A STUDY ON

PERFORMANCE MANAGEMENT SYSTEMS

with reference to

MEDICOVER HOSPITALS
VISAKHAPATNAM CITY, A. P., INDIA

A project report submitted to Department of Commerce and Management Studies,

Andhra University, Visakhapatnam in partial fulfillment for award of
MASTER OF BUSINESS ADMINISTRATION
Submitted by

KURASALA SHIVANI
REGD No. 120200202267

Under the esteemed guidance of

Prof. M. UMA DEVI
MBA, Ph.D.

Department of Commerce & Management Studies,

Andhra University
VISAKHAPATNAM

ANDHRA UNIVERSITY
VISAKHAPATNAM - 530 003
Batch: 2020-2022
 DECLARATION

I hereby declare that the project report entitled ―A STUDY ON

PERFORMANCE MANAGEMENT SYSTEMS in MEDICOVER

HOSPITALS, VISAKHAPATNAM‖ submitted to Department of

Commerce and Management Studies, Andhra University,

Visakhapatnam under the esteemed guidance of Prof. M.UMA

DEVI , in partial fulfillment for the award of the degree of Master of

Business Administration is entirely based on my own study and is

being submitted for the first time and it has not been submitted to any

other university or institution for any degree or diploma.

Place: VISAKHAPATNAM KURASALA SHIVANI

Date: (Regd. No: 120200202267)

 CERTIFICATE

This is to certify that the project report entitled ―A STUDY ON

PERFORMANCE MANAGEMENT SYSTEMS IN MEDICOVER

HOSPITALS , VISAKHAPATNAM‖, is being submitted by

KURASALA SHIVANI, in partial fulfillment of the requirements for

the award of the degree of MASTER OF BUSINESS

ADMINISTRATION has been carried out by her under my guidance

and supervision.

Place: Visakhapatnam Prof. M. UMA DEVI

MBA, Ph.D.
 ACKNOWLEDGEMENT

It is of great pleasure to take the opportunity to acknowledge and express my

gratitude to all those who helped me throughout my project work.

I am grateful to Prof. P. VISWANADHAM, Head of the department,

Department of Commerce and Management Studies, for availing me the

opportunity to do this project.

I express my deep gratitude to my project guide Prof. M. UMA DEVI ,

Department of Commerce and Management Studies, Andhra University,

Visakhapatnam for her valuable guidance and suggestions without which the

project could not have completed.

My heartfelt thanks to Prof. P. RAJENDRA KARMARKAR, Principal of Arts

and Commerce, Andhra University, for providing me with this opportunity to

learn and grow.

I owe my sincere gratitude to Mr. S. CHANDRA SEKHAR, Sr.Manager (HR

Department), Medicover hospitals (Visakhapatnam), for giving me an

opportunity to work on this project in their esteemed organization and for their

guidance which helped in completing the project throughout the period of my

study.

KURASALA SHIVANI

(Regd. No: 120200202267)

S.NO CONTENTS Pg.NO
CHAPTER – 1
1.  INTRODUCTION 1-3
 NEED FOR THE STUDY 4
 SCOPE OF THE STUDY 5
 OBJECTIVES OF THE STUDY 6
 RESEARCH METHODOLOGY 7-8
 LIMITATIONS OF THE STUDY 9
 PRESENTATION OF THE STUDY 10

CHAPTER-2
2.  INDUSTRY PROFILE 11-25
 COMPANY PROFILE 26-40

CHAPTER-3
3.  THEORETICAL FRAMEWORK OF 42-66
PERFORMANCE MANAGEMENT SYSTEMS
CHAPTER-4
4.  DATA ANALYSIS AND INTERPRETATION OF 67-83
PERFORMANCE MANAGEMENT SYSTEMS

CHAPTER-5
5.  SUMMARY, FINDINGS, SUGGESTIONS AND 84-88
CONCLUSION

 BIBILOGRAPHY AND ANNEXURE 89-94

 CHAPTER 1

 INTRODUCTION
 NEED FOR THE STUDY
 SCOPE OF THE STUDY
 OBJECTIVES OF THE STUDY
 RESEARCH METHODOLOGY
 LIMITATIONS OF THE STUDY
 PRESENTATION OF THE STUDY

1
 INTRODUCTION

Human resource management (HRM or HR) is the strategic approach to the

effective management of people in a company or organization such that they help their
business gain a competitive advantage. It is designed to maximize employee performance
in service of an employer's strategic objectives.

Performance management (PM) is a set of activities that ensure goals are met in
an effective and efficient manner. Performance management can focus on the
performance of an organization, a department, an employee or the processes in place to
manage particular tasks.

Performance management for business is defined as a "strategic and integrated

approach to increase the effectiveness of companies by improving the performance of the
people who work in them and by developing the capabilities of teams and individual
contributors. Managers use performance management to align company goals with the
goals of teams and employees in an effort to increase efficiency, productivity, and
profitability. Performance management guidelines stipulate clearly the activities and
outcomes by which employees and teams are evaluated during performance appraisal.
Performance management principles are used most often in the workplace and can be
applied wherever people interact with their environments to produce desired effects—
schools, churches, community meetings, sports teams, health settings, governmental
agencies, social events, and even political settings.

IN COMPANIES -

Organizations and companies typically manage employee performance over a

formal 12-month period (otherwise known as the formal company performance
period).The results of performance management exercises are used in: Employee
development planning to select the most appropriate and suitable development
intervention to improve employees' knowledge, skills and behavior, Factual basis for

2
compensation and rewards (pay raise & bonuses being the most common), Factual basis
in consideration with other factors for mobility (Example: transfers and promotions).

3
 NEED FOR THE STUDY

Providing information about the performance ranks on which decision regarding

salary fixation, promotion and etc. To learn and realize the importance of performance
management system, various Performance appraisal systems and different techniques to
improve employee‘s performance ,Which helps in Review of the performance of the
subordinates, Providing information that helps to counsel the subordinates, Getting
information to diagnose deficiency in employees regarding skills, knowledge, etc, To
prevent grievance and in disciplinary activities.

4
 SCOPE OF THE STUDY

 Performance management is not a sporadic event but a strategic set of

management policies and concrete actions. It is a systematic process resulting in
constantly improving organizational effectiveness. It contributes to the effective
management of individuals and teams in order to achieve high levels of
organizational performance. It includes:
 Planning work (setting goals, expectations and performance standards)
 Monitoring performance and providing feedback
 Rating performance regularly
 Rewarding and encouraging good performance
 In performance management managers use various tools, policies and systems to
help employees unleash their potential and be successful at their jobs, some of
these are:
 Employee orientation programs
 Coaching and mentoring
 Internal communication systems
 Performance-based remuneration systems
 Career and succession management systems.

5
 OBJECTIVES OF THE STUDY

 The aim of objective of performance management in MEDICOVER HOSPITALS

(VISAKHAPATNAM) is to evaluate the capacity and competence of individual
as well as the organization
 To analyze the processes and evolution of performance management system over
the years in the organization
 To observe whether the performance appraisal technique is effective and
challenging
 To assess the feedback of the employees regarding performance management
system in the company
 To offer suggestions regarding the techniques after the study and observation of
my research in performance management system in their company.

6
 METHODOLOGY OF THE STUDY

A methodology is a systematic procedure of collecting information in order to analyze

and verify a phenomenon. The collecting of information has been through two principles
sources .They are:

 PRIMARY DATA
 SECONDARY DATA

 PRIMARY DATA:

Primary data is the data that has not been previously published and is collected by the
investigator conducting the research. It is information that is obtained directly from first
hand conducting sources by means of surveys, observations or experimentation.

The primary data has been collected through campaigning questionnaire among
employees in MEDICOVER HOSPITALS, VIZAG.

 SECONDARY DATA:

It is the data that has already been collected from someone other than the user and readily
available to the user. Common sources of secondary data for social, Science senses,
organizational records and data collected through qualitative methodologies and
researches

The secondary data has been collected through various sources such as records journal
books and company website and record.

Sampling Techniques:

The type of Sampling Techniques adopted in this project analysis is simple

random sampling. Employees were approached and given administrating

7
Questionnaires to know their opinion about performance management system in
Medicover Hospitals (Visakhapatnam).
The Sample for the study was chosen which covers employees from Human
resource department of the company.

Sample size:
The size of sample was fixed to 30 employees. The study was carried forward
with the help of the working data- Primary Data and Secondary data. This data
was collected in two ways namely,
● Observation method
● Interview/ Questionnaire method.

Hence the methodology followed during this report is:

● Collection of data via questionnaire
● Analysis of that data.
● Collection of data through company‘s website, internet and etc.

8
 LIMITATIONS OF THE STUDY

 The company or team consists of a large number of people; the process of learning
performance appraisal becomes extremely hectic, difficult and inaccurate.
 Due to busy work schedules of the employees most of the employees couldn‘t answer the
questionnaire or share their views
 As company was recruiting fresher‘s in that period most of the people couldn‘t give any
information or share their views from organization point of view
 As performance appraisal takes place only once in the end of the year , people weren‘t
working upon this process in the period , so only theoretical knowledge is been learnt and
revised.

9
 PRESENTATION OF THE STUDY

The study entitled "PERFORMANCE MANAGEMENT SYSTEMS"

has been divided into 5 chapters and is presented as follows:

Chapter1: Deals with the concept of Performance Management Systems

and gives the objectives, sampling details and limitations of the study.

Chapter2: Presents the highlights of Medicover Hospitals along with the

corporate profile, major departments and human resource policies and
philosophy in Medicover Hospitals.

Chapter 3: Explains the Theoretical framework of Performance

Management Systems in detail.

Chapter4: Depicts the data analysis and interpretation of

Medicover Hospitals.

Chapter5: Fine presentation of summary, findings, suggestions, conclusion,

annexure, bibliography.

10
 CHAPTER 2

 INDUSTRY PROFILE
 COMPANY PROFILE

11
 INDUSTRY PROFILE

Healthcare Industry:

The healthcare industry (also called the medical industry or health economy) is an
aggregation and integration of sectors within the economic system that provides goods
and services to treat patients with curative, preventive, rehabilitative, and palliative care.
It includes the generation and commercialization of goods and services lending
themselves to maintaining and re-establishing health. The modern healthcare industry
includes three essential branches which are services, products, and finance and may be
divided into many sectors and categories and depends on the interdisciplinary teams of
trained professionals and paraprofessionals to meet health needs of individuals and
populations.

The healthcare industry is one of the world's largest and fastest-

growing industries. Consuming over 10 percent of gross domestic product (GDP) of
most developed nations, health care can form an enormous part of a country's economy.
U.S. health care spending grew 4.6 percent in 2019, reaching $3.8 trillion or $11,582 per
person. As a share of the nation's Gross Domestic Product, health spending accounted
for 17.7 percent. The per capita expenditure on health and pharmaceuticals in OECD
countries has steadily grown from a couple of hundred in the 1970-ies to an average of
US$ 4'000 per year in current purchasing power parities.

Background:

For the purpose of finance and management, the healthcare industry is typically
divided into several areas. As a basic framework for defining the sector, the United
Nations International Standard Industrial Classification (ISIC) categorizes the healthcare
industry as generally consisting of:

1. Hospital activities;
2. Medical and dental practice activities;
3. "Other human health activities".

12
 This third class involves activities of, or under the supervision of, nurses, midwives,
physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health
facilities, or other allied health professions, e.g. in the field of optometry, hydrotherapy,
medical massage, yoga therapy, music therapy, occupational therapy, speech therapy,
chiropody, homeopathy, chiropractic, acupuncture, etc.

The Global Industry Classification Standard and the Industry Classification

Benchmark further distinguish the industry as two main groups:

1. healthcare equipment and services; and

2. pharmaceuticals, biotechnology and related life sciences.

The healthcare equipment and services group consists of companies and entities that
provide medical equipment, medical supplies, and healthcare services, such as hospitals,
home healthcare providers, and nursing homes. The latter listed industry group includes
companies that produce biotechnology, pharmaceuticals, and miscellaneous scientific
services.

Other approaches to defining the scope of the healthcare industry tend to adopt a
broader definition, also including other key actions related to health, such as education
and training of health professionals, regulation and management of health services
delivery, provision of traditional and complementary medicines, and administration
of health insurance.

Providers and Professionals:

A healthcare provider is an institution (such as a hospital or clinic) or person

(such as a physician, nurse, allied health professional or community health worker) that
provides preventive, curative, promotional, rehabilitative or palliative care services in a
systematic way to individuals, families or communities.

