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

[Foreign Language] Welcome to the analyst presentations for the third quarter of the year 2025 Bumrungrad Hospital Public Company Limited. My name is Achariya Sanrattana, Investor Relations & Sustainability. For third quarter, we are having an analyst meeting in an online format, where we will post this prerecording of the analyst presentation on our website, and then we'll follow by the Q&A session with management. For today's analyst presentations, we have Khun Neil Sorrentino, Corporate Chief Strategy Officer, to talk about the key takes away in the third quarter of 2025. Then we'll have Khun Artirat Charukitpipat, Chief Executive Officer, talk about the business update. And then we'll have Khun Oraphan Buamuang, Chief Financial Officer, to talk about the financial highlights and the financial performance for the third quarter and for the 9 months 2025. Then we have Khun Rajeev Rajan give us an update on the business development side. But let me begin with the presentation on the update of the CapEx plan for the next 5 years from the year 2026 to the year 2030. So on this slide here, you will see that the total amount for the CapEx plan for the next 5 years will be THB 16.8 billion. This will cover both the BIH Bangkok and also the BIH Phuket. For the BIH Bangkok, it will include both the new constructions project as well as the existing campus. For the new construction, it will include the Soi 1 project, in which we will add a building for the 59 licensed bed in one building, and then we'll have another building for the other clinics and services. And then we have the BIH annex building, where we will have the Bumrungrad Oncology Institute. This building will house the -- will unify the Center of Excellence for the oncology or the cancer care in which we will unify the Center of Excellence there in that 1 building next to the main campus. Both of the project, the Soi 1 project and the BIH annex are under construction, and now we expect to complete for the both construction to be in the year 2027. And for the existing campus at the Bangkok campus, we have the renovations and expansions as well as the general maintenance. For the renovations, we have the check-up center renovations, and we have the expansion for the Digestive Disease Center or the DDC. Then we will have also opening up the Arabic check-up center as well. For the renovations of the IPD as usual, we will start off the renovations this year to be for the ward for #10 of the 12th floor. And then as usual, we will have the general repair and replacement of the mechanical, electrical and plumbing or the MEP system. For the BIH Phuket, we will have the main hospital campus where we're now under the constructions, and we expect to complete for a soft opening in the first half of 2027. Then additional to the main hospital campus, we will add the resident, the Bumrungrad Phuket resident staff housing center, where we already acquired the land next to the main hospital campus of THB 56 million there. On this presentation page here, you will see the Soi 1 project exterior design. It will consist of the 3 buildings. So the first building is the car parking in which is already completed in 2023. And then there will be another 2 building on the right-hand side that it will be -- one will be the 59 licensed bed and another building will be other clinic and services. Thank you very much.

[Foreign Language] Good morning and welcome to Q3 2025 analyst presentation for Bumrungrad Hospital Public Company Limited. My name is Neil Sorrentino, and I'm going to take you through what turned out to be a very, very stunning quarter, especially from our Middle East and international business space. Next slide. As I looked at the detail for the performance summary for the quarter, we were able to generate earnings of 5.5% growth year-over-year, equaling to THB 142 million greater earnings from prior year Q3 2024 to Q3 2025. Now what's interesting about that THB 142 million growth is that it was based upon 2.1% revenue growth -- top line revenue growth. And you may try to understand or not understand how is that possible. And let me explain. If you go down to the revenue intensity line down below, our revenue intensity for the quarter was 8.6%. It was amongst the highest, if not the highest revenue intensity percentage growth of almost the last 8 or 9 quarters of the company's performance quarter-over-quarter. And this is the reason why we were able to drive that kind of earnings at 5.5% on top line revenue growth to 2.1%. As you may remember, I guided 3% to 5% top line revenue growth. We had some slight dilution in the quarter because we had a lot of RSV and a lot of flu, but it didn't minimize the ability to grow the earnings in the quarter at 5.5%. And in addition to that, because of good cost control, we were able to raise our EBITDA margin from 40.2% to 41.5%, and I'm going to go through the EBITDA and NOPAT numbers later. As Rajeev has -- will explain or has explained to you, depending upon when you hear it, the growth for the quarter by market verticals was pretty dramatic, Qatar, Myanmar, Bangladesh, UAE. You see the percentages there in the summary. What we didn't -- what I didn't put in there was also the percentage of growth for the U.S. That business grew 20-some-odd percent quarter-over-quarter. And when you look at that business in detail, it's split evenly between expat and inbound U.S. visitors coming in. However, as you know, the tourism sector in Thailand has declined