Sinusitis

Development plan for the paid services department in the hospital. Your own business: how to open a medical office

The need for medical services is growing every year. According to the forecast, the market volume will grow to 2.865 billion rubles by 2021. from the current almost 2.5 billion rubles. According to the results of a study by MAR Consult conducted in 2017, more and more Russians are willing to pay for quality medical services: both for simple tests and for seeing specialized specialists.

In these conditions, opening a private medical clinic has great prospects even in conditions of high competition. The implementation of such a project will require fairly large investments on the part of the entrepreneur, taking into account the important features of this area of business.

In this business plan for a medical center, we will describe a brief organizational plan and touch on the points necessary for the success of the business. At the end of the article, an example of calculating payback is offered for your reference.

Directions in the work of the medical center

The range of services offered in medical centers depends on their profile and the scale of the clinic.

Sample list of services:

primary and secondary appointments with specialized doctors;
preventive examinations;
traumatology;
laboratory tests;
X-ray examinations;
ultrasound diagnostics;
MRI (magnetic resonance imaging);
tomography;
colonoscopy;
FGDS, etc.

From highly specialized areas:

children's;
cardiological;
ophthalmological;
surgical (including plastic surgery), etc.;

Plastic surgery is now one of the most profitable areas of business.

The more profiles a medical clinic includes, the more investment and highly qualified personnel will be required.

Opening a medical center: step-by-step instructions

Here is a brief organizational plan for opening a medical center.

The first step is to conduct a SWAT analysis, assess all the opportunities, risks, strengths and weaknesses of the business. Development should be based on a clear document (business plan), which will describe the entire sequence of actions and development prospects.

After analysis, making a decision to open a business and finding investment capital, the entrepreneur begins real action.

Selects the organizational and legal form of activity and starts the licensing process.
Finds and prepares premises for the object.
Searches for experienced personnel.
Purchases and installs equipment.
Coordinates the mechanism of operation of the establishment and the interaction of all staff.
Organizes a large-scale advertising campaign for the new medical clinic.

A private medical institution can begin work after completing stage 5 of the plan.

What you need to open a business

The largest initial cost item is the purchase of equipment. Of course, when buying equipment you need to look for the best price offer, but you shouldn’t skimp on it. The quality and, ultimately, the success of a private health/rehabilitation center depends on the equipment.

Table 1. Initial costs for opening a medical center.

The work is expected in a city with a population of 1.5-2 million people. Additional expenses include costs for utility bills, promotion, preparation of premises, etc. The amount of tax deductions is not taken into account in the calculation.

Documents

Initially, the entrepreneur will have to choose a legal form of activity: individual entrepreneur or LLC.

When registering, indicate OKVED 2 codes from group 86 “Activities in the field of health care”:

86.21 “General medical practice”;
86.22 “Special medical practice”;
86.23 “Dental practice”;
86.90 “Other activities in the field of medicine.”

When providing inpatient medical services, the documents indicate 86.10 “Activities of hospital organizations”, in the presence of massage services - 86.90.3 “Activities of massage parlors”.

To operate, you will need to obtain licenses. Before submitting an application for licensing, you need to take into account all the requirements, prepare premises, purchase equipment (with certificates), employ personnel, etc. The licensing itself will take a lot of time - at least about six months.

Room

When choosing a complex of premises, you need to take into account several factors: transport accessibility, human flow, rental cost.

It is best to rent a room at a place where traffic flows intersect and people are present: the new medical center will be noticed faster, and the influx of new clients will be higher. We are not necessarily talking about the central part of the city (where rents are always high). It is advisable to open near government medical institutions.

It is imperative to prepare the premises and make repairs: a lot depends on the appearance of the medical clinic. The more prestige and comfort customers feel, the higher the trust in the establishment.

When selecting and preparing premises for a medical center, the requirements of SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities” are taken into account.

Staff

It is necessary to carefully select health center workers - this is very important. Qualified workers will help solve the problem that causes clients to contact the company. This will lead to satisfaction of needs and increase the image of the clinic.

For experienced doctors, the likelihood of making a mistake when making a diagnosis and determining treatment is much lower than for workers with insufficient experience.

Employees are required to interact with customers respectfully.

The list of employees depends on the profile of the clinic. First you need to have the following specialists:

gynecologist, 1 specialist;
cardiologist, 1 specialist;
pediatrician, 1 specialist;
ultrasound room specialist, 1 specialist;
dentist, 1 specialist;
therapist, 2 specialists

Administrators, nurses and laboratory assistants (if analysis and diagnostic services are available), accountant and cleaners (orderlies) will be required. Total staff - 16 people.

Equipment

Clients are received in several separate rooms, where specialists will work and the required equipment will be installed. The purchase of the latter will take most of the initial capital.

You need to buy high-quality equipment that will give accurate analysis and diagnostic results. The success of the entire business depends on the quality of the selected equipment, so saving on this expense item is not worth it.

Approximate list of equipment:

comprehensive equipment for cardiological, gynecological, pediatric and therapeutic rooms (RUB 1.20 million);
equipping a dentist’s office (RUB 700 thousand)
ultrasound machine (650 thousand rubles);
lamps for quartz treatment (50 thousand rubles);
laboratory equipment (thousand rubles);
purchase of additional tools, consumables, refrigerators (350 thousand rubles).

Total - 3.350 million rubles.

Common services

When compiling the list, research data from MAR Consult was used.

In first place are dental services. Clients are willing to pay for better quality treatment, more expensive drugs and advanced equipment for dental treatment.

Secondly, it is taking tests (blood, feces, urine, etc.). Private medical clinics use more modern and sensitive laboratory equipment compared to government institutions.

Thirdly, this is the reception and consultation of specialized specialists. Often qualified doctors work in private medical centers - this allows them to receive more money for their work.