The World Health Organization estimates there are 9.2 million physicians, 19.4
million nurses and midwives, 1.9 million dentists and other dentistry personnel, 2.6
million pharmacists and other pharmaceutical personnel, and over 1.3 million community
health workers worldwide, making the health care industry one of the largest segments of
the workforce.
13
 The medical industry is also supported by many professions that do not directly
provide health care itself, but are part of the management and support of the health care
system. The incomes of managers and administrators, underwriters and medical
malpractice attorneys, marketers, investors and shareholders of for-profit services, all are
attributable to health care costs.

In 2017, healthcare costs paid to hospitals, physicians, nursing

homes, diagnostic laboratories, pharmacies, medical device manufacturers and other
components of the healthcare system, consumed 17.9 percent of the gross domestic
product (GDP) of the United States, the largest of any country in the world. It is expected
that the health share of the Gross domestic product (GDP) will continue its upward trend,
reaching 19.9 percent of GDP by 2025. In 2001, for the OECD countries the average was
8.4 percent with the United States (13.9%), Switzerland (10.9%), and Germany (10.7%)
being the top three. US health care expenditures totaled US$2.2 trillion in
2006. According to Health Affairs, US$7,498 be spent on every woman, man and child in
the United States in 2007, 20 percent of all spending. Costs are projected to increase to
$12,782 by 2016.

The government does not ensure all-inclusive health care to every one of its
natives, yet certain freely supported health care programs help to accommodate a portion
of the elderly, crippled, and poor people and elected law guarantees community to crisis
benefits paying little respect to capacity to pay. Those without health protection scope are
relied upon to pay secretly for therapeutic administrations. Health protection is costly and
hospital expenses are overwhelmingly the most well-known explanation behind
individual liquidation in the United States.

Delivery of Services:

The delivery of healthcare services—from primary

care to secondary and tertiary levels of care—is the most visible part of any healthcare
system, both to users and the general public. There are many ways of providing
healthcare in the modern world. The place of delivery may be in the home, the
community, the workplace, or in health facilities. The most common way is face-to-face
delivery, where care provider and patient see each other in person. This is what occurs in

14
general medicine in most countries. However, with modern telecommunications
technology, in absentia health care or Tele-Health is becoming more common. This could
be when practitioner and patient communicate over the phone, video conferencing, the
internet, email, text messages, or any other form of non-face-to-face communication.
Practices like these are especial applicable to rural regions in developed nations. These
services are typically implemented on a clinic-by-clinic basis.

Improving access, coverage and quality of health services depends on the ways
services are organized and managed, and on the incentives influencing providers and
users. In market-based health care systems, for example such as that in the United States,
such services are usually paid for by the patient or through the patient's health
insurance company. Other mechanisms include government-financed systems (such as
the National Health Service in the United Kingdom). In many poorer
countries, development aid, as well as funding through charities or volunteers, help
support the delivery and financing of health care services among large segments of the
population.

The structure of healthcare charges can also vary dramatically among countries.
For instance, Chinese hospital charges tend toward 50% for drugs, another major
percentage for equipment, and a small percentage for healthcare professional fees. China
has implemented a long-term transformation of its healthcare industry, beginning in the
1980s. Over the first twenty-five years of this transformation, government contributions
to healthcare expenditures have dropped from 36% to 15%, with the burden of managing
this decrease falling largely on patients. Also over this period, a small proportion of state-
owned hospitals have been privatized. As an incentive to privatization, foreign
investment in hospitals—up to 70% ownership has been encouraged.

Industries Within the Healthcare Sector

The healthcare sector contains a diverse array of industries, with activities
ranging from research to manufacturing to facilities management.

15
Drugs
Drug manufacturers can further be broken down into biotechnology firms, major
pharmaceutical firms, and makers of generic drugs. The biotech industry consists of
companies that engage in research and development to create new drugs, devices, and
treatment methods.

Many of these companies are small and lack dependable sources of revenue.
Their market value may depend entirely on the expectation that a drug or treatment will
gain regulatory approval, and FDA decisions or rulings in patent cases can lead to sharp,
double-digit swings in share prices. Examples of (larger) biotech firms include Novo
Nordisk (NVO), Regeneron ( REGN), Alexion ( ALXN), Vertex ( VRTX), Gilead
Sciences Inc. (GILD), and Celgene Corp. (CELG).

Major pharmaceutical firms also engage in research and development but tend to
focus more on manufacturing and marketing an existing portfolio of drugs than the
typical biotech firm. These companies tend to have more dependable streams of revenue
and a more diversified "pipeline" of drugs in the research and development stages,
making them less dependent on make-or-break drug trials and their shares less volatile.
Examples of major pharmaceutical firms include Johnson and Johnson, Roche, Pfizer,
Eli Lilly, Novartis AG. GlaxoSmithKline, and Astrazeneca.

Some pharmaceutical firms specialize in generic drugs, which are identical to

name-brand drugs but no longer enjoy patent protection. As a result, there is often
competition to manufacture identical drugs, leading to lower prices and thinner profit
margins. An example of a generic drugs firm is Teva Pharmaceutical Industries Ltd.

Medical Equipment
Medical equipment makers range from firms that manufacture standard, familiar
products—scalpels, forceps, bandages, and gloves—to those that conduct cutting-edge
research and produce expensive, hi-tech equipment, such as MRI machines and surgical
robots. Medtronic PLC is an example of a medical equipment maker.

16
Managed Healthcare
Managed healthcare companies provide health insurance policies. The "Big Five"
firms that dominate the managed Medicaid industry are UnitedHealth Group Inc.,
Anthem Inc., Aetna Inc., Molina., and Centene.

Healthcare Facilities
Healthcare facilities firms operate hospitals, clinics, labs, psychiatric facilities,
and nursing homes. Examples include Laboratory Corp. of America Holdings, which
operates facilities that perform blood tests and other analyses, and HCA Healthcare Inc.,
which operates hospitals and other healthcare facilities in the U.S. and U.K.

Health care Industry in India

Healthcare industry in India comprises of hospitals, medical devices, clinical
trials, outsourcing, telemedicine, medical tourism, health insurance, and medical
equipment. The healthcare sector is growing at a tremendous pace owing to its
strengthening coverage, services, and increasing expenditure by public as well private
players.
Healthcare has become one of India‘s largest sector, both in terms of revenue and
employment. Healthcare comprises hospitals, medical devices, clinical trials,
outsourcing, telemedicine, medical tourism, health insurance and medical equipment. The
Indian healthcare sector is growing at a brisk pace due to its strengthening coverage,
services and increasing expenditure by public as well private players.
Indian healthcare delivery system is categorised into two major components public and
private. The Government, i.e. public healthcare system, comprises limited secondary and
tertiary care institutions in key cities and focuses on providing basic healthcare facilities
in the form of primary healthcare centres (PHCs) in rural areas. The private sector
provides majority of secondary, tertiary, and quaternary care institutions with major
concentration in metros and tier I and tier II cities.
India's competitive advantage lies in its large pool of well-trained medical
professionals. India is also cost competitive compared to its peers in Asia and Western

17
countries. The cost of surgery in India is about one-tenth of that in the US or Western
Europe.
As of November 19, 2021, >115 crore COVID-19 vaccine doses have been
administered across the country.

Market Size:
The healthcare market can increase three-fold to Rs. 8.6 trillion (US$ 133.44
billion) by 2022. In Budget 2021, India‘s public expenditure on healthcare stood at 1.2%
as a percentage of the GDP.
A growing middle-class, coupled with rising burden of new diseases, are boosting
the demand for health insurance coverage. With increasing demand for affordable and
quality healthcare, penetration of health insurance is poised to expand in the coming
years. In FY21, gross direct premium income underwritten by health insurance
companies grew 13.3% YoY to Rs. 58,572.46 crore (US$ 7.9 billion). The health
segment has a 29.5% share in the total gross written premiums earned in the country.
Recent developments. Indian medical tourism market was valued at US$ 2.89 billion in
2020 and is expected to reach US$ 13.42 billion by 2026.
According to India Tourism Statistics at a Glance 2020 report, ~697,300 foreign
tourists came for medical treatment in India in FY19. India has been ranked 10th in the
Medical Tourism Index (MTI) for 2020-21 out of 46 destinations by the Medical Tourism
Association.
By FY22, Indian healthcare infrastructure is expected to reach US$ 349.1 billion.
The e-health market size is estimated to reach US$ 10.6 billion by 2025.
Between April 2000 and June 2021, FDI inflows for drugs and pharmaceuticals sector
stood at US$ 18.12 billion, according to the data released by Department for Promotion
of Industry and Internal Trade (DPIIT). Some of the recent initiatives in the Indian
healthcare industry are as follows:

 As of November 18, 2021, 80,136 Ayushman Bharat-Health and Wellness

Centres (AB-HWCs) are operational in India.

18
 As of November 18, 2021, 638 e-Hospitals were established across India as part
of the central government's ‗Digital India‘ initiative.
 In November 2021, Flipkart Group announced its foray into the healthcare sector
through the launch of Flipkart Health+. As part of this development, Flipkart has
signed definitive agreements to acquire a majority share in Sastasundar
Marketplace Limited, which owns and operates SastaSundar.com, an online
pharmacy and digital healthcare platform.
 In November 2021, Aster DM Healthcare announced that it is planning ~Rs. 900
crore (US$ 120.97 million) capital expenditure over the next three years to
expand presence in India, as it looks at increasing the share of revenue from the
country to ~40% of the total by 2025.
 By September 21, 2021, the Health Ministry‘s eSanjeevani telemedicine service
crossed 12 million teleconsultations since its launch, enabling patient-to-doctor
consultations, from the confines of their homes, and doctor-to-doctor
consultations.
 In September 2021, Biological E. Ltd. announced that it is expected to launch its
vaccine against coronavirus in October 2021.
 In September 2021, Russian-made COVID-19 vaccine, Sputnik Light received
permission for Phase 3 trials in India.
 In September 2021, Phase 2 trials of India's first intranasal vaccine, against
COVID-19, that is being developed by Bharat Biotech in conjunction with
Washington University School of Medicine in St Louis, the US, commenced At
Prakhar Hospital in Kanpur.
 In September 2021, Biocon Biologics Limited, a subsidiary of Biocon, announced
a strategic alliance with Serum Institute Life Sciences, a subsidiary of Serum
Institute of India (SII). The alliance is expected to strengthen India's position as a
global vaccine and biologics manufacturing powerhouse.
 In July 2021, India made its Covid-19 vaccination platform, CoWIN, open source
for all countries. Almost 76 countries have displayed interest in leveraging the
CoWIN platform to manage their national COVID-19 vaccination drives.

19
 As of July 2021, Biological E. Ltd, is conducting Phase-III trials for its Corbevax
vaccine. The company is expected to apply for an ‗Emergency Use License‘ by
August end and supply 300 million doses to the Government of India by
December 2021.
 In July 2021, the Indian government granted Sanofi and GSK approvals to
conduct late-stage clinical trials of their protein-based vaccines.
 In July 2021, the Ministry of Tourism established the ‗National Medical &
Wellness Tourism Board‘ to promote the Medical and Wellness Tourism in India.
 In July 2021, the Union Cabinet approved continuation of the National Ayush
Mission, responsible for the development of traditional medicines in India, as a
centrally sponsored scheme until 2026.
 In July 2021, the Union Cabinet approved the MoU between India and Denmark
on cooperation in health and medicine. The agreement will focus on joint
initiatives and technology development in the health sector with the aim of
improving public health status of the populations of both countries.
 In June 2021, PharmEasy acquired a majority stake in Thyrocare Technologies, a
diagnostics chain, to diversify and bolster its testing business.
 In June 2021, AstraZeneca India signed a memorandum of understanding (MoU)
with Docon Technologies, a Bengaluru-based health start-up, to digitise 1,000
clinics across India by implementing customised electronic medical record (EMR)
systems in clinics to offer doctors access to a patient‘s complete medical history.
 In April 2021, Tata Digital infused Rs. 100 crore (US$ 13.45 million) debt in
1mg, the online medicine start-up, and was in the final stages of acquiring a
controlling stake in the company.
 In April 2021, the Ministry of Ayush and Council of Scientific & Industrial
Research completed multi-centre clinical trial of a AYUSH 64 (a medicine) and
found it useful for treatment of mild-to-moderate COVID-19 infections.
 By March 2021, India exported more vaccines than it had administered to its
citizens—60 million doses had been dispatched to 76 countries, while 52 million
doses had been administered to Indian citizens. Apart from vaccines, drugs
indicated for Covid-19 treatment too witnessed an uptrend in exports. For

20
 example, Remdesivir exports doubled in March 2021 to $14.8 million from $5.75
million in February 2021
 In March 2021, Union Health Minister Harsh Vardhan informed the Rajya Sabha
that 157 medical colleges are under various stages of implementation across India.
Of this, 58 colleges are in the first phase of implementation, 24 in the second
phase and 75 are in the third phase.
 In June 2021, gross written premiums of health insurance companies in the non-
life insurance sector increased by 32.25% YoY (for the FY period up to August
2021) to Rs. 30,192.30 crore (US$ 4.04 billion), driven by rising demand for
health insurance products amid the COVID-19 pandemic.
 In March 2021, Virchow Biotech, a Hyderabad-based firm, and the Russian
Direct Investment Fund (RDIF) announced a collaboration to manufacture up to
200 million doses of the Sputnik V vaccine in India.

