Over the past year, I’ve had a front-row seat to how healthcare businesses operate. Working at a healthtech aggregator, I get a close-up view of what works, what doesn’t, and where opportunities quietly emerge.

The more I learned, the more fascinated I became with how complex and full of opportunities healthcare really is.

Today’s edition is about a three-year-old health tech startup that spotted an opening in the market and moved fast to own it. We are going deep into the works of Orange Health. A company that quietly carved out a niche in at-home diagnostics, outpacing even some of the industry's biggest, most deep-pocketed players.

Let’s dive right in 👇

Table of Contents

• Industry Outlook

• How Orange Health Started?

• Perfectly timed launch and Orange Health Market Fi …

• Why didn’t the larger brands capitalize on this opportunity?

• What differentiates Orange Health

  • Positioning

• How Orange Health Engineers Growth

  • Owning an end-to-end experience

  • In-app experience

  • Nailing the in-person experience

  • Full-stack Ops model

  • Orange Health Reverse Logistics

• Orange Health’s Current Scale and Way Ahead

  • Current scale

  • Expansion levers

  • Future outlook

On his podcast Masters of Scale, Reid Hoffman, co-founder of LinkedIn, said:

This quote is so powerful. Often, we see companies with great ideas, strong teams, but wrong timing, going nowhere. 

Take Zepo for example, they tried to become Shopify for Indian kiranas in 2011 when sellers preferred marketplaces and had no digital capability. They eventually shut down in 2021. 

But a few months later, Dukaan got the timing right. Lockdown forced every small business owner to learn digital, and Dukaan gave them a fast way to go digital.

The same invisible force, timing, set the stage for Orange Health.

But before we dive into how they built their advantage,  let’s first step back and get a sense of industry maturity at the time Orange Health launched. 

Industry Outlook

The pandemic rewired the way India thought about healthcare.

As gaps in the traditional system became glaringly obvious, healthtech companies moved fast to fill them. Slowly but steadily, they started solving pain points across every stage of the patient journey. 

From 2018 to 2021, Healthtech grew remarkably by 192%, with 25% growth in teleconsultation, 104% in diagnostics, 57% in eOTC, and 42% in epharma categories. 

It might seem that this growth is temporarily fueled by COVID, but here’s where it gets interesting. Even after pandemic’s 2nd wave, the GMV of the eHealth sector normalized 50% higher than pre-COVID stages. This indicates the beginning of a new normal for the healthcare industry. People got used to at-home care, online consultations, and sample pickups.

Another outcome of COVID was an active consumer move towards trust.

A Praxis Global Alliance study found that by FY20, pan-India diagnostic chains were growing faster than their smaller, local counterparts. Home collection (non-COVID) revenue for these national players shot up by 25–30% in FY21, indicating that patients were now choosing labs the same way they wanted groceries: fast, branded, and seamless.

Lab accreditation became a proxy for trust.

• NABL-certified labs jumped from 347 in 2012 to 1,880 by March 2021, mostly thanks to organized chains like Thyrocare and Metropolis.

• These players already had molecular diagnostics infrastructure, so when COVID hit, they sprinted. 

And when consumers move faster than the system, infrastructure follows. Redseer notes that this digital wave not only increased adoption but lowered customer acquisition costs for diagnostic brands.

In short, the platforms were ready. Behavior was ready.

The only missing piece?

Someone to stitch it together 🪡

Enter Orange Health—a company that spotted the inflection point and crafted a category of their own full-stack diagnostics with a speed-and-trust-first mindset.

With that context, let’s unpack Orange Health’s story.

How Orange Health Started?

Before Orange Health, Dhruv Gupta had already been a serial entrepreneur. He had built and sold companies across social networking, fitness, and healthtech. But from the beginning, his career wasn’t shaped by observing and acting on market trends, tt was shaped by chasing problems he personally felt.

Growing up in India and later studying in the US, Dhruv always had an entrepreneurial itch. Even during his early professional years in tech and consulting at PWC, he was bouncing off business ideas with friends, spotting India–US arbitrage opportunities, and dreaming about what he could build next.

