Indian Healthcare is Incomplete without a Hospital Broker
- Khushi Berry
- 4 days ago
- 5 min read
India has built one of the most complex healthcare ecosystems in the world. There are private hospitals, government schemes, insurance companies, TPAs, corporate health programs, digital health platforms, and wellness startups. Every layer of the system has evolved to serve a specific stakeholder. And yet, one stakeholder has consistently been left without representation: the patient.
This gap has gone unnoticed for decades, largely because it sits at the intersection of emotion, urgency, and silence. Hospitalisation is not a rational consumer moment. It is a crisis moment. Families are worried about outcomes, not invoices. And the system, intentionally or otherwise, has been built to take advantage of that.
The result is a healthcare ecosystem that negotiates aggressively everywhere—except where it matters most.
Hospitals negotiate with insurers. They negotiate with corporates. They negotiate with government schemes. Pricing teams, revenue managers, and contract specialists work behind the scenes to optimise every rupee. These negotiations determine package rates, room rent caps, billing slabs, implant pricing, and payment terms. This is normal business behaviour. Hospitals are commercial organisations. They are expected to negotiate.
But when it comes to patients, the negotiation stops.
Patients are given a “standard package.” One number. One estimate. Often delivered quickly, with little explanation, and framed as urgent. There is no benchmark. No comparison. No leverage. And most importantly, no one is sitting on the patient’s side of the table.
That is the missing layer in Indian healthcare.
We accepted insurance brokers early on because we recognised that insurance is complex. Policy language is dense. Coverage varies. Exclusions matter. Consumers need help. So we built agents, brokers, aggregators, and advisory platforms. We regulated them. We normalised them. Today, buying insurance without advice feels risky.
But we made a dangerous assumption: that insurance would protect patients financially once they entered a hospital.
It doesn’t.
Insurance companies settle claims based on the terms of the policy. It does not negotiate hospital pricing. It does not control how packages are constructed. It does not prevent inflated base rates. It does not eliminate non-payables. It does not stop sub-limits from being triggered. It does not ensure that the patient is paying a fair, optimised price.
Insurance transfers risk. It does not control cost.
Cost control occurs within hospitals, and hospitals price their services differently depending on who is sitting across the table.
Insurers bring volume. Corporations bring employee pools. Government schemes bring scale. Patients bring vulnerability.
So patients pay retail.
Retail pricing in hospitals is not illegal or unethical. It is simply what happens when one side has all the information and leverage, and the other doesn’t. Retail pricing thrives in moments of urgency, confusion, and fear—exactly the conditions under which hospital admissions occur.
Most patients don’t realise this is happening. They assume the bill is inevitable. They tell themselves healthcare is expensive. They move on, often financially strained, emotionally exhausted, and still unaware that the same treatment could have cost less.
This is not because patients are careless or uninformed. It is because the system never gave them a fighting chance.
This is why hospital broking is not a “nice-to-have.” It is a structural necessity.
Hospital broking simply means representation. It means someone whose sole job is to sit on the patient’s side and negotiate hospital pricing before admission—just as insurers do. It means reviewing estimates, benchmarking rates, questioning inclusions, optimising insurance usage, and ensuring that patients are not paying retail simply because they are alone.
This role does not conflict with medical practice. It does not dictate treatment. It does not influence doctor choice. It operates entirely on the financial layer of hospitalisation, which is already negotiable for every other stakeholder in the system.
The discomfort around hospital negotiations is cultural, not ethical. We have been conditioned to believe that questioning hospital costs is disrespectful. But hospitals themselves negotiate relentlessly. They understand pricing is flexible. They expect negotiation from institutions. The silence exists only on the patient's side.
And silence is expensive.
The absence of hospital broking has real consequences. Families exhaust savings. Insurance covers less than expected. Out-of-pocket costs balloon. Trust erodes. And yet, the root cause remains unaddressed because there has been no formal mechanism to represent patients before admission.
That is the gap Health Samadhan was built to fill.
Health Samadhan operates as a patient-side hospital broker. Our mandate is simple: before a patient is admitted for any planned or elective procedure, we negotiate the hospital deal on their behalf. We review existing hospital quotes, benchmark them across multiple hospitals, and work through the financial structure of the admission packages, room categories, billing slabs, implants, non-payables, and insurance optimisation.
We do not change doctors. We do not alter treatment plans. We do not compromise care. The medical decision remains between the patient and their doctor. Our role is to ensure that the financial outcome is fair, transparent, and optimised.
When patients are represented, outcomes change. Pricing becomes clearer. Options emerge. Out-of-pocket costs are reduced—not because care was downgraded, but because inefficiencies and opacity were eliminated. The same hospital, the same doctor, the same surgery can cost significantly less when negotiation happens before admission instead of after discharge.
The most crucial aspect of hospital brokering is aligning incentives. Without alignment, representation collapses into referral marketing. Health Samadhan operates on a pure success-fee model. If we do not reduce a patient’s out-of-pocket cost, we do not charge a fee. We do not take commissions from hospitals. We do not earn unless the patient benefits.
This model is important because it fosters trust. Patients know we are incentivised to get them a better deal—or walk away. Hospitals know we are not selling volume. And the system adjusts accordingly.
Critics may argue that hospital broking commoditises healthcare. In reality, it does the opposite. It separates care from pricing. It allows doctors to focus on medicine while pricing is handled professionally and transparently. It reduces post-discharge conflict. It improves expectation-setting. And it restores balance in a system that has long favoured institutional buyers over individuals.
India’s healthcare spending is rising. Private hospitals dominate care delivery. Insurance penetration is increasing, yet out-of-pocket expenses remain stubbornly high. This is not because Indians lack insurance. It is because pricing remains opaque and unchallenged.
Hospital broking addresses this at the root.
The question is no longer whether hospital broking should exist. The question is why it took this long.
Every mature market eventually creates representation where power is asymmetrical. Real estate did. Insurance did. Investments did. Healthcare is simply catching up.
Patients deserve the same rights that insurers and corporates have enjoyed for years: the right to negotiate, the right to compare, and the right to make informed decisions before money leaves their account.
The missing layer in Indian healthcare is finally being built. And once patients experience representation, there is no going back.
Hospital broking is not a disruption. It is a correction.
And it was always inevitable.
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