According to the 2021 Health Statistics Yearbook, in 2020, the revenue of non-public hospitals nationwide was 676 billion yuan, the expenditure was 806.7 billion yuan, and the loss was serious, reaching 130.7 billion yuan. Under such a situation, non-public medical institutions have experienced ups and downs and industry reshuffles, and have gone through the 2021 year of industry pattern reorganization and transformation and self-help.
Private hospitals are on the market
The epidemic has opened a window for listing.
On July 7, 2021, Chaoju Ophthalmic Medical Holdings Limited (stock code: 2219. HK) is listed on the Main Board of the Hong Kong Stock Exchange, the first PRC eye medical services group to be listed in Hong Kong.
On September 15, the official website of the Shenzhen Stock Exchange disclosed that Sanbo Brain Hospital Management Group Co., Ltd. met the issuance conditions, listing conditions and information disclosure requirements.
On December 10, Gushengtang, a TCM chain management group operating 41 medical institutions, knocked on the door of a Hong Kong IPO and became the first listed TCM medical service chain in China.
In addition, Corning Hospital, a Hong Kong-listed company known as the "first share of psychiatric hospitals", announced that after two years, it was trying to break into the ChiNext board of the Shenzhen Stock Exchange and intended to issue A shares to achieve "H+A" listing in both places; and the IPO application of Fukang Medical Co., Ltd., located in Tibet, was also accepted and will be listed on the Shanghai Stock Exchange.
The listing of private hospitals seems to be a trend, but it is expected. Zhuang Yiqiang, director of the Management Research Center (GAHA) of Guangzhou Elippi Hospital, told the health community that in the wave of social medical treatment, doctors account for nearly 1/3 of the share of medical treatment. In addition to sanbo brain department, Lu Daopei hospital and other founded by big doctors, people in the pharmaceutical industry such as Wang Bin, cross-border businessmen such as Lu Jianming, Aier ophthalmology founder Chen Bang, etc., are typical sources of private medical enterprise founders.
But Zhuang Yiqiang does not think that the wave of listing is breaking out. "This is a normal capital market behavior, social medical treatment has not been cold, but it is not as hot as some people think." These listed companies are actually following their normal development rhythm."
On the other hand, it is true that more medical service providers are seeking to go public, and indeed it is not a one-time and one-day effort. For example, as early as October 2017, Fukang Medical signed a listing counseling agreement with Guojin Securities Co., Ltd., and registered the counseling with the Tibet Securities Regulatory Bureau on October 17, 2017. In December 2020, Guojin Securities released a summary report on the listing counseling work, saying that Guojin Securities has completed the counseling work for Fukang Medical and achieved the expected purpose of the counseling.
Gui Haoming, chief market expert of Shenwan Hongyuan Securities, told the health community that the scale of private hospitals is not large, and it lacks volume. "Tongce Medical, Aier Ophthalmology, etc., which were listed in the early days, were actually developed through a chain of ways based on capital as a link. There are not too many similar new cases in the current market, and listing is one of the paths to open up the volume, which can allow medical companies to get more financing and more development opportunities."
Image source | figureworm idea
There are mixed events on the specialist tracks
According to the 2021 Health Statistics Yearbook, the income of oncology specialties in the specialty field won the championship, with an annual surplus of nearly 9 billion yuan; the income of cardiovascular, pediatric, plastic surgery and other specialized hospitals decreased compared with last year.
According to the types of specialized hospitals: cancer hospital revenue "won the championship", about 90.7 billion yuan, and the surplus is in good condition, nearly 9.1 billion yuan; psychiatric hospitals, infectious disease hospitals, and children's hospitals ranked second to fourth in terms of income, and all had surpluses;
The revenue of stomatological hospitals and eye hospitals ranked in the middle, with 29 billion yuan and 35.6 billion yuan respectively, of which the surplus of eye hospitals was even more impressive, about 5 billion yuan. Income decreased compared with the previous year in oncology, cardiovascular, ENT, obstetrics and gynecology, pediatrics, plastic surgery hospitals, etc.
The specialist track continues the bullish trend in 2020, and financing and mergers and acquisitions in various segments continue to occur. On November 22, Donglei Brain Group, a self-built brain specialist hospital by the Doctor Group, announced the completion of the C round of financing of 200 million yuan, which was exclusively invested by Sequoia China.
On the evening of December 17, Aier Ophthalmology issued an announcement that it intends to acquire part of the equity of 14 hospitals such as Yiwu Aier and Yuanjiang Aier, with a total transaction price of 501 million yuan. Since the beginning of this year, Aier Ophthalmology has increased its mergers and acquisitions, acquired part of the equity of 5 ophthalmic hospitals in the first half of the year, continued mergers and acquisitions in August and October, and added this merger and acquisition, a total of about 29 ophthalmic hospitals have partial equity acquired under its command.
Social medical institutions usually choose to develop specialties or set up weak departments in public hospitals such as plastic surgery, ophthalmology, stomatology, etc., to fill the shortcomings of public hospitals. However, Sanbo Brain And Wuhan Asian Heart Hospital are among the few private specialized hospitals that can compete with public hospitals in their respective specialties, and have launched the pace of listing in 2021 in unison.
