Aster DM Healthcare Limited ($ASTERDM)

Welcome to Aster DM Healthcare Earnings Conference Call for the Fourth Quarter and Full Year of FY '26. Today with us, we have the senior management of Aster DM Healthcare, namely Mr. 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 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'll also -- 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 Dim 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 2 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. So coming to the quarter's performance. On a combined pro forma basis, the revenues have grown 18% year-on-year to INR 2,361 crores for the quarter supported by a 12% increase in total patient volumes and an 8% improvement in ARPP 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 INR 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 FY '26, the combined platform has delivered revenue of INR 9,273 crores, growing 14% year-on-year, with growth supported by a balanced increase both in patient volumes as well as ARPP IP. The improvement in ARPP IP was underpinned by 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 INR 2,013 crores margins expanded by 116 basis points now to 21.7%. Importantly, this performance reflects sustained momentum rather than a 1-year outcome. Over the past 3 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 while strengthening our position as a leading pan-India health care 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 board cast in favor, reflecting strong alignment and confidence in the strategic direction. From a regulatory point -- standpoint, the transaction has progressed through all key stages including the receipt of the CCI approval and no objection letter from the NSE and BSE with no adverse observation. 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 time lines, 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 are 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 a robust patient volumes and the 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 INR 1,182 crores reflecting an 18% year-on-year increase. This growth was supported by a 15% increase in total patient volumes, a 9% improvement in ARPP IP and the contributions from the recently operationalized Kasargod Hospital. Importantly, the growth was not just volume led, but also a mix driven with a higher share of specialized tociary care, particularly in DBS 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 FY '26 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 equity, 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 football. Within Kerala, MVT revenues grew 51%, with stronger inflows from Kasargod , 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 INR 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 FY '26 with margins up by 120 basis points. While the Kasargod facility remains in its initial ramp-up phase, the underlying performance of the core network continues to demonstrate very strong operating leverage. Excluding Kasargod, revenue and EBITDA grew 17% 31% year-on-year, respectively, with margins expanding by 239 basis points to 21.7%. Within core hospitals and clinics, excluding Kasargod, operating EBITDA grew 36% with margins improving to 24.3%, reflecting a 345 basis point expansion. Coming to some of the noncore 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 nurse strike. Inpatient volumes grew 11% year-on-year, indicating sustained demand. Excluding Kasargod, 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 ARPP IP supported by a strategic shift towards higher value procedures in cardiology and neurosciences and the [indiscernible] 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 ARPP 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 and 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 Kasargod. This expansion has been good measured and demand led, ensuring that capacity addition translates to sustainable growth. As part of this road map, 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 on goal 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 continue to be recognized across leading platforms. In the Newsweek World's Best Hospital rankings 2026 our facility secured prominent positions in India with Aster CMI Hospital ranked #12 and Aster Medcity at rank #28. This was further complemented by strong national recognition. In the times of India, all in their rankings 2026 where Aster Medcity and Aster CMI were ranked 2 and 5th, respectively, while Aster MIMS secured the 9th position. At the leadership level, during the year, Dr. Azad Moopen recognized recognition on global platforms having been featured among the top 5 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 health care industry at the FICCI Heal 2025. To conclude, this quarter reflects the strength of our well-defined and consistently executed model, where scale is driving improvements in case mix, operating leverage and ultimately, capital efficiency. The combined 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 are 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. KIMS Health strengthened its position in transplant performing the first heart transplant in Q4 FY '26. Karbanjara installed a [indiscernible] laser, which is the first of its kind in the QCR 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 our team and the power of our people, people who are accountable have the ability to motivate teams and lead with purpose. The team at QCR has come together in a cohesive way at a very meaningful one and delivered industry-leading growth in FY '26, while simultaneously working towards a merger that will create value for all of us. As a team, we are excited for the journey ahead of us and are geared up towards the robust performing performance in the coming year as well. So let's get to the financial performance. Q4 FY '26, witnessed a strong growth overall revenue growth by 18% year-on-year to INR 1,178 crores. EBITDA grew 23% year-on-year to INR 272 crores. The EBITDA margin expanded 103 bps Y-o-Y to 23.1%. Revenue growth was driven by an increase in IP and OP volumes treated. [indiscernible] described 10% more patients in Q4 FY '26 over the same period last year, serving 62,500 in patients. OP footfalls grew 9% to 8.8 lakh consumers patients in that period. ARPP 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 FY '26 over Q4 FY '25. Payer mix moved favorably to 79% from cash insurance up 98 bps Y-o-Y. 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 FY '25. 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% Y-o-Y, 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 a large part of our business. 59% of our revenue comes from the mature units and that delivered a 13.5% revenue growth Y-o-Y, along with 20.7% EBITDA growth Y-o-Y. The resulting EBITDA margin witnessed an expansion of 198 bps Y-o-Y to reach 33.2% driven primarily through synergies and cost optimization efforts. Emerging units, which are the newer units that we have, they contribute 7% of our revenue. They ramped up strongly, 62.4% Y-o-Y 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 INR 15 crores, which was INR 70 lakhs in Q4 FY '25. For the full year financial performance, Consolidating the strong quarter-on-quarter performance, QCL registered 17% revenue growth year-on-year to INR 4,630 crores. The FY '26 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%, commodity mix improved 270 bps to 59% of the total revenue. QSL recorded an EBITDA of INR 1,066 crores. first time ever reaching the INR 1,000 crores 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 INR 85-odd crores to the bottom line. The FY '26 EBITDA has been supported by the best-in-class operating EBITDA breakeven at [indiscernible] , which became EBITDA positive in 3 months of operations. Nagpur contributed INR 30 crores to the EBITDA and currently stacks up at 28.5% EBITDA margin for FY '26. Continuing our clinical augmentation, we maintain focus on doctorate models, talent acquisition and have onboarded 100-plus doctors clinical teams in FY '26, which has aided the performance in volumes and specialized procedures. In Q4 FY '26, we reduced our loss by 2% to 3.9 days. KIMS Health making significant strides in transplants. KIMS performed its first cardiac transplant on a 10-year-old girl. In this quarter, Tims Health has conducted 2 dual organ transplants, a simultaneous kidney and banter 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 Bojana Hills facility. CARE [indiscernible] performed the group's first dual chamber leadless pacemaker implantation. Care Hospitals Bogner, operator on a 4-year old with subaortic VST, which 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 45% for the year. The focus on high equity care is visible across our specialties. Robotic procedures more than doubled in FY '26 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 midterm expansion plans and intend to invest INR 2,000 crores to add 1,700 beds in the next 3 to 4 years. Strength true to the mission that we have to improve accessibility to health care. 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 1 million subscribers in YouTube, which is making up the second hospital in India to have done so. QCL 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. Now I would request Mr. Ramesh to take through the detailed cluster vice performance of Aster DM.

