Rainbow Children's Medicare Limited (RAINBOW) Earnings Call Transcript & Summary

May 26, 2025

National Stock Exchange of India IN Health Care Health Care Providers and Services earnings 56 min

Earnings Call Speaker Segments

Operator

operator
#1

Ladies and gentlemen, good day, and welcome to the Q4 FY '25 Earnings Conference Call of Rainbow Children's Medicare Limited hosted by IIFL Capital. [Operator Instructions] Please note that this conference is being recorded. I now hand the conference over to Mr. Rahul Jeewani from IIFL Capital. Thank you, and over to you, sir.

Rahul Jeewani

analyst
#2

Good morning, everyone. I welcome you all to the fourth quarter earnings conference call of Rainbow Hospitals hosted by IIFL Capital. From Rainbow, we have with us today Dr. Ramesh Kancharla, Chairman and Managing Director; Mr. Vikas Maheshwari, Group CFO; and Mr. Saurabh Bhandari, Head, Investor Relations and Group Business Analyst. Over to you, sir, for your opening comments.

Ramesh Kancharla

executive
#3

Thank you, Rahul. Good morning, everyone. It's a pleasure to speak with you all today as we discuss the performance for the fourth quarter and the financial year '24-'25. It's been a transformative year for the Rainbow marked by operational milestones and continued focus on delivering high-quality pediatric and perinatal care. As I reflect on the fourth quarter and the year gone by, I'm pleased to report that we have made significant progress across several areas. Here are some of the key highlights. On the operational front, performance for the fourth quarter was modest compared to the strong second and third quarters of the year. We have witnessed an unusually quiet season, approximately about 35% of our business, which includes pediatrics, outpatient department and pediatric admissions and the pediatric intensive care remained low during this period. However, we did see a strong performance in the certain segments of our business, particularly in the pediatric surgery, pediatric multi-specialty care and obstetrics. All the new beds added during the last year have been seamlessly integrated into the Rainbow network and performing well. This is visible from the performance of our new units for the quarter and full year. I'm pleased to share that we have performed the first pediatric liver transplantation successfully in our Chennai hub hospital. Additionally, we've secured a liver transplant license for Bengaluru hub, a step forward in our efforts to build Chennai and Bangalore as a tertiary care hubs -- quaternary care hubs. It gives me immense pride to share that Rainbow has recognized with the prestigious accolades as follows. We were honored to receive the Great Place to Work with our 90% score award for the first time -- for the 5th time we've got a Great Place to Work award, empowering and -- is a testament to our ongoing efforts to build a culture where our people feel valued, empowered and inspired. We are proud to be recognized as an amazing workplace for excellence in people's practices and received the Best Place to Work for Women awarded by The Economic Times. Further, the Newsweek recognized Rainbow as the Best Pediatric and Women's Hospital for the year. Our fertility business -- our fertility center at Kondapur, Hyderabad received a reaccreditation of JCI, which is Joint Commission International. With this, Rainbow continues to have 3 JCI accredited hospitals in the network and also 13 NABH Hospitals in its network. Our IVF services have shown good progress, reinforcing the potential as a key growth driver for future. Butterfly Essentials is an initiative to offer a comprehensive range of baby and woman care products through the retail stores format has done well. Recently, we have launched a pilot testing to offer the products on online as well. We are still encountering challenges in our international business, particularly in countries like Bangladesh, Oman, Kenya and Sudan, where there has been a significant reduction in the issuance of health care permits for patients seeking medical travel. For the year, the international business revenue was INR 30.7 crores as against INR 44 crores last year. We continue to prioritize cost management, actively seeking opportunities to optimize expenses. This disciplined approach is crucial as the new hospital beds comes into the operations to maintain profitability. Now delving on into the numbers. For the Q4 FY '25, our revenue registered a growth of 8.5%, amounting to INR 370.1 crore. Similarly, our EBITDA increased by 8.7%, reaching to INR 114.7 crores, while PAT registering the growth of 10.7% to INR 56.5 crores. Our overall occupancy rate was -- rate for the quarter was 46.5%, with matured hospitals achieving 52.2% occupancy and new hospitals recording 35.6% occupancy rates. Let me share some updates on the key projects. Regional hub hospital in Rajahmundry in Andhra Pradesh of 100 beds is in the final stages of conclusion and it's expected to commence operations by end of the Q1 FY '26. The 2 new spoke hospitals in Bengaluru, one is in Electronic City of 90 beds and Hennur with 60 beds, the operations are like to commence towards the end of the Q2 FY '26. The project work commenced at the regional hub hospital Coimbatore of 130 beds and is expected to take another 20 to 24 months. We performed Bhumi Puja, which is groundbreaking at both the land parcels in Sector 44 and 56 in Gurgaon in the last week of April. The project work is in full swing in both the sites. In addition to growth plans, I would like to highlight some key achievements that reflect our commitment to delivering high-quality pediatric and perinatal care. Let me share a couple of examples. A desperate couple traveled all the way from Myanmar, hoping to fulfill their dreams of having a baby after several attempts of fertility treatments in Myanmar. They were quite happy and excited when they received the IVF successfully in Chennai and the pregnancy was progressing fairly smoothly. The joy was soon met with a challenging -- a challenge where mother went into premature delivery, delivering a 472 grams baby and the baby came out without -- with a very feeble signs of life. Our neonatology team fully prepared with the advanced notice and the transport systems and registration systems received the baby immediately and began life-saving care. We knew how much this child meant for these parents, spending a lot of time in Chennai. The newborn went through full range of problems of prematurity with extreme low birth weight and being on respirator more than 3 months' time, various cycles of infections, gut problems and requiring a total parental nutrition. So thanks to the 24/7 dedication of our neonatal team and unwavering trust and payers of the parents, this tiny fighter made a remarkable recovery now. At 6 months of age, the baby is thriving well, with a healthy brain, healthy gut and healthy lungs and is expected to have normal neuro-developmental milestones. This incredible journey is a reminder to all of us, as we always say that it takes a lot to treat the little. In another case, when the 2 rare conditions have met together in one child made very complicated to diagnose. A 5-year-old child who had come to Rainbow Children's Hospital with the signs and symptoms of intestinal obstruction. On evaluation, there was no signs of obstruction, but was settled with medical management. This child kept coming back to the hospital with what we call intestinal obstructions with bilious vomiting and constipation. So the -- we discovered that the baby has severe constipation and the colon is not moving at all. This particular condition is kind of what we call the intestinal motility disorder, which is very, very rare. So we also found that child had unusually high blood pressures. This prompted us to investigate extensively, including a PET scan. The PET scan revealed there's a mass behind that chest in the mediastinum, which was subsequently removed and tested histopathologically showed undifferentiated neuroblastoma. Our oncology team believes that outcome of the baby is fairly good with the chemotherapy. The bowel issues are being addressed now. These cases underscore the critical role of multidisciplinary approach in managing tertiary and quaternary care patients, which is key to achieve better outcomes. With that, I will now pass the mic to our Group CFO, Mr. Vikas Maheshwari, to take you through the financial update. Thank you once again for joining us today. So we look forward to your questions and insights as we move forward. Thank you. Vikas?

