Hospital Valuations: The Hidden Power of ARPOBn

Hospital Valuations: The Hidden Power of ARPOBn

Healthcare in India, and particularly in Gujarat, has been on a remarkable growth trajectory over the last decade. Hospitals today are not just centers of care—they are institutions of trust, innovation, and also key drivers of the healthcare economy.

As someone who has been actively leading hospital operations, advising boards, and working with investors for over 14 years, I have observed one clear truth: hospital valuations are no longer defined merely by bed capacity or infrastructure investment.

They are shaped by a mix of operational excellence, financial outcomes, patient perception, and market positioning.

And at the heart of this valuation framework lies a single metric that too often gets overlooked: ARPOBn (Average Revenue Per Occupied Bed-night).

Why ARPOBn Matters More Than Ever

ARPOBn is more than just a number—it is the most accurate mirror of:

  • Case Mix – the blend of high-end procedures, critical care, and general admissions
  • Service Differentiation – specialized clinical programs, centers of excellence, advanced diagnostics
  • Patient Trust & Brand Value – willingness of patients to choose and pay for your care over competitors

In simple words: A hospital with stronger ARPOBn doesn’t just earn more—it commands greater respect in the valuation market.

High vs. Mid ARPOBn Hospitals

From my analysis, listed hospitals across India typically fall into two categories:

  • High ARPOBn Hospitals: ₹60,000–₹80,000 range
  • Mid ARPOBn Hospitals: ₹30,000–₹50,000 range

In Gujarat, given the rapid development of multi-specialty and super-specialty care in Ahmedabad, Surat, Vadodara, and Rajkot, many leading private hospitals are now moving closer to the upper ARPOBn band, particularly those focused on oncology, cardiology, neurosciences, and transplants.

Valuation Multiples: The Market Speaks

Currently, listed hospitals in India are valued at approximately:

  • 28.5x EV/EBITDA
  • ₹7.5 crore EV/Bed

But averages are misleading. There is:

  • ~15% deviation in EV/EBITDA multiples
  • ~50% deviation in EV/Bed multiples

…between High ARPOBn and Mid ARPOBn hospitals.

Illustrative Comparisons

Example 1: Two 200-Bed Hospitals in Gujarat

  • Hospital A (Mid ARPOBn – ₹40,000)
  • Hospital B (High ARPOBn – ₹70,000)

👉 Despite fewer occupied beds, Hospital B commands nearly 65% higher per-bed valuation, thanks to stronger clinical depth and service differentiation.


Example 2: The Big vs. Specialized Hospital

  • Hospital C (300 beds, ARPOBn ₹35,000)
  • Hospital D (150 beds, ARPOBn ₹75,000)

👉 Here, the smaller hospital with higher ARPOBn is valued higher than the larger one. Size is not the sole driver—quality of revenue is.

What This Means for Gujarat’s Hospitals

In Gujarat, where healthcare is rapidly professionalizing, the difference between a mid-market hospital and a premium hospital will increasingly be defined not just by infrastructure, but by ARPOBn strategy.

Hospitals that build centers of excellence, attract super-specialists, strengthen clinical outcomes, and optimize service pricing will command significantly higher valuations—whether for IPOs, private equity, or acquisitions.

My Message to Doctors & Hospital Leaders

Every doctor and healthcare professional is a stakeholder in this transformation. Your contribution to clinical excellence, patient care, and innovation directly impacts ARPOBn and, therefore, the overall value of your institution.

As boards and investors increasingly focus on ARPOBn, doctors and management teams must align their vision—not just for better financial returns, but for building hospitals that stand out as leaders of quality care.

Final Word

Hospital valuations in India, and especially in Gujarat, are moving from infrastructure-driven to outcome-driven.

The message is simple: Elevate ARPOBn, and you elevate your valuation.

I welcome all doctors, promoters, and hospital leaders to reflect on this. And for any assistance—whether in strategy, operations, financial advisory, investor readiness, or valuation planning—please feel free to command me. Together, we can shape a stronger, sustainable future for healthcare.

Parimal Astik Business Coach | Healthcare Strategist | COO | Advisor to Leading Hospitals

To view or add a comment, sign in

More articles by Parimal Astik

Others also viewed

Explore content categories