Strategic Analysis of NMC Health plc.

NMC Health plc.

Strategic Analysis of NMC Health plc.

Instructions:-

  1. Organization 

Break the analysis into the following major headings:

  1. Introduction                         1+ page
  2. Strategic Issue                     1+ page
  3. External Environment      3+ pages
  4. Industry Analysis                               4-5+ pages
  5. Company Situation           4-5+ pages
  6. Recommendations            3+ pages

In addition, use the subheadings described in this document to break up long sections. 

  • Style

Use APA style which means double space throughout—do not add any additional space between paragraphs.  Be sure to indent the first word of each new paragraph.  Do not have long paragraphs containing a variety of related but different topics—break into smaller paragraphs for organization and ease of reading.  Use a topical sentence to clarify the purpose of each paragraph.  Number the pages starting with the Introduction , e.g., do not include the title page.

Check your work and correct the spelling and grammar errors.  Write clearly with correctly structured complete sentences.  The ability to present an effective case analysis depends on your critical thinking skills AND your ability to express your ideas in writing.

Start each of the major sections with an introduction that briefly characterizes and sets the stage for the section.  Also at the end of each significant section, summarize with a paragraph capturing the key strategic findings of your analysis for that section.  Do not make comments like “The case did not provide information on . . .”  You do not need to site the textbook or case.  Eliminate personal pronouns such as I, we, etc.

Staple or clip the paper in the upper left hand corner—no binders, please.

  • Show Impact

Your job is not to “spill back” the facts from the case.  Assume that the person who reads your write up will have read the case carefully.  Support your statements of analysis with brief examples from the case information.  Your focus should be on the impact, effect, and strategic implications of your analysis.  Do not overlook exhibits in the case with additional data.

  • Apply Tools and Vocabulary

Demonstrate that you understand and can effectively apply the tools of strategic analysis: macro environment, driving forces, key success factors, industry analysis, financial analysis, SWOT, strategic group map and the nine cell industry attractiveness, competitive strength matrix.  An effective case analysis effectively incorporates the language of strategic analysis throughout.

Major Sections

  1. Introduction

Provide a brief overview of the mission, business, markets, products and scope of operations the company is in.  The past/current strategic direction of the firm can be briefly summarized but the focus should be on the most recent events that will impact the decisions and future direction of the firm.  Identify strategic actions by generic and grand strategies. 

This is NOT a long historical view.  It shows how capable you are of describing the company’s business and current strategy.

Common Errors

  • Focusing on history rather than the current situation.
  • Not using strategic vocabulary for strategies.
  • Giving too much detail about the case—assume I’ve read the case.
  • Strategic Issue

In one or two paragraphs, summarize the company and strategic situation.  This should characterize the fundamental state of affairs that exists in the focus company and industry with enough background information to understand it.  See instructions under the section “Strategic Issue” at the beginning of the recommendations section.  Refer to page 9 and 85 in the text book.

Common Errors

  • Failure to introduce the key conditions or “givens” in a problem statement.
  1. Addressing only the external or the internal situation rather than both.

Situational Profile and Prospects.  This summary paragraph(s) is the opportunity to integrate the analysis and bring it all together.  This section MUST summarize the strategic situation the company faces.  “Situation” means “state of affairs.”  It must set the stage for the Strategic Problem that follows.  Summarize and connect to the key findings of each section.  Weave these findings into a summary story leading to a clear and specific statement about the future prospects for strategic success for the company.  Make a specific statement about whether the company’s prospects are good, indefinite, or poor.

Strategic Problem/Challenge.  This must be a single, well-crafted sentence that captures the fundamental problems and concerns that came out of the analysis.  This single sentence must be formed as a question and will end with a question mark.  Write this in very specific terms addressing both the company’s short-term situation and the broader strategic situation.  Incorporate the need to provide shareholder value, sales growth, profitability and sustained competitive advantage but incorporate the specific problems with which the focus company must deal.  Everything prior to this is headed toward this one culminating formulation of the problem.  This sentence forms the basis for the recommendations.

