What's the real health opportunity in India? ft. Dilip Kumar (VC, Rainmatter by Zerodha) ✨
And what not to build.
A few weeks back, we sat down with Dilip (Venture Capitalist at Rainmatter by Zerodha) to deep dive into one of the most complex and execution-heavy sectors in Indian startups: healthcare.
We explored how India’s healthcare landscape evolves and what it takes to build a meaningful, scalable company in 2025. If you're serious about solving real healthcare problems and building long-term trust, this article will save you years of effort.
Before we begin, the deadline to apply for the GrowthX Advanced Strategy Program ends this week. The cohort begins coming Sunday, May 25th.
If you are in a marketing, product, business or strategy role, this is built for you. Over, 4,000 senior leaders at Coca-Cola, Jio, Stripe, Google, CRED, Zepto, Invideo & more have used this program to solve real growth problems at their companies.
The 4-week live program teaches you the absolute A-Z of solving revenue growth for every product. Here’s what we cover, it is a live online experience & built on a case study method of learning. By the end of the program, you will apply four key levers of growth to real products. The deadline to apply for the program is May 23rd.
Healthcare in India “was” reactive.
The question was — “Where do I go when I fall sick?”. Today, that mental model is crumbling. “Hospitals are built for when something breaks. But consumers today are asking, How do I not break in the first place?” - Dilip Kumar (VC@Rainmatter)
The top 1% of Indian Janta have way more “health awareness,” make over Rs. 20L in annual income, and have a stressful lifestyle — all roads lead to long-term health management. And, to be honest, that’s a massive win for public health as a category.
But, it complicates the traditional healthcare business model where doctors typically earn when people are unwell, and hospitals are monetised based on occupancy.
Interesting no?
Consumers are shifting from "care when sick" to "care to stay well”. They are now spending on experiences that signal well-being.
↳ Healthier snacks
↳ Premium gym sessions
↳ Boutique wellness retreats.
They’re choosing what they believe will genuinely improve their lives. As a result, the total addressable market (TAM) appears to be shrinking if viewed through the old lens. But, as care moves from reactive to preventive, the upside is huge.
Indian Healthcare market is heterogeneous, period.
Dilip breaks it down into four fast-evolving segments —
1. Preventive Health
↳ Screenings, diagnostics, wellness tracking
2. Chronic Care
↳ Diabetes, PCOS, and hypertension require long-term consistency
3. Mental Wellness
↳ Therapy & stress support, especially in urban India
4. Longevity
↳ Still early, but gaining traction with performance-focused users.
If you look at the market size, the consumer often engages with multiple care segments at once. So, the idea that the diabetes market is a 150 million-user market is misleading. You are double-counting that user.
As a healthcare startup, you need to narrow down the target demographic and solve a focused, specific problem before scaling. You can’t build a play for everyone.
Why are healthcare startups failing?
As we said earlier, Healthcare in India is too big to address all at once. Despite a lot of effort, no large healthcare company has emerged in India over the past five years.
“You can’t lift a solution from abroad and expect it to work. You have to design for Indian realities,” says Dilip. “US healthcare models are not plug-and-play ready for India, since the fundamentals are very different.”
In India, low insurance coverage, out-of-pocket spending, and price-sensitive consumers make most Western approaches unviable. Most builders miss this point.
Also, there are some deeper problems —
↳ Products over-indexing on features rather than {trust + access + relevance}.
↳ Users still prefer guidance from doctors, family, & local network over apps.
↳ Most AI tools are showing technical capability & not delivering real value.
↳ Telemedicine adoption has been slow because it hasn’t earned trust or integrated well with the offline ecosystem.
Trust Is the Missing Piece.
In India, trust in the healthcare system is shaped by deeply personal & cultural cues. People often make choices based on which medical college a doctor went to or which hospital is closest during a crisis. Treatment depends on perception more than medical guidelines.
Trust becomes the moat.
Take Fittr (a Rainmatter portfolio company). The founder, JC (Jitendra Chouksey), leads by example. He educates, speaks directly to his audience, and builds credibility through action. Users see him walk the talk and think, “If he can do it, so can I.”
B2B healthcare also requires long-term credibility.
Why should a doctor trust the product? Why should HR trust the new wellness program? Why should an insurer embed a certain tool?
The Market Everyone Misses.
Most startups today are building for the urban elites, tracking sleep scores and macros. Healthcare needs in Tier 2 and Tier 3 cities are drastically different. People in smaller towns often prioritise urgent and essential care needs. There’s a much larger audience with simpler, more practical needs. Categories that lack effective solutions include —
Nutrition models adapted to regional diets
Chronic care plans that fit rural healthcare constraints
Fall detection systems for elders (massive problem)
What do investors want?
The builders Rainmatter has been funding are not necessarily healthcare professionals. They’re people who’ve seen the gaps up close and can’t unsee them. Healthcare needs people who think independently, operate with grit, and care deeply about the problem.
Founders who walk the talk & have the ability to drive outcomes
Models that can serve millions, not just a privileged few
Clear unit economics and proven outcomes
Real defensibility through data, distribution, or deep engagement
The AI in healthcare question.
AI will inevitably become part of healthcare, but it must serve real, practical use cases. The biggest gains lie in the backend. For example, AI can help in oncology, where 60 to 70 percent of patients undergo repeat care cycles with massive data overhead.
Some operational changes are obvious.
For example, uploading reports via WhatsApp and getting LLM-based support. Such tools will make doctors more effective, not irrelevant. The real question, though, is — Can the solution help doctors spend their time more meaningfully?
Closing.
This category will evolve, the winners will be those who build trust, focus on outcomes, and solve real problems for specific groups. The opportunity is massive. Success will come from delivering solutions that improve everyday health, period. Hope this was helpful. Cheers!