Bumrungrad Hospital Public Company Limited (BH) Earnings Call Transcript & Summary

Hello. Good morning. [Foreign Language] Welcome to Bumrungrad Hospital PCL's analyst presentation for the year 2020 and for the fourth quarter as well. I'd like to start this presentation a little bit differently from the usual format by highlighting something that we're very proud to announce. Bumrungrad will be publishing its very first sustainability report along with its annual report in a couple of months. And why is that the case? We'd like to highlight the fact that we've recognized increasing importance from our international stakeholders and investors as well as our domestic investors on the topic of sustainability and how we, as an organization, are responding to the needs of disclosure as well as to protecting the environment and to providing a good place to work. As you may or may not be aware, we are constituents of the FTSE4Good Index. This is an index that recognizes a company for its good corporate governance, good principles, ethics and its ESG ratings. In addition to this, we are also constituents of the MSCI Index whereby we're rated an A. And although we believe we can do better, we hope that with this report, we will be able to provide you with a lot more detail and to increase the transparency that we intend to continue to do in the future. I'd like to touch on a few topics that I believe could be of interest for certain shareholders or certain potential investors who are listening to this presentation. There are certain key elements to the sustainability report that we'd like to focus on. One is on the issue of striving for excellence. And what we mean by that is not only our culture of operational and service excellence, but also the incorporation of this concept throughout the organization. Whether it be in the patient safety aspect, to the quality of service aspect to even drug-related safety issues through pharmacogenomics. Providing a great workplace is something that we have always been active and always taken seriously with, and this is no different. We want to recruit the best talent possible. And we have to create an organization that encourages and facilitates this. And we'd like to disclose to you more details on how we do that. Moreover, the environment, something that is off top of mind in many countries and with many people now. What we are doing as an organization in energy management and water management, these are things that increasingly crop up in the news and there's a concern for viability of businesses in the future. Finally, on supporting communities, building upon the culture and the foundation that we have had since the beginning of the company's founding. And in fact, supporting communities is incorporated in our name itself, Bumrungrad, taking care of the people. We will highlight areas not only in CSR, but also in ethical marketing. Something that is very important nowadays, especially in the -- in an era of increased digital penetration and data-driven marketing. On the next slide, you will see that there are other areas that preoccupy many of our investors and stakeholders in. On cybersecurity, on data protection, on ethical marketing as I touched upon earlier, how we are communicating to our patients in an ethical manner and in generating proper and approved content for them. So without further ado, I'd like to move on to what is usually the case and that is starting off with the overview of the quarter and for the year. And for that, I'd Like to hand over to Neil Sorrentino, Chief Global Strategist, who will highlight -- who will take this further. Thank you.

[Foreign Language] and I wish you good morning as well. As Daniel said, we're here this morning to talk about our Q4 and our year-end 2020. It was a challenging year in many respects, as all businesses literally around the world, have faced some very, very challenging times, and it has not been any exception for Bumrungrad. However, in the quarter, and in the Q3 quarter, we did see some significant gains on both our international business. Limited as it was coming into the country, especially on our Thai business and specifically on our expat business, we did maintain our market share growth moving -- coming off of 2, 3 into -- coming off of Q2 into Q3 and then maintaining that strength and growing on it in Q4. And I'll talk about the details in just a moment. In the quarter, we did celebrate 40 years of service to the Thai community, to the expat community and to the world in the sense of what we do as the international medical tourism preferred provider of care in the world, and we're very, very proud of that 40-year period of making ourselves available, doing public service in many, many different ways, apart from simply just providing high-quality patient care. As well in the quarter, we prepared ourselves for 2021, insofar as developing a budget for the upcoming year, which we are in now. As we looked at 2021, looked at the sagging economy, looked at the continuing growth in COVID-related infections in Thailand, understanding better what the Thai government is doing insofar as vaccination program development and rollout, we essentially see as a projection as carrying forward our market share, our strong market share in both Thai business, in both expat business and continuing to bring in international patients selectively and specifically, depending upon approvals by the Ministry of Foreign Health -- Ministry of Public Health and Ministry of Foreign Affairs. In that budget, we determined that wage inflation was 0. So as a result, we budgeted a no increase in prices, both through our doctors' fees as well as our hospital charges. So for the first 6 months, we will be maintaining our 2020 pricing strategy, both for doctors' fees, which our doctors are quite willing to cooperate as well as our hospital charges. And we intend on maintaining that price freeze through 1H of 2020 (sic) [ 2021 ]. We expect that in the third and the fourth quarter, assuming the borders open up by that time, and it's a big assumption. But we assume that if the borders do open up, we plan to bring in the large amount of pent-up demand that we have in international business. As of today, we have over 360 patients that want to come to Bumrungrad. And this number varies anywhere between 350 to 400 on any given period. So we're confident that once the borders do open up without the necessity for quarantine, 14-day quarantine period requirements, we're quite confident that the combination of our international business returning in Q3 gradually and more and more gradually higher in Q4, we're quite confident that as that returns, we'll marry that with our increased market share in Thai, expat and other international business, meaning expat business that have nationalities internationally, where we experienced, by the way, quite a jump in Q4, and I'll talk a little bit more about that in just a moment. Another major event that Daniel intimated about was our new major shareholder. As many of you know, if not all of you know, a local competitor made the decision that Bumrungrad Hospital Public Company Limited was not for sale. And so they've sold their stake in the company. 