India’s hospital bottleneck may lie outside the ward

For years, India’s healthcare debate has revolved around a familiar shortage: very few hospital beds for a growing population. But new data released this week by Bengaluru-based Even Healthcare suggests a different pain point driving costs, crowding, and poor outcomes: what happens after patients leave the hospital.

Even Healthcare, a managed-care provider, said, it recorded zero unplanned readmissions within 30 days across more than 350 surgeries, spanning specialties such as orthopaedics, general surgery, urology, and ENT. Nationally, readmission rates for comparable procedures typically range between 8% and 12%.

The company’s data points to a gap that Indian healthcare has long struggled to address: continuity of care. Most complications, clinicians say, do not arise on the operating table, but in the days and weeks after hospital discharge, when patients are at home, unsure about symptoms, medication schedules, or when to seek help.

Rather than expanding hospital capacity, Even’s model focuses on structured follow-up. Patients are assigned care managers after discharge, receive scheduled check-ins, medication adherence support, and symptom monitoring, with rapid escalation to doctors when early warning signs appear. The company reported no post-operative infections among the surgeries it tracked.

The approach appears to have reduced not just readmissions, but admissions altogether. Even said it avoided more than 200 hospitalisations, managing conditions such as seasonal fevers, respiratory infections, and urinary tract infections at home through daily monitoring and guided recovery. Such cases frequently result in hospital visits in India, often driven by lack of guidance rather than clinical severity.

The financial implications are significant. Even reported generating a six-fold return on spending related to readmission claims, suggesting that post-hospital care may be one of the most underused levers for controlling insurance costs.

In a separate programme run with insurance partners, the company said it recorded a 2.58% readmission rate across more than 1,000 claimants treated at different hospitals, well below national averages.

Those results were achieved without relying exclusively on Even-owned facilities. That detail matters in a healthcare system as fragmented as India’s, where most care is delivered by independent hospitals with little coordination beyond the point of discharge.

Another signal emerges from hospital utilisation. Even said its patients recorded average lengths of stay at least 40% shorter than those in comparable hospital settings. Shorter stays, combined with managed recovery at home, could ease pressure on hospital beds without compromising outcomes, a counterpoint to the assumption that capacity constraints can only be solved by building more hospitals.

“India doesn’t lack medical expertise; it lacks continuity of care,” said Mayank Banerjee, Co-founder of Even Healthcare. “Most complications happen at home, when patients are unsure of what to do next.”

The findings arrive as insurers and hospitals face mounting pressure to rein in costs without limiting access. Unplanned readmissions and avoidable admissions remain a persistent drain on resources, while patients often bear the stress and expense of repeated hospital visits.

Globally, health systems have been moving toward managed-care models that reward outcomes rather than volume of procedures. India has lagged that shift, in part because care delivery remains hospital-centric. Even’s data suggests that a relatively modest layer of coordination, telemedicine, at-home diagnostics, care managers and structured follow-ups, can alter outcomes materially.

For policymakers, the implications are uncomfortable. If a meaningful share of hospital demand stems from weak post-discharge support, then adding beds alone may do little to fix the underlying problem. For insurers, the numbers point to a different calculus: spending on care coordination may reduce claims more effectively than tighter utilisation controls.

For patients, the shift is simpler. It means fewer hospital visits, faster recovery at home, and clearer guidance at moments when uncertainty often turns manageable illness into an emergency.

Even, founded in 2020, operates on a membership-based model offering consultations, diagnostics, and cashless hospitalisation, and launched its first hospital in Bengaluru earlier this year. While its data reflects an early-stage sample, it adds to a growing body of evidence that India’s healthcare inefficiencies may be rooted less in what happens inside hospitals, and more in what happens once patients walk out the door.