Thank you, Mr. Varun, and good morning, everyone. So I'll begin with the cluster performance for the quarter and a full year followed by our key operational updates. To begin with Kerala. Let me begin at the cluster has delivered a resilient performance this quarter. sustaining its contribution to the growth. In quarter 4 FY '26, the cluster reported a revenue of INR 604 crores, reflecting a healthy 21% year-on-year growth despite the nurse strike during the quarter, the impact of which was limited. Excluding Castle board, the revenue grew by 18% year-on-year to INR 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 to rise. While the macro headwinds led to a decline in the NBT from the UA. This loss was efficiently neutralized by the business from Maldives and African markets. We are renewed focus at a stronger local partnership have kept a patient flow study. Furthermore, performance was supported by consistent traction in oncology, a growing contribution from the [indiscernible] facility and 11% increase in inpatient volume. A more case mix for the drove a 5% increase in ARPP IP, rounding out a strong quarter 4 FY '26. On the profitability side, in quarter 4 FY '20, operating EBITDA grew by 27% year-on-year, while excluding Kasargod, EBITDA increased by 35% year-on-year, with margins expanding by 330 basis points to 25.6%. This was 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 expansion and pipeline for over 800 bps, including the recent brownfield addition, 130 beds in MIMS Kannur and 150 beds at MIMS Calicut. Kerala is well passed to sustain the growth momentum. Karnataka, Maharashtra cluster reserved INR 394 crores in quarter 4 FY '26, representing 11% year-on-year growth, fueled by the robust realization. This performance was underpinned by a 21% increase in ARPP IP driven by a higher volume of complex procedures in cardiology and neurosciences and the [indiscernible] of our low-yielding government schemes at a tater continued. The cluster operational efficiency and the clinical expertise were further evident by the continued traction in the MBT segment alongside a significant growth in advanced interventions. By focusing on the targeted hiring for the key doctor position, the Karnataka subsegment 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 Telegana Casas reported a strong growth term quarter 4 FY '26 with the revenue increasing by 30% year-on-year, driven by higher inpatient volume and a 13% increase in ARPP IP supported by a 200 basis point improvement in Congo mix. Operating EBITDA registered a sharp 113% year-on-year growth in quarter 4 FY '26 with margins improving to 18.3% in quarter 4 FY '26, with over 700 bps expansion. Within the cluster, Aster Ramesh Hospital Group had a strong revenue growth at 32% year-on-year in quarter 4 FY '26 with a robust 118% year-on-year EBITDA growth in A&T cluster. Further to this, we have operationalized 75 beds in Ramesh Ongol 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 have seen benefits of the focused efforts on our case mix, capacity utilization, cost discipline translating into improved operating performance, but strengthened clinical team and a clear expansion road map, we are well positioned to sustain the growth trajectory and deliver consistent performance going ahead. Thank you. I 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 Healthcare financial performance for quarter 4 FY '26. For the quarter ended 31st March 2016, excluding our newly launched Kasargod Hospital for the first 6 months. Despite the global headwinds, the Aster India's revenue increased INR 216 crores reflecting a strong growth of 17% from quarter 4 FY '25. Operating EBITDA increased to INR 253 crores with a margin of 21.7 percentage compared to INR 193 crores in quarter 4 FY '25, registering a growth of 31 percentage. Normalized PAT post NCI for the quarter stood at INR 153 crores compared to INR 106 crores in quarter 4 FY '25, reflecting a growth of 45 percentage year-on-year. For the year ended 31st March,again, excluding the newly launched Kasargod Hospital. India revenues increased to INR 46.7 crores, up by 12 percentage from INR 438 crores in FY '26. Operating EBITDA increased to INR 969 crores with a margin of 21% for the full year as compared to FY '25, registering a growth of 20% rate. Normalized PAT post NCI for FY '26 stood at INR 451 crores compared to INR 357 crores in FY '25, reflecting a growth of 26 percentage 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 percentage and operating EBITDA grew by 31 percentage leading to 40 basis points improvement in the margins. Importantly, the performance was considered across hospitals at different stages of maturity. Our mature hospitals, which are about 7 years old, contributing almost 80% of the total hospital and clinic revenue delivered 16% revenue growth and 26% operating EBITDA margin operating at a robust ROCE of 36.5 percentage. Hospital in the 3- to 7-year maturity bucket recorded 23% revenue growth and a strong 21 percentage. EBITDA with the ROCE improving by 470 bps to 23.8 percentage. Our new assets, which are less than 3 year olds, saw revenue growth of 15 percentage. Turning to our Diagnostic business. I'm pleased to Aster labs has successfully delivered turnaround since the start of the year FY '25. Operating EBITDA margins have expanded from a negative 7.6% in of FY '24 to a positive 7.6% in FY '25 and further to 12.8 percentage EBITDA margin in FY '26, driven by a robust 32% year-on-year growth in external business, enhanced operating leverage and improved material cost efficiencies. This turnaround has passed into a healthy ROCE of 27 percentage, a remarkable recovery from negative levels 2 years so. For the year ended March 2026, our capital expenditures stood at INR 549 crores with approximately 45% allocated towards expansion projects. We continue to maintain a robust liquidity position with cash and cash equivalents at INR 1,327 crores while our gross debt remains at moderate INR 701 crores. Additionally, we have a significant improvement in ROCE, increasing by 180 basis points from 19.5 to 22.8 percentage expense. We have operationalized white field block with 159 bits on as Ramesh, [indiscernible] gold a brownfield expansion with Sandfire bits in April 2026. Over the next 4 years, we plan to add approximately 2,500 beds at the cost of INR 2,700 crores. Of this INR 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 [indiscernible] our focus on disciplined capital allocation and sustainable profitability. With this, we have laid a 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. [Operator Instructions] Moving on to the Q&A session. The first question is from Mr. Tausif.

