The construction industry in India suffers from major time and cost overruns. Data from government and industry reports suggest that projects suffer from 20 to 25 percent time and cost overruns. Waste of resources has been identified as a major source of inefficiency. Despite a substantial increase in the past few years, demand for professionals and contractors still exceeds supply by a large margin. The traditional methods adopted in the Indian construction industry may not suffice the needs of this dynamic environment, as they have produced large inefficiencies. Innovative ways of procurement and project management can satisfy the needs aspired to as well as bring added value. The problems faced by the Indian construction industry are very similar to those faced by other developing countries. The objective of this paper is to discuss and analyze the economic concerns, inefficiencies and investigate a model that both explains the Indian construction industry structure and provides a framework to improve efficiencies. The Best Value (BV) model is examined as an approach to be adopted in lieu of the traditional approach. This could result in efficient construction projects by minimizing cost overruns and delays, which until now have been a rarity.