Purpose– The purpose of this paper is to develop an improvised sustainable health-care model by integrating best practices, innovations and new dimensions to the present public health-care system – National Rural Health Mission (NRHM) – for improving the health status of the bottom of pyramid (BoP) in India.Design/methodology/approach– The contribution of NRHM in ensuring the availability of health-care services and improving health indicators has been assessed. Some unique proven models of excellent health-care services and innovations have also been considered in designing an improvised health-care model. The empirical context takes the use of case study research methodology. The data have been extracted from various relevant papers, reports and websites.Findings– Despite substantial augmentation in health infrastructure and human resources, increased local engagement and technology integration, the progress in health indicators during the NRHM has not been fairly better than that before. The present paper provides an improvised model that integrates all the potential stakeholders such as Government, Private health-care services providers, pharmaceutical and insurance companies and BoP community itself to ensuring 5As rather than 4As (Prahalad, 2004) in rural health care.Research limitations/implications– This study has relied mainly upon the secondary sources of data and some published case studies. The model is a hypothetical framework designed exclusively for rural setups of India.Practical implications– The study shows the ways and invites all the stakeholders to come forward and build hybrid partnerships not only to develop society but also to develop sustainable BoP markets and earn profits.Originality/value– The paper brings forth the aspects of achievements and limitations of NRHM in improving BoP health status, and it develops an improvised model to achieve the BoP-health objectives.
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