Good morning, and yes, am I audible.

Yes.

This is Tausif from BNB Pariba. First question is to Varun. Can you tell us whether the industry currently stands with the common insurance and pariment with private insurers and which gives uniform pricing with private insurers. Any of the hospital star USL has been onboard in this policy? And do you see this is a threat for the private hospital change in coming years?

So Tausif, first of all, I think the parent piece has been in play for a while. It's not new. Two, from a data standpoint, I don't think -- well, I'm sure that between CSL at least in QCL we haven't signed up on this, and I'm assuming Aster hasn't as well. I have also not seen large tier hospitals get onto this platform. I think fundamentally, while a lot of conversations have happened, there are 2 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. And the other is transparency as to how this is being done. -- right? So until that gets sorted, I think this is still a framework that's been worked upon is the way I see it.

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

Well, it cannot be done unilaterally to sale. It can only be done in private hospitals want to accept -- and that -- there are 2 ways to see this. It can -- you can actually save you a lot of costs on empanelment, et cetera, et cetera. If it is done right. So there are benefits and merits to doing it as well. But the current upturn is somebody going to get on to the band back in my sense is -- so I would -- it's not cost. So if that's the question.

That's helpful. Second question to Ramesh, on the Kerala piece. I think despite the month of Ramzan, the BT business has grown significantly, especially in Kerala Rami, can you give some color also what's the current status of MBT patients? Have they started flowing in the last couple of weeks?