Government Initiatives
Some of the major initiatives taken by the Government of India to promote Indian
healthcare industry are as follows:

 In November 2021, the Government of India, the Government of Meghalaya and

the World Bank signed a US$ 40-million health project for the state of
Meghalaya. Project will improve the quality of health services and strengthen the
state‘s capacity to handle future health emergencies, including the COVID-19
pandemic.
 India could restart deliveries of Covid-19 shots to global vaccine-sharing platform
COVAX in November-December 2021 for the first time since April 2021. The
World Health Organization (WHO), which co-leads COVAX, has been pushing
India to resume supplies for the programme,, particularly after it sent ~4 million
doses to its neighbours and allies in October 2021.
 In September 2021, Prime Minister Mr. Narendra Modi while speaking at the
global COVID-19 summit said that India has shared its vaccine production with

21
 95 countries and the UN peacekeepers. He also stated that India will supply
COVID-19 vaccines to other countries after increased production.
 In September 2021, Prime Minister Mr. Narendra Modi launched the Ayushman
Bharat Digital Mission. The mission will connect the digital health solutions of
hospitals across the country with each other. Under this, every citizen will now
get a digital health ID and their health record will be digitally protected.
 In September 2021, Telangana government in a joint initiative with World
Economic Forum, NITI Aayog and HealthNet Global (Apollo Hospitals) launched
‗Medicine from the Sky‘ project. The project will pave the way for drone delivery
of life saving medicines and jabs in far-flung regions of the country.
 According to a spokesperson, the Indian government is planning to introduce a
credit incentive programme worth Rs. 500 billion (US$ 6.8 billion) to boost the
country‘s healthcare infrastructure. The programme will allow firms to leverage
the fund to expand hospital capacity or medical supplies with the government
acting as a guarantor and strengthen COVID-19-related health infrastructure in
smaller towns.
 In June 2021, the Union Cabinet was apprised of an MoU that was signed
between Indian Council of Medical Research (ICMR), India and the Department
of Medical Research (DMR), Ministry of Health and Sports of Myanmar in
February 2020. The objective of this MoU was to build on the health research
relationship in topics of mutual research between India and Myanmar.
 In June 2021, the Union Ministry of Health and Family Welfare, in partnership
with UNICEF, held a capacity building workshop for media professionals and
health correspondents in Northeastern states on the current COVID-19 situation in
India, the need to bust myths regarding COVID-19 vaccines & vaccination and
reinforce the importance of COVID-19 Appropriate Behaviour (CAB).
 In June 2021, Bolo Indya, a domestic social live streaming platform, partnered
with the Ministry of AYUSH to improve awareness for traditional Indian methods
of medicines and care such as siddha, yoga, unani and ayurveda to boost healthy
living among citizens. Through this partnership, >10 million citizens will be
covered in the next 12 months.

22
 In June 2021, West Bengal proposed for six new medical colleges in the state,
nine new medical colleges became operational in Uttar Pradesh, Telangana
approved six medical colleges in the state and Punjab announced establishment of
four new medical colleges in the state.
 In June 2021, the Uttar Pradesh government announced to introduce automatic
medicine dispensing machine to expand the primary healthcare industry and
clinical centres in the country. The state health department has been nominated to
design an action plan and install ‗Health ATMs‘ walk-in medical kiosks, with
combined medical devices for basic laboratory testing, emergency offerings,
cardiology, neurology, pulmonary and gynaecology testing services that will be
operated by a medical assistant in all 75 districts of Uttar Pradesh.
 In June 2021, the government invited bids for using drones to deliver COVID-19
vaccines and drugs to remote and difficult-to-reach areas to ensure last-mile
coverage in select locations of the country.
 As of May 2021, 11.9 lakh Health IDs have been generated and 3,106 doctors and
1,490 facilities have registered on the National Digital Health Mission (NDHM)
platform.
 In May 2021, Defense Minister Mr. Rajnath Singh launched ‗Services e-Health
Assistance & Tele-consultation (SeHAT)‘ OPD portal to provide telemedicine
services to armed forces personnel and veterans.
 On May 12, 2021, the Drugs Controller General of India (DCGI), accepted
recommendation of Subject Expert Committee (SEC) and accorded permission to
conduct the Phase II/III clinical trials of Covaxin (COVID vaccine) for the age
group of 2-18 years to its manufacturer, Bharat Biotech Ltd.
 On May 17, 2021, the Defence Ministry launched the first batch of anti-COVID
drug, 2-deoxy-D-glucose (2-DG) that was developed by the Institute of Nuclear
Medicine and Allied Sciences (INMAS), a lab of Defence Research and
Development Organisation (DRDO), along with Dr. Reddy‘s Laboratories (DRL),
Hyderabad.
 In May 2021, the government announced its plan to ramp up supply and
availability of Amphotericin-B, the anti-fungal drug, for treatment of the ‗Black

23
 Fungus‘ disease. It has also given the license to five manufactures to produce the
drug within the country.
 In March 2021, various states and UTs started implementation of the ‗Intensified
Mission Indradhanush 3.0‘—a campaign aimed to reach those children and
pregnant women who were missed out or have been left out of the routine
immunisation programme due to the COVID-19 pandemic. This is aimed to
accelerate the full immunisation of children and pregnant women through a
mission mode intervention.
 In March 2021, the Parliament passed the National Commission for Allied,
Healthcare Professions Bill 2021, which aims to create a body that will regulate
and maintain educational and service standards for healthcare professionals.
 In the Union Budget 2021, investment in health infrastructure expanded 2.37x, or
137% YoY; the total health sector allocation for FY22 stood at Rs. 223,846 crore
(US$ 30.70 billion).
 The government announced Rs. 64,180 crore (US$ 8.80 billion) outlay for the
healthcare sector over six years in the Union Budget 2021-22 to strengthen the
existing ‗National Health Mission‘ by developing capacities of primary,
secondary and tertiary care, healthcare systems and institutions for detection and
cure of new & emerging diseases.
 In Union Budget 2021-22, the government announced its plans to launch ‗Mission
Poshan 2.0‘ to merge ‗Supplementary Nutrition Programme‘ with ‗Poshan
Abhiyan‘ (Nutrition Mission) in order to improve nutritional outcomes across 112
aspirational districts.
 The Government of India approved continuation of ‗National Health Mission‘
with a budget of Rs. 37,130 crore (US$ 5.10 billion) under the Union Budget
2021-22.
 In the Union Budget 2021, the Ministry of AYUSH was allocated Rs. 2,970 crore
(US$ 407.84 million), up from Rs. 2,122 crore (US$ 291.39 million).

24
Road Ahead
India is a land full of opportunities for players in the medical devices industry.
The country has also become one of the leading destinations for high-end diagnostic
services with tremendous capital investment for advanced diagnostic facilities, thus
catering to a greater proportion of population. Besides, Indian medical service consumers
have become more conscious towards their healthcare upkeep.
Indian healthcare sector is much diversified and is full of opportunities in every segment,
which includes providers, payers, and medical technology. With the increase in the
competition, businesses are looking to explore for the latest dynamics and trends which
will have positive impact on their business. The hospital industry in India is forecast to
increase to Rs. 8.6 trillion (US$ 132.84 billion) by FY22 from Rs. 4 trillion (US$ 61.79
billion) in FY17 at a CAGR of 16–17%.
The Government of India is planning to increase public health spending to 2.5% of the
country's GDP by 2025.
India's competitive advantage also lies in the increased success rate of Indian companies
in getting Abbreviated New Drug Application (ANDA) approvals. India also offers vast
opportunities in R&D as well as medical tourism. To sum up, there are vast opportunities
for investment in healthcare infrastructure in both urban and rural India.

25
 COMPANY PROFILE

About Us:
Medicover is a globally recognised healthcare brand with operations in 12
countries: Germany, Sweden, Poland, Turkey, Belarus, Bulgaria, Georgia, Hungary,
Romania, Serbia, Moldova, Ukraine, and India.

Medicover is the leading Multispecialty Hospital chain in India. It is one of the

largest healthcare providers in Europe with a significant presence in India. The Group
provides a broad spectrum of Health care services and has an extensive network of
clinics, hospitals, specialty care facilities, Fertility Centers, and diagnostic labs.

Medicover Hospitals is spread across Telangana, Andhra Pradesh, and Maharashtra

treating millions of patients every year with a clear focus on raising the standards of
health care in India. It has renowned medical teams who work with the greatest
technologies and international evidence-based protocols which offer the most
comprehensive treatment across all specialties of medicines.

Medicover has also established focus specialty centers-

 Medicover Women and Child Hospitals

 Medicover Cancer Institute

26
Who we are ?

Medicover is one of the most respected healthcare brands in the world with presence
in 12 countries across the globe - Germany, Sweden, Poland, Turkey, Belarus, Bulgaria,
Georgia, Hungary, Romania, Serbia, Moldova, Ukraine and India

Medicover's global highlights:

 24 Hospitals
 125 Medical Centers
 16 Fertility Centers in India and Europe
 3500 Beds
 6.1 Million Medical Visits
 2 Million Patients Served Per Year
 6 Public-Private Partnerships
 91 Medical Labs
 92 Million Lab Tests Per Year
 25,000 Employees

WHY CHOOSE MEDICOVER?

 Expertise Group of Doctors

With highly qualified and experience group of Doctors Medicover
Hospitals has crossed milestones. Our expertise are well experienced in handling
rare and critical cases.

 Right Treatment
Right treatment begins with an accurate diagnosis. A team of specialists
will listen to your needs and evaluate your condition from every angle in order to
make the best plan.

27
  24/7 Active health care
Every year millions of patient visits Medicover Hospitals. Our health care
providers are unstoppable and are active for 24/7. The team take proper care of
all the patients.

 Advanced Technologies
Medicover Hospitals is equipped with all the greatest and advanced
technologies as PET-CT Scan, Intravascular Ultrasound (IVUS) and C-ARM X-
ray machine.

Core Value

 Empowerment
 Integrity
 Passion for quality
 Entrepreneurship
 Teamwork

The Passion for Quality Value Division of Health Care Service has increased
emphasis as it is vital to deliver on our cause. All our values are important, but our
quality value enables us to live, to save life, to maintain and to improve life.

Mission
"Caring for your health is all we do. "

Vision
"To be globally recognized for excellence in patient-centric healthcare, multi super-
specialty expertise with precision treatment, affordable to patients. "

MISSION and STRATEGY

At the base of Medicover‘s growth journey is access to high-quality healthcare

services when and where customers require these. Growth opportunities are further

28
enhanced by a strategy of diversification in terms of markets, revenue streams and
healthcare-service offerings.

CENTRE OF EXCELLENCE:

Cardiology:

The Cardiology department at Medicover Hospitals offers the latest technology

and top specialists with best practices in emergency cardiac services and minimally
invasive interventions and surgeries. The cardiology department at Medicover Hospitals
is an integrated health center with a highly trained, skilled and committed team of heart
surgeons, cardiologists and radiologists working in full collaboration to provide
comprehensive and multidisciplinary treatment to patients suffering from varied heart
disorders. The interventional team is accessible round the clock to render assistance and
ensure a quicker recovery. Our Cardiac Institute is fully equipped with the Latest
Electrophysiology lab with a 3D mapping facility for assessment and removal of different
forms of Arrhythmias. We hold the best in the state for device implantations like ICDs
and CRT.

