The Ramsay Health Care Growth Study

The Ramsay Health Care Growth Study

Ramsay Health Care was established in 1964 as a psychiatric hospital. Today, it is a multinational healthcare provider and hospital network with operations in 3 continents. Here's its incredible journey…

Ramsay Health Care is a multinational hospital and healthcare provider with operations in Australia, Europe, the UK, and Asia.

Yet, when it was established in 1964, it was merely a guesthouse converted into a psychiatric hospital in Sydney.

Over the years, Ramsay Health Care has grown exponentially to become the largest private healthcare and medical services provider. It has achieved remarkable success due to its highest quality and safety standards as well as its signature way of doing business by caring for people.

Here are some of the key highlights and stats of the Ramsay Group from 2021:

Ramsay Health Care specializes in surgery, psychiatric care, and rehabilitation. It aims to become the ultimate patient-centric integrated healthcare provider of the future, catering to the ever-evolving needs of people and the dynamic healthcare environment worldwide.

Let's now delve deep into the remarkable journey of growth of Ramsay Health Care, full of trials, tribulations, and lessons…

Foundation & Early Years of Ramsay Healthcare (1964-1999)

How do you do something that's not been done before, and how do you do it exceptionally well? Well, Ramsay Health Care knows that better than anyone else. 

The company's beginnings were humble, and it took around three decades for it to make an impact. But once it picked momentum, it never looked back. 

The 1960s: The Beginning

The journey of Ramsay Health Care began in 1964. 

Paul Ramsay was one of the earliest people to identify the need for a psychiatric care center for his people in Australia. Thus, he decided to build a healthcare facility in the Warrina guesthouse in Sydney, North Shore, Australia.

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Before his own hospital, Ramsay had observed the US market for Psychiatric care and realized that competition was extremely intense. He understood that establishing a new hospital was expensive and highly risky. As a result, he invested in an existing structure to start the company with only a psychiatric care unit.

The company believed in assisting in mental health, which was a frowned upon and controversial medical condition.

Therefore, Australians were less responsive to the mental healthcare facilities and approaches to mental health early on. However, they understood the need for it over time and warmed up to it. Notably, when the issue such as psychiatric care for the mentally unfit was the concern. 

Soon after, the healthcare facilities expanded to Evesham Clinic in 1967, a psychiatric care unit. The clinic was outside the town center, making the investment less expensive and competition minimal. The Evesham Clinic has been named Northside Cremorne and is still a fully functioning psychiatric facility.

The 1970s – Expanding the Facilities

In the next few years, several other facilities were established — namely Lynton Private Hospital in 1972 and Northside Clinic in 1973. These clinics were just the beginning for Ramsay Health Care. 

Slowly, the company was expanding the clinics around the country, and specifically within the bustling city center and the business districts.

It enabled the founder's vision to be brought to life with the best quality of psychiatric help in the country. Even today, these care units are considered one of the finest and most well-reputed private psychiatric centers in the country.

In the late 1970s, the expansion continued for Ramsay Health Care. This time around, it was not just more hospital facilities, but the health service provider ventured into the surgical/medical business.

1978 and 1979 were the years of diversification for Ramsay. It built its first two surgical hospitals, Baringa Private Hospital in Coffs Harbour, in 1978 and Albury Wodonga Private Hospital in Albury in 1979. These hospitals at the time provided the best healthcare. The Albury Wodonga Private Hospital started as a two theatre and 35-bed facility. Over time, it grew into one of the most well-developed private hospital facility in the area, with 103 beds and five theatres. The hospital continues to provide mental health and surgical facilities to the people of Australia and is highly regarded for its diagnostic and support services as well.

The 1980s – Growth of the Psychiatric Care Units

Ramsay Health Care continued to invest enormously in psychiatric care centers in the 1980s as well.

It obtained the East Terrace Psychiatric Clinic in Adelaide in 1982, where it built South Australia's first purpose-built psychiatric clinic. To grow further, it designed the New Farm Clinic in 1986 in Brisbane and the Adelaide Clinic in 1988.

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The company firmly believed in research and better facilitation for mental healthcare and so shared their experiential knowledge with the industry. It did so in the form of lobby groups and other vital associations that helped the mental health industry grow and facilitate the needs of the people.

