The Surge of Healthcare Payments Fueled by APIs: The Significance of underlying Infrastructure

Date: August 08, 2025

In a significant move towards digital transformation, the Ayushman Bharat Digital Mission (ABDM) in India is building a national health stack with open APIs. This infrastructure, designed to be modular and flexible, is set to revolutionise the Indian healthcare sector.

The growing demand for financing options like pay-later, no-cost EMIs, and insurance portability is creating a need for such an overhaul. With out-of-pocket expenditure on the rise, the need for seamless, digital payment solutions is more pressing than ever.

Healthcare organisations are investing in modular digital architectures, separating front-end experiences from back-end systems like Electronic Health Records (EHR), claim processing engines, and healthcare payment settlements. This approach allows for greater flexibility, scalability, and security, ensuring compliance with industry standards.

An API-first healthcare infrastructure, built on this modular architecture, offers numerous benefits. It promotes faster innovation, streamlines processes, and enhances security. A prime example of this is the ability to automate split billing across multiple payers - employer, insurer, and patient - without the need for manual reconciliation.

In India, a robust API infrastructure is essential in healthcare payments due to the industry's complexity and the involvement of multiple stakeholders. The country's vibrant FinTech ecosystem can serve as a testbed for scalable solutions that could be replicated in other emerging markets.

The CEO of QubeHealth, Chris, recently discussed the importance of a unified, scalable, and secure payments framework in healthcare. Companies like Stripe, Health Gorilla, and Redox are demonstrating how API-first platforms can abstract away complex back-end integrations while maintaining compliance and security.

In India, companies like Paytm, Mfine, and PharmEasy are developing API-based solutions for digital health financing. These services range from digital payment integration, telemedicine, online pharmacy, to financing options for healthcare expenses. FinTech platforms are also integrating with healthcare providers to offer instant medical loans or no-cost EMIs.

API-first healthcare payment apps in India can settle payments instantly to various healthcare providers. Moreover, they can verify patient insurance coverage in seconds, ensuring a smooth and efficient payment process.

In developed markets like the US and Europe, regulatory reforms have catalysed the adoption of API-driven data exchange in healthcare. A robust API infrastructure ensures real-time eligibility checks, streamlined pre-authorizations, accurate and transparent patient billing, faster reimbursements to providers, and the ability to embed EMI and financing options at the point of care.

The shift towards microservices and modular APIs in healthcare payments is similar to the change observed in the banking and logistics sectors. API-driven platforms in India can bridge the gap between the country's fragmented healthcare systems and a digitally savvy population.

The need for API-driven healthcare payments is highlighted as a key factor in reshaping how money flows within the healthcare ecosystem globally. Some insurers in India are even using AI-powered APIs to auto-process claims, reducing settlement time from weeks to hours.

As the healthcare industry embraces digital transformation, the adoption of API-first infrastructure promises to streamline processes, enhance security, and foster innovation. The future of healthcare payments in India, and potentially globally, seems to be paving the way towards a more efficient, accessible, and seamless healthcare system.