So thank you, Those, for that question. Kerala pieces Celator has done well again. You can see that overall performance has been really good. And especially MBT has done 41% year-on-year growth has been registered. So we have seen a traction from across, yes, Middle East as well as what you call malls and, of course, African countries. -- there is a flow of patients coming in from all these areas. Now in the last few days, yes, Middle East, we have formed at a few, which is 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 [indiscernible] patients started focusing on African countries, and there is a steady flow which has been happening. So we are trying to mitigate the losses through the expanded coverage what we have now. So we are trying to ensure that the impact is much not much felt and still continue to perform well. [indiscernible] have been contributing more now.

Just lastly question on Kerala. Where do you stand currently for the nurses issue? Has there been a negotiation between the private hospital and the nurses? And can you highlight what are the total number of nurses in Kerala for Aster [indiscernible] Healthcare? And how many of them are currently working with a minimum wage of 20,000?

Okay. So when we talk about minimum majors and the strike which has happened in Kerala, this started sometime in the mid of March. And at that point of time, their demand was -- they wanted the government every 5 years, the government of Kerala issues, I guess it, government notification for the [indiscernible] basically has been issued by the government. But here at this point of time, we have around 4,300 nurses approximately in Kerala. And all these nurses are paid the basically according to the government notification. And the new notification is yet to come. So they first started the strike asking the government to release the geo. They have the government of [indiscernible] at that point of time, Kerala government had at least an interim geo, which will 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 INR 40,000 per nurse. But assets, we have the Private Hospital Association. And of course, we also part of it, and we ensure we requested them on April 13, we had a negotiation with them as well. The government has asked -- or the quoted redirected us to, especially the private hospital to mediate and get the things done. So we have spoken to them. And on April 13, we have come to a settlement with them. And yes, there is -- the strike is called off.

Can I just ask Mr. Wilson also to add to one...

Yes, yes. Let's -- thanks, Tausif. That's a good question actually. So even though the demand they were asking for a basic salary of 40,000 actually, we were able to conclude by giving a small increase only like the overall impact may not be significant actually like. So we used to give an annual agreement every April. So this time, we have to give something more than that on as -- so our total impact in Kerala crores to crores what we have given. Our total income and what we have offered is all at Calicut, partners, which is in Cochin that became 4,000 and the remaining places at 3,000 -- that's the increment that we have given. They were asking for a significant amount, like remeta40,000 as the basic salary. So we were able to negotiate and condo that one in a very nice manner. More than a fact.

The next question is coming from Damani.

My first question is on your ARPU and IP volume trends, very strong across the clusters. So 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? And what kind of headroom you have in terms of growing the Congo contribution for your business? So that's my first question.

Sunil, do you want to comment?

Thanks, Damani. I think for the Aster for the quarter 4, yes, as we called out, we had a very good IP almost 7 percentage. But also this includes a negative 8% growth in the [indiscernible] also. I just want to call out in advance that the 8% negative growth is because of the TM pendant of the low-end schemes, which even Alisha called out. If you remove that, you're going to get into the positive 3% growth. So that way, I think all our clusters, whether it's a [indiscernible] , KLM plus or indels, 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 OP, the processes or OP to IT conversion process or, say, the call center management. So we're looking into all those things, and we're driving it. But the primary thing will be the doctor acquisition. So Doors 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 new. I'm talking about the other than the replacement only the new doctors or mostly around 36-plus doctors we added in the last 6 months aloha is something which we are expecting the ramp-up to happen. And I think with the continued growth, what we're looking at, whatever we have done currently with the on percentage that's a fantastic growth to continue to happen over the next medium term.

Just to add to what's ailing, I think you're asking about the Congo mix, right? So this is I think there's a huge room for us to kind of improve. We are sitting at, I think, at a blended level, now 55% Congo contribution. We think we can definitely take it up to and then 65 as well. You see a lot of the groups in that direction. So that's something which will actually give us good headroom to sort of further improve the numbers, especially on the equity and ARPPs.

That's helpful. So continuing the point on doctor engagement. So again, I think I want to have some more color on what is helping you to get doctors because -- but we understand in markets like Bangalore, the [indiscernible] Italy intense. So 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 take?

Yes, surely. So overall, I think last few months, we have added a good number of clinicians that I said some of the star clinicians were onboarded. And they're pretty much -- the reason -- I mean, they're -- why they were convinced to join Aster simple reason. One, we had a bigger vision for Raster 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 3 units now, and we are adding another 2 more units in Bangalore. So it's quite visible for them that what is vision of star. So that is one attraction to all the clinicians who have joined. Secondly, we are also looking at high-end procedures and niche segments. The high-end work has been happening like the robotic transplants. So there is a good amount of what you call kind of faith in the in Aster 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. So some of the CONGO also, I think we have good clinicians on board. That is also attracting other clinicians to join us and expand each department and also that more patients. So 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 and 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 taste.