22% of the company's shares sold it into the open market. And Khun Satit, representing his family and his father being Dr. Pongsak, who was a founder, if not the principal founder of Bangkok Gen more than 40 years ago, bought 17-plus percent of Bumrungrad Hospital Public Company Limited's shares. I and my Managing Director have visited for many hours with Khun Satit and talking to him about how we would work together. And now I will point out that although he is an investor in Principal Capital Healthcare, they did not buy shares in Bumrungrad Hospital Public Company Limited. This was a family investment, not a company investment. And Khun Satit has no interest in being a Board member. He has no interest in being part of management. He verbalized to us and to the press that his principal interest was to invest in a strong public company that has a great reputation, strong brand, excellent management, and his interest is having his investment grow in terms of its market price. And so we had a very, very good long chat. In fact, several chats with Khun Satit, and we hope to be working closely with him as we go forward together. As you know, and we've mentioned in the past, prior to this investment stake, we have been doing business with Principal Capital in the development of joint centers and spine centers at various hospitals in their network. We continue to develop those networks. And while they are a related party now, at the same time, we see, and they see, as a company, a strong opportunity here to help uplift their secondary hospitals in the Thai market. As I mentioned, we saw strong support in Thai, expat and international. And I'm going to go through that detail with you in just a moment. So you'll see what happened in the quarter in very, very specific ways. In addition, in Q4, we saw some major launches in what we have called the Bumrungrad Hospital health care ecosystem digital development. You will meet for the first time Khun Wisut later on in this presentation. We recruited him well over a year ago from AIS. He was arguably well-known as the most advanced and most experienced and most accomplished Digital Marketing Technology Officer in all of Thailand. And we were fortunate to have him join us at Bumrungrad. And he's done some amazing things for us. He'll be talking about that in just a moment. Khun Ling, my CEO will be talking also about, finally, our hard launch December 1 into our RAKxa 6-star villa resort complex for which we built our second Vitallife scientific wellness center in, and it opened March 1. It had very strong initial support. Now while this was initially developed for the international market as well as the Thai market, but principally the international market because the borders are closed, we and M.K. Real Estate Development Company and the Minor Group that's managing this complex focused domestically on how it is we could get interested Thai people and expats to use this on a daily basis or a 2- to 3-day basis. And I think unsurprisingly, when you look at the campus and it's beautifully, beautifully done, very zen-like, very peaceful place to go just visit and hang out, apart from getting 6-star service, apart from getting very good scientific wellness care. When you visit it, you're immediately impressed. I've spent a lot of time out there. And true to that impression, we have now sold, I think, 44 memberships, Khun Artirat will talk more about this. On the nonmembership piece, just in December, we generated THB 2.2 million in revenue. And on the membership side, well over THB 40 million. And this is just for the first 4 to 6 weeks of operation. So we see a very, very bright future there, both for M.K. Real Estate Development Company and Bumrungrad Vitallife. And this takes us, as I've talked for many quarters to you, this takes us closer and closer and closer to the integration of wellness and sickness. It's a major, major trend throughout the world. We have been pushing this as Bumrungrad for several years. And this is a very, very good example of where one joins the other and patients see the value in wellness, in health, in prediction and in prevention of their ill health by taking advantage of wellness health. So let's go now to the individual markets, if I can, using this next takeaway and international revenue growth, Indochina and Middle East. Next slide, please. So starting with top line net revenue growth. If you look here, as I was saying earlier, we came off of a very, very large Q-over-Q change to Q2 to Q3. We maintained that strength and grew the net revenue growth by an additional 1%. And this is in the face of a red zone declared for Bangkok because of this flare-up of COVID infections in December. And it's also in the face of Myanmar having a coup imposed upon them. And also Myanmar having a red zone of its own with a major flare-up in COVID infections and still -- and still including, I would say, Bangladesh, it also had a red zone flare up. And still, we grew the revenue off of a very strong base in Q3, we grew at 1% in Q4 overall versus Q3. Of course, year-over-year, it's not something you can compare and really look at because in 2019, we had international revenue. With borders closed, it's really a noncomparable thing to really look at. Next slide. So let's look at the Thai business, even more strong. If I take you now year-over-year, fourth quarter '20 versus fourth quarter '19, we grew the Thai business 4.2%, and this is a pre-COVID normal year for Bumrungrad. And this depicts -- this 4.2% really depicts our ability to reach out digitally into the market with our promotions, with our telemedicine, with our