falck group emergency medical services february 2011 georgian health care 2020: medea 2011...
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FALCK GROUPEMERGENCY MEDICAL SERVICES
February 2011
GEORGIAN HEALTH CARE 2020: MEDEA 2011WASHINGTON, DC, UNITED STATES
Overview
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1. Introduction to the Falck Group1. Introduction to the Falck Group
2. Falck’s worldwide Emergency Medical Services2. Falck’s worldwide Emergency Medical Services
3. Falck entering new markets – Slovakian case study3. Falck entering new markets – Slovakian case study
Key facts
Falck at a glance – Group overview
Revenue breakdown
Business Area
Geography
Revenue (2009): 1,369m USDEmployees (2009): 16,457
Falck provides services to a wide range of customers, including.:
Public sector
Private persons
Corporate/Business
Insurance companies
Pension providers
Market position:
#1 Global cross-border provider of privatized ambulance services
#1 Global provider of offshore and maritime safety training
#1 Nordic provider of auto, home and healthcare assistance
Note: Revenue converted from DKK to 5.5 USD.
Segmental breakdown based on FY 2010 financials
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Emergency51%
Assistance27%
Healthcare12%
Training10%
Denmark56%
Nordic17%
Europe11%
RoW16%
Falck is present in 23 countries
Introduction to Falck GroupAll Activities are linked to Mission and Values
For more than 100 years, it has been Falck’s mission to:
Prevent accidents, diseases and emergency situations
Rescue and assist people in emergencies quickly and competently
Alleviate the after-effects of emergencies
Rehabilitate people after illness and injury
Always be there so that people can live their lives safely
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Mission Values
Accessible
Fast
Efficient
Competent
Reliable
Helpful
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Introduction to Falck GroupMore than 100 years of history within emergency, safety and healthcare services
Serv
ices
1906 1908 1922 1995 1996 2000 2001 2005 2006 2007 2008 2009 2010
Rescue
Ambulance FireOffshore Training
Home care
Listed
Standalone Group4Falck Standalone
Healthcare
Ow
ners
hip
Falck Founded
Falck family Baltica Private ownership
Geogra
phie
s
Denmark
Rest of Europe 9
Nordics 3
Rest of World 10
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1926 1933
PatientTransportation
Roadside Assistance
Alarms
No. of countries
1988
Introduction to Falck GroupGeographic diversification – a global company
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Countries with established activities
Countries where Falck currently is establishing new activities
Introduction to Falck GroupSegmental overview
Geog
rap
hy
Cu
sto
mers
● 12 countries
● Long-term contracts, high visibility
Emergency
Leading international provider of
emergency services
51% of revenues
B2B10%
B2G90%
● 5 countries
● Subscription model, highly resilient
Leading Nordic provider of auto and home
assistance services
27% of revenues
Assistance
B2C51%
B2B49%
● 7 countries
● Partly subscription based
Leading Danish provider of private
healthcare services
12% of revenues
Healthcare
B2B49%
B2G49%
B2C2%
● 15 countries
● Framework agreements
Leading global provider of offshore and maritime
safety training
10% of revenues
Training
B2B91%
B2G4%
B2C5%
Denmark67%
Nordic14%
Europe19%
Denmark72%
Nordic28%
Denmark88%
Nordic5%
Europe5%
RoW2%
Denmark5%
Nordic25%
Europe31%
RoW39%
Note: Segmental breakdown based on 2010F financials
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Introduction to Falck GroupEmergency
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Core services
● Emergency Medical Services
─ Ambulance services
─ Pre-hospital service/rapid response units
─ Critical transfers (CCT)
─ Transport of stretcher patients (ATS)
─ Dispatch centers
─ Helicopter Emergency Medical Services (‘HEMS’)
─ Passengers with Reduced Mobility (‘PRM’)
● Fire fighting
─ Petrochemical/nuclear plants
─ Other industrial fire fighting
─ Airports
Introduction to Falck Group Assistance
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Core services
● Auto
─ Roadside assistance
─ Roadside repair services
● First-aid courses and materials / Fire extinguishers
● Home assistance
─ Storms, flooding and other house damage
─ Home alarms
● Transportation for treatment
● Travel assistance
Introduction to Falck Group Healthcare
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Core services
● Employee health
─ Preventive cross-disciplinary
─ Physical healthcare
─ Health checks and counselling
─ Psychological crisis aid and counselling
● Primary health clinics
─ Primary care, specialist care, day surgery, dental and rehabilitation
● Medical professionals staffing
─ Doctors
─ Nurses
─ Health assistants
● Home care services
● Jobservice and absence management
─ Fast diagnoses
─ Workability analysis
─ Case management and counselling
Introduction to Falck Group Training
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Core services
● Offshore and maritime training
─ Helicopter underwater escape training
─ Fire fighting
─ Confined space evacuation
─ Working in heights
● Specialized hazardous chemical/safe handling
● Consultancy, Hot work enclosures, Health
checks and Manning
● Major Emergency Management Training
─ Provide personnel with knowledge, experience and techniques
─ Enable Emergency Command Teams to react effectively to maintain protection to all personnel, environment and assets.
