Why does a healthcare provider need to grow? Or for that matter, why does any organization need to grow? There are many successful and profitable businesses that have consciously decided to remain small. Surely, growth can’t be a business imperative!

For over a year now, I have been focusing on this topic of “growth” for iKure – a social enterprise that delivers primary healthcare and wellness & prevention services through disruptive technology, network of Hub & Spoke Clinics, trained frontline health workers and continuum of care. I have summarized my key learnings in this article. While these learnings are from a single company in the primary healthcare sector, I am certain that most of these insights are generic and relevant for other companies in other sectors.

What does growth mean for iKure?

At iKure, we consider the following parameters to measure our growth:

• Impact: in terms of number of patients treated, population covered, number of community health workers (CHW) trained, villages covered, etc.
• Physical Presence: number of primary healthcare clinics.
• Financials: in terms of revenue & profitability

Why is it necessary for iKure to grow?

Over the past several years, iKure has established a successful model for technology-enabled primary healthcare delivery. iKure has been a profitable organization since the last 3 years doing great work with significant impact in select communities that we serve.

In this scenario, what is the imperative for iKure to grow? Why can’t we continue the good work at our current scale of operations?

We have identified the following as the key reasons why growth is vital for us:
1. Economies of Scale: Growth will enable us to optimize resources, reduce costs, acquire greater purchasing power and become more efficient. Through growth we will be able to build clusters of Hub & Spoke primary healthcare clinics. We will be able to deliver greater value to our customers.

2. Sustainability: Growing to a certain size will provide greater stability, increase our survival rate and enable us to better face competitive pressures.
3. Diversification: Growth will provide us opportunities to diversify by introducing new products and services. This will further fuel our growth and improve our sustainability.
4. Customer Retention: For retaining our existing customers and acquiring new customers, it is important for us to grow. There have been several instances when despite having very good solutions and the necessary experience, we have not been able to engage with certain potential customers since we did not meet their “size” criteria.
5. Talent Management: With growth, size and scale, our ability to attract and retain talent will improve significantly.
6. Branding: Growing to a certain size will enable us to build goodwill, brand and reputation and gain visibility.
7. Research& Development: At iKure, we have significant focus on conducting research with leading global organizations and academic institutes. Growth will enable us to support more such projects and also conduct experiments in primary healthcare delivery models and innovative technology.
8. Cross Subsidization: As a social organization, we are keen to deliver healthcare services across a wide spectrum of population. Growth will enable us to better cross subsidize services across various socio-economic groups.
9. Stakeholder Returns: Growth will provide us an opportunity to adequately reward our key stakeholders – primarily our investors and employees.
10. Fund Raising: Our ability to raise funds and at a lower cost of capital is directly proportional to the rate at which we are growing. It is ironic that funds have a tendency to flow to companies who need it the least.

How does iKure plan to grow?

We have drawn up an aggressive growth plan for iKure, based on the following key levers:

• Penetrate Existing Markets: iKure is focusing on delivering greater value to existing customers by increasing our basket of products and services. We are focusing on customer services and building increased customer loyalty.
• Extend Market Reach: Setting up additional primary healthcare clinics will be a key driver for iKure’s growth. We plan to replicate our successful model using a “cookie cutter approach”. These clinics will be a combination of iKure owned and operated centres as well as in collaboration with business and corporate partners. We also propose to extend our market reach by getting into new geographies.
• Strategic Partnerships: This involves collaboration with partners including corporates, non- government organizations, insurance companies, medical device manufacturers and pharmaceutical companies
• Technology Platform: Technology is a key enabler for iKure’s growth and scaling up. iKure’s population health management platform will streamline internal business processes and operations. In addition, our technology platform will integrate other components of the ecosystem like point of care digital medical devices, wearables, BI & Analytics, supply chain management, AI/ML use cases, telemedicine, digital health cards, payment applications, insurance products, remote and home care solutions and other 3 rd party systems.
• De-Medicalization: A key approach in iKure’s growth journey is to optimize scarce “clinical resources” and reduce dependence on qualified MBBS doctors through technology and business process re-engineering
• Mergers & Acquisitions: While we will primarily focus on growing organically, we will also explore opportunities for rapid growth through strategic partnerships with other companies.

What are our challenges to growth?

We are gearing up to face several challenges in our growth journey including the following:

Change Management: We will need to keep up with changing market conditions and competition. Also, we will be required to constantly align our systems and processes and our people with the growth.

• Strategy: While we grow rapidly, we will need to maintain our focus and overall direction and vision. We must learn to say “NO” to some of the opportunities and say this quickly. We have to accept our failures and quickly pivot. One of our success criteria will be “how fast are we able to experiment” and scale up the successful ones.
• Planning & Execution: Scaling up our primary healthcare delivery through setting up new clinics will require excellent planning and implementation. We are in the process of fine tuning our systems and processes so that we are able to maintain a very high level of quality as we grow.
• Resource Management: In the healthcare provider business the availability of MBBS doctors and specialists is a challenge – especially in the social sector. This will be a key success factor for iKure.
• Company Culture: iKure has been created with a vision of making a social impact. As we grow, we will need to ensure that we build a company culture that supports this vision.

Adequate funding is a key requirement for growth. However, I have not included it in the above list.
This is because, we see this as a pre-requisite for growth and not necessarily as a challenge.

Will our growth negatively impact focus on equitable healthcare?

The above question is extremely relevant for all healthcare providers. More so for a social enterprise
like iKure.

We at iKure are convinced that growth is absolutely imperative to provide “quality primary healthcare services” that is Accessible, Available and Affordable.

At iKure, technology is a major driver for equitable healthcare in the following ways:

• reduce costs
• improve accessibility & affordability – helps to rapidly scale up
• improve quality of care by streamlining business processes and enabling continuity of care

GROWTH is a key requirement in the pursuit of Universal Health Coverage!

Rahul Chatterjee
Chief Growth Officer, iKure

.