Sure. And just I think I want to hear Mr. Khanna thought also on the clinical talent engagement. Again, anything -- or similar strategy for QCL as well, which is working for you.

Thank you, at. So essentially, I'll go back to why a clinician would join more than what we are succeeding with because it's a lot to do with 4 or 5 elements that recondition 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've spoken about developing Clinic because our focus on clinical independence and outcome is so significant. That is also yielding a lot of gains from a volume standpoint. And that is what the clinician was the lesion really wants that you should allow them clinical independence. So 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. And I think the last part is largely commercial, and we are top tier in that too. So 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. But I think our ability to connect to forge alliances relationships, partner is better than anybody else.

The next question is coming from Mr. Kunal.

Sir, my first question is on quality care. So I see that the mature units have grown 14% as of the focused units. So just wondering what the growth drivers can be going forward because some of the things seem to be very well optimized like payer mix or a loss. So would it be the case mix? Or will it be the expansion going forward? Just wanted to get your thoughts, sir?

Thank you, Kunal. So Kunal, the growth drivers for each one of those categories is slightly different. So let me try and give you some color on that. So 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. And they are in X30 the EBITDA profile as well. So what's working for us there is still enhancing complexity. Alisha spoke about it, and let me just reiterate the same thing. We are currently at about 59% [indiscernible] mix. And my sense is we will continue to grow that because I told you that we are underleveraged on oncology. And that is one piece that we've still not got our investment rolling. In fact, this year on onto the next 2 years, you'll see a significant growth in oncology volume in our network. So that will play out from a mature hospital standpoint. If you look at our emerging and, let's say, the focused assets, we're still sub 20% return in there. We've done extremely well. But the runway is still a long way. for us to grow. And various things are playing out. So 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 [indiscernible] if we have missed out something, 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 we'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 are making, some of these assets are doing extremely well. In fact, the Hyderabad sticky market. You've always known that, in fact, 2 years back when I came in, most of people asked me about what will happen to hard -- so Hyderabad has started to grow so significantly. We are now seeing huge growth on the top in terms of volume and EBITDA has grown 66-odd percent. So I think different levers for each 1 of those categories and currently all seem to be firing.

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

If you see the growth percentages, it's across all units. So our focus units have grown top 25-odd percent are mature, have grown 14-odd percent are emerging have grown 60-odd percent. So yes, the playout is across the network.

Sure. Sir, second point is on, sir, the synergies between the 2 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 INR 85 crores of synergies that you're seeing in care. So are we seeing something similar as to also -- and 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?

So Kunal, First of all, tthe synergies that I've alluded to are pre asters merger. So these are -- you got to understand that within QSL also, we are in a way, merging 3 companies. We acquired Care, Evercare and Bangalore and Kim in Tiwana Tom. So that's the synergy that I'm referring to. So bringing the 3 entities together has also given us synergies on account of procurement, on account of in-sourcing of food a lot in terms of AMC, et cetera. And that is the INR 80 crores that I alluded to INR 885 crores that I alluded to. So that has we are -- we've still not started the work on Aster synergies really, and they will start to flow in post merger.

Great, sir. And just one more, if I can, on Aster. Sir, on the greenfield expansion, you have around 100 capacity beds in the next couple of years. So 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 in the next couple of years?

Yes. Kunal, if you look at the last year, right, you saw only CASA Gold commencing the operations sometime in October. And if you look at the margin profile, the impact is hardly 60 bps, right? Because we closed at 20.4%, including Kasargod. If you remove the Kasargod, which approximately I think we have EBITDA losses in more negative of around INR 19 crores to INR 20 crores. So from 21 percentage. It's only 60 bps, which is impact. And again, it's our own cluster. So we don't -- we expect to bounce back very quickly and break even in a quarter or 2. Next in the FY '27, you look at, we have got already 2 brownfield expansion, which has started, right? One is the -- our [indiscernible] Whitefield Block B, which already comes to operations in ipi and also the other unit is in Angul, which is another Sandfire pets on the existing hospital. We commenced that was in April. That means we've got almost 200-plus bits of brownfield expansion, which is usual and you can see that it's EBITDA accretive. Just to give an example, a year back in Kannur, we were running at 300 bath. We added 100 , the margin expand we went from 8.5% to 22.5%, right? So keeping that -- good thing is that in this year, already you're starting with the profit expansion, which is EBIT accretive. Secondly, only this year, we are expecting only our [indiscernible] to commence sometime in October. That's only the H2 beginning. And you know already in Trivandrum, it's part of the Kela cluster, second Q entity Kim already is present there. It's very underpenetrated. So we expect to do really, really well. So even whatever the losses comes in, it's hardly any dilution. Even with that losses, I expect from the current year EBITDA margin should grow. The third point, which also to be very important to note is that with the merger, very much, I would say, hindsight sometime in the quarter 1, you should see that majority of the period will be under the more entity, right? So we'll also have -- we also already I think weren't called out that synergy is going to start after the merger entity, right? That's something which you're already working on, and I think we will hit the ground from the day 1 and that should also bring and help us in ensuring stability on the margins also growing the margins also. So 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 have -- we'll grow in the margins.

