With medical costs under the microscope, IHH Healthcare group CEO continues to eye expansion 

[SINGAPORE] As IHH Healthcare looks to streamline its operations and expand in its current markets, it is also keeping its eyes peeled for opportunities to grow in new countries, said group chief executive Dr Prem Kumar Nair.

When Dr Nair took over the role of group CEO in 2023, he aimed to transform the company to become leaner so that it can continue to grow.

“This is a group that has grown by M&A (mergers and acquisitions) – every time we buy something or we expand, we try to synergise as much as possible… but what happens is, over a period of time, the red tape and bureaucracy build up,” he said.

But he noted that “most of (the) countries (where it operates) have got scope for expansion” by adding hospital beds, or acquiring new hospitals, or building ambulatory care centres.

The healthcare operator, which has a presence in 10 countries including Singapore, Malaysia, India, Turkey and China, has grown steadily over the years by acquiring new hospitals.

In 2024, it bought Island Hospital in Penang and Timberland Medical Centre in Kuching, Sarawak. Before that, its Indian subsidiary Fortis also bought two hospitals, while its Turkish subsidiary Acibadem Healthcare expanded into East Europe.

Its acquisitions aim to be earnings accretive. For example, Dr Nair said, Island Hospital added “a new dimension” to its Malaysian operations, with 60 per cent of its patients being medical tourists.

To expand in a more cost-efficient manner, it is looking at brownfield expansion – or adding beds – for markets with bigger land space, such as Malaysia and India.

The group has a five-year plan to add 4,000 beds, or 33 per cent of capacity, by 2028. By 2024, it had already added 1,004 beds across its markets.

Meanwhile, in Singapore and Hong Kong, it is moving towards the ambulatory care sector, or what it terms as the “out-of-hospital” strategy.

This is because it is not possible to open more private hospitals in these two markets, due to regulations, high costs and lack of space, Dr Nair said.

Nevertheless, he noted several similarities in healthcare that can be dealt with at the group level.

“The truth is, a lot of healthcare is the same – (such as) licensing of doctors, accreditation of specialists, nurse licensing, building controls,” he said.

“What we try to standardise are things that may have some variation – quality is one area where we feel that we need to have some standardisation because we want the same outcomes.”

By ensuring that patients are able to achieve the same results wherever they choose to engage with the group, Dr Nair said, this will push the group from being just a leader in business to a leader in healthcare services.

Medical inflation, insurance premiums

Dr Nair noted that as a group, it sees issues that may turn up in different markets from time to time.

In 2024, Malaysia went through a bout of medical inflation that likely caused the group “some softening” in patient admissions and revenue.

In June 2025, insurer Great Eastern temporarily suspended pre-authorisation certificates for IHH Healthcare’s Mount Elizabeth Hospitals, citing higher costs compared to other private hospitals.

Dr Nair noted that payer-provider issues are not new to the healthcare industry, nor to the group.

He added that the company is likely “the most risk diversified healthcare group in the world”, operating in 10 countries from the far east to the west.

“We are a heavily regulated industry, and we will continue to be – and it’s good because we are dealing with people’s lives,” he said.

But costs are a perennial issue for an industry that should not compromise quality for price. Hence, to manage costs, Dr Nair said, IHH Healthcare tries to procure equipment at the group level.

Technology, digitalisation and innovation also remain key priorities as the ageing population will likely increase healthcare utilisation and push up healthcare costs.

Looking ahead, Dr Nair noted that the group is already operating at an average capacity of more than 70 per cent – “fairly high” for a private hospital – so it needs to continue expanding.

He also noted opportunities in Indonesia and Vietnam – two new markets in South-east Asia where the hospital operator is already operating.

“Our preference would be for continued growth in (our existing) countries… but as a responsible global healthcare group, we will have to look at opportunities down the road.”