Welcome to the GE India Case Study Challenge!

From inspiration to imagination at work, GE has been at the forefront of innovation.

With newer opportunities and ever-increasing challenges, GE works on things that matter!

Heres your opportunity to try and solve one of Indias toughest healthcare challenges and
showcase your genius!


PREFACE
Ravi and his wife Sapna reside in a village in one of the districts of Karnataka, India. The couple is
expecting their first child and wants to ensure a safe maternity. They are also wary about any
complications that might arise during the delivery. The clinic nearby caters to the basic healthcare
needs of the town. But complicated cases are referred to the hospital in Mangalore which is 160 kms
away. This has been a concern for the local population. The cost of treatment in the city hospitals is
another challenge as patients and their families have to arrange for finances and be prepared for the
hospitalization costs.
Dr. Waghe from the Government Hospital at Mangalore shares similar concerns. Expecting mothers
who arrive at our hospital at late stage of their pregnancy are sometimes diagnosed with
complications which are difficult to address. There are certain cases where infants are referred to us
by doctors of near-by villages due to lack of adequate healthcare facilities and infrastructure in their
villages. But at times they arrive too late for us to help them out in anyway.
A skewed distribution of medical facilities between urban and rural India has resulted in limited
access to quality and specialized medical care services to the rural population. Research has pointed
out that only three out of ten people ultimately get treated in tier 3 and other small towns. This
reflects a huge potential for infrastructural investment in these markets and a gap for healthcare
delivery that needs to be plugged.
For GE Healthcare, the backbone of the In Country for Country model (products for local customers
and local environments) rests on tier 3, 4 and 5 towns - these are markets with huge potential for
hospitals/healthcare services and where GE would like to grow its footprint, with a special focus on
the Maternal and Infant Care segment.








THE HEALTHCARE INDUSTRY IN INDIA
A report on Indian healthcare forecasts the USD 52.7 billion sector to grow at 13 per cent per annum.
It is expected that the healthcare will double to USD 106.3 billion in the next five to seven years. The
healthcare industry is poised for growth with these drivers:
Changing landscape (faster up gradation in technology, new product innovation, burgeoning
middle class, political agenda, government expenditure as a per cent of GDP),
Improvement in healthcare delivery and financing (large private sector players, rise in
insurance, large players targeting small towns), and
Changing patient profile (increased incidence of lifestyle diseases, rise in disposable income,
growing patient awareness, access and preferences, increased life expectancy)
Industry bodies have been lobbying for the healthcare sector to be given infrastructure status and
associated tax benefits that will trigger investments in hospitals. If this demand is accepted, it would
give an additional fillip to the healthcare industry in India
However, there are some alarming statistics to be shared here. With 20 per cent of the world's
disease burden, we have only 6 per cent of the world's hospital beds. Hospital beds per 1000
population in India is less than 50 per cent of that in other emerging markets like Brazil and China
and less than 35 per cent of the world average. Even the infrastructure that exists is highly
fragmented and disproportionately distributed. It is dominated by public healthcare facilities which
have 62 per cent of the beds while private players account for the remaining 38 per cent. The
healthcare insurance industry has witnessed growth in the recent years. However, not to the level
expected, considering 64 per cent of the healthcare expenditure in India is out-of the patients
pocket.
Despite these barriers and challenges, improved quality of care which is both accessible and
affordable is a felt need across tiers of healthcare facilities.
MATERNAL AND INFANT CARE MARKET IN INDIA
With approximately 30 million births India creates a mini Australia every year. 74 per cent of these
births occur in non-metro locations out of which only 49 per cent are in equipped healthcare centres.
The magnitude of the problem can be gauged by the fact that Maternal Mortality Rate and Infant
Mortality Rate in India is 230 and 55 respectively, as compared to 11 and 5 for developed countries.
A majority of deliveries occur in small nursing homes and primary health centres. These centres are
equipped to handle a normal delivery. However, in case of complications or post-birth care scenarios,
most of the cases are referred to secondary health centres in bigger towns, district hospitals, or city
nursing homes. The time lost in moving from a primary to secondary health centre is a major reason
for fatalities that occur in infants/mothers.