Competencies:• Ability to manage complexity• Expertise across the value chain• Operational excellence• Medicine focus• Strong track-record partnering with
local entrepreneurs
Infrastructure:• IT and communication platform• Control centers network• Global knowledge base
Brand:• Trustful, reliable, credible, efficient and
accessible• Publicity of operations, and quick to
establish strong reputation
Introduction to Falck Group Unique ability to build and execute the business
Strong fundamentals Ability to execute
Brand
Competencies
Infrastructure
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2
3
• More than 100 years of experience
• Flexible execution model
• Convert single service offering to multi service offering
Uniqueness of Falck
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High complexity in Emergency Situations
● Leading and managing people in life-and-death situations
● Stringent performance requirements
─ E.g: high performance response times
● Dimensioning and managing network to provide services efficiently
─ Utilize full time employees and mutual aid agreements
─ Station network and rolling stock
Competencies leveraged in other segments
• Dimensioning of healthcare networks with guaranteed treatment time
• Handling peaks and valleys in demand analysis
• Simulate life-and-death situations in a secure environment
• Train and maintain highly skilled instructors
• Roadside assistance with maximum response time requirements
• Cost efficient dimensioning with retainers for peak service demands
Exceptional ability
More than 100 years of training to adapt to any accident scene
Introduction to Falck Group Ability to manage complexity
Falck was a key player in the disastrous Deep Water Horizon oil spill in the Gulf of Mexico
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● Deep Water Horizon exploded in April 2010; 11 people died and 17 were injured. Subsequently, the spill developed into one of the worst environmental disasters of all time.
● Falck provided disaster training prior to the incident which played a key role in minimizing injuries and death.
● To help facilitate the clean up, Falck developed a training program in close cooperation with BP to train more than 5,000 people in Houma, Louisiana.
● Falck provided training on the clean up animal habitats on the beach and in the ocean.
Introduction to Falck Group Unique adaptation competencies in handling major accidents
● The operations and tasks at hand were enormous and Falck quickly hired 200 additional people to further help with the clean-up.
● This is the largest single personnel assignment Falck has had so far in the US.
“In the past, we’ve sent everything from paramedics to firefighters to jobs in the Gulf
of Mexico; however, we’ve never had an assignment of this magnitude. It has given us invaluable experience in handling disasters –
experience that we can put to good use in the future.” Morten Halager VP Falck Alford.
Falck takes pride in participating in disaster management activities and has decades of experience.
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● Tsunami in December 2004
● Co-working with The Danish National Emergency Agency
● Large explosion incident in November 2004, damaging approximately 250 homes and evacuating 5,000 residents.
Introduction to Falck Group Disaster management capabilities and experience
● 365 days per year, 24 hours per day, the Emergency Response Team (ERT) is on stand-by to be deployed in the event of fires on board ships, incidents with hazardous substances, and/or refinery fires.
● The team consists of specialists, who in addition to their daily activities, immediately deploy to the scene of an emergency with their own equipment - anywhere in the world.
● The ERT is employed by government authorities, shipping companies, salvage companies, and insurance companies.
● The commitment of the ERT makes the difference between limited damages and total loss, as well as the difference between life and death.
