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Growth Spurt in Healthcare

As the Lebaran holiday approaches, ensuring our health is paramount to fully enjoy these precious moments with family, free from any concerns. Amid our preparations, there's uplifting news from the healthcare sector, particularly from Siloam Hospitals, which recently reported significant achievements in its financial performance for 2023.

Siloam experienced an extraordinary increase in revenue, with earnings soaring by 73.91% yoy to IDR 1.21 tn. Meanwhile, their revenue also grew by 17.57% yoy to IDR 11.19 tn.

Source: Bloomberg

Breaking down this revenue, the largest contribution comes from the non-specialist segment, which saw an increase of 17% yoy, amounting to IDR 8.66 tn. Meanwhile, the specialist segment contributed IDR 2.53 tn, marking a 29% yoy growth.

What's particularly intriguing in the specialist segment is the inclusion of what's termed as CONGO (Cardiology, Oncology, Neurology, Gastroenterology, Orthopaedics, Uro-Nephrology). This specialized cluster represents a competitive edge for Siloam Hospitals, contributing a significant 38% to its revenue. Notably, the contribution from the CONGO segment has shown a consistent quarterly increase throughout 2023.

Source: Company

Siloam is ambitiously planning to grow more on its CONGO specialties. Their strategy involves delving into more complex surgeries, aiming to capture the market that typically seeks medical treatments abroad. By offering high-quality medical services locally, Siloam intends to provide a compelling alternative to going overseas for treatment.

Achieving this goal is made possible through the availability of skilled specialist doctors. Currently, Siloam boasts a roster of 3,000 specialist doctors, with about 30% of them being exclusive to Siloam. This exclusivity is particularly advantageous, as it mitigates the common risk in the healthcare sector where a single doctor practices at multiple hospitals.

Siloam not only aims to grow in specialized medical sectors but also maintains a steadfast commitment to the quality of its medical professionals. Doctors at Siloam engage in partnerships and share knowledge with peers internationally, especially with those in Singapore

Furthermore, Siloam boasts the highest Average Revenue per Occupied Bed (ARPOB) compared to its peers. The ARPOB metric is crucial as it reflects the ability to compensate doctors. A 25% portion of the patient's bill is allocated to the doctor fee. 

Source: Company

This higher ARPOB not only ensures that doctors are well-compensated but also makes Siloam an attractive workplace for top medical professionals, including those from abroad.

Looking ahead, Siloam is focusing on internal growth, with plans to expand its capacity further. Currently boasting around 8,700 beds, the hospital group aims to increase this number. 

This expansion is not merely about adding more beds; it's also about enriching their specialist services, particularly in the CONGO segment.

Financially, Siloam is targeting to maintain an EBITDA margin of 30% and achieve revenue growth of 15%-20% this year. These goals are attainable through strategies including a 3-4% price increase, the addition of 1-2 hospitals annually, and an increase in bed capacity.

While recognizing SILO for its positive outlook and impressive achievements, we lean more towards HEAL as a preferred choice, particularly due to its potential to benefit more significantly from economies of scale, primarily because it generates a larger portion of its revenue from BPJS.

Even with a larger contribution from BPJS, the EBITDA margin for HEAL is still very attractive.

If we look at SILO, whose revenue from BPJS is only 20-25% compared to HEAL, which last 2023 was 70-75%, HEAL's EBITDA margin can remain high at 27.7%, just slightly below SILO's 30%.

This indicates that the more patients a hospital has, the higher the demand for medicines and medical equipment, thus resulting in a higher bargaining power with suppliers. HEAL can ask for better discounts from its suppliers.

Hermina's stronger alignment with BPJS not only positions it to capitalize on the vast market of insured patients but also underscores its pivotal role in Indonesia's healthcare ecosystem, offering affordable and accessible care to a broader segment of the population.


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