year-over-year. There's many, many factors for it, one of which is the very, very strong Thai baht, which has moved some China business over to Vietnam as well as security concerns about China nationals coming to Thailand. When you look at our performance for Q3 2025 on the issue of China and Cambodia, year-over-year, we had a decline of THB 239 million less out of those 2 markets in Q3 2025 versus Q3 2024. Notwithstanding that, we were still able to grow the top line revenue growth by 2.1%. If you look at our record business by percentages, you will see that our total revenue for international business was at an all-time high of 67%. It has been between 65% to 66%. There's been some quarters, very few quarters, where it's been 67%. And the reason for that is the strong international and Middle Eastern business in the quarter. As we talk about Phuket hospital and campus development projects, all those projects are on target. Khun [ Om ] is going to talk to you about what those elements are of the campus development projects. But the Phuket project, which many people are very, very interested in, is on target to open soft opening 1H 2027. I'll be talking about guidance for Q4 at our live stream Q&A next week since we have a very, very tight schedule this quarter. Please tune in for our answers to your live stream questions that you have, and I'll be discussing guidance for Q4. But I will say this about Q4. Q4 continues to be tracking equal to or better than Q3. So we're cautiously optimistic that Q4 will have a positive outlook for the Q4 and for year ending. Next slide. I thought I would show you the historical trend for Thai -- non-Thai revenue. And if you look at the compound annual growth rate over the last several quarters, you'll see that it's almost at 5%. What's most interesting is as you look at Q3 2024, it was negative 6.8% from the prior year. Principally, that was driven by the Kuwait business shutdown of that country shutting down. But then as you look at Q3 2025, it's up 3.5%. So if you consider going from 17.6% in 2023 down to negative 6.8%, we've made that up and more going up to 3.5% for the non-Thai revenue. Next slide. And this is non-Thai revenue by nationality group, meaning Middle East and non-Middle East. And the trend is identical to what I just talked about. Specifically, when you look at the Middle East, 16.6% negative for Q3 2024. And then for this quarter, Q3 2025, it jumped to 10%, 9.9%. Very, very dramatic growth in Middle Eastern business coming out of Ramadan, coming out of Songkran, coming out of earthquakes, et cetera, et cetera. Really, I think what we're going to see in the end is 2H and 1H are going to be diametrically opposed in terms of their performance, really a tale of 2 cities. 1H being troubled by those things that have been really noncontrollable, especially the impact of the earthquake in Myanmar affecting Thailand, whereas as we've come out of 1H into 2H, Q3 has been a very, very strong quarter. Next slide. So I mentioned earlier that what we've seen is a very, very strong percentage growth not only in the Middle Eastern business, but as a percentage of the total, it's as high as it's ever been for our company at 67% non-Thai, which equals Middle East and all other international. And bear in mind that given this, we still show the THB 239 million decline year-over-year because of the Cambodia issue, territorial issue as well as the China issue that I mentioned earlier. Given that, we were still able to manage 67% of our total business being non-Thai. Next slide. These are the highlighted nationalities, the top 10. Rajeev has talked about this and he'll be -- and/or he'll be talking about it depending upon when you hear this presentation. But most interesting here is if I point you to China and I point you to Cambodia, when you look at those 2 negative numbers, that's what equates to the THB 239 million negative year-over-year number, which we're very proud that we were able to cover that negative number and also grow the revenue by 2.1%. And I mentioned earlier about the U.S., you can see that it's up 12.2%. And this is tracking both equally for expats as well as inbound U.S. citizens. This number continues to grow for us for this U.S. vertical. Next slide. Well, I'd be remiss to say if I didn't talk about Qatar for a moment. It's our largest Middle Eastern vertical, and we try very, very hard to take care of these patients from around the world. This country has been a big part of this 8.6% revenue intensity, mostly from Middle East, but principally from Qatar and UAE. This slide here, consolidated BHPCL revenues, I mentioned earlier that if you look to the right, the total revenue is 2.1% growth. Net patient revenues are 1.7%. We differentiate between net patient revenues, meaning hospital specific or medical center specific versus company specific, which is the 2.1% total growth. Next slide. This shows the non-Thai versus Thai at 67% and 33%, one of the highest percentages we've tracked as a company. You see the earlier years, 66%, 63% in 2022. You see a couple of years at 67%, and we achieved that in Q3 2025. Next slide. And here are the numbers that have been produced as a result of our inbound business for the quarter. As you can see, the earnings were up 5.5% for the quarter, THB 142 million increase in EBITDA because of very good cost control and because of the resource consumption that's being driven by this high revenue intensity business we had in the quarter. It drove the EBITDA margin to 41.5% versus 40.2% a year ago. Next slide. And for the net profit, it grew by 4.1%, and it also increased in margin from 30.3% to 30.9% for the quarter. Next slide. So we'll go back to the performance summary, the first slide. And as I mentioned earlier, for those that missed it, I'll be talking about the guidance for the quarter 4 at our live stream Q&A. Please join us. This is going to be at 10 a.m. on Wednesday, November 12. Please join us. Thank you. [Foreign Language]

