Welcome you to Aster DM Healthcare earnings conference call for the fourth quarter and full year of FY26. Today with us we have the senior management of Aster DM Healthcare, namely Ms.

Alisha Moopen, Deputy Managing Director, Mr. T.J.

Wilson, Non-Executive Director, Mr. Ramesh Kumar, Chief Operating Officer, Mr.

Sunil Kumar, Chief Financial Officer, and Mr. Hitesh Dhaddha, Chief Investor Relations and M&A Officer.

We are also delighted to have Mr. Varun Khanna, Group MD of Quality Care.

Mr. Khanna is here solely in the capacity of a representative of Quality Care to give insights into the business and future plans of Quality Care, the entity which is in the process to get merged with Aster DM Healthcare.

It is to be noted that merger is subject to further regulatory approvals. All external attendees will be in listen-only mode for the duration of the entire call.

We will start the call with the opening remarks by management followed by an interactive Q&A session. Certain forward-looking statements in this meeting involve risks and uncertainties.

Aster DM assumes no responsibility for actions based on these statements and undertakes no obligation to update them for further events. With this, I will now request Ms.

Alisha Moopen to start with the opening remarks. Over to you, Ms.

Alisha.

Thank you, Puneet. Good morning, everyone, and thank you for joining us despite being Labor Day.

As we move closer to completing the proposed merger with Quality Care, I would like to thank our shareholders for their continued confidence and support in approving the scheme. With this milestone behind us, the transaction now awaits final approval from the NCLT.

Even ahead of the formal completion, the combined pro forma performance provides a very useful view of the potential scale and the operating profile of the two organizations together. It highlights how the complementary footprints, aligned clinical philosophies, and the disciplined execution can translate into operating leverage and capital efficiency over time, providing visibility into the longer-term earnings potential of the combined platform over the coming years.

With that context, I will begin with the combined pro forma performance of Aster and Quality Care before moving on to Aster's results. Turning to the pro forma performance, the combined view indicates a very steady and broad-based trajectory supported by very strong patient volumes, improving case mix, efficient cost management, and a continued focus on clinical excellence.

What is particularly encouraging is how these factors, when viewed together, point to the potential for both scale and as well as improving the quality of earnings. Coming to the quarter's performance, on a combined pro forma basis, the revenues have grown 18% year-on-year to ₹2,361 crores for the quarter, supported by a 12% increase in total patient volumes and a 8% improvement in ARPOB IP.

More importantly, as the benefits of scale and mix begin to play out, operating EBITDA has outpaced the revenue growth, increasing by 25% to ₹517 crores. This operating leverage translated into margins of 21.9% and a ROCE improvement of 293 basis points to 21.1%, reinforcing the underlying strength of the model.

Now coming to the full year, this interplay between scale, mix, and profitability becomes even more evident when we look at the full-year performance. For FY26, the combined platform has delivered revenue of ₹9,273 crores, growing 14% year-on-year, with growth supported by a balanced increase both in patient volumes as well as ARPOB IP.

The improvement in ARPOB IP was underpinned by a 200 basis points in our CONGO mix expansion, which now stands at 55%, along with a very healthy payer mix of cash and insurance at 83%. As a result of this, our earnings continue to outpace our revenue, with operating EBITDA growing at 21% to ₹2,013 crores and margins expanded by 116 basis points now to 21.7%.

Importantly, this performance reflects sustained momentum rather than a one-year outcome. Over the past three years, the combined entity has delivered a revenue CAGR of 14.5% and an operating EBITDA CAGR of nearly 20%.

This has been achieved even as we have continued to add capacity and manage inherent business seasonality, reflecting a very well-aligned and consistently executed operating philosophy. Now coming to capacity expansion.

To support this momentum, our capacity expansion has remained very disciplined and closely aligned with long-term demand. Over the past year, we have added 373 beds, taking the combined capacity to 10,620-plus beds across 28 cities.

Our pipeline includes 4,445 additional beds, which will take our total capacity beyond 15,000 beds through a balanced mix of greenfield and brownfield expansion. This calibrated approach ensures that scale is built with precision, optimizing capital efficiency as well as supporting long-term shareholder returns, whilst strengthening our position as a leading pan-India healthcare platform.

Coming to the update on the merger. Against this backdrop, the progress on the merger with Quality Care marks a very, very important strategic milestone.

During the quarter, the merger received overwhelming approval from shareholders and creditors, with 96.7% of shareholder vote cast in favor, reflecting strong alignment and confidence in the strategic direction. From a regulatory standpoint, the transaction has progressed through all key stages, including the receipt of the CCI approval and no-objection letters from the NSE and BSE with no adverse observations.

The merger application was subsequently filed with the NCLT on December 11, 2025. With the shareholder and the creditor approvals also now in place, the matter is currently before the NCLT for the final approval.

The next hearing is expected in May, and upon receipt of the order, the merger will become effective. Based on current timelines, we expect the process to be completed within this quarter.

Overall, the combined pro forma performance, along with the progress on the merger, reinforces a consistent message that we're not only scaling the platform, but we're doing so in a way that enhances the mix, drives the operating leverage, and improves capital efficiency in a very sustainable manner. Now turning towards Aster's performance for the final quarter of the year.

Despite macro headwinds, we delivered strong double-digit growth across our core hospitals, clinics, and lab businesses, driven by robust patient volumes and a continued shift towards higher acuity care. The combination of volume growth and improving case mix remained the key driver of performance during the quarter.

Revenue from operations stood at ₹1,182 crores, reflecting an 18% year-on-year increase. This growth was supported by a 15% increase in total patient volume and 9% improvement in ARPOB IP and the contributions from the recently operationalized Kasaragod Hospital.

Importantly, the growth was not just volume-led, but also mix-driven, with a higher share of specialized tertiary care, particularly in DNB and robotic procedures, which saw a very meaningful increase during the quarter. This shift in case mix is also very evident at a specialty level.

If you look at cardiology revenues, those grew by 25% year-on-year, with contribution increasing to 15% in Q4 FY26 from 14% last year, while oncology revenues have grown 23%, contributing to 11% of the overall mix. Together, these segments continue to anchor the transition towards higher acuity, higher value care.

Alongside this, the medical value travel segment maintained strong momentum, growing 41% year-on-year on the back of increased international patient footfall. Within Kerala, MVT revenues grew 51%, with stronger inflows from Maldives, helping offset macro-related softness from the Middle East, demonstrating the resilience and diversification of the platform.

In our ancillary businesses, the labs continue to scale steadily, with revenues increasing 18% year-on-year. As this growth and mix improvement flows through, operating leverage is becoming increasingly more visible in our financials.

Operating EBITDA for the quarter stood at ₹244 crores, growing 26% year-on-year, with margins at 20.7%, despite the addition of the new capacity. Core hospitals and clinics delivered particularly strong performance, with operating EBITDA growing at 32% and margins at 23.1%, which reflects very steady execution across all our mature assets.

Normalized PAT grew by 32% year-on-year in Q4 FY26, with margins up by 120 basis points. While the Kasaragod facility remains in its initial ramp-up phase, the underlying performance of the core network continues to demonstrate very strong operating leverage.

Excluding Kasaragod, revenue and EBITDA grew 17% and 31% year-on-year respectively, with margins expanding by 239 basis points to 21.7%. Within core hospitals and clinics, excluding Kasaragod, operating EBITDA grew 36%, with margins improving to 24.3%, reflecting a 345 basis points expansion.