Vikas Maheshwari

executive
#4

Yes. Thank you, sir. A very good morning to all of you, and thanks for attending this investors conference call. I'm pleased to brief you on the financial performance and key developments of Rainbow Children's for the fourth quarter and for the full year FY '24-'25. Our operating revenue for the quarter stood at INR 370.1 crores, reflecting a growth of 8.5% when compared to the corresponding quarter of the previous financial year. For the full year, our revenue stood at INR 1,515.9 crores, reflecting a growth of 16.9% when compared to the previous financial year. Our EBITDA for the quarter stood at INR 114.7 crores, marking an 8.7% growth compared to the same period last year. For full year, our EBITDA stood at INR 489.9 crores, reflecting a growth of 14.2% when compared to the previous financial year. Our EBITDA margin for the current quarter is 31%, while for the full year, our EBITDA margin is 32.3%. The profit after tax for the quarter is INR 56.5 crores, marking a growth of 10.7% in comparison to the corresponding quarter of the last financial year. For the full year, our PAT stood at INR 244 crores, reflecting a growth of 11.9% when compared to the previous financial year. The main highlight for the year is that our cash generation from the operation for the full year remains very, very robust. Cash generation from the operations was INR 481.2 crores versus EBITDA of INR 489.8 crores, resulting in 90% conversion into the cash generation from the operations. In terms of operational performance, outpatient and inpatient volumes witnessed a growth of 3% and 4%, respectively, when compared to the corresponding quarter in the last financial year. Deliveries grew by 6% compared to the corresponding period of last year. For the full year, outpatient, inpatient and delivery volumes witnessed a robust growth of 12% and 10%, respectively, when compared to the last financial year. Our payer mix continued to remain robust and balanced with 52.9% of the revenue coming from the insurance and the balance 47.1% coming from the cash patients. For full year, the payer mix stands at 48% cash and 52% insurance. I'm pleased to inform that our company's balance sheet remains very robust with cash positions of close to INR 700 crore as of March 31, 2025, and will support our ongoing capital expenditure plan. Given our current cash and anticipated internal accruals in the coming years, we remain confident in our ability to complete all planned capital expenditures through internal accruals without any debt financing. During the quarter, the company has invested approximately INR 43.7 crore in the capital expenditure. For the full year, the CapEx is INR 145.7 crore. With these insights, I conclude my financial update. I now invite questions and suggestions from the participants. Thank you.

Operator

operator
#5

[Operator Instructions] The first question is from the line of [ Mahesh Atal from Atal Investment Advisors ].

Unknown Analyst

analyst
#6

My first question is more on how many beds are going to mature in the FY '26 out of our new hospitals? How much would be shifted to our mature hospital space? And how much new would be added to the new hospitals? That is what my first question would be.