Thanks, Kunal. I would request you to limit your question to 2 but not more than 3 per participant at a time. With this, the next question is coming from Mr. Senard.

Thank you for the opportunity. Congrats on a good set of numbers, fairly strong set of numbers. Just wanted to understand what was the primary -- I have a few questions. I'll take my top 3. What are the primary challenge in the slow growth even in Karnataka IT volumes, which were at 3% versus 89% in the overall group, right? And within that, if you could give us some understanding, you mentioned that there was a degrowth because of Aster, was that a negative margin scheme that you took away? And how should one think of recouping that set of patients? So that was question number one. Question number 2 is on -- if you could give us a sense of what's the share of chemo and dialysis within Onco and Metro, which I would assume more daycare and therefore, brings down the loss. So that is one. That is question two. And question 3 was if you could share any specific AI or robotics implementation that you're doing within Aster [indiscernible] ?

So let me jump in. So that will be the first 2 questions. One is on the Karnatakas. You're asking saying that your IP volume for other thing is at least in the high single digit to double digit why Karara Marshals at 3%, yes. As I called out very clearly, what we exited is the low-end schemes. I think we are very clearly called out. It's a government scheme. It's a low-yield scheme. The our POPs compared to a cash market, it's less than 50 percentage. That's how it's been -- and good thing is that we exited that. And also 1 of the reasons we exited also is that there's a capacity button like in Aster Aadar. It's already running at 75% occupancy. We will be looking at how to expand and [indiscernible] 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, yes, we have a positive 3% growth. There are 2 parts, right? One is that competition intensity is very, very high, right? And maybe before that, let me take a step back. If you look at FY '24 and '25, in KMP, we've been growing more than 20 percentage, 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 INR 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 percentage when unit has already reached to a mature phase now. So keeping that in mind, that's the reason why also one of the reason why the revenue growth has stepped down to around 10 to 11 percentage and volume has been around 3 percentage growth. But at the same time, we also had competition in the city particularly in north of Bangalore. We had attrition of 1 or 2 teams also. And 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 agenda surgery or other teams which left in quarter 3 to the competition joined back in quarter 4, right? That basically shows the strength of our clinical ecosystem and the management, what we do there. That's very, very strong. So we don't expect this to be the norm. So we expect to go to mid- to high single digit. Good thing is that all the doctors, what we have gotten now are already there in the stability. So we expect the volumes to trickle down in the next 1 to 2 quarters. Second also is that you see that April already, we launched the [indiscernible] Hospital also which is the block the Whitefield product, which as we mentioned on 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 the ramp-up is expected to be really got. So whatever you see is the 3% is 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 [indiscernible] is approximately 50 to 60 percentage, 30%, 35% is come from surgical oncology of the over 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, someone who want to take up the question?

Yes. let me take the questions. set thanks for the question. this is more of an academic question than currently in terms of what's happening on the ground. So essentially, AI will, in the near term to impact patient safety, the operating world, financials and clinical. Now as a company, we've already started working on all 4 tiers. So if you ask us what are the early successes, we've been able to bring in CDSS, which is enabled we've been able to bring in call center support, which is 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. We're looking at significant clinical augmentation happening through AI. So there are 2 parts to that. One is looking at radiology, getting more efficient. We are -- as I told you last time, we are setting up in rather Asia's first radiotherapy platform. which will be enabled. This is the first EOP platform that [indiscernible] is sold in India as well as in Asia, which is AI enabled. So a lot's happening on all 4 of these sites. They will -- we are also mindful that some of the newer technologies in AI are currently a huge cost and their use cases from a revenue generation standpoint -- haven't seen the light of the day. So I think we are being very particular in terms of -- because technology is low. 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 center is getting AI enabled and conversion ratios have gone significantly better. So 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 on, so I'm probably giving a little bit of a [indiscernible]

No. I think this does give -- Varun, I think this is fairly helpful in terms of what you're planning. And I concur with you that he is probably fairly early stage and theoretical today. But given that there is a merger, you're going to be leading the entity, it does help to get a color from you. So thank you so much for that. And just a follow-up on what Sunil mentioned on -- on some of the challenges in Karnataka, you'd mention -- so 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 bottle neck elsewhere because that seems to be more like mid-50s occupancy. So there does seem to be capacity, right?