Fourthly, massage. The popularity of this trend has grown literally over the last 7-8 years. In clinics, people are looking for massage therapists.

Financial plan: profitability and payback of the medical center

The amount of initial costs is 4.940 million rubles.

Prices depend on the doctor’s qualifications, specialization, order of consultation, etc. To calculate revenue, let's look at the cost of services offered by the center:

initial consultation with a gynecologist - 1500 rubles, 150 times a month, total 225 thousand rubles.
initial consultation with a cardiologist - 1600 rubles, 180 times a month, total 288 thousand rubles.
initial consultation with a pediatrician - 1,700 rubles, 270 times a month, total 459 thousand rubles.
Ultrasound examination - 1300 rub. (average), 150 times a month, total 195 thousand rubles.
initial consultation, dental treatment - 2500 rub. (average), 200 times a month, total 500 thousand rubles.
initial consultation with a therapist - 1200 rubles, 360 times a month, total 432 thousand rubles.

Total for the month - 2.099 million rubles.

You can earn so much if the clinic is developed and known to people. You can develop an establishment in about 1 year, subject to an active advertising campaign. The calculation takes into account only the prices for initial consultations; subsequent appointments also bring in a lot of money.

The total monthly costs are RUB 1,340 million.
Net profit (in developed state) - 759 thousand rubles.
Under such conditions, the medical center will pay for itself in 6.5 months, plus a year for development. The clinic will break even in 18.5 months.

Table 2. Economic justification for the business idea.

Risks and disadvantages of business

Working in the medical field has certain risks.

Decrease in the well-being of citizens. People with a higher income level, that is, a narrower target audience, turn to private medical centers. In conditions of the economic crisis and falling levels of real income, the flow of customers to the establishment may decrease.
High competition. For the most part, people prefer to go to free public clinics and hospitals. This partly leads to the churn of potential customers. At the same time, more modern private medical clinics are opening - that is, direct competitors who can “intercept” clients.
Unprofessional staff. An incorrect diagnosis and prescription of incorrect treatment may not only fail to give the client the desired result, but also worsen his condition. This threatens, at a minimum, negative consequences for the image of the center, and even legal proceedings or even deprivation of a license.

Opening a medical center in the current conditions of popularization of paid medicine is very profitable. After breaking even, the business will bring good income to the owner. But an entrepreneur needs to prepare: to achieve the goal, many risks will have to be taken into account; Only with a thoughtful approach can you really achieve success in this business.

Commercial medical care is increasingly entering our lives. Medical offices are becoming one of the accessible forms of providing primary diagnostics and performing minimally invasive operations. This business plan was developed taking into account the changes introduced by the adoption by the Ministry of Health of the Russian Federation of the Order “On approval of the procedure for organizing and providing medical care using telemedicine technologies” and the start of work of the medical services aggregator DocDoc.ru. The calculations necessary for a medical office business plan were carried out in Microsoft Excel and are universal. You can independently adapt the calculations to the economic conditions of your own business.

Resume

The goal of the business project: to create a medical office providing general therapy services, testing, consultations and minimally invasive gynecological and vascular operations.

1. Develop a legal, marketing, organizational and financial model for a medical office

2. Justify the possibility of repaying the loan, returning funds to the investor and bringing the medical office to the payback level within 5 years.

Project initiator

The project is being developed to meet the requirements of the investor: a gynecologist. Investments are partly own funds, partly bank loans.

Investment costs

The planned capital investment for opening a medical office will amount to 7.4 million rubles.

Capital expenditure items:

Registration of a legal entity and licensing of activities: 53 thousand rubles.
Preliminary payment for renting premises: 270 thousand rubles.
Repair work and preparation of the premises: 1,778 thousand rubles.
External facade work: 32.5 thousand rubles.
Purchase of equipment, furniture, office equipment (general): 2,961.75 thousand rubles.
Recruitment and training of personnel: 15 thousand rubles.
Initial purchase of consumables: 250 thousand rubles.
Unforeseen expenses (based on 7% of the total amount): 380 thousand rubles.

Total initial investment in capital: 5,835.25 thousand rubles. Investments in working capital: 1.5 million rubles.

Project financing

Investments in the medical office business project will amount to 7.4 million rubles, and are distributed as follows:

Bank loan - 5.5 million rubles.
Personal funds of the project initiator - 1.9 million rubles.

Credit terms:

Annual rate - 15% per year
Lending duration - 3 years
Deferred payments - 4 months.

Project payback

Investment plan

Investment volume

Name of works/products/services	Quantity	Price	Price
Registration of a legal entity and licensing of activities			53 000,00
LLC registration
Licensing of activities
Carrying out an examination of the premises
Registration of sanitary and epidemiological report
Disposal agreement
Certificates for equipment
On-site state examination of the licensing object
Payment of state duties
Legal support
Advance payment for renting premises			105 000,00
Repair work and premises preparation			1 778 000,00
Finishing building materials
Finishing works for common areas
Purchase and installation of a ventilation system
Purchasing and air conditioning systems
Finishing work for medical offices
Plumbing work
External facade works			32 500,00
Purchase of equipment, furniture, office equipment (general)			2 961 750,00
Common area

coffee table
Card index
Computer
Staff chairs
Laser MFP
Upholstered furniture for visitors
Front Desk

Phones
Wardrobe for outerwear
General practice office
Floor scales
Staff chairs
Medical couch

Height meter
Document rack
Working tables
Chairs for visitors
Washing cabinet
Medical screen
Gynecological office
Doppler analyzer
Ultrasound machine
Bactericidal irradiator-recirculator
Washing cabinet
Gynecological chair
Medical containers (biks)
Colposcope
Working chairs for staff
Staff chair
Medical couch


Set of gynecological instruments (examination)
Set of gynecological instruments (surgical)
Blood pressure measuring device


