India’s Home Healthcare market is seeing a steep rise as Covid-19 hits hard

Home healthcare as a market has been a game changer ever since it was launched in India. The segment was touted as the next big thing, and it sure has lived up to its expectation.

As per USA’s Grand View Research, the India home healthcare market size was valued at USD 5.2 billion in 2019 and is projected to expand at a compound annual growth rate (CAGR) of 19.2% from 2020 to 2027. According to a survey by the Federation of Indian Chambers of Commerce & Industry (FICCI), as of 2019, about 54% of people preferred laboratory tests, delivery of medicines, and nursing care at home.

These are figures before the Covid-19 impact evaluation. After the pandemic has hit India hard, the demand for home care services has jumped to extraordinary levels. Players are seeing a rise in demand for their services by 40-60%, while expecting the overall demand to grow 10 times by the end of this year.  

The government too has been pushing the agenda of availing healthcare at home ever since the pandemic started showing its effect on the Indian population. It is by far a much safer option than visiting hospitals and other healthcare facilities, especially for the vulnerable section of people (in terms of age, medical conditions, and such). The people themselves are unwilling to step into a hospital, unless absolutely necessary.

All of this has decreased the footfalls in hospitals and similar entities, while in turn giving rise to the demand in home healthcare.

“Indeed, the demand and cognizance towards home-based care has skyrocketed amid the Covid crisis. The virus epidemic had also led to the closing of many hospital and private clinic out-patient units. Several hospitals have also been designated facilities dedicated to the Covid-19. This has been a direct cue for organised home healthcare players to step in and fill a critical gap, as lakhs of patients are struggling to get appropriate medical help in these pandemic times,” says Vivek Srivastava, Co-founder & CEO, HealthCare at Home (HCAH).

“Covid-19 has brought in a mixed response. On one side, people are worried about a healthcare provider coming into their homes and the risk associated with it, whilst on the other side, there are quite a few who need medical care and are apprehensive about going to the hospitals during Covid times,” says Dr. Mahesh Joshi, CEO, Apollo Home Healthcare Ltd.

“The challenges that the institutional healthcare facilities are facing due to Covid-19, can be effectively addressed by home healthcare. As a result, we have been surely witnessing a steep rise for our home healthcare and telemedicine services,” shares Vaibhav Tewari, COO, Portea Medical.

Ramping up & adding services that are more in demand

As market demands and conditions change, so does the service delivery. Apart from the usual service panel of home healthcare providers, they are also seeing a rise in newer frontiers. Thus, making them re-work on their services, by either adding new or ramping up the current ones.

HCAH has seen a significant surge in calls for teleconsultation with experts, Covid testing at home, medical equipment, home infusion & chemotherapy and ICU set up at home; and have scaled up dialysis at home and equipment delivery at-home services. They also vouch for how the trained medical staff at home has proven to be a saviour for the elderly population.

Additionally, they assert with being the first company in the country to launch the Home Isolation program. Likewise, they are conducting a lot of Covid-19 sample pick up at the doorstep.

“We also help industries and corporates with advisory, implementation and monitoring services around the health of their employees as they move towards post lockdown resumption of production. We are extending assistance to corporates with telehealth helplines dedicated to their employees in these challenging times. Additionally, we have created an oxygen bed capacity in RWAs and for certain corporates,” shares Mr. Srivastava.

Similarly, Apollo Home Healthcare is seeing a rise in demand for tele/video consultation, home chemotherapy sessions, and a significant demand for oxygen support devices, home isolation kits and non-invasive ventilatory devices like BIPAP.

“Monitored home isolation service to address the need of pre-symptomatic and mildly symptomatic Covid patients as recommended by ICMR was the new service line that we have started specifically during this pandemic. It is also preferred by patients, especially as it’s cost effective, convenient and comfortable,” says Dr. Joshi.

In addition, Apollo started with Telerehab services to address the need of continued physiotherapy for home bound patients. They have also launched the post Covid-19 rehab services for people with moderate to severe Covid-19 presentation, and who have been discharged from the institutions. This is aimed at providing holistic rehab at home including lung rehab, mental and emotional wellbeing.

Portea Medical too is seeing a demand hike in contactless healthcare for non-critical services such as minor ailments, fever, and health-related queries, and more.

Their specialized service for Type 2 diabetics patients named InControl, is helping patients to manage their health and fight the virus. Another initiative called Portea Health Prime, which is an exclusive service for the people over 65 years of age, is again proving extremely helpful as this age set of people are one of the most vulnerable.

“In the wake of the pandemic, we have introduced new services such as chemotherapy and dialysis at home. We are also offering home quarantine services for those who have tested positive for Covid-19, but display only mild symptoms or are asymptomatic. We have supported over 35,000 Covid-19 positive patients in the last two months, across different states. Considering the market dynamics, we plan to diversify into other much-needed verticals including training of medical workers and innovation,” says Mr. Tewari.

Making a case for Home Healthcare

Players across the board are seeing that home healthcare is proving to be a silver lining in the current situation. Citing some case studies of their own, they tell us how strong is the case for home healthcare right now.