Good morning. I'm Oraphan Buamuang, Chief Financial Officer. I'm pleased to report you all the financial highlights and financial performance of third quarter 2025 and 9 months 2025. In third quarter this year, total revenue increased by 2.1%. EBITDA and net profit increased by 5.5% and 4.1%, respectively. The growth was primarily driven by a 3.5% increase in revenue from non-Thai patient, which offset with a 1.7% decline in revenue from Thai patient. The EBITDA margin and net profit margin in this quarter were 41.5% and 30.9%, respectively. The EBITDA margin and net profit margin for 9 months 2025 were 40.3% and 29.8%, respectively. I will walk you through more detail in financial performance section. In third quarter this year, total revenue was THB 6,582 million, increased from third quarter last year by 2.1%. The total revenue increase mainly came from the improve in revenue from hospital operation, which increased by 1.7% when compared to third quarter last year. The growth was primarily driven by a 3.5% increase in revenue from non-Thai patient, offset a 1.7% decline in revenue from Thai patient. The growth in non-Thai patient mainly came from Middle East growth by 9.9%, consist of Qatar growth by 14.2%, UAE growth by 18.6%, plus the increase in Myanmar, 21% and Bangladesh 31%. For 9 months 2025, total revenue was THB 18,890 million, decline from same period last year by 2.3%. The total revenue decline mainly came from the decrease in revenue from hospital operation, which declined by 2.9% when compared to 9 months 2024. The decrease was primarily driven a 4.3% decrease in revenue from non-Thai patient, along with a marginal 0.2% decline in revenue from Thai patient. Non-Thai patient decline mainly came from Middle East declined by 11.6%. Indochina declined by 2%, consist of Cambodia declined by 37.3%, offset with the increase in Myanmar, 17.4% and Bangladesh increased by 6.1%. In terms of revenue contribution by service. In third quarter this year, total revenue contribution from inpatient service increased to 52% from 50% in third quarter 2024 due to IPD revenue increased by 6%, while OPD revenue declined by 1.9%. IPD revenue increased mainly due to higher intensity and longer length of stay. In 9 months 2024 and 9 months 2025, the revenue contribution from outpatient service and inpatient service remained at 50%. In terms of revenue contribution by payor type, insurance contribution in 9 months 2025 increased to 21% from 19% in the same period last year due to insurance revenue for 9 months this year grew by 9.6%. The government third-party contribution in 9 months 2025 was 16%, dropped from 18% in 9 months last year due to lower Middle East revenue. Self-pay contribution remained at the same at 62% in both years. In terms of EBITDA and EBITDA margin. In third quarter this year, EBITDA was THB 2,731 million, increased from same period last year by 5.5%. This is a new high record EBITDA amount based on quarterly basis. The increase mainly due to the total revenue improved by 2.1%, plus the cost of hospital declined by 0.9%. And selling admin declined by 10%, mainly came from the marketing expense reduction and offset with the administrative expense increase by 8.8%. EBITDA margin in this quarter was 41.5%. EBITDA in 9 months 2025 was THB 7,607 million, declined from same period last year by 3%. The decrease mainly due to the total revenue decline by 2.3% and offset with the cost of hospital decline by 3%. And selling expense declined by 12.8%, mainly came from marketing expense reduction. EBITDA margin in 9 months 2025 was 40.3%. In terms of net profit and net profit margin. Net profit of third quarter this year was THB 2,035 million, which increased by 4.1% from third quarter last year. This is due to higher revenue and effective cost management. Net profit margin of third quarter this year was 30.9%, slightly improved from 30.3% in third quarter last year. Please note that the net profit amount and net profit margin are the new high record based on quarterly basis. Net profit for 9 months 2025 was THB 5,626 million, declined from same period last year by 4.2%, with net profit margin 29.8%. In terms of leverage ratio, net debt to EBITDA of 9 months 2025 was negative at 0.4x, and net debt to equity was also negative at 0.1x due to less net debt. In terms of liability to asset. At the end of 9 months 2025, the percent liability to asset remained at low level around 13.6%. This is due to higher net asset continuously. In terms of cash flow statement. At the end of 9 months 2025, total cash and investment increased to THB 15.2 billion from THB 11.9 billion in 9 months 2024. This came from the company's operating cash flow and the cash collection from account receivable, especially Middle East account, offset with the dividend payment to the shareholders. In terms of increase in short-term and long-term investment, we allocate excess cash to invest in multiple financial assets to capture the higher interest income yield in this year. These are our financial highlights and financial performance of third quarter and 9 months 2025. Thank you for your attention.