Vikas Maheshwari

executive
#7

There are 2 hospitals, which would basically move from the new hospital category to matured hospital, which is one is the Children's Heart Institute and the second is the Rosewalk Hospital. And the number of beds, which will basically move is 100 beds of Rainbow Children's Hospital Heart Institute and 24 beds of Rosewalk. So total 124 beds will move from new to matured category by end of this year.

Unknown Analyst

analyst
#8

And how many new would be added to the new?

Ramesh Kancharla

executive
#9

It's about 250 beds are going to be added to the new beds, which is -- so there's about 150 in Bangalore, the 2 spokes plus Rajahmundry of regional spoke -- is about 250 are going to add to the network, which makes it the new beds.

Unknown Analyst

analyst
#10

Okay. Fair enough. My second question would be more on -- we could see that you are -- I mean, I'm not -- I'm failing to understand this. We have -- actually our new hospitals has come up, the new beds have come up, but our -- one is that ARPOB is down in the new hospital space and -- but the occupancy is quite good. So what is that we are doing? We are like trying to focus more on occupancy levels right now, so that -- what is the strategy for the new hospitals going in FY '26? How do we increase the ARPOB to the matured hospital thing?

Ramesh Kancharla

executive
#11

The ARPOB comes over a period of time. Whenever there's a new hospital, a new geography or micro market, one is that insurance will take some time. Some -- the tariff is going to be kind of a little more attractive to attract the more patients to your hospital. So this is a very common practice for every hospital. So as the kind of hospitals occupancy is picking up, insurance are all boarded, then the second, third year, the pricing power increases. So that's very natural for most of the new hospitals across the industry.

Unknown Analyst

analyst
#12

All right. Is there any change in the insurance rate that you have taken?

Ramesh Kancharla

executive
#13

I think there is a once in 2 years supposed to be kind of all the renewals happens. Sometimes it can be longer also. So periodically, as kind of they have come in the various stages, each year, some another cluster will come into then. We negotiate and do it. Nowadays, what we have been doing is kind of group level, we do it kind of a Bangalore cluster, Hyderabad cluster and Chennai cluster. Chennai was done last year, but Bangalore is due now and also Hyderabad is going to be done now. Delhi is also going to be done.

Unknown Analyst

analyst
#14

Any guidance you'd like to give on the broader margins for the FY '26?

Ramesh Kancharla

executive
#15

See, as we kind of a growing franchise like this, like last year, if you may recall that -- so what we have always done is about pre-Ind AS EBITDA is about 25% EBITDA, which is something which is we always guided based on our operations and our ability to drive the growth. Whenever you have a kind of a significant number of beds are added, there may be a kind of half to a percentage of EBITDA pressure may be there. But that's what is temporary. If you look at last year, we exactly given then the guidance of that -- this is likely growth of late teens and 25% of pre-Ind AS EBITDA and the margin pressure is probably about 1%. This is exactly what panned out to be after adding 270 beds. So we had about 0.9% of margin pressure compared to the previous year.

Vikas Maheshwari

executive
#16

Just to add what Dr. Ramesh has just told is that what he is trying to say in the previous calls also he has guided that whatever the beds we are adding, there will be definitely some pressure. But there will be threshold limits where we always foresee that our EBITDA margin pre-Ind AS will be 25%. Happy to say that for the FY '25, though we have added 280 beds last year, our EBITDA margin got saved up by 0.9%. So it stands at 26.6% and post-Ind AS 32.3%. Again, there will be a 0.8% save off. As we are entering this year, again, we are adding beds. Obviously, there will be some pressure of the cost from the new units, but may get partially set off from the new units which we have opened that will get set off. But it is safe to assume, as Dr. Ramesh, CMD, is guiding that, the minimum of 25% EBITDA is what is the minimum. We will try to do better as we have done this year at 26.6%.

Unknown Analyst

analyst
#17

Do you foresee any competition coming in your main scope, I mean, main Hyderabad market?

Ramesh Kancharla

executive
#18

Well, there's always been a competition for the last 15 years' time. And city is growing and also population is growing, the more new hospitals are coming up. That's a natural history. And...

Unknown Analyst

analyst
#19

Sorry to interrupt you, sir, any inorganic thing that you are looking at in Hyderabad?

Ramesh Kancharla

executive
#20

In Hyderabad, no, very unlikely because we don't need to do inorganic in Hyderabad because if something opportunity is there, we also will do it. That's probably more efficient than going for inorganic.

Operator

operator
#21

[Operator Instructions] The next question is from the line of Anshul Agrawal from Emkay Global.

Anshul Agrawal

analyst
#22

Sir, first question is on the mature portfolio. Any comment on this performance, sir? Have occupancy been weak in a certain cluster? Or is it across cluster?