Medical screen
Phlebology office
Medical containers (biks)
Staff chair
Working chair for staff
Medical couch
Laser diode surgical device
Manipulation table for storing sterile instruments
Mobile medical lamp
Blood pressure measuring device
Doctor and nurse workplace

Washing cabinet
Medical screen
Electrocoagulator
Treatment room for collecting tests
Medical containers (biks)
Isothermal container
Staff chair
Medical couch
Manipulation table for storing sterile instruments
Tool set (examination)
Blood pressure measuring device
Washing cabinet
Medical screen
Laboratory for sterilization of medical instruments
Aquadistiller
Washing bath for disinfection and pre-sterilization of instruments
Bactericidal irradiator (lamp)
Steam sterilizer (autoclave)
Dry heat cabinet
Staff office




Wardrobe wardrobe
Utility room (warehouse)
Storage cabinets
Medical refrigerator
Additional equipment not included in the list
Recruitment and training of personnel
Payment for HR agency services
Initial purchase of supplies			250 000 ,00
Initial investment in marketing			70 000 ,00
Website and group
Printing and distribution of leaflets

Unforeseen expenses			370 000 ,00
Total initial investment			5 620 250 ,00

Note: The recycling agreement and equipment certificates are included in the mandatory set of documents required to obtain a license and obtain permission to start operating the office. An agreement must be concluded, but payment for the medical waste disposal company’s services is made only after the company begins its work. Certificates for equipment and consumables are provided by the supplier company.

Investment work plan

Approximately, the work before the opening of the medical office will take 4 months. and carried out in accordance with the schedule:

Room

Requirements for the area of medical offices are regulated by Appendix No. 1 “Minimum area of premises” to SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities”, approved by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated May 18, 2010 No. 58 (valid. as amended on June 10, 2016):

General therapy room - 12 m2, in fact - 13.2 m2
Gynecologist's office - 18 m2 with a specially equipped place, in fact - 21.4 m2
Phlebologist's office (doctor's office, with a specially equipped workplace) - 18 m 2 with a specially equipped place, in fact - 20.2 m 2;
Sterilization room for emergency sterilization - 10 m2, in fact - 9.4 m2;
Staff room - 12 m2, in fact - 10.4 m2;
Storage room for consumables and medicines - 4 m2, in fact - 5.2 m2;

Additional premises not regulated by SanPiN 2.1.3.2630-10:

Waiting room - 8 m2;

The total area, including the bathroom and corridors, is 110 m2.

The medical office layout is shown below:

Equipment

Equipment is purchased only from specialized companies, because all equipment must be certified. The supplier company participates in the preparation of the premises design (calculation of the load on the electrical network, work with ventilation and plumbing) and installs the equipment that requires installation. Provides all certificates without fail. Subsequently, an agreement is signed with the company for the prevention and maintenance of the supplied equipment.

Opening hours

The medical office operates on a schedule from 9.00 to 21.00. Breaks and days off are not included in the work schedule.

Service delivery process

Reception registration of visits to specialist doctors:

Accepting pre-orders by phone and by mail
Coordination and registration of the order;
Search for a patient card; when a patient is registered, a new card is created;
Without an appointment, services are provided on a first-come, first-served basis, and the patient with an appointment has priority.

Client service by a therapist;

Tests are prescribed;
A visit to a specialist is scheduled (in the medical office, and if the required doctor is not available, in a partner clinic or hospital at the place of residence);
The order of treatment is determined;
Medicines are prescribed;
The office is being cleaned

Client service by a gynecologist;

The appropriate specialist nurse invites the patient to the doctor's office;
The patient's tests are checked;
The patient's request is checked and initial diagnostics is carried out;
The necessary procedures are carried out
The data is entered into the patient’s card and transmitted to the reception desk;
The office is being cleaned

Client service by a phlebologist;

The appropriate specialist nurse invites the patient to the doctor's office;
The patient's tests are checked;
The patient's request is checked and initial diagnostics is carried out;
The necessary procedures are carried out;
If necessary, a treatment plan and follow-up visit are prescribed;
The data is entered into the patient’s card and transmitted to the reception desk;
The office is being cleaned.

After services are provided:

The client card is verified and the client data is entered into the electronic system
The administrator receives payment from the client
A check is issued;
Follow-up visit to be confirmed.

Cost of services

The cost of medical services consists of the cost of consumables, calculated as a percentage of the tariff for services and depreciation of equipment. The cost is consistent with the costing sheet.

Other types of costs, including wages (with deductions), taxation, are presented as separate items in the financial section of the business plan.

Marketing plan

Medical offices provide general and special diagnostic services and minimally invasive surgeries. The main problem is slow entry into the market at the initial stage, which depends on the target audience.

Attention!!! Clinics designed for children and women are growing their client base faster, while clinics with a male target audience are slower. However, men tend to progress illnesses into acute or chronic conditions, so they require longer and more expensive treatment. This means that in the long term the average bill and overall profitability of such a medical office will be higher. However, a business model aimed at the male target audience will require more costs, a more targeted marketing policy and has higher commercial and financial risks.

The forecast for the expansion of the medical office capacity is presented in the graph

Target Audience

The target audience is women 18-55 years old with average income in the region. The basic need is anonymity and comfortable conditions.

Competition and location

The medical office is located in a residential area in a non-residential building on the ground floor of a residential building.

The premises were renovated to ensure that the premises met the requirements of SanPiN and made it possible to obtain a license to carry out medical activities. The walls were repaired, the floor tiles in the offices were re-laid, hot and cold water and sewage were supplied to the offices, split systems and ventilation were installed. Facade work is minimal: cosmetic repairs to the entrance and placement of a sign.

Main competitors:

state clinics
network medical offices or franchises;
private medical offices;
medical offices.

