This paper develops a conceptual framework to integrate healthcare financing and delivery in India’s fragmented private sector so that competition promotes value rather than service volume. Drawing on international models from Israel, the U.S., Spain, Brazil, and the U.K., the study uses contingency theory, the resource-based view, dynamic capabilities, and institutional theory to design a context-specific typology. It identifies two integration pathways: hospital-first vertical integration for advanced states like Tamil Nadu and Delhi, and primary-care-first reverse integration for lower-resource states such as Bihar and Chhattisgarh. The framework emphasizes enabling regulations—ownership flexibility, solvency oversight, risk adjustment, and outcome transparency—to foster accountable, sustainable managed-care models in India.