Orthopedics:

Orthopedics is a branch of medicine that focuses on the musculoskeletal system,

skeletal system, and its interconnected components. An orthopedist is a doctor who
specializes in the treatment of joints, bones, ligaments and nerves. Orthopedists treat a
variety of musculoskeletal ailments, including sports injuries, joint discomfort, and back
problems, with both surgical and nonsurgical treatments. It's a frequent misperception
that orthopedic doctors usually advise surgery for bone and joint disorders. Surgery is
usually the last option. Instead, the orthopedic specialist is likely to suggest non-surgical
options.

29
Gastroenterology:

Gastroenterology is a branch of internal medicine that focuses on digestive

disorders. It deals with conditions like IBS, Ulcers, Constipation abdominal pain, etc.
Gastroenterologists are the doctors who focus on diagnosing and treating medical
conditions that affect the entire digestive tract (esophagus, stomach, small intestine, and
large intestine), as well as the liver, pancreas, and biliary system (gallbladder and bile
ducts).

Neurology:

Neurology is the branch of medicine that deals with the study and treatment of
nervous system problems. The nervous system is a sophisticated, complicated system that
controls and directs physiological functions. A neurologist is a doctor who specializes in
the treatment of nervous system disorders. Medicover Institute of Neurosciences is the
integrated institute with a dedicated and highly qualified team of Neurologists,
Neurosurgeons, and Neuro-Psychiatrists who ensure the best possible care for the patients
supported by the latest technology. We strive to provide comprehensive and
multidisciplinary care for disorders of the brain, spine, and nervous system.

General Surgery:

General surgery provides surgical interventions that target the endocrine system,
gastrointestinal tract, liver, colon, and other important parts of the human body A general
surgeon is a physician who specializes in the diagnosis and treatment of major and minor
diseases of the colon and rectum, ulcerative colitis or Crohn's disease, diverticulitis, colon
and rectal cancer, gastrointestinal bleeding, and hemorrhoids. In addition, they are an
integral part of a surgical team that also includes an anesthesiologist, nurses, and surgical
technicians. Our team of professionals provides each patient with high-quality care based
on their significant clinical experience, innovative technology, and extensive resources.

30
The team's complete care encompasses both pre and post-surgical treatment, ensuring the
patient's wellness, safety, and speedy recovery.

Oncology:

Oncology is the study of medicine that identifies and treats all types of cancer.
Oncologists provide comprehensive cancer care that includes prevention, treatment, and
rehabilitation. Our oncologist team emphasizes the importance of combining all treatment
modalities in the proper order to achieve the best outcomes while reducing serious
complications. Medicover Oncologists operate with experts from all departments to
provide coordinated and multidisciplinary care to cancer patients.

Gynecology:

Gynecology and Obstetrics is a surgical-medical speciality that encompasses the

health of the female reproductive organs and their function. The department is run by
efficient personnel and medical specialists who are well qualified and experienced in
dealing with a wide range of health conditions affecting young girls and women in their
middle and later years. Based on international standards of evidence-based clinical
protocols, Medicover Hospitals provides medical and surgical treatments for a variety of
gynecological issues including menstrual irregularities, infertility, prolapsed uterus,
fibroids, and other tumors of the uterus and ovaries. Our OB/GYN specialists have a
successful track record of handling various types of emergency and high-risk
pregnancies.

Pediatrics:

Pediatrics is the branch of medicine that deals with the health and medical care of
babies, children and adolescents from birth to the age of sixteen. A pediatrician provides
medical care to the children who are acutely or chronically ill. The Pediatric department
at Medicover Woman & Child Hospital provides a comprehensive spectrum of regular
and sophisticated treatment to children. We are supported with a team of highly qualified
31
and experienced child specialists to treat a wide range of diseases and disorders,
including congenital and inherited conditions of the neonates, babies, toddlers, and
children of all ages. We ensure your child gets the best treatment with unmatched care in
our facility.

Neonatology:

Neonatal babies or newborn babies are specifically those who are less than four
weeks old. This is a key phase in a baby's life when events such as feeding routines are
formed; it's also the time when bonding between the baby and the parents begins; and,
most critically, it's the time when the infant is more susceptible to infections that can
become serious. A separate speciality called neonatology was created to take care of such
small newborns. The Neonatology department mainly focuses on the medical care of
newborn infants, particularly those who are sick or premature. Neonatologists are doctors
who specialize in the care of newborn children. The department is dedicated to the
prevention and treatment of issues that arise during the fetal, intrapartum or neonatal
periods. In a soft and nurturing environment, the NICU at Medicover Hospitals provides
the infant with complete and highly specialized care by our experienced and dedicated
team. Highly trained specialists provide compassionate care to the youngest and tiniest
children, using cutting-edge technology designed specifically for premature infants.

Kidney Transplantation:

Kidney transplantation has become a lifeline for people with chronic renal
sickness, allowing them a chance to live a normal life as the number of cases of end-stage
renal disease (ESRD) has increased. The kidneys are two bean-shaped organs, each about
the size of a fist. They are located at the back of the abdominal cavity on either side of the
spine. The main function of the kidneys is to filter the blood before sending it back to the
heart and remove wastes and extra fluid from the blood. They help the body pass the
waste as urine.

32
Liver Transplantation:

A Liver Transplant Surgery is a surgical treatment that detaches a liver that no

longer works appropriately and restores it with a healthy liver. Liver Transplant Surgery
will be easier if the donor is ready to donate their part of the Liver. Meanwhile, if there
are no donors, then the patient has to wait for Cadaveric Liver. Cadaveric Liver means
Brain Dead/ Cardiac dead patient‘s liver. However, this will take time and the patient will
be kept on a waiting list of UNOS. Based on the criticality the patient will be given a
Liver. For example, in many parts of the world, the major Liver is coming from Brain
Dead people. As a result, many Liver Transplant Surgery waiting lists are increasing. To
decrease this shortage, other procedures had come into existence like Split Liver
Transplant, Living Liver Donor Transplant, and donating liver after Cardiac Death.
Meanwhile, Liver Transplant Procedure involves 4 to 8 hours depending upon severity.
After Living Liver donation, a donor can get back to his normal life by following some
precautions, medications, and guidelines prescribed by the doctor.

Nephrology:

The Nephrology Department at Medicover Hospitals is well-versed in dealing

with the systemic implications of impaired kidney function. We are well-known across
India for our competence in treating the most difficult renal disorders. Nephrology is a
branch of internal medicine that specializes in the treatment of kidney problems. We are
the best nephrology department in India with a clinical speciality that has a unique
potential to provide a new life to its patients even though the kidney is fully damaged.
The team of nephrologists at Medicover Hospitals has a proven track record in treating
chronic kidney disorders and performing renal transplants with high success rates.
Nephrologists are highly experienced in diagnosing and treating renal problems in
children, adolescents, and adults, collaborating with other pediatric experts.

33
Internal Medicine:

The internal medicine department at Medicover Hospital works with a wide range
of health issues that impact human internal organs. Internal medicine specialists or
internists diagnose and treat adults with illnesses varying from minor to severe. Internal
medicine is a broad field that deals with a wide range of ailments. The department is
committed to providing high-quality, comprehensive care for disease prevention and
chronic disorder management. We provide 24x7 treatment services and laboratory
support for in-patient care and emergency cases.

Plastic Surgery:

Plastic surgery is a surgical speciality that involves the restoration, reconstruction,

or alteration of a person's Physical Appearance. A plastic surgeon is a medical doctor
who specializes in the treatment, repair or reconstruction of any part of the body and
includes facelift, rhinoplasty, liposculpture, eyelid surgery, breast reduction, breast
augmentation, breast lift, tummy tuck, and body lift. Cosmetic and plastic surgery helps
patients of all ages and types, including children with birth deformities or youth injured
in an accident. The team of plastic surgeons at Medicover hospitals has medical and
surgical knowledge with technical expertise to achieve desired patient outcomes and
problem-solving. Medicover Hospitals has a specialized department of Plastic, Aesthetic
and Reconstructive Surgery that has world-class infrastructure and advanced types of
equipment to treat plastic and cosmetic surgery patients.

Urology:

Urology is a field of medicine that focuses on the study of medical and surgical
functions and disorders that affect the urinary system. The kidneys, the adrenal glands,
the ureters, the urinary bladder, the male and female reproductive organs, namely the
testicles, the epididymis, the prostate, and the penis, belong to the branch of Urology.
34
Urologists are doctors who specialize in the diagnosis & suggest the best treatment for
conditions that affect the male and female urinary tract systems. Urology combines the
management of non-surgical conditions, such as urinary tract infections and benign
prostatic hyperplasia, with the management of surgical conditions such as prostate or
bladder cancer, kidney stones, congenital anomalies, traumatic injuries, and stress
incontinence.

Physiotherapy:

Injuries, illnesses, and disabilities can put a pause on your mobility and affect
your daily living. This is where physical therapy comes to your rescue offering you a
plethora of expert-guided physical treatments that help in alleviating pain and restoring
and regaining the movement. A physiotherapist can help you go back on track with pain-
free movements which is also important for preventing a lot of other chronic diseases.
The Department of Physiotherapy at Medicover Hospitals is managed by experienced
practitioners who have accrued experience working with some of the biggest names in
the speciality area. The department helps restore well-being to people following injury,
pain or disability. Our certified physiotherapists and exercise physiologists also deliver
excellent services for back care, sports injury rehabilitation and work-accident
rehabilitation. Likewise, our Orthopedics department is also ably supported by the
physiotherapy team who use stretching, strength and stabilization exercises to restore
movement capacity, strength and function of patients operated with us.

Dental:

Dentistry is the diagnosis, treatment, and prevention of conditions, disorders, and

diseases of the teeth, gums, mouth, and jaw. The dental clinic at Medicover Hospitals is
an advanced facility boasting state-of-the-art equipment in a pleasant and soothing
environment. The primary focus is in the areas of top quality dental treatments, dental
surgeries, cosmetic dentistry, Orthodontics, Periodontics and Implantology. The
Department is synonymous with world-class oral healthcare services and we use the best-

35
in-class equipment and the most skilled dentists. Patients who undergo sophisticated
dental treatments or dental surgeries benefit from the use of innovative pain-management
devices.

Emergency Medicine:

There are circumstances in life which come uninformed. Mishaps, falls, injuries,
and accidents do happen and people need immediate care during such difficult times to
preserve their lives. ―Emergency Medicine‖ is the branch of medicine which deals with
all such sudden illnesses or injuries that require emergency medical intervention to
support life during this critical phase. The Emergency Care Department of Medicover
Hospitals is fully equipped with medical facilities and emergency care experts to provide
care for accident victims and others in emergency situations like heart attack or stroke.
Our medical supplies remain available 24*7 from the in-house pharmacy and we also
have an in-house Blood Bank to meet sudden blood needs.

Psychiatrists:

Psychiatry is the branch of medicine that focuses on the diagnosis, treatment, and
prevention of mental, affective, and behavioural disorders. A psychiatrist is a doctor who
specializes in mental health, including substance use disorders. Medicover Hospitals are
committed to enhancing the mental health of every child and adolescent in our
community while also assisting parents, caregivers, and other family members. We are
dedicated to assisting people in recovering from substance abuse in a secure and pleasant
setting. Our psychiatrists have worked in some of the most prestigious national and
international institutions, managing a wide range of mental diseases. Psychiatrists are
qualified to assess the mental and physical aspects of psychological problems. This may
include a physical exam, laboratory tests, and/or a psychological evaluation.

36
HISTORY

Medicover Hospitals is a multinational hospitals chain in Europe and India. It is a

part of European healthcare groups having its presence in 12 countries across the world
with 26 hospitals.

The Medicover group provides a broad spectrum of Health care services and has a
network of hospitals, cancer institutes, specialty care facilities, Fertility Centers,
and diagnostic labs.

Medicover was established in 1995 and headquartered in Poland. Medicover

Warsaw Hospital first opened in Poland in 2009.

Medicover invested into Sahrudaya Healthcare Private Ltd., the holding company
of MaxCure. After acquiring the MaxCure Group, India, on August 22, 2017, the
company changed its name to Medicover Hospitals.

It now has 20 outlets in India, spread over three states i.e., Telangana, Andhra
Pradesh, and Maharashtra.

HEALTHCARE SERVICES

WHO WE ARE?

Healthcare Services offers high-quality care based on its Integrated Healthcare

Model and a broad offering of specialty-care services with a focus on health and
wellbeing.