● In 2010 the team had 6 deployments, mainly to extreme fire disasters on board large ships.
Falck’s Emergency Response Team
Overview
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1. Introduction to Falck Group1. Introduction to Falck Group
2. Falck’s worldwide Emergency Medical Services2. Falck’s worldwide Emergency Medical Services
3. Falck entering new markets – Slovakian case study3. Falck entering new markets – Slovakian case study
Emergency Medical ServicesOverview of services
Emergency ambulance services
Rapid response units with paramedics, nurses and doctors
Other pre-hospital modalities
Air ambulance services
RPM-services for Airports
Fire Fighting
Fire Training
Fire and Safety Consultancy
Airport Fire Fighting
Risk Management
Non-emergency patient transport
Critical care transport
Patient transport services (PTS)
Transport of disabled persons (ATS)
Dispatch of fire resources, emergency ambulances, non- emergency ambulances, assistance vehicles and patient transport
Monitoring of different alarm systems
Logistics management
Services are provided and developed according to local requirements in close co-operation with the public authorities – state, regions, and
municipalities; and/or clients in high-risk industries – nuclear, petrochemical, airports, ports, etc.
Services are provided and developed according to local requirements in close co-operation with the public authorities – state, regions, and
municipalities; and/or clients in high-risk industries – nuclear, petrochemical, airports, ports, etc.
Ambulance Services Control CentersFire FightingPatient Transport
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Emergency Medical ServicesOverview of European markets
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Norway
• Emergency vehicles: 34• Ambulance stations: 19• Ambulance staff FTE: 78
Denmark
Sweden
• Emergency vehicles: 121• Ambulance stations: 39• Ambulance staff FTE: 574• Fire stations: 4
Poland
• Emergency vehicles: 79• Ambulance stations: 23• Ambulance staff FTE: 826• Control centres: 7
Belgium
Spain
• Fire stations: 20• Fire fighters FTE: 281• Training centres: 3
Denmark
Nordic
Europe
Romania
• Fire stations: 6• Fire fighters FTE: 212
Slovakia
• Emergency vehicles: 476• Ambulance stations: 134• Rescuers FTE: 4,549• Fire stations: 148• Municipality fire contracts: 66• Control centres: 5
• Emergency vehicles: 104• Ambulance stations: 91• Ambulance staff FTE: 851• Fire stations: 1• Fire fighters FTE: 48
• Emergency vehicles: 103• Ambulance stations: 15• Ambulance staff FTE: 803• Control centres: 2
The Netherlands
• Consultants, trainers FTE: 109• Training centres: 2
Emergency Medical ServicesOverview of American markets
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USA - East Coast
• Emergency vehicles: 440• Ambulance stations: 26• Ambulance staff FTE: 1,224
Brazil
• Emergency vehicles: 194• Ambulance staff FTE: 885
USA - West Coast
• Emergency vehicles: 135• Ambulance stations: 33• Ambulance staff FTE: 626
Falck Worldwide
• Emergency vehicles: 1,690• Ambulance stations: 383• Ambulance staff FTE: 9,830
Emergency Medical Services Operational services and competencies
Falck’s vast experience and knowledge in the EMS industry is second to none.