Yes. Sutat in K&M, we have capacity, for example, stress is at 60% of this occupancy is our white field, we have added 150 beds, right? So if you include that, it has got still only 55% is occupancy. So I think we've got a great runway in Karnataka cluster to add beds. Also, you know that we are also coming with Sachar in the next 1 more year, and we have is for 3 more years. So I think we've got a very good runway towards it.

The next question is coming from Mr. Ame.

Thank you got question and congrats to the management on good set of numbers. So first question I have for Varun. So we will intend to spend close to INR 500 crores in Hyderabad cluster to get that cluster to its potential. Has that investment over and where it has been spent? And also, along with this, if you can give us the CapEx guidance for the QCI for next 2 years?

Thanks. So I don't know where the INR 500 crores number essentially, but the work that we are doing in Hyderabad is turning every asset around. So we've completed [indiscernible] Let me stick to Mandara for a minute. We are also now working this year to enhance oncology service in [indiscernible] -- so we'll be able to bring in radiation and [indiscernible] which is going to be a significant bump up. We operate an OBD building there, and the Roper building will also be an IPD building going forward. So those are the plans that we've laid out from Minjar. -- and therefore, a significant transformation going to happen there. Hi-Tech, as I mentioned to you earlier, is doing extremely well as an asset. We've grown 65%, 70% of the top over the -- over quarterly averages last year to this year. So that's been a significant upside as well. Now we are working on the namely asset. We are sprucing it up because I think it needs a little bit of work. which would allow us to enhance our ARPOB and also be able to take significant higher footfall. This also comes along with adding clinical capability across the board. -- right? So every asset will see clinical enhancement. And as I told you, [indiscernible] is on market where we are 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. So that's happening. In terms of overall bed capacity expansion, I think I'll give you a sense about 1,700-odd beds will get added, INR 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 the 1,700 beds are actually 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. And as I mentioned to you earlier, wherever we are in the mature setup, our strategy has been to add more beds, add more capacity, bring more complexity. So we are kind of firing all cylinders onto that and so far, so good. We are hopeful that [indiscernible] 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 have 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 either new clinical programs or to -- sorry, plus the existing facility or to add clinical programs. So 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 for running the business. So we stick to that. We're, again, very prudent in terms of managing those plans. As I mentioned, as a part of the synergy between teams for that I'm very clear, between KIMS and Care. We've already started to find synergy in the procurement of equipment as well. And this is pretty significant. So the 5% spend earlier and the 5% spend now is giving us significantly more than what you just to give earlier. So I think that's how I mean, all of this is working out so far.

Sure. And this year, we have ended at around 16%, 17% top line growth and around [indiscernible] margin 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, so you expect this growth momentum and the margin expansion to continue for next 2 years?

Yes, I do. I mean we've got 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 year has just been a testimony of the fact that what we've started is the right thing to do, and which is where we start to see the numbers roll in. As I mentioned, our team is rock solid, very committed, and we are reasonably sure that we'll continue to add to what we've done last year.

I just have a last question on Aster. On the [indiscernible] unit particularly, I think not cluster has looking like it is coming out of woods quickly after these leadership changes. But if you can give some clarity, how is the occupancy now in Whitefield for FY '26, 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?

See, on the occupancy, currently, it's once that's only for the block C which is one now that the block is moving to the block. That's another 159 bits getting added. That's a separate, I would say, road path, what we have. In addition to the M50 bets, which is there, that will integrate to the existing morticians. And also, I think I called out even for the CMI where we are coming to another year or so, we'll have the underbids expansion on top of the existing hospital. They're already occupancy [indiscernible] -- so there is a good room. But the only thing in Aster because it's just a 250-bed hospital without having oncology there. There, the runway is a little lesser because currently already occupies is at 66 percentage. So runway, but still you can go up to 75, 80 percentage anyway. So that room is already there. And from the EBITDA margin point of view, I think only in the Whitefield you asked for, it's already in the high teens. ITS is the margin with the white field coming up. I think then you can look at more than mid-20s is the margin, what we are expecting to reach.

