India — the world’s largest democracy, with well over 1 billion citizens — certainly has large annual healthcare costs to contend with.

But it doesn’t spend 17.9% of its gross domestic product (GDP) on healthcare, as the United States did in 2016, nor does it rank last among its peer nations in care value and patient outcomes, as America did in a 2017 Commonwealth Fund report.

“In India, poverty has driven a handful of private Indian hospitals to pursue breakthrough innovations in health care delivery that let them provide medical services on par with the best U.S. hospitals for a fraction of U.S. prices,” wrote Vijay Govindarajan, the Coxe Distinguished Professor at Dartmouth’s Tuck School of Business, and his co-author Ravi Ramamurti in their joint op-ed last month for Stat.

“What’s more,” the researchers noted, “they often give away care to those who can’t afford even their minimal prices. Remarkably, these organizations are also making enough money to attract investors from around the world.”

At Narayana Health, a Bangalore-based for-profit cardiac hospital system, they reported, a typical heart surgery runs approximately $2,100 — tens of thousands of dollars less than US patients would pay for a comparable procedure.

Moreover, they’re not skimping on quality. For example, Narayana Health’s 30-day mortality rate for coronary-bypass procedures stands at 1.4%, whereas the US’s is 1.9%.

How do they do it? Simple.

Resources in India — where much of the population is impoverished — are exceedingly scarce. That drives hospitals and provider organizations there to continually examine and early-adopt cost-saving innovations. US healthcare stakeholders, they assert, could learn much from them.

Read more of Govindarajan and Ramamurti’s analysis here, in Stat.