Characteristics Falck operations:•All types of emergency vehicles
•Equipment•Training•Communication•Telemedicine•Electronic patient care record
Characteristics Falck operations: •GPS/GIS(for more than 10 years)
•Securing effective and available resources by planning and simulation systems
•Systematic reporting internally and to the customer
Falck: Advisor
Alarm Center
operations
DispatchCenter
operations
Ambulance operations
Emergency rooms
Falck: Operator
R&D on pre-hospital medical services through non-profit Falck Foundation •Board of internationally recognized medical professionals from different countries
The proper resource to the actual need
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Emergency Medical Services World class radio and data network solutions
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Alarm Call
Radio system
Dispatch systemGIS work station
E H <A M I
J
N
1 2 3 4 5
6 7 8 9 0
AFG
OPT
PÅ
AF
FRI
HJE
TP RADIODENMARK
K
Dataradio
E H <A M I
J
N
1 2 3 4 5
6 7 8 9 0
AFG
OPT
PÅ
AF
FRI
HJE
TP RADIODENMARK
K
Dataradio
Emergency Medical Services Operational services and competencies
Size and international experience, as well as the global reach capabilities of Falck, provide credibility for safe, reliable, and adaptable service models in different environments
● Ability to adapt to different environments/different concepts and maintain the same operating efficiency
● Key Performance Indicator (KPI) - reporting system to support effective resource management
● Quality certified(ISO) or accredited services
● Economies of scale due to size
Operational excellence Equates to improved outcomes
● Pre-hospital systems with doctors, nurses, paramedics
● Ambulances, critical care transport units, neonatal and pediatric transport units, and other adaptable – specialized units
● Training of resources in collaboration with the public schools for pre-hospital education
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• BtC
• Ambulance and other pre-hospital services in 8 countries• BtG
• Assistive aids company
• BtItC
• Road assistance, courses in first aid and fire fighting• BtB and BtC
Business modelBusiness model
Emergency Medical Services Operational experience and competencies
• PPP
• Ambulance and pre-hospital in Slovakia
• Ambulance and pre-hospital in USA
Emergency Medical Services Falck operates numerous pre-hospital and care models at incident scenes
Country EMT Paramedic Nurse (CCT) Doctors HEMS
Denmark None Level 1+2+3 (British type)
Re-educate to paramedic level 2 or 3
Medical support teams (intervention cars)
SAR+HEMS
Poland One in every ambulance
One basic in every ambulance
One in every ”R” ambulance
One in every ambulance ”R” and ”W”
Government operated
Slovakia One in every ambulance
3 different levels one in every ambulance
None One in part of the ambulances by region / demography / distances determined by the government
Private HEMS regulated by government used intensively for the military
Holland One in every ambulance
None One in every ambulance
Special trauma teams / HEMS (anaesthesiology)
Private. Scaled and financed by government
Belgium At least one in every ambulance
None In some ambulances (departing from hospital)
Medical support teams (intervention cars)
Private and limited SAR. Financed by sponsors and government
Sweden None One basic in every ambulance
In 50% of the ambulances
Telemetry – advise back up system: severe circumstances
Private. Scaled and financed by government
Norway None Advanced level (British type) or equal
None Medical support teams (mostly HEMS)
Private. Scaled and financed by government
USA One in every ambulance
One in every ambulance
Only in critical care transports
None SAR+HEMS
Brazil One in every ambulance
None Nurse or doctor Nurse or doctor
• Several principles around the level of healthcare are currently in operation around the world
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PriceDiscipline
Brand
● Slovakia (2006)
● Nigeria (2009)
● United Arab Emirates (2009)
International Greenfields
Countries
Cost discipline● Our size and international reach makes Falck a
reliable and adaptable partner
● Disciplined and selective approach
− Identification of local partner with competencies and market knowledge, i.e. local contacts and network
− Local knowledge and adaptation
− Match with Falck brand and values
● Attractive partnerships
− 8 out of 10 local founders are still part of Falck
Greenfield strategy
Very successful track record
● ~ 10 Greenfields since 2005
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Emergency Medical Services Greenfield strategy and experience
Partner ship
Focus onValue-Add
Overview
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1. Introduction to Falck Group1. Introduction to Falck Group
2. Flack's worldwide Emergency Medical Services2. Flack's worldwide Emergency Medical Services
3. Falck entering new markets – Slovakian case study3. Falck entering new markets – Slovakian case study
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Market Entry Case Study: SlovakiaOverview
• Competitive RFP entry in September 2006
• Successful greenfield start-up
• Local equity participation
• Cross-pollination between industrial fire fighting
and healthcare clinics
• New RFP round in 2009 expanded emergency
coverage from 28% to 33%
Achieved results (revenues, DKKm)Key facts
54
140
157
178
2006 2007 2008 2009
159%
13%12%
Market Entry Case Study: SlovakiaStatus 2010
Key Facts
Coverage:• Regions: Various across Slovakia • 1.4m inhabitants covered• 14,500 km2 (91 licenses)• Market share: 91 of 264 licences, 34%
Through:• 91 ambulance stations, approx. 40% of the ambulances are
physician staffed (3 person crew) with the remainder being paramedics (2 person crew)
• 104 ambulance vehicles• More than 1000 staff (paramedics, doctors, nurses, EMTs,
administration, and part-time employees)• 87,500 emergency transports per year• 26,000 non-emergency transports per year• Response time average - 15 minutes• Medical training unit in place• Funded by health insurance companies partly owned by the
state, based on fixed fees defined by government• ISO certification 07.02.2008
Falck Záchranná a.s.
