Investing in a Vocentures Healthcare Facility

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2 Ventures Healthcare (VHC) is a subsidiary of Ventures Middle East which was established in 2002 and is recognized in the Gulf Region as a leader in Market and Business Intelligence, Management Consultancy and Strategic Planning. Ventures Healthcare was Established in 2009 with a combined staff experience of more than 100 years. VHC staff have a proven staff track record of strong commitment to meeting Client s needs and satisfaction with a strong knowledge of local market including suppliers and service providers. Health Program and Project Management Medical Equipment Technology Planning and Procurement Services Health Informatics Planning and Project Management Health Planning and Consultancy Samsung Corporation, Korea ABB Sweden Armstrong Floor Products, UK RMD Kwikform, UK LG, Korea Marubeni Corporation, Japan Cisco Systems, USA GE, USA 3M, USA Honeywell, USA Microsoft, USA Hilti Corporation, Switzerland Audi, Germany Guardian Industries, Australia Bukhara Maternity Hospital UAE Offsets Group Abu Dhabi Investment Company (ADIC) Department of Planning & Economy, UAE Union National Bank, UAE Emirates Holdings Mohammed Bin Masaood & Sons, UAE Al Hamed Enterprises, UAE Arabian Construction Company (ACC) ETA Ascon, UAE Dewan Architects & Engineers Bilt Middle East PME, UAE Emirates Specialities, UAE Emaar, UAE Sorouh, UAE Mubadala Healthcare, UAE Aspetar Orthopaedic & Sports Medicine Hospital, Qatar Al Habtoor Contractors SEHA

3 Since 2002, Ventures has been a market leader in Market Research. Ventures Middle East is one of the premier market research companies in the Gulf, which offers cost-effective B2C insights, to get your organization ahead. Ventures Healthcare Market Analytics Team applies accurate and bias-free methodologies, analytic techniques and technologies to meet the information needs of public and private sector clients. Our group of market analysts, survey research professionals, database specialists and statisticians provide a full range of research services. We work with clients to clarify their research objectives, develop and execute a research plan, then analyze, interpret and manage the data to help them make effective business decisions. Our projects include collecting, organizing and analyzing large quantities of varied data from multiple sources to support market research, decision-making, business plans and marketing strategies Our Healthcare Research Team delivers insights and analysis to clients primarily in the following interrelated areas: - Health expenditures and appropriations - Health Policy - Policy and decision makers in the public and private sectors - Health Demographics and prevailing diseases including morbidity and mortality rates - Existing Facilities, Mix and Market Segmentation - Service levels and utilizations, occupancy rates per facility, specialization, average length of stay - Planned facilities and under design / construction - Prevailing and forecasted project costs and budgeting hat includes soft services, construction, equipment and furniture, Information Technology, Contingencies and start-up Operating Costs - Consultants, Contractors, Operators and PM/CM Firms - Licensing requirements, regulations and applied standards - Payer Mix and reimbursement rates - Availability, qualifications and origin of Human Resources - Concept Research (How good is your idea?) and market demand - Customer Satisfaction of services provided by individual facilities or systems This service is offered to Consultants, Operators, Contractors, Developers, and organizations and is customized according to specific needs and objectives.

4 ? Is your proposed venture commercially viable Would you like Ventures Healthcare to provide a `reality check and help define product development to enhance its appeal to customers We conduct feasibility studies, researching all aspects of capital requirements, skills, marketing and physical requirements and likely payback period in deciding how a product or service should be designed, delivered, priced and marketed. We also review business cases, including revenue streams and market demand, apart from analyzing project profitability and carrying out sensitivity analysis. Essentially we collect and analyze primary and secondary data through focus groups, telephone surveys and other methodologies. The value of projects studied by Ventures Middle East in the GCC region, exceeded 1.5 billion US Dollars in 2008, reflecting the trust and confidence we inspire. We provide Consultancy Services in: - Defining Corporate Vision - Market Definition and Competitive Positioning - Defining tactics and road maps that will assist in achieving desired outcomes - Analysis of market situations, demands and competitors - Client satisfaction with rendered services by individual providers - Demand Analysis and forecasting of services and refinement. Demand projections for specific services and subspecialties by focused population segments. Analysis incorporates service area, patient origin, market share, population trends, utilization shifts, geographic barriers, travel patterns and competitive actions and reactions that will impact future demand. - Credentialed Feasibility studies that address: * Marketing and Physical Requirements * Determination of capacity needs, volume projections, size of facilities, skills requirements, development of staff * Baseline situation and competitive landscape assessment. This includes provider / payer implications and reimbursement rates