Vikas Maheshwari

executive
#23

Yes, occupancy for the matured hospitals, so whatever we have listed has been slightly muted. As told in the opening remarks, right, the pediatrics was slightly muted in this March quarter. Other side, this mother care and other things was good. And Anshul, what we have always guided is if you look at our 3-year CAGR or the 5-year CAGR has been very, very robust at 16%, right? And in 3 years or 5 years, when we are taking to the 16% growth, it has been 12 quarters or 20 quarters, how do you see. There has been 1 or 2 quarters or 3 quarters where performance has not been good or subdued than the market expectations. But that is where we always catch up as a management, if you look at the long-term horizon of 3 years and 5 years. So obviously, it may be subdued. It doesn't show something that it is something we have to worry about. Or it is something that is a long-term growth plan coming into some clouds. That is not the way. It is a one-off. And as the June quarter is progressing, we hope things will settle down and it will catch up to our long-term trajectory of 15%, 16% growth. This year is going to be very, very busy. In the next 6 months, as we have outlined in our presentations, is a lot of capacity is getting added. We are adding 250 beds, starting with our Rajahmundry, Hennur and Electronic City Hospital. So it is going to be a very busy year, which will further lay our foundations for the growth for the coming quarters.

Anshul Agrawal

analyst
#24

Noted, sir. Sir, just a follow-up on this. So are we saying our mature portfolio should also clock, say, around about mid-teens growth going forward, considering this is just a one-off kind of quarter?

Ramesh Kancharla

executive
#25

I think the mature hospitals usually kind of, when they do with the pricing power and those things, about 8% to 10% growth, they will deliver excellent results. That's what we always see it. So for example, took place like Hyderabad that yes, 8% to 10% growth is fantastic. We will deliver excellent results because they are kind of mature to the extent most of the hospitals in Hyderabad, so occupancy is clocking up to 70%. So still there's room and scope and also the always the mature clusters will have pricing power also. So it's a combination of things which we need to look at it in the mature hospitals. And also the case mix change also happens in the matured hospitals. These are all the combinations about the hospital.

Anshul Agrawal

analyst
#26

My second question is, sir, out of the new units that you have commissioned in Q4 last year, could you quantify the drag in margins from these new units in FY '25? And the ones in Hyderabad broken even?

Vikas Maheshwari

executive
#27

Yes. So Anshul, the Hyderabad is broke even as per the guidelines, which we say is the 1 year for us and then 15 or 18 months, depending upon the cluster of Bangalore or Chennai. We are on the same trajectory. There is no change on that. Is that around for the 3 years, the drag was at around INR 12 crores to INR 13 crores for the full year.

Anshul Agrawal

analyst
#28

From all the 4 new hospitals, right?

Vikas Maheshwari

executive
#29

For the 3 hospitals which opened last year, 1 each at cluster, Hyderabad, Bangalore and Chennai, the INR 12 crore to INR 13 crore was on the track.

Anshul Agrawal

analyst
#30

Got it. And sir, any guidance on the Gurgaon project commissioning time line? I heard your comments in your opening remarks, but any definitive guideline of whether it should open by FY '28 end?

Ramesh Kancharla

executive
#31

Yes. I think, see, originally, we kind of -- some time ago, we guided about calendar year of '27 will probably kind of a second half of the year is likely this one, maybe plus or minus 2, 3 months. So we have taken some initiatives, steps to kind of speed up the project because we are taking a hybrid way of construction with a column -- steel column structures. So we are trying to do all the possible things to kind of get the structure done quickly. So once the structure is done from there, it's probably about 1 year, 2 months to get rest of things. So we are on job. We are trying to see that how we can get it done in the next 2 years and 2 years, 3 months. This is where we are. 26 to 28 months is the time we are looking at it now. This is what our project team is promising, unless there is any other headwinds comes in between.

Anshul Agrawal

analyst
#32

All right. Very clear. Just one last question, if I can squeeze that in. Sir, for the next 3 years, sir, what would be our CapEx plan, sir? Would it be on par with what we had guided last quarter, around INR 650-odd crores in the next 3 years?

Vikas Maheshwari

executive
#33

Yes, it more or less remains same. There is no change on that. So the same time lines.

Operator

operator
#34

[Operator Instructions] The next question is from the line of Damayanti Kerai from HSBC.

Damayanti Kerai

analyst
#35

Just wanted to understand for the upcoming units at Rajahmundry and 2 units in Bengaluru, have you started doctor recruitment, et cetera?

Ramesh Kancharla

executive
#36

Yes. Yes. We have actually -- yes, we have done for Rajahmundry almost kind of near closure, the doctor recruitments. And Bengaluru, yes, we are on the job.

Damayanti Kerai

analyst
#37

Okay. So for all the 3 units, it's underway. And Rajahmundry, as you mentioned, is broadly completed?

Ramesh Kancharla

executive
#38

Yes, the doctors -- are almost closed. And also, we have kind of recruited almost about 70-plus doctors to the network in the last 1 year on the various specialties and surgeons and various other subspecialties.

Damayanti Kerai

analyst
#39

Okay. But 70 new additions were across the network, not specific to...

Ramesh Kancharla

executive
#40

Hyderabad, Bangalore, Chennai and Delhi.

