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

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

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.

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 healthcare sector as its 1.4 billion-plus population wrestles with limited access to healthcare services despite having one of world’s largest disease burden in diabetes and cardiovascular ailments.

The Indian healthcare market is expected to nearly double to US$320 billion by 2028, up from US$180 billion last year, Bain & Co said.

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It is also chronically under-penetrated by healthcare services, with only 16 beds and 7.3 physicians for every 10,000 people as at 2021, according to the World Health Organization.

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 (S$483 million), 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 fundraising through an initial public offer. It will 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 – adding nearly 2,750 beds to its network.

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. BLOOMBERG