Differences between the project and analogues

	State clinics	Network medical offices, franchises	Private medical offices	Project
Location	In every residential area	In the city center	In the city center and residential areas	Sleeping area
Range of services	Maximum wide
Participation in compulsory medical insurance
Participation in VHI
Possibility to refer the patient to a specialized clinic		Own specialized clinics		To a specialized specialist
Availability of specialists	Almost all specialties	Profile and related	Only profile	Profile and related
Qualification
Taking tests
Biomaterial analysis	Own laboratory	Own laboratory		Transfer to a public or private laboratory
Carrying out operations	Invasive	Invasive and minimally invasive	Minimally invasive or not	Minimally invasive
Service
Client support
Cost of services

The main competitors are chain medical offices, franchised medical offices and private practices. The designed medical office outperforms the first two in terms of price, and the second in terms of the ability to support clients with specialists.

Range of services

Medical office services are presented in the graph:

A larger number of requests are for tests, general and special diagnostics, which are the cheapest services.

However, the structure of sales in financial equivalent differs significantly from the number of services provided:

Therefore, the greatest income comes from phlebological and gynecological care, or more precisely the support of diseases, their treatment and minimally invasive operations. For example, gynecological cosmetic surgeries include hemenoplasty, labiaplasty, vaginoplasty, etc. Sales prices are indicated as average for the type of service without taking into account additional diagnostics.

Pricing policy

Pricing policy is determined by the competitive situation. In the initial period, prices are comparable to the city average in the category of medical offices. Gradually, prices for basic services are being brought up to the price level of network medical offices, but prices for primary diagnostics and tests remain at the same level.

Please note that minimally invasive operations are grouped and the average bill for similar interventions is taken. For example, foam sclerotherapy for varicose veins carried out within the lower leg or thigh is estimated at about 15 thousand rubles, and foam sclerotherapy for varicose veins within the entire lower limb is 25 thousand. The average figure for calculations is 20 thousand rubles.

Sales volume

Health in any economic situation is one of the most in demand services, therefore, even with a low level of income of the population, services will be in demand. The market has stabilized and there will be no significant growth.

The sales volume will be affected by the seasonality factor; therefore, seasonality coefficients were determined for further calculations.

The influence of seasonality on the provision of services by the medical center is low. The main demand falls on the period October-May, in the summer there is a decline, the minimum number of requests for gynecological and phlebological care is September. Therefore, the opening of a medical office should occur in the month of October in order to cover the peak sales season.

SWOT analysis

A SWOT analysis allows you to identify opportunities and challenges in setting up a medical office and take advantage of the strengths and weaknesses to properly take advantage of the opportunity and neutralize or avoid the challenge.

Strengths:

location
professional level services
comprehensive services
exit to

Weaknesses:

small target audience
advertising promotion

Possibilities:

Reaching planned service volumes
pricing policy

proximity to Central Asia
high level of loyalty
price differentiation

customer support
discounts for regular customers
comfort
anonymity of service

Difficulties:

the problem is to interest the client
low growth in customer base
high demands on customer service with little understanding of the essence of services
limiting the expansion of the range of services
return on investment

optimization of advertising budget
advertising customer support and discounts for regular customers
price redistribution
opportunities to expand the range of services after loan repayment

optimization of advertising and sales channels
educational articles on the website, customer education
access to public clinics
work with compulsory medical insurance and voluntary medical insurance

Advertising strategy

advertising brochures and distribution of leaflets;
advertising in local newspapers and radio;
opening a website, justifying and starting to implement an SEO strategy;
registration and promotion of the group on VK (targeting women 16-30 years old), OK (targeting women 30-50 years old), FB and Instagram (targeting women 25-45 years old);
access to client bases of public clinics;
implementation of an ERP system

Upon reaching a sufficient customer base:

expansion of the ERP system;
SMM and group support on all social networks;
programs to support regular customers.

Organizational plan

Form of doing business

Organizational and legal form: limited liability company with a full taxation system.

Accounting and legal support is outsourced. Legal support is mandatory since there is a significant amount of legal information: permits, certification, etc.

Personnel and staffing structure

The medical office employs 19 people: General Director (gynecologist) - business owner, therapists, gynecologist, phlebologists, administrators, specialized nurses, nurse (tests), technical worker.

The personnel structure is shown in the diagram.

The work schedule of the medical office is in shifts: 2x2 for 12 hours, extra pay for overtime

Job title	Quantity	Salary, (thousand rubles)	Prize		Total
Job title	Quantity	Salary, (thousand rubles)	bid	base
General manager				from income
Therapist				from sales
Gynecologist				from sales
Phlebologist				from sales
Administrator				from sales
Nurse				from sales
Nurse (tests)				from sales
Technical worker				from the rate
Total

The general director has an irregular work schedule and combines the work of a gynecologist and the head of a medical office:

performs professional duties according to schedule;
organizes the process of providing services;
monitors the execution of instructions by subordinates;
endorses reporting and legal documentation;
control of information transfer to a lawyer and accountant;
based on data received from the administrator and nurses, approves orders for the supply of consumables and medications;
determines marketing strategy;
controls the work of SEO and SMM;
works with regulatory and tax authorities.

Outsourced accountant and lawyer. The implementation of an ERP system allows you not only to keep records of clients, but also complete accounting online. The accountant remotely monitors the work of the administrator, periodically (once a week) conducts an internal audit and checks the results of the administrator’s work in person. A lawyer checks the execution of contracts remotely. Internal audit and verification of the administrator's work results is also carried out in person once a week. An accountant and a lawyer must be present in the medical office during an external audit by certifying and regulatory government bodies.

Responsibilities of specialized doctors:

Providing services to patients on a pre-order basis and on a first-come, first-served basis;
Prescribes medications necessary for the treatment of clients.
Maintaining and monitoring documentation for each client, issuing cards, entering them into the ERP system.