  • External Environment

Provide an introduction that characterizes the essence of the external environment and industry situation at the time of the case and sets the stage for the analysis that follows.  Research “industry life cycle” and analyze where the industry or focus company is in the industry life cycle.  If the case has data on historical industry sales, calculate the sales growth rate and determine whether the industry is in the introduction, growth, maturity or decline phase of their life cycle.    If there is information such as the revenue of the top 3 competitors for the last few years, combine their sales and calculate the change in sales growth to infer where the industry is in the industry life cycle.  Discuss this analysis in any of the sections where it is appropriate.

Common Errors

  • Writing about historical events rather than the current state of the industry.
  1. Identifying the topics you are about to discuss without discussing the state of the industry.

Key Success Factors (KSFs).  What are the factors that are key to any company being successful in the focus industry?    What activities must the organization do especially good at in order to ensure success for the company?  They represent areas that must be given attention to in order for a company to perform well.   They incorporate an understanding of how customers buy and what is important to customers in deciding to purchase the product or service.   Identify WHAT they are, WHY they are key success factors, and HOW they affect the industry.  Based on a thorough understanding of KSFs, managers can determine if they are positioned to compete successfully and where capabilities need to be strengthened.  Identify the strategic implications of each KSF. 

For example, an important KSF in the retail food industry is a strong network of retail stores in convenient location so that customers have easy access to the store.  This means locating stores in high traffic areas and making the stores available in a wide number of neighborhoods.  People prefer to shop close to home.  Many consumers work and at the end of the day, they do not like to drive long distances to shop for food.  Convenient locations will result in increased revenues and a larger market share.  Therefore, companies should conduct market research to identify growing neighborhood communities to open new stores.

Common Errors

  • Not naming each key success factor.
  • No identifying the strategic implication of each factor.
  • Not developing a convincing argument for why the factor is critical to success.

Porter’s 5 Forces Analysis.  Use the Porter model to evaluate the strength of the five forces that affect the strategic choices of all firms in the industry.  Discuss the balance of power in the industry.  Relatively weak forces (low threats) place power in the hands of the firms that comprise the industry, and, therefore, broaden their freedom of choice of strategic actions.  Relatively strong forces (high threats) reduce the power of the industry firms and limit their strategic choices.  An industry with strong forces tends to be less attractive than an industry with weak forces.

Specifically state your assessment of the strength of each of the 5 forces—intense, strong, moderate or weak.  Justify and show why you reached your conclusion.  For example, it is not enough to write, “Competitive rivalry is strong because the number of competitors is high, barriers to entry are low and product differentiation is low.”  A better explanation is, “The many competitors in this industry must aggressively battle for market share in this slow-growth market.  They each have considerable investments in the physical plant, which makes it difficult to leave the industry.  The products are difficult to distinguish from one another, so companies must focus on aggressive, marketing programs to win customers away from their competitors.  All these factors contribute to a strong rivalry and continued downward pressure on profit margins.”

Put the actual diagram of the model in the APPENDIX and discuss each force in the body of this section.  Include a closing paragraph on the implications of the analysis to the overall attractiveness of the industry and the potential for companies to be profitable.

Common Errors

  • Not identifying the strength of a force or the conditions that lead you to your finding of a force as being strong or weak.
  • Getting supplier, firm and buyer mixed up.
  • Overlooking key factors you previously identified in the external/industry analysis.
  • Not recognizing the strength of competitive rivalry.

Industry Profile and Attractiveness.  Summarize the characteristics of the industry.  Draw together all of the key findings from each area of the macroenvironment and industry analysis.  What conclusions can you draw about the nature of the industry?  How attractive is it to its current incumbents?  What are the future prospects for the industry?  Why?  What challenges does the industry face?  Provide a summary statement about whether it is highly attractive, moderately attractive, etc., to current players re profits, sales and competitive intensity.

  • Company Situation

Provide an introduction that characterizes the essence of the company situation and sets the stage for the analysis that follows.  Identify the key company-specific issues with which the company is dealing.

Financial Analysis.  Be sure to distinctly address each of the four areas of financial analysis—profitability, liquidity, leverage and activity—identify each in the topical sentence for that paragraph.  Calculate the past sales growth rate for the company if there is historical data.  The financial analysis must be thorough and accurate.  Look at trends and compare the company’s performance to industry targets, if available.  Evaluate the primary financial indicators, provide supporting data and interpret them to show how they affect the company regarding its present and future strategic performance. 