The 80s also did not stop the growth of the hospital facilities. Ramsay purchased two hospitals in Tamworth, namely, Allambie and Tamara Private Hospitals.

Tamara Private Hospital has been established into a better, more advanced, innovative hospital facility and functions as a top-notch private hospital. It has two new operating theatres, a recovery unit, more beds than ever, and a new x-ray area to meet the growing needs.

The 1990s – The BIG Boom

It had taken various small steps over the last three decades by establishing and expanding healthcare facilities and services. However, the 90s decade was the big boost that Ramsay Health Care needed to establish its mark across the country.

The company privatized two repartition hospitals called Hollywood Hospital in Perth and Greenslopes Hospital in Brisbane. 

These hospitals were teaching centers and provided care for the elderly which was a major contributing factor to the privatization of these facilities by Paul Ramsay. He took special interest and promised to retain these institutions and facilities' essential character and ethics.

It also allowed the company to move into the education industry because of the association these facilities had with medical departments at universities. It made advances into the medical teaching industry with a firm footing. Additionally, the privatization allowed them to be identified as a health management expert in the industry.

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In the 1990s, the company announced itself as a public health company and invited all Australians to purchase shares of "one of Australia's largest and most successful private health care groups." Also, it employed some 2000 people and provided healthcare service to 70,000 patients at their 11 hospitals.

In 1998, the company finally showcased itself as a successful healthcare facility and service provider by constructing the North Shore Private Hospital. It reflected its capabilities of design, finance, construction, and services. It was considered a five-star hospital in Australia. It started with 164 beds, and it has now grown into a 272-bed facility in Sydney. 

Key Takeaway 1: Small, Consistent Growth is Essential for Long Term Success

It took three decades for Ramsay Health Care to finally become the best, most well-regarded healthcare facility and service provider. This three-decade journey is reflective of its consistent commitment to quality service and making the world a better place.

The desired results did not come right away. But Ramsay healthcare kept at it. From carefully yet very consistently growing by exploring all possible services in the industry to expanding in different regions, Ramsay Healthcare did it all in its quest to provide quality healthcare to all. It sure was not easy. 

Various issues ranging from the concerning attitude of people towards mental health to managing the finances and standing out from the competition threatened the very existence of Ramsay Healthcare. However, it persevered and continued to grow on the back of small care units, which eventually led to the construction of the North Shore Private Hospital – the hallmark hospital of the time – just before the turn of the century. 

Ramsay Health Care In The 21st Century (2000-2021)

By the 2000s, Ramsay had made its mark on the home turf, and it was time to go global.

The Big Step

After establishing itself in Australia with North Shore Private Hospital, it was time for further expansion and collaboration. 

The company acquired many of the large hospitals in Australia as the private sector had begun to consolidate. The acquisitions bolstered the company's business and enabled it to provide more comprehensive services to a larger customer base.

In 2001, it acquired Alpha Healthcare and its eight hospitals (Westmead, Berkeley Vale, Southern Highlands, Lawrence. Hargrave, Figtree, Hunters Hill, Mt Wilga Private Hospitals, and Wentworth Private Clinic – later known as Northside West Clinic) for $17m. 

Alpha Healthcare allowed the company to make its way into the rehabilitation industry and strengthen its portfolio. It was a move to show its power as a management and health service provider, making the right impact. It made its presence visible in New South Wales, which was previously unexplored by the company.

Three years later, in 2004, Ramsay acquired Benchmark Healthcare and its subsidiary hospitals, including Peninsula, Beleura, Mitcham, and Donvale Private Hospitals. It had now brought the Ramsay Hospitals to 35. 

Ramsay was growing in leaps and bounds with an extensive number of assets under its belt.

In April 2005, the company brought in the biggest ever purchase yet with Affinity Healthcare, formerly called Mayne Health. This move made Ramsay Health Care the largest healthcare provider now in Australia. Now, 69 hospitals operated under the Ramsay name.

The "company's transforming acquisition" solidified its position as the best, largest, and most influential healthcare business in Australia after many years of small steps to make it to this point.

Onwards & Upwards To Bigger Markets 

Now that the company has made its mark in its home country, it moved to other markets. The first destination was the United Kingdom. This offshore expansion was risky and required more awareness of that market and its working models.