vaccines at home, with our home care. This demonstrates that we have been very, very aggressive in being able to give Thai people and expats what it is they're looking for during a very scary period of time given COVID. So when you look at these numbers here off of 2, it went up 30%. And then in addition to that, went up an additional 1%. So we're very, very proud of our ability to not only hold what we had, grow where we came from off of '19, but also grow off of Q3. And you can see the trend lines here. I've also provided those for you to see the years differences between the green and the black lines. It's something you can study when you have more time. Next slide. So on the expat side. Another interesting statistic here is that Q4 '20 over Q4 '19, the expat business grew 8.5%. We haven't had that kind of quarter-over-quarter growth, although we do look at it, we don't present it. We haven't had this kind of quarter growth for as long as I have been involved with Bumrungrad. On a Q3 versus Q4 comparative, it was about flat. It was down 0.8%. That is principally because of the December COVID impact creating the red zone in early December where fear kept people home. Going to international, next slide, please. If you look at international, the Q-over-Q change was 2.5%. Now what's driving this? The 2.5% that is driving that number when you see international, you say, well, "Gee, I think -- I thought the borders were closed?" Well, the borders are partially closed. They're closed to the extent that unfettered tourists can't just come into Thailand, not serve a quarantine of 14 days and then just enjoy medical tourism as well as tourism in Thailand. For that benefit, it really doesn't exist. But where we have been very successful is being able to reach out into our international referral markets. And specifically, in this case, the Middle East market, Kuwait, UAE, Qatar, Oman. We had patients coming from these markets where they were flying to Thailand. Patients came here, went through a negative COVID test, were put into our AHQ, alternative hospital quarantine. And then from there, flipped over into medical-surgical care at Bumrungrad. That is what drove this number from the Middle East market, from the Cambodian market and Indochina market and the like. In addition, this number was also driven -- because we also look at international patients by nationality. And we had a number of U.K. patients that, yes, would be titled expats, but they were also international patients. And that's what also drove this number up mainly from the Hua Hin market. But of course, Q2 -- Q4 '20 versus 4Q '19, there's no comparison there because borders are closed. Next slide, please. On the Middle East, I mentioned a little bit about that a bit ago. Look at the strength of the Middle East market. It's the countries that I just mentioned to you. From Q3 to Q4, the net revenue went up 8.1%. Why is that so high? We didn't raise prices. This is specifically driven by admissions. And specifically driven by those countries I just mentioned to you that now see themselves able to travel a little bit better. And of course, these countries in the Middle East are far advanced on their vaccination program than really almost any other country in the world, absent New Zealand and of course, absent Israel, which is the most advanced country in the world. I believe they vaccinated all of their citizens. Yes, it's a smaller country. But nonetheless, the Middle East has been buying Sinovac vaccines and got in line very, very early. And there -- they just had their citizen requeue up, and people got vaccinated with literally whether they wanted to or not in order to open up the country. And as a result of that, we're available and being able to fly, they came to Thailand because they love coming to Thailand. That's what drove this number. Now of course, again, the comparative '19 to '20 is not a comparative because this is selective. This was open source, where we took all-comers from all over the world, not allowed otherwise. Next slide. Indochina, down 15.7%. What is that driven by? That's driven by principally Myanmar because that's in that Indochina sleeve. High COVID infections as well as the coup. They had a major coup there in December, and the volume just dropped right off the end of the table. And the other country was Bangladesh, which also had very high COVID infections. They stopped flying to Thailand. And that was the 2 things -- the 2 countries that drove this percentage down Q3 over Q4. And very, very well calculated, nothing going on here, except those 2 countries, negatively affecting the comparative quarter-over-quarter. Next slide. I wanted to show you this slide because we did nothing, obviously, no one else did either about alternative hospital quarantine and ASQ performances in the year. But we took this very, very seriously early on in 2020 as COVID started taking effect. And if you look at this trend line here, we started at 0 on net revenue for our AHQ. And at the end of the year, the cumulative number was THB 608 million. Now that's 2 things. That is the, the money is paid by people in the AHQ as well as the revenue driven by those patients as they convert out of quarantine into hospital services. And so when you look at the AHQ conversion rate, meaning -- AHQ means these are patients that came into the country, were housed on our campus in a quarantine status. And then from there, converted into patients. When you look at this trend line, the conversion rate of those patients was 46%, almost 50% of the patients came, served the quarantine and sought health care, which drove this THB 608 million number. If we hadn't had an AHQ services in place on-campus, we would have lost that revenue. It would have gone some place else. So when you look at this number, THB 608 million, and you come here to 1Q, the percentage contribution of that number at the start was literally 0. And at the end of Q4, it jumped to 5% of our total revenue. So for us, we were opportunistic. We were agile. And as we brought these international patients in, we were able to accommodate them in our AHQ and create a serviceable medical-surgical intervention for these patients. Please go back to the takeaway slide. So on this takeaway here, the dividend policy, let me talk a little bit about that. When last we met you digitally, I talked about the 1H dividend policy that was approved by our Board. And