AHPI Flags Regulatory Reforms as Key to Scaling Private Healthcare’s Role in Universal Health CoveragePrivate sector accounts for over 55% of hospitalisations and nearly two-thirds of treated ailments, underscoring its central role in India’s healthcare economy

As India accelerates its journey towards Universal Health Coverage (UHC), healthcare leaders have stressed that meaningful progress will depend on deeper policy alignment between public financing mechanisms and the country’s extensive private healthcare infrastructure. With private providers delivering 55.3 per cent of hospitalisations and 65.8 per cent of treated ailments, regulatory reforms and predictable engagement frameworks are critical to sustaining and scaling care delivery, experts said.

These perspectives emerged at a high-level round table discussion on “Regulatory Reforms Enabling Private Sector in Achieving Universal Health Coverage (UHC)”, organised by the Association of Healthcare Providers (India) (AHPI) in association with Trehan Group and Double Helical Magazine in Gurugram.

Data presented at the forum highlighted the private sector’s dominant role in India’s healthcare spending and service delivery. According to the National Health Accounts 2021–22, private general hospitals constitute the single largest provider category, accounting for 27 per cent of current health expenditure, compared to 18 per cent contributed by government general hospitals. Pharmacies account for another 19 per cent.

Findings from the NSS 75th Round (2017–18) further underline this reliance, showing that over half of all hospital admissions occur in private hospitals, while nearly two-thirds of outpatient care and treated ailments are managed by private facilities, including clinics. Despite this utilisation pattern, out-of-pocket expenditure remains high at 39.4 per cent, pointing to continued gaps in financial risk protection and effective pooling of healthcare costs.

Opening the session, Dr. Girdhar Gyani, Director General, AHPI, said that achieving UHC at scale requires a shift from fragmented engagement to structured partnerships with private providers. He emphasised that clear regulations, standardised quality benchmarks and timely reimbursements are essential to ensure equitable access while maintaining operational and financial sustainability for providers.

The session was chaired by Dr. A. K. Agarwal, former President, Delhi Medical Council, and Dr. Suneela Garg, Director Professor (HAG), Community Medicine, MAMC & Associated Hospitals, New Delhi. The deliberations were moderated by Dr. Vijay Agrawal, President, Consortium of Accredited Healthcare Organizations (CAHO).

Speaking on system design and public financing, Dr. Madan Gopal, Advisor and Head, National Health Systems Resource Centre (NHSRC), highlighted the importance of strategic purchasing, contracting and payment reforms to effectively leverage private capacity under publicly funded health schemes. He noted that without aligned incentives, the system risks underutilising existing infrastructure while continuing to burden households with high out-of-pocket expenses.

Dr. Narin Sehgal, Secretary, AHPI Delhi Chapter, called for reimagining regulatory frameworks to improve ease of doing business while safeguarding quality and patient safety. He noted that complex compliance requirements and inconsistent implementation across states often discourage private investment, particularly in underserved regions.

Highlighting operational challenges, Cdr. Navneet Bali, Executive Director & CEO, Clearmedi Healthcare, pointed to the financial strain caused by price controls, rigid package rates and delays in reimbursements, especially for tertiary and specialised care providers. He cautioned that prolonged uncertainty could impact future investments in advanced healthcare infrastructure and technology.

From a clinical standpoint, Dr. Amit Bhushan Sharma, Director & Unit Head – Cardiology, Paras Health, Gurugram, spoke about the rising incidence of cardiac events among younger populations. He emphasised the importance of early diagnosis, preventive care and timely interventions, underscoring how integrated public–private healthcare delivery can reduce mortality and long-term complications.

Participants unanimously agreed that UHC must be viewed as a system-wide economic and social priority, rather than a public-versus-private debate. Given current utilisation trends, experts stressed that public purchasing mechanisms should strategically engage private providers to expand coverage at scale while ensuring quality, affordability and sustainability.

Concluding the discussion, Harsh Trehan, CMD, Trehan Group, said that predictable regulation, transparent quality standards and time-bound payments are crucial for sustained private sector participation in government-backed health programmes. The organisers announced that key recommendations from the round table will be consolidated into a structured policy submission to the Ministry of Health and Family Welfare, aimed at strengthening alignment between financing and delivery systems and accelerating India’s progress towards equitable and sustainable Universal Health Coverage.