Ramsay made a wise decision by not establishing a hospital itself. Instead, it chose to purchase Capio UK, the fourth largest private healthcare provider in the UK at the time. 

It now owns 36 hospitals and healthcare facilities under its supervision and holds a reputable position in the region.

After the UK venture was successful, Ramsay understood how to maneuver into a newer market and make a name for itself.

In 2010, the company acquired 57% interest in Group Proclif SAS (Proclif), the leading healthcare provider in France. It made a well-calculated risk, and it paid off for it. Proclif provided its services in the Paris region with many acute hospitals in medicine, surgery, and obstetrics.

Ramsay took these hospitals and brought them under the name of Ramsay Sante for the French market. It was another successful venture into a foreign market. In 2011 Ramsay Sante purchased another hospital in France by the name of Clinique Convert in the Rhône Alpes region.

It did not stop, and in 2013, the company went on to purchase Clinique de l'Union in Toulouse. It is considered one of the top three finest and most well-regarded hospitals in all of France. It has an occupancy of 500+ beds.

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It was now time to move to the peninsula's eastern side, and Ramsay aimed for Malaysia. In July of 2013, the company signed a joint venture with Malaysian conglomerate Sime Darby Berhad. This included Sime Darby's portfolio of healthcare facilities; three hospitals, nursing, and health sciences college, in Malaysia. This was a successful venture into the Asian market. 

Although Ramsay previously had been involved in the healthcare business in Indonesia, with three hospitals working under its supervision. But this was their formal operational and physical entry into the Asian land; it was an impactful one with the right incentives for Ramsay.

Staying Still Is Not An Option

In 2013, Ramsay expanded in Australia by opening Sunshine Coast University Private Hospital. This was the company's first hospital after North Shore Private hospital, almost two decades ago. This was a 200-bed facility that could treat public and private patients under its five-year agreement with Queensland Health.

Ramsay ended the year with a major purchase in France by acquiring Medipsy, a psychiatric hospital group from Générale de Santé (GDS), the leading psychiatric care provider in France. The chain of hospitals tallied up to 30 with 2600 bed capacity. With this deal, Ramsay had confirmed their stronghold in France with 40 hospitals and the third-largest healthcare service provider in the country. 

Furthermore, in 2014 the company acquired the controlling interest of Générale de Santé. It was a breakthrough that made Ramsay Sante the market leader of private hospitals in France and one of the top five in the world. It has brought the French portfolio to an extensive 115 healthcare facilities. 

This was a resounding success for the company since it shows its commitment, expertise, and management skills that enabled it to establish and build a successful healthcare service in its own country and be able to venture into other markets and be successful elsewhere.

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Pan European Expansion

The aim for Ramsay was always to provide quality healthcare and a wide range of services to the patients in need. As it fulfilled the needs of the Australian market, it aimed to expand its service and reach to other regions. The expansions were well-received, which convinced the company to think bigger. 

As a result, in November 2015, the company bought Capio AB through Générale de Santé (GDS), a Ramsay Group subsidiary in France. 

Capio AB was a Scandinavian healthcare operator. The acquisition of this company reflects the success for Ramsay as it was a European pan company with facilities in Germany, Norway, Denmark, Sweden, and France. 

Consequently, Ramsay was now a global healthcare service provider with its healthcare units in Australia, the UK, Malaysia, France, and many countries in the European Union.

Becoming The Ramsay Of Today

In 2016, Ramsay continued its organic growth and also acquired HPM Group of nine hospitals in Lille, France, expanding its footprint in France and becoming a leading healthcare and medical service provider in the region. Plus, $300 million worth of brownfield developments and the addition of 500 beds as well as 26 operating theaters were made in the already extensive portfolio in the year.

Solid business growth continued in the next years. In 2017, Ramsay Healthcare invested heavily in expanding and improving the quality of its services and explored the out-of-the-hospital growth opportunities such as in retail pharmacy. Also, evolving with changing times, Ramsay Healthcare doubled down on innovation as it launched a digital admission process for patients in France and started a cancer clinical trial network in Australia. The following year, Ramsay Healthcare carried forward with its unwavering focus on healthcare affordability and sustainability in all the markets it operates in. 