Put the calculations of the ratios in a table in the APPENDIX.

Close this analysis by writing a paragraph that draws conclusion about the company’s overall financial situation, prospects and the impact of its financial condition on its potential strategic plans.  The fundamental question you are trying to answer is, “What is the overall financial status of the company now, and what does its current financial status mean for its future strategic success or ability to grow sales?”

Common Errors

  1. Incorrect computation of the ratio.
  1. Incomplete computations of the ratios (trends, etc.).
  • Focusing on the definition rather than the strategic impact that the ratio implies.

SWOT Analysis.  Discuss each of the four legs of the SWOT fully—strengths, weaknesses, opportunities and threats in this section.  Be clear that events are not the same as attributes.  SWOT is about attributes, not events.  An attribute describes the characteristics of the company.  For example, you might say, “The company isn’t profitable.”  True, but what is its weakness attribute?  What characteristics of the company drives its lack of profitability?  A better way to express it is, “The company has not managed costs in its value chain.  This is supported by the sustained increase in cost of goods sold accompanied by flat sales reflecting a weakness that must be overcome to improve profitability.”

Summarize the SWOT analysis in a one-page table and place in the APPENDIX.  Discuss the table in the body of the paper.

SWOT is the “integrator” of the analysis.  SWOT draws from the findings resulting from the Macroenvironment, Industry Analysis, and Financial Analysis.  No new information is provided.  Use the terminology in the previous sections.  For example, “An opportunity identified in the discussion of the competitive analysis . . .”  Another example, “The dumping of foreign products into this industry, identified earlier as a driving force, is a significant threat to incumbents.”

Common Errors

  • Not linking the findings to the previous analysis through the use of common terminology.
  • Omitting important findings discussed previously.
  • Focusing on historical events rather than inherent strengths and weaknesses.
  • Not recognizing obvious strengths and weaknesses in the business functions:  financial analysis, marketing (product, price, place and promotion), human resource management, operations, etc.

V.  Recommendations

Strategic Issue.  This is the same question that was presented in the beginning of the report.  Restate the question.

Strategy Recommendations.  Identify the GENERIC and GRAND strategy recommendations.  These will tie closely to the SWOT analysis.  The recommendations should play into the company’s strengths and opportunities.  They should minimize the company weaknesses and overcome its threats.  Discuss each strategic initiative in detail including the actions required in the functional areas to support the strategic recommendations: marketing, operations, human resource management, finance, etc.

Objectives.  Specify the performance objectives that should be monitored and result from the strategic recommendations and earlier analysis.  What key performance indicators should be reported and what are the appropriate targets?  For example, what are the sales and profitability goals?  What goals should be established for nonfinancial indicators?

Strategic Justification.  Justify why your recommendations are the best option and why other options are not.  This is a comparative analysis.  Develop this fully, tying it back to the various factors in your strategic analysis.  Evaluate the pros and cons of the recommended direction.  Demonstrate that you understand the implications of your recommendations. 

A justification analysis weights the strength of the pros and cons fro a given alternative in comparison to the other alternatives.  It presents a rationale for why the pros of the recommended alternatives are better than the pros of the other alternatives.  It also addressed why the cons of the recommended alternatives are less significant the those of the rejected alternatives.

Common Errors

  • Developing recommendations that don’t tie clearly to the previous analysis.
  • Not describing distinguishing characteristics of the strategies.
  • Not using the strategy vocabulary for generic and grand strategies.
  • Not aligning strategy recommendations with objectives.
  • Writing in generalities rather than company and situation specific.

Solution

Strategic Analysis of NMC Health plc.

ensure that healthcare is delivered in an effective, efficient and equitable manner. In the UAE, professionalism is a core value of the Ministry of Health (Ministry of Health, 2016). Professionalism will ensure that the sanctity of human life is protected. A failure to be professional can also put a provider out of business due to their inability to resolve customer issues.