Responsibilities of specialized nurses:

Performing duties in accordance with job descriptions and the provisions of regulations of the Ministry of Health of the Russian Federation;
Assisting the specialized physician in providing services to patients;
Preparing the workplace of a specialized doctor
Checking the availability of all medical instruments, consumables and medications necessary for the work of a specialized doctor;
Monitoring the operation of equipment, the availability of consumables, transferring data to the administrator in case of violations.
Maintaining documentation and entering data for each client, issuing cards, entering them into the ERP system by order of a specialized doctor.

Responsibilities of the nurse (analysis):

Performing duties in accordance with job descriptions and the provisions of regulations of the Ministry of Health of the Russian Federation;
Preparation of the workplace;
Checking the availability of all medical instruments, consumables and drugs necessary for collecting biomaterials for analysis;
Monitoring the operation of equipment, the availability of consumables, transferring data to the administrator in case of violations.
Placing the obtained biomaterials in the storage area;
Conducting analysis of biomaterials at the storage location;
Transfer of obtained biomaterials to clinical centers (if the necessary analysis cannot be carried out in a medical office);
Maintaining documentation and entering data for each client, issuing cards, entering them into the ERP system.
Sterilization of used medical instruments received from specialized doctors. Preparation of medical instruments for further use by specialized doctors.
Cleaning the workplace and office.
Collection and disposal of medical waste.

Administrator responsibilities:

Receiving orders and scheduling services;
Receives and systematizes data from nurses about the presence or absence of consumables and medications, and then transfers them to the head of the medical office;
Controls the delivery of consumables and medications;
Monitoring the maintenance of the ERP system by specialized doctors and nurses;
Receiving payment for treatment performed;
Initial work with customer objections;
Customer service in the waiting room;
Monitoring the placement of materials on the website and social networks, transferring information about the placement of materials to the manager.

Responsibilities of a technical worker:

Cleaning of common areas (waiting room, warehouse, bathroom);
Cleaning the offices of specialized doctors (if necessary).

Financial plan

Project financing

To implement the project, an investment of 7.4 million rubles is required. Of these, initial capital investments will amount to 5.9 million rubles, which is 5.5 million rubles. secured by a bank loan. Additional working capital will amount to another 1.5 million rubles. The entire amount exceeds the loan amount and is the personal funds of the project initiator.

low incomes and purchasing power of the population. Potential clients cannot spend significant amounts of money on the necessary treatment.

the state of the drug market and the system of compulsory and voluntary health insurance.

Slow accumulation of client base, but faster than that of the male target audience

High competition between individual and network (franchise) medical offices will lead to the linking of individual offices to public clinics, like commercial branches, or their inclusion/absorption by networks. Individual medical offices will remain only as points for receiving analysis and providing individual services.

Information risks associated with the authorization of telemedicine. This is the Order of the Ministry of Health of Russia “On approval of the procedure for organizing and providing medical care using telemedicine technologies” dated November 30, 2017 No. 965n and the development of the medical services aggregator DocDoc.ru will lead to a situation similar to that in taxis, when aggregators have reduced prices so much that there is barely enough income to carry out activities. This will lead to a decrease in the quality of medical care.

legal risks associated with market dynamics. First of all, with compulsory medical insurance and voluntary medical insurance in the light of pension reform and the provision of medicines and medical care to pensioners.

consumption model. People prefer to come with problems and get treatment; preventive visits are not common. It is necessary to gradually change the behavior pattern.

Conclusions

Calculations have shown that the medical office project can pay off under current conditions. Opening requires significant investment in equipment and business support. Given the high risks associated with forecasting changes in the medical services market, it is necessary to have higher growth rates. Attention should be paid to the development of the client base and service.

Nowadays, more and more people trust only private medical institutions, since public ones are no longer always able to provide proper service and good medical care.

Absolutely every person who decides to engage in entrepreneurial activity has the opportunity to open a medical center from scratch. It is not at all necessary to have a medical education for this, although if you have it, you will have a very slight advantage over other entrepreneurs, since you will be able to better understand all the specifics of the activity. However, organizational and entrepreneurial skills are more important here than specialized medical education.

Download free medical center business plan

How to open a medical center

First of all, you should start by researching the market for these services in your city or region. Many people tend to visit the same medical institutions if they are satisfied with the quality of care, prices and qualifications of doctors. Therefore, if your city is oversaturated with private clinics of different profiles, it may be very difficult to squeeze into this market and win the sympathy of a large number of clients. After studying your competitors, you can create your own market entry strategy, which will be the most optimal specifically in your case.

Licensing procedure

If many other types of business, for example, or, do not require a license to operate, then conducting medical activities is impossible without a licensing procedure. An application for a license can be submitted after the premises have been brought into the required condition in accordance with regulations, the necessary equipment is available, and staff with valid certificates to practice medicine have been recruited. The entire process of collecting the necessary documents and waiting for a response from the authority that issues the license can take a long time, up to one year. Take this downtime into account when organizing your business.

After receiving a license, you will not be able to move your clinic to another premises, since the license will only be valid at a specific address. If you plan to provide different types of medical services, then you need to submit a separate licensing application for each type.

Choosing a location

A medical center is a business in which location plays a huge role. Regardless of whether your clinic is specialized or multidisciplinary, it should be located as close to the city center as possible.

There should be a constant flow of people on the street where the clinic is located. This way, more and more people will learn about your clinic, even just passing by. And your visitors won’t have to look for it for long, which will also be to your advantage.

Choosing a room size

The size of the room directly depends on the number of services you are going to provide. If your clinic is highly specialized, for example, a dental office, then an area of 30 square meters will be enough to open it.

In the case of computer diagnostic centers, the situation is more complicated. Although this is also a specialized clinic, you need to consider whether you can place all the necessary equipment in the available space. For a multidisciplinary clinic, in which doctors of different specializations will receive appointments, you should look for a room of 80 square meters or more.