Damayanti Kerai

analyst
#41

Okay. That's helpful. And my second question is on your 2 recent initiatives. If you can update us on the Child Development Center and the IVF business, how these 2 units are picking up? And where do you see these scaling up in next, say, 3 years or so?

Ramesh Kancharla

executive
#42

Yes. So the Child Development Center is something which kind of take its own time. We are trying to kind of build a SOP-based kind of overall care, and we're looking for more development pediatricians. This is a service which we are actually trying to see that how do we cost it, how do we kind of -- this is very price sensitive also because of long-term care, not a short-term care. So we are kind of being a little slow on that. Just we don't want to see that -- how to address the community, how to address the community -- these burden of development issues and attention to all the behavioral issues. So we are trying to get some doctors also. One of the things is that the number of doctors trained in this area are very, very few. We've got 2 doctors now. We are looking for 2 more doctors to add. I think that's what is going to kind of change this one. It would take a little bit of time to kind of in terms of revenue size and those things. My interest is to see that how do we build a kind of a high-quality developmental service to address these children. And as we move forward, I think it's probably in the next 6 months' time, I'll be able to kind of give you better projections of the CDC.

Damayanti Kerai

analyst
#43

Okay. And on the IVF business?

Vikas Maheshwari

executive
#44

Yes, Damayanti. So IVF business did very well. And right now, it is 12 or 13 of the hospitals, our IVF is functioning and is growing. For the year-on-year growth since because of the low base, it is very, very strong. It is more than 70% or close to 70% growth on the IVF revenue. As far as the percentage of total revenue, it still remain low, but it is moving upward. It's roughly at around close to 2.9% of the total overall revenue, which the IVF is contributing.

Damayanti Kerai

analyst
#45

Okay. So right now, like under 3% of your total revenue, but it's growing obviously much faster?

Vikas Maheshwari

executive
#46

Correct, correct.

Damayanti Kerai

analyst
#47

Okay. And my last question is on your ARPOB trajectory. So earlier, we talked about like somewhere in high single-digit growth. So will that continue?

Vikas Maheshwari

executive
#48

Yes, that continues, Damayanti, and also in the various investors calls and the meetings, what we have guided because in ARPOB, what happens is that there is a one component of ALOS, which may change because of the various reasons, right? So what we are guiding that, what we should look at, what is the ARPP growth basically. And for the IP ARPP growth, if you look at year-on-year on the quarter-on-quarter, year-on-year comparison basis, you'll find there is always a growth in IP ARPP. And for the last 3 years, we have seen a consistent growth in the ARPP. So for the full year, the ARPP growth was something like 5.6%. I think that will be the right metrics to see that one. If you look at the full year ARPOB, it's 3.4% down, but ARPP is up by 5.6%. I think that is the right way of looking at because the ALOS is nobody's control. It's more of operational driven and the case driven.

Operator

operator
#49

[Operator Instructions] The next question is from the line of Alankar Garude from Kotak Institutional Equities.

Alankar Garude

analyst
#50

Sir, you mentioned 2.9% contribution from fertility in FY '25. Similarly, can you comment on the broad sales split between pediatrics and maternity and fertility for the quarter?

Vikas Maheshwari

executive
#51

So the overall, the broader percentage, Alankar, has not changed. So roughly 30% of our business comes from the mother care-related business and the 70% comes from the pediatrics. So if I'm saying mother care 30%, that includes IVF also.

Alankar Garude

analyst
#52

Sir, but you mentioned about mother care doing well in this quarter. So just trying to understand from a fiscal standpoint and specifically for the fourth quarter standpoint, what was the contribution of pediatrics for us?

Vikas Maheshwari

executive
#53

So as a percentage, Alankar, that is what I'm saying. For the quarter, the fertility business was roughly 32%. But overall, if you see for the full year, it will come to the main reversal of 30%, 30%.

Alankar Garude

analyst
#54

Okay. So basically, a few percentage points here and there, okay.

Vikas Maheshwari

executive
#55

Yes, yes, plus/minus here because both the specialties are growing, right?

Alankar Garude

analyst
#56

Got it. Sir, the question then is, I mean, if we assume that over the next 3, 5 years, the share of fertility and maternity inches up further, should we expect the seasonality in the business coming from pediatrics to gradually reduce over the years?

Vikas Maheshwari

executive
#57

It should, theoretically, yes. But our focus in growing the pediatrics also because if you have gone through our -- we are adding the super specialty projects in our -- another hub, which is Bangalore and Chennai, where we have started the transplant programs, et cetera. So as those programs start in other hospitals, the pediatrics business will also start moving up actually on the value chain. So the focus is not that we leave the pediatrics here. The focus is equally to grow that business also.