His first real venture, DesiMartini, was about solving a cultural loneliness: Indians abroad wanted better ways to connect. Built in the pre-iPhone era, when online dating and social networking were still taboo in India, it had its own challenges. He had to pivot from a pure-pure dating side to a movies and entertainment social hub.  DesiMartini was eventually acquired by Hindustan Times. But that early success taught him a crucial timing lesson: you can be solving a real problem, and still be either too early or have to pivot hard, depending on how culture evolves.

After moving back to India, he turned personal frustration into a second company, FitHo, around 2011.
He saw how India was the chronic disease capital and still lacked accessible preventive care. FitHo helped people manage obesity, diabetes, and lifestyle diseases through personalized exercise and nutrition plans. It was the beginning of India's preventive health conversation, and FitHo scaled quietly and eventually got acquired by Practo.

Next, Dhruv moved to Practo himself. It was Dhruv’s window into the messy, fragmented world of Indian healthcare delivery at scale. Inside Practo, he saw up close how urban healthcare behavior was deeply unbundled: patients didn't stick to one brand or one provider. They optimized for convenience and trust in each transaction, whether it was choosing a gynecologist, a pharmacy, or a diagnostic lab.

So when COVID came and broke the inertia around healthtech adoption,  he was ready.

He already knew there would be a huge opportunity if someone could stitch healthcare convenience, trust, and speed into one seamless experience. On top of this knowledge, he had a personal trigger. His wife and daughter had dengue, and they had to walk to a lab every alternate day for platelet testing. There was no high-trust, fast at-home service available.

That’s what birthed Orange Health, an at-home diagnostic test service built on speed (60-minute home pickup + 6-hour reports - twice as fast as the industry norm), accuracy, and trust.  

Dhruv put his decade-long exposure to healthcare behavior, his operational instincts honed at Practo, and a logistics-led mindset into building Orange Health. It didn’t take him long to find product-market fit after launching because he already knew gaps in the industry that weren’t obvious to an outsider. 

Perfectly timed launch and Orange Health Market Fit

If you break down why Orange Health hit product-market fit so precisely, four forces stand out: shifting consumer behavior, a deep trust gap, growing digital adoption, and slow-moving incumbents.

Here's how each trend played out, and how Orange Health fit right in:

Orange Health Funding

Orange Health’s vision to flip outdated, slow diagnostic processes into a fast, consumer-first experience soon found believers in investors, too.

Within just eight months of launch, they closed a $10 million Series A led by Y Combinator and Accel Partners. 

In June 2022, momentum continued with a $25 million Series B round, this time led by Bertelsmann India Investments, further fueling their city expansion and operational depth.

And by December 2024, Orange Health secured an extension to its Series B, bringing in Amazon Sambhav Venture Fund, a strategic signal that even the largest players were betting on faster, tech-driven healthcare delivery.

Sidebar

Founder’s Unfair Advantage

Every breakout company has an unfair edge, something that gives them an invisible head start others can't easily copy. Here’s how different startups in India found their unfair advantages

Bigger question: Why didn’t the larger brands capitalize on this opportunity?

Alright, so far we’ve seen how Orange Health crafted a category of its own with 60-minute diagnostic sample pickups. Just to give some context, this doesn’t happen in the US yet

But there’s a larger question: Large hospital chains such as Apollo, Manipal, or large pathology chains such as Dr. Lal Path Labs and Agilus Diagnostics would also have seen the changing consumer behaviour.

What stopped them from capitalizing on this?

The answers can be found in 3 broad categories

1. Existing systems and it’s complexities

Established diagnostic labs and hospitals had strong brand credibility, widespread presence, and robust relationships with doctors. However, many of them did not aggressively expand or modernize their at-home collection process. Their legacy systems were built for customer walk-ins and manual report tracking. In short, they remained less agile compared to a startup building a modern tech stack from scratch.

2. Reorganizing large-scale operations is a hell of a task

Giants like Dr. Lal PathLabs or Metropolis Labs have deep pockets, expansive lab infrastructures, and large geographic footprints. Theoretically, these factors should have made it easier for them to roll out an on-demand collection system.

But rolling out a hyperlocal dispatch system in major cities requires reorganizing large-scale operations. Adopting a more digital-first approach probably meant cannibalizing their own slower, but operationally simpler, channels. Many incumbents were less motivated to disrupt themselves.