Porter’s 5 forces

The five forces framework is a model developed by Michael Porter for the evaluation of the external business environment in which organizations operate in or intend to expand.  The first force is barriers to entry which describe the ease with which new competitors can enter a particular industry. For the healthcare industry, barriers to entry are intense because entities have to make significant capital investments in equipment and personnel. While products can easily be replicated, the industry is a service industry and thus highly personnel specific. Consequently, the shortage in the number of skilled professionals capable of delivering high quality services also acts as a barrier to entry. Moreover, the industry is significantly subsidized by the government, which has a mandate to provide healthcare services and this can reduce the viability of the private enterprise model.

A second factor is the purchasing power of consumers, which is moderate because price is not a particularly significant consideration. The insignificance of price as a consideration can be attributed to the fact that the UAE is tending towards mandatory health insurance, with Abu Dhabi and Dubai already having implemented mandatory health insurance policies (U.S.-U.A.E. Business Council, 2016). Moreover, government subsidy of the industry further reduces the price imperative on consumers.

Thirdly, there is competitive rivalry which is highly intense in the UAE healthcare sector. The sector is characterized by both public and private sector players, with the government entities including the Abu Dhabi Health Service Company, Dubai Health Authority and the Ministry of Health and Prevention, which is particularly active in the northern emirates (U.S.-U.A.E. Business Council, 2016). Other government entities also provide healthcare. There are also private sector players, and finally, free zone entities. While the healthcare sector is fast-growing, enterprises are compelled to compete within these highly competitive environment where they compete not just among themselves, but against public and other government backed entities. These entities have the advantage of financial support from the government. Moreover, the free zones provide an opportunity for foreign health care providers to enter and operate with very few financial constraints. Due to the ineffectiveness of price and the inability to differentiate products significantly, entities in the industry must then compete aggressively with limited access to competitive advantages.

The fourth force is the bargaining power of suppliers, which is a highly intense factor. The bargaining power of suppliers stems from the fact that about 92.5% of medical equipment requirements are satisfied through imports, since the UAE lacks the manufacturing capacity in terms of both facilities and expertise to locally produce these materials and equipment (Alpen Capital, 2014).The power of suppliers is further enhanced by the fact that only local distributors who are registered with the government are allowed to import medical products. Consequently, this requirement increases the bargaining power of the few suppliers who attain such approval.

The final force is the threat of substitute products, which is strong at the primary care and individual company level, but moderate at the industry level. As noted, there are a range of different companies offering primary healthcare services, thereby making the industry very competitive. Since the industry is characterized by low product/service differentiation, then customers can easily access substitute products. At the firm level, there is a moderate threat since consumers can seek treatment abroad, particularly for secondary and tertiary services. Consumers opt to go abroad for a number of reasons, such as the unavailability of services, cost and a shortage of experienced personnel (Alpen Capital, 2014). The government also subsidizes these expenses.

The healthcare industry in the UAE is moderately attractive to current players in the industry. While the industry is characterized by high barriers to entry, this limitation is easily mitigated by government funding of healthcare facilities. Suppliers have a high bargaining power but the purchasing power of consumers is moderated by the mandatory insurance policy. The industry is highly competitive due to the presence of many public healthcare providers. Companies that hope to compete effectively need to focus on the key success factors of professionalism and quality of service.

Company Situation

The company situation presents an analysis of the company’s current situation in terms of opportunities and risks present in the market. The company situation analysis reveals the threats and opportunities in the market, and whether the company has the required resources to exploit these opportunities. The company situation evaluation of NMC Health will include a financial analysis as well as a SWOT analysis of the healthcare provider. NMC is currently seeking to exploit the variety of opportunities within its purview, guided by key strengths such as its extensive experience and its large corporate size.