My name is Rajeev Rajan. I'm the Chief Business Development Officer. The third quarter 2025 reflected a steady performance with overall net profit revenue of 1.7% year-over-year growth. Growth was primarily driven by the non-Thai segment, which was 3.5%, which continued to benefit from sustained recovery in the international markets, particularly the Middle East and Southeast Asia. Meanwhile, the Thai segment declined 1.7% year-over-year for the quarter, reflecting softer domestic demand. Key growth highlights included strong double-digit performance from Bangladesh, which was around close to 31% for the quarter; UAE, which was 18% for the quarter; and Qatar, which was 14% for the quarter, while Indochina, negative of 6.5% and China remained under pressure due to the geopolitical and travel-related challenges. Overall, the quarter underscored a diversified recovery across key international markets with encouraging momentum expected to continue in Q4 of 2025. During the third quarter of 2025, overall net patient revenue recorded a 1.7% growth year-over-year. This improvement was primarily driven by continued recovery of the non-Thai segment, which grew 3.5% year-over-year, partially offset by 1.7% year-over-year decline in the Thai patient segment. The non-Thai revenue performance, the key updates demonstrated resilience led by strong performance from the Middle East and selected South Asian markets while growth from the Indochina and China markets were constrained due to the geopolitical and tourism-related factors. Middle East. Revenue from Middle East grew by 9.9% year-over-year in third quarter of 2025, supported by sustained recovery in volumes and revenue intensity. Qatar and UAE were the standout performers with revenue growth of 14% and 18%, respectively. This reflects continued brand recognition and strengthened referral partnerships in the region. Indochina revenue declined 6.5% year-over-year for the quarter, largely attributable to the border conflict situation with Cambodia, which resulted in approximately 37.3% contraction in that market. The Myanmar market, however, achieved a 21% growth for the quarter, driven by improved accessibility and expanded referral network. The Chinese market has yet to rebound meaningfully as safety and travel concerns continue to affect inbound medical tourism. Bangladesh posted an exceptional 31.2% growth, making the highest ever quarterly performance supported by expanding corporate partnerships and sustained patient demand from the region. For other markets, revenue from international community and international expats living around the CLMV region continued to see demand where we saw a 3.8% growth. Key contributors include U.S., Germany and the U.K. And for the final slide, these are the top 10 nationalities, non-Thai and their key contributions for Q3. Thank you. [Foreign Language].

Hello, everyone. It's my great pleasure to meet all of you today. I will be presenting about business updates of Bumrungrad Hospital in third quarter this year. The first slide, we are very pleased to share with you that Bumrungrad was named the Best Public Company of the Year 2025 in health sector by Money & Banking Magazine. This is our second consecutive year receiving this recognition, which reflects our strong financial performance, governance and sustainable business growth. The Bumrungrad Heart Institute continues to set global standards in cardiovascular care through advanced technology and clinical expertise. Our team is highly experienced in using minimally invasive and precision guided that help patients recover faster and fewer complications. This reflects our mission to combine technology, innovation and teamwork for better outcome in complex cases. At the regional level, we also recognized at the Hospital Management Asia Awards 2025 for Patient Experience Improvement. Our project Empathy-Driven Nursing for Difficult Patients was selected from 399 entries across 140 hospitals in 14 countries. This award highlights our culture of compassion and our commitment to continuously improve patient care and experience. I'd like to highlight this key medical milestone achieved this year. We successfully performed the first Impella procedure in the Thai private sector. This is an important advancement in high-risk cardiac care. This milestone show how Bumrungrad continued to lead in advanced high-acuity and technology-driven care. For the third quarter, our performance has picked up strongly, driven by the rebound from international patients. Most of our Center of Excellence, especially those handling advanced and complex cases show very strong solid growth, such as heart center growing 16%, followed by strong gain in neuroscience center, 14%; cancer, 9%; and gastroenterology, 9% as well. These results reflect our strength in high-intensity, technology-driven care and reinforce Bumrungrad's leadership in specialty medicine. Last but not least, this is part of our investment in clinical innovation. We are continuing to promote and introducing several new technology next year. In cardiology, we will adopt 2 advanced equipment, as I mentioned above, about Impella. This is a minimal invasive heart pump to support patients with severe heart failure. Another one in heart center is pulsed field ablation. This is a new procedure to treat complex heart rhythm disorders with higher precision and safety. In ENT, we are bringing Inspire therapy. As everyone knows already, this is a nerve stimulation device for sleep apnea patients who cannot tolerate with CPAP. In breast surgery, we will introduce vacuum-assisted excision to offer less invasive procedures with faster recovery. And in oncology, we also introduced cryoablation. This is a freezing therapy for tumor in kidney, bone and lung. That's all for me for this quarter. [Foreign Language]

To those of you who received the invitation to join our Q&A session, it will be on Wednesday, 12 November, 10:00 a.m. to 12 p.m., where our management will be happy to answer all of your questions that you may have. During this time, if you have any questions before the meeting, please feel free to send your questions to ir@bumrungrad.com, and then we will address those questions during the meeting. For today, thank you very much for your attention and [Foreign Language]