Ramesh Kancharla

executive
#58

This is -- Alankar, I'm sitting here. So the pediatrics is our main priority. That doesn't mean that we have less focus on obstetrics. So our drive and focus is a lot more on pediatrics. So we are the organization, which is kind of -- we always believe that we are the people to solve pediatric health care for the country. And obstetrics is a part of the pediatrics. We always say that as far as the child health is one large priority, the opposite comes along with the pediatrics, which is why we don't talk so much about advancing the gynecological side, gynae surgeries and going into too much on gynecology. It's more of a perinatal side we are interested. Of course, you do need to have some gynecology because when you have a network patients, they require some surgical issues. We need to address that. So we've always been very clear in our positioning of we are the children's -- multi-specialty children's hospital and the perinatal part of the children's hospitals. Unlike other people, we have absolute clarity of what we are trying to do, what we're going to do for the future.

Alankar Garude

analyst
#59

Got it, sir. The second question is we saw a 3% decline in ARPOB in FY '25. How should we look at ARPOB growth in FY '26? And maybe a second one related to fertility itself. Does fertility have a positive impact on ARPOB?

Vikas Maheshwari

executive
#60

Yes. It's a very small piece of business, right? It's a growing business for sure. It's a smaller piece. But as we have told in the previous questions asked by Damayanti, ARPOB has multiple factors and sometimes it may not be in control of the company because of the operational-related issues of the case, what type of case is landing at the hospital. I think the ARPP growth, if you look at, I think that is the right metric. For the full year, if you look at, you will feel the ARPOB has come down by 3.4%. But ARPP, if you look at, it has gone up by 5.6%, which is purely as a function of ALOS, which has gone up in this full year by 7.7%. So I think the focus should be on the ARPP, which is the true reflection. ALOS is important. Obviously, it is important. But for the time being, I think remaining focus on ARPP is important to judge our performance.

Alankar Garude

analyst
#61

Understood, sir. So broadly, a 5%, 6% number on ARPP should be something which we can pencil in?

Ramesh Kancharla

executive
#62

Yes, yes, yes.

Vikas Maheshwari

executive
#63

Yes. And if are over ALOS, then ARPOB will go up.

Alankar Garude

analyst
#64

Got it. And one final thing, sir, one request from our end. Now that we have 19 hospitals and a sizable number in -- across Hyderabad, Bangalore, Chennai, we have a couple in AP. There's Rajahmundry also coming up. Can we please start sharing cluster-wise details? It would be really helpful if we can get some of those details to understand the numbers better, sir. Yes, that's it from my side.

Ramesh Kancharla

executive
#65

Alankar, we'll try and give you what are the best possible way. At the end of the day, for us to see that what our annual growth of a CAGR of 4, 5 in terms of metrics. And these are -- the question is that Hyderabad is matured. Story of Bangalore is evolving and going well. And Chennai is kind of a fairly recent. When you try to compare apple to -- one to other, it's going to be a huge difference. We try to work around on that. And so this is -- I mean, when you give those things, it's not going to be kind of very legitimate also to kind of conclude on any of those things. So let's allow us probably a year or so, so that we'll have a kind of a better understanding of how it works. Perhaps we are the only kind of proper hub-and-spoke hospitals in the country, which works in a very similar -- which works in a hub-and-spoke -- truly hub-and-spoke model. So I mean, I will -- kind of let me work on this and come back to you on this, okay? Otherwise, I will lose my hair completely.

Operator

operator
#66

[Operator Instructions] The next question is from the line of Rahul Jeewani from IIFL Capital.

Rahul Jeewani

analyst
#67

Sir, of the 4 new hospitals, which we have opened since fourth quarter of fiscal '24, you said that the Hyderabad hospitals have achieved breakeven. So can you also talk about the Chennai and the Bangalore hospitals, which were opened up in, let's say, last year?

Ramesh Kancharla

executive
#68

Yes, Bangalore is fairly kind of doing very well, not very far from the breakeven. And Chennai will take a little longer time because of high CapEx in hospital and also getting a doctor teams in Chennai always takes some time. So -- and overall, this year, probably kind of as a combined all spreads together, we're hoping that we'll do the kind of a neutral, neutral or positive.

Rahul Jeewani

analyst
#69

Okay. So sir, this INR 12 crore, INR 13 crore EBITDA loss which you had from these hospitals in FY '25, that will, let's say, at a combined level will be neutral going into '26?

Ramesh Kancharla

executive
#70

Yes. Exactly, yes.

Rahul Jeewani

analyst
#71

Sure, sir. And sir, while you pointed out that the margins would, let's say, moderate by 50 to 100 basis points depending on the capacity expansion, but given that in FY '26 -- and in -- so FY '25, we already had this base of INR 12 crores, INR 13 crores hitting the EBITDA, which would, let's say, get to a neutral position this year. So FY '26, is there a possibility that FY '26 margins would broadly be similar to FY '25 margins?