Financial Analysis

One of the principal areas of financial analysis is profitability analysis, which seeks to determine how efficient a company is at generating revenues to cover its costs and expenses over a particular time frame. Profitability analysis is determined through the use of profitability ratios, which include the profit margin, return on assets (ROA) and return on equity (ROE). Some of these ratios are provided in the annual report, while others need to be calculated. NMC’s profit margins include both the gross margin and the net margin. Its gross margin for the year 2015 was 17.1% up from 15.9% in 2014, while the net profit margin was 9.7%, down from 12.0% in 2014 (NMC, 2015). The increase in gross profit was due to an increase in revenues, which was offset by higher depreciation and higher interests associated with new acquisitions, hence the decline in net margins. NMC’s ROE was 0.176 in 2015 and 0.173 in 2014, while its ROA was 0.059 and 0.082 in 2015 and 2014 respectively. Finally, its P/E ratio for the two years was 22.39 and 20.85 respectively. The low figures of ROE and ROA are indicative that the company is not particularly efficient at utilizing shareholder’s equity and its assets to generate revenue. Increased ROE indicates that the company’s asset base is growing, with activities being financed by these growing assets. Finally, the P/E ratio is very high indicating that the company is a very attractive investment option.

The second area of financial analysis is liquidity analysis, which indicate how readily the company can cater for its debt. A higher ratio is usually desirable, since it indicates that the company can easily cover its short-term obligations. There are a number of liquidity ratios. The current ratio indicates the company’s liquidity status, with a figure greater than one being desirable, as it indicates the current assets are higher. NMC’s current ratio is 1.502 for 2015 and 1.56 for 2014. The quick ratio indicates how easily a company can pay off its short-term obligations with its most liquid assets. NMC’s quick ratios are 1.167 and 1.262 in 2015 and 2014 respectively. Finally, there is the operating cash flow ratio. It indicates the company’s abilities to generate revenues that are sufficient to cover its short-term liabilities. At 0.377 and 0.287 for 2015 and 2014, this ratio is worrisome, since for a company in good financial health, the figure is expected to be higher than one. A positive indicator, however, is the fact that the ratio is increasing. Based on the liquidity analysis, NMC is in good financial health, but it needs to improve on the operating cash flow ratio.

Leverage ratios evaluate the company’s financial standing on the basis of its debts. These ratios are a good indicator of the company’s financial risk situation. Lower ratios are desirable since higher ones indicate a higher level of financial risk. The first ratio is the debt ratio, which indicates how much leverage a company is relying on. NMC’s debt ratio is 0.626 for 20105 and 0.523 for 2014. These ratios are relatively low, indicating that the company faces lower risk. The upward trend is, however, problematic. The second ratio is debt-to-equity ratio, which compares the company’s liability against equity. Higher values indicate that more money has been committed by supplier, creditors and obligors rather than shareholders. NMC’s value on this ratio is 1.957 (2015) and 1.108 (2014). These figures are very high, and the upward trend is worrying, especially the 2015 figure which indicates that liabilities are nearly twice the contribution by shareholders. The final leverage ratio is the capitalization ratio, which indicates whether a company’s capital structure is capable of supporting growth. For NMC, the capitalization ratio is 04.98 and 0.203 for 2015 and 2014 respectively. These figures are relatively low and hence provide a positive assessment of the enterprise.

A final area of financial analysis is activity analysis, which measures how easily a company can convert its accounts into cash or sales. Activity analysis is essentially a measure of how efficient the management is in cash form the company’s assets and resources. The first activity ratio is the accounts receivable ratio, which indicates how efficient a company is at collecting cash from customers. It entails dividing the total credit sales by the accounts receivable. A higher ratio is desirable. It was not possible to calculate this ratio for NMC since data on credit sales was not readily available or determinable. The second ratio is the merchandise inventory turnover ratio, which measures how much inventory was sold during a particular accounting period. The value of this ratio was 4.272 and 3.945 for 2015 and 2014 respectively. The high figures indicate that the company is easily able to convert inventory to sales, and is well complemented by the incremental trend. The final ratio is the total assets turnover ratio, which highlights how efficiently a company utilizes assets to generate sales. For NMC, this ratio was 0.606 and 0.677, indicating that the company was able to sell a greater amount of its inventory.

SWOT Analysis

This section provides a comprehensive review of the strengths and weaknesses of NMC, as well as the opportunities and threats present in the market.

Strengths

NMC enjoys a few key strengths, such as its highly skilled workforce. As noted, healthcare is a service industry in which success is closely tied to professionalism and quality of service. The highly skilled workforce thus enables NMC to compete effectively. Another strength is its early mover advantage, which it enjoys as the pioneer private healthcare provider. It therefore has a good understanding of the industry. A closely tied strength is the organizational experience of its business units. A final advantage is its brand recognition which makes it a trustworthy choice for consumers.

