Top Hospital Acquisitions of 2023

India's healthcare sector is experiencing unprecedented growth, boasting a compounded annual growth rate (CAGR) of around 22% since 2016. Anticipated to reach a staggering $372 billion by 2022, as per a 2021 NITI Aayog report.

However, this robust expansion comes with challenges, notably India's ranking of 155th in bed availability, with just five beds and 8.6 doctors per 10,000 people, highlighted in a 2020 Human Development Report.

To meet the evolving demands, a recent PwC report emphasises the necessity for a $245 billion investment in the hospital industry over the next two decades. This imperative investment aims to add 3.6 million beds, 3 million doctors, and 6 million nurses, reflecting the sector's pivotal role in India's healthcare landscape.

Concurrently, the private healthcare sector, valued at $48 billion, is projected to grow at an annual rate of 12-14%, signifying a post-pandemic surge in focus on healthcare services and infrastructure. Global private equity funds are eyeing the under-penetrated Indian hospital sector, amplifying its significance in the economic landscape.

In the healthcare investment space, mergers and acquisitions (M&A) have soared significantly, reaching $4 billion in 2022, with an additional $2.2 billion in the initial five months of 2023, per Reuters.

As we delve deep into the transformative Indian healthcare landscape of 2023, this article explores the top hospital acquisitions and M&A activities shaping this revolutionary shift, unravelling vital players, strategic moves, and the overarching impact on healthcare delivery and infrastructure in the country.

1. Manipal Hospitals' Strategic Eastern Expansion

In a pivotal move, Manipal Hospitals, the second-largest hospital chain in India, secured an 84% stake in four hospitals under the AMRI brand, previously owned by the Emami Group. Valued at around INR 2,300 Cr, this acquisition comprises three hospitals in Kolkata and one in Bhubaneswar. Beyond the financial metrics, Manipal Hospitals aims to streamline patient experiences by rebranding these facilities under its own name, marking its entry into the underserved eastern region.

Dilip Jose, the managing director and CEO of Manipal Hospitals, underscored the importance of this expansion, aligning with the company's broader strategy. This strategic move is facilitated by Temasek's acquisition of a majority stake in Manipal Health Enterprises, providing the impetus for further growth and regional penetration.

2. Asia Healthcare Holdings Elevates Nephrology and Urology Care

Asia Healthcare Holdings (AHH), a key player in the healthcare delivery platform, bolstered its position through the acquisition of a majority stake in the Asian Institute of Nephrology and Urology (AINU). With an investment of INR 600 Cr, AHH solidified its status as India's largest single-specialty healthcare delivery platform, focusing on urology and nephrology care.

Vishal Bali, executive chairman of AHH, emphasised the critical role AINU plays in addressing the rising incidence of urological disorders and chronic kidney diseases in India. AINU caters to the growing demand for specialised care in these fields by operating seven specialised hospitals across Hyderabad, Visakhapatnam, Siliguri, and Chennai.

3. Regency Health's Strategic Partnership with Norwest Venture Partners

Norwest Venture Partners is poised to acquire a substantial 40% stake in Regency Health for INR 600 Cr, signalling a significant expansion for the Kanpur-based hospital. With a current 1,000-bed facility, Regency Health's joint venture with Germany's Fresenius Medical Care for dialysis clinics positions it as an attractive investment in India's burgeoning healthcare sector.

The strategic location of Regency Health in Kanpur, Uttar Pradesh, provides a gateway to a substantial patient base. This acquisition is indicative of private equity firms' increasing interest in India's healthcare sector, reflecting the growing demand for quality medical services. The deal is expected to strengthen Regency Health's market position, enhance infrastructure, and introduce advanced medical technologies.

4. Max Healthcare's Foray into Lucknow with Sahara Hospital Acquisition

Max Healthcare Institute Ltd, a leading private healthcare provider, is set to acquire Lucknow's Sahara Hospital for a significant INR 940 Cr. This strategic move marks Max Healthcare's entry into one of the fastest-growing cities in Uttar Pradesh, demonstrating its commitment to extending quality healthcare services to emerging urban centres.

The acquisition aims to introduce high-end medical programs, including oncology and organ transplants, while strengthening existing programs such as orthopaedics, cardiac sciences, neurosciences, and renal sciences. This strategic manoeuvre reflects the increased M&A activity in the Indian hospital space, with PwC projecting 12-14% annual growth for the country's private healthcare market.

5. Blackstone's QCIL Acquires KIMS Health Management

Quality Care (QCIL), a hospital platform owned by private equity fund Blackstone, is poised to acquire KIMS Health Management (KHML), a leading hospital chain in Kerala, for approximately INR 3,500 Cr. This deal positions QCIL as the fourth-largest hospital group in India, trailing only Apollo Hospitals, Manipal Health, and Fortis Healthcare.

The acquisition encompasses an 80-85% stake in KIMS, adding nearly 3,800 beds to QCIL's extensive network. Dr MI Sahadulla, the founder of KIMS, will retain a 15-20% stake and continue to manage the hospital business. This move follows Blackstone's earlier acquisition of a majority stake in QCIL, signalling the private equity giant's deepening commitment to India's growing healthcare industry.

6. General Atlantic's Strategic Entry into Ujala Cygnus Healthcare Services

Global private equity major General Atlantic is set to acquire approximately a 70% stake in Ujala Cygnus Healthcare Services, a multi-speciality hospital chain based in Delhi. The deal values the chain at about INR 1600 Cr and includes the acquisition of existing stakes held by Eight Roads Venture India, Evolvence India Fund, and Somerset Indus Healthcare Fund.

Ujala Cygnus Healthcare Services, operating 19 hospitals across Tier-II and Tier-III cities, is anticipated to report a revenue of INR 600 Cr with an EBITDA of about INR 120 Cr in FY24. This deal underscores General Atlantic's commitment to investing in India's growing healthcare sector. It aligns with Ujala Cygnus Healthcare Services' vision of providing inclusive primary and preventive healthcare access across regions.

The above-listed developments signify Indian healthcare’s thrust for growth and also a collective effort to meet the escalating demand for advanced healthcare services. The substantial investments in specialised care, regional expansion, and technology integration signal a positive trajectory for India's healthcare sector, ensuring it remains at the forefront of global healthcare advancements in the years to come.