The changing face of the Indian healthcare industry: A focus on access, affordability and quality

Mint

30-04-2025

A growing demand for personalised healthcare, efficiencies in healthcare costs and digital innovations are changing the face of the Indian healthcare industry. There is a strong push towards achieving greater levels of efficiencies in healthcare costs that have burgeoned in India in the past few years, thereby ensuring that quality healthcare becomes more accessible and sustainable.
Powering this transformation are rapid advancements in the digital space, which are creating new possibilities in how healthcare is delivered and experienced by both sides – patients as well as providers. In a country as vast and diverse as India, this is expected to address some fundamental challenges, including expanding access to quality healthcare across different geographies ensuring affordability for a much larger section of our population and, at the same time, elevating the quality of healthcare being provided.
Global Capability Centres (GCCs) like Optum India, the GCC of United Health Group, are playing a pivotal part in this transformation journey as they move beyond traditional roles focused on cost savings and operational efficiency.
In a recent panel discussion, leaders from Optum India – including Rohit Agarwal, Senior Vice President for Transformation, Innovation and Enablement, Abhishek Kumar, Senior Vice President for Operations, Surendra Singh, Senior Vice President for Operations, Madhuri Raya, Vice President of Software Engineering – shared their insights on the pressing issues faced by the Indian healthcare industry and the way forward towards a more human-centered health system, driven by frontline-led innovation and deeply integrated TechOps cultures.
Key challenges in healthcare
'I think the three key challenges in healthcare are lower cost, improved access to care and the quality of outcomes. The healthcare cost has been steadily rising over the years. If you were to look at the US, I think it has crossed over 5 trillion more than the inflation in the country,' said Surendra Singh, as he set the context for the discussion.
The second challenge – access to healthcare in the remote corners of any country – saw advancements during the pandemic with the introduction of tele-health, which brought your doctor closer home on your smartphone screen. But, this also has its challenges in terms of safety, privacy, and the depth to which teleconsulting can actually provide the right degree of care.
Finally, he stressed on the imperative of not just providing care but ensuring its effectiveness. 'Technology has enabled us to manage health outcomes in real time, manage protocols, procedures, best actions, medicine adherence, and so on. We need to continue to strengthen some of these to become more real time, to be able to and also start monitoring health outcomes, rather than just in and out of healthcare facilities.
Abhishek Kumar stressed that the core of any healthcare system is the interaction between a physician and the patient. 'Everything around that is really an admin setup to enable that entire process. Unfortunately, what happens today is a lot of time a physician spends doing a lot of admin activities, which is essential to be able to get reimbursements for the care provided. I think moving away from a volume-based care to a value-based care, creating incentive for physicians for delivering value pitches, which means you avoid readmission, you improve medication adherence – that's the broad impact that the entire thing creates.'
Addressing challenges using technology
However, physicians need the right actionable knowledge in order to offer value-based care to their patients with more personalised healthcare outcomes at reduced costs. For patients, the goal is empowerment through information, so that they can make the right healthcare decisions for themselves. All this is being made possible through technology.
Outlining the key technological trends in this space, Madhuri Raya highlighted the potential of tele health to 'increase the accessibility, whether you are in the rural areas or if you are on a mobile' and the transformative impact of emerging tech to 'deliver the personalised care to patients based on their previous markers'.
Interoperability, she explained, is crucial for enabling large population health data analysis. There is a preventive and a curative aspect to healthcare, and both of these need to be integrated into the solutions as hyper personalisation enables people to take better care of themselves with the use of data, Artificial Intelligence (AI) and other emerging tech like smart wearables, which can help with prevention as well as cure with early diagnosis.
Innovative solutions for the healthcare ecosystem
The panel went on to discuss the key drivers for innovation, which include people, process, technology and data. It starts with an informed and a tech-enabled consumer who can use the internet and understand his/ her health condition, find the right doctor, carry out a price comparison, set up an appointment and make alterations, if needed.