Weaknesses

One of the weaknesses of NMC is its high level of liability, which reduces the shareholder’s control over the company’s assets. The operating cash flow ratio indicates that the company is not generating enough cash to meet its current liabilities. Furthermore, the debt-equity ratio also indicates that shareholder’s contribution is nearly half the contribution by suppliers, creditors and other lenders. Another weakness is the concentration of the company’s operations in the UAE, which makes the enterprise vulnerable to changes there, such as increased competition. Finally, the company also has a broad brand portfolio, which weakens its focus on its core business.

Opportunities

There are several opportunities in the market. One of these is the projection of a continual growth in the UAE health sector, which means that the company can expect greater demand for its services. The company also has an opportunity to expand internationally into new markets, whereby it has already began to do so through its acquisition of a hospital in Egypt. Going forward, the company should focus on going global, as the competition in the UAE increases.

Threats

While exploiting these opportunities, NMC also has to cope with several threats. Firstly, the diversification of its business is a threat to NMC, as it reduces the company’s focus on healthcare, which may lead to poorer services. Another threat is the establishment of free zone entities, which is bound to lead to higher competition in the UAE, this would further exacerbate NMC’s weakness of its concentration in Dubai.

Recommendations

Strategic Issue

This analysis sought to determine the following question: Is global growth the solution for NMC Health as it seeks to continue satisfying its shareholders’ expectations through growth strategies?

Strategy Recommendations

NMC health should adopt a differentiation approach in terms of its generic strategies. This will involve developing health packages that are more attractive to its consumers than the packages offered by its competitors. This generic strategy is appropriate since the industry is highly competitive, and customers have a low bargaining power. Consequently, by choosing a differentiation strategy, the company will be able to appeal to consumers who are seeking better services, which in the health sector, happens to be nearly everyone. To implement this strategy, the enterprise will need to ensure that it continues to acquire highly skilled labor. The company will also need to invest in health technologies that will enable it to provide specialized healthcare for a broad range of healthcare issues. This strategy is well complemented by the company’s strengths such as its experience in the industry and its brand recognition. Combined with these strengths, the differentiation strategy will help the enterprise to overcome the threat of new entrants posed by the establishment of the free zones.

When it comes to the grand strategies, NMC should focus on growth/expansion strategies, particularly via the integration and diversification sub-strategies. The company has the financial base required to implement an integration strategy. It can focus on backward integration by acquiring some of its suppliers, as this will enable it to mitigate the bargaining power of suppliers. Moreover, this will also strengthen the competitive position of its distribution vertical. Horizontal integration is also recommended, as it will complement the diversification strategy of concentric diversification. Together, these strategies will enable the firm to take advantage of the potential opportunities in the UAE market. Diversification will require intensive capital input. Given the high threshold of liability the company currently incurs, it is recommended that the company implement these strategies after two to three years, or to such a time, when its operating cash flow and debt-to-equity ratios indicate a better position.

Objectives

The following objectives should be monitored closely:

  1. Increased customer satisfaction through a higher number of retained customers as well as higher levels of customer engagement
  2. Ability to deal with a broad range of medical issues
  3. Reduced referral of customers to institutions that are not part of NMC’s portfolio
  4. Continuous acquisition of the highest skilled human personnel, through programs such as direct absorption from campus and mentoring endeavors.
  5. Reduced cost of supplies

Strategic Justification

The recommended strategies are the best because the combination of their costs and benefits (pros versus cons), results in the most positive balance of benefits. For starters, an alternative to the differentiation strategy would be a focus strategy. This approach, however, would simply limit the capabilities of the enterprise, since it has the capital required to address a broad market and a broad range of market issues. In most instances, this strategy is usually suited for smaller enterprises. The other strategy is the cost leadership strategy. Given the high bargaining power of suppliers, and the low bargaining power of consumers, however, this strategy would not translate in a competitive advantage for the firm. Most consumers have a health insurance policy and as such, cost is not such a significant consideration for them. The cost leadership strategy is based on offering lower prices, and the lack of price sensitivity amongst consumers neutralizes its strategic significance.

