ESG Financing and Sustainable Investment Decision - Making in the Healthcare Sector

This mixed - methods paper evaluates the motivation factors, impediments and policy consequences of ESG financing and sustainable investment decision - making in Indian corporate healthcare organisations using quantitative survey data on 186 respondents, and qualitative data on 20 senior stakeholders gathered using interviews. The results contribute to three key areas of knowledge about ESG integration in health care. First, the study makes two key imputations — it finds Perceived ESG Materiality is the strongest driver of intension to adopt an ESG approach in healthcare investment contexts, and that high values on materiality dimensions that are most pertinent to investors' interests relate to patient outcomes, governance of workforce issues and clinical quality metrics (rather than environmental measures which have been shown increasingly dominant as drivers in genericized ESG rating frameworks). Direct implications of the findings on health care are also evident too; that is, the development of particular ESG rating methodologies and disclosure frameworks. Second, ESG Reporting Quality plays a mediating role in the relationship that identifies high - quality, verifiable and comparable ESG disclosure as the main bottleneck in the adoption chain. The internal aptitude of hospitals to produce a workable ESG data, known as institutional readiness, is a sufficient, yet not necessary prerequisite to adoption; before it can impact investment behaviour, corporate discretion has to be transformed into a plausible external disclosure. Such results are a call to the urgent need to create BRSR guidelines tailored to the healthcare area, and the standards of third party certification of clinical and social performance measures. Third, the moderating result (H4) proves that regulatory environment quality to turn stakeholder pressure into commitment to adopt it (a finding with urgency to policy) is about to be demonstrated. SEBI BRSR, and the sovereign green bond framework created by RBI, constitute a regulatory framework that has an exploratory potential of multiplied ESG forces in corporate healthcare in India so long as they are intentional made to match each other.

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