The private sector will emerge as the main gainer of this supply inadequacy. Most healthcare providers primarily focus on the urban markets in the Tier I & II cities. Income disparity, lower patient-doctor ratio lower insurance penetration in Tier III cities and rural areas, has mainly resulted in the concentration of hospitals in the Tier I & II cities. Healthcare chains are mostly increasing their national coverage and penetration in Tier III cities through Polyclinic formats in the Primary Care segment. The recently introduced National Health Protection Scheme and proposal of Ministry of Health and NITI Aayog to introduce PPP model will also have a dual impact - increase private sector facilities in Tier II & III cities and rural areas thereby reducing regional disparities increase insurance penetration as well as incentivise investments in private hospitals. The sector is also emerging as a major alternate real estate asset class on account of high EBITDA margin of 16%-17% and average ROCE of 15%-18% resulting in increased private equity and global funding. Real Estate Investment Trusts (REITs) can also be floated in the sector; mature hospital developments in the long run will tap the funding and offload its capital investment in real estate and employ the same for scaling up of operations and improving operational efficiency.