5 * Development of details value proposition to define exact list of services to be provided by each facility * Definition of how services should be designed, delivered, process and marketed * Development of business cases including revenue streams, revenue modeling, pricing strategy, market demands, project profitability and sensitivity analysis. This leads to financial viability of the proposed project * Development of a financial model document will include a ten year pro forma forecast of the income statement, balance sheet and cash flow statement. The financial documents can also be presented to lending institutions and venture capitalist to obtain financing and investments * Capital and Project Cost requirements * Payback period and financial indicators analysis * Gap Analysis and value propositioning / concept definition * Realistic project / Concept sizing, and scope that will achieve equity investment, debt financing and supporting appraisals. * Implementation and roll-out plan and risk registry. This include setting a time-line of implementation and phasing-in approach * Conceptual Design Master Planning of project and land in relation to surrounding areas. This will facilitate the selection and identification of the acceptable plot to use for the project. * Development of functional program for all services and departments in each facility as well as preliminary space requirements.

6 Ventures Healthcare team of Gulf-based business planning specialists makes it our `business to help your company grow operationally, commercially and financially. We offer our expertise to organize your enterprise and implement activities necessary for your venture to succeed. - A good Business Plan is necessary for effective operational purposes, where time and resources need to be utilized optimally. The hallmark of a successful venture is its focus as also the strategies and plans it uses to realize its objectives and maximize its opportunities. Every aspect of business requires planning and deliberation and it is worth the effort to create and update your business plans, Marketing Plans and Strategic Plans. Your plan is virtually your modus operandi which details and integrates every component of your business to achieve your targets effectively. - Banks and venture capitalists use Business Plans to measure your capabilities and resources as well as forecast your performance. Presenting a clear and professional blueprint could win you many a potential investor. - Planning helps you anticipate roadblocks in your business and formulate responses to contingencies, besides giving the manager and the personnel a greater understanding of your business and of the options available. Planning apprises you of your strengths and weaknesses. - No business plan is complete without a marketing plan. Marketing Plans show you who your customers really are and the best way to reach them. You also need Strategic Plans to position your products, increase sales, streamline costs and increase efficiency in order to move your company in the right direction. - In today s commerce-driven world, competition is rife, no matter how creative your business concept. Strategic Plans give you the tactics to steal an edge over your competitor and address the threats to your business. With changing technology, capricious customer demands and increasing sophistication, you need to `plan your business tactics effectively. Our services include: - Development of Modus Operandi for organizations and companies which detail and integrate every component of the business to achieve targets effectively. This includes administrative and clinical business units assessments. - Development of Business Plans, Marketing Plans, Growth Plans and multi-years strategic plans. This is done at the system / medical center, institutional and clinical programs levels. The plans cover a full range of strategic issues focusing on growth and enhanced market positioning. The plans also improve organizational performance and in obtaining future financing and influx of capital investments. - Assist in implementation of plans and monitoring of progress (Translating the strategy into practical action plans) - Benchmarking improvements against international standards and offer advice for improvements - Resource prioritization and strategic capital planning.

7 Is your organization prepared and capable of developing a new healthcare facility What other considerations should be given to ensure that the project will be successful and profitable How will the facility operate and what services / programs should it deliver? What tools does the owner need to measure performance and progress All of these are valid questions that each investor should consider prior to embarking on a very large investment opportunity in developing a healthcare facility or system. Ventures Healthcare can assist the Owner in not only obtaining the right answers but also in settingup and managing all of the elements that represent a Comprehensive Facilities Program Management approach. The program encompasses: - Assessment of internal organization s capabilities and position to undertake development of new facilities. This includes formulating the vision, strategies and tactics of the stakeholders. - Building internal capacity and capabilities to undertake development of projects which includes board structure, medical staff structure, management organization, and leadership development. - Development of organizational structure, governance and management control of new and existing facilities. This entails crating operating models and concepts of operations. - Geographic distribution of facilities and satellite planning. This takes into consideration planning for a continuum of care model that addresses ambulatory services, primary care, secondary care, acute care and post acute care

8 - Planning, development and deployment of Clinical Programs and services. This is performed in close coordination of management, clinical and physician leadership to cover a broad range of clinical services and to define appropriate delivery models for the programs and the facility, financial, manpower and technology implications for the services. Manpower planning encompasses all administrative and clinical categories including medical staff requirements and credentialing. - Business Line planning including governance, management structure, organizational structure, and integration of departments. It also includes alignment of management and medical staff to manage the facilities. - Financial planning including revenue and expense modeling as well as resource allocations and capital planning. The process includes funds flow within and between organizations / departments as all aspects of affiliations and merger options. - Financial operational audits, assessments, productivity measurements and analysis to develop performance metrics and benchmarking. Determine the financial marks to measure the organization s progress towards achieving financial targets. - System / Network / Group Practice formation which can le ad to mergers and acquisitions and other partnerships. The process begins with an evaluation of potential partners, and asset divestiture; and leads to negotiation, final appropriate selection and implementation planning