Ramesh Kancharla

executive
#72

I think so. Yes, very well expanding. I think this is what -- see, when you give a guidance, I don't want to go kind of completely haywire. So we have always been -- if you go back and see our commentary about -- we believe and we see that we will try to do bigger than 25% pre-Ind AS. But the pre-Ind AS 25% is something a benchmark, which we have kept it. I mean that's where it is, we feel that now is something is it's not really right to Rainbow. And I mean, we would always try to achieve 26% or 26.5% pre-Ind AS. That's the ambition, which I think most of the times we are fulfilling. So I mean, going forward for the year also, this is what is now with the number of beds being there and what's important for me is the growth. And a lot of beds are there in the maturing stage and great operational drive and sales-marketing drive. And we added a significant number of doctors, about 60, 70 doctors in network this year. And the 3 more hospitals are opening up, if they can do a kind of a growth of 20% or north of 20%, so that will solve all the problems, whatever it is. It's not going to kind of leave any numbers which are kind of a lag behind.

Rahul Jeewani

analyst
#73

Sure, sir. And sir, since you pointed out that, obviously, our business has some seasonality, can you also talk about, let's say, that how are we looking at the growth of the business from a next 3-year perspective before the 2 Delhi hospitals get commissioned?

Ramesh Kancharla

executive
#74

So let's look at this broadly, I mean -- see, the seasonality always will be there. See, when we look at -- we are a medical hospital. We are not a surgical hospital. Our medical is about 75%, 80%. Surgical is 20%. We are not a wear-and-tear hospital. We are more of an emergency-based community driven and an emergency driven and seasons always play out positively and negatively. So this is how the children's hospitals worldwide evolves. But at the same time, we build our resilience and also we are increasing large for -- by adding more specialties and pediatric super specialties, intensive care services and also quaternary care. That's a long-term story, quaternary care. So as we mature more and more, to an extent, we'll start behaving more like towards like a multi-specialty hospital. But it would never be like this, will be like multi-specialty, where there's a lot of business is coming as a kind of a prefixed like cardiac or whether it's orthopedics or urology, neurosurgery and those things, which is why your ARPOBs also keeps changing with us because based on the tickets, the same ICU ticketing can be low in 1 year, higher next year. So newborn ticketing can be low in 1 year, high next year. So there will be a kind of -- when you look at the CAGR of 3 years or 5 years, I can assure you that we are growing as much as any other hospital or better than other peers. So this is what we always kind of urgent request our analysts and investors to see that. Look at the CAGR rather than looking at the quarter-on-quarter. That is what my thing is when you -- I was looking at what is the CAGR for the last 3 years' time is about 16%. And the CAGR for 5 years' time is about 16%. So there will be a kind of odd 1 or 2 quarters. There will be kind of superlative quarters 1 or 2 quarters. So this is how -- but eventually it gets kind of set off. This is a little overall to give you the comprehensive picture.

Rahul Jeewani

analyst
#75

Sure, sir. So a mid-teens kind of a revenue CAGR is what we should expect going forward as well?

Ramesh Kancharla

executive
#76

I would expect it to be kind of late teens to 20%.

Rahul Jeewani

analyst
#77

Okay. Sure, sir. And sir, obviously, our cash generation has been very good, and we have INR 700 crore of cash lying on the books. We were also evaluating inorganic opportunities in some of the markets. So can you update us in terms of how some of those M&A discussions have been ongoing?

Ramesh Kancharla

executive
#78

For sure, we are working on that. I think maybe kind of -- we'll come back to you very soon that to give more updates on M&As. It's a bit premature for me to talk about them.

Rahul Jeewani

analyst
#79

Okay, sir. Okay. And sir, one last question from my end. Within your core Hyderabad market, some of your peers have also announced stand-alone dedicated pediatric hospitals. So some of your peers are now putting up dedicated blocks within their multi-specialty hospitals for pediatrics. So how do you see the competitive intensity, let's say, in your 2 core markets of Hyderabad and Bangalore? And do you face any challenges in terms of onboarding doctor talent for, let's say, the spokes which you are adding in these markets?

Ramesh Kancharla

executive
#80

We'll have to see that when they come actually. So it's too early to say that. We have seen this positioning and also a couple of large multi-specialties have done it in the past, a couple of large credible hospitals in Hyderabad and I don't think they have done very well. And see, basically, it's not something any rights of proprietorship or anything. Essentially, if someone has got so much of patience to see that how to build a children's hospital and they've got energies and patience to do that, it will be successful. Otherwise, it's going to be difficult. So this is how it is. You've been asking me, we have INR 700 crores on the balance sheet. I can do 1,000 beds, but would I do 1,000 beds? No, it's not possible. It's impossible to for me to do 1,000 beds and make it operational. See, if I was a multi-specialty player, I would have definitely thought about it to do about 500 beds. So there's a huge difference in how you build multi-specialty hospitals and how you build a pediatric hospitals, which are very community inclusive and also kind of a very emergency based.

Rahul Jeewani

analyst
#81

Sure, sir. So -- and just a follow-up to that. So in the core Hyderabad market, what is the potential to add more beds, let's say, over the next 3-year period? So in the past, you have indicated that Bangalore market could potentially mirror the number of beds which we have in Hyderabad over a period of time. But within Hyderabad, let's say, do you see opportunities to further add capacities over the next 3-year period? Or are we sufficiently covered in Hyderabad?