Coming to some of the non-core business performance, this has also been encouraging, with improvement also visible in all these ancillary businesses. The lab segment saw a sharp increase in profitability, with operating EBITDA growing 181% and margins expanding to 14.7% from 6.2% last year.

Coming to the cluster-wise performance highlights across clusters, the same operating philosophy continues to play out, with each region at a different stage of maturity. Kerala continues to anchor stability and profitability despite a temporary and modest impact from the nurses' strike.

Inpatient volumes grew 11% year-on-year, indicating sustained demand. Excluding Kasaragod, revenues grew nearly 18% year-on-year, while operating EBITDA margins remained strong at 25.6%, supported by cost efficiencies and operating leverage.

Kerala continues to serve as a core earnings and cash generation pillar, supporting investments across other regions. In the Karnataka and Maharashtra cluster, operating performance continued to improve, with revenue growing 11% year-on-year.

This was driven by a strong increase in ARPOB IP, supported by a strategic shift towards higher value procedures in cardiology and neurosciences and the de-empanelment of low-yielding schemes at Aster Aadhar. Operating EBITDA grew 25%, with margins expanding by 270 basis points, reflecting the combined impact of revenue growth, operating leverage, and disciplined cost management.

The Andhra and Telangana cluster delivered strong performance, with revenues growing 30% year-on-year, driven by both higher volumes and improved ARPOB IP. Operating EBITDA more than doubled during the quarter, with margins expanding significantly by 700 basis points to 18.3%, highlighting the sharp operating leverage in this cluster.

Moving to capex and expansion. Our growth strategy continues to balance near-term operating performance with long-term capacity creation, anchored in disciplined expansion and return-driven capital deployment.

Over the past year, we added 290 beds, taking Aster's total capacity to 5,449 beds as of 31st March 2026 and expanding our India network to 20 hospitals, including Kasaragod. This expansion has been both measured and demand-led, ensuring that capacity addition translates to sustainable growth.

As part of this roadmap, we launched 159 beds at Block D in Aster Whitefield in April 2026, a dedicated women and child care facility that strengthens our specialized capabilities in Bengaluru and addresses a growing demand segment. In the same month, we also operationalized 75 beds at Ramesh Ongole, further augmenting our presence in the region.

Looking ahead, we plan to add nearly 2,500 beds over the coming years through a balanced mix of greenfield and brownfield expansion, which will take our total capacity to over 8,150 beds. This includes planned brownfield expansion of 150 beds in MIMS Calicut as well as 130 beds in MIMS Kannur.

Importantly, our expansion pipeline remains phased and closely aligned with demand visibility, ensuring that growth is delivered with capital efficiency as well as supporting long-term returns. Beyond our operational performance, this quarter also brought along strong validation of our clinical and leadership excellence through several prestigious global and national recognition.

At an institutional level, our hospitals continued to be recognized across leading platforms. In the Newsweek World's Best Hospital Rankings 2026, our facilities secured prominent positions in India, with Aster CMI Hospital ranked number 12 and Aster Medcity ranked number 28.

This was further complimented by strong national recognition in the Times of India All India Rankings 2026, where Aster Medcity and Aster CMI were ranked two and fifth respectively, while Aster MIMS secured the ninth position. At the leadership level, during the year, Dr.

Azad Moopen received high recognition on global platforms, having been featured among the top five Forbes Middle East Sustainability Leaders 2025 and in the 100 NRI 2026 by Entrepreneur Middle East. This was further reinforced at the national level, where he was honored as a legend in the healthcare industry at the FICCI HEAL 2025.

To conclude, this quarter reflects the strength of a well-defined and consistently executed model, where scale is driving improvement in case mix, operating leverage, and ultimately capital efficiency. The combined pro forma performance reinforces the strategic merit of our merger with Quality Care, demonstrating that the benefits of scale and disciplined execution are already translating into stronger and more sustainable earnings.

As we move through this final stage of regulatory approval, our focus remains firmly on execution excellence, capital efficiency, and attracting high-quality medical talent as we continue to build clinically superior, scalable platform positioned to deliver sustainable long-term value for all stakeholders. I will now invite Mr.

Varun Khanna to take you through the performance highlights of QCIL. Thank you.

Thank you, Alisha. Good morning, and thank you for joining us today.

I'm actually pleased to report that this quarter is yet another testament to the power of disciplined strategic execution and operational focus across Quality Care India Limited. Our unwavering commitment to placing the patient at the center of every initiative and our relentless focus on clinical outcomes has once again translated into strong business performance.

This quarter, we're proud to report a double-digit volume growth across the company, with several of our key markets delivering even stronger results. This reflects a consistent pattern of doing things right in the right way.

Beyond volumes, our strategic priorities continue to gain meaningful traction. We are making deliberate and measurable progress on enhancing clinical complexity, positioning QCIL as the destination of choice for advanced and high acuity care.

Our work on CONGO T is progressing well, and we are seeing the early fruits of that focus reflected in our operational metrics. KIMSHEALTH strengthened its position in transplants, performing the first heart transplant in Q4 FY26.

CARE Banjara installed a cardiac laser, which was the first of its kind in the QCIL system. Our payer mix continues to be extremely key for us, and the team's disciplined execution here continues to yield results quarter-on-quarter.

This year, we witnessed the coming together of a team and the power of our people, people who are accountable, have the ability to motivate teams, and lead with purpose. The team at QCIL has come together in a cohesive way and a very meaningful one, and delivered industry-leading growth in FY26 while simultaneously working toward the merger that will create value for all of us.

As a team, we're excited for the journey ahead of us and are geared up towards a robust performance in the coming year as well. Let's get to the financial performance.

Q4 FY26 witnessed a strong growth, overall revenue growth by 18% year-on-year to ₹1,178 crores. EBITDA grew 23% year-on-year to ₹272 crores.

The EBITDA margin expanded 103 bps YoY to 23.1%. Revenue growth was driven by an increase in IP and OP volumes.

QCIL treated and discharged 10% more patients in Q4 FY26 over the same period last year, serving 62,500 inpatients. OP footfalls grew 9% to 8.8 lakh patients in that period.

ARPOB grew 7.4% to INR 135,000. Our efforts to strengthen clinical offerings and clinical teams has resulted in 97 bps increase in CONGO T revenue, which now forms 58% of the total revenue.

CONGO T revenue grew 20% in Q4 FY26 over Q4 FY25. Payer mix moved favorably to 79% from cash insurance, up 98 bps YoY.

EBITDA growth represents our concerted efforts in synergy realization across the network, including procurement centralization, continued focus on clinical talent recruitment and management, along with strong controls and turnaround in our focus units, where the EBITDA contribution has improved to 19% from 14% in Q4 FY25. Let's talk about the focus units first, and then I'll get to mature and emerging.

Focus units, which contribute to 29% of our revenue, delivered a major turnaround this year. Focus units recorded a double-digit revenue growth—actually more than double-digit, 21% revenue growth—all while improving efficiency to post a robust EBITDA growth of 66.6% YoY, resulting in 422 bps EBITDA margin expansion to 15.4%, a function of our continuous emphasis on patient-centricity and operating excellence in every aspect of our business.

Let's get to the mature units, which is the large part of our business. 59% of our revenue comes from mature units, and that delivered a 13.5% revenue growth YoY along with 20.7% EBITDA growth YoY.

The resulting EBITDA margin witnessed an expansion of 198 bps YoY to reach 33.2%, driven primarily through synergies and cost optimization efforts. Emerging units, which is the newer units that we have, they contribute 7% of our revenue.

They ramped up strongly: 62.4% YoY revenue growth and 44% quarter-on-trailing-quarter EBITDA growth. The margin actually moved to 17.9% for this category.