Qian Liqiang, PwC China's M&A leader in the medical industry, believes that investors favor specialized hospitals for two main reasons: on the one hand, private specialized hospitals have the characteristics of main business concentration, service standardization and large-scale replication, and their predictable growth and clear profit model have become the most important factors attracting financial investors; on the other hand, the cultivation cycle of specialized hospitals is relatively short, which meets the needs of financial investors for the time of exit and predictable yield.
Rehabilitation and off-hospital care are promising
Following the release of the data of the Seventh Population Census, the National Health Commission issued the Opinions on Accelerating the Development of Rehabilitation Medicine in June, which emphasized the importance and urgency of developing rehabilitation medicine from the perspective of top-level design, and was considered by the industry to be a "policy inflection point".
In November, the General Office of the National Health Commission issued the Pilot Work Plan for Elderly Medical Care Services (hereinafter referred to as the "Plan").
The Plan requires that 15 provinces and cities, including Beijing, Shanghai, Tianjin, Sichuan and Shandong, will launch pilots in January 2022. After a 1-year pilot, explore local experiences and typical practices that form replicable and scalable health care services for the elderly. By 2023, the pilot experience will be replicated nationwide.
Rehabilitation and pension may become the focus of people's livelihood topics in the next stage, and whether it is investment and mergers and acquisitions, or new measures to change the industry pattern, they are happening frequently.
In August, Wenzhou Kangning Hospital Co., Ltd. (Corning Hospital) spent 155 million yuan to buy a 100% stake in a county hospital, Pingyang Changgeng Yining Hospital.
Coincidentally, Gu Lian Medical, a member company of Xinfeng Tianyu Group, also announced in August that it had completed the strategic acquisition of all the remaining minority shares of its Hangzhou Hekang Rehabilitation Hospital, Hangzhou Jianggan and Kang Second Rehabilitation Hospital, and Hangzhou Kangxin Rehabilitation Hospital (hereinafter referred to as the three rehabilitation hospitals in Hangzhou), becoming a wholly-owned shareholder and completing the delivery.
In the secondary market, Samsung Medical and International Medicine, which has the concept of rehabilitation hospital, once experienced sharp fluctuations in stock prices in the middle of the year, especially Samsung Medical, whose stock price has not improved for many years, suddenly started in early May, and once continued to rise and fall.
Samsung Healthcare intends to raise funds for the acquisition of three rehabilitation hospitals, including three target companies in Hangzhou Mingzhou, Nanjing Mingzhou and Nanchang Mingzhou. The capital market was once full of imagination for Samsung Medical, and the stock price rose 3 times a month.
The aging of the population, the high incidence of chronic diseases, and the population growth brought about by the three-child policy will likely further lead to the shortage of medical resources in China, and medical care work is also facing increasing pressure.
Not only in the hospital, but also in demand for care outside the hospital will also be high. At a time when "digital health" is becoming the basic standard in China's medical service market, introducing truly meaningful innovations through technology is one way to narrow the resource gap.
The continuous pilot of "Internet + Nursing" and the pilot of long-term care insurance in new increments have opened up sustainable space for out-of-hospital medical care. Song Jianyong, assistant general manager of Taikang Health's Operation Division, believes that the extension of out-of-hospital nursing care is wider, such as pension institutions are not medical institutions in nature, but more places of life, and carry out all-round care for the body, mind and soul of the elderly. "In medical care, we are more about treating diseases and solving a problem. In elderly care, more attention is paid to the overall feeling of people, and there are life solutions for various health conditions."
The key point of the home medical care landing model lies in the nurses. Gold MEDAL CEO Ding Shaolei believes that nurses should change from "followers in the medical service chain" to "active managers of patient health", and smart nursing should empower nurses, liberate nurses' labor volume and increase work safety, so as to create opportunities for nurses to become managers of nursing and even medical behavior.
"To date, there are about 4.7 million registered nurses in China, and there are a large number of retired nurses. In fact, retired nurses themselves have very high seniority, can work for a long time, and their skills can actually be shared to create value for society." Ding Shaolei said.
Out-of-hospital nursing brings higher incomes and also gives nurses a high degree of motivation. "There has never been an era when the Internet and nurses have been so tightly tied up as they are today." Wang Zhong, general manager of the enterprise development department of Zhongpuda, thinks so.
The extension of out-of-hospital nursing has brought an increase to the smart nursing cake. From the new format of in-hospital to out-of-hospital, smart nursing includes the integration of multiple types of work and multiple fields, opens up software and hardware, and opens up the whole process of pre-diagnosis, diagnosis, post-diagnosis, emergency period, next emergency period, rehabilitation period, and weekend period.
In 2021, from medical informatization, online nurse platforms to chain medical service institutions, as well as related equipment and aging products enterprises, are trying to share a piece of the cake of out-of-hospital nursing.
Sources | the health community
The author | a treasure
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