that 1H dividend policy at the time was 113% of EPS, and it tracked exactly to what the 1H dividend EPS was for 2019. The Board at the time felt that they didn't want to give anything less than what was given in 2019 to our loyal shareholders in 1H 2020. In the same way, this past Wednesday night, I presented to our Board, different options about choices. Given their history, given their concerns about maintaining loyalty to loyal shareholders. And on Wednesday night last, they approved and will be recommending to our shareholders at our Annual General Meeting in April a dividend of THB 3.20 per share. That THB 3.02 (sic) [ THB 3.20 ] per share is exactly the same amount that was given to shareholders of record in 2019. That represents 211% of EPS for 2020, which was THB 1.54. I'll explain why the Board did that. The reason why they were able to do that is that as a company, we have a very, very, very strong balance sheet. And this is not to be underestimated when you go through some kind of a worldwide crisis like we've been through. We meaning the world. We have unappropriated retained earnings of over THB 17 billion on our balance sheet. But as important, if not more important, we have free cash flow of THB 8.37 billion in cash. In the last 4.5 months, we have been able to collect THB 4.2 billion in cash in 4.5 months. We have seen our AR grow because Middle Eastern countries, among other countries, Middle Eastern countries have been slow to pay because of COVID. We've been very, very aggressive, but professional with our sponsors and pleased asking them to pay. And they being long-term clients of ours, they supported our understanding. We took care of their patients in a first-class fashion. And they paid us THB 4.2 billion in the last 4.5 months. So we were pleased to see that, that professional relationship we've developed over the years is well-respected and well-regarded by our sponsors and guarantors. We don't know how our shareholders will react or behave in April. But in the past, if the past is any predicate about the future, it's quite likely they will follow the recommendation by the Board, but that is a decision up to the shareholders at our Annual General Meeting in April. Finally, insofar as guidance is concerned, I started my discussion about Q4, the budget that we developed, our expectations for 2021. In addition, as many of you know, the Bank of Thailand has reduced GDP projections into the high 2s. Again, we have many, many, many Thai people unemployed and the borders are still closed, and it's going to be probably March before the initial phases of the vaccine program begins to be administered to Thai people. The first vaccination -- first capsules of vaccine are supposed to arrive in Thailand, February 24, next week. And then there is a period of testing to undergo. So vaccine administration is not going to begin, vaccination-wise, until probably the 1st of March. So given that, guidance is difficult to come up with for Q1. We're still in a situation, in a period where there's a high level of uncertainty in Thailand until such time as borders open. I mean that's the predictive thing. When will the borders open? We don't know the answer to that question. So we will maintain withholding any kind of guidance going forward for Q1. Until such time as we have more visibility and more clarity about the vaccine program, when it's going to threshold into a greater amount in -- after Q1, we should know more at the end of Q1 about how fast the vaccine program will progress through Thailand. That concludes my portion of the presentation. As you know -- or as you may not know, we intend on holding a live Webex streaming Q&A next week. We invite you to submit any and all questions you have to myself and Khun Ling and Khun Oraphan, we as management will do whatever we can to answer your questions. You may submit them before. You may submit them live on stream, or you may submit them even after if you -- if you don't remember to ask the questions you want to ask during the call. So with that, I'll close. Thank you very much.

Thank you, Neil. Our next part is on the financial highlights, and I'd like to hand that over to Khun Oraphan, our CFO. Khun Oraphan, thank you.

Good morning, everyone. Today, I would like to report you on the financial performance in fourth quarter 2020 and for the whole year 2020. For the financial highlight, despite growth in Thai and expat business, the continued restriction on travel and medical tourism, although improving, but still continue to impact the company's international business. In fourth quarter 2020, revenue declined by 38.5%, mostly due to a decrease in revenue from non-Thai patient by 59.8%, offset with an increase in revenue from Thai patient by 4.2%. EBITDA declined by 63.2% with EBITDA margin, 17.1%, down from 28.6% in the same period last year. Net profit and diluted EPS down by 80.5%, with net profit margin 5.9%, down from 18.5% in fourth quarter of last year. However, in fourth quarter 2020, total revenue will continue to improve from third quarter 2020 primarily due to less overall discounting compared to the previous quarter. And in case in international patient from alternative hospital quarantine, or AHQ service, total revenue for fourth quarter 2020 increased by 1% from third quarter 2020. Due to THB 15 million onetime compensation to staff paid in fourth quarter 2020 for Bumrungrad 40 years' anniversary and the shown in patient mix, fourth quarter 2020 EBITDA declined by 5.4% from third quarter 2020, with an EBITDA margin of 17.1% in fourth quarter 2020 compared to 18.3% in third quarter 2020. For the whole year performance, total revenue declined by 32.9%, mostly due to a decrease in revenue from Thai patient and non-Thai patient by 1.8% and 48.4%, respectively. EBITDA declined by 54.8% with EBITDA margin 20.8%, down from 30.9% in the same period last year. Net profit and diluted EPS down 67.9% with net profit margin 9.7%, down from 20.2% in year 2019. For our financial performance, total revenue in fourth quarter 2020, the company reported total revenue of THB 2,947 million. This amount represents 38.5% decrease from fourth quarter last year. For the whole year 2020, company report total revenue THB 12,445 million, 32.9% decrease from prior year. This was mostly due to a decrease in revenue from Thai patient and non-Thai patient by 1.8% and 48.4%, respectively. For revenue contribution by