On a like-to-like quarter, the EBITDA stands at ₹15 crores, which was ₹70 lakhs in Q4 FY25. For the full-year financial performance, consolidating the strong quarter-on-quarter performance, QCIL registered 17% revenue growth year-on-year to ₹4,630 crores.

The FY26 revenue growth has been supported by improvement in volumes, focus on strengthening clinical programs and teams. IP volumes grew 7%, while OPD volumes grew 10% to 35 lakh footfalls in our hospitals for the year.

CONGO T revenue increased 23%. CONGO T mix improved 270 bps to 59% of the total revenue.

QCIL recorded an EBITDA of INR 1,066 crores, first time ever breaching the ₹1,000-crore mark, which represents a growth of 24.1% year-on-year. EBITDA margin for the year stood at 23%, which is 136 bps expansion over the previous year.

EBITDA growth was bolstered by activities to realize synergies across all our units, including procurement centralization, which contributed to ₹85-odd crores to the bottom line. The FY26 EBITDA has been supported by the best-in-class operating EBITDA break-even at Nagercoil, which became EBITDA-positive in 3 months of operations.

Nagercoil contributed ₹30 crores to the EBITDA and currently stacks up at 28.5% EBITDA margin for FY26. Continuing our clinical augmentation, we maintained focus on doctor-led engagement models, talent acquisition, and have onboarded 100-plus doctors, clinical teams, in FY26, which has aided the performance and volumes and specialized procedures.

In Q4 FY26, we reduced our ALOS by 2% to 3.9 days. KIMSHEALTH, making significant strides in transplants, KIMS performed its first cardiac transplant on a 10-year-old girl.

In this quarter, KIMSHEALTH has conducted two dual-organ transplants, a simultaneous kidney and pancreas transplant on a chronic diabetic as well as a combined liver and kidney transplant on a 4-year-old child. The team at CARE Hospitals performed a robotic procedure for a case of abdominal cocoon syndrome, an extremely rare cause for intestinal obstruction.

CARE Hospitals has strengthened its cardiac and vascular programs with the installation of its first cardiac laser at the Banjara Hills facility. CARE Banjara performed the group's first dual-chamber leadless pacemaker implantation.

CARE Hospitals Bhubaneswar operated on a 4-year-old with subaortic VSD. The child was successfully discharged within 4 days of the procedure.

Among CONGO T specialties, orthopedic, neurology, and gastro had an accelerated ramp-up this year, with each growing minimum 25% for the year. The focus on high acuity care is visible across our specialties.

Robotic procedures more than doubled in FY26 and moved to 1,300 procedures for the year, which is a 152% growth. Initiatives to accelerate growth for the next year and beyond: expansion continues to remain a key strategic focus for our leadership.

We are committed to growing our footprint both within our home markets and in new markets through greenfield builds, brownfield additions, and M&A. We have upgraded our near-term to mid-term expansion plans and intend to invest ₹2,000 crores to add 1,700 beds in the next 3 to 4 years.

Staying true to the mission that we have to improve accessibility to healthcare, we plan to add 1,300 of these 1,700 beds in non-metro markets. Of the total, 1,500 beds are planned to be added through brownfield expansions, while the balance 200 will come from greenfield.

We got a few awards, which I'd like to mention. CARE Hospitals crossed a million subscribers on YouTube, which is making us the second hospital in India to have done so.

QCIL received the Green Health Award at the International Patient Safety Conference 2026. CARE and KIMS both received multiple awards and recognitions in clinical care, patient safety, and nursing excellence.

We thank you for your participation this morning.

Thank you, Varun. Now, I would request Mr.

Ramesh to take through the detailed cluster-wise performance of Aster DM.

Thank you, Mr. Varun, and good morning, everyone.

I'll begin with the cluster performance for the quarter and a full year, followed by a few operational updates. To begin with Kerala, the clusters delivered a resilient performance this quarter, sustaining its contribution to the growth.

In quarter four FY26, the cluster reported a revenue of ₹604 crores, reflecting a healthy 21% year-on-year growth despite the nurse strike during the quarter, the impact of which was limited. Excluding Kasaragod, the revenue grew by 18% year-on-year to ₹587 crores, demonstrating the consistent strength of the core hospitals.

The current quarter highlights a stable demand environment and marked an improvement in the quality of revenue. Growth was significantly bolstered by around 51% year-on-year surge in medical value tourism.

While the macro headwinds led to the decline in the MVT from the UAE, this loss was efficiently neutralized by the business from Maldives and African markets, where renewed focus and a stronger local partnership have kept the patient flow steady. Furthermore, performance was supported by consistent traction in oncology, a growing contribution from the Kasaragod facility, and an 11% increase in inpatient volume.

A more complex case mix further drove a 5% increase in ARPOB IP, rounding out a strong quarter four FY26. On the profitability side, in quarter four FY26, operating EBITDA grew by 27% year-on-year, while excluding Kasaragod, EBITDA increased by 35% year-on-year, with margins expanding by 330 basis points to 25.6%.

This is driven by a combination of operating leverage across mature assets, continued focus on reducing average length of stay, and disciplined management of manpower and overhead cost. With 3,000 beds and an expansion in pipeline for over 800 beds, including the recent brownfield addition, 130 beds in MIMS Kannur and 150 beds in MIMS Calicut, Kerala is well-poised to sustain the growth momentum.

Karnataka, Maharashtra cluster reached ₹394 crores in quarter four FY26, representing an 11% year-on-year growth, fueled by the robust realization. This performance was underpinned by a 21% increase in ARPOB IP, driven by a higher volume of complex procedures in cardiology and neurosciences and the de-empanelment of a low-yielding government schemes at Aster Aadhar continued.

The cluster operationally efficiency and clinical expertise were further evident by the continued attraction in the MVT segment, alongside a significant growth in advanced interventions. By focusing on the targeted hiring for the key doctor position, the Karnataka sub-segment successfully improved its operating metrics and achieved a 3% year-on-year growth in inpatient volume for the quarter.

The shift towards a high clinical complexity and talent acquisition resulted in a 25% increase year-on-year in our operational EBITDA at the cluster level. Consequently, margins were also expanded by over 260 basis points to reach 24.5%, positioning the cluster for more consistent and sustainable growth moving forward.

AP and Telangana cluster also reported a strong growth quarter four FY26, with the revenue increasing by 30% year-on-year, driven by higher inpatient volume and a 13% increase in ARPOB IP, supported by a 200 basis point improvement in CONGO mix. Operating EBITDA registered a sharp 113% year-on-year growth in quarter four FY26, with margins improving in 18 to 18.3% in quarter four FY26 with over 700 bps expansion.

Within the cluster, Aster Ramesh Hospital Group had a strong revenue growth at 32% year-on-year in quarter four FY26, with a robust 118% year-on-year EBITDA growth in A&T cluster. Further to this, we have operationalized 75 beds in Ramesh Ongole as per our planned expansion strategy.

Overall, the quarter reflects a steady progress across Kerala and Karnataka cluster and a sharp turnaround in A&T. We are seeing a benefits of the focused efforts on a case mix, capacity utilization, cost discipline, translating into improved operating performance.

With strengthened clinical team and a clear expansion roadmap, we are well-positioned to sustain the growth trajectory and deliver consistent performance going ahead. Thank you, and now hand it over to Sunil for the detailed review of the financial performance.

Thank you, Ramesh. Good morning, everyone.

