Home care startups have been bringing in serious capital in recent years, both in the United States and abroad. India in particular has been a hot market, and a closer look reveals that while the country is different from the U.S. in some key regards, some of the same factors–including demographics, industry fragmentation and mobile technologies–are driving investment in home care in both nations.
Just like in the U.S., the country is facing a growing aging population. In 2011, India’s population census tallied 104 million elderly persons age 60 years old and above, according to a report published by the country’s Ministry of Statistics and Programme Implementation.
The country’s aging population is expected to only increase in time, with the demographic projected to grow up to roughly 300 million in the next 10 years, according to Varsha Tagare, MD, managing director of Qualcomm Ventures India, based in Mumbai.
Qualcomm Ventures is the investment arm of Qualcomm Incorporated, a San Diego-based technology firm that specializes in the development of mobile platforms for use in a variety of settings, like health care. Including the U.S. and India, Qualcomm Ventures invests in companies in markets including China, Korea, Israel, Europe and Latin America.
“Home health care in India is a large market with growth opportunities,” Tagare told Home Health Care News via e-mail. “It had been an unorganized market in India for a long time, being served by standalone, small players; [however] the need for quality home care has been there, always.”
Recognizing this need, Qualcomm Ventures India recently participated in a $26 million Series C funding round for home health provider Portea Medical.
Based in Bangalore, India, Portea is a private-pay provider of a variety of health care services, including primary care, chronic disease management, elder care and post-operative care in the home setting. In 2015, the company’s footprint spanned 24 cities, servicing roughly 50,000 patients, according to TechCrunch.
On a broader scale, the country’s health care landscape continues to experience tremendous growth.
Its hospital and diagnostic centers attracted foreign direct investment worth $4.3 billion between April 2000 and March 2017, according to India Brand Equity Foundation, a trust established by the country’s Department of Commerce and Industry.
“We were impressed by the home health care opportunity in India and the strength of the Portea management team,” Tagare said, regarding Qualcomm’s investment in the home health provider.
A draw to Portea’s model for investors like Qualcomm is its utilization of mobile platform in delivering care, according to Tagare.
“[Portea’s] technology-driven approach was built to scale with a strong mobility focus,” Tagare said. “Family members could monitor their loved one’s health through the Portea app and know their health status. Blood tests, diabetes care, medicine delivery, physiotherapy can be initiated [via mobile], along with the ability to chat with doctors and access to health records.”
The utilization of mobile platforms by home health companies like Portea eases any logistical burdens felt by the country’s health care providers, Tagare explained.
“In India, it reduces the pressure on hospitals, doctors and caregivers to focus on critical patients in hospitals, while remotely monitoring patient vitals who are in home health care,” she said.
Focus on private care
A contributing factor to the strain on India’s health care and senior care capacity is the country’s adoption of universal health care, according to David Kaplan, CFA, director of New York-based investment firm S&P Global Ratings’ health care group.
“I think some of that is the for-profit nature of the U.S. health care system. Here, a lot of the nursing homes are for-profit … therefore, you find adequate capacity in the U.S., providing that there is the reimbursement to make it profitable,” Kaplan told HHCN. “Whereas, in countries where there is socialized medicine—and it’s not just India—a lot of [them] have waitlists for providers and for nursing homes.”
For Kaplan, this is the reason why home health is growing in popularity in India.
“Home-based care really is much, much cheaper,” he said. “You’re really just paying for the nurse or the aide [and] there’s no capital that has to be invested. It’s the cheapest side of care.”
The rapid rise in growth of home health companies like Portea in India is no surprise for investors like Kaplan.
Apart from Portea, Mumbai-based home health provider Care24 raised $4 million in 2014 during its Series A funding round from Haryana, India investment firm SAIF Partners. Similarly, in 2016, Mumbai-based Zoctr, a home health startup founded by Nidhi Saxena, raised $1 million in funding from the founder of SPA Capital Sandeep Narwal and founder of Organic Wellness Krishna Guptain, in addition to a few other angel investors.
“Demographics are driving continued demand, in terms of a population that’s aging and people are living longer,” he said. “Thanks to many of the medical developments in recent decades, the demand is increasing and, certainly, if the demand is there and the opportunity is there, it’s not surprising that there would be an interest or capital available to support that.”
As the U.S. home health industry continues to grapple with a plethora of regulations, Kaplan foresees a growth in interest in a private-pay home care model.
“There certainly is a demand for a home health kind of private-pay element,” he said. “That could be an area of growth over the coming years [as there are] more people using home health services out of pocket where needed that I think we haven’t seen so much in the past.”
This is certainly the case for patients in India, according to Tagare.
“With purchasing power growing across the board, demand for quality health care has increased significantly in India,” she said. “There has been a steady rise in corporate hospital setup in India with focus on quality healthcare. As a result, patients are looking for quality healthcare at home and are willing to pay for it.”
Written by Carlo Calma