GEs PRESENT BUSINESS MODEL & FUTURE PLAN
As a pioneer in the healthcare industry, GE Healthcare manufactures large medical equipment e.g.
CT, MRI, X-Ray etc. which are used in hospitals located in metros, tier 1 & 2 cities. These are high-price
sophisticated healthcare equipment with high margin and low volume. The customers who purchase
the equipment are trained and skilled in using them. Also, the equipment is serviced either by GE
engineers or by the bio-medical engineers recruited by these hospitals.
However, given the opportunities in the non-metro markets, GE Healthcare has increasingly ventured
into manufacturing smaller equipment that meets the needs of these markets, for example, the
Lullaby warmer, LED Phototherapy, and ECG.
GE Healthcare has
gradually been adopting
an in country for
country approach to
product development
researching, developing
and manufacturing
technology that is
appropriate for local
customers and local
environments, to bring
down costs and make
diagnostics more
affordable and
accessible. For example,
the growing infant
mortality rate posed a
major problem for India with more than 5 per cent infants dying in the country. GE used to import the
Lullaby Baby Warmer, at a substantial cost of $20,000 which acted as a price barrier. But, now that it
has been especially designed for the Indian market and is being manufactured locally in India, the
cost has come down drastically.
GE envisions that the next wave of growth for the company will come from these markets, looking at
newer and better technologies for screening, earlier diagnosis, treatment assessment and
monitoring, which is both cost effective and accessible. This requires that the equipment be reliable
and robust. The equipment must be low cost as the price affects the margins of the product
considerably. Hence these products need to be sold in high volumes to cater to the affordability
factor of customers and thereby ensure profitability for GE.





Additionally, the customers in the tier 3/4/5 markets are neither trained nor skilled enough to use the
equipment. Furthermore, in case of any service issues with the equipment, both GE personnel and
external engineers are not readily available to service these markets.
The ability to use GE equipment is critical for winning in this market and depends on the following
parameters:
- Ease of use
- Minimal training on equipment (intuitive to use)
- Parts & Service Delivery
- Maintenance (regular maintenance and replacement of parts)
- Logistics to serve the population in tier 3/4/5 towns
GOVERNMENT INITIATIVE
A number of steps are being taken by the Government to ensure that quality care at affordable cost
reaches the masses in the smaller towns of India. One such initiative is the Janani Suraksha Yojna
aimed at reducing maternal and infant mortality rates and increasing institutional deliveries in below
poverty line (BPL) families. The government offers cash-assistance to expecting mothers so that their
deliveries happen in institutions (private/government centres/nursing homes).
Before this scheme 45 per cent births occurred in homes with poor health and hygiene conditions.
With the successful launch of the Scheme, this figure has reduced to 35 per cent resulting in
approximately. 2.6 million additional births through institutional delivery. This has led to an increase
in demand for care where more consumers are reaching out to private setups apart from the govt.
established facilities.
However, the current market is unable to meet the requirements of this surge in demand due to
inadequate infrastructure and lack of trained/skilled manpower.
TARGET GROUP
For the purpose of this case, the focus is on the private small-town mom & pop clinics in tier 3/4/5
towns.