3. Missing the mark on retail demand

~50% of the volumes to these chains were coming from doctor referrals. The rest from their b2b and hospital tie-ups. And labs are a volume business. So a more direct-to-patient approach (like offering 60-minute pickup windows) didn’t seem like a priority compared to their established B2B pipeline.

Okay, great!

So far, we’ve seen how Orange Health started and what advantages the large companies had, but they didn’t fully use them. Next, let’s dig a little bit into “How” Orange Health does what it does?

If you’ve learnt something so far, consider subscribing. 

Oranges are refreshing. So is Orange Health. What differentiates them?

As of October 2024, Orange Health Labs has served over one million patients across major Indian cities, including Bengaluru, Delhi-NCR, Mumbai, and Hyderabad. Let’s move to their positioning moat, pricing, and decode their right-to-win.

Orange Health’s Positioning: Winning the Speed Game

The home collection service existed before Orange entered the market. But no one positioned themselves around the speed of sample pickup and results. Orange staked this ground early and marketed it effectively and made it their central promise.

They positioned themselves around speed: speed of pickup, speed of results, speed of care.

By doing it consistently and credibly, they captured consumer mindshare before larger players could react. This gave them a clear early-mover advantage that still compounds today.

Price positioning of Orange Health

With money in the bank, Orange could’ve easier grown by uncercutting the market prices but they didn’t do it.

They positioned themselves in the mid-range—more affordable than premium hospital labs like Apollo, but slightly higher than mass-market players like Aarthi.

Their bet?

Consumers who cared about faster pickups, faster reports, and a smoother experience would gladly pay a small premium for it.

Here’s how they compare:

How Orange Health Engineers Growth

Health needs trust—and trust takes time, consistency, and control to build. Orange Heath rethought every part of the user journey to get this right. Let’s break it down into four categories: In-app experience, in-person experience, full stack ops model, and reverse logistics.

Owning an end-to-end experience

In-app experience

Orange Health has designed its app for retail customers. And, it shows. Here’s how their app quietly delights users in seven ways:

1. Smarter search

If you’ve ever tried booking tests elsewhere, you know the frustration.

Search for CBC on some platform (like Thyrocare) and you'll get zero results. Search for "Complete Blood Count," and only then you find it.  

Alias mapping seems to be broken in a lot of lab chains. And it’s not a small detail, for a sick, stressed customer, it’s instant disconnect or delight. (Side note: Tata 1mg is an exception to this, and their auto-suggest and auto-fill search features are excellent)

Orange Health got it right from the start.

2. Search results that informs, not just list

A search on Narayana Health shows the test list, but Orange Health takes it a notch up.

They show the test, list its aliases, highlight when the report will be ready, and show what components are measured. They also smartly upsell packages right within the search results, making it easy to upgrade if you're thinking preventively.

3. Product pages that educate

Tap into "View Details" and it’s clear: this isn’t designed for admins. It’s built for patients.

You’ll find a clean explanation of the test, which parameters will be tested, preparation instructions (fasting, precautions), and even how to interpret your future report.

4. Categories Designed for Real-Life Thinking

If you scroll through their app, you would see a good category management job by the Orange Health team. It’s built for how the growing health-conscious customers think. For example, let’s say you smoke and you feel a chest pain one day, and decide to get your heart checked. You could simply navigate by organ to heart and choose a relevant package. 

By the way, these bite-sized health packages also make preventive care feel approachable and pocket-friendly.

5. Comparison made easy

If you’ve ever done a health checkup, I can say for sure that you had spent time evaluating options that sounded like Health Comprehensive vs Health Total. Some clever-sounding names do not help you actually compare what matters.

Orange Health fixes this.

Their comparison flows feel closer to car websites. One click reveals what’s extra in top model vs top minus one, and in which category

6. Trust markers throughout the journey

From the moment you start placing an order to when the report arrives, Orange Health keeps you updated: 

Report ETA is shown upfront, and you get real-time tracking for your eMedic (phlebotomist). When you get the reports, it shows who signed off on it, which eMedic picked it up and where was it processed.

7. Easy deep dive into reports

Reports from labs have traditionally been a PDF handed over in person or a PDF available via a link. 

With Orange, it’s different. Owning a lab and the complete experience enables them to make your reports smart. You can slice and dice them the way you want them. You can filter abnormal results and review them separately. You can compare result trendlines over time and view highlights of improvement or deterioration across tests.

