the development of the entire non-public medical market.
Stepping into the policy dividend and starting to get involved in the non-public medical market, to a certain extent, it can seize the advantages in setting conditions, finance, tax incentives, government public services, and government procurement. However, in the face of the market structure of Beishangguang Medical Resources, the layout of second- and third-tier cities can win market opportunities. Therefore, the city where the headquarters is located is crucial. Among the 39 listed companies involved in medical services, there are 6 companies in Zhejiang and Beijing, the highest proportion, followed by Guizhou and Guangdong, and Hong Kong and Jiangsu.
Extending to the main business of the company, among the 39 listed companies, 26 companies are not only medical services, accounting for 66.67%; 13 companies are mainly engaged in medical services, accounting for 33.33%. . In other words, two-thirds of enterprises are transforming from other fields to medical services, including pharmaceutical manufacturing, real estate, department store retail, glass ceramics, freshwater pearls and other industries.
Micro-analysis: original business types, non-public medical segments and market development
Focus one, three types of enterprises, play medical services
According to the original business type of the company, the above 39 listed companies can be roughly divided into three categories:
The first category is experienced players, who started out as medical services, including Corning Hospital, Huaxia Medical, Dean Diagnostics, Kanghua Medical, Aier Ophthalmology, Taihe Cheng Medical, Kang Jian International Medical, China Resources Phoenix Medical, Honghe Renai Medical, Rui Ci Medical, Hemei Medical and New Century Medical;
The second category is industry extensions. They started with pharmaceutical manufacturing or medical devices and belong to the medical industry , but they are not medical services, including Xinhua Medical, Winbond Health, Ma Yinglong, Hengkang Medical, Xinbang Pharmaceutical, Jinling Pharmaceutical, and Yishun. Pharmaceutical, Guizhou Bailing, Baiyun Mountain, Jimin Pharmaceutical and Peking University Pharmaceuticals. The reason why this type of enterprise enters medical services is to open up the entire medical chain, from upstream medicines or equipment to downstream medical service institutions, and seize new market share outside the public medical system;
The third category is transboundary transitioners who have transformed into other medical services from other non-medical fields, including international medicine, hospitality, innovative medicine, Langma information, Huaye Capital, Yihua Health, Mei Nian Health, Chengzhi , Aoyang Technology, Ocean Investment, Hunan Development, Tongce Medical, Legend Holdings, Samsung Medical and Shenzhou Great Wall. This type of enterprise is either a backdoor listing, which has caused the original business to be unrelated to medical services, or is a development opportunity for the big health industry. It has transformed into a big health industry through group operations such as mergers and acquisitions and strategic investment in high-quality equity.
Focus 2, choose private hospitals, cut into the non-public medical market
Private hospitals, third-party independent medical institutions, clinics, Internet hospitals and doctors' groups all belong to the non-public medical subdivision. Judging from the 39 listed companies mentioned above, except for Dean Diagnostics, Peking University Medicine, Yuexin Health and other companies, most enterprises choose private hospitals as the entrance.
The reason why private hospitals are selected as the entrance is affected by the size of the organization. Compared with clinics, Internet hospitals, third-party medical institutions and doctor groups, the turnover of private hospitals is usually higher than that of other sub-sectors, resulting in turnover. The multiples are used to estimate higher value, which raises the market value of the company when creating new profit growth points for listed companies. On the other hand, thanks to the reform of public hospitals, social capital intervention has changed the business nature of public hospitals. The profitability was changed to for-profit, which led to an increase in the number of private hospitals.
According to statistics from the official website of the Weijian Committee, as of the end of May 2018, the number of public hospitals was 12,145, and the number of private hospitals was 19,461. At the end of May 2017, there were 12,596 public hospitals and 17,007 private hospitals; at the end of May 2016, public hospitals 12,971 private hospitals, 15193; at the end of May 2015, there were 13,326 public hospitals and 13,153 private hospitals; at the end of May 2014, there were 13,380 public hospitals and 11,666 private hospitals. It can be seen that in the past four years, the number of public hospitals has been declining year by year, the number of private hospitals has increased year by year, and some public hospitals have been converted into private hospitals.
Take Samsung Medical, in May 2015, Samsung Medical entered the medical service field through the acquisition of Ningbo Mingzhou Hospital, and established the medical industry as the company's key development industry. Mingzhou Hospital is a limited liability company jointly funded by Oaks Group Co., Ltd. and Ningbo Samsung Group Co., Ltd., and obtained a business license on November 5, 2014. The predecessor of Mingzhou Hospital was Ningbo Mingzhou Hospital. It was established in June 2001 by the Zhejiang Provincial Health Department. In September 2014, the Ningbo Municipal Health Bureau issued the “Ningbo Municipal Health Bureau's approval of the change of Ningbo Mingzhou Hospital as a for-profit medical institution†(甬å«å‘ã€2014】104å·), agreeing to the nature change of Ningbo Mingzhou Hospital For the for-profit hospital, and obtain the business license of the enterprise legal person with registration number 330212000426118. According to relevant laws and regulations, Mingzhou Hospital undertook the business of the former Ningbo Mingzhou Hospital.
Focus 3, manufacturing differentiation, entering the second and third tier cities, opening up new medical service market
The market developed by the above-mentioned 39 listed companies involved in medical services is often determined according to the richness of local medical resources. The core is to avoid the high-quality medical resources of Beishangguang, to create differentiation and to find new service markets.
Usually, if you invest in a general hospital, you will usually choose a second- and third-tier city. Because there are so many large-scale hospitals in Beishangguang, it is difficult to form a positive competition with them. Second- and third-tier cities are relatively suitable choices. If you invest in a specialized hospital or Outpatient clinics, then Beishangguang is also a good choice, such as brain, oncology, or can seize a certain market space.
Take Corning Hospital, which is a pragmatic original Chinese Zhejiang hospital's own hospital business, through the light asset model in the country's strategic layout, in the Bohai Rim region and the Southwest region to host spiritual hospitals, while in Shenzhen, Hangzhou Open medical institutions in places such as Linhai and Pingyang.
In addition, Shenzhou Great Wall acquired Wuhan Commercial Hospital, international medical fundraising to build Xi'an International Medical Center, Ouhai Investment to acquire Ningbo Stomatological Hospital, Hunan Development to set up Children's Rehabilitation Hospital in Hunan Changsha, Jinling Pharmaceutical Investment Holding Suqian Hospital and Yizheng Hospital, Huaye Capital invested in the construction of the Third Hospital of Chongqing Medical University in Chongqing Medical University, and also opened the layout in the second and third tier cities.
In general, most of the above-mentioned 39 companies have chosen second- and third-tier cities as the main battlefield, and a few have landed in the north.
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