The portfolio includes services in the areas of prevention, specialist healthcare,

inpatient care, state-of-the-art dental services and innovative wellbeing solutions
including sports and diet. The division targets both corporate and private customers and
patients as well as public payers. Healthcare Services operates 117 medical clinics, 25
hospitals, 52 dental centers, 20 fertility clinics and 25 gyms. The major markets are
Poland, India and Romania.

In 2020 the division‘s revenue amounted to EUR 539.7m and represented 53 per
cent of total revenue.

37
WHAT WE DO?

We accompany our patients at every stage of their lives: ―We enable life, we save
life, we maintain and improve life‖

Healthcare Services wants to change the way healthcare services are delivered
today, by offering patients uncompromising customer service and by constantly
developing its business. Increased health awareness and healthy living, together with
rising disposable income, are increasing demand for the services offered. By meeting the
demand with a broad range of services together with high-quality care and accessibility,
Healthcare Services creates good conditions for continued growth.

Medicover entered the market for employer funded healthcare services in Poland
in 1995, and subsequently took this same business model to Romania. The integrated
healthcare model provides steady and predictable revenues and high customer loyalty. At
the end of 2020, Healthcare Services provided care to close to 1,400,000 members. There
are various ways to become one of our members.

Most employers in the countries where Medicover operates chose to provide their
employees with ambulatory healthcare, both primary care and some specialist care,
because these are the services which the employees are most likely to need. However,
many individuals and some employers wish to ensure access to a broader range of
specialist ambulatory services, and to hospital care as well. It is the demand for these
services that led Medicover to expand into hospital care and to broaden the range of
specialist care provided.

Medicover is the largest private medical company in Poland to have its own,
multi-profile hospital, located in Warsaw‘s district of Wilanów. The hospital operates
seven inpatient departments.

38
 QUALITY AND SATISFACTION

Quality of service is crucial to Medicover remaining successful and competitive.

We measure various parameters that help to indicate the quality of our delivery
and what can be improved. Every doctor‘s performance is assessed not only by their
clinical outcomes but also by customer satisfaction, their attitude and effectiveness of
their decisions. We measure every aspect of our operation, and constantly analyse the
data to find ways to ensure service and clinical effectiveness improvement.

The results are reflected in the growing number of customers using us. At present,
the number members with medical packages amounts to close to 1.4 million.

Areas Served:

Belarus, Germany, Poland, Turkey, Bulgaria, cyprus, Georgia, Hungary, Romania,

Serbia, Moldova, Norway, Denmark, Ukraine, and India.

Key People:

 Fedrick Ragmark (CEO, Medicover Group)

 Dr. G. Anil Krishna (Chairman & Managing)
 Fedrick Ragmark (CEO, Medicover Group)
 Dr. G. Anil Krishna (Chairman & Managing Director)
 John Stubbingston (COO, Medicover Healthcare Services)
 Dr. Sharath Reddy (Executive Director)
 P. Hari Krishna (Executive Director)

Products:

Hospitals, pharmacy, diagnostic centres

39
 MEDICOVER CODE OF CONDUCT

Medicover‘s customers and patients are key for us and our continued
development, just as our contribution to society. Our sustainability work is focused on the
following areas: prevention and education, quality of care and services, access to care,
environmental care and business ethics. We are committed to operate with high ethical
standards and to responsible commercial success.

Medicover Code of Conduct is the main framework for the way we do business
and ensure we translate our values into action.

The purpose of Medicover Code of Conduct is to ensure that all our employees
and business representatives are informed and comply to the fundaments for Medicover‘s
business ethics and ways of working.

Medicover is accordingly committed to international and fundamental principles

on human rights, labour rights, the environment and the fight against corruption
throughout our operations. Together with local laws and regulations these are principles
that the Medicover business is committed to adhere to.

40
 CHAPTER 3
 THEORETICAL FRAMEWORK OF PERFORMANCE
MANAGEMENT SYSTEMS

41
 PERFORMANCE MANAGEMENT SYSTEM

Meaning and Concept of Performance Management:

The term performance has several meanings. It can be referred as:

 The act of performing or the state of being performed.

 The act or style of performing a work or role before an audience.
 The way in which someone or something functions.

―Performance refers to all activity of an individual which occurs during a period marked
by his continuous presence before a particular set of observers and which has some
influence on the observers.‖ (Goffman)

The act of performing; the carrying into execution or action; execution;

achievement; accomplishment; representation by action; as, the performance of an
undertaking of a duty is also performance.

Concept of Performance Management:

Ultimately, it is the cost of poor performance that makes performance

management important. The organizations that are doing well nowadays are because they
are quite aware of the tough competition persisting in the market and the way out to it is
improve performance. The complete reliance of businesses on their information systems
means that these businesses come to a standstill when the system is unavailable.

Poorly performing systems will also result in poorly performing organizations and
poor customer perception of these organizations. Companies that could sense these issues
in advance have moved beyond traditional availability initiatives (usually focusing on
uptime only) and are implementing programs with a wide view of time.

Performance Management is a way of systematically managing all such people

for innovation, goal focus, productivity and satisfaction- it is a goal-congruent win-win
42
 plan. Its main aim is to ensure success for all managers – and all task teams- who believe
in its approach, and implement it with sincerity and commitment. The managees‘ success
must reflect in the organization‘s bottom- line in terms of fulfillment of its planned goals.

Some Common Performance Problems:

 Not meeting business goals (inventory, manufacturing, shipping, bookkeeping, etc.).

 Unnecessary hardware upgrades and over-specifying.
 Over-staffing.
 High turnover.
 Loss of business opportunities to competition.
 Poor technology.
 Bad publicity etc.

In order to cope up with these performance problems arises a need to manage

performance or in other words performance management.

As systems, structures and attitudes undergo change-and they indeed undergo sea
changes over time- they modify the workplace experience often positively for many and
negatively for some. Effective organizations use such experience – positive or negative as
sources of continuous learning. Vibrant organizations appropriately capture this learning,
and act to systematically use it while reviewing the design, structure as well as the
functioning of their systems, processes and attitudes.

Most contemporary organizations possess some of the following features:

 A diversity of locations, units programs, sectors, and specialized disciplines.

 Dramatically varying rules that govern day-to-day operations in different segments.
 Complex cultural interactions.
 Varied tasks and problems.
 Decentralization- meaning that a lot of power vests in the localized managerial levels.
 Interdependence and dynamism- what one segment of the organization does, affects the
total organization, and vice versa.
 Truly globalized.

43
 Such organizations aspire to provide high quality goods and services to highly
discerning and differentiated customers, clients, or other kinds of stakeholders. They
understand that abiding organizational excellence can rest only on excellence in the
performance of individual managees, who may be located next to each other, or miles
apart- whether front-line stars, or back-room boys and girls.

Performance Management is an unending spiral, linking process such as

performance planning, managing performance throughout the year, taking stock of
managee performance and potential; at the same time recognizing and rewarding success
at the end of the year.

It links these processes in a manner that an individual manager‘s performance

targets continuously subscribe to those of the total organization- providing consistent
super coordination -to create positive goal-oriented task, motivation and reduce intra-
organization conflict.

It is realism that an organization does nothing if it doesn‘t manage performance.

Each manager devises his own system for managing performance within what he
perceives the organization‘s norms to be. These are often not explicitly clear even to the
manager, leave alone being known to and shared with the managees. Standards or
expectations, which define good performance, may be generally understood, but are
rarely specific.

It is neither the familiar kind of performance appraisal, nor the almost-forgotten

system of ‗management by objectives‘, although some relevant features of those are
palpable in the design of performance management systems. Its high points are
performance standards- representing the organizational goals and objectives, managee
recognition and rewards corresponding to managee needs and aspirations.

44
 Importance of Performance Management:

 Performance Management Focuses on Results, Rather than Behaviors and

Activities:
A common misconception among supervisors is that behaviors and activities are the same
as results. Thus, an employee may appear extremely busy, but not be contributing at all
toward the goals of the organization.

An example is the employee who manually reviews completion of every form and
procedure, rather than supporting automation of the review. The supervisor may conclude
that the employee is very committed to the organization and works very hard, thus,
deserving a very high performance rating.

 Aligns Organizational Activities and Processes to the Goals of the Organization:

Performance Management identifies organizational goals, results needed to achieve those

goals, measures of effectiveness or efficiency (outcomes) toward the goals, and means
(drivers) to achieve the goals. This chain of measurements is examined to ensure
alignment with overall results of the organization.

 Cultivates a System-wide, Long-term View of the Organization:

Richard A. Swanson, in Performance Improvement Theory and Practice (Advances in

Developing Human Resources, 1, 1999), explains an effective performance improvement
process must follow a systems-based approach while looking at outcomes and drivers.

Otherwise, the effort produces a flawed picture. For example, laying off people will
likely produce short-term profits. However, the organization may eventually experience
reduced productivity, resulting in long-term profit loss,

45
 Produces Meaningful Measurements:

These measurements have a wide variety of useful applications. They are useful in
benchmarking, or setting standards for comparison with best practices in other
organizations. They provide consistent basis for comparison during internal change
efforts.

They indicate results during improvement efforts, such as employee training,

management development, quality programs, etc. They help ensure equitable and fair
treatment to employees based on performance.

Features of Performance Management:

Performance management is a continuous process that goes on through out the

year, with its three sub-systems, namely planning managee performance and
development, monitoring managee performance & mentoring managee development and
annual stocktaking, sequentially feeding, sometimes overlapping each other.

 It is flexible- A manager and his managees, acting together, have sufficient

maneuverability to design their own processes within the overall framework for
performance management provided by the organization to integrate its different task
groups into a synergistic whole that is working to achieve the same, ultimate
organizational goals.
 Performance management is future -oriented, rather than retroactive. Even the appraising
process -as part of stocktaking- feeds significantly into futuristic performance planning
and improvement.
 It is participatory and provides for regular and frequent dialogues between a manager and
her managees- both dyadic and, as a group- to address performance as well as
development needs.
 Performance management aims at measuring managees delivered performance against his
planned performance- the targets, standards and performance measuring or indicators.
 Performance management is blatantly developmental and concerns itself vigorously with
a managees personal attributes and behavior as critical inputs to the performance

46
 expectations are not equated with the other inputs of a physical, financial or
infrastructural nature. Performance management specifies these personal attributes and
behaviors in respect of each managee, meticulously assesses the extent of their
contribution to the managee‘s level of performance and thereby identifies his future
developmental needs.
 It provides a framework in which managers must support their managee‘s to succeed, and
to win.

Process of Performance Management:

The three stages of performance management- planning, managee performance

and development, monitoring managee performance, mentoring managee development
and annual stocktaking- occur in a definite sequence. Planning is done at the beginning of
the year; monitoring and mentoring right through the year as the plans are executed; and
stocktaking in toe at the year, when it is also time to plan afresh for yet another year.

Each one of these phases requires certain concrete actions to be taken by the
manager and the managee, both of them providing appropriate inputs, while keeping the
whole process in perspective.

These three phases also work in an action research mode. Planning, review and
stocktaking happen all through the year; more pointedly at times of the periodic review
during the monitoring and mentoring phase. As, such, the three phases are dynamic and
they continuously interact. The plans, made at the outset, are revisited periodically to be
reality-tested for relevance and feasibility in a changing context where all events or
influences may not be adequately foreseen.

Similarly, the criteria and standards used during the appraisal, while stocktaking
are largely developed and rehearsed during the year. This process becomes participatory
since the review meeting, where it happens, involves both managees and the managers.
This is the way in which the standards and criteria for relative assessment of managee‘s
performance evolve.

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 Mistakes in Performance Management:

It has been observed with many organizations that many mistakes are made, not
through lack of effort but rather lack of experience in this area. Here the author discusses
some of the re-occurring mistakes which have been seen practically in this area.

 Our Appraisal System does the Job:

With an Appraisal system, reviews are typically conducted based on the definition
of job description. Appraisal systems fail to address the critical issue that jobs change as
business and organizational environments change. Appraisal systems do not focus staff
on critical performance outcomes but only review if the employee has performed their
basic job function.

The basic job function should be dealt with through day-to-day management of
the employee while Performance Management systems should deal with the critical focus
areas.

Managers should set specific objectives for business outcomes as well as

developing the employee. Appraisal without these objectives is often a waste of time as
the manager should be dealing with the core job function during day-to-day management.

Performance Management is the process that focuses employees, guides them to

success and assists in achieving the organisations goals. Appraisal without these
objectives is a mistake that provides little value to the employees, managers and the
organisation.

