MANIPAL HEALTH ENTERPRISES LIMITED

Manipal Health Enterprises is India's 2nd largest private hospital chain by number of hospitals. It operates 49 multispecialty hospitals with 13,037 licensed beds (Owned + O&M hospitals) across 14 states, along with clinics, diagnostics and ambulance services. Hospitals contribute ~95% of revenue, with a focus on complex specialties such as Cardiac, Oncology, Neuro, Renal, Gastro and Orthopaedics (CONGO-R).

DRHP filed: 23 March 2026

IPO open & close: July 29, 2026 to July 31, 2026

Listing date: July 30, 2026 (tentative), on BSE and NSE

BRLM: Kotak Mahindra Capital, Axis Capital, Goldman Sachs (India), Jefferies India, J.P. Morgan India, UBS Securities India, DBS Bank India 

Auditor: B S R & Co. LLP

Disclaimer - Delta Partners (public market division under Dexter Capital) is not a SEBI registered Investment Advisor and this report does not constitute a recommendation but is only prepared for educational purposes. We (our team members including our directors) may or may not apply to IPO.

This note is not reviewed by our CIO - Devendra Agrawal, CFA. It is prepared by our team of Investment Analysts, and is reviewed by our senior team members. Any questions related to the IPO can be directed to shubham@deltainvest.in and we will come back.

We at Delta Partners continue to analyse many business and IPOs. Investors interested to be part of this network are requested to fill the form & our team will reach out with more details. [Click Here]

Delta's View:

No Material Listing Gains | Skip (High valuation)

Manipal Health Enterprises Ltd is India's 2nd largest private hospital chain (43 hospitals, 9,252 beds), having scaled revenue from 2,161 cr to 10,336 cr (FY20-26). Growth has been driven largely by debt-funded acquisitions, but repayment from IPO proceeds should ease D/E to ~0.3x post-listing, on par with Max/Fortis. Operationally, it remains strong with healthy occupancy (64%), rising specialty mix, and the lowest ALOS (2.8 days) in the peer set. It's backed by Temasek (controlling shareholder) and promoter Dr. Ranjan Pai. However, at an IPO valuation of ~30x EV/EBITDA, much of this quality is already priced in, and we'd avoid the IPO at current levels.

One can expect only flat to moderate listing gains as per current GMP ~1.5% (29th July 2026), provided the GMP sustains.

1. Manipal Health Enterprises Ltd had scaled from 2,161 cr (FY20) to 10,336 cr (FY26) revenue, growing at a CAGR of 30%. It had 43 owned hospitals and 9,252 licensed beds with them, making it the second largest private hospital player in India by number of hospitals. It also managed 3,785 beds in 6 hospitals owned by other companies. Growth was primarily led by acquisitions during this time, having acquired Columbia Asia (2021), Vikram Hospitals (2021), AMRI (2023), Medica Synergie (2024) & Sahyadri Group (2025). Between FY21 and FY26, it added 5,548 beds across 31 hospitals inorganically (which is the highest by any Indian private chain over this period).

1. The acquisitions have been funded largely by debt, and the total debt increased from 2,150 cr (0.64x D/E) in FY23 to 10,553 cr (1.2x D/E) in FY26. A significant portion (~5,553 cr) of 8,000 cr Fresh issue will be used for prepayment of outstanding NCDs & accrued interest for Sahyadri acquisition. Total debt post listing would decrease significantly to ~5,000 cr, with the D/E ratio easing to 0.3x (similar to Fortis healthcare & Max healthcare). Manipal's 3 yr avg return on capital (ROCE) of ~16% is good among the industry, with ROCE of Apollo being ~16%, Max ~14%, Aster DM ~8%, Fortis ~12%, KIMS ~14% and Narayana ~19% on last 3 yr average basis.

1. It has been one of the fastest growing hospitals among peers. Its revenue grew at ~29% CAGR while industry has grown at an avg of ~18% CAGR during the period (Apollo ~15%, Max ~22%, Fortis ~13%, Aster DM ~16%, KIMS ~21%, Narayan Hrudayalaya ~20% for 3 yr CAGR). It is also a leading private player in 3 key metro cities (Bengaluru, Kolkata and Pune). Research houses (CRISIL, IMARC, TechSci, EMR) cite strong demographic tailwinds & rising insurance penetration for the industry and expect it to grow by at least 6-12% for next 5 years.

1. Growth has been broad-based rather than price-led. OPD (Out-patient) footfalls and IPD (In-patient) footfalls grew 44% and 59% over FY24-26, while ARPOB (Avg Revenue Per Occupied Bed) also increased 11.7% during this period. This is supported by improving quality of case mix, with CONGO-R (Cardiac / Onco / Neuro / Renal / Gastro / Ortho) contribution to In-Patient revenue rising from 61.6% to 64.3% (oncology: 8.9% → 11.6%), while maintaining 64.5% occupancy, with a large operational base of 6,227 beds.

1. ALOS (Avg Length of Stay) of 2.78 days is the lowest in the peer set (Apollo 3.2, Max 4.1, Fortis 4.2). Shorter stays mean more patients per bed per year, which supports ARPOB. About 50% of inpatient revenue came from insurance, providing stability but limiting pricing power.