Equipment cost

Medical equipment is an expensive purchase, and you must understand that the largest portion of your investment will go towards the equipment. Equipment from foreign manufacturers with the latest technology is a strong factor in attracting customers. The prestige of the clinic will largely be determined by the level of technology, in addition to the qualifications of the doctors.

For example, an ultrasound diagnostic device will cost you no less than 170 thousand dollars, and a laboratory research device – about 60 thousand dollars.

You can also consider the option of purchasing used equipment. If it is in excellent condition and perfectly performs all its functions, then your patients will definitely not suffer from this, and you can save a significant amount of money at the initial stage of your business.

Staff

You can select personnel to work in a medical center as you wish, the main thing is to follow the selection rules: having a diploma of higher medical education, successful completion of medical practice, sufficient work experience. Internships in foreign clinics and participation in international medical conferences will be a significant advantage.

There will always be people whose confidence in the clinic will significantly increase if certificates of his professional success and achievements hang in the office of the doctor who sees them.

The phenomenon of luring good specialists from other companies to one’s own has always been and will be present in various areas of business. If we are talking about medicine, then this phenomenon is practiced very often. If you have sufficient arguments to convince a good doctor to come to work at your medical center, then be sure to try. Maybe this is unfair in relation to the clinic in which this doctor already works, but these are the harsh laws of business: everyone is trying to take their place in the sun and does this by any means available to them.

The most profitable areas of medicine

Considerable profits can be obtained both from multidisciplinary medical centers and from highly specialized clinics. If you are considering opening a multidisciplinary clinic, of course, you have a chance to get more clients. But you must take into account that the costs of opening and developing such a clinic will be much higher, and marketing activities to increase popularity will also be more complex and extensive.

If you are thinking about opening a clinic that specializes in one area, then please note that the most popular areas in private medicine today are:

Dentistry;
Gynecology;
Urology;
Cosmetology;
Laboratory research.

Often, entrepreneurs who are interested in the medical field of business first open a small, highly specialized clinic. Such a business requires less investment, less equipment and is also much easier to manage. Over time, when the entrepreneur has already earned enough money from a small clinic and gained experience in running a business, he opens a large multidisciplinary clinic. This strategy is very reasonable and justified, but, of course, only you can assess your capabilities.

Business plans for medical centers and clinics were developed by the Invest-Project ECC for various projects in 2008, 2010, 2013, 2014, 2015, 2016, 2017, 2018, 2019 and 2020.

Settlement date: 21.02.2020.

Payment currency: rubles

Planning period: 10 years (monthly).

Planning methodology: international UNIDO recommendations, own methods.

Purpose of the business plan: calculation of economic, production and marketing parameters for opening a medical center to confirm its economic efficiency and attract financing.

The business plan contains aggregated data on the project, reflects the concept of the medical center and is a technical specification for the development of project documentation, obtaining a medical license and further development taking into account the requirements of the bank, authorities, and partners.

Financial and economic model of the business plan developed according to the proprietary methodology of the Invest-Project ECC specifically for opening private medical institutions and shows under what conditions an enterprise can achieve success.

When purchasing a business plan for a medical clinic/financial center. The model is provided free of charge, which allows the customer to change the values of financial, production and economic parameters to suit their needs and find the optimal solution.

Medical center (clinic) concept

According to the project, it is planned to rent premises in Moscow or one of the large cities of the Central Federal District with a total area 2181 sq. m, make a major overhaul in accordance with the requirements of the SES and open a modern multidisciplinary medical center with departments:

Diagnostic department(laboratory services, instrumental and functional diagnostics, radiation diagnostics department);
Outpatient department with narrow specialists (multidisciplinary consultative and diagnostic center);
24-hour hospital with 10 beds - capacity up to 20 patients per day;
Operating unit to perform high-tech interventions;
Additional types of services: pharmacy, laboratory.

Parameters of the medical center (clinic):

total area of the center - 2 181 sq.m. rented at a rate *** thousand rubles/ sq.m. / year;
Medical center operating hours: 24 hours a day, seven days a week;
number of personnel: *** people, incl. doctors - *** rates;
production capacity of the medical center: up to *** thousand visits(appointments) per month;
planned workload of the medical center: *** thousand visits(appointments) per month;
"average bill": *** thousand rub. / visit (including surgery);
cost of services: *** rub. / visit (salary of doctors + consumables);
unit cost of investment: *** thousand rub. / sq. m;
planned revenue of the medical center: *** million rubles per month;
taxation system: OSN(with preferential VAT 0 % and income tax 0 %).

The need for investment in a medical center (clinic)

To implement the project you will need 237 000 000 rub. ($3.6 million) in the form of a bank loan (***% of investment) at the rate ** % per annum and investor funds (***% of investments). The loan is not capitalized. Interest will be accrued *** million rubles

Payback period (return) of investments - ** years.

Attractiveness of the paid healthcare market

In the Russian Federation there are more than *** thousand institutions in the "Healthcare Activities" industry.

Determining the real volume of the market for paid medical services in Russia is quite difficult due to the lack of official information on the shadow sector of the market.

According to Rosstat, the volume of the Russian market for paid medical services in 2019 was *** billion *** %.

According to Rosstat, the volume of the Moscow market for paid medical services in 2019 was *** billion rubles, increasing compared to the previous year by *** %. Over the past five years the growth has been *** %.

The share of the Moscow market of paid medical services accounts for *** % of the entire Russian market of paid medical services.

Average per capita expenses for paid medical services in Moscow in 2018 amounted to *** thousand rubles, which is almost twice the Russian figure ( *** thousand rubles).

According to expert estimates, the capacity of the Moscow market for paid medical services is about *** billion rub.

