About a year ago, on The Ken’s First Principles podcast, Viren Shetty, Executive Vice Chairman of Narayana Health, was asked what set the company apart and enabled it to differentiate itself against competition.

Shetty’s long, thoughtful answer began with a somewhat interesting admission.

“That’s a good question. See, our business, the services-based industry, it doesn’t have a lot of moats. Like anyone could take the elements of what we have and put it together, you could basically recreate the same thing.”

But he added a caveat.

“It’ll take a lot of time… it will take a lot of money.”

Narayana Health is a name you might have heard, especially if you’re from Bangalore. But what we know as Narayana Health today began as Narayana Hrudayalaya, a super speciality hospital with a laser-sharp focus on cardiac health. It was founded in 2000 by Dr. Devi Shetty. What began with just one heart hospital in Bangalore and one in Calcutta, just doing cardiac surgeries, expanded across the country without ever giving up its mission of providing accessible healthcare for all. The company went public in 2016 and currently has a market capitalisation of around Rs 34,000 crore. Financially, Narayana Health is in its strongest position ever—in the most recent financial year, it reported a revenue of Rs 5,500 crore and, more crucially, a profit of Rs 762 crore.

Narayana Health has already done impressive work—but it’s what comes next that’s truly ambitious.

The company is transitioning from being just a provider of low-cost surgeries to becoming an integrated healthcare company.

As a part of this new vision, Narayana Health wants to create an end-to-end health management system where Narayana Health is involved in a person’s life well before they get sick, aiming to democratize preventative care and make it a pleasurable, proactive experience rather than a dreaded necessity. To achieve this vision, Narayana Health is building a model that combines multiple healthcare services into a single, integrated offering with the patient at the center. Viren Shetty draws parallels between this approach to Apple’s strategy of integrating existing technologies to create a seamless experience with iOS across all their devices.

There are two primary factors that drove Narayana Health to reinvent itself and pursue this bold and ambitious strategy.

First, there’s the size and the urgency of the market itself. The company’s business model is shifting from a reactive, surgery-focused approach to a proactive, holistic health management system. While it was once known for providing surgeries at low prices to patients who were already critically ill, the company realized this was a narrow market segment and not true “healthcare”, which should begin long before a person needs surgery.

The second reason is much more compelling, and is the oldest driver of change for incumbents—paranoia.

Healthcare in India, for the average person, is broken. There are countless stories of prohibitively expensive hospital visits, bad experiences, and poor public investments. And the ones who spotted the opportunity last time weren’t incumbents like Narayana Health, but healthtech startups like Practo, Pristyn Care, and others. While none of them could match Narayana Health’s reputation, brand, and health expertise, they raised the bar on customer convenience, predictability, and experience.

Luckily, Narayana Health saw the wave of disruption ahead and sprinted to adapt—even embracing methods it once thought it never would. It built Athma, its very own hospital operating system, hiring engineers and product teams to automate manual systems and reduce clinical workload. This software not just solves for inefficiencies, but also focuses on fixing the broken user experience that frustrates so many patients. It tracks patients both inside and outside the hospital to provide timely reminders for checkups, tests, and medication. It's helping Narayana get closer to becoming a paperless organization and eliminate waiting time in the hospital.

The last time disruption came knocking, Narayana Health rose to the challenge.

But that was all before AI showed up.

Now, Narayana Health is at the edge of something bigger—gearing up for the next wave of change.

Where will the next wave of disruption come from?

It’s hard to predict, simply because healthcare remains, in many ways, still broken.

Last time, healthtech startups attacked it by targeting customer experience and solving for convenience. The next wave may come from nimble startups attempting to do something radically different across areas such as health insurance, patient management, primary care, or prescriptions. They may even create software that gives Narayana Health’s rivals the upper hand.

Narayana Health is at its strongest point yet. Paradoxically, it is also at its most vulnerable.

Because it has gone beyond being just a hospital to something much bigger, the next disruptor could come from anywhere.

Even from students across India’s top campuses.

Executive Sponsor

Viren spearheads Narayana Health’s efforts to change the way Indians think about healthcare, shifting the focus from sickness to wellness. He does this through the hospital network’s new chain of clinics and health insurance arm.

Before becoming Executive Vice Chairman, Viren Shetty has served in multiple senior leadership capacities, including Chief Operating Officer (COO) and Senior Vice President – Strategy & Planning.

He holds an undergraduate degree in Civil Engineering from RV College of Engineering, Bengaluru, and earned an MBA from the Stanford Graduate School of Business.

Teams shortlisted in The Ken’s case-build competition who choose Narayana Health as their company of choice will gain access to Viren and other senior Narayana Health leaders at every stage. They’ll receive valuable insights, have their assumptions challenged, and be guided toward stronger strategies.