India’s national health spend may double to 6–7% of GDP by 2047: FICCI–EY Parthenon

Changes in India’s demography and shift in disease patterns could increase aggregate hospitalisations 2.5-3 times by 2047 and may see national health expenditure reaching ₹160–190 lakh crore, pushing the country’s health spend to 6–7% of GDP, nearly doubling its share, a report by FICCI and EY-Parthenon cautions.

“The challenges ahead are not just about scale, but about the very nature of health and disease in a rapidly changing society. The demographic dividend that once promised decades of growth is giving way to a new reality: an ageing population, a surge in chronic and lifestyle diseases, and a sharp rise in comorbidities. These trends are not only multiplying the quantum of healthcare needs but also compounding their complexity; thus, demanding a fundamental shift in how care is delivered, financed and experienced”, the report states.

India has progressed a lot in the last two decades but a lot more needs to be done, the report points out. It shows that the country’s beds per capita have grown nearly 2x since 2000 (0.7 to 1.3 per 1,000 people), while MBBS seats have expanded 5x, creating a stronger workforce pipeline. Similarly, infrastructure for advanced care has surged with cathlabs per capita growing 58x, while linear accelerators (Linacs) per capita expanding 17x in the last two decades. India has also rapidly narrowed the innovation adoption gap—cutting from a lag of over 10 years in the 1990s to just two years today for technologies such as AI-assisted radiology and hybrid cathlabs. However, India still has one of the lowest hospital bed densities globally and a dual payor-provider fragmentation challenge with just 25–30 beds per hospital compared to over 100 internationally, and top 5 payers driving only about 40% of payouts versus 80%+ in other developed markets. Coupled with the vast disparities in access and affordability across geographies as well as patient sensibilities with respect to health, this places a formidable challenge to creating scaled solutions, it notes.

According to the report titled ‘True Accountable Care: Maximizing Healthcare Delivery Impact, Efficiently’, By 2047, the population aged 60 and above is projected to grow nearly five-fold compared to 2001, while the 40+ years cohort will nearly triple, reaching approximately 820 million and comprising half the country’s population. This aging trend is accompanied by a rapid epidemiological transition: non-communicable diseases (NCDs) such as diabetes, cardiovascular disease and cancer have overtaken infectious diseases as the dominant health burden, it says.

“The opportunity and necessity, is to move from episodic, reactive care to a longitudinal, lifecycle approach. This means investing in prevention, early detection and coordinated disease management. It means building systems that support patients across the entire health journey – from wellness and risk assessment, to early intervention, to chronic disease management and palliative care”, the report said.

International benchmarks and modelling by EY-P suggest that with the right interventions, hospitalizations could be reduced by 20%–30% from projected levels and health expenditure could be contained closer to 5% of GDP – delivering best-in-class outcomes at a fraction of the cost seen in developed markets.

The report introduces a seven-pronged framework – the “7C framework” – to guide India’s healthcare transformation towards accountable care. It emphasizes ‘Cohorting and segmentation-based approach’, ‘Clinical excellence’, ‘Cost consciousness’, ‘Care reimbursement’, ‘Care coordination’, ‘Consumer empowerment’ and ‘Connected ecosystem’. The framework is designed to move the sector from one-size-fits-all solutions to bespoke care pathways, ensuring both efficiency and equitable health outcomes.

“Our report shows strong alignment between patients who seek transparent quality data and clinicians willing to support standardized outcome measurement and reporting. This creates a unique opportunity to implement tiered reimbursement frameworks, strengthen accreditation and governance, and scale digital adoption. Our report provides a practical roadmap to navigate the complexity and urgency of India’s healthcare transformation”, Kaivaan Movdawalla, Partner and National Healthcare Leader, EY-Parthenon India said.