nationality, due to the lifting of the national lockdown within Thailand, including [indiscernible] promotion to stimulate local market and create many news activity and channel for patients, resulting in late recovery and growth in Thai and expat business in second half 2020, while international is still facing with difficulty on traveling due to the continued restriction on travel and medical tourism. The revenue contribution of Thai increased from 33% to 56% and 48% in fourth quarter 2020 and year 2020, respectively. For revenue contribution by service. In fourth quarter 2020 and year 2020, revenue intensity of inpatient services increased from longer length of stay in both of Thai and non-Thai patient. Revenue contribution from inpatient service increased to 51% and 52% in fourth quarter 2020 and for the year 2020, respectively. For revenue contribution by payer type, there were change in payer mix due to the COVID pandemic impact. Self-pay declined from 69% to 61% in year 2020 mostly due to the [ case 11 ] reform international self-pay as the result of travel ban in all international country during first half of 2020 and selected opening on a few country in second half of 2020. And insurance contribution increased from 16% to 21% in year 2020 due to increase in Thai and expat insurance patient. For government third-party contribution increased from 13% to 15% in year 2020 due to less self-pay in Middle East patients. For EBITDA, we had implemented many cost management program throughout year 2020, including workforce management, contract management and inventory management. As a result, we grew actually cost saving THB 531 million for year 2020 and plan to continue cost management program for year 2021. However, there are few fixed cost that could not reduce such as software support maintenance, ground service, depreciation on fixed assets and amortization of software license from digital platform expansion. As the result, EBITDA in fourth quarter 2020 was THB 505 million, declined by 63.2%. Year 2020, EBITDA was THB 2,593 million, declined by 54.8% from the same period last year. For the EBITDA margin in fourth quarter 2020 was 17.1%, declined from 28.6%. And year 2020 EBITDA margin was 20.8%, decline from 30.9% in last year. For the net profit decline with the same reason of EBITDA decline. Net profit of fourth quarter 2020 was THB 173 million, declined by 80.5%. And year 2020, net profit was THB 1,204 million, declined by 67.9% from last year. For net profit margin in fourth quarter 2020 was 5.9%, declined from 18.5%. And year 2020 net profit margin was 9.7%, declined from 20.2% in last year. For net debt to EBITDA, year 2020 was 0.5x, higher than last year due to less cash on hand and EBITDA. For net debt-to-equity, in year 2020 was slightly up due to less cash on hand when compared to last year. For interest coverage, ratio in 2020 dropped to 19.7x due to less EBITDA in year 2020. When considering bond covenant requirement for net debt-to-EBITDA, it should less than 3.25x and net debt-to-equity less than 1.75x. The current net debt-to-EBITDA and net debt-to-equity in year 2020 was still a lot lower than bond covenant requirement. Based on the covenant requirement, we had still has borrowing capacity THB 7.1 billion. This is our financial performance in fourth quarter 2020 and for the year 2020. Thank you for your attention.

Thank you, Khun Oraphan. Our next subject is on business updates. Khun Artirat, our CEO, will be providing you an update on what we've been doing in 2020. Khun Artirat, please?

[Foreign Language] I'm very pleased to meet all of you again. So for today, my presentation, I would like to start with domestic referral and partnership Center of Excellence. You can see the revenue growth of our domestic referral business is quite a good growth. It's around 24% compared to 2019. This revenue is around THB 780 million, which include the MOU hospital which are 59 network hospital and non-MOU hospital. In terms of the segmentation, we have around 64% of non-Thai patients. That means all the expat because last year, most of the international cannot fly in. And the new patients from the referral business is 31%, which means of the referred patient that come to Bumrungrad, we can have around 69 is our existing patients of Bumrungrad and the new patients from the hospital that referred the patients to us. So for the partnership of the Center of Excellence, in 2020, we opened a joint and spine center at Princ Suvarnabhumi Hospital. And in October, we opened our spine center with Nakornthon Hospital. And early of December, we also opened spine center with Aikchol Hospital. For the Princ Suvarnabhumi, this is quite new. So the average OPD volume is around 30 patients. And the conversion is very low. But Nakornthon Hospital, they have very good outpatient numbers, which is around nearly 280 cases per month, and the conversion to be the -- to do the surgery is around 2%. For Aikchol Hospital, we opened in December. But the outpatient that come to consult with our spine center is quite good. It's around 160 cases. But we don't have conversion because COVID came -- for second wave of COVID. The next one, this is the map of the center of excellence that we opened in our hospital network. You can see that this is Bumrungrad. So of the partners that we opened our Center of Excellence, the distance is far from Bumrungrad, it's around more than 20 kilometers. And each one is in the Chonburi Province. So this is to confirm that we try to avoid cannibalization among the spine patients and the joint patients. The strategy for the Center of Excellence for this year, we will continue to strengthen the -- for existing partnerships with that 3 hospitals, and we will collaborate in terms of the online, off-line digital marketing. And we will continue doing the teleconference and also have the health seminar with our hospital networks to increase the education and awareness to the doctors and nurses and other professional staff. We plan to expand our center of excellence to other hospitals. And we will expand not only joint and spine. Right now we -- everyone may know that we already start to implement cancer network with Princ -- at the PrincHealth and Princ Ubon. So the center of excellence that we plan to expand to our network hospital will be high-intensity specialties. So during COVID, telemedicine is becoming the very popular. And when we start to use