9 What type of facility will I need, how much will it cost and what are the services to offer? What is the proposed size and location of the facility, and how can it function efficiently? Who will operate the facility and what are the tools that will be used to manage its clinical, administrative and financial operations? How can I get the best qualified designer(s) and contractor(s), and make sure that the project is built on time and within budget? How can I measure the performance of the project and optimize outcomes? Unless an Owner has had extensive previous experience in developing healthcare facilities and in operating them, a specialized Program Manager will be needed to represent the best interest of the Client and to oversee the implementation of the project. VHC has the required expertise in healthcare administration, healthcare facility planning, clinical services, financial services, information technologies, equipment technologies, design and construction requirements, and project management to Guarantee the successful implementation of a new healthcare project from inception to commissioning. - Development of new program vision and mission. - Clinical and program capacity analysis and development of requirements (throughput analysis, bed need assessment) - Alternative facility scenarios, including projected space needs, cost opinions or orderof-magnitude cost evaluations and construction phasing Integrated capital planning and forecasting across facility, strategic and IT initiatives - Planning for information technology requirements, including capital cost estimates - Service Line Development and operations management. This includes provision of concept diagrams detailing operations and process planning, operations concepts, patient encounter design and process improvement. It also includes care modeling and simulation in the form of flow diagrams, staffing analysis and projections, and planning for individual services or product lines with all information technology requirements and cost estimates. - Development of detailed clinical and functional requirements by department and service level. This includes programming every room in the facility as well as departmental adjacencies and stacking. - Development of space programs for the facility according to American Institute of Architecture Guidelines. This is normally carries out in association with a healthcare planner.

10 - Plot and site selection based on demographic demands, availability of public utilities, availability of public transportation and roads, future growth and expansion requirements, competitive market positioning and other factors. - Development of project projected budgets which include construction cost, consultants and project management company fees, medical equipment and furniture cost, as well as operating costs (labor and supplies) during the first year of operation. - Obtaining licenses and approvals from regulatory agencies as well as local municipalities. This includes obtaining accreditation of the facility and credentialing its staff. - Project Management from the inception of the project to commissioning of the facility (Completion) on behalf of the owner(s). This includes selecting and overseeing the performance of the Project / Construction Management Company, the Main Design Consultant and Sub-Consultants, Equipment Contractors, and the Facility Operator(s). The scope of work includes but is not limited to: * Leading the project management and operational planning function that compliments the design and construction team. * Scheduling of activating management * Coordination of efforts and tasks * Budget Management and cost control * Issuing Requests for proposals or tenders for the appointment of: ~ Project and Construction Management Firm. While the traditional role of the PM/ CM firm has been on scheduling, project time line control, control of expenditures, oversight of the contractor, VHC requires in depth expertise in healthcare planning, design reviews, health and safety, and other health related design issues in order to effectively oversee the work of the consultants and contractors. VHC will issue the proper RFP on behalf of the Client to secure the most qualified PM/CM firm for the project and will assist the Client in making the right selection. ~ Design Consultants. Designing healthcare facilities requires specialized experience at every design stage. While several international firms have this experience, VHC ensures that the correct consultant is selected for the particular project. It also ensures proper coordination among all of the sub-consultant. One of the key requirements is the accuracy and comprehensiveness of the construction documents that will be generated in order to reduce the amount of sight interpretation and intervention in design work or shop drawings. Elevating the quality expectations of the design consultants is paramount to completing the project on time and within budget. ~ Contractor(s). Not all Contractors are qualified to build hospitals. Some do not understand the proper sequence of events and coordination that is required to complete the job in a timely manner. VHC assists the PM/CM firm make the prudent selection and institutes performance measurements to avoid and reduce claims or variations. ~ Facility and Management Operator(s). ~ Other Specialty Consultants and outsourcing services * Perform tender response evaluations and recommend selection to owner * Oversee the work of the design consultants and ensuring quality and timely submission of deliverables * Participate in Value Engineering exercises

11 * Provide construction oversight services * Secure licensure and regulatory approvals * Conduct second opinion studies * Perform detailed equipment and furniture planning (FF&E). * Project management and implementation of all health informatics components. * Procurement alternatives (Purchase, lease, rental, etc.) - Performance Process Outcome Management. Measurements of cost savings, revenue enhancements, quality improvements, human resource development and customer satisfaction. The performance management objectives include: * Identifying set of key metrics (key performance indicators) to establish quantifiable measures of how each process is operating * Integrating process measurement activities with other organizational measurements and reporting efforts such as demonstrating value, benchmarking, planning and forecasting and quality reporting. This is done on a system wide basis. * Developing tools and techniques for future monitoring of performances in order to enable optimization * Align the entire organization to understand the workflow across all departments and functions

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