Rede D'Or São Luiz S.A. ($RDOR3)

Good morning. Welcome to the earnings call of the first quarter of 2026 of Rede D'Or. We have here with us today, Mr. Paulo Moll, President; Rodrigo Gavina, CEO of Hospitals; Otavio Lazcano, VP of Finance and IR; Raquel Reis, CEO of Dental of SulAmerica. This should last about 1 hour and it will be available at the IR website of the company. Thereafter, we're going to start with the Q&A where you're going to get more instructions. Before continuing, any statements that are made during the earnings call regarding the business perspectives of Rede D'Or regarding the financial expectations are based on the beliefs of the Board of Directors based on information that is currently available. Forward-looking statements are not guarantees of performance. They involve risks, uncertainties, and they might take -- might incur in risks that may or may not take place. Industry conditions and other operational factors might affect the performance of the company and might lead to results that are different from the forward-looking statements. I'd like to give the floor to Mr. Paulo Moll. He will start. The floor is yours.

Good morning. It's a pleasure to be here once again with you. Let's talk about the first quarter of 2026. We started with a gross consolidated revenue of BRL 15.5 billion, a growth of 10%. Our EBITDA consolidated of BRL 3 billion, an expansion of 27.3% year-on-year, a gain of 2.7 percentage points in our margin. Let's consider the results of the assets of the insurance. We have an expanded EBITDA with the insurance restricted assets of BRL 3.4 billion, 27.6% year-on-year. Net income, 13.9% year-on-year. And I'd like to highlight that we are -- have a solid capital structure, and we should finish the quarter with a leverage of the debt 1.75x net debt over EBITDA below what was 2025. Let's reinforce that we have synergies in our integrated model with the hospitals, insurance, oncology, coordination of care has brought positive results quarter-on-quarter. We have in hospitals a quarter that is strong in mix and operational quality. We got to the number of 727,000 patient day in that period, a growth of 1.4%. Occupancy rate, 77% 77.5%. It's an expansion of another 0.5% year-on-year. Let's consider that we have the operation of another 35,000 beds. So we have another 146,000 surgeries, a growth of 11.9% against the first quarter of last year. And the surgeries that we classify as high complexity, we've had a growth of 15%, and they are representing 1.8% of the total surgeries. I'd like to highlight that this growth consistent of the surgeries has sustained healthy levels in our occupancy. The gross revenue of the hospitals in oncology got to BRL 9.2 billion, growing 15.6%. Average ticket consolidated of the last 12 months, 9%, CAGR of 6.9% if we see a period that is longer since 2020. The EBITDA margin in hospitals, 26.6%, expansion of 2.4 points year-on-year without the effect of the asset -- the assets that were incorporated to Atlantica D'Or, the margin would be 22.2% without that, even though -- even so, we would have an expansion of 0.5% in regards to the first quarter of '25. Oncology, also important, we grew 23.6%. Oncology got to 11.7% of the revenue of services provided in medical service provided against the 11% in the first quarter and 10% in the first quarter of '24. We observed a growth that is very strong. We had the expansion of 16% in volume of infusions, 7% in the average ticket. Also, our conviction that the best model, operational model for oncology, which is the integrated model of the oncological clinics and hospitals, allowing for the treatment of the patient in all of their needs has been the best model. For patients and a more sustainable one that delivers best outcomes and great attractiveness to the oncologists that have been working with us, and we've reinforced our team. At SulAmerica, we would like to highlight the results. We would like to state that we have BRL 6 million in dental and health growth in regards to last year. Just in health care, we are adding 209,000 lives in the last 12 months. Consolidated loss ratio, 77.2%, an improvement of 1.4 percentage points year-on-year and the EBITDA of the operation, BRL 850 million, a growth of 28%. The asserted asset, the adjusted EBITDA of BRL 1.3 billion, an advancement of 29%. With that, I will give the floor to discuss the expansion. We're going to close the quarter with 13,500 beds, 10,000 of these operational, 10,486 in the pipeline between '26 and '28. An addition of 2,500 beds, most of them in projects of brownfield, 72% of these beds. I'd like to highlight that we are advancing in the works, very important ones in the Eastern zone of Sao Paulo, Gloria D'Or and Oeste D'Or, Ribeirao Preto Hospital Brasil and Santo Andre, Taubate, Sorocaba City at the ICU and Maranhao and San Carlos Hospital Fortaleza. Also, I'd like to highlight that at Atlantica D'Or, we have 6 operational assets and 3 of these projects are being developed by Atlantica D'Or. With this, I will give the floor to Raquel, and then I remain here for the Q&A.

