TPG Plans RM30 Bn Malaysian IPO for Asia OneHealthcare Despite Deep Post-Acquisition Loss

US-based private equity giant TPG and the Hong Leong Group are preparing a blockbuster initial public offering for Asia OneHealthcare that could value the hospital operator at RM30 Bn ($7.4 Bn), testing investor appetite for premium healthcare assets despite an RM428.15 Mn FY25 loss following a massive acquisition spree.

The group, known as A1Health, plans to raise between RM7 and RM7.5 Bn ($1.7-1.9 Bn) in a Kuala Lumpur listing slated for the first quarter of 2027. Prospectus documentation is expected to surface as early as November 2026. TPG has already filed confidentially with the Securities Commission Malaysia to raise up to RM10 Bn, while running a dual-track process that leaves the door open for a direct trade sale to hospital operators or rival buyout firms.

That dual track gives TPG useful leverage. A strategic or financial buyer can put a value on control of a hospital network that would take years to assemble. Bursa investors, meanwhile, have just shown how aggressively they can price Malaysian healthcare growth.

The Capital Race for Malaysian Hospitals Gathers Pace

The aggressive valuation target arrives amid a fierce bull run for Malaysian healthcare. In March 2026, Sunway Healthcare Holdings raised RM2.86 Bn at a RM16.7 Bn valuation, with its shares surging 28% on trading debut. The company had 1,805 licensed beds and entered the market with a profitable earnings record: 2025 revenue rose 19% while net profit slipped 2% to RM252.2 Mn.

Last week, global investment firm KKR validated the sector’s private-market thesis, taking a minority stake in Avisena Healthcare. KKR backed expansion at its two Shah Alam hospitals and the development of new facilities in the Klang Valley. The firms did not disclose financial terms, although the bidding process reportedly valued Avisena at about RM1.5 Bn.

Private Hospital Deal Activity in Malaysia: 2023–2026 YTD

Year	Deal Volume	Disclosed Deal Value
2023	3	RM5.93 Bn
2024	2	RM3.92 Bn
2025	0 identified	–
2026 YTD	2	RM2.86 Bn

Note: Figures cover publicly announced M&A, minority investments and priced IPOs involving Malaysia-based private-hospital operators or Malaysian hospital assets. Undisclosed transactions are included in deal volume but excluded from deal value. Proposed, cancelled, property-only and capex transactions are excluded. The 2026  figure covers the period through to September 8.

The RM5.7 Bn Ramsay Sime Darby Health Care transaction included four hospitals in Malaysia and three in Indonesia, with no country-level value disclosed. Sunway Healthcare’s RM2.86 Bn represents its gross IPO offer size, including secondary shares.

Sources: Company announcements and filings; Bernama, Reuters and Entrepreneur APAC analysis

A1Health’s Acquisition-Led Transformation

A1Health presents public investors with a far more complicated financial puzzle than its peers. The company’s latest corporate filings show a striking divergence between explosive top-line growth and a deep bottom-line deficit. The deep loss warns potential investors, but it sits against a business model aggressively reshaped by large acquisitions, making it hard to separate underlying operations from consolidation effects without fuller accounts.

But that transformation began years ago.

To begin with, TPG and Hong Leong agreed in 2019 to buy 17 Columbia Asia hospitals and one clinic in Malaysia, Indonesia and Vietnam for about $1.2 Bn. Twelve of these hospitals were in Malaysia, and the Southeast Asian network had 1,494 beds.

Four years later, TPG-backed Columbia Asia Healthcare, now known as A1Health, acquired Ramsay Sime Darby Health Care for RM5.7 Bn. The deal brought four hospitals in Malaysia and three in Indonesia into the group, adding 1,530 licensed beds and giving the predominantly secondary-care platform a much larger tertiary-care footprint. The price paid for the shares was based on an overall business valuation of about RM6.05 Bn, putting the transaction at 20.1x FY23 EBITDA, well above the 16-times median traded EV/EBITDA multiple for selected Southeast Asian hospital peers cited by Sime Darby.

To help foot the bill, TPG-managed funds invested alongside co-investors through One Health Holdings. Malaysia’s Employees Provident Fund (EPF) and a subsidiary of the Abu Dhabi Investment Authority (ADIA) were the two largest providers of new capital outside TPG and Hong Leong. They were expected to hold a combined stake of about 25% in One Health Holdings after the transaction.

