Manipal has delivered strong growth in the last three years with revenue growth at 29 per cent CAGR in FY24-26 to ₹10,335 crore and PAT growth of 31 per cent CAGR to ₹916 crore
The IPO of Manipal Health Enterprises, the India’s largest and fast-growing hospital chain is open till July 31, 2026. The offer consists of a fresh issue of ₹8,000 crore and an OFS portion of ₹1,275 crore. At the upper end of the IPO price band, it will have a market capitalisation value of ₹77,606 crore and is being valued at 31 times EV/EBITDA, including the fresh issue proceeds. The valuation is at a marginal 10 per cent discount to Apollo Hospitals’ EV/EBITDA of 35 times. Considering the minor discount to valuations as compared to Apollo which has a long track record as a listed player and its business model is well understood by investors, we recommend investors skip the IPO and wait for post listing clarity on growth outlook, get more insights on business/margin trends from quarterly results, before investing.Acquiring growthManipal has delivered strong growth in the last three years with revenue growth at 29 per cent CAGR in FY24-26 to ₹10,335 crore and PAT growth of 31 per cent CAGR to ₹916 crore. The originally Karnataka focussed company has emerged as a pan India company owing to several acquisitions in the last five years. The company now has a strong presence in Karnataka, Maharashtra & Goa, West Bengal and Eastern India with acquisitions of Columbia Asia Hospitals (2021), Vikram Hospital (2021), AMRI Hospitals (2023), Medica Synergie (2024) and most recently Sahyadri Hospitals (Oct-2025) which will be integrated into operations in FY26-27 period.The acquisition track record is also strengthened by the strong profitability reported as well. The EBITDA margin of the company in the period of high acquisition driven growth has remained stable at the industry leading range of 25 – 27 per cent in FY24-26. Against a greenfield based expansion, the acquisition strategy has benefitted from quick turnaround and strong operations of target companies in new geographies.Growth outlookThe expansion plan in RHP lays out licensed bed capacity growth from 13,037 beds in March-26 to 15,463 beds in FY30 and is a combination of brownfield (483 beds) and greenfield expansion (1,943 beds). This is a mere 4 per cent CAGR bed addition and is slower than the announced bed additions at peers ranging from 3,415 for Apollo to 3,190 for Medanta which is on a smaller base and provides higher growth.The other growth driver is operational improvement. The company has strong operating metrics which can be further improved. Manipal has acquired Maharashtra based Sahayadri Hospitals in Oct-2025. The benefit of complete integration and improvement in operating metrics will benefit the consolidated entity. Manipal has reported advanced case mix from cardiac sciences, oncology, neurosciences, gastro sciences, orthopaedics, and renal sciences at 64 per cent in FY26 which is a 300 bps improvement from FY24. A further improvement in the advanced case mix will improve realisations as well. The hospital group will also benefit from industry wide phenomenon of utilizing advanced robotics in surgeries which can improve operating metrics as well. Financials and valuationsThe acquisitions, including the ₹5,000 crore transaction for Sahayadri in October-2025 has led to an outstanding net debt of ₹10,230 crore as on March 31, 2026 or a net debt to EBITDA of 3.9 times. The fresh issue proceeds of ₹8,000 crore and strong cash generation from operations (₹2,078 crore in FY26) should significantly reduce the debt burden. The company has earmarked ₹5,500 crore for debt repayment from the fresh issue proceeds which should reduce the interest cost for the company and strengthen its balance sheet for further acquisitions.The post issue enterprise value of ₹79,835 crores consists of - a market capitalisation of ₹77,605 crores plus net debt of ₹2,230 crore (current net debt of ₹10,230 crore offset by fresh issue proceeds of ₹8,000 crore). This implies an EV/EBITDA of 31 times. On a PE basis, the company is valued at 84.5 times trailing earnings. But assuming adjustments for interest cost savings from debt repayment post the IPO, it should be around 62-64 times which is comparable to peers. Despite the fast growth in last three years and leading status of the pan India operator the outlined growth prospects need more clarity after listing which investors should track before gaining exposure to the stock.Published on July 29, 2026