telemedicine with our patients, start from March. In 2020, we got the revenue around nearly THB 40 million. And right now, we have the revenue per month for telemedicine, nearly THB 6 million per month. And the number is quite high, nearly 1,000 cases per month for the telemedicine. And this is Bumrungrad @Home service. During COVID, we already start to provide new service and becomes the next normal of our Bumrungrad service. So we -- since April in 2020, we provide a service to our patients, around 810 cases. And the revenue from Bumrungrad @Home is around THB 9 million. So -- and the tactic to regain the Thai and expat volume. Today, we will have Khun Wisut, our Chief Digital Market Officer. He will present to you about all the digital marketing campaign and promotion. And I believe everyone interested in this campaign. So now I would like to show you the RAKXa at Bangkrajao. We start to simulation our service since September in 2020, and we start opening in November. We start the campaign by selling the membership programs to our customers, and we've got very good numbers. We have around 44 members now. And as of January, it's around 47. And the amount is around THB 40 million. So we plan to expand other services to Bangkrajao, such as post-operative care, the cancer rehabilitation and senior care. For senior care, we will focus on healthy elderly customers. In 2021, we focus on the continuing to strengthen our Center of Excellence, especially the number one is our oncology center. Number two is urology that we have robotic surgery, and we have the magnet physicians. And the critical care is the highlights of Bumrungrad especially during COVID. The revenue growth from the referral I think because of -- when COVID comes and the patient is very concerned of the safety and quality. So we have quite a good growth in the critical care patients as well. I mean, in terms of referral. And we focus on the tissue and organ transplants, especially the kidney transplants that right now, our price is very competitive and very attractive. And we will continue to strengthen our spine center. And we opened colorectal surgery, and we got the very good doctors from Chulabhorn Hospital. So this is my last slide. The plan to strengthen the Center of Excellence and expand new service of Bumrungrad. So we cannot stop to recruit the magnet and good doctors. In 2020, we recruit total 32 physicians which are full time, 8 persons; and 24 part-time physicians. Among these 32 physicians, you can see that 21 of them are international board certified. So this is to confirm the positioning of Bumrungrad Hospital that we're very focused on the top talent physicians. And this one is to strengthen our center of excellence and open the plan to expand the new services. And I know that someone may think that maybe this is replacement or not. In fact, we just lost only 8 full-time physicians in 2020 and the part-time physician is around 12. So in total, it's 20. So we got 32 now. Not only can replace, but we also can support our service. Thank you ka.

Thank you, Khun Artirat. Now Dr. Thassanawut will be updating you on the alternative hospital quarantine service that we're providing. Dr. Thassanawut, please?

Good day, everyone. I'm Dr. Thassanawut Dhearapanya, Division Director of Medical Transport and Business Development International of Bumrungrad International Hospital. I'm so glad to meet you here today. I'm about to give you an update on our AHQ, our alternative hospital quarantine. Despite the hardship and restrictions imposed by the Thai government, alternative hospital quarantine remains the gateway in bringing international patients into Thailand. We are not only bringing the patients in traditionally by air, but we are trying to explore a new way of bringing the patients in. Let me show you right here. A camper van installed with the bathroom and the sink, able to put the patients and companions and keep them in the closed system since they crossed the border from the neighboring country into Thailand. We are trying to bring more patients in, not only by air but by ground. As you might have heard, Cambodian is #1 in the proportion of the patients that we could successfully bringing in last year. So with the ground transportation able, we hope that we can bring more and more patients in. Let me show you here the successful story of the patient coming in from Laos. Think about it. A long enduring 9-hour car ride. How can you manage without a toilet? With the recommendation from the Ministry of Public Health, we need to find some way to keep the patient safe and sound during this ride. Here is what we came up with. The camper van with the bathroom in it so we can keep the patients and their companions, safe and sound in the closed system, the close environment. So the quarantine could be started right away after crossing the border. Last year, we successfully brought in 159 patients with 545 companions of theirs. These people are desperate in looking for the state-of-the-art health care where Bumrungrad International Hospital can provide. That accounted for very big number in the total number of AHQ patients coming into Thailand, and that generated THB 478 million in total revenue. The trend is keeping up and up. So we are -- hopefully, this year, more and more patients will come in from international to our hospital acting as an AHQ. Number of patients were coming in from Cambodia, China, Myanmar, Kuwait and Ethiopia. As of yesterday, 17th of February, before we recorded this, the total waiting list tallied up to 360 patients. These people are looking forward to coming to receive the health care that only Bumrungrad International Hospital can provide. They are from China, Kuwait, UAE, Qatar, Myanmar, Cambodia, even Ethiopia, which is almost half the way around the world. Bumrungrad International name is not only the brand that is famous in the neighboring country or the region anymore. Patients flew in from Africa to seek for their medical care. With the ban lifted by the Thai government, patients can come in from Kuwait, Ethiopia, even Bangladesh, thanks to the new list of accepted countries by the Thai government earlier this month. Hopefully, this year, we'll be bringing in more and more patients and generate more revenue. Thank you.

Thank you, Dr. Thassanawut. Now an update from Khun Wisut, our Chief Digital Marketing Technology or MarTech Officer. Khun Wisut, please?