Thank you, Paulo. Good morning. Bringing the main highlights of SulAmerica, I'm going to start the year in the same way that we do 2025, a growth that is consistent and sustainable. In the first 3 months of '26, we've added 22,000 lives, 22,000 beneficiaries in health and 8,000 in dental. Our base go over 6 million lives, and this is a historical record for us, with over 600,000 net additions last year, 200,000 in health care and 400,000 in dental. One of the big highlights over the last years has been the capacity to increase the portfolio by adding to the mechanisms that you know and you've heard us talk about such as co-participation and modular reimbursement that help to service more profiles of clients, more regions with more modern and accessible options. And this helps with the control of frauds, abuse, consolidated loss ratio in general. 900,000 beneficiary with the modular reimbursement and most of the sales have some level of court participation, including retail, which is a great news. Of course, that has an impact in the average growth of the ticket given the effect of the mix in the portfolio, but this is a natural reflection of a strategy that increases sustainability. And we always try to get the lowest reimbursement possible for the client. And I can also talk about the readjustment for the pool of the companies. This year, we have 11.83, which is 4 points below what was last year. At the same time, the consolidated loss ratio is controlled, 1.4 points versus the first quarter of '25. We have a consistent trajectory of improvement year-on-year. This reinforces our mantra of responsibility, responsibility at the subscription without ever trying to find the wars of price and the provisions that are well done. Now I will give the floor to my colleague.

Thank you, Raquel. Good morning. Let me thank all of our collaborators, our employees, our patients, our providers for being with us in this journey and for believing in this work. Paulo already discussed a lot of what I was going to mention. I'm not going to be repetitive. Raquel really stated well, we are growing consistently and sustainably. This is on the side of Rede D'Or as well on the hospitals. And I'd like to highlight that as SulAmerica, the hospitals, we are very focused in this in delivering quality and safety. This is what will move us to the next thresholds and to be recognized for delivery of results that is of assistance with quality and safety, always getting the operational efficiency, of course, in hand. We grew the patient year-on-year. We grew the beds. As Paulo said, we grew the operational beds. And fundamentally, we brought more patients to our institutions even with this growth in beds with more occupancy and more complex surgeries. So this is due to quality of assistance that demonstrates to the public physicians, patients, those that pay the math, how much we're focused on improving our operational efficiency and bringing safety to our patients. This is a summary. Once again, thank you very much. I will give the floor to Otavio.

Thank you, Gavina. I'm on Page 7, the gross revenue ticket of the service -- hospital services on the graph on the left, we have the first quarter, the gross revenue of this segment, BRL 9.1 billion. This is a growth of 15.6% year-on-year, an increase of the average ticket 11% and an increase of the number of patients. Quarterly comparison, stability result of the increase of the average ticket 6.6% and a drop of the patient 81%. On your right, you can see the record -- the evolution of this ticket since March of 2020. Page 8, same information, oncology. On the left, company reported a gross revenue of BRL 1,075 million, a growth of 23.6% year-on-year, an increase of the average ticket of 6.6%, an increase of the number of the infusions, 15.9%. In the quarterly comparison, a growth of 2.4%, an increase of the average ticket 1%, an increase of the number of infusions 1.4%. On the right, we present graphically the evolution of the average ticket of the segment since the first quarter of '25. Page 9. Costs and expenses. Services, hospital services. On your left, the cost on the segment, BRL 6,287 million in the first quarter of '26, a growth of 13.9% in the year-on-year comparison, a decrease of 1.1% with a quarterly comparison as the revenues of this segment grew higher than the cost in the annual and the quarterly comparison, we had an expansion of the gross margin in the annual comparison, the 80 bps gross margin in the quarterly 40 bps. So on the right, we have general and administrative expenses, BRL 363 million first quarter of this year, a certain stability when you compare to the previous quarters and the highlight is for the positive nonrecurring events reported in the third quarter of '25 and the fourth quarter of '25, mainly related to SulAmerica, ISS tax that are postpayment. These nonrecurring events, we have a stability and an evolution of this expense line, very similar to the top line of the company. Moving ahead to the Page 10 in net debt, we reported for the hospital service, BRL 2,120 million in the first quarter. In the first quarter of '26. This is a growth of 26.7% in the annual comparison, a growth of 1.5% in the quarterly margin EBITDA of 26.2%. On the right, we presented the net income and adjusted net income for the first quarter of '26, BRL 1,159 million and BRL 1,203 million, respectively. Page 11. SulAmerica, we start on the top left. Company reported a net revenue of this segment in the first quarter of '26, BRL 8,685 million, a growth of almost 8%. And moving clockwise on the top right, consolidated loss ratio, 77.2%, a drop of 1.4 percentage points in the yearly comparison. On the right, the beneficiaries of health and dental of 6 million clients consistent growth. And on your left, at the bottom, an adjusted EBITDA of BRL 1.2 billion adjusted EBITDA, a growth of 29%. The EBITDA of the company and the adjusted EBITDA consolidated data were BRL 2,969 million and BRL 3,148 million, respectively. Page 12, indebtedness. You can see on the top left, the company reporting cash and cash equivalents, BRL 45.2 billion. The net cash from technical reserves, BRL 26 billion, the gross debt and net debt of BRL 48.1 billion and BRL 22.1 billion, respectively, we have a net debt over EBITDA 1.75x. The company is deleveraging. We went through the peak of the cycle of investments. We're generating cash growing. This allows for the deleveraging of the company regardless of the payment of the extraordinary dividends in the previous FY that was BRL 6.5 billion. Still on credit metrics, when we insert in the concept of cash flow with the impact in the net debt, the technical insurance provisions we have a relationship net debt of EBITDA of less than 1.2x. At the center of the page, we have an indebtedness of 6 years, cost of capital of CDI tax 1.1 and the cash position and the debt amortization of the schedule throughout the next years. There is enough money to face all the commitments until 2032. And here, we would have the cash generation. Here, the combination of cash in the first quarter. On the left, managerial cash flow, we start with an EBITDA of BRL 2,969 million. Moving to the right, we verified a positive working capital of BRL 280 million, BRL 188 million of Rede D'Or Hospital and BRL 91 million, the SulAmerica entities. On the right, other items of the balance sheet. Here, we have the transference of hospitals of Gloria to Atlantica D'Or, a joint venture that we have with Bradesco. Another step to the right, we have payments of leasing, BRL 194 million, taxes of BRL 585 million. On the right, the financial activities, cash flow positive, BRL 709 million. We have captures of BRL 3 billion, payment of interest, BRL 1.5 billion. We have the liquidation of derivatives for BRL 451 million, the payment of interest of capital of BRL 984 million and repurchasing of cash in the BRL 285 million. Another step to the right, investments, BRL 61.6 million. Here, we have the transference of the hospitals, Gloria and Maternidade Star, the joint venture with Bradesco. We get to an evaluation of cash ex private pension of BRL 2.8 billion, excluding the effects that are stemming from the private pension, we have the cash generation of the first quarter delta BRL 2.9 billion. This is the presentation, and now we open for the Q&A. Thank you very much.