I am pleased to share the Aster DM Healthcare financial performance for quarter four FY26 for the quarter ended 31st March 2026, excluding our newly launched Kasaragod Hospital for the past 6 months. Despite the global headwinds, the Aster India's revenue increased to ₹1,166 crores, reflecting a strong growth of 17% from quarter four FY25.

Operating EBITDA increased to ₹253 crores with a margin of 21.7% compared to ₹193 crores in quarter four FY25, registering a growth of 31%. Normalized PAT post-NCI for the quarter stood at ₹153 crores compared to ₹106 crores in quarter four FY25, reflecting a growth of 45% year-on-year.

For the year ended 31st March 2026, again excluding the newly launched Kasaragod Hospital, India revenues increased to ₹4,647 crores, up by 12% from ₹4,138 crores in FY25. Operating EBITDA increased to ₹969 crores with a margin of 21% for the full year as compared to FY25, registering a growth of 20%.

Normalized PAT post-NCI for FY26 stood at ₹451 crores compared to ₹357 crores in FY25, reflecting a growth of 26% year-on-year. Moving to segmental performance, our hospital segment continued to deliver consistent and strong performance during the year.

Revenues grew by a healthy 17% and operating EBITDA grew by 31%, leading to 240 basis points improvement in the margins. Importantly, the performance was consistent across hospitals at different stages of maturity.

Our mature hospitals, which are above 7 years old, contributing almost 80% of the total hospital and clinics revenue, delivered 16% revenue growth and 26% operating EBITDA margin, operating at a robust ROCE of 36.5%. Hospital in the 3 to 7-year maturity bucket recorded 23% revenue growth and strong 21% EBITDA, with ROCE improving by 470 bps to 23.8%.

Our new assets, which are less than 3-year-old, saw revenue growth of 15%. Turning to our diagnostic business, I'm pleased to share that Aster Labs has successfully delivered turnaround since the start of the year FY25.

Operating EBITDA margins have expanded from a -7.6% in FY24 to a +7.6% in FY25 and further to 12.8% EBITDA margin in FY26, driven by a robust 32% year-on-year growth in external business, enhanced operating leverage, and improved material cost efficiencies. This turnaround has translated into healthy ROCE of 27%, a remarkable recovery from negative levels 2 years ago.

For the year ended 31st March 2026, our capital expenditure stood at ₹549 crores, with approximately 45% allocated towards expansion projects. We continue to maintain a robust liquidity position, with cash and cash equivalents at ₹1,327 crores, while our gross debt remains at a moderate ₹701 crores.

Additionally, we have a significant improvement in ROCE, increasing by 180 basis points from 19.5 to 22.8%, excluding Kasaragod. We have operationalized Whitefield Block D with 159 beds and Aster Ramesh Sanghamitra, Ongole, a brownfield expansion with 75 beds in April 2026.

Over the next 3 to 4 years, we plan to add approximately 2,500 beds at the cost of ₹2,700 crore. Of this, ₹350 crore has been invested up to March 2026, with the remaining amount to be deployed over the next 3 to 4 years, supporting our next phase of growth while remaining our focus on disciplined capital allocation and sustainable profitability.

With this, we have laid our foundation for future growth. As we move forward, we are confident on building on this momentum with the same discipline and focus.

On that note, I conclude my remarks and I hand it over to Puneet to begin the Q&A session. Thank you.

Thanks, Sunil. Dear participants, during the Q&A session, you will get a chance to ask a question by raising your hand through the raise hand icon in Zoom application.

We will call out your name, after which your line will be unmuted and you will be able to ask your question. I would also like to request to all the participants if you can introduce yourself with your name and company that you are associated with before asking the question.

If you're not associated with any company and you are an individual investor, you can highlight that as well. Moving on to the Q&A session, the first question is from Mr.

Tausif.

Good morning. Am I audible?

Yes, you are audible, Tausif.

This is Tausif from BNP Paribas. First question is to Varun.

Varun, can you tell us where does the industry currently stands with the common insurance empanelment with private insurers and which gives uniform pricing with private insurers? Any of the hospital, Aster QCIL has been onboarded in this policy?

Do you see this is a threat for the private hospital chains in coming years?

Morning, Tausif. Tausif, first of all, I think the empanelment piece has been in play for a while.

It's not new. Two, from a data standpoint, I'm sure that, at least in QCIL, we haven't signed up on this, and I'm assuming Aster hasn't as well.

I have also not seen large-scale hospitals get onto this platform. I think fundamentally, while a lot of conversations have happened, there are two things that are bothering the industry around it.

One is data privacy. Still, I don't think the insurance companies have really figured out a way to ensure data privacy across so many hospitals.

The other is transparency as to how this is being done. Right?

Till that gets sorted, I think this is still a framework that's being worked upon is the way I see it.

Varun, do you see this is a threat for private hospital if it's completely adopted by the industry?

It cannot be done unilaterally, Tausif. It can only be done if private hospitals want to accept.

There are two ways to see this. It can actually save you a lot of costs on empanelment, etc., etc., if it is done right.

There are benefits and merits to doing it as well. The current avatar is somebody going to get onto the bandwagon, my sense is no.

It's not coercive. If that's the question.

Thanks, Varun. That's helpful.

Second question to Ramesh on the Kerala piece. I think despite the month of Ramadan, the MVT business has grown significantly, especially in Kerala.

Ramesh, can you give some color? Also, what's the current status of MVT patients?

Has they started flowing in last couple of weeks?

Thank you, Tausif, for that question. Kerala story has done well again.

You can see that overall performance has been really good and especially MVT has done 41% year-on-year growth has been registered. We have seen a traction from across, yeah, Middle East as well as Maldives and, of course, African countries.

There is a flow of patients coming in from all these areas. Now for the last few days, yes, Middle East, we have found that especially from Oman and UAE, a few less number of patients are flowing in, but we have tried to keep that both steady by more number of Maldive patients, started focusing on African countries, and there is a steady flow which has been happening.

We are trying to mitigate the losses through the expanded coverage what we have now. We are trying to ensure that the impact is not much felt and still continue to perform well.

Maldives have been contributing more now.

Thanks, Ramesh. Just last piece of question on Kerala.

Where do we stand currently on the nurses' issue? Has there been negotiation between the private hospital and the nurses?

Can you highlight what is the total number of nurses in Kerala for Aster DM Healthcare and how many of them are currently working with a minimum wage of ₹20,000? Okay.

When we talk about minimum wages and the strike which is happened in Kerala, this started sometime in the mid of March. Every 5 years, the government of Kerala issues a gazette.

Government notification for the basic pay is been issued by the government. Here at this point of time, we have around 4,300 nurses approximately in Kerala, and all these nurses are paid the basic pay according to the government notification.

The new notification is yet to come. They first started the strike asking the government to release the GO.

At that point of time, Kerala government had released interim GO, which would take 60 days for them to go back and rectify the same. The nurses, of course, the UNA didn't want to wait for that time, and they've continued with the strike, demanding the private hospitals to take it up to ₹40,000 per nurse.

As such, the private hospital association and, of course, we also were part of it, and we requested them on April 13th, we had a negotiation with them as well. The government has asked or the court had redirected us to especially the private hospital to mediate and get the things done.

We have spoken to them, and on April 13th, we had come to a settlement with them. The strike is called off.

Can I just ask Mr. Wilson also to add to on this?

Yeah. Thanks, Tausif.

That's a good question, actually. Even though they were asking for a basic salary of ₹40,000, actually, we were able to conclude by giving a small increase only.

The overall impact may not be significant, actually. We used to give an annual increment every April.

