KOCHI: Big private healthcare players in Kerala are expanding their footprint into rural and semi-urban areas by setting up peripheral centres offering primary services. While it improves accessibility and affordability, the move is reshaping the state’s healthcare landscape, posing a challenge to the survival of small and mid-sized hospitals.
The fast-growing facilities threaten small-scale hospitals that have been catering to people in rural areas, say industry stakeholders.
Hussain Koya Thangal, president of the Kerala Private Hospitals Association (KPHA), said that setting up health centres in rural areas has become a marketing strategy of corporate hospitals. “The aim is to make their presence felt by people everywhere.
They are trying to attract more patients and thereby increase referrals to their main hospitals. Though immediate care is available in villages, the facilities are limited,” Hussain said. According to him, the impact of the trend is huge. “Establishing health centres and clinics in rural areas affects the existence of small-scale hospitals. Several small hospitals have been closed in the state,” Hussain said.
Dr Suresh Kumar, the president of the Kerala Association of Small Hospitals and Clinics, said around 600 small hospitals and clinics in the state have been closed down in the past 4 to 5 years due to high expenses and the entry of private hospitals. “Small hospitals and clinics in the state were more service-oriented. By providing treatment at a lower cost, these clinics set up by the corporate hospitals have been able to attract patients. However, these initiatives are driven by business motives,” he said.
Renjith Unnikrishnan, president of the Kerala chapter of the Association of Healthcare Providers (India), points out that the hub-and-spoke model ensures accessibility and affordability. “From a patient’s point of view, it helps avoid travelling woes. When a middle-class man visits a tertiary hospital in the city, he will have to compromise on a day’s work. Closer access helps him avail similar services at his convenience,” Renjith said. The hub-and-spoke model also helps avoid overcrowding in tertiary hospitals.
Major hospitals have also been setting up pharmacies and health laboratories across the state. “The labs and pharmacies have also becomes spots where patients can book an appointment with a doctor or avail themselves of basic facilities of the hospital,” added Hussain.
Kerala has also been witnessing major acquisition and merger (M&A) activity in the sector. In 2023, Quality Care, a hospital platform owned by private equity fund Blackstone, acquired KIMSHealth Management, a leading hospital chain in the state. Last year, around the time Caritas Hospital, Kottayam, acquired Matha Hospital, there was news of Kozhikode Baby Memorial eyeing Chazhikattu Multi Super-Speciality Hospital in Thodupuzha.
“Healthcare is a capital-intensive business. We cannot set up hospitals everywhere. Also, only 25-30% of patients require tertiary care. In such cases, they can visit the hospital. Those in need of primary and secondary care can visit a health centre nearby,” added Renjith, who is also CEO of Kinder Hospitals, Kochi.
MOVERS & SHAKERS
VPS Lakeshore has set up a clinic in Kozhikode
KIMSHealth has established seven clinics in Thiruvananthapuram and Kollam
Rajagiri Hospital is set to launch a clinic in Kochi Infopark
Amrita Hospital has established three charitable trust hospitals and three peripheral clinics across the state
Kinder Hospitals has set up a health centre in Alappuzha