In 2019, Ramsay Healthcare made a major acquisition of Capio, the pan-European healthcare company, becoming the largest private healthcare operator in the world. This strategic acquisition enabled Ramsay to leverage Capio's expertise in integrated healthcare models and digitalization. 

2020 was an extremely challenging and remarkable year in the company's history. The extraordinary circumstances posed by the Covid-19 pandemic hit the company's finances hard but at the same time demonstrated the leading role of Ramsay Healthcare in caring for the communities all across the globe. The company provided critical support to governments and the healthcare industry in the fight against Covid, doing everything in its capacity to lend a helping hand to those in need.

In 2021, Ramsay Healthcare continued with its mission to care for patients, people, the environment, and the community. Adapting to the new normal, the company embraced changing preferences in the healthcare sector, expanded its facilities, reinforced organizational foundations, and played an integral role in vaccination drives worldwide. Also, it acquired Elysium Healthcare, UK mental health group, adding another prominent name to its portfolio at a time when mental health services were in high demand.

Key Takeaway 2: Gain Ground With Strategic Acquisitions

The global success of Ramsay Health Care proves that with calculated risks, any company can go grow exponentially. 

While exploring the markets abroad, the company didn't take the risk of establishing its operations from scratch. Instead, it did so by acquiring established healthcare operators and handling their management. This proved to be a master-stroke and allowed Ramsay to strategically penetrate new markets.

While it had taken nearly three decades to make a name for itself in Australia, within two decades, the company has hospitals on multiple continents thanks to its array of acquisitions.

Doing Business & Doing Good Together

Ramsay Health Care is determined to provide quality service to its customers in a sustainable manner, doing right by the people and the planet.

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The goal is to be a responsible company and adhere to high-quality standards while simultaneously continuing on the growth journey to become the leading healthcare service and facility provider globally.

Sustainability A Hallmark of Ramsay

Ramsay Healthcare works under the founder's philosophy, "The Ramsay Way," which is to care for the people and planet. It entails being progressive, using a positive spirit to succeed in future endeavors, and deeply caring for others.

To achieve the spirit of the company in the long-term, establishing a Ramsay Cares policy was integral. It highlights the three critical pillars; people, planet, and community. 

The sustainability committee has been formed to focus more on sustainability projects and investments. 

The company firmly believes in the climate crisis and commits itself to making minimal unnecessary waste and reducing consumption of scarce resources. The sustainability program by Ramsay enables it to reduce the cost to the environment and maintain a sustainable financial balance. It is taking steps to create a resilient business that adapts to climate-related risks. It is rolling out a renewable energy efficient program at its hospitals, arranging regular awareness campaigns to help its staff members lower their carbon footprint, and reducing, reusing, and recycling in its quest to follow environmentally-friendly practices. Plus, the Supplier Code of Conduct and Environment Sustainability Policy highlights its resolve to help mitigate the climate crisis.

Putting its money where its mouth is, Ramsay Australia and Ramsay UK refinanced their facilities with a $1500m syndicated sustainability linked loan facility, the most significant sustainability linked loan in the healthcare industry in the Asia-Pacific region. Furthermore, the company has remained in the FTSE4Good Global Index every year since 2011 courtesy of its continued investment and efforts to ensure sustainability across the organization. 

Patient Safety And Quality Of Service Are Paramount

The principle of the company has been "People Caring for People," and it has been ingrained in the work ethic, approach, and policy-making of the company.

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A sound, high-quality healthcare system can only respond by actively listening to the patients and their needs. Ramsay prides itself on focusing on the people and responding to their needs. It utilizes customer feedback and customer satisfaction surveys to continue to improve its offerings.

The organization aims to review and improve the quality of service. It assists healthcare professionals and medical practitioners in maintaining patient safety and quality. 

Further, to make sure all checks and balances are being kept, the accountability committee follows up on the tasks and quality checks.

The company has designed a Clinical Governance Framework that ensures clinical risk management and continuous quality improvement. This means that errors, effectiveness, and patient participation are being accounted for at all times.

Furthermore, Ramsay firmly believes in Hospital Accreditation and considers it an essential element in establishing and implementing good standards.