This time, we have to give something more than that one, actually. Overall total impact in Kerala will be ₹5 to ₹6 crores.

That is what we have given. Our total increment what we have offered is actually at Calicut, we have given ₹3,500 per nurse and which is in Kochi, that became ₹4,000, and the remaining places at ₹3,250.

That increment we have given. They were asking for a significant amount like Ramesh said, ₹40,000 as the basic salary.

We were able to negotiate and conclude that one in a very nice manner. All the nurses are back.

That's helpful. I have more questions.

I'll get back in the queue.

Thank you.

Thanks, Tausif. The next question is coming from Damayanti.

Damayanti, can you please unmute yourself and ask the question?

Hi, good morning all, and thank you for the opportunity. My first question is on your ARPOB and IP volume trends, very strong across the clusters.

Just want to understand from the management, first, what are the key initiative which is currently underway and which should help Aster to continue similar momentum in coming quarters? What kind of headroom you have in terms of growing the CONGO T contribution for your business?

That's my first question.

Sunil, you want to comment?

Yeah. Thanks, Damayanti.

I think for the Aster, for the quarter four is, as you called out, we had a very good IP volume, almost 7%. Also this includes a -8% growth in the K&M cluster also.

I just want to call out in advance that 8% negative growth is because of the de-empanelment of the low-yield schemes, which even Alisha called out. If you remove that, you're going to get into the positive 3% growth.

That way, I think all our clusters, whether it's a Kerala cluster, K&M cluster, or A&T cluster, everyone has done really well. In terms of the growth capacity, there are multiple things which we're working on.

One is that we're strengthening all our processes, whether it's doctor engagement programs or whether it's the OP to IP conversion process, or say, the call center management. We're looking into all those things and we're driving it.

The primary thing will be the doctor acquisition. Doctor acquisition is something which we are very, very strong, and we also called out saying that in the last 6 months, we have added more than I'm talking about the other than the replacements, only the new doctors, mostly around 36-plus doctors we have added in the last 6 months alone.

That is something which we are expecting the ramp-up to happen. I think with the continued growth what we are looking at, whatever we have done currently with the 7%, that's a fantastic growth to continue to happen over the next medium term.

Sure. So— Yeah.

Sorry, Damayanti. Just to add to what Sunil saying, I think you're asking about the CONGO mix, right?

This is where we think there's a huge room for us to kind of improve. We're sitting at, I think, at a blended level now 55% CONGO contribution.

We think we can definitely take it up to 60% and then 65% as well. You see a lot of the groups in that direction.

That's something which will actually give us a good headroom to sort of further improve the numbers, especially on the acuity and ARPOB and stuff.

Sure. That's, yeah, that's helpful.

Thank you for that. Continuing the point on doctor engagement, again, I think I want to have some more color on what is helping you to get doctors, because what we understand, in markets like Bangalore, the competition is really intense.

What are the key strategy again which is helping you to attract the best clinical talent, and also the strategies for retaining the talent which you have in your network?

Ramesh, would you like to chime in?

Surely. Overall, I think last few months, we have added good number of clinicians, some of the star clinicians were onboarded, and why they were convinced to join Aster is simple reason: one, we had a bigger vision for Aster, and especially when it comes to, as you rightly mentioned about Bangalore market, it is very competitive, and thanks to we are having not only three units now, and we are adding another two more units in Bangalore.

It's quite visible for them that what is vision of Aster. That is one one attraction to all the clinicians who have joined.

Secondly, we are also looking at high-end procedures and niche segments. High-end work has been happening like the robotic transplants.

There is a good amount of faith in Aster and Aster's work which has been happening. That has also been attracting most of the clinicians, and they find that especially when it comes to CONGO mix, we are in certain areas we are truly leaders, especially in neurosciences.

Oncology, we are getting there. Some of the CONGO mix also I think we have good clinicians on board.

That is also attracting other clinicians to join us and expand the each department and also attract more patients. That's where I think ring-fencing these clinicians, of course, we have our vision for each and every specialty very clear and the clinical excellence pathway what we have been engaging them, be it technology, be it investment in whatever and also the branding and taking it to the next level.

I think that is where the clinicians are quite happy about and they are pretty much with Aster.

Sure. Just, I think, want to hear Mr.

Khanna's thought also on the clinical talent engagement. Again, anything or similar strategy for QCIL as well, which is working for you?

Thank you, Damayanti. Essentially, I'll go back to why a clinician would join more than what we're succeeding with, because it's a lot to do with four, five elements that a clinician looks at.

I think the first and foremost is relationships, and our relationships in the market, the transparency that we operate with is probably top-tier. The second part is we are developing a model.

In fact, in one of the previous quarterly results, I'd spoken about developing CliniQ because our focus on clinical independence and outcome is so significant that that is also yielding a lot of gains from a volume standpoint, and that is what the clinician wants. The clinician really wants that you should allow them clinical independence, you should be focused on outcomes, you should be able to draw referral volume into the center because of the good work that you're doing.

That, coupled with the technology investments that we're making, is another big reason why clinicians really want to move. I think the last part is largely commercial, and we are top-tier in that, too.

I think that is the holistic mix. Now it depends from one to the other as to which one plays out more than the other.

I think our ability to connect, to forge alliances, relationships, partner is better than anybody else today in the market.

That's helpful. Thank you, team.

I'll get back in the queue.

Thanks, Damayanti. The next question is coming from Mr.

Kunal. Kunal, can you please unmute yourself and ask the question?

Hi. Good morning.

My first question is on Quality Care. I see that the mature units have grown 14%, as have the focused units.

Just wondering what the growth drivers can be going forward, because most of things seem to be very well-optimized, like payer mix or ALOS. Would it be that case mix, or will it be the expansion going forward?

Just want to get your thoughts, sir.

Thank you, Kunal. Kunal, the growth drivers for each one of those categories is slightly different.

Let me try and give you some color on that. The good part is our mature has continued to grow.

The mature hospitals are currently growing 13.5%, 14% on the top and 20-plus percent on the bottom line. They are in excess of 30% EBITDA profile as well.

What's working for us there is still enhancing complexity. Alisha spoke about it, and Ramesh just reiterated the same thing.

We are currently at about 59% CONGO T mix, and my sense is we will continue to grow that, because I told you that we are under-leveraged on oncology, and that is one piece that we've still not got our investments flowing. In fact, this year onwards, onto the next 2 years, you'll see a significant growth in oncology volume in our network, so that'll play out from a mature hospital standpoint.

If you look at our emerging and let's say the focus assets, we're still sub-20% EBITDA in there. We've done extremely well, but the runway is still a long way for us to grow, and there are two things are playing out.

One, wherever we have under-occupancy, I think we're bringing in the clinical talent that is required to fill up the gaps that we have. It's called the Golden Few in our parlance.

If we've missed out something in one of those hospitals, we try and bring that talent. What is interesting is that our brands have a long legacy, and some of the work that you're doing in Hyderabad essentially in CARE is bringing doctors who left us back, because we've always stood for ethics, we've always stood for integrity.

The consumer value perception is phenomenal around the brand, and with the investments that we're making, some of these assets are doing extremely well. In fact, the Hyderabad, a sticky market, you've always known that.

In fact, 2 years back, when I came in, most of the people would ask me about what will happen to Hyderabad. Hyderabad has started to grow so significantly.

We're now seeing huge growth on the top in terms of volume, and EBITDA has grown 66-odd percent. I think different levers for each one of those categories, and currently all seem to be firing.

Right, sir. I assume you meant it's across your units, right, the emerging, the new ones, and even the focused units, right, mature units?

