Dr. Emmanuel Rupert – Chief Executive Officer and Managing Director
Ms. Sandhya J – Group Chief Financial Officer
Mr. R. Venkatesh – Group Chief Operating Officer
Dr. Anesh Shetty – MD, International Businesses
Mr. Nishant Singh – Vice President, Finance and Investor Relations
Mr. Vivek Agarwal – Deputy General Manager, Finance and Investor Relations
Key Discussion Topics
India Business Performance
Bangalore cluster achieved ARPP (Average Revenue Per Procedure) exceeding ₹250,000, among the highest in India
EBITDA margin for India business reached 25.1% in Q4 FY26, up from 21.5% in same quarter previous year
Margin expansion driven by high-end procedures including robotic cardiac surgeries (100 cases/month), percutaneous aortic valve reimplantation (160 procedures), and pediatric bone marrow transplants
Volume growth achieved without adding new beds through operational efficiencies and transformation initiatives
Clinic Business Update
11 clinics currently operational in Bangalore
Plans to double clinic count in FY27, including expansion to Kolkata
Clinic business reported losses of approximately ₹66 crores in FY26
Each new clinic takes approximately 18 months to break even
Corporate overheads contributing to ongoing losses
Clinic business to be merged with core hospital operations from FY27 onwards
UK Acquisition (Practice Plus Group)
Acquired Practice Plus Group (PPG) in UK healthcare market
EBITDA margins improved from 7-8% at acquisition to 10% in Q4 FY26
GBP 150 million loan taken for 7 years for acquisition, serviced locally in GBP
Integration ongoing with IT separation still underway
Transition costs and deal-related expenses impacting current P&L
Targeting improvement in payer mix (private pay currently ~7% of revenue)
No plans to enter insurance business in UK
Cayman Islands Operations
Insurance business reported losses of approximately USD 5 million
Annualized premium revenue rate reached USD 60 million
Loss ratio at 110-112% (claims paid divided by premiums net of reinsurance)
Price increases planned for June 2026 for 30-35% of accounts
Hospital business scaled from less than USD 30 million to USD 50 million per quarter run rate
Management recommends analyzing Cayman business as integrated operation rather than separate entities
Capital Expenditure and Expansion Plans
Total planned capex of INR 3,000 crores for new projects
FY26 greenfield capex of INR 109 crores against planned INR 424 crores (74% miss due to election-related delays and permission issues)
Projects include Rajarhat (Kolkata), HSR, Raipur, and Bangalore expansions
Commissioning timeline maintained for FY28-FY29
Construction costs increased by 60% compared to 5 years ago (post-pandemic impact)
No additional capex planned for Cayman; UK capex plans to be shared later
Regional Performance
Kolkata: Revenue share 26%, grew at 5-6% in FY26; limited expansion capacity in current 3.5-acre campus; awaiting Rajarhat project for quaternary care facility
North Cluster: Grew 7% in FY26; challenging competitive environment in NCR region
Mumbai: Broke even in Q4 FY26; adult program approval in advanced stages with trust
Operational Metrics and Strategy
Occupancy levels typically between 60-65%
Focus on ARPIP (Average Revenue Per Inpatient) rather than ARPOB or occupancy as key performance measure
Technology transformation through ATHMA system eliminating manual processes and paper usage