HealthCare at Home

• We had this 72-year-old lady from Ghaziabad recently diagnosed with CKD – Grade 3, bedridden, already immune-compromised & suspected to have Covid-19. Since the daughter of the lady was in another part of NCR, and could not travel to her, she reached out to us. Not only we deployed trained & PPE-equipped nursing attendant by her side, but also got her Covid tests done (which came back negative). The doctor on call was well versed and managed her care plan smoothly throughout. With this kind of arrangement at home, her daughter had the peace of mind that her mother is being taken care of and is in safe hands.
• A couple of months ago, we received a request froman affected parent from Bangalore, whose daughter is suffering from PKU (rare disorder) and she was in dire need of a special food supplement Abbott Prophree. Our team went beyond the call of duty to get this delivered to the child amid the lockdown situation. In this case, this was a lifesaving medicine for the child.
• About 2 weeks back, we received a call from one of our corporate clients who was having mild symptoms of Covid-19 and was in a complete panic situation as to ‘what next’. When he reached out to our Employee Helpline, he was immediately connected to a doctor, Covid testing was done at home with a hassle-free sample collection, along with a psychologist and dietician tele consult. Not only his medical needs were remotely managed, but we took care of his emotional and mental health too.

Apollo Home Healthcare

• Of the first 250 cases that we handled for home isolation, only 12 required to be referred to a hospital during their 2-week monitored home isolation. Rest all of them improved and did extremely well and were discharged at the end of 2 weeks. This goes to show as to how effective this can be as a first line intervention for mild cases.
• All of this happened online, contact less care through effective use of technology and at a fraction of a cost. For instance, a per day hospitalisation cost for a non-oxygen bed would be anywhere between Rs. 3000-5000/day. In monitored home isolation, you are spending just about Rs. 300-600/day, which is 1/10^th of the cost. In addition, you are far more relaxed and comfortable at your home, than in an hospital environment. Also, not visiting a hospital reduces the chance of acquiring secondary infection.
• Above all, these 250 beds were then available for the more needy/deserving-moderate to severely Covid affected cases, who need to be in the hospital for better care. So, from multiple aspects, this is an extremely beneficial intervention for the patient, government, hospitals and the community at large.

Market forecast

As is evident, the already-strained healthcare infrastructure of India is even more burdened because of the pandemic. The market scenario is surely changing. With such fluctuations, it is vital to keep track of the current demands and tweak one’s business model and offerings to fit into the present scheme of things.

Agreeing to the above, Dr. Joshi says, “Covid has been an unparalleled event and its long-term impacts are yet to be seen. We will hence have to improve the community healthcare delivery system and home healthcare will be a very strong pillar in this paradigm shift. We are already witnessing this as many hospital chains have ventured into home isolation services.”

Experts also opine that simpler & more effective technology will become a key focus area, as service delivery takes a shift towards home & away from healthcare facilities. Training and skilling will also need a greater push, as it is important to leverage the technology by adequate skilled manpower.

Dr. Joshi further avers that health insurance will also become a game changer; there are already approvals in place for home care reimbursement for Covid care.

Mr. Srivastava supports the view, “Insurance sector has been honouring requests for Covid-19 at-home care, retaining no-claim bonus value even in the case of a claim for hospitalisation, and for the waiting period. This was something we have been hoping for long.”

HCAH has recently tied up with ICICI Lombard, GIC, which has offered additional benefits to the insured patients, at no extra cost. This would enable the policyholders to derive maximum benefit from their health insurance cover. As part of this offering, insured patients can get themselves treated at home instead of having to avail hospitalisation to avail of the insurance claim.

Such facilities are overall increasing the insurance demand. As per a report, after the pandemic, health insurance policy enquires have increased by 30-40%.

Even the government has scaled up its efforts and changed policies, while also introducing new guidelines for the industry to cope with the existing situation.

“In March this year, the Health Ministry and NITI Aayog, announced guidelines on telemedicine to step up the fight against the pandemic. As per the new norms, registered medical practitioners can use all channels of communication, including voice, video, and text, for diagnosis,” shares Mr. Tewari.

Armed with telemedicine and doorstep delivery of medicines & diagnostic services, home-based healthcare services are expected to form the bulk of the healthcare ecosystem in India going forward. This will also enable wider reach to the providers & more affordable care across the country, he adds.

As per experts, the opportunity is surely huge especially for home-grown start-ups offering healthcare at home and tech-based, scalable solutions.

“All this is and will attract several players and a lot of investment in this sector. Unfortunately, this has also led to a lot of fly-by-night operators. However, customers should be careful that all these players may not have the necessary clinical expertise to deliver care and can also end up worsening the conditions of patients at home. Thus, one should opt for players who have experience, demonstrated clinical outcomes, have high patient satisfaction scores and most importantly are accredited under QAI (India’s homecare standards),” informs Mr. Srivastava.

Wrapping it up

The world can only plan so much. There are numerous catastrophes, which are beyond the control & planning of humans. However, what sets the human race apart is the pace at which adaption can take place. Advancements have reached levels that have the capacity to help us quickly tune in to the new world norms. The world is witnessing the same right now with healthcare delivery.  

It can be safely deduced that home healthcare is not only here to stay, but is on its way to becoming a more efficient, more hi-tech & a more powerful sector.