The market for paid medical services continues to show growth, despite the changing economic situation in the Russian Federation.

Today, the Moscow market of paid medical services offers the entire range of healthcare facilities:

- federal,
- state and departmental medical institutions,
- Research Institute,
- specialized institutes,
- private clinics.

All of these medical institutions have both advantages and disadvantages, so competing for patients will be difficult for all market participants in the near future. To succeed, you need a professional business plan.

News: According to our business plan, an elite dental clinic was opened in Moscow

Are you planning to open your own medical center or clinic, but don’t know where to start? Or do you have an existing medical business, but it is not profitable? ECC "Invest-Project" together with the Medical Consulting Agency "ZERTS" offers

A ready-made business plan for opening a medical center contains 186 pages, 56 tables, 33 graphics, 22 diagrams and 1 drawing.

List of tables for a medical center (clinic) business plan

Table 1. Main areas of investment.

Table 2. Planned revenue of the medical center.

Table 3. Reference values.

Table 4. Project performance indicators.

Table 5. Demographic indicators of the Russian Federation.

Table 6. Main causes of mortality in the population of the Russian Federation, 2014-2018, people.

Table 7. Forecast of the population of the Russian Federation until 2036.

Table 8. Morbidity rate of the population of the Russian Federation by main classes of diseases, thousand people.

Table 9. Main health indicators of the Russian Federation, 2015-2018.

Table 10. Attitudes towards medical care among residents of large and medium-sized Russian cities.

Table 11. Attitude of the population to the sufficiency of medical institutions.

Table 12. Frequency of requests for medical help among the population.

Table 13. Household expenditures on medical services in 2018.

Table 14. Volume of paid medical services to the population in the Federal District, 2017-2019, thousand rubles.

Table 16. Average financial indicators of the “Activities in the field of healthcare” industry.

Table 17. Distribution of the permanent population of Moscow by age and gender, thousand people.

Table 18. Cash income of the population of Moscow.

Table 19. Distribution of the total cash income of the Moscow population by 20 percent population groups, %.

Table 20. Distribution of population by average per capita cash income in Moscow, 2018, %.

Table 21. Consumer spending by Moscow megaclusters.

Table 22. Resident population by district as of 01/01/2019

Table 23. Morbidity rate of the Moscow population by main classes of diseases, thousand people. (for medical organizations of the Russian Ministry of Health system).

Table 24. Main health indicators in Moscow.

Table 25. Structure of the medical center's areas.

Table 26. List of medical equipment.

Table 27. Medical center attendance by department.

Table 28. Monthly attendance plan for the medical center, 2021-2030, visits.

Table 29. Medical center load plan by year, 2021-2030.

Table 30. Average bill and revenue of the medical center.

Table 31. Monthly revenue receipt plan, 2021-2030, rub.

Table 32. Revenue plan by year, 2021-2030, rub.

Table 33. Structure of the medical center's current costs.

Table 34. Monthly current cost plan, 2021-2030, rub.

Table 35. Current cost plan by year, 2021-2030, rub.

Table 36. Structure of direct costs of the medical center.

Table 37. Monthly direct cost plan, 2021-2030, rub.

Table 38. Direct cost plan by year, 2021-2030, rub.

Table 39. Medical center staff and wage fund.

Table 40. Payroll monthly, 2021-2030, rub.

Table 41. Payroll by year, 2021-2030, rub.

Table 42. Main directions of investment.

Table 43. Project implementation schedule.

Table 45. Calculation of break-even sales volume.

Table 46. NPV sensitivity analysis for 5 key parameters.

Table 47. Monthly cash flow plan, 2021-2030.

Table 48. Cash flow plan by year, 2021-2030.

Table 49. Profit and loss plan by year, 2021-2030.

Table 50. Profit and loss plan by year, 2021-2030.

Table 51. Summary indicators of operating expenses.

Table 52. Taxation by month, 2021-2030.

Table 53. Attraction and return of invested funds monthly, 2021-2030.

Table 54. Investment efficiency indicators.

Table 55. Calculation of NPV of the project for the forecast period, 2021-2030.

Table 56. Financial analysis of the project.

List of charts

Chart 1. Plan for disbursement of financing (rub.).

Chart 2. Revenue plan for the medical center (rub.).

Schedule 3. Medical center workload plan.

Chart 4. Current cost plan (rub.).

Schedule 5. Plan of direct costs (rub.).

Chart 6. Dynamics of inflation and GDP in Russia, 2003-2020, %.

Chart 7. Volume of paid medical services provided to the population of the Russian Federation, 2013-2019, billion rubles.

Chart 8. Volume of the medical services market in the Russian Federation, 2012 -2021 P, billion rubles.

Chart 9. Volume of paid medical services provided to the population of Moscow, 2013-2019, billion rubles.

Schedule 10. Medical center workload plan.

Chart 11. Revenue plan by area (RUB).

Schedule 12. Revenue plan for the medical center (rub.).

Chart 13. Current cost plan (rub.).

Chart 14. Direct cost plan (rub.).

Chart 15. Share of payroll in revenue (%).

Chart 16. Funding disbursement plan.

Chart 17. Investment calendar plan.

Chart 18. Break-even point.

Chart 19. Break-even sales volume (rub. and visits).

Graph 20. NPV sensitivity analysis.

Chart 21. Revenue and net profit (rub.).

Chart 22. EBITDA and net profit (RUB).

Chart 23. Net profit margin (%).

Chart 24. Revenue, costs, profit (rub.).

Chart 25. Dynamics of net profit (rub.).

Chart 26. Financial results (RUB).

Chart 28. Receipt and repayment of debt (rub.).

Chart 29. Debt servicing (rub.).

Graph 30. Sensitivity of NPV to the discount rate.

Chart 31. Project NPV and undiscounted cash flow (RUB).

