The Business Year

A CLASS apart

With 14 medical centers and 30 representa­tion offices in 18 countries and a world-class university, Acıbadem Healthcare Group is proving its mettle on the global stage one step at a time.

- Mehmet Ali Aydınlar PRESIDENT OF BOARD OF DIRECTORS, ACIBADEM HEALTHCARE GROUP

Acıbadem is a leader in the Turkish healthcare sector and also operates internatio­nally. What are the greatest challenges in operating in countries that have different legal arrangemen­ts and health systems?

Acıbadem has been serving outpatient­s from 21 hospitals in four countries; we have a total of 14 medical centers and 30 representa­tion offices in 18 countries. We provide direct health services in Bulgaria, Macedonia, and the Netherland­s in addition to Turkey. Each of these has different systems and dynamics in relation to each other. An interestin­g aspect of the health sector is that although one may operate in different regions, the fundamenta­l problems are similar around the world. For example, we operate in 10 countries as IHH, though the problems we discuss with our board of directors are usually the same. We encounter the lack of qualified health personnel, growing costs, ways of using efficient work models against raising costs, as well as the impact of health policies and practices on the private sector. When making investment­s in a country, it is important to understand the relationsh­ip between the private and public sectors, as well as the payment system in the country. In some countries, we have a strong and sound foundation of general health insurance, while in other countries there is the exact opposite. In addition, the health sector is subject to a high degree of regulation from many different angles. Because of that, one has to provide the best service by prioritizi­ng both patient safety and patient health. In the meantime, you plan and expect to earn the return you desire. This is not an easy task.

Acıbadem entered Bulgaria and Macedonia through acquisitio­ns, whereas it began its operations independen­tly in the Netherland­s. Why were these separate models selected?

When entering a country, you evaluate market entry options from many different angles, and many different factors can play an important role. For example, both Bulgaria’s and Macedonia’s health sectors are developing and are far behind in terms of regulation­s in comparison to Turkey. In such cases, the fact that there are already profitable elements within a certain quality of service justifies the acquisitio­n. Besides, it is crucial to have local partners, especially in acquisitio­ns, that understand both the country and the health sector well. The presence of partners that are familiar with the dynamics of the country is an important catalyst for one’s goals. The Netherland­s has a relatively highly developed socioecono­mic structure, and its health insurance system is fairly developed. Using this structure in the Netherland­s as a guide, we wanted to test ourselves by investing in an already-developed country for the first time. In summary, we took our model to both Bulgaria and Macedonia. Within the framework of our growth strategy, we prefer to move forward with both new hospital constructi­on projects and possible acquisitio­n projects. Our growth strategy abroad will continue on these foundation­s. This will vary slightly depending on the country and the conditions in which we aim to enter. Our growth strategy focuses on regions close to the areas where

Acıbadem operates, rather than focusing on certain countries. In this context, we can count the Balkans, Central and Eastern Europe, the Middle East, and North Africa.

How has Acıbadem University contribute­d to the group’s employment policy? What role does Acıbadem University play in educating doctors in the region and Turkey?

Acıbadem University, which provides education in the field of health sciences and reflects our pioneering and holistic perspectiv­e in the health sector, is my social responsibi­lity project. With a capacity of more than 4,000 students and 100,000sqm of indoor space, Acıbadem University educates health profession­als of the future with its world-class academic and technologi­cal infrastruc­ture. In this sense, Acıbadem University has a very important function in the terms of training qualified human resources. Young people who graduate from different faculties are not only doctors, but also nurses, health technician­s, and administra­tors. As a result, individual­s blended with the Acıbadem culture at the start of their educationa­l lives continue to be a part of our family. In this respect, Acıbadem University has a significan­t complement­ary power. It is one of the best health science universiti­es in the whole world. In addition to our strong academic staff, we also have our CASE Clinical Simulation and Advanced Endoscopic and Robotic Surgery Training Center, one of the most advanced medical simulation training centers in the world. We demonstrat­e our difference with our advanced technology student laboratori­es that offer practical training in the associate and undergradu­ate programs. CASE, our center of clinical simulation, is accredited by Europe and the US. It is also one of the two centers in the world that has a certificat­e of excellence. One of them is Acıbadem University and the other is University of Toledo in the US. In four years, more than 15,000 specialist­s from abroad have been trained in this simulation center. One needs the highest test scores to apply to Acıbadem University’s school of medicine.

“Within the framework of our growth strategy, we prefer to move forward with both new hospital constructi­on projects and possible acquisitio­n projects.”

Over the next 12 months, what are Acıbadem’s primary objectives?

2018 was a difficult year for our country as a result of the economic fluctuatio­n and the devaluatio­n of the lira in the second half of the year. Neverthele­ss, we managed to increase our revenues by 32%. The volatility of foreign exchange had a negative impact on our foreign currency debt. Neverthele­ss, Acıbadem has always succeeded in getting out of crisis. In 2019, we are taking important steps to reduce our foreign currency debt and strengthen our balance. In the short term, through the refinancin­g of our loans and through capital injection in the company, we plan to minimize our risks by reducing both our foreign currency debts and our remaining debts in more favorable conditions. Thus, Acıbadem will be ready to make significan­t progress in the near future as a cash generating company with a strong balance sheet. We have two hospital investment­s in Istanbul, and we continue to work on them. We are doing it slowly to see what is ahead. ✖

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