India is home to over 100 million senior citizens and this figure is expected to grow to a whopping 350 million by 2050. Indian families are turning nuclear and a large segment of millennials have been migrating from their hometowns in search of better opportunities. As a result, senior citizens are increasingly managing day-to-day healthcare needs all by themselves.

Traditionally, the focus of senior healthcare has largely been restricted to emergency care, hospitalization episodes and post-hospitalization recovery. While these are episodic events dominate our senior-care discussions, day-to-day healthcare management such as arranging doctor appointments, physiotherapy follow-ups, refilling of medical supplies, scheduling regular health checkups etc. are equally challenging for senior citizens.

The home healthcare market in India is at a very nascent stage and the current market is estimated to be less than 2 per cent of the total healthcare spend in India. This figure is extremely low when compared to a country like the United States where home healthcare comprises around 8.3 per cent of the total healthcare industry.

A combination of 3 factors makes India a unique and promising market for home healthcare.

· Owing to the demographic dividend of India, senior citizens currently comprise only 8 per cent of the total population but this figure is expected to rise to 19 per cent by 2050. The senior population is expected to double over the next 25 years creating huge stress on the traditional healthcare infrastructure.

· Informal safety net provided by large families is vanishing in India. With increasing nuclear families, senior citizens cannot tap into the support traditionally offered by family members

· Large scale migration, both domestic and international, that has happened in the ’90s and the first 2 decades of 21st century has led to a situation where seniors are largely left to themselves to navigate day-to-day healthcare issues

Key areas of opportunity

Home healthcare market for seniors is in a very nascent stage and is dominated by local, unorganized players. The market stood at $3.2 billion in 2016 and is expected to hit $6.2 billion in 2020 with a yearly growth rate at a healthy 18 per cent. Future opportunities in-home healthcare are centred around building professional and personalized recovery management programs for critical illnesses/injuries/ diseases.

Post hospitalization care: Certified care providers who can offer high quality, specialized and personalized care for cardiac conditions, dementia, pulmonary diseases etc will be in massive demand.

Remote monitoring devices & preventive care: Countries like Japan with almost 30 per cent of the senior population are leading the way in leveraging technology for senior care. Key innovations in this space are technologies that reduce the burden on care-giver and that empower senior citizens by making them more independent.

Smart senior living facilities: Providing smart homes with dedicated caregivers designed exclusively for seniors is again a huge untapped opportunity in India. CarePredict, a technology firm in the US, and a bunch of artificial intelligence companies are working with senior living facilities to monitor daily patterns of seniors in a non-intrusive manner.

At-home chemo, dialysis & disease management programs: With evolving developments in the field of medicine, complex treatments such as chemotherapy are now possible at home. Each cycle of chemotherapy costs up to Rs 60,000 and assuming six cycles, a patient has to shell out ~4 Lakhs out-of-pocket for hospital treatment.

Challenges in the home healthcare industry

Quality & consistency of care providers: Training of care providers is the biggest challenge in-home healthcare industry. A lot of poorly trained and unprofessional care providers often end up breaching the trust of patients or their family members.

Attrition and burn of caregivers: All said and done, the job of caregivers is thankless. Spending a significant amount of time at someone’s home is nothing short of a challenge. Unlike a professional environment like a hospital, a ‘private home’ can have a huge variation in living conditions, family customs, gender issues etc that make a caregivers job extremely challenging.

Low technology adoption: Home care has always been a highly human-centric industry. Whether it is caregivers or families, service was always person-dependent with little or no role for technology.

Lack of insurance coverage: One of the biggest roadblocks to this sector is the way health insurance works in India. A lot of home healthcare services are either not covered or partially covered by insurance providers.

Conclusion

Healthcare in India has always been centred around hospitals and concept home healthcare is a relatively nascent concept in India. All demographic, economic and social factors indicate that home healthcare as an industry is ready for a massive boom. From disease management to preventive care to smart senior living, multiple opportunities are emerging in the home healthcare space.