Khosla Ventures doubles down on Even Healthcare to challenge India’s hospital economics

Even Healthcare's model centers on aligning incentives within the healthcare system to prioritize patient outcomes. The company pays doctors fixed salaries, rather than linking compensation to the number of procedures or tests performed. This approach is intended to remove financial motives for unnecessary treatments. This incentive structure extends to hospital management and other staff, who receive equity and company-wide incentives, aiming to foster a collective stake in the startup’s long-term performance and patient well-being.

Initially, Even relied on partner hospitals but shifted to building and operating its own facilities after finding what it considered unnecessary tests and recommended surgeries for its members. This move to direct control over care delivery is intended to ensure adherence to its patient-centric philosophy and manage costs. Even has opened two hospitals in Bengaluru, which it states reached operational profitability, excluding depreciation, within a year, and plans for five more in the city.

Even generates most of its revenue from patient payments and through relationships with insurers. It is also working with insurer partners on a model that could compensate it for hospitalizations it helps prevent, rather than solely for providing treatment. The company tracks patient recovery using established medical scoring systems, such as the Oxford Knee Score for knee replacements, and publishes these results on its website for comparison with other healthcare systems. This focus on measurable outcomes underpins its stated goal of rewarding better health rather than higher service utilization.