GEs CHALLENGE
Given the current demand of this market and the alignment of GEs low cost product solution to tier 3
and below markets, these products should ideally be a running success in these mom & pop clinics.
GE expects the demand for the products to be in tens of thousands, however till date it has only
served a few thousands, due to constraints in reaching the market.
The challenge for GE is to reach out to these untapped markets and drive usage of their equipment in
mom & pop clinics. With its designed for India products that are affordable and reliable, GE is on the
look-out for solutions that can drive high volumes of these products in these markets. The challenge
exists in shortage of trained manpower that can service or fix the equipment in remote locations.
The ability to implement a business model with the right channel partners for such extensive services
all over the country and proper governance is another challenge. The options for GE are to either go
to this market on its own or come up with a strategy by partnering and sharing channels with other
healthcare/service providers.
In the current scenario, 90 per cent of
GE sales happen through its direct
sales force. The GE sales force structure
for the Maternal & Infant Care segment
is represented alongside.
Product Sales Specialists are domain
experts and handle sales for the
Maternal & Infant Care Segment.
Specialists handle sales for all products
under the Life Care Solutions segment
(Maternal & Infant Care is part of this
segment).
Generalists handle sales for the entire product portfolio of GE Healthcare (including all segments).
The remaining 10 per cent of GE sales is through a dealer or distributor network (approximately 40
dealers or distributors located in big cities). The GE empanelled dealers in turn create sub-dealers to
enable sales. These multiple layers end up adding cost to the structure (typically a double mark-up),
which in turn increases the cost for the customer. In order to be empanelled as a GE dealer
/distributor, a vendor must meet rigorous business/financial criteria. This poses a big challenge for
GE towards creating a large dealer network across Tier 3/4/5 towns.







YOUR CHALLENGE
Design an overarching strategy for GE to succeed in delivering healthcare equipment and support
services in tier 3, 4 and 5 towns. While doing so provide particular emphasis on the aspects detailed
below:
a. Provide solutions for GE to reach the customer in the specified markets along with a map of
the appropriate channel structure. The proposed solution should not have too many layers of
distribution channels to ensure that the cost of the product remains low.
b. Draw a plan of action for GE to fulfil the training and awareness needs of the customer.
Explore avenues that will help the customer self-maintain the product (troubleshoot, part
replacement, clean, upkeep etc.) thereby providing a sustained model of delivery of
healthcare support solutions.
c. GE has a strong compliance policy when it comes to selection of partners or dealers. Draw
best practices from existing B2B/B2C MNCs to develop a strategy for selection of channel
partners in this market without it being a deterrent to the business.
Teams are advised to highlight some of the best practices followed by B2B/B2C MNCs in this market
segment and propose a benchmark for GE.
For the purpose of the case, you could consider the following as a definition of the tiers:
Tier 3 4-8 lac population
Tier 4 1-4 lac population
Tier 5 Less than 1 lac population

Also, a visit to a private clinic or a primary health centre in a sub 1 lac population town is
recommended for understanding the challenges on the ground.













APPENDIX
GE HEALTHCARE IN INDIA
GE recognized India's healthcare challenges of cost, access and quality and was amongst the few
MNCs to set up manufacturing plants in India to produce high end healthcare imaging products, in a
cost-effective manner. GE also set up a Research & Development Centre for designing healthcare
solutions In India, for India and employs over 1500 scientists and engineers specifically to develop
healthcare solutions. GE Healthcare has received multiple awards from the Government of
Karnataka as well as Government of India towards achieving growth and excellence in exporting
medical technologies from India. GE has already developed many products in India, for India, some of
which are exported to other markets for e.g. MAC 400 (a portable ECG device), Lullaby baby warmers,
Phototherapy solutions, Vivid P3 (cardiac imaging ultrasound system) and a number of ultrasound
systems.
GE CURRENT SCENARIO
GE Present GE Future (requirements)
Tier 1, 2 Tier 3, 4, 5
Large equipment

e.g. CT/MR etc.
Smaller equipment that meets needs of these
markets
e.g. LED PT, Lullaby Warmers, ECG etc.
Delicate, High end equipment Robust, reliable, rugged
High price + Sophisticated

Low volume products predominantly
Low price + Price sensitive

Need higher volumes for the same level of
revenue
Trained & skilled manpower and customers Need to train customers to build skillset and
expertise (both technical & clinical)
Service delivered through GE personnel and
staff recruited and trained by GE & customers
Neither GE nor trained staff present currently for
service or maintenance needs; need to address
the gap