 Implementing Performance Management:

It has been found that in big organisations, manual Performance Management

systems typically fail 18 months after deployment. Compliance typically reduces to less
than 30% after 18 months. This is because manual systems do not facilitate effective and
timely reporting. Therefore, line managers learn that they can avoid the process by
simply not doing it. HR is then blamed for lost forms, line managers don‘t complete the
process and the process becomes fragmented.

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 The recovery from this position is to install an automated system that provides
line managers with a simple way to implement performance management. An automated
system provides both MR and line managers with a way to keep on top of the process
through meaningful compliance reporting.

 Force Fit Application to Automate Performance Management:

One of the largest mistakes we have seen in performance management is to force

the organisation to change well established and highly functional processes (Force Fit) so
that a new software application will work properly. The organisational maturity and
culture need to be considered when implementing the system.

It is pointless trying to get managers to evaluate employees on complex criteria

when they can‘t even set objectives and review staff against basic objectives.

 Unscientific Self-developed System:

Another mistake we have seen is to develop and deploy an in-house Performance

Management application. The applications are typically sub-standard, lack reporting and
are often very difficult to use. There is rarely a meeting of the minds of the stakeholders,
especially IT and HR. The end result is that compliance falls, the application is removed
and HR has to start over with a very cynical audience.

 Expecting Line Managers can Cope with Manual Performance Management:

Managers lose track as to who they have set objectives for, who has been
reviewed and what actions they need to take in relation to an employee‘s development
plan. Invariably, nothing happens as the line managers forget what actions they need to
take (forms are sent back to HR and then nothing happens). The fact that line managers
do not act, means that staff don‘t see action and in turn see little value in the process.

 How to Set Realistic Goals?

Setting objectives is a simple process for HR professionals but this is not the same
with all. Line Managers typically have little or no appreciation of the process and often

49
 struggle with setting objectives. Line managers also tend to defer setting objectives
because it means they have to think and plan (thinking and planning is more difficult than
doing the day-to-day job and responding to more urgent work issues).

I feel that any implementation should be complemented with detailed training for
line managers. Training must be provided on how to set objectives and appropriate
examples provided for each functional unit. In addition, more senior managers may need
one on one coaching on how to set meaningful objectives for their teams.

 Lack of Face to Face Interaction:

Again, this assumption is a mistake made by people who are not familiar with
automated systems. Staff are still required to meet face to face in order to set objectives
and perform reviews. The benefits that accrue through the use of an on line system are
realized through features that help HR and Line Managers get the job done.

Performance Management System is a Costly Affair:

Most CEOs want to improve the quality and quantity of their human capital output.

Performance Management is one of the most powerful ways to:

 Increase quality of human capital through personalised development plans thereby

increasing the organisations capability.
 Increase output through clarity of focus.
 Performance Management is a very powerful process if implemented correctly. Mistakes
can be avoided by consulting experts who have had experience across multiple industries
and many implementations.

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OBJECTIVES OF PERFORMANCE MANAGEMENT

There are five main objectives of performance management:

 To enable the employees towards achievement of superior standards of work

performance.
 To help the employees in identifying the knowledge and skills required for
performing the job efficiently as this would drive their focus towards performing
the right task in the right way.
 Boosting the performance of the employees by encouraging employee
empowerment, motivation and implementation of an effective reward mechanism.
 Promoting a two way system of communication between the supervisors and the
employees for clarifying expectations about the roles and accountabilities,
communicating the functional and organizational goals, providing a regular and a
transparent feedback for improving employee performance and continuous
coaching.
 Identifying the barriers to effective performance and resolving those barriers
through constant monitoring, coaching and development interventions.
 Creating a basis for several administrative decisions strategic planning, succession
planning, promotions and performance based payment.
 Promoting personal growth and advancement in the career of the employees by
helping them in acquiring the desired knowledge and skills.

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TYPES OF PERFORMANCE MANAGEMENT SYSTEM

THE EVOLUTIONS OF TYPES OF PERFORMANCE MANAGEMENT

SYSTEMS

Traditionally, the measure of performance was whether you met your monthly or
quarterly target. Numbers took center stage. These types of performance management
systems have, over time, evolved into more inclusive, detailed and nuanced forms of
performance reviews.

Not only are they more refined and fine-tuned to the employee‘s needs but also take
into account learning and development initiatives. Methods of performance
management systems in the modern workplace are based on:

 Employee motivation and job satisfaction to make sure they can thrive in a
functional, healthy and supportive work environment

 Key performance indicators to measure each aspect of their jobs, not just
generating revenue and making their numbers

 Learning and development efforts to help employees upskill, grow and become
well-rounded professionals

 Retaining top talent to make sure they have the resources to realize their full
potential

 Aligning personal goals with organizational goals to work in tandem with

employees

Employee development is the key to a successful business. Your employees can

benefit from initiatives that help them transition into their new roles. First-time managers,
for instance, will require training and mentorship for their first performance management
cycle. Giving feedback, setting goals and requesting feedback are critical for an early

52
manager. Understanding different methods of performance management will give them
clarity on how to approach this unfamiliar part of their job.

MODERN METHODS OF PERFORMANCE MANAGEMENT SYSTEM:

Performance management may be conducted weekly, monthly or quarterly for

best results. Depending on techniques of performance management, you can decide
which works best for your employee and senior executives.

Here are common types of performance management systems:

1. MEASURE KEY PERFORMANCE INDICATORS

Key performance indicators or KPIs help managers assess employee performance.

For instance, if an employee‘s KPI is to achieve certain sales numbers for a quarter,
their performance will depend on whether they were able to meet the target. Other
KPIs include project management in terms of decreasing turnaround time, or time
taken to complete a task. Skill development such as completing online courses or
upskilling can also work as KPIs.

2. 360-DEGREE APPRAISALS

A 360-degree appraisal is an overall employee review where each member they work
with—from their manager to juniors—gives anonymous feedback on their work. This is a
great tool to understand employee strengths and weaknesses.

3. MANAGER PERFORMANCE REVIEW

Managers require performance reviews to make sure their teams are aligned. Their
employees may have some feedback on what they can improve. This will help managers
become better leaders who listen, support and mentor their teams.

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 4. EMPLOYEE SELF-ASSESSMENTS
Self-assessments may not seem effective since employees have to grade their own
performance, but they work. Employees take stock of their tasks, things they found
challenging and what they were good at. It‘s a great way to compile achievements and
identify improvement areas.

5. GENERAL PERFORMANCE REVIEW

A general performance review is how most organizations conduct performance

management. It measures employee performance based on predetermined, standard
metrics such as meeting their goals, working in teams and following a code of conduct.

Different methods of performance management have unique benefits. If you want

to train early-stage managers on how to conduct performance reviews, you can assess the
ones they‘ll find easy to manage.

HEALTH CARE PERFORMANCE MANAGEMENT

Healthcare Source calls healthcare performance management ―the biggest opportunity

in improving healthcare today.‖ That‘s a bold statement—but it‘s also hard to argue with.

Other industries have seen huge benefits from performance management, both in
difficult-to-measure areas like corporate culture and in bottom-line financial outcomes.

As the healthcare industry faces new pressures and increased competition,

organizations need new practices to stay competitive and provide high-quality care.

Instituting a performance management system in your healthcare organization is a

serious undertaking. But without one, you could face serious problems.

54
Benefits of Performance Management in Healthcare
Performance Management helps healthcare organizations ensure that their goals are
consistently met in an effective and efficient manner. More specifically, it can help them
achieve goals in areas such as patient-centered care, accountability, quality, cost
management, and data management. The U.S. Department of Health and Human Services
lists the following as ―typical circumstances of why an organization may choose to
measure its performance‖:

 Distinguish what appears to be happening from what is really happening

 Establish a baseline; i.e., measure before improvements are made
 Make decisions based on solid evidence
 Demonstrate that changes lead to improvements
 Allow performance comparisons across sites
 Monitor process changes to ensure improvements are sustained over time
 Recognize improved performance
Through the process of building and executing a Performance Management Plan,
organizations often establish and continuously refine metrics and standards, reporting,
budgeting, and governance.
For example, an organization that establishes increased patient volume without increasing
wait times as one of its strategic goals may need to:
 Ensure that its data collection efforts adequately measure the attributes needed to
accurately determine patient volume and wait times;
 Determine the resources required for monitoring and reporting;
 Design and implement process changes and stand up both human and technological
capital to perform the reporting activities;
 Carefully plan and manage the organizational changes which might be required; and,
 Review its Data and IT Governance structure to ensure successful oversight and
accountability for the entire process.
Thus, Performance Management goals need to align with both an organization‘s strategic
goals as well as with its current and future capabilities. Often, a Performance Maturity
Model (PMM) is used to communicate an organization‘s current Performance
Management capabilities, and to define its future goals for Performance Management

55
improvement. There are many models available, but most are adapted from the classic
Capability Maturity Model:

A Maturity Assessment is usually completed by an independent team, such as outside

consultants or a separate group within the organization that focuses on assessment and
analysis.
Finally, there may be additional motives for a healthcare organization to measure its
performance:
 Accreditation: Government-accrediting organizations and funding sources rely on
performance measure to prove resources are used effectively and efficiently.
 Fundraising: Fundraising success is increasingly tied to documented performance
measures.
 Transparency: Stakeholders such as patients and payors increasingly want to see
additional measures of the quality of care being provided.

Performance Aspects to Focus On

Performance measurements should be a good indicator of progress towards a strategic
goal, and should be realistic and reasonable given the current capabilities of the
organization.

56
As an example, a large hospital system will typically look at many performance measures
across different service and care areas to meet regulatory reporting requirements and
internal organizational goals.
Example: Performance Management in Electronic Health Record Security

PERFORMANCE IMPROVEMENT PROCESS:

PURPOSE

This policy identifies the proactive and progressive actions a supervisor may take when a
Professional Staff Member‘s performance, attendance, or behavior is unsatisfactory (e.g.,
does not meet the performance or competency expectations of the position). This policy
is not intended to create a contract of employment or to change the employment-at-will
relationship that exists between Drexel and its Professional Staff Member. As an at-will
employer, Drexel reserves the right to discipline and terminate professional staff at any
time with or without cause and to modify, at any time, the terms and conditions of
employment (without limitation to salaries, work schedules, work duties, etc.).

57
APPLICABILITY

This policy applies to all eligible non-faculty Professional Staff Members, excluding any
Professional Staff Member who is affiliated with a collective bargaining unit.

IMPLEMENTATION

Implementation of this policy is the responsibility of the Department of Human

Resources.

ADMINISTRATIVE OVERSIGHT

The Executive Vice President, Treasurer and Chief Operating Officer is the Drexel
University official responsible for the administration of this policy.

POLICY

When a Professional Staff Member‘s performance, attendance, or behavior is

unsatisfactory, the supervisor will advise the Professional Staff Member of the issue(s)
and give him/her an appropriate opportunity to improve to an acceptable level through
the Performance Improvement Process, subject to the other provisions of this policy.
When a supervisor determines there is an unacceptable performance, attendance, or
behavior issue(s) with the Professional Staff Member, the supervisor shall document the
issue(s) and required change(s) in a Performance Improvement Plan (PIP) and share the
plan with the Professional Staff Member in a face-to-face meeting. Should the
Professional Staff Member‘s performance, attendance, or behavior fail to improve as
specified by the PIP, the Professional Staff Member will be subject to further action, up
to and including termination.

58
PROCEDURES

Performance Improvement Process

The Performance Improvement Process has five formal actions:
 Counseling
 Written Warning
 Written Warning with Probation
 Suspension Without Pay

The University reserves the right to determine what actions are appropriate and in what
order such actions are to be taken depending on the facts and circumstances of the
situation.
In order to identify the appropriate action to take in the process, the supervisor should
take into account:
 The number, variety, and frequency of performance, attendance, or behavior
issues involved.
 The seriousness of the issue(s).
 The Professional Staff Member‘s work history.
 The Professional Staff Member‘s response to prior Performance Improvement
Plans
 The supervisor must use a PIP to document any action taken in the Performance
Improvement Process. The PIP is to be filled out completely and signed by both
the immediate supervisor and the Professional Staff Member (note: signatures are
not required for Counseling). If the Professional Staff Member refuses to sign the
PIP, the supervisor must note this refusal above the Professional Staff Member‘s
signature line.
Each of the actions in the Performance Improvement Process is detailed below.
Counseling
Prior to the Counseling session, the immediate supervisor will complete a PIP.
During the Counseling session, the immediate supervisor should:

59
  Provide the Professional Staff Member with a copy of the PIP.
 Clearly and concisely, explain the performance issue(s) that need to be improved,
providing examples as necessary for clarity.
 Communicate expectations for change, including the timeframe.
 Answer the Professional Staff Member questions and address his or her concerns.
 Offer the Professional Staff Member the opportunity to write comments on the
PIP.
At the conclusion of the meeting:
 The supervisor and Professional Staff Member should agree upon a date and time
to meet to review progress.
 If the Professional Staff Member disagrees with the action taken, the supervisor
should advise the Professional Member that he or she may contact the appropriate
HR Partner.
 The supervisor will place a copy of the Counseling PIP in the Professional Staff
Member‘s Departmental file. (Human Resources does not require a copy of a
Counseling PIP at this time).