Hi, everyone. [Foreign Language] My name is Wisut Ua-anant, I'm the Chief Digital MarTech Officer. And MarTech is stand for marketing technology. Currently, we work as a Bumrungrad startup to be hybrid between marketing and IT team. But my IT team is different, legacy from the IT because we do the digital engineering with the cloud system for the digital. And for marketing, it's different from the typical marketing as well. We do like data digital marketing, utilize the data to monetize return on investment. Okay. This is the chart -- understand about the MarTech word. Okay. The next one, after I came here, right, 7 years ago, I did the digital transformation for AIS and worked with AIS for 13 years. And we start to transform in 7 years ago. And we know that the most important thing we need to have the foundation for digital is called SMAC. SMAC is mean -- S is social, M is mobile, A is analytics data and C is cloud. Currently, I reduced the time and everything in 1 year. From 5 years AIS to 1 year to develop Bumrungrad digital health care ecosystem now. You can see from this picture, we have the website and online store part, and we have the application, wearable, IoT platform. And we also had the payment, online appointment, API and with the marketing cloud, technology that we can utilize the social media with the data. And with the push messaging, SMS and e-mail as well. And also integrated with the TrakCare off-line data to utilize the data that we have in the hospital to target the right people at the right time and the right place. Okay. It is the first one that we did already for last year. Okay. For this picture, we can make it 5 angle of the commerce. You can see we can build e-commerce, they have for the website and online store. We can build mobile commerce for application for the mobile. And the third one, wearable commerce is the future that you can use wearable to make payment. And C-commerce is a conversation commerce. Currently, Facebook have the Facebook business research that says Thailand is #1 in the world to use the C-commerce. The C-commerce stands for conversational commerce. It's many people love to ask before the sale. That's why currently, we already developed the system that people can ask us and we going to change the nurse, we come to be the health consultant for this C-commerce. And the last one is about S-commerce, it's the social commerce, the one that we try to utilize. So share to make revenue generation. Okay. Next one. Okay. Next one is about the road map, I show you what we did from MarTech platform. We just -- actually, the whole year, we did about 45 projects launched. But right now, I show you about only the most important platform. That business went on for each month. The first one, we have the online appointment on our website. And when people submit, it can send to us directly faster and make internal post for appointment for customer. The second one, on February, we did the live chat, people can start to live chat. This one is kind of like the C-commerce startup on that time. And March, we launched the online store. We can sell the whole package from 60 clinics in the online store now. And people can click to buy now and make payment and get voucher right away. I will show you later in more detail. And April, we start to do the marketing cloud. We implement the system and try to educate the data to utilize the data in the future for marketing. And on May, we did the first success case. This one is the short-term win success one that we not utilize the data yet on that time. We did the Buy1Get1, get one in online store, and we can make the new high, [ THB 36 million ] in 36 days. It is the new challenge that I think it's a really successful on that part. And on that time, we just focus on the Thai people and expat only because the COVID situation. Right now, this website already translate more 80 language. It means in the future after COVID is done, we have more opportunity to sell more, allow to work. And for June, we did the C-commerce platform integration with Facebook and Facebook Messenger. And this go to the contact center to answer the question -- any question from customer. Okay. The next one on July. We start to develop the marketing automation. This one is kind of the loop-based marketing that when we make appointment, we can go to the e-mail first. Notification on the application first. If people not open the e-mail in 7 days, we start to send it to social media. After social media, if they're not open yet, we just put it back to the SMS something like that. This way is the way to track customer and not like make them feel bad because we're going to check the status for each day first. Okay. And then August, we start to launch the first phase of the application, the Bumrungrad application. And start to have the appointment, find doctor and start to have to see the My Cart, the My Patient Profile, My Doctor and My Appointment Reminder in the application as well. We're done already on August. And every month -- we will have update feature every month. The September, we launched the new concept of organ search in the website. It means that when people don't know who he is the doctor that I should meet, right? They just click on the organ that they have problem, and they can select the symptom and it will recommend the doctor for them automatically. This one is the new one that make people convenient and experience better than before. And on October, we start to develop the growth engine platform. This one is kind of like it's called abandon cart reminder. It's called like when you see something and you not do anything yet, we have the push notification, web push to remind you again, something like that. This step, we already done as well. And on November, we did the digital signage. We tried to utilize the offline digital signing hub to do O2O concept, online to off-line and off-line to online to integrate more in the hospital. And also developed the IPD TV room inside there to start to develop the content in there. In the future, we can sell the package, sell the content anything in the TV in the IPD room as well. And the last one on December, we launched the new concept, the -- actually it's Thailand first, hospital that launched the gift voucher on the online. Everything is digital. When you buy gift voucher, you can use this gift voucher instead of the money, apply our cash. And you can use in many situations. Like if you have someone or have a newborn, right, you can give the gift voucher to them. If they want to married, we can gift like a married gift, something like that to be like the new concept that we're not going to give voucher anymore. We can change to be this one. And people can use and rebuilt the cost that they have to pay that. Okay. And this is the before hospital service. It's the concept before we developed the online store. We call reduce time -- reduced waiting time to come to hospital, reduced the waiting time to cashier and can go