Chart 32. The balance of the enterprise's DS on an accrual basis (rub.).

Schedule 33. Plan of monthly costs of the medical center (rub.).

List of charts

Diagram 1. Medical center revenue by area (RUB).

Diagram 2. Morbidity rate of the population by disease class in the Russian Federation, 2018, %.

Diagram 3. Main problems of state and municipal clinics according to patient assessment.

Diagram 4. How often Russians seek medical help, %.

Diagram 5. Behavior of Russians in case of health problems, %.

Diagram 6. Why Russians pay for medical care, %.

Diagram 7. The most pressing health problems.

Diagram 8. Structure of the paid medical services market by profile of services provided, %.

Diagram 9. Main profiles of services provided by commercial medical clinics.

Diagram 10. Structure of the Russian market of paid medical services in the Federal District, 2019, %.

Diagram 11. Structure of the medical services market, 2018, %.

Diagram 12. Structure of consumer spending by households in Moscow, 2018, %.

Diagram 13. Revenue structure of Moscow medical institutions by main types of activity, 2018, %.

Diagram 14. Structure of the medical center area (sq. m).

Diagram 15. Medical center attendance by department.

Diagram 16. Medical center revenue by department (rubles).

Diagram 17. Structure of the medical center’s current costs.

Diagram 18. Structure of direct costs of the medical center.

Diagram 19. Payroll structure of the medical center (rub.).

Diagram 20. Structure of initial investments.

Diagram 21. Structure of tax deductions (%).

Diagram 22. Cost structure in the 10th year of project implementation (%).

List of drawings

Figure 1. Structure of the medical center area (sq. m.).

A ready-made business plan for a medical center, clinic contains 186 pages, 56 tables, 33 graphics, 22 diagrams and 1 drawing.

Any person who does not even have a specialized education can open a medical center. The main thing is to want to start your own business and have organizational skills.

conduct a thorough analysis of the market in the region where you are going to open a medical institution (what services do the local population need, how much money are people with average incomes willing to pay for an examination);
find out how efficiently the market operates;
collect information about competitors.

Medical center business plan

Think through all the important points. Indicate the type of future clinic (specialized or multidisciplinary), how much money will be spent on equipment, the nature of the premises, and the number of employees.

Directions in the work of the medical center

The founders of private medical institutions should initially make a list services, consider whether only a diagnostic center or a clinic will be located here. Popular areas are gynecology, dentistry and cosmetology.

Types of medical centers:

Children's;
Consulting and diagnostic;
Highly specialized;
Multidisciplinary.

Location of the clinic and its appearance

For successful business development, you should take care of the convenience and aesthetics of the building. Choose a location in the city center or on a busy street.

To open a small dental office you will need a room of 25-30 square meters. m. Treatment room - at least 14 sq. m. m, for sterilization - 6 sq. m, plus a reception area for visitors.

Purchase of equipment

You will have to spend money on modern devices. Just for a regular ultrasound diagnostic device, pay at least 160 thousand dollars.

Official permissions

The activities of all medical institutions are subject to licensing. The center receives documents if the premises and personnel have passed the requirements check. The license will also require a list of equipment and certificates for each piece of medical equipment. A complete list of requested documents is issued by the regional Ministry of Health. It will be different for a consultation center and a full-fledged clinic with a hospital.

The application is considered for about two months. But each type of medical service requires a separate license. To have the right to issue sick leave, you will need a separate piece of paper. Obtaining all work permits may take a year. When the company moves to another address, you will have to deal with them again.

Often, medical centers turn to commercial companies for document verification and turnkey licensing. This can cost a considerable amount.

Taxation of clinics is carried out according to a simplified system. This is 6% of income or 15% of the difference between them and costs. The first option saves the entrepreneur from scrupulous calculations and most often turns out to be more profitable.

Medical center staff

A good private clinic should only employ real specialists with an official experience of at least 3 years. If candidates have completed internships abroad and speak a foreign language, this will be taken into account during the interview.

Let's list the employees:

Medical staff. Its quantity depends on the size of the clinic.
Two administrators with a 2x2 or 2x3 schedule.
Cleaners. For a small center, two shifts are enough.

A doctor’s salary is about 800 USD. per month, nurses – 300 USD

Patients more often go to a clinic where a doctor with an impeccable reputation works, even if the equipment is not the latest.

Please note: you can download ready medical center business plan from our partners with a quality guarantee.

Doctors often leave institutions where they are not valued and paid low salaries in order to get better working conditions.

Common services

Obtaining sick leave and documents for children’s leisure, driver’s license.
Consultation. Many clients will want help in selecting a drug. Routine examinations by specialists can also be included in this category.
Dentistry.
Examination: fluorography, ultrasound, ECG, tomography, tests.
Gastroenterology.
Gynecology.
Pediatrics.
Cosmetology and treatment of skin diseases.

How much money is needed to open a medical center?

The amount is about 20-30 thousand dollars. It will be enough for a highly specialized clinic.

Many aspiring entrepreneurs choose this business to gain experience, knowledge and skills for development. They hire a minimum number of workers, buy used equipment, and provide a limited number of services.

Mandatory initial costs:

rental of premises, renovation for the needs of the center. On average - 3 thousand dollars;
purchase of equipment - about 15 thousand dollars for one type of medical equipment;
obtaining an official license – at least $200;
purchase of tools and materials - about 2 thousand.

If you add up all these amounts, you get an average of $20,200 to open a small private clinic. For a full-fledged center you will need at least $100,000.

Profitability

Profitability depends on traffic. If an average of 50 people visit the institution in 1 day, the income will be about $60,000 per month (with an average price for the service of $50).

The number of clients depends on the ratio of cost and quality of service, as well as the reputation of the clinic and specialists. If a doctor changes jobs, his patients can follow him. But one unscrupulous specialist can ruin the reputation of the entire center.