After the meeting, and while the PIP is in effect:

 The supervisor and Professional Staff Member should meet to assess the
Professional Staff Member‘s progress towards identified goals.
 The supervisor must document follow-up meetings and progress on the PIP.
 If the Professional Staff Member‘s performance has not improved or shown
sustained improvement or if new problems have developed during the timeframe
established in the PIP, the supervisor will consult with the appropriate HR Partner
and will decide the appropriate action to take in the Performance Improvement
Process (e.g., Written Warning, Written Warning with Probation, or Termination).
Written Warning
Before having a performance discussion with the Professional Staff Member and issuing
a Written Warning, the supervisor:
 Should consult with the appropriate HR Partner. If desired, the supervisor may
also request that the HR Partner participate in the performance discussion.
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  Will document the specific performance, attendance, or behavior issue(s) and
improvements needed in a PIP, indicating that this is a Written Warning.
Observations should be supported with examples and documentation, when
available, including the PIP used for Counseling.

During the performance discussion in which a Written Warning is

issued, the supervisor should:

 Provide the Professional Staff Member with a copy of the PIP.

 Clearly and concisely, explain the performance issues that need to be improved,
providing examples.
 Communicate expectations for change, including the timeframe.
 Answer Professional Staff Member questions and address his/her concerns.
 Offer the Professional Staff Member the opportunity to write comments on the
PIP.
At the conclusion of the meeting:
 The supervisor and Professional Staff Member should sign the PIP. If the
Professional Staff Member refuses to sign the PIP, the supervisor must note this
refusal above the Professional Staff Member‘s signature line.
 If the Professional Staff Member disagrees with the action taken, the supervisor
should advise the Professional Staff Member that s/he may contact the appropriate
HR Partner.
 The supervisor should make a copy of the PIP for the Professional Staff Member,
a copy for the Professional Staff Member‘s departmental file, and a copy for
Human Resources. A copy of the signed and dated PIP detailing the Written
Warning and a copy of any related Counseling PIPs (if applicable) must be sent to
Human Resources.
 The supervisor and Professional Staff Member should agree to meet regularly to
review progress.

61
After the Written Warning is issued, and while the PIP is in effect:
 The supervisor and Professional Staff Member should meet regularly to assess the
Professional Staff Member‘s progress towards identified goals.
 The supervisor must document follow-up meetings and progress on the PIP.
 If the Professional Staff Member‘s performance has met the goals and
expectations described in the PIP, the supervisor will document that s/he has
successfully completed the PIP.
 If the Professional Staff Member‘s performance has not improved or shown
sustained improvement or if new problems have developed during the timeframe
outlined in the PIP, the supervisor will consult with the appropriate HR Partner
and will decide the appropriate action to take in the Performance Improvement
Process (e.g., Written Warning with Probation, or Termination).
Written Warning with Probation
 Before having a performance discussion with the Professional Staff Member and
issuing a Written Warning with Probation, the supervisor:
 Should consult with the appropriate HR Partner. If desired, the supervisor may
also request that the HR Partner participate in the performance discussion.
 Will document the specific performance, attendance, or behavior issue and
improvements needed in a PIP, indicating that this is a Written Warning with
Probation. Observations should be supported with documentation, including the
PIP used for Counseling and/or Written Warning.
During the performance discussion in which a Written Warning with Probation is
issued, the supervisor should:
 Provide the Professional Staff Member with a copy of the PIP.
 Clearly and concisely, explain the performance issues that need to be improved,
providing examples.
 Communicate expectations for change, including the timeframe.
 Answer Professional Staff Member questions and address his/her concerns.
 Offer the Professional Staff Member the opportunity to write comments on the
PIP.

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Before suspending the Professional Staff Member:

 The supervisor must consult with the appropriate HR Partner to review the
circumstances and related documentation.
 Once approved by Human Resources, the supervisor will complete a PIP
documenting the specific performance, attendance, or behavior issue and
improvements required in a PIP, indicating that this is a Suspension Without Pay
for the specific timeframe (e.g. one to five workdays). Observations should be
supported with documentation, including the PIP used for Counseling and/or
Written Warning.
During the performance discussion in which the Suspension Without Pay is issued,
the supervisor should:
 Provide the Professional Staff Member with a copy of the PIP.
 Clearly and concisely, explain the performance issues that need to be improved,
providing examples.
 Communicate expectations for change, including the timeframe.
 Answer Professional Staff Member questions and address his/her concerns.
 Offer the Professional Staff Member the opportunity to write comments on the
PIP.
 Suspension Without Pay for the specific timeframe (e.g. one to five workdays).

At the conclusion of the meeting:

 The supervisor and Professional Staff Member should sign the PIP. If the
Professional Staff Member refuses to sign the PIP, the supervisor must note this
refusal above the Professional Staff Member‘s signature line.
 If the Professional Staff Member disagrees with the action taken, the supervisor
should advise the Professional Staff Member that s/he may contact the appropriate
HR Partner.
 The supervisor should make a copy of the PIP for the Professional Staff Member,
a copy for the Professional Staff Member‘s departmental file, and forward the

63
 original to Human Resources along with any supporting documents including any
related Counseling or Written Warning (if applicable).
 The supervisor and Professional Staff Member should agree to meet regularly to
review progress.

After the Suspension is issued or during the Suspension and while the PIP is in
effect:

 The supervisor and Professional Staff Member should meet regularly to assess the
Professional Staff Member‘s progress towards identified goals.
 The supervisor must document follow-up meetings and progress on the PIP.
 If Professional Staff Member‘s performance has met the goals and expectations
described in the PIP, the supervisor will document that he or she has successfully
completed the PIP.
 If the Professional Staff Member‘s performance has not improved or shown
sustained improvement or if new problems have developed during the timeframe
outlined in the PIP, the supervisor will consult with the appropriate HR Partner
and will decide the appropriate action to take in the Performance Improvement
Process (e.g., short continuance or extension of the Written Warning with
Probation by extending the probationary period or Termination).
 During the performance discussion, in which a Suspension Without Pay has been
issued, the supervisor should:
 Provide the Professional Staff Member with a copy of the PIP.
 Clearly and concisely, explain the performance issues that need to be improved,
providing examples.
 Communicate expectations for change, including the timeframe.
 Answer Professional Staff Member questions and address his/her concerns.
 Offer the Professional Staff Member the opportunity to write comments on the
PIP.
 Following the meeting with a Professional Staff Member regarding any
Suspension Without Pay, the supervisor should complete a Personnel Action

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 Form placing the Professional Staff Member on Suspension and submit it to
Human Resources.
 At the conclusion of the Suspension Without Pay, the supervisor should complete
a Personnel Action Form returning the Professional Staff Member to active, paid
status and submit to Human Resources.

Termination of Employment

Before terminating a Professional Staff Member:

 If Termination of Employment appears to be warranted, as described in the

Performance Improvement Plan, the supervisor must consult with the appropriate
HR Partner to review the circumstances and related documentation.
 Once approved by Human Resources, the supervisor will complete a PIP for
termination, and a termination letter will be prepared by the HR Partner. This
letter will include the general reason(s) for the Termination of Employment, the
effective date of termination, and applicable information regarding final pay,
continuation of benefits, preliminary retirement plan distribution and any other
matters deemed appropriate.

The Termination Meeting:

The supervisor will meet with the Professional Staff Member privately to inform
him/her of the termination decision and to provide him/her with the PIP and the
termination letter from Human Resources. When possible, this will be done in the
presence of the appropriate HR Partner or designee.
At the termination meeting, the supervisor and the Professional Staff Member will
sign the PIP. If the Professional Staff Member refuses to sign the PIP, the supervisor
must note this refusal above the Professional Staff Member‘s signature line. The
supervisor will make a copy of the PIP for the Professional Staff Member, a copy for the

65
Professional Staff Member‘s departmental file, and send the original to Human Resources
along with a copy of any supporting documents including those used in previous stages of
the Performance Improvement Process (if applicable).
At the termination meeting, the supervisor will collect from the Professional Staff
Member the items outlined in the Termination Checklist to be provided by Human
Resources.
Following the termination meeting, the supervisor will complete the Termination
Checklist and a Personnel Action Form and submit both to Human Resources.

AT-WILL EMPLOYMENT NOT AFFECTED

Notwithstanding anything to the contrary stated in this policy, nothing herein is
intended to alter the at-will status of any Professional Staff Member. Drexel University
at all times retains the right to terminate any Professional Staff Member at any time for
any lawful reason, or for no reason at all.

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 CHAPTER 4

 DATA INTERPRETATION AND ANALYSIS OF

PERFORMANCE MANAGEMENT SYSTEMS

67
 DATA INTERPRETATION AND ANALYSIS OF
PERFORMANCE MANAGEMENT SYSTEMS

Q1) Performance management system acts as a deciding factor for salary

increments, transfers and terminations.

Table 4.1

Scale No. Of Respondents Percentage

Strongly agree 16 53%
Agree 8 27%
Neutral 6 20%
Disagree 0 0%
Strongly Disagree 0 0%
Total 30 100%

Graph 4.1

strongly agree agree neutral disagree strongly disagree

0% 0%

20%

53%
27%

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INTERPRETATION: According to the Table 4.1, 100 % of the employees agree and
believe that performance management system acts as deciding factor for salary
increments, transfers and terminations as the company really does provide these based
upon the performance system evaluation.

Q2) Performance of employees improves after process of performance

appraisal.

Table 4.2

Scale No. Of Respondents Percentage

Strongly agree 13 43%
Agree 9 30%
Neutral 6 20%
Disagree 2 7%
Strongly Disagree 0 0%
Total 30 100%

Graph 4.2

strongly agree Agree neutral disagree strongly disagree

0%

7%

20%
43%

30%

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INTERPRETATION: According to the Table 4.2, 93% of the employees agree to the
fact that the and has given positive response saying performance of employees improves
after evaluation of performance system while the other 7% disagrees implying they are
not interlinked .

Q3) The performance management processes are used to determine compensation

i.e. bonus/merit pay, variable pay raise.

Table 4.3

Scale No. Of Respondents Percentage

Strongly agree 18 60%
Agree 9 30%
Neutral 3 10%
Disagree 0 0%
Strongly Disagree 0 0%
Total 30 100%

Graph 4.3

strongly agree agree neutral disagree strongly disagree

0% 0%

10%

30%
60%

70
INTERPRETATION: According to the Table 4.3, 100% of the employees gave
positive response agreeing to the statement that the performance management processes
determine their pay scale as the pay scale of a employee depends on their performance at
work.

Q4) A successful performance management system must be fair and accurate.

Table 4.4

Scale No. Of Respondents Percentage

Strongly agree 26 86.7%
Agree 4 13.3%
Neutral 0 0%
Disagree 0 0%
Strongly Disagree 0 0%
Total 30 100%

Graph 4.4

strongly agree agree neutral disagree strongly disagree

0% 0% 0%

13%

87%

71
 INTERPRETATION: According to the Table 4.4, 100% of the people agree and
believe that successful performance management must be accurate and fair so as to
improve employee job satisfaction and motivation

Q5) Your organization recognizes and acknowledges your work.

Table 4.5

Scale No. Of Respondents Percentage

Strongly agree 30 100%
Agree 0 0%
Neutral 0 0%
Disagree 0 0%
Strongly Disagree 0 0%
Total 30 100%

Graph 4.5

strongly agree agree neutral disagree strongly disagree

0% 0%
0%
0%

100%

72
INTERPRETATION: According to the Table 4.5, 100% of the employees strongly
believe that their organization recognizes and acknowledges their performance at work
place.

Q6) The incentives encourage friendly competition between associates when linked
to job performance.