back right away. Because after we do empathy map, we know insights of customer, we found that people are scared about getting COVID. They really want to go back home right away. That's why we make them -- can come to access our portal, online portal and they buy the package that they want. When they come to here, they have the fast lane to scan the voucher and treatment and go back home. They don't need to wait in the cashier anymore, okay? And we also developed the -- we just launched this one in this week, we call LINE My Shop, sell the gift voucher as well. It means that right now, we can buy any gift voucher, THB 1,000, THB 5,000, THB 10,000, and we can give it to LINE Friends -- LINE sticker. You can send the gift voucher LINE sticker, and you can like say something to them. This will be easier and faster. This is the first time in Thailand as well. Okay. And you can see, look and fill up the online stone. Currently, the good one of this one, we have 80 language already. It means we have potential more to sell around the world. Our payment is supported around the world as well. And we try to increase more payment method for each country. We try to increase the Alipay, we will try to increase AMEX more and more for each of the customer by each country. People can buy here 24 hours. Okay. You can see the example vaccine store. We already launched vaccine store as well. This one, we have vaccine for hospital and vaccine at home. People can have option to select the vaccine here as well. This one ready for sell COVID-19 vaccine as well. Okay. And the next one is about genetic store. This is the new trend that people love to buy the DNA and no predictive wellness partner. We already have the store for this one as well. We have pharmacogenomic as well. And right now, some partner like an insurance, work with us to redeem the [ pie] and use that [ pie ] to be the core discount and get the genetic for free. Something like this. We opened for the partner right now, and we're going to work with the one and another as well. Okay. This one is Buy1Get1 that show you, on that time, is the new high and new success case of us on March, on April. And we can make the new high like this. And overall, we can make THB 36 million in 36 days on that time without any utilized data yet because our data were just in demand on that time, not used yet. This means if we do, again, in this year, I really believe we can grow it more than this 3x. Okay. And you can see ROAS, return on ad spend. We got really, really good result. If you see the whole campaign in 36 days, we returned more than 1,800% for this. Okay. Talk about the application. We launched application, the first phase in August. And my team, like I told you, we make like a start-up of the Bumrungrad, right? The culture of the team development MarTech. We did the agile mindset with the sprint -- every 2-week sprint, we need to deliver some result. This means our application right now, every month, we will have the new feature every month. That's why we can delivery this result more and more. Today, I show you some feature that until now, what we have in this video. [Presentation]

Okay. It is the first one that we launched, and we try to summarize in this video. You can see we already have the digital member card. This means no more physical card. Customer patient, no need to have the physical card anymore. They just reach the station and link HN. With our application, they will have the digital member card with the loyalty program in there. Right now we have many cards. We have -- first, we have gold, platinum and centurion to be the segment of the customer. And they can do the appointment in application. And we can remind them in the calendar of the device currently. And find doctor easier. And check the doctor that you just meet and history of the doctor in 1 year. And you can see the online store package in the application and ask any question to the chat in application as well. This is the main feature that we launched about 8 features right now. You can see the real one look and feel like this. You just click on the My Account menu, and you can see your card like this. When you come to the hospital, we just scan your barcode. Everything -- every information will go inside there. And when you click on My Care, you will see the list of your doctor in 1 year back. And you can click on the doctor and you can make -- book appointment as well. In the future, it's going to be telemed as well, okay? And the appointment also, you can see the appointment list that history that you come to here. You can have the multiple appointment in one day. If you have to meet multiple doctor in one day, right now, you can see from view all, you can have the list of the doctor and what is the place -- where is the place that I have to go. We have any information in the application. And find a doctor, easier, you can search, brain, eye, you can search whatever you think about and it will show the list of the doctor to -- for you to recommend. And you can search about the name of the doctor as well. So the profile of the doctor, specialty of them. And you can add book appointment and add to calendar to remind you. In the morning, when you remind, it will check your location, and it will calculate how long it's going to take to come to here as well from Google. Okay? And we already have the social integration. With our app right now is so easy. If you use iPhone, you can create account with Apple ID. You can use Facebook, you can use Google, you can use Twitter. Anything is flexible for us to create an account. And we also have the security part of biometric unlock, face scan, finger scan when you go to your privacy data. And the application, social integration, this one is just only feed content to an application. We did the new thing about the gift voucher that I just told you. And we can use gift voucher for married, for the newborn, for the health screening, right? We can use in many ways with their family and friend and your loved one. And okay, you can see we've start 12.12. On that time, we start 12.12 with the Grab app. We pushed our voucher in the Grab app. And people awareness about this one, about 2 million people to see this one. And we start to have the new concept of the BH LINE My Shop. Currently, if you go to the LINE Bumrungrad and you click on the voucher, gift voucher -- gift card, you can see the gift voucher in there. After you buy it, you paid it, you will have the barcode to use and you can share to your friend LINE sticker. Currently, we already launched this one this week. Look I feel like this, we can have many picture. Many seasonal, many reasons to give to anyone. That's all.

Thank you, Khun Wisut. And finally, we'd like to close this presentation. Thank you for listening. As a reminder to everybody, we will be holding a live Q&A session digitally on Webex. The live Q&A session will be hosted at 10:00 in the morning on the 24th of February. See you there. Thank you.