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Quadria Capital: Managing Healthcare Impact in Three-Tiers
Quadria Capital, a leading private equity firm specializing in healthcare solutions in Asia with over $3.9 billion in assets, launched its proprietary Impact Management and Measurement (IMM) framework in 2022. The 3-tiered framework leveraged its Impact Circle concept to ensure measurement and monitoring of healthcare impacts across the investment cycle. By applying the IMM framework to investments such as the one in NephroPlus, Quadria identifies the right opportunities and understands the impact performance towards addressing global health needs, while delivering compelling financial returns.
Quadria Capital's Proprietary IMM Framework - Three Tiers and Four Pillars
Quadria believes that adopting a sustainable impact approach is fundamental to its success in building meaningful businesses and delivering superior returns. Back in 2016-2017, Quadria had designed and implemented the "Impact Circle", a process for assessing possible investments for their potential to generate impact across four core impact pillars - Accessibility, Affordability, Quality and Awareness. Based on the concept of "Impact Circle", Quadria further developed its IMM framework in 2022, a three-tiered framework that guides and governs the delivery of its ESG and impact commitments.1
The first tier represents an impact thesis which articulates Quadria's intended impact and long-term, SDGs-based impact goals. Quadria analyzes healthcare challenges, opportunities, and emerging trends within Asian healthcare markets to set an impact thesis for each deal. The second tier involves an "ABC" investment approach - Avoid harm, Benefit stakeholders, Contribute to Solutions. This process is designed to translate impact objectives into clear and practical guidance for investment decision making. The third tier is an ESG and impact evaluation process across the investment lifecycle. Quadria implements ESG negative screening, risks and/or opportunities identification through materiality studies and third-party due diligence for each deal before investing. Quadria also continuously monitors and tracks performance throughout the investment period.
As part of the third tier, Quadria uses an impact scorecard to quantify the current, anticipated and actual impact across the following four core impact pillars:
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Improve healthcare access (Accessibility),
- Reduce healthcare costs (Affordability),
- Enhance care quality (Quality), and
- Enhance healthcare outcomes through awareness (Awareness).
Each pillar is scored on a scale from 1 (low) to 5 (high) with thresholds defined for screening potential investments. Quadria makes investment decisions using the scorecard comprehensively by incorporating qualitative judgments and quantitative assessments. After investing, impact scores are updated annually to understand the exit rationale.
The framework adheres to the Operating Principles for Impact Management and aligns with relevant SDG targets. Quadria Capital Fund III achieved a Platinum Rating in BlueMark's Fund ID assessment, placing it in the top quartile globally and earning a position on BlueMark's 2025 Fund ID Leaderboard. Since initiating independent impact verification in 2023, Quadria has continued to strengthen the rigor, structure, and integration of its impact management practices. In December 2025, BlueMark conducted an independent assessment of Fund III's alignment with global impact investing best practices. Additionally, as a signatory to the United Nations Principles for Responsible Investment (UN PRI), Quadria achieved top ratings performing above-median in its 2025 assessment.
Operationalize IMM Framework: Investment in NephroPlus, a Leader of Affordable Dialysis Revolution
To Quadria, "successful investing is about identifying the right management team, business model, and strategy for the given opportunity." As such, Quadria's IMM approach was incredibly important in determining the viability of the investment in NephroPlus. Companies that are increasing access to chronic kidney disease (CKD) services were attractive investment targets aligned with Quadria's IMM framework. Quadria sees a strong opportunity to address the increasing demand for dialysis services, making treatment more affordable and accessible.
With a commitment to social impact that is closely aligned with Quadria's own, NephroPlus is a fast-growing dialysis provider founded in 2010 that operates centers in hospitals and standalone clinics across Asian markets. The company focuses on delivering high-quality, accessible healthcare, particularly in underserved communities in South and Southeast Asia where the end stage renal disease (ESRD) burden is rampantly growing.
Dialysis requires patients to be physically present for several hours, often twice a week, making accessibility a crucial factor. Aiming to provide better dialysis access to patients in need, NephroPlus strives to extend its network to underserved communities, establishing new centers and integrating with local players. Additionally, the high cost--up to $3,000 per year--puts it out of reach for many patients across the region. NephroPlus manages costs effectively by training its clinical staff in-house through its own academy and by leveraging procurement efficiencies through economies of scale and contract manufacturing. As a result, NephroPlus prices range from $22 to $300 across geographies. Affordability does not sacrifice quality. The company is committed to ensuring high-quality clinical care across diverse settings--from top-tier corporate hospital to public-private partnerships (PPP) centers in small rural communities. It also launched the AP Mortality Reduction Program, aimed at reducing preventable deaths through early diagnosis and timely intervention, achieving infection control in 87.5% of patients. In rural areas, the company is also working to raise awareness of renal health.
As part of its sustainability-focused strategy, NephroPlus has established systems to capture and monitor key ESG data across centres, reduced plastic usage in dialysis bloodlines, and adopted the cloud-enabled patented Renova Dialyzer Reprocessing System to reduce human error and improve treatment traceability. It is also contributing to sector knowledge through published research (e.g., The Lancet Regional Health - Southeast Asia), setting benchmarks for patient survival and quality of care in India.
NephroPlus was scored at the time of investment and thereafter assessed annually to evaluate performance against the anticipated impact score at exit, and to determine whether the impact outcomes achieved remain aligned with the company's impact thesis, focusing on "Accessibility", "Affordability" and "Quality". The use of impact scorecard, consistent with the IMM framework, contributed to the investment decision and the monitoring process of NephroPlus.
NephroPlus has served over 36,500+ patients, having expanded to 520+ centers across 5 countries, including 450+ centers in India. ~78% of centers are located in Tier II and Tier III markets, bringing specialist renal care to underserved communities.
"Quadria's investment in NephroPlus underscores our ambition to invest in regional champions of Asian healthcare, who are providing high-quality, affordable healthcare to large, underserved populations where the impact is greatest. NephroPlus has demonstrated its ability to significantly improve health outcomes for its patients, whilst maintaining industry-leading growth and profitability,"
recalled Sunil Thakur, Partner and Head of South Asia at Quadria Capital.
Looking to the Future
At Quadria, we will continue to strengthen institutional rigor, transparency, and accountability to ensure that impact and ESG strategies are embedded into investment discipline and operational execution. Quadria's ambitious goal is to impact a billion lives by 2030, and are confident of turning the vision into reality with the support of investors and portfolio companies.
1https://quadriacapital.com/impact#framework
2https://www.impactprinciples.org/