Table 4.6

Scale No. Of Respondents Percentage

Strongly agree 16 53%
Agree 11 37%
Neutral 3 10%
Disagree 0 0%
Strongly Disagree 0 0%
Total 30 100%

Graph 4.6

strongly agree agree neutral disagree strongly disagree

0% 0%

10%

37% 53%

73
INTERPRETATION: According to the Table 4.6, 100% of the employees responded in
a positive way that incentives are a way to create healthy competition between the
associates.

Q7) Focusing more on negative feedback gives positive zeal and motivation towards
work.

Table 4.7

Scale No. Of Respondents Percentage

Strongly agree 9 30%
Agree 8 27%
Neutral 0 0%
Disagree 10 33%
Strongly Disagree 3 10%
Total 30 100%

Graph 4.7

strongly agree agree neutral sdisagree strongly disagree

10%

30%

33%

27%

0%

74
INTERPRETATION : According to the Table 4.7, 57% of the employees agree that
negative feedback drives employees positively where as 43% of the people disagree to
the statement implying it creates a negative impact on employees.

Q8) Performance appraisal lets both manager and employee to set up long and
short term goals.

Table 4.8

Scale No. Of Respondents Percentage

Strongly agree 20 67%
Agree 10 33%
Neutral 0 0%
Disagree 0 0%
Strongly Disagree 0 0%
Total 30 100%

Graph 4.8

strongly agree agree neutral disagree strongly disagree

0% 0% 0%

33%

67%

75
INTERPRETATION : According to the Table 4.8, 100% of the employees agree that
appraisals helps in creating both long and short term goals as an individual and in an
organization .

Q9) In the bell curve appraisal model, only a limited number of employees come
under top performer’s category, employees who have actually performed
exceedingly well through the year period may be forced to in the Average
performers’ category which causes lack of morale in employees.

Table 4.9

Scale No. Of Respondents Percentage

Strongly agree 19 63%
Agree 11 37%
Neutral 0 0%
Disagree 0 0%
Strongly Disagree 0 0%
Total 30 100%

Graph 4.9

strongly agree agree neutral disagree strogly disagree

0% 0% 0%

37%

63%

76
INTERPRETATION : According to the Table 4.9, 100% of the employees believe that
bell curve appraisal methods creates a lack of maorale in employees as it only favours
20% of employees in the organization

Q10) Performance Improvement Process is an action taken by management to

improve unsatisfactory Professional Staff Member performance, attendance, or
behaviour by a Professional Staff Member.

Table 4.10

Scale No. Of Respondents Percentage

Strongly agree 26 87%
Agree 4 13%
Neutral 0 0%
Disagree 0 0%
Strongly Disagree 0 0%
Total 30 100%

Graph 4.10

strongly agree agree neutral disagree strongly disagree

0% 0% 0%

13%

87%

77
INTERPRETATION : According to the Table 4.10, 100% of the employees have
agreed that performance management process mainly focuses on low performers by a
professinal staff member to improve or mentor his skills

Q11) Performance management is clear job description and employee performance

plan.

Table 4.11

scale No. Of Respondents Percentage

Strongly agree 4 13%
Agree 7 23%
Neutral 19 64%
Disagree 0 0%
Strongly Disagree 0 0%
Total 30 100%

Graph 4.11

strongly agree agree neutral disagree strongly disagree

0% 0%

13%

23%

64%

78
INTERPRETATION : According to the Table 4.11, 100% of the employees have
responded in a positive way agreeing to the statement that performance management is a
clear job description and employee performance plan

Q12) The purpose of promotion is to attract trained, competent and hard working
people.

Table 4.12

Scale No. Of Percentage

Respondents
Strongly agree 7 23%
Agree 10 33%
Neutral 8 27%
Disagree 3 10%
Strongly Disagree 2 7%
Total 30 100%

Graph 4.12

strongly agree agree neutral disagree strongly disagree

7%
10% 23%

27%

33%

79
INTERPRETATION : According to the Table 4.12, 83% of the employees have said
that the purpose of promtion is to attract only hardworkig and competent people while
17% of the employees have disagreed to that statement implying promotions not only
meant for competent people.

Q13) The performance management system should elevate performance, not just
measuring the performance.

Table 4.13

Scale No. Of Percentage

Respondents
Strongly agree 9 30%
Agree 4 14%
Neutral 6 20%
Disagree 7 23%
Strongly Disagree 3 13%
Total 30 100%

Graph 4.13

strongly agree agree neutral disagree strongly disagree

13%
30%

23%

14%
20%

80
INTERPRETATION : According to the Table 4.13, 44% of the people strongly agree
that it should elevate oerformance not only measuring the performance where as 33% of
people do not agree with the above statement and 20% of the people are very neutral
upon this statement under their own experiences.

Q14) Performance management system optimizes the results through a channel

process which reduces the conflicts and grievances among teams and employees.

Table 4.14

Scale No. Of Respondents Percentage

Strongly agree 0 0%
Agree 7 23%
Neutral 19 64%
Disagree 4 13%
Strongly Disagree 0 0%
Total 30 100%

Graph 4.14

strongly agree agree neutral disagree strongly disagree

0% 0%

13%
23%

64%

81
INTERPRETATION : According to the Table 4.14, 64% of the employees are neutral
about the above statement that performance management system reduces conflicts and
grievences among team and other employees where as 13% of people disagree to the
satement and 23% of the empoyees agree

Q15) Performance management might discourage free thinking of employees.

Table 4.15

Scale No. Of Percentage

Respondents
Strongly agree 11 37%
Agree 4 13%
Neutral 4 13%
Disagree 5 17%
Strongly Disagree 6 20%
Total 30 100%

Graph 4.15

strongly agree agree neutral disagree strongly disagree

20%

37%

17%

13% 13%

82
INTERPRETATION : According to the Table 4.15 , 50% of the people agree to the
above statement that says performance management may discourage free thinking of
employees , 13% of employees have neutral opinion and 37% of people disagree to the
above statement.

83
 CHAPTER 5

 SUMMARY, FINDINGS, SUGGESTIONS AND

CONCLUSION

84
 SUMMARY

Effective performance management is often cited as the most vital component of

organizational success, and hence ensuring it takes place is very important to any
company. Whether it is ensuring targets are reached, deadlines are met or quality is
maintained at a high level, ensuring your employees maximize their performance is
crucial for the output of the organization. It is important to recognize and emphasize the
link between an individual‘s performance and the effect this has on the organization. This
helps to align everyone‘s goals and objectives with the organization and acts as useful
motivation and engagement tool.

Armstrong and Baron (1998) define performance management as a ―systematic

process for improving organizational performance by developing the performance of
individuals and teams. It is a means of getting better results from the organization, teams
and individuals by understanding and managing performance within an agreed
framework of planned goals, standards and competence requirements.

Towards the end of the 20th century performance appraisal, where the output of
employees would be compared with their objectives and their peers, started to gain
popularity. It is now common for a cycle of activities to exist within an organization,
aimed at aligning individual and organization goals, monitoring performance and
improving performance. Performance management agrees that expectations should be
determined at an early stage and should be supplemented by support, review and
appraisal stages, before finally a re-assessment.

85
 FINDINGS

The following details can be inferred after analyzing the sample size of 30 respondents of
Medicover Hospitals, Visakhapatnam, by questionnaire method to findout the
performance of the employees.
 Performance Management method is a continuous process of evaluation
 Measure are taken to ensure employee job satisfaction
 Majority of the respondents, i.e, 100% of them are satisfied with their organization
recognition towards their hard work .
 Majority of the respondents, i.e, 100% of them believe that performance management
system acts as a deciding factor increments, transfers and terminations
 93% of the employees agree to the fact that performance of employees improves after
process of performance appraisal.
 Majority of the respondents, i.e, 90% of the stated that performance management
processes are used to determine compensation i.e. bonus/merit pay, variable pay raise.
 100% employees believe that Bell curve appraisal methods create a lack of morale in
employees as it only favours 20%of employees in the organization.
 63% of the people agree to the statement that says performance management might
discourage free thinking of employees.
 64% of the respondents are neutral about the statement that performance management
system optimizes the results through a channel process which reduces the conflicts and
grievances among teams and employees where as 23% of the people agree to it.
 77% of the people agree that the performance management system should elevate
performance, not just measuring the performance.
 57% respondents agree that negative feedback drives employees positively where as 43%
of the people disagree to the statement implying it creates a negative impact on
employees.
 The incentives encourage friendly competition between associates when linked to job
performance.
 A successful performance management system must be fair and accurate

86
 SUGGESTIONS

 Should try to adopt other performance appraisal methods as people aren‘t completely
satisfied with bell curve method
 Conduct more mental motivation and stress free workshops to create healthy working
environment.
 Have proper working hours which won‘t burden the employees latter affecting their work
 Proper performance improvement sessions should be conducted for low performers in the
company
 Should identify minor loop holes like inaccuracy in performance appraisal method and
rectify them.

87
 CONCLUSION

Regardless of the performance management system, employee and manager

training is absolutely necessary for improving performance. Coaching, development,
giving and receiving feedback are a learned and necessary skill for all employees,
regardless of their position in the organization.

Our performance management systems grew into systems that were almost
expected to produce mediocre performance. The focus should be placed on the majority
of the employees who are doing good to excellent work. Performance improvement plans
should be implemented and performance documented when a specific problem is
identified. The organization can then either help that employee improve or move out. It is
more efficient and more humane to all considered.

The performance management system that the firm intends to implement will
enable it to satisfy the expectations of its stakeholders in the long run. The firm will
follow all important phases that are related to the new strategy to ensure the system is
aligned to the long term vision that guides its operations in the industry. More
importantly, performance management systems implemented by the firm will focus on
opening up decision making processes to enable employees to develop their professional
skills in the long term. As a result, this will allow employees to contribute to the long
term success of the organization by proposing valuable ideas which will improve the
quality of results attained. Appraisal systems which the organization will use will enable
it to be fair to all its employees to encourage them to attain good results in their
respective workstations.

88
 BIBILOGRAPHY AND ANNEXURE

89
 BIBILOGRAPHY

Books referred:
 Human Resource Management, Dr.S.C. Guptha
 Personnel Administration & Management,S.L. Goel
 Human Resource Management , Sashi K Guptha & RosyJoshi Kalyani publishers.
 Human resource management, L.M Prasad
 Human resource & Personnel management, K .Aswathappa

Net sources:
 Google search
 Company‘s website www.medicoverhospitals.in
 https://excardo.com/content/healthcare-performance-management/index.html
 https://www.managementstudyguide.com/objectives-of-performance-management.htm

90
 ANNEXURE

QUESTIONNAIRE

NAME:
DEPARTMENT:
GENDER:
DESIGNATION:
AGE :

Q1) Performance management system acts as a deciding factor for salary

increments, transfers and terminations.

a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

Q2) Performance of employees improves after process of performance appraisal.

a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

Q3) The performance management processes are used to determine compensation

i.e. bonus/merit pay, variable pay raise.

a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

Q4) A successful performance management system must be fair and accurate.

a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

91
 Q5) Your organization recognizes and acknowledges your work.

a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

Q6) The incentives encourage friendly competition between associates when linked
to job performance.

a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

Q7) Focusing more on negative feedback gives positive zeal and motivation towards
work.

a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

Q8) Performance appraisal lets both manager and employee to set up long and short
term goals.

a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

Q9) In the bell curve appraisal model, only a limited number of employees come
under top performer’s category, employees who have actually performed
exceedingly well through the year period may be forced to in the Average
performers’ category which causes lack of morale in employees.

a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

92
 Q10) Performance Improvement Process is an action taken by management to
improve unsatisfactory Professional Staff Member performance, attendance, or
behaviour by a Professional Staff Member

a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

Q11) Performance management is clear job description and employee performance

plan.
a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

Q12) The purpose of promotion is to attract trained, competent and hard working
people.

a) Strongly agree b) agree c) neutral d) disagree e)strongly disagree

Q13) The performance management system should elevate performance, not just
measuring the performance.

a) Strongly agree b) agree c) neutral d) disagree e)strongly

disagree

Q14) Performance management system optimizes the results through a channel

process which reduces the conflicts and grievances among teams and employees.

a) Strongly agree b) agree c) neutral d) disagree e)strongly

disagree

93
Q15) Performance management might discourage free thinking of employees.

a) Strongly agree b) agree c) neutral d) disagree e)strongly

disagree

_____________________

(Employee signature)

94