Yes. If you see the growth percentages, it's across all units.

Our focus units have grown top 25-odd percent, our mature have grown 14-odd percent, our emerging have grown 60-odd percent. The playout is across the network.

Sure, sure. Sir, second point is on the synergies between the two companies.

I was given to understand that a lot of these synergies will start flowing in once the merger consummates between the company, but I think in your presentation, you mentioned almost 200 bps, I think ₹85 crores of synergies that you're seeing in CARE. Are we seeing something similar in Aster also?

If that is the case, then going forward, once the merger completes, would there be even more synergies more than what you have booked so far?

Kunal, first of all, the synergies that I've alluded to are pre-Aster QCIL merger. Right.

You've got to understand that within QCIL also, we are in a way merging three companies. We acquired CARE, Evercare in Bangladesh, and KIMS in Trivandrum and Tamil Nadu.

That's the synergy that I'm referring to. Bringing the three entities together has also given us synergies on account of procurement, on account of insourcing of food, a lot in terms of AMC, etc.

That is the ₹80 crores that I alluded to, ₹80, ₹85 crores that I alluded to. We're still not started the work on Aster QCIL synergies really, and they will start to flow in post-merger.

Great, sir. Just one more, if I can, on Aster.

Sir, on the greenfield expansion, you have around 2,500 capacity beds in the next couple of years. Just wondering how will the cost profile move going forward and the margin impact, if any, that we should expect only in Aster's business the next couple of years?

Yeah.

Kunal, if you look at the last year, right, you saw only Kasaragod commencing the operations sometime in October. If you looked at the margin profile, the impact is hardly 60 bps, right, because we closed at 20.4, including Kasaragod.

If you remove the Kasaragod, which is approximately, I think, we have EBITDA losses somewhere negative of around ₹18, ₹19 to ₹20 crores, from 21%. It's only 60 bps which is impact.

Again, it's our own cluster, we expect to bounce back very quickly and break even in a quarter or two. Next, in the FY27, you look at, we have got already two brownfield expansion which is started, right?

One is our Aster Whitefield Block D, which already commenced operations in April, and also the other unit is in Ongole, which is another 75 beds on the existing hospital, we commenced that also in April. That means we got almost 200-plus beds of brownfield expansion, which is usually, you can see that it's EBITDA-accretive.

Just to give an example, a year back in Kannur, we were running at 300 beds. We added 100 beds, the margin expanded by 400 bps.

We went from 18.5 to 22.5, right? Keeping that, good thing is that in this year, already you're starting with the brownfield expansion, which is EBITDA-accretive.

Secondly, only this year we are expecting only our Trivandrum to commence sometime in October. That's only the H2 beginning.

Already in Trivandrum, it's part of the Kerala cluster. Second, QCIL entity KIMS already is present there.

It's very under-penetrated, we expect to do really, really well. Even whatever the losses comes in, it's hardly any dilution.

Even with that losses, I expect from the current year EBITDA margin should only grow. The third point which is also to be very important to be noted is that with the merger very much I would say hindsight, sometime in the quarter one, you should see that majority of the period will be under the merged entity.

Right? Already I think Varun called out, the synergy is going to start after the merged entity, right?

That's something which you're already working on, and I think we will hit the ground from the day one, and that should also bring and help us in ensuring stability in the margins and also grow in the margins also. That way, with all these levers being there, from the cluster presence to the brownfield expansion already there, and also towards the synergy coming in, we don't expect any margin dilution.

It's year-on-year, we'll grow in the margins.

Good to hear that, sir, and all the best.

Thank you.

Thanks, Kunal. We would request you to limit your question to two, but not more than three per participant at a time.

With this, the next question is coming from Mr. Siddharth.

Siddharth, can you please unmute yourself and ask the question?

Hi. Thank you for the opportunity.

Congrats on a good set of numbers, fairly strong set of numbers. Just wanted to understand, I have a few questions.

I'll take my top three. What was the primary challenge in the slow growth even in Karnataka IP volumes, which were at 3% versus 8, 9% in the overall group, right?

Within that, if you could give us some understanding, you mentioned that there was a de-growth because of Aster Aadhar. Was that a negative margin scheme that you took away?

How should one think of recouping that set of patients? That was question number one.

Question number two is on, if you could give a sense of what's the share of chemo and dialysis within onco and nephro, which I would assume is more daycare and therefore brings down the ALOS? That was one.

That was question two. Question three was if you could share any specific AI or robotics implementation that you're doing within Aster or QCIL?

Let me jump in, Siddharth, with the first two questions. One is on the Karnataka.

You're asking saying that if IP volume for other things is at least in the high single-digit to a double-digit, why Karnataka, Maharashtra cluster is at 3%? Yes, as I called out very clearly, one what we exited is a low-yield schemes.

I think we have to very clearly called out, it's a government scheme. It's a low-yield scheme.

The ARPOBs compared to a cash market, it's less than 50%. That's how it's been.

Good thing is that we exited that, and also one of the reasons we exited also is that there is a capacity bottleneck in Aster Aadhar. It's already running at 75% occupancy.

We will be looking at how to expand in Kolhapur also. At the same time, we want to see that whatever the capacity we have, we optimize for the cash and TPA patients.

Second, in the K&M, yes, we have a positive 3% growth. There are two parts, right?

One is that competition intensity is very, very high, right? Maybe before that, let me take a step back.

If you look at FY24 and '25, in K&M cluster, we've been growing more than 20%, right? That's mainly because of our Aster Whitefield Hospital, which started 2 years back, and the ramp-up was really, really good, right?

We achieved ₹44 crores per month in less than 2 years. That is a ramp-up, if you want to compare, CMI took more than 6 years to achieve that, right?

That's a very, very fast ramp-up, and we can't expect the same revenue ramp-up at 20-plus percent when a unit has already reached a mature phase now. Keeping that in mind, also one of the reasons why the revenue growth has tapered on to around 10 to 11% and volume has been around 3% growth.

At the same time, we also had competition intensity, especially in north of Bangalore. We had attrition of one or two teams also.

Good thing, I also called out saying that we got them back already. Second most important thing, I think we didn't call out, one of the general surgery or other team which left in quarter three to the competition joined back in quarter four, right?

That basically shows the strength of our clinical ecosystem and the management, what we do there. That's a very, very strong.

We don't expect this to be the norm, we expect to go to mid to high single digit. Good thing is that all the doctors what we have got in now already they're in the stability, we expect the volumes to trickle down in next one to two quarters.

Second also is that you see that April, already we launched the brownfield hospital also, which is the Whitefield Block D, which is Women Children Hospital. Also we have doubled the number of doctors there.

We had around 10 or 11 doctors in women, children. We have added another 11 doctors there, so that is something which ramp-up is expected to be really good.

Whatever you see the 3%, it's just a one-off thing. It's not a structural issue.

We should bounce back very easily. Second on the onco, usually the broad contribution is that med onco is approximately 50 to 60%, 30, 35% is come from surgical oncology of the global oncology, and 10 to 15% from radiation.

Out of the medical oncology, you can see 60% will be chemo, and 40% usually is in the immunotherapy and targeted therapies, what we do. I hope that answers the question.

Alisha or someone you want to take up the AI?

Let me take the AI question. Sid, thanks for the question.

This is more of an academic question than currently in terms of what's happening on the ground. Essentially, AI will in the near term to midterm impact patient safety, the operating world, financials, and clinical.

As a company, we've already started working on all four tiers. If you ask us what are the early successes, we've been able to bring in CDSS, which is AI-enabled.