Owning the lab backend allowed them to unlock what most competitors can't.

Nailing the in-person experience

The diagnostic industry traditionally treated at-home eMedics like a Swiggy/Zomato delivery agent. 

Are they well-dressed? Are they polite? Does experience matter?  All secondary.

But Orange Health approached home visits like Urban Company. 

• eMedics show up in polished uniforms (almost pilot-like)

• Professional, respectful presence at the door

• Equipment carried in neat, structured kits. Not flimsy bags with torn side pockets

All in all, it feels as if someone has really given thought to leaving an impression on every visit.

Full-stack Ops model

At-home collection costs between ₹250-₹320 per order, depending on volume. Ballpark number,  ~30% of the revenue goes into collections + material.

That's why most players outsource: aggregators pick up from multiple hospitals and lab collection centers, drop off at processing labs, and optimize for cost.

But here, Orange Health has taken a strong stance.

They kept 100% in-house eMedics—a choice that likely pushes their cost per order closer to ₹320–₹350, but I think it’s a strategic decision to promise top-notch quality.

Plus, given that they are serving retail customers, there are other ways to recoup the cost. They can introduce dynamic pricing, offering higher discounts at non-peak hours or add pick-up charges in the peak time slots (6 am to 9 am).

Net net, full-stack operations aren’t cheap, but that’s how Orange Health offers a delightful experience

Orange Health Reverse Logistics

Reverse logistics refers to the supply chain between blood/urine sample collection from your home to reaching the processing lab. Orange Health works on a hub and spoke model, where samples are dropped off at a collection centre from where a mid-mile runs and delivers it to the lab.

Samples collected from, say, Whitefield, Bangalore, are pooled at a local center before moving to the main lab in Kormangala.

The hub-and-spoke model is not novel per se. Most lab chains work on the same model. However, the difference is in not using third-party vendors. Orange runs the complete reverse chain in-house, providing better visibility and control end-to-end.

Orange Health’s Current Scale and Way Ahead

Current scale

Today, Orange Health operates across four major metros—Bangalore, Delhi-NCR, Mumbai, and Hyderabad—covering the densest pockets of India's diagnostics demand.
They've served over 1 million patients and built a loyal base where 50%+ of monthly users are repeat customers.

Their model is heavy on operational control:

• 18+ collection centers

• 6 in-house labs

• Fully employed eMedic workforce—no gig-based outsourcing

• NPS score of 89, an outlier in an industry where customer love is rare

Expansion levers

Orange Health isn't playing the land-grab game like some of the earlier generation healthtech companies. Their playbook leans on three focused levers:

• Geographic Expansion:
  Expanding into more Tier-1 and large Tier-2 cities where customer density, digital behavior, and healthcare spending are already primed.
  

• Category Expansion:
  Moving beyond standard tests into higher-order categories like:

  • Advanced health panels (cardiac, cancer markers)

  • Preventive health subscriptions

  • Specialized diagnostics (e.g., genomics, women's health)
    

• Physical Accessibility:
  Building out more localized collection hubs and labs closer to residential clusters, making at-home collections faster, and clinic walk-ins frictionless.

The playbook is very similar to the 10-minute delivery grocery businesses. To summarize, the focus is not just to grow wider, but to grow deeper, where customer experience can still be controlled.

Future outlook

Orange Health doesn’t see itself as just a diagnostic lab company.
They’re setting up for a much broader play: becoming a continuous health measurement company.

Their long-term vision is clear:

• Help consumers measure, monitor, and manage their health seamlessly over time

• Move beyond episodic blood tests to continuous, passive, real-time insights

Blood testing remains the first major surface. But over time, Orange Health plans to integrate wearables and even future technologies like embedded biosensors that allow health monitoring without friction.

As Dhruv Gupta puts it:

Orange Health isn't just competing with labs, they’re trying to replace the very idea of a once-in-a-while checkup with always-on health awareness.

That’s all from me on Orange Health Deep Dive. I hope you enjoyed reading 🙂 

PS: Other random, interesting highlights of my last week

1. An ad I laughed a lot at: here

2. Something I deeply enjoyed watching this week: Very Maggie Smith, Detective Nugget

Until next time! 👋

Saurabh