At the grand level, the expansion strategy was chosen because of the opportunities available in the market. The UAE health sector is at the growth stage and as such, there are opportunities that NMC can exploit. The company is highly and favorably competitive and as such, there is no need for retrenchment or liquidation strategies. Secondly, given the intensifying competition in the industry, the company needs to be proactive and deploy its strengths to obtain and sustain a competitive advantage. The company has market experience, and a well-known and recognized brand. These strengths are best deployed through growth strategies that will further mitigate current weaknesses such as the concentration of its operations in the UAE. Moreover, the concentric strategy is proposed over the conglomerate strategy since as noted, a key weakness of the company is its broad portfolio, which poses a threat of reduced focus on its core business. The concentric strategy will allow NMC to focus on its core business.

References

Al Masah Capital. (2011). MENA: Healthcare Sector Report. Dubai: Al Masah capital Management Limited.

Alpen Capital. (2014). GCC Healthcare Sector. Dubai: Alpen Capital.

Kim, Y. K., & Lee, H. R. (2011). Customer satisfaction using low cost carriers. Tourism Management, 32, 235–243.

Ministry of Health. (2016, May 03). MOH Strategy. Retrieved from Ministry of Health: www.moh.gov.ae/en/About/Pages/Strategy.aspx

NMC Health. (2015). Annual Reports & Accounts 2015. Abu Dhabi: NMC Health plc.

NMC Health. (2015). History. Retrieved from NMC Health: http://www.nmchealth.com/history/

NMC Health. (2017). Strategy and Vision. Retrieved from NMC Health: http://www.nmchealth.com/strategy-and-vision/

Saha, G. C., & Theingi. (2009). Service quality, satisfaction, and behavioural intentions: A study of low-cost airline carriers in Thailand. Managing Service Quality: An International Journal, 19(3), 350-372.

Siddiqi, K. O. (2011). Interrelations between service quality attributes, customer satisfaction and customer loyalty in the retail banking sector in Bangladesh. International Journal of Business and Management, 6(3), 12.

U.S.–U.A.E. Business Council . (2016). The U.A.E. Healthcare Sector: An Update. Washington: U.S.-U.A.E. Business Council.

Appendix 1: Financial Analysis Calculations

Financial Ratio Calculated as: Year
2015 2014
Profitability Ratios
Return on Equity Net income/ Shareholders’ equity  = 0.176  =0.173
Return on Assets Net income/ Total Assets  = 0.059  = 0.082
Price to Earnings ratio Market value per share*/ earnings per share  = 22.39  = 20.85
Liquidity Ratios
Current ratio Current assets/ current liabilities  = 1.502  =1.56
Quick ratio (Acid-test ratio) (current assets-inventory)/ current liabilities  = 1.167  = 1.262
Operating cash flow ratio Cash flow from operations/ current liabilities  = 0.377  = 0.287
Leverage Ratios
Debt ratio Total liabilities/ total assets  = 0.626  = 0.523
Debt-to-equity ratio Total liabilities/ shareholders’ equity  = 1.957  = 1.108
Capitalization ratio Long-term debt/ (long-term debt + shareholders’ equity)  = 0.498  = 0.203
Activity Ratios
Accounts receivable turnover ratio Total credit sales/ average accounts receivable    
Merchandise Inventory turnover ratio Cost of goods sold/ average inventory  = 4.272  = 3.945
Total assets turnover ratio Total sales/ total assets  = 0.606  = 0.677

Appendix 2: SWOT Analysis

Strengths Weaknesses
Highly Skilled Workforce Increased liability increasing vulnerability to creditors.
Early mover advantage as the pioneer private healthcare provider in the UAE NMC main operations are centered in the UAE
Experienced organization and business units Broad brand portfolio which introduces inefficiencies
Brand Recognition  
Opportunities Threats
Projected continual growth of the UAE health sector Diversification of the business leading to less focus on health provision.
Internationalization of business presenting new opportunities for the provider abroad Establishment of freezone entities promoting the entry of foreign health providers thereby leading to greater competition.