Good Governance Key To Success

The Ramsay governance structure is designed to ensure that it is effectively managed, and the obligations devised by the founder, The Ramsay Way, are being followed. 

Being the world's largest private healthcare operator, Ramsay has a number of divisions within the company. Hence, to effectively run it, there are a number of committees responsible for different tasks. 

The Board is responsible for effective decision making, the Audit Committee is there to make sure finances are in order, Risk Management Committee Charter is present to ensure that the investments and expansions are calculated decisions with manageable fallout for the company. Similarly, many other committees work together to run the company to the best standards under The Ramsay ideology, alleviating risks and maximizing the rewards for all. 

This delegation of responsibilities has proven to be quite effective.

Social Contributions Are Essential

The Ramsay Way enforces the "open door" policy for all the employees at the company. The environment created by the top management has enabled two-way communication that is comfortable and flexible. This enriches the experience of the staff and doctors and allows them to make valuable contributions to the company's overall performance.

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Ramsay has a workplace health and safety policy that protects all accidents at work for staff and employees; it is constantly being worked on to improve everyone associated with the company. The healthcare provider invests in the corporate community welfare by providing teaching and training to the staff and doctors. 

Additionally, medical research wings operate as two not-for-profit foundations – the Ramsay Hospital Research Foundation (in Australia) and the Fondation Générale de Santé (in France) that conduct cutting-edge research to elevate people’s lives.

Key Takeaway 4: People, Planet & Profits Go Hand-In-Hand

The Ramsay Way of doing business has encouraged the company to operate in a way that promotes caring for all, including the staff, employees, and patients. The healthcare business requires sensitivity and people skills, and Paul Ramsay inculcated that into the company ethos. 

Even after he died in 2014, the company has retained that value and exhibits it within and across communication with people. The company continues to progress thanks to continuous innovation, sophisticated strategizing, commitment to shared values, and provision of quality service.

The Ramsay Way Of Doing Business

Ramsay Health Care has a phenomenal patient healthcare and hospital management record. It facilitates various healthcare needs around the globe, from surgical procedures to psychiatric care, rehabilitation, and nursing services. 

But how has it grown so remarkably over such a short period of time?

The pivotal factors in Ramsay's success and exponential growth are its clear-cut vision and on-point business strategy. Let’s delve deep to understand the latter:

Constant Growth A Hallmark

Ramsay aims to grow organically by leveraging its strong market share underpinned by demographics, via strategic expansions through brownfield and greenfield developments to grow its network of hospitals, and with public/private collaboration to achieve win-win outcomes. 

The company also plans on moving purposefully into adjacent services through acquisitions, offering integrated care, and introducing new models of care.

Efficiency In Everything

The company realizes the importance of strengthening the core through optimization, achieving operational excellence, doing extensive research and development, and harnessing the power of digitization.

It’s doing just that through rapid innovation, modernization, digitization of healthcare system interactions, and clinical delivery models. Plus, it is strategically outsourcing operations and services that can be delegated to enhance its focus on what truly matters - delivering better outcomes for patients.

Expand Calculatedly

Ramsay made significant advances by expanding within the local market for numerous decades. It started small and then established itself as the country's largest hospital and healthcare facility. After achieving the goal, it moved to foreign markets, including Europe and Asia.

Ramsay retained its strategy of buying out the competition and using its skills and experiential knowledge to expand in the new regions.

Management Style

Paul Ramsay started with buying out the controlling share of each acquisition to ensure minimal external pressure. It allowed the company to utilize, exhibit, and build its operations according to its wishes. 

Similarly, the company believes in removing the influence of institutional investors, analysts, and financial institutions, including the banks that do not seem to understand the healthcare business. With its strategy and management style, Ramsay proved that it understood the industry better than the competition, experts, and regulatory institutions. 

In addition to this, the company continues to empower its people to take bold decisions and set the bar higher when it comes to providing quality services.

Progressive People Policies Are Key

One of the reasons that Ramsay Health Care has flourished in its industry is by empowering its people and being willing to go above and beyond to care for all - the patient, employees, and wider community.

Paul Ramsay set the tone by leading the company in a paternalistic way, which motivated people to stay loyal. Unsurprisingly, the turnover remained low. It is not a hidden fact that much of the company's success springs from his (Ramsay's) personality. He is the better side of the Catholic faith, and he treats everyone, from the specialist doctors to the cleaners, decently. It has paid dividends for the company. 

