We are targeting growth where demand outpaces supply, says Manipal CEO 

Manipal Hospitals has announced the acquisition of Pune-based Sahyadri Hospitals from the Ontario Teachers’ Pension Plan, adding 11 hospitals across Maharashtra and raising its total bed capacity to around 12,000. This move strengthens its presence in western India and aligns with its broader plan to expand across underserved regions. In an exclusive interview with Business Today, Dilip Jose, MD & CEO of Manipal Hospitals, spoke about the group’s expansion strategy, growing focus on Tier 2 and Tier 3 cities, its balanced approach to greenfield and acquisition-led growth, the use of remote care technologies, and how it plans to finance ongoing projects. Edited excerpts:

BT: Can you share details of your hospital group’s current expansion plan—number of beds being added, new hospitals coming up, and geographies being targeted over the next 3–5 years?

DJ: In addition to the greenfield hospital, we commissioned in South Bengaluru in June this year, we are currently executing four other hospital projects—two in Bengaluru and the others in Maharashtra and Chhattisgarh. Collectively, these facilities will add over 1,400 beds over the next two years. In terms of geography, we continue to be keen on opportunities in Kerala, Telangana, and the NCR. We will also explore the possibility of deepening our presence in the East.

BT: What are the key drivers behind your decision to expand aggressively at this time? Is it the post-COVID patient surge, rising NCD burden, insurance penetration, or other macro trends?

DJ: The fundamentals driving the growth of healthcare delivery in India remain strong—stemming from the size of the population, demographic shifts towards an older age group, the rising prevalence of non-communicable diseases (NCDs) requiring advanced treatment, and the increasing ability to afford high-quality care.

BT: Tier 2 and Tier 3 cities are seeing significant investments by hospital chains. What’s prompting your expansion into these markets, and how do you assess their viability?

DJ: Tier 2 and Tier 3 locations do not necessarily reflect lower affordability or awareness. Larger cities traditionally attracted more attention and were operationally easier. While pricing in smaller towns may be lower, these markets still offer a viable ecosystem for well-managed hospitals.

BT: What challenges do you face when entering these non-metro regions—availability of land, medical talent, affordability, or operational issues? How are you addressing them?

DJ: The primary challenge in such regions is often attracting talent. Given the continued demand for high-quality medical professionals in metros and larger towns, it’s crucial to focus on building social and educational infrastructure in Tier 2 and Tier 3 cities to attract and retain talent—beyond just the quality of the healthcare facility.

BT: How much of your expansion is organic (greenfield projects) versus inorganic (acquisitions, partnerships)? Can you give examples of recent deals or collaborations?

DJ: The choice between greenfield projects and acquisitions is often opportunistic. Greenfield developments are preferred when we want to deepen presence in an existing geography, as they allow us to design infrastructure tailored to our needs. Acquisitions help us access new locations more quickly than building from scratch.

BT: What role is telemedicine, remote monitoring, or home care playing in your expansion strategy, especially for serving semi-urban and rural populations?

DJ: Remote technologies enable hospitals to reach under-served areas that might otherwise lack access to advanced clinical expertise. They also help ensure continuity of care and can sometimes facilitate earlier discharge from hospitals. When used thoughtfully, such tools can help address, to some extent, the rural–urban gap in healthcare delivery.

BT: With over ₹30,000 crore being invested across the sector, how are you financing your expansion—internal accruals, debt, or private equity backing? Are investors bullish on the hospital story?

DJ: We typically use a balanced mix of internal accruals and debt to finance new projects and expansions. Given the structural growth drivers in India’s healthcare sector (as discussed earlier), investor sentiment remains positive.

BT: What kind of government support, policy changes, or regulatory interventions would help make hospital expansion easier and more sustainable in underserved parts of India?

DJ: Both the Central Government and several State Governments have taken proactive steps to foster high-quality healthcare delivery. Programmes like Ayushman Bharat, which offer universal coverage, have significantly helped improve health outcomes. The National Health Authority’s push for digital transformation has also been commendable. While underserved areas remain, the gap with more developed regions is gradually narrowing. Overall, we are on the right path as a nation.