HEALTHCARE SCENARIO IN SMALL TOWNS
Untapped Opportunities
A district and sub-district level analysis shows a large gap and lack of good secondary care
facilities in towns across the country
On an average people travel up to 200 kms to avail quality secondary care/ tertiary care
services
The need of the day is to strengthen secondary/higher secondary level healthcare at the
district HQ level where 70 per cent of population resides
A largely unregulated industry and skewed bed additions biased towards the metros have
resulted in 80 per cent healthcare facilities servicing less than 30 per cent of the countrys
population
Private hospitals are mostly single doctor owned nursing homes offering very basic
healthcare services at questionable quality

Challenges
High capital costs: Depending on the region and real estate costs, an average hospital requires a
capital infusion of Rs 40 lakhs to 1 crore per bed. Land and building account for almost 40 per cent of
the total project cost and affects the viability depending on the resulting per bed cost.
Medical equipment: About 40 per cent of the costs in a tertiary setup are taken up by medical
equipment (cutting edge technology at the time of purchase). This becomes obsolete within 5-7 years
of the setup. This is even more challenging as majority of equipment is imported and very few local
reputed manufacturers exist. This will lead to higher treatment costs and low utilization rates
resulting in undesired operating margins.






Please note that the contents of the case have been created jointly by GE India and the Industry
Institute Partnership Cell, NMIMS Mumbai.






GUIDELINES FOR WORKING ON THE SOLUTION
Registered teams are expected to work on the Case Study shared by GE and present the
analysis/recommendation in the form of a power point presentation, not exceeding 11 slides
(including one cover slide)
Each team is allowed to submit only 1 entry at the end of the challenge. In case of multiple
entries from the same team, we will consider only the first (earliest) entry for evaluation
Participating teams are required to send in their entry in the form of a pdf file (ppt converted
to pdf) over email to genius@ge.com
The name of the pdf file and the email subject line must be
Genius2012_InstituteNameCode_TeamName
All entries must be submitted by Sunday, October 21, 2012 11:59 pm
Any team submissions made beyond the stipulated timelines or in any other format will not
be considered for evaluation
Our mailbox may receive high traffic close to the deadline. Hence, we request the teams to
send across their entries well in advance
All teams which have successfully submitted their entries within the stipulated time will
receive an acknowledgement of receipt within 2 working days
EVALUATION PROCESS
Each entry will be carefully evaluated by a panel of senior leaders from GE
The analysis should be presented in a way that it solves all objectives in the best possible way
We encourage teams to visit a nearby village or Tier 3/4/5 town to understand the case in
depth
The panel will shortlist the Top 5 teams for the Grand Finale based on the following criteria:
Strategic Focus
Depth of analysis
Originality, Innovation and Imagination
Ease of Implementation of the solution
Understanding of the challenge in a holistic way
Quality of presentation
The Top 5 teams will be announced on Friday, October 26, 2012










GRAND FINALE
All members from the Top 5 teams will be invited to attend the Grand Finale in person at
Mumbai. Details on the pre-work and other requirements for the Grand Finale will be shared
with the shortlisted teams accordingly
The Grand Finale will be hosted at Mumbai on Thursday, November 8, 2012
The Jury for the Grand Finale will consist of senior leaders from GE and senior faculty
members from reputed B-Schools
All costs pertaining to travel of the shortlisted teams to Mumbai, boarding/lodging, as well as
return to the campus will be borne by GE
The decision of the Judges pertaining to Genius will be final and binding

PRIZES
The Winning Team shall receive a cash prize of INR 1,50,000. The runners-up team shall
receive a cash prize of INR 75,000. All members of the Top 5 teams will be felicitated by
personalized certificates of achievement.
The Winning Team members will be given an opportunity to get mentored by senior leaders
from GE.
The Winning Team members shall be eligible for a Pre-Placement Interview (PPI) for the
Entry-level GE Leadership Programs, basis eligibility criteria and Jury discretion.

All the Bestand may the Better Team Win!!