We've been able to bring in call center support, which is AI-enabled. We're looking at solutions that can actually save time for the doctors when the patient comes into the OPD by pre-populating some of the EMR work through AI.

We're looking at significant clinical augmentation happening through AI. There are two parts to that: one is looking at radiology, getting more efficient.

We are, as I told you last time, we are setting up Asia's first radiotherapy platform, which will be AI-enabled. This is the first EOB platform that Elekta has sold in India as well as in Asia, which is AI-enabled.

A lot's happening on all four of these sides. We are also mindful that some of the newer technologies and AI currently are a huge cost, and their use cases from a revenue generation standpoint haven't seen the light of day.

I think we are being very particular in terms of because technology is galore, but in terms of what we can really use to enhance our metrics is something that we're mindful of. On the sales front, we've seen significant improvement with our CRMs now getting AI-enabled, our call centers getting AI-enabled, and our conversion ratios have gone significantly better.

All of that is playing out, and that's how the volumes have gone to 10% kind of a growth as you see on the IP and double-digit growth on the OP as well. I don't know if there's a specific question that you wanted to ask, but it's a broad-based question that you touched upon, I'm probably giving a little bit of a broad answer.

No, I think this does give, Varun, I think this is fairly helpful in terms of what you're planning. I concur with you that AI is probably fairly early stage and theoretical today.

Given that there is a merger, you're going to be leading the entity, it does help to get a color from you, thank you so much for that. Just a follow-up on what Sunil mentioned on some of the challenges in Karnataka.

I get the capacity bottleneck in Kolhapur, but for the rest of the hospitals, you also called out some other sort of capacity utilization. Is there a bottleneck elsewhere?

Because that seems to be more like mid-50s occupancy, there does seem to be capacity, right?

Yes, Siddharth. In K&M, we have capacity.

For example, Aster CMI is at 60% of the occupancy. RV is at 69.

Our Whitefield, we added 150 beds, right? If you include that, it has got still only 55% of the occupancy.

I think we've got a great runway in Karnataka cluster to add beds. Also you know that we're also coming with Sarjapur in next one more year, and we have Yeshwanthpur in three more years.

I think we've got a very good runway towards it.

Thank you.

Thanks, Siddharth. The next question is coming from Mr.

Amey. Amey, can you please unmute yourself and ask the question?

Am I audible, Puneet?

Amey, you're audible.

Thank you for giving opportunity to ask a question, and congrats to the management on good set of numbers. First question I have for Varun ji.

We were intend to spend close to ₹500 crore in Hyderabad cluster to get that cluster to its potential. Has that investment over, and where it has been spent?

Also along with this, if you can give us the capex guidance for the QCIL for next 2 years? Thank you.

Amey, thanks. I don't know about the ₹500 crore number essentially, but the work that we're doing in Hyderabad is turning every asset around.

We've completed Banjara. Let me stick to Banjara for a minute.

We are also now working this year to enhance oncology services in Banjara, we'll be able to bring in radiation in Banjara, which is going to be a significant bump-up. We operate an OPD building there, and that OPD building will also be an IPD building going forward, those are the plans that we've laid out for Banjara.

Therefore, a significant transformation is going to happen there. HITEC City, as I mentioned to you earlier, is doing extremely well as an asset.

We've grown 65, 70% at the top over quarterly averages last year to this year, so that's been a significant upside as well. Now we're working on the Nampally asset, we're sprucing it up, because I think it needs a little bit of work, which will allow us to enhance our ARPOB and also be able to take significantly higher footfall.

This also comes along with adding clinical capability across the board. Right?

Every asset will see clinical enhancement. As I told you, Hyderabad is one market where we're being seen very favorably.

It's not a market that has grown volumes very significantly, but the fact that we've been able to grow the market well ahead of our competitors should give you a sense that I think we're being preferred both by the consumers and doctors alike. That's happening.

In terms of overall bed capacity expansion, I think I give you a sense: about 1,700-odd beds will get added, 2,000-odd crores of expense will happen for those 1,700 beds, and which is what we call the project capex. This will be revenue-accretive because 1,500 of these 1,700 beds are actually brownfield.

It's only 200 which is greenfield, and therefore I'm desperately looking forward to these beds coming in, because they're coming in assets where we need more capacity. As I mentioned to you earlier, wherever we are in the mature setup, our strategy has been add more beds, add more capacity, bring more complexity.

We're kind of firing all cylinders onto that, and so far so good. We're hopeful that Bhubaneswar as well as Raipur, both the assets will get incremental capacity and clinical complexity from oncology standpoint as well.

Outside of that, our guidance on capex has always been clear. We've stuck to the same number.

5-odd percent is the capex spend when it comes to the annual capex spend to spruce up the existing facility or to add clinical programs. Generally the breakup is 3:2, which is 3% is spent in terms of refreshing what we've already spent, and 2% becomes incremental every year.

That's the cost of running the business, we stick to that. We're again very prudent in terms of managing those spends.

As I mentioned, as a part of the synergy between KIMS, for that matter, between KIMS and CARE, we've already started to find synergy in the procurement of equipment as well, and this is pretty significant. The 5% spend earlier and the 5% spend now is giving us significantly more than what it used to give earlier.

I think that's how, Amey, all of this is working out so far.

Sure. This year, we have ended at around 16, 17% top-line growth and around 1 1.5% margin bps expansion.

Looking at the improvement we are doing across the clusters ahead, as well as the around, I think, 900 bed addition we are doing for next 2 years at least, you expect this growth momentum and the margin expansion to continue for next 2 years?

Yes, I do. We've gone to a solid start, and I do see that the margin expansion as well as the top-line growth will continue.

I think the strategy is firing, and again, strategies are not made for a year. I think the last period has just been a testimony of the fact that what we've started is the right thing to do, and which is where we started to see the numbers roll in.

As I mentioned, our team's rock-solid, very committed, and we're reasonably sure that we'll continue to add to what we've done last year.

Sure. Thank you so much.

I just have last question on Aster on the Whitefield unit particularly. I think Karnataka cluster has looking like it is coming out of woods quickly after these leadership changes.

If you can give some clarity, how is the occupancy now in Whitefield for FY26, how it has moved year-on-year, and what profitability this unit is working on so that we can get some sense what potential it has in terms of the EBITDA addition for next 2 years? Thank you so much.

See, on the occupancy, currently it's at 60% occupancy. That's only for the Block A, B, C, which is existing one.

Now that Block C is moving to the Block D, that's another 159 beds getting added. That's a separate, I would say, road path what we have.

In addition to that, the empty 50 beds which is there, that will be integrated to the existing multispecialty hospital. Also, I think I called out even for the CMI, where we're coming another year or so, we'll have the 100-bed expansion on top of the existing hospital.

There, already occupancy is still 56%, there is a good room. Only thing in Aster RV, because it's just a 250-bed hospital without having oncology there, there the runway is a little lesser because currently already occupancy is at 66%.

Runway, but still you can go up to 75, 80% anyway. That room is already there.

From the EBITDA margin point of view, I think only in the Whitefield you asked for, it's already in the high teens. Right?

High teens is the margin. With the Whitefield coming up, I think then you can look at more than mid-20s is the margin what we are expecting to reach.

Sure, sure. Thank you so much.

It is quite helpful. Thank you so much.

Thanks, Amey. We would like to highlight that we'll be giving preference to attendees who have not asked the question before, in that line, the next question is for Mr.

Vivek. Vivek, can you please unmute yourself and ask the question?

Yeah. Am I audible?

Yes, you are audible.

Great. Thank you for the opportunity.