'It is making sure that the entire healthcare experience is in the hands of the consumer at a place and at a time when the consumer needs it. I think that is going to be an absolutely critical trend,' said Rohit Agarwal.
The second one is around wellness, which is gaining priority. The third one is a digital platform that helps drive interoperability and the last one is the move towards value-based competency models.
Agarwal further felt Optum is a key driver of this change, and said: 'I think Optum is well-positioned to really accelerate and drive this innovation in the healthcare industry. We've got a program that we call Innovate, which is our innovation framework, which really helps us bring together multiple aspects of what really is needed to guide that innovation and is helping us really accelerate innovation.'
Synergy between technology and business operations
The panellists underscored the critical need for alignment between technology and operations, which is a shift from the historic model wherein technology and operations were two distinct functions operating out of different office spaces.
'If we are able to look at co-location of operations and technology teams, that can drive a lot of synergies, and fill a lot of silos. Getting technology and ops together allows you to be able to make sure that your technology roadmap is linked to the preferences and the requirements of the patient and the provider,' said Kumar.
'The second element is how do you look at adjacent capabilities, and how do you create value out of that? At Optum, we have all the capabilities. We run claims, we do revenue cycle management, we do clinical, pharmacy benefit management. If you look at that, each one of them serves the patient or the provider at some stage or the other. Now, each of them is interconnected,' he further said.
Identifying opportunities
The healthcare space is dotted with new innovations to tackle challenges around quality and consumer experience. The panel also discussed how leaders can find the right solutions to prioritise. 'Innovation is going to be effective only when it's aligned to the priorities of the enterprise. So it is extremely critical that we make sure that everybody in the organisation understands what enterprise priorities are,' said Agarwal.
He also stressed upon the importance of a patient-centric approach and added: 'it is important to make sure that we are putting the consumer at the centre of everything we do that makes sure that we focus on the right real problems, the real pain points.' At Optum, this is done through 'voice of the consumer surveys', 'voice of the employee', and 'voice of the process'.
'We leverage our Innovate framework...a multi-faceted program that brings people, process, technology and data together to make sure that we're able to really focus on the key things and accelerate innovation across the company. Ideas can be everywhere, but ideas really are created or brought together when we have a strong innovation culture. And for me, I think that is the single most important thing,' he said.
Developing the Tech organisation
Players like Optum offer multiple ways for business teams to stay up to date with this landscape of changing technologies and continued innovation. Raya spoke about Optum Tech University which offers a lot of courses in technology, operational agility, organisational agility, design thinking, customer centricity, and the like.
They also organise industry-focused events that 'bring in the industry leaders, our technology partners and our own employees in one event...to explore what we can do for the future of technology'. 'Continuous upskilling and reskilling and the creation of an environment like a sandbox environment...so that employees can actually work there, build their systems without disrupting their core functionality' are some of the important steps towards innovation.
The panel stressed the importance of building solutions that are scalable. 'A creativity mindset is key when you are building solutions, identifying your stakeholders and engaging with them. I think the diverse perspectives from multiple stakeholders helps in building strong systems,' said Raya.
'Innovation initiatives should be aligned to strategic objectives that they have to be measured against some predefined KPIs, that emphasise the importance of balancing our short-term wins versus long-term value creation,' said Singh.
He enlisted some key points that make innovations successful, the first of which is adoption both internally by employees and externally by customers for which they need to be simple and effective. 'I think higher rates of adoption are a true signal that we have really solved a real-world problem, either internally, for our team members or for our members or customers. Second, you will measure them qualitatively as well as quantitatively,' he said.
In conclusion, the future of Indian healthcare is linked to the evolution of its GCCs. As these hubs continue to mature, their focus on technological advancement, innovative solutions, and a deeply ingrained patient-first approach will be instrumental in building a healthcare ecosystem that is more efficient and accessible to all but also fundamentally more attuned to the individual needs of every Indian.
First Published: 30 Apr 2025, 06:19 PM IST