Agriculture

India's
Healthcare
Endowments

World-class pharma sector,
with India hailed as the "pharmacy of the world"
​Strong focus on sciences
in school curriculum
​Numerous state-of-the-art hospital
chains and healthcare facilities
​74 percent FDI in
private health insurance
Many successful health-tech start-ups
​Global powerhouse of digital technologies and talent





Coverage

Only about 37% of Indians have any form of health insurance coverage. Two-third of healthcare expenditure is still out-of-pocket.

 

Talent and infrastructure

India has lower healthcare professionals per capita than many peer economies.

Access and quality

On the global Healthcare Access and Quality (HAQ) Index, India ranks 145th, behind many peer economies.

 


Challenges for
India to
address




Vision: From Pharmacy of the world to Hospital of the World, with Universal Healthcare for All

From $60-65 Bn in 2022
200-250 (2030)
2200-2300 (2047)
Nominal GDP ($ Bn) for India's Healthcare Sector
From 37,000 - 38,000 in 2022
20-000-25,000 (2030)
15,000-20,000 (2047)
Disease Adjusted Life Years (per 10,000 Population)
From 7-8 in 2020
15-20 (2030)
50-60 (2047)
Number of qualified MBBS Doctors (per 10,000 population)
From 17-18 in 2021
35-40 (2030)
180-190 (2047)
Number of qualified Nursing & Midwifery Personnel (per 10,000 population)
From 5-6 in 2020
40-45
Hospital Beds (Per 10,000 population) By 2047
From 48.2% in 2021
10-15%
Out-of-pocket-expenditure (OOPE) as % of India's Healthcare spend By 2047
From 50-70% in 2020
100%
Percentage of population with Health Care coverage By 2047
From 3-4 in 2020
5-10 (2030)
20-25 (2047)
Number of qualified Allied Health professionals per 10,000 population


Priority Unlocks

What India Inc could do now

Digitize hospitals and upgrade legacy architecture

Hospitals could modernize operations by investing in IT system modernization programs and process digitization solutions to, for instance, assign new patients to the right wards, allocate staff dynamically, schedule procedures, and optimize inventory use and procurement.

Key actors: Private hospitals

Strengthen telemedicine platforms and deepen penetration

The Ayushman Bharat Digital Mission and eSanjeevani could be bolstered by improving last-mile delivery, especially in low-connectivity and underserved regions (such as rural Northeast India).

This could be achieved by boosting doctor availability through improved scheduling mechanisms and addressing connectivity-related challenges by introducing asynchronous modes of communication, etc.

Key actors: Government and health-tech players

Improve underwriting efficiencies and reduce cost of insurance

Insurers could harness PM-JAY data, electronic medical records, and the national health stack to build comprehensive actuarial databases that can enable high-efficiency risk-premium pricing, make claims processing and billing faster and more accurate, and reduce insurance costs.

Key actors: Private insurance and insurtech players

Build innovative treatment and advanced healthcare solutions

Various healthcare players could join hands to use next-gen digital technologies to build innovative treatments and advanced healthcare solutions. For instance, they could develop personalized prevention and treatment regimens for patients by analyzing genomic, metabolomic, and epigenomic data and the national health stack. They could also leverage AI/ML algorithms to enable robotics-based automation of routine diagnostics and surgical procedures as well as to identify advanced alternative treatments.

Key actors: Various healthcare ecosystem players: hospitals, research organizations, digital health startups, etc.

Promote universal FHIR standards

Healthcare sector players could form a council to drive the adoption of Fast Healthcare Interoperability Resources (similar to the Payment Card Industry Security Standards Council), with the objective of establishing, maintaining and promoting universal FHIR standards.

Key actors: Private healthcare services providers and payors

Improve lifestyle decisions through rewards ecosystems

The sector could create and scale rewards programs to incentivize better lifestyle habits. For instance, they could incentivize people to exercise regularly and adopt healthier diets by offering discounts on insurance premiums and reward points.

Key actors: Insurance players, in partnership with wearable players and digital wellness platforms




How policymakers could help


Boost number of specialists

India could boost the number of specialist doctors by increasing the number of Diplomate of National Board (DNB) graduates. This could be achieved by relaxing the ratio of specialties-to-bed requirement to allow small hospitals to increase the number of specialties for their DNB programs and allowing hospital chains to club their total infrastructure, facilities, and faculty strength when applying for accreditation.

Key actors: National Medical Council

Incentivize high-quality treatment and preventive healthcare

The government could use EHR analytics to augment the reimbursements system of PM-JAY and assign "star ratings" to hospitals via an independent auditor.

The revised system could incentivize doctors to aim for early diagnoses, minimize procedural complications and misdiagnoses, deliver treatments at low costs, and encourage lifestyle improvements for people availing their care.

Key actors: MoHFW and independent auditors (e.g., NABH)

Standardize MCAs for healthcare infrastructure PPPs

The government could create uniform model concession agreements (MCAs) for healthcare infrastructure PPPs.

The new MCAs could outline specific guidelines for conception, design, implementation, and management of such PPPs across India.

Key actors: NITI Aayog, MoHFW and state governments

Build a national public health emergency surveillance system

The government could use the national health stack and EHR records to create centralized dashboards for tracking public health trends. Using these dashboards, the government could establish a National Surveillance Program to monitor and proactively respond to public health emergencies.

Key actors: MoHFW

Increase private-sector participation in PM-JAY

Increasing private-sector participation in PM-JAY could boost insurance coverage across India. Two steps that the government could take to action this are a) expanding the use of DRG-based dynamic procedure pricing to maximize the utilization of hospital resources and b) including primary and OPD care (e.g., high complexity oncology OPD) in insurance coverage packages, instead of just inpatient care.

Key actors: MoHFW

 

Strengthen state-level governance mechanisms for PPPs

PPP contract management for healthcare infrastructure could be improved by a) establishing specialized cells to design, govern, and monitor PPPs (supported by curated capability-building programs for officials in charge of PPP activities) and b) ringfenced budgets for PPP projects and schemes, to prevent later budgetary adjustments and auditory objections.

Key actors: State-level health departments

 

Accelerate adoption of FHIR

Adoption of FHIR by the healthcare ecosystem could strengthen the national health stack and support next-gen healthcare use cases.

To drive adoption, the government could accelerate the enactment of a statute for healthcare data privacy and EHR interoperability standards, build robust digital patient consent governance systems, deploy ASHA/AHM workers to drive door-to-door registration campaigns for ABHA and HFR, and develop standardized requirements for registering healthcare facilities on HFR.

Key actors: MoHFW, MeiTY, NeHA, and state governments

 

Promote physician assistants and nurse practitioners

Introduce cadres such as Nurse Practitioners and Physician Assistants in public as well as private sector to enable task-shifting thus reducing the burden on doctors and allowing them to focus on specialised services.

Key actors: MoHFW

 

Digitize medical pedagogy

The government could revamp medical training and drive digital healthcare adoption by updating medical curricula to include modules on EHR, analytics-based healthcare delivery systems, etc. Training could be delivered through next-gen pedagogical tools (e.g., AR/VR-enabled surgery simulations.

The government could also make provisions for continued digital upskilling/re-skilling of qualified primary healthcare providers.

Key actors: National Medical Council, in partnership with big-tech, digital services providers, and private educational organizations

 



Initiative by
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