We advise on both hospital and school transactions, and we routinely see the same investors and family offices evaluate both — sometimes in the same conversation. It's an understandable instinct: both sectors involve capital-intensive physical infrastructure, both are increasingly the subject of platform consolidation strategies in India, and both trade on EBITDA rather than revenue once a business is established. The comparison isn't unreasonable. It's just incomplete in one specific place that changes the entire analysis.
Where the Comparison Genuinely Holds
- Both are real-asset-backed businesses where the underlying land and building carry independent value from the operating business running on top of them.
- Both are active PE consolidation themes in India right now — hospital platforms have absorbed the largest share of India's roughly US$2–3 billion in annual healthcare PE/VC deployment, and we've separately covered why private equity is increasingly buying school chains, not just EdTech.
- Both can use a PropCo/OpCo structure to separate real estate ownership from operations. Max Healthcare, one of India's largest hospital chains, has explored REITs to unlock capital tied up in its real estate, and has a disclosed 60-year operations-and-maintenance agreement for a 300-bed hospital in Dwarka, South-West Delhi — a genuinely asset-light structure that lets it expand without owning the building outright.
What This Does to the Multiple
The practical result shows up directly in valuation. Indian healthcare has real, if wide, disclosed benchmarks: one 2026 industry report on Indian healthcare private equity puts quality hospital platform transactions at high-teens EV/EBITDA and above, broadly in line with listed hospital chains, with EY-Parthenon's own Q2FY26 sector update showing multiples for listed players ranging from the mid-teens to over 30x in higher-growth specialty and diagnostics segments. As we've written elsewhere, no equivalent public benchmark exists for Indian K-12 or higher-ed institutions — not because nobody has done the deals, but because the mandatory not-for-profit OpCo structure makes the comparable-transaction data far harder to standardise and far less likely to be disclosed in the first place.
An investor pricing a school acquisition using a hospital-sector multiple as a reference point is not just using the wrong number — they're implicitly assuming a legal ownership structure the school deal cannot actually offer.
The Risk Profile Is Different Too, Not Just the Legal Structure
Even setting structure aside, the same India-focused healthcare research is candid about what high-teens entry multiples actually demand: sustained mid-teens earnings growth and no adverse regulatory event across the holding period, with operational value creation left to do essentially all the remaining work. Healthcare's risk is largely an execution risk sitting on top of a well-understood valuation framework. Education's risk starts a step earlier — it's a benchmarking risk, where the investor often can't be fully confident the multiple itself is right before execution risk even enters the picture.
Evaluating a platform play across healthcare or education?
MAS Advisory works across both sectors and can help you apply the right underwriting logic to each — not the other one's.
Healthcare M&A data based on EY-Parthenon India's Q2FY26 Healthcare Sector Update (January 2026) and InsightRx's "Private Equity in Indian Healthcare 2026" report (July 2026). Max Healthcare's asset-light and REIT strategy based on publicly disclosed company information. Education deal-structuring points based on MAS Advisory's own published guides. General guidance only — specific transaction terms and applicable multiples should be assessed on a deal-by-deal basis.