The modern way of management is to ensure cost-cutting and leverage control. Ramsay, however, doesn't do that. The company, while striving for efficiency, empowers its people, right from doctors to the administration staff, involving them in the decision-making. This equity of management has created ownership within the company and hence, the employees go above and beyond to get the desired results.

By investing in strong organizational foundations, Ramsay is improving its doctor-patient experience, achieving clinical excellence to cater to all patient’s needs, and employing talented people worldwide that are committed to creating a lasting impact and making the world a better place. Ramsay understands the value of a strong team and heavily invests in retaining and attracting the best in the world. All along, it remains conscious of its impact on the wider society.

Key Takeaway 3: Solid Strategy Is Pivotal To Success

Effective strategizing, a sustainable vision, and the commitment of the people in the company are the key to any company’s success and Ramsay is no different.

The healthcare industry is quite a turbulent and competitive one. There are too many variables that can influence the market demand and supply. 

Ramsay has been successful in founding and flourishing a large-scale, diverse, and global business due to effective strategies and management style. It understands the value of a well-researched and thought-out strategy. Plus, the company has continuously innovated and evolved in order to grow and invested in people management. Consequently, Ramsay has been pouring in profits and grown from a guesthouse care unit to a global healthcare service chain on the back of its vision and strategy.

Growth By Numbers & Key Strategic Takeaways

Ramsay Health Care is a name that’s synonymous with high-quality of healthcare and medical service. Over the years, the company has continued to grow thanks to its rock-solid fundamentals, laser-sharp focus on caring for people, and tried as well as tested strategies that include consistent expansion, acquisitions, and diversification.

With the size and stature of the company today, it’s hard to believe that it all started with a single make-shift facility in a rural area.

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Here’s how the company has grown over the last decade:

Growth By Numbers

 

Year

 

2021

 

2011

 

Revenue

$13.3 billion

$3.7 billion

 

Profit

$511.5 million

$200.3 million

 

Workforce

80,000+

22,000+

 

Share Price

$71.5

$19.4

 

Identify The Gap In The Market

Paul Ramsay was a wise man who observed the US market and identified the gap in his own region. He understood the Australian healthcare ecosystem and made conscious choices to leverage the market dynamics as well as evolving needs of people, and proactively started a venture ahead of time.

Having identified an opportunity, he wasted no time in getting to work and set up a facility in Sydney. The rest is history. Today, Ramsay Healthcare is one of the largest private healthcare providers in the world, having achieved the feat in just 50 years.

Expand Calculatedly

No, Ramsay Healthcare did not just go about randomly expanding the business. In fact, the growth for the first three decades was quite nominal. Slowly and steadily, Ramsay Healthcare expanded into different cities and eventually countries and continents as well.

Success in Australia, the UK, Europe, and Asia reflects the informed choices, extensive research, business acumen, and measured risk-taking approach of the company. By understanding the foreign market and collaborating, acquiring, and establishing hospital facilities and healthcare units, Ramsay Healthcare managed to grow exponentially.

Embrace Mergers & Acquisitions

Over the years, Ramsay Healthcare has acquired many businesses, including Proclif SAS, Sime Darby Berhad, HPM Group, and Capio, among others, to venture into a new market, diversify, and augment its offerings. 

From enhancing operational and cost efficiencies to gaining a competitive advantage in a new region and market, the collaborations have worked quite well for the company. It highlights the importance of looking beyond one’s own company for growth opportunities and pouncing on them.

Never Compromise On Your Values

The Ramsay Way ‘People Caring For People’ is the core of the company. It gives every employee, right from the top to bottom of the hierarchy, a clear-cut vision to follow. This has enabled the company to distinguish itself from the competition and continue to delight its customers time and again.

For businesses, large and small, clarity on the mission and vision is essential. Without it, they cannot survive, let alone thrive. After all, these fundamentals act as a guiding light on a day-to-day basis, enabling everyone to make the right decisions and act accordingly.

What’s more, is that Ramsay stuck to its vision of caring for people and the planet - never compromising on it. It helped the company win the trust of the people and continue to pave its way to success.

 

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