The largest ambulance service provider in Slovakia
The largest ambulance service provider in Slovakia
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Market Entry Case Study: SlovakiaHow it was done.....
Key Facts
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• Based on successful competitive bid process, licenses were awarded by the Slovakian Ministry of Health– 36 licenses in January 2006– 37 licenses in May 2006
• Slovakia was a completely new country for Falck
• Roll out based on Danish model complemented with experience from Poland
• Fast track setup with very tight deadlines opening 12 stations on March 1, 2006, and then 12 stations per month, totalling 73 stations in just 9 months
01.01.2006
01.08.2006
31.12.2006
30.06.2007
Building Phase
“Initial Ramp-up”
January 2006; first 36 licences; deadline
06/15/2006
Building Phase
May 2006; another 37 licences; deadline
08/15/2006
Building Phase terminated
07/31/2006
73 stations opened
Consolidation Phase
“Maintenance Phase”
09/15/2006, last station in Beladice opened
Processes setup update
Stabilization Phase
“Fine-tuning”
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2
3
A three phased roll out.....
Market Entry Case Study: SlovakiaHow it was done.....
....to start of operations From building phase….
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● Roll-out done locally according to local laws and regulations - by local people, managed and guided by centrally coordinated Falck Group competences.
● Priority was to hire and train personnel and to build-up and equip all stations. In 6 months more than 1,000 people were employed and stations built in 30-day periods, with 82% built from scratch.
● August 2006 all stations were connected to internal data network and voice VPN, both fixed and mobile.
● In 7 months the operational platform was in place and operations started throughout the country.
● The project team accomplished everything from the bid process and the contract signing, to ordering and organizing uniforms for 1,000 people, and building and equipping 74 stations with medical equipment, infrastructure, etc.
● 84 new ambulances were delivered by Falck within this time period.
Market Entry Case Study: SlovakiaHow it was done.....
....to stabilization phase From consolidation phase….
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● The priorities for the second phase were to fine tune operational processes: administration, procurement, human resources etc.
● Minimizing overtime, optimal planning of shifts, structuring operational and regional management
● Completed distribution of all internal policies and procedures
● Finalization of the project from the building phase, included installing garages and other reconstruction and equipment management
● The priorities of the last phase were to optimize cost procedures related to personal, ICT, fuel, rental costs, and other medical equipment
● Building medical training center
● Focusing on training and development to increase quality in service at all levels
● Promotion of Falck by education of the operation to city councils, schools, organizations and other public entities
Market Entry Case Study: SlovakiaEffect on the Slovakian EMS system
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In 2002 – 2006 Slovakia undertook a long period of reforms aimed at social security, pensions, and healthcare. Reforms included hospital network specializations and reductions, as well as a total reform of the EMS system.
When bids were announced, Falck decided to participate and agreed on a joint venture with the largest Slovakian Private Equity Group Penta. Falck Zachranna a.s. was established as a joint venture operation.
Prior system
● ~ 80 different public providers, mostly hospitals
● 1,500 employees
● 91 stations all around the country
● 100 emergency vehicles
● Average response time ~30min
Reform process
After venture
● 43 providers, mostly private
● 4,500 employees
● 264 stations all around the country
● 280 emergency vehicles
● Average response time ~15min
● Falck is the only international provider
Superior medical quality standards and training
Strong execution capabilities
Flexible business and services models
Operational excellence
Long term partnerships
100 years of EMS experience
Certified International Emergency Services provider
Falck GroupThe “go to” company for global emergency services
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Creates and enhances core competencies in a country’s EMS sector
Q & A Session
Questions?
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Contact Information
Boo Heffner
Group Senior Vice President
Falck
President and CEO
Falck USA
Contact details:
E-mail: [email protected]
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