Investee Spotlight: Pushpagiri Vitreo Retina Institute

PVRI’s new hospital building, decorated for its inauguration

What is PVRI, and what do they do?

PVRI, the Pushpagiri Vitreo Retina Institute, is an organization treating preventable eye disease in India. PVRI provides a broad range of eye care services – from out-patient procedures to surgeries and post operative care. Focused on one of the leading causes of blindness – diabetic retinopathy, or blindness caused by diabetes, they’ve also found that this one of the most easily preventable causes of blindness. This is in part due to a complete lack of awareness surrounding this issue in at-risk populations, and lack of access to specialized services.

Loss of eyesight has a tremendously negative economic and social impact on low-income families, especially for agricultural and factory workers, artisans, and those that depend on production of small scale goods.

Where do they work?

Andhra Pradesh, the Indian state of over 83 million people, has been home to PVRI’s first hospital based out of Hyderabad since 2007. Of all Indian states, Andhra Pradesh has the highest incidence rate of diabetes, and consequently diabetic retinopathy. Diabetic retinopathy can occur in people suffering from Type I and Type II diabetes, and overall prevalence in India is estimated to be around 14% of all diabetics. These rates in Andhra Pradesh are far higher – ranging around 23-25% of those with diabetes.

On March 5th, 2012 PVRI opened and operationalized the first of two new hospitals supported by Acumen capital in Vizianagaram, Andhra Pradesh. The second hospital, in Kadappa, Andhra Pradesh, is targeted for a July 2012 opening.

What is their business model?

PVRI is the only eye care hospital in the state to be sanctioned by the AP government health insurance scheme – ArogyaSri. This means that any BPL (below poverty line – approximately $2/day) card holder can avail free care at PVRI facilities. Beyond the cost of care – transportation to and from the facility, accommodation, and food during the post operative period is also covered by the hospital. PVRI’s overall model functions as a cross subsidy – their high quality of care and use of state of the art equipment enable them to charge the standard private care charges to those who can afford it, while still providing affordable care and lower prices to those who cannot – either through the ArogyaSri scheme or independently. PVRI is also in the process of acquiring NABH accreditation – a high quality standard independently conferred by the Quality Council of India.

Where is the break-through innovation?

PVRI’s major innovation is the dual accomplishment of being able to provide access to affordable and quality medical care. In a sector where there is an overload of new, unproven medical technology, PVRI stands apart with its sound business model.

Through a combination of regional camps, one flagship urban hospital and two new hospitals funded by Acumen Fund’s capital in rural areas of the state – PVRI will cover approximately 50% of the state’s population. These screening and treatment camps help spread awareness, facilitate access, and provide a much needed treatment for what can only be described as a growing epidemic.

Decorations adorn the wings of one of PVRI’s new hospitals

The two new hospitals are located in tribal regions of the state – areas that are traditional neglected by conventional private care due to often volatile political conditions and lower income populations who often cannot afford traditional models of care. However, these are the areas with the highest incidence rates due to long term neglect – either due to distance from the treatment centres, inability to pay or even unawareness of the root cause. PVRI preservers to address all three of these factors.

The monthly one-day camps that take place in a radius around all of these operational or soon to be operational hospitals play an important part in education and awareness. PVRI also builds local capacity by hiring and training staff from these regions, though this process is often a lot harder than procuring urban talent. To jump start this process, starting next year with 30 students the recently opened Vizianagaram hospital will offer diploma courses post SSC exams.

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As a Senior Associate on the Portfolio Team in the Acumen India office, Manasa focuses on the health sector. Her responsibilities include working with and providing management support to existing health portfolio investments, as well as identifying and conducting diligence on new areas of investment opportunity. She holds a Bachelor’s of Science degree with a double major in Finance and International Business from New York University’s Stern School of Business.