Ramesh Kancharla

executive
#82

We still have opportunity to do more beds in Hyderabad. And I think probably we are exploring some opportunities. Definitely, we will do some more beds in Hyderabad.

Operator

operator
#83

[Operator Instructions] The next question is from the line of Manik from Findoc Investment.

Manik Gautam

analyst
#84

Sir, I'm pretty new to this company. So can you please help me with the OPD revenue and volume for FY '25?

Vikas Maheshwari

executive
#85

See, it's the way we look at the OPD revenue, which includes of our consultation, lab and radiology plus pharmacy is that around 30% of our revenue comes from the OPD. And as far as the numbers of OP is concerned, it is roughly 14,26,000 for the full year. Does that answer your question?

Manik Gautam

analyst
#86

Yes, that answers my question. And how are we envisaging the growth in this segment? Is it somewhere linked to the number of beds that we have? Or how will it be shaped going forward?

Vikas Maheshwari

executive
#87

As far as OP revenue you are saying?

Manik Gautam

analyst
#88

Yes, yes.

Vikas Maheshwari

executive
#89

Or overall revenue?

Manik Gautam

analyst
#90

For OP revenue.

Vikas Maheshwari

executive
#91

OP revenue, I think it is the overall proportionate. If you look at our last -- we have seen the last few years number is more or less remains at the same number, plus/minus 1%. So it will get linked to overall revenue growth. And the number should stack up with the same number of 30% plus/minus 1% of the overall revenue.

Operator

operator
#92

The next question is from the line of Nitesh Dutt from Burman Capital.

Nitesh Dutt

analyst
#93

Just one reconfirmation. An earlier participant had asked about Gurgaon time lines. I missed your response. Is it as per the schedule that you previously highlighted or any delays in that?

Ramesh Kancharla

executive
#94

Yes. No, we did mention when the calendar year of '27 towards the kind of the last October, November, that has actually been guided in the past. We are now having started that. We're sticking to that, unless we feel the sales the way kind of we envisage should be done by then.

Nitesh Dutt

analyst
#95

Is it for both the hospitals, October, November of '27?

Ramesh Kancharla

executive
#96

Yes, more or less a couple of months plus or minus. I don't think there's going to be huge variability because there are greenfield projects. And also the teams work -- project teams and everyone works together in tandem.

Operator

operator
#97

The next question is from the line of Rahul Jeewani from IIFL Capital.

Rahul Jeewani

analyst
#98

Yes, sir. Sir, just a clarification. This IVF revenue, which you called out as 2.9% of the revenue, was it for the quarter or for the full year?

Ramesh Kancharla

executive
#99

Full year.

Vikas Maheshwari

executive
#100

This is for the -- okay. So for the full year, Rahul, it was 2.6%. For the quarter 4, it was 2.9%.

Rahul Jeewani

analyst
#101

Okay. Sure, sir. And when you are talking about this, sir -- so this is of the overall company revenue or the IPD revenue?

Vikas Maheshwari

executive
#102

Overall revenue, Rahul.

Rahul Jeewani

analyst
#103

Okay. Sure, sir. So sir, the IVF business is scaling up pretty well given that, let's say, we started this business 1.5 years or 2 years back. And now this business has surpassed the international revenues, which we are doing. So what are your further plans in terms of trying to grow the IVF portfolio? So is IVF now available across all your 19 hospitals or there are still some hospitals where we don't offer IVF services?

Ramesh Kancharla

executive
#104

I think wherever there is the possibility kind of opportunities, we would like to kind of integrate IVF within the facilities. So right now, we have done about 12, right, isn't it? 12, yes. We may be kind of adding some more, but it's not on my top of head at the moment. So the -- one of the things which we look at it is the IVF as a -- we do not want to go out of our campuses and do stand-alones too many. That is a call which we have taken because we wanted to have a complete control on the clinical side of IVF, which is -- we believe in that is -- still a lot of ethical construct is very important. So that's also being a hospital, the children's hospital and also the large maternity services, we believe in organic growth and B2C rather than B2B. Absolutely, we are not looking at the B2B business in the segment. It's difficult also B2B because very unlikely an obstetrician refer you to another obstetric hospital.

Operator

operator
#105

[Operator Instructions] As there are no further questions from the participants, I now hand the conference over to the management for closing comments.

Vikas Maheshwari

executive
#106

Thank you for joining today's conference call and for your thoughtful questions. Your continued support is instrumental in our strategic journey, and we sincerely appreciate the time you all have invested in engaging with our business and the future directions. For any further information or clarification, you may please reach out to Mr. Saurabh Bhandari at the e-mail ID being given in the presentations. Thank you very much.

Ramesh Kancharla

executive
#107

Thank you very much. Thank you.

Operator

operator
#108

Thank you. On behalf of IIFL Capital, that concludes this conference. Thank you for joining us, and you may now disconnect your lines.

Vikas Maheshwari

executive
#109

Thank you.

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