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

I just have a couple of questions. One was with regards to the performance in the [indiscernible] Telangana unit. The growth has been outstanding in that particular cluster. So just wanted to understand what steps or have you taken any particular steps to do the cost correction and 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 3 main hospitals. One is the Ramesh Hospitals Group, then we have 2 hospitals, which is in the Hyderabad asset prime, which is smaller 150 beds and Narrabri Hospital in Trupti, which is the 150-odd bets again. So in this, I think the 2 hospitals specifically driving the growth is the Naranahospitals and also Aster hospitals. Not another hospital, I think we opened up almost 3 years back. It's doing really, really well. Even in the current year, you've just seen, we've seen a 46% growth in the revenue and almost 25% plus growth -- because one of the good things why the Narang hospital growing really well is that we had -- we're able to add good clinicians there and also the market is underserved currently. So we are able to execute things at the right time. And also in major of the specialties like cardiac and to another end of specialties, we were able to handle at the second in line also. That is helping us in taking more volumes. And also, we'll be looking at now to convert some of the general was into single rooms so that we can expect more ARPU 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-on-quarter and in addition to that, there are also good things that when the artesian happened, they added to clinicians in 3, 4 specialties, including the nephrology, pediatric department, ortho and cardiology. That's -- there has been -- that's their stronghold there. And 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 we've seen. Last 4 months, and even the April trends are looking very similar, so similar. So with that, they achieved more than 32 percentage revenue growth. And 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 are holding on to the cost, not jumping into hiring more manpower. We can leverage on the existing fixed cost, which is anywhere there. And 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 the last 4 to 5 months. And I think we will expect to continue to grow, not -- maybe not in a similar manner, but I think the runway of what we've created I think we expect Ramesh hospitals to continue to do well.

Secondly, just wanted to understand from Varun about the QC expansion, right? So 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 INR 2,000 crores for 1,700 beds, of which 1,500 is approximately brownfield. So just wanted to understand the permit CapEx that you plan on doing approximately for the brownfield and the greenfield units that QCIL has in its pipeline.

So the blended [indiscernible] do any vary by which hospital, what kind of expansion are we doing. But putt generally comes about INR crore to INR 11 crores, right? That's what the number would be for you to take back. expansion in a quick run through, you look at Bogner, which comes this year. There's a there's capability enhancement happening in Rio, and there's capability as the less bed expansion happening in Budesoand that's largely for this year. FY '28, we expect to add [indiscernible] and capability in Bajada. 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 Majaraah. 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 their clinical fraternity. And that seems to have happened. People now are seeking more from us. So that is another investment that we're making. We've been very excited with the [indiscernible] launch. We've done extremely well. The assets at about 28%, 29% EBITDA and growing month-on-month, month and trading months rather. We are now looking at expanding that to by another 100 beds. So that's another expansion that's going to happen. We are adding beds in '28 in [indiscernible] as well. As I just told you, we're turning that asset around closing at us. 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 [indiscernible] across the board when you're looking at downfield and greenfield, there's one greenfield that we're doing, which is in the are on brownfield, which accumulate to the 1,500 that I spoke about.

Just on the per CapEx, you said INR 1 crore to INR 11 crores, right? So can you break it down for me in terms of brownfield [indiscernible] CapEx and greenfield CapEx?

Yes. So greenfield will come to about INR 1.5 crores and Brownfield will go down to about -- in the range of 0.8% to 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. But the fact is that if you are adding a linear accelerator setup or an onco setup, in a particular hospital, then the numbers will go up. So it is not just the bed. It is also the complexity and capability that we are closing up in the assets. So Vivek, there's no one answer. There will always be a broad range and a broad range for round will be between 0.8% to 1.1%. For green could be about 1.5, 1.6.

Got it. 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?

Vivek, in case of Aster, it's around 8 percentage. And that is with only 2 units currently, which is NIMs. We have still a minority of 20% there, and Ramesh Hospitals on 30 percentage. So overall, at a consol Aster level, it should be at 8% to 9%. I think maybe Q2 should be between 15 to 20 percentage. So blended should be between 10% to 15% should be now. Overall, it's 10%, 15%, right?

Yes. Got it. And secondly, I just wanted to understand your gross number, right? So 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? So if you could

Yes. See, in case of Aster, what we excluded is only 2 things. One is the revaluation reserve that's related to the land driver listing reserve, which we taken up when we converted from the old IGAAP to Ind AS. So it's just a book in reserves, no actual capital employment. Second is the CV because that asset is still not deployed to on your profits or revenue. So there's only 2 teens. In case of QCIL, I think we export the intangibles, right? When they -- because as [indiscernible] the entities in Bangladesh and specifically in KIMS. There are certain intangibles like a brand and goodwill. That is something we're excluding. And that's the only 3 differences we will have between your calculation and our calculation. But we'll be very happy to share it off-line also.

Just one more thing I wanted to ask about QCIL. So the QCIL EBITDA margin, we reported at around 20%, 21%. But as per the annual report that I could see of say, the EBITDA margin is coming out to be around 17% to 18%. If you could me understand like if I'm missing out on anything in terms of understanding the EBITDA margin, what's reported in the asset versus what I can see in the Q3 financials.

So Vivek, there is this onetime that impacts us broadly around the onetime that we are doing on merger and also some of the work that we are doing with consultants to enhance the productivity. So all of that is onetime. We can probably provide you a breakup of that in that reside later.

If anyone other attendees would like to ask a question, please raise your hand. Okay. So there is no more question to the management. Thank you all. This concludes the earnings call for this quarter for Aster 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.