Compounding the structural shift, A1Health had acquired five separate super-speciality hospitals from TE Asia Healthcare, including ALTY Orthopaedic Hospital, Beacon Hospital, Cardiac Vascular Sentral Kuala Lumpur, Hospital Picaso and Northern Heart Hospital Penang by September 2024. The group said the enlarged platform now spanned secondary, tertiary, quaternary and super-speciality care.

The rapid consolidation campaign helped transform A1Health into a platform with 22 Malaysian hospitals, according to media reports, while shifting its care mix from predominantly secondary hospitals toward tertiary, quaternary and super-speciality care.

Revenue Doubled, but Company Was in the Red

That acquisition history is critical to reading A1Health’s FY25 figures.

Its revenue rose about 92% to RM3.55 Bn from RM1.85 Bn, but FY24 was a very different comparison base. The Ramsay acquisition closed in late December 2023, leaving only about three months of the acquired business in FY24. FY25 captured a full year of that business and also reflected the broader hospital portfolio A1Health had assembled by September 2024. The surge, therefore, largely reflects the mathematical result of adding entirely new, large-scale hospital networks to the balance sheet.

More important, the bottom line moved sharply in the other direction. A1Health swung to an after-tax loss of RM428.15 Mn in FY25 from a RM155.39 Mn profit a year earlier. It is not yet clear how much of the net loss stems from core hospital operations versus integration frictions, steep non-cash depreciation or the heavy interest expenses required to fund the M&A blitz.

The deterioration began before FY25. In FY23, A1Health earned RM238.85 Mn after tax on RM1.27 Bn of revenue. Profit then fell to RM155.39 Mn in FY24 even as revenue climbed to RM1.85 Bn, before the company moved into the red in FY25. In other words, revenue was expanding well before the bottom line collapsed, but profitability was already weakening.

The FY25 figures do not reflect A1Health’s latest completed financial year. While FY26 concluded in March 2026, the company did not disclose revenue, EBITDA or profit for the period. Under Malaysian corporate law, a private company must circulate its accounts within six months of its financial year-end and lodge them with the Companies Commission of Malaysia within 30 days of circulation. Consequently, the FY26 results may remain off the public record until after September, while the confidential nature of the IPO filing leaves no public visibility into recent performance.

The Exit Test

The absence of FY26 results creates a significant blind spot. A first-quarter 2027 IPO would typically be marketed on FY26 and forward operating earnings. Those figures are vital to determine whether the FY25 loss represents an acquisition-driven trough or structural pressure. Consequently, the prospectus expected in November must disclose FY26 revenue, EBITDA, operating profit, finance costs, net debt, operating cash flow and capital expenditure for the Malaysian unit being listed, alongside a clear bridge from operating earnings to net income.

Without those figures, there is no defensible way to derive A1Health’s forward EV/EBITDA multiple or conclude whether RM30 Bn is cheap or expensive against Sunway.

The acquisition history also makes assessing TPG’s historical returns from its original Columbia Asia investment far more complex. The $1.2 Bn transaction in 2019 cannot simply be compared with a RM30 Bn valuation today to calculate TPG’s return. The asset base and capital structure have changed substantially. The Ramsay acquisition alone represented a separate RM5.7 Bn transaction, while EPF, ADIA and other investors subsequently supplied fresh capital.

The RM30 Bn aspiration itself is not new. A valuation at that level had already been discussed when TPG began exploring exit options earlier this year. What has changed is the weight of market evidence surrounding it. A1Health has moved from considering options to a confidential regulatory filing and a reported Q1 2027 listing timetable.

That makes TPG’s dual-track process more than just insurance against a volatile IPO window. A strategic buyer can attach a premium to control and the scarcity of a scaled hospital network. Another private equity owner can underwrite the next expansion cycle. Public investors can measure A1Health against a Sunway benchmark already tested in the market.

But A1Health still has to supply the denominator.

The RM30 Bn question is no longer whether investors will pay a premium for Malaysian hospitals. They already have. It is whether A1Health can show that the massive scale TPG assembled is generating enough core operational earnings to justify the RM30 Bn valuation.