Buyouts Help Manipal Health Enterprises Firm Vie For Top India Spot

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A health worker checks a patient’s blood pressure at a hospital in Gurgaon, India.

Manipal Health Enterprises Pvt. is looking to acquire a smaller India hospital chain — its fourth buyout since 2020 — that can propel the Temasek Holdings Pte-backed firm to being the country's No. 1 health care provider, toppling Apollo Hospitals Enterprise Ltd.

The Bengaluru-based closely held firm, in which Temasek owns 51% equity, is in talks to buy a hospital firm in the eastern part of India, Dilip Jose, Manipal's chief executive officer said in an interview, adding that there would be clarity on the deal in six weeks. He didn't specify the target or the deal size. 

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Local news website MoneyControl reported earlier this week that Manipal was in the final leg of discussions to acquire Kolkata-based Medica Synergie, which will bring in 1,200 beds.

The eastern parts of India “continue to be under-penetrated and undeserved,” he said, adding that the company wanted to expand its presence in the region. 

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The transaction, if closed, will propel Manipal's current 9,500-bed capacity past Apollo's 10,103 beds, underscoring the heated competition in India's burgeoning health care sector as its 1.4 billion-plus population wrestles with limited access to health care services despite having one of world's largest disease burden in diabetes and cardiovascular ailments. 

The Indian health care market is expected to nearly double to $320 billion by 2028, up from $180 billion last year, Bain & Co. said in a March 6 report. 

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It's also chronically under-penetrated by health care services, with only 16 beds and 7.3 physicians for every 10,000 people as of 2021, according to the World Health Organization. 

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Apollo, meanwhile, is also expanding, implying the country's two largest hospital operators will keep vying for the pole position in the years to come. It plans to add more than 2,000 beds over the next four years at a cost of 30 billion rupees, Apollo said in a recent earnings call.

Actively Scouting

Manipal is also looking to expand into smaller Indian towns besides scouting for deals in Hyderabad and Mumbai, according to Jose, who sees no need for fund raising through an initial public offer. It'll also add another 1,100 beds across four new hospitals in Bengaluru and Raipur by 2026, he added.

Since 2020, Manipal has acquired three hospital chains — 11 hospitals owned by Malaysia's Columbia Asia Hospitals Group, a high-end tertiary care hospital in Bengaluru and last September, AMRI Hospitals Ltd. — adding nearly 2,750 beds to its network.

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In April, Temasek increased its stake in the company and last month, the Singapore-based private equity giant sold a part of it to Mubadala Investment Company, Novo Holdings, and others. 

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