I just have a couple of questions. One was with regards to the performance in the Andhra and Telangana unit.

The growth has been outstanding in that particular cluster, just wanted to understand what steps or have we taken any particular steps to do the course correction? Going forward, what can we expect in terms of a sustainable level in terms of both revenue and margins for the cluster?

Vivek, thanks for the question. See, there are three main hospitals.

One is the Ramesh Hospitals Group, then we have two hospitals which is in the Hyderabad Aster Prime, which is a smaller 150 beds, and Narayanadri Hospital in Tirupati, which is the 150-odd beds again. In this, I think the two hospitals specifically driving the growth is the Narayanadri Hospitals and also Aster Ramesh Hospitals.

Narayanadri Hospital, I think we opened up almost 3 years back. It's doing really, really well.

Even in the current year, we've seen a 46% growth in the revenue and almost 75% plus growth in EBITDA, because one of the good things why the Narayanadri Hospital growing really well is that we're able to add good clinicians there, and also the market is underserved currently. We are able to execute things at the right time.

Also in major of the specialty like cardiac and ortho and other general specialties, we're able to add the second in line also. That is helping us in taking more volumes.

Also we will be looking at now to convert some of the general wards into single rooms so that we can expect more ARPOB growth also. The second big change what we've seen is the Ramesh Hospitals.

Ramesh Hospitals were a little stagnant for last couple of years, and they also lost a few doctors in the quarter one, quarter two. In addition to that, good thing is that when the attrition happened, they added clinicians in three, four specialties, including the nephrology, pediatric department, ortho, and cardiology.

That's their stronghold there. We have seen after that, I think from the end of December, we have seen a good growth momentum.

It's not a one-off growth what you've seen. Last 4 months and even the April trends are looking very similar, result is similar.

With that, they have achieved more than 32% revenue growth. Why EBITDA has been growing, it's very simple: because you're sitting on a low base, fantastic growth, we ensure that there is a good operating leverage which is working currently.

We're holding on to the cost, not jumping into hiring more manpower. We can leverage on the existing fixed cost, which is anyway there.

I think because it's a 1 or 2 months, I would have said it's just a one-off, and we've seen a good runway for last 4 to 5 months, and I think we will expect to continue to grow, maybe not in the similar manner, but I think the runway what we have created, I think we expect Ramesh Hospitals to continue to do well. Great.

Thank you for the detailed answer. Secondly, just wanted to understand from Varun about the QCIL expansion, right?

Firstly, what you had mentioned about QCIL, two things here. One is with respect to if you could provide the expansion plan by cluster for QCIL, and secondly, what you had mentioned about the QCIL expansion budget, which is around ₹2,000 crores for 1,700 beds, of which 1,500 is approximately brownfield.

Just wanted to understand the per-bed capex that you plan on doing approximately for the brownfield and the greenfield units that QCIL has in its pipeline?

Blended cost per bed capex will vary by which hospital, what kind of expansion are we doing, but per bed generally comes to about ₹1 to ₹1.1 crore. Right.

That's what the number would be for you to take back. In terms of expansion, a quick run-through, if you look at Bhubaneswar and Raipur, which comes this year, there's capability enhancement happening in Raipur, and there's capability as well as bed expansion happening in Bhubaneswar, and that's largely for this year.

FY28, we expect to add beds in Banjara and capability in Banjara. I probably brought that response to the previous question as well.

We will add capacity, we will add capability in a very significant way in Banjara and Hyderabad. We were waiting to see if we are able to turn the asset around, and we start to get favorability both from the consumer, patients, as well as the clinical fraternity, and that seems to have happened.

People are now seeking more from us. That is another investment that we're making.

We've been very excited with the Nagercoil launch. We've done extremely well.

The asset sat about 28, 29% EBITDA and growing month-from-month, quarter-from-previous-quarter. We're now looking at expanding that to another 100 beds, so that's another expansion that's going to happen.

We are adding beds in '28 in Nampally as well. As I just told you, we're turning that asset around, sprucing it up, and with that, we will need more beds to come in.

Some of the other projects that we are currently looking at beyond that is going to be Malakpet, Chattogram, Vizag. It's across the board.

When you're looking at brownfield and greenfield, there's one greenfield that we're doing, which is Indore. 14 assets are on brownfield, which cumulate to the 1,500 beds that I spoke about.

Just on the per-bed capex, you said ₹1 to ₹1.1 crore, right? Can you break it down for me in terms of brownfield per-bed capex and greenfield per-bed capex?

A greenfield will come to about ₹1.5 crores, and brownfield will go down to about in the range of ₹0.8 to ₹1.1, depending again on complexity. See, I think there's no one number.

We'll have to give you a number by specialty or by each unit, which is not something that I intend to share at this point in time. The fact is that if you're adding a Linac, linear accelerator setup or an onco setup in a particular hospital, then the numbers will go up.

It is not just the bed, it is also the complexity and capability that we're sprucing up in the asset. Vivek, there's no one answer.

There'll always be a broad range, and the broad range for brown will be between ₹0.8 to ₹1.1. For green, could be about ₹1.5, ₹1.6.

Got it. Got it.

Thank you. Thank you for the explanation, Varun, yeah.

Just a couple of bookkeeping questions. Just wanted to understand what comprises as a minority share as a percentage of our total profits, and what should we take that as a percentage going forward?

In case of Aster, it's around 8%, and that is with only two units currently, which is the MIMS. We have still a minority of 20% there, and Ramesh Hospitals around 30%.

Overall, at a console Aster level, it should be at 8 to 9%. I think maybe QCIL should be between 15 to 20%.

Blended should be between 10 to 15% should be the.

Overall, it's 10 to 15%, right?

Yeah.

Got it. Secondly, just wanted to understand your ROCE number, right?

As per what I could understand in terms of ROCE calculation, my ROCE number is coming out to be a bit different to what has been reported in our presentation, right? If you could help me out as to how?

See, in case of Aster, what we exclude is only two things. One is the revaluation reserve, that related to the land revaluation reserve, which we had taken up when we converged from the old IGAAP to Ind AS.

It's just a book entry, there was no actual capital employed. Second is the CWIP, because that's asset is still not deployed to earn your profits or revenue.

These are the only two things we have excluded. In case of QCIL, I think we exclude the intangibles, right, because as QCIL, they acquired the entities in Bangladesh and specifically in KIMS, they have certain intangibles like a brand and goodwill, that is something we're excluding.

That's the only three differences you will have between your calculation and our calculation. We will very happy to share it offline also.

Sure. Just one more thing I wanted to ask about QCIL.

The QCIL EBITDA margin, we reported around 20, 21%, but as per the annual report that I could see of QCIL, the EBITDA margin is coming out to be around 17 to 18%. If you could make me understand if I'm missing out on anything in terms of understanding the EBITDA margin with what's reported in the Aster PPT versus what I can see in the QCIL financials?

Vivek, there's one-time that impacts us, broadly around the one-time that we're doing on merger, and also some of the work that we're doing with consultants to enhance the productivity. All of that is one-time.

We can probably provide you a breakup of that if that's desired later.

Sure. Yes, I can get back on this later.

Sure.

Thank you.

Thanks, Vivek. Sure.

If anyone other attendees would like to ask a question, please raise your hand. Okay.

There is no more question to the management. Thank you, all.

This concludes the earnings call for this quarter for Aster DM Healthcare. I thank the management and all the attendees for joining us today.

If you have any further queries and questions, please get in touch with us. Thank you.

Thank you, all.

Thank you.

Thank you, everyone. Bye-bye.

Bye-bye.