1. It expects to add 483 licensed beds across existing hospitals by 2030 through brownfield expansion and also plan to add 1,943 licensed beds through greenfield projects by 2030. They also state strategy to pursue inorganic growth in order to enter new markets or consolidate existing markets.

1. Manipal's origins date back to 1953 when Dr. T.M.A. Pai founded India's first private medical college without government funding. The first Manipal Hospital opened in Bengaluru in 1991, while Dr. Ranjan Pai (3rd-gen heir) corporatised the business in 2000, bringing in institutional capital. In 2023, Temasek acquired an additional stake, becoming Manipal Health's controlling shareholder (~59%) and promoter. It holds ~49% pre-offer, which will reduce to ~43.5% post-offer (assuming full dilution).

1. While Manipal is a high-quality business backed by marquee shareholders and favourable industry tailwinds, we believe the IPO valuation of ~30x EV/EBITDA already prices in much of the optimism. We would avoid the IPO at the current valuation.

Business

•    Manipal Health Enterprises operates a pan-India network of multispecialty hospitals. As on March 31, 2026 it ran 49 hospitals with 13,037 licensed beds across 14 states and union territories, alongside 21 clinics, a diagnostics business spanning 18 states and a 102-vehicle ambulance fleet. Of the 13,037 licensed beds, 9,252 across 43 hospitals are owned and 3,785 across six hospitals are operated under management agreements with MAHE and Sikkim Manipal University.

•    Revenue is almost entirely hospital-led: hospital services contributed 94.7% of FY26 revenue, with pharmacy at 4.1%, diagnostics at 2.3% and other operating income at 1.3%. Geographically, Karnataka accounted for 46.4% of revenue, eastern India 22.4%, rest of India 19.7% and Maharashtra & Goa 11.5%.

•    The company’s 6 complex specialties which it groups as CONGO-R : cardiac sciences, oncology, neurosciences, gastro sciences, orthopaedics and renal sciences, together delivered 64.3% of gross inpatient revenue in FY26. Within this, cardiac sciences is largest at 16.3%, followed by orthopedics (12.9%) and oncology (11.6%). The remaining 35.7% comes from internal medicine, general surgery, obstetrics and gynaecology, paediatrics, critical care, pulmonology and ENT. FY26 procedure volumes included 74,600 angiography and angioplasty procedures, 25,400 gastrointestinal surgeries, 10,000 joint replacements, 8,300 neuro surgeries and 620 transplants.

•    Insurance companies and third-party administrators settled 49.7% of gross inpatient revenue in FY26, self-paying patients 30.3%, government schemes 13.8% and corporate & international patients 6.2%. Patient volumes were 54.8 lakh outpatient footfalls and 5.27 lakh inpatient footfalls in FY26.

•    Average operational beds stood at 6,227 with occupancy of 64.47%, ARPOB of ₹68,938 per day and average length of stay of 2.78 days, the lowest among major peers. The estate includes 2,972 ICU beds, 338 operating theatres, 58 catheterisation labs and 23 orthopaedic and spine robots; 31 of the 43 owned hospitals are wholly or partly on leased premises. Planned additions are approximately 483 brownfield and 1,943 greenfield beds by 2030.

Promoters and Leadership

•    Manipal traces to Dr. T.M.A. Pai, who founded India's first self-financed private medical college at Manipal in 1953, and the first Manipal Hospital opened in Bengaluru in 1991. The third-generation heir, Dr. Ranjan Ramdas Pai, corporatised the group by setting up MEMG in 2000 and progressively brought in institutional capital, culminating in Temasek acquiring majority control in 2023.

•    Control now rests with Temasek, not the founding family. In 2023, Temasek acquired an additional stake, becoming Manipal Health's controlling shareholder (~59%) and promoter. It holds ~49% pre-offer, which will reduce to ~43.5% post-offer (assuming full dilution). The promoter group in total will hold ~61% post-offer.

•    The company is professionally managed with no family member in any executive role. Dilip Jose has been MD and CEO since November 2017, following senior positions at Fortis, CARE Hospitals and TPG Capital, and was reappointed in March 2026 for a five-year term.

Shareholding Pattern

Issue Details

Fresh issue size - Amount → 8,000 cr; To be utilized in -

•    Repayment/prepayment of MHPL's outstanding NCDs + accrued interest. MHPL issued 5,310 cr NCD on September 12, 2025, to fund the Sahyadri acquisition which carry a mandatory prepayment trigger on listing → 5,553 cr

•    Acquisition of minority stake (Tranche III) from Summit Bidco Pte. Ltd. in Sahyadri Hospitals → 574 cr

•    General Corporate Purposes & Others

Offer For Sale size - Amount → 1,275 cr;

•    Promoters - Imperius Healthcare (Temasek) and MEMG India would be selling 1,039 cr worth of shares in the OFS. Other investors such as TPG SG Magazine, Seventy Second Investment (Mubadala), Ammar Sdn Bhd, Novo Holdings, Phoenix Bear are liquidating just ~2% of their stake in the OFS.

Financials