Manipal’s Sahyadri buy signals next phase in hospital consolidation

India’s private hospital sector is undergoing rapid consolidation with players like Manipal, Apollo and Max Healthcare racing to scale up their presence across regions through strategic acquisitions. The aggressive expansion is being driven by rising demand for quality healthcare, a shift in consumer preference for organised players, and deep-pocketed private equity backing.

In its latest move, Manipal Hospitals has acquired Sahyadri Hospitals, a prominent regional chain in Maharashtra, adding 11 facilities and significantly strengthening its Western India footprint. The deal marks Manipal’s entry into key tier-I and tier-II cities such as Pune, Nashik, Ahilya Nagar and Karad, where Sahyadri holds a dominant presence.

The acquisition follows Manipal’s earlier purchases of Columbia Asia, Vikram Hospital, MEDICA Superspecialty Hospital, and AMRI Hospitals. With 49 hospitals and over 12,000 beds in its network, Manipal has cemented its position as one of India’s largest and most acquisitive hospital chains.

Why Sahyadri was a strategic fit?

According to Kaivaan Movdawalla, Partner and National Healthcare Leader at EY-Parthenon India, Sahyadri’s stronghold in Maharashtra made it a valuable asset for any national chain looking to scale regionally.

“Sahyadri has always stood out as the jewel of the West. What makes it unique is its highly focused, region-first strategy. Unlike national chains that expand broadly, Sahyadri has grown concentrically, starting strong in local catchments such as Pune, then moving into cities such as Nashik and Ahmednagar. This ripple model has enabled it to dominate micro-markets across income segments and the full secondary-to-tertiary care continuum,” says Movdawalla.

Geographically, Maharashtra is a compelling healthcare market. With a population of 13 crore, half of which is urbanised, and 50% health insurance penetration, demand is robust. Yet, access to quality care remains patchy, he said.

Pune, for instance, has significantly lower penetration of high-end procedures, 30-40 per cent less than metros such as Bengaluru or Hyderabad. And organised hospital chains have barely scratched the surface in this region,” Movdawalla notes. “Sahyadri’s footprint is particularly strategic in this context, and it’s no surprise that Manipal, which has been methodically expanding from Karnataka to the north and then to the east, was keen to expand into western India via this acquisition.

A PE-backed race to scale

While acquisition-led expansion isn’t new in Indian healthcare, Manipal’s pace and scale stand out. Neha Singh, Co-founder of Tracxn, observes that the group has adopted a distinctly aggressive M&A strategy, aided by strong private equity backing. “Manipal’s acquisition strategy is notably more active than that of its peers. With Temasek and TPG as marquee investors, it has been able to pursue large-ticket deals and scale steadily,” Singh says. “TPG, the leading investor, has participated in three funding rounds, leading two, while Temasek has invested across two. Beyond capital, these firms bring deep transaction expertise and strategic guidance that are critical for executing such growth plans.”

This financial and strategic backing has positioned Manipal as one of India’s most acquisitive hospital networks in recent years.

How acquisition looks like for peers

Apollo Hospitals, too, has been actively looking to acquire to fill gaps in its regional footprint, especially in North India. In April 2025, the company told businessline it was accelerating its expansion through a series of acquisitions aimed at cities such as Noida and Varanasi, along with tier-II hubs such as Kanpur.

While Max has acquired the 550-bed Sahara Hospital in December 2023, it took over Alexis Multispecialty Hospital in Nagpur (200 beds) in February 2024, Apollo acquired the AyurVAID (an integrative care chain), and a 650-bed hospital asset in Gurugram, Haryana, among others.

The Sahyadri acquisition is part of a broader shift in India’s healthcare landscape. M&A is now seen as the most efficient route to scale, especially when compared to the time-intensive and capital-heavy process of building greenfield hospitals.

Regional players

“Whether it’s Manipal, Max, or Aster, consolidation is the theme. Chains are acquiring smaller regional players to deepen their presence in select markets. Patients are increasingly shifting towards organised care, and private equity interest remains high, given the favourable valuations and growing demand,” Movdawalla says.

This wave of consolidation is not just about size, it’s about capturing demand in underserved regions, improving patient outcomes through standardisation, and building strong regional brands in a market where healthcare remains deeply local.

Published on July 10, 2025