[Operator Instructions] First question, Samuel Alves, BTG Pactual.

Two questions on our side. First, about technical provisions. We realize that the technical provision is at the max in regards to the revenue of SulAmerica. And last year, you mentioned that you didn't have any change in criteria. The question is, is there any curve of warnings that is more aggressive that would lead to the company having that conservative -- additional conservative? And the second question, finance, about the effective rate of interest of the tax return. Having that increase that we've seen in the first quarter, is it fair an effective [indiscernible] of 2026 that is similar to the following years? Or should we have an increase of the effective because of the contribution of SulAmerica because of the contribution that is higher of the segment?

Samuel, thank you for the question. I'm going to start with the first one, and then I'll give the floor to Otavio. In regards to the policy of provisions, we still have the same provision that we have commented. So responsible, a bit more conservative and it reflects in the behavior of the consequences. The fluctuations of the quarter are normal. So more and more, we see that return of the seasonality in the pre-pandemic scenario. So it's very normal to see the increase in the provisions. There is nothing else different to comment. We are always following and observing adjustments, and this can happen throughout the year. But nothing that we should highlight.

Well, Samuel, about your second question. I think that you got into an interesting point. We had a fourth quarter an income that is higher in health and that in the first quarter has the biggest payment of taxes. But now I don't see reasons to change the effective structural rate throughout the time. And remember that the company has the controller. We have negative OCSL. We have the explanatory notes, and we have an x amount of mechanisms to administer the effective ala carte of the company. So there shouldn't be any changes in the first quarter.

Next question, Mauricio Cepeda, Morgan Stanley.

Our first question is judicialization. We realized that there is an increase in that issue. I wanted to know if these are commercial issues. And how do you see this moving ahead? There is a change in the rules? And do you see any improvements with this issue of the judicialization of the system? And here, commenting on the regulatory. If you -- since we have an election year, you can update us on those restrictions that were proposed, health care plans, the unilateral and how are these discussions? And if that can somehow be impacted because the sector is better, and we have the sector being preserved.

Cepeda, thank you for the question. Well, in regards to judicialization, there isn't a lot of changes in the reasons that we've seen throughout time. Maybe there is more pressure since last year. We saw an increase of the judicialization, but I think that, that is a reflection of what we are doing with the sinister. So we have a big team working with this, an important front, our legal team is working, dealing with hunting those frauds. And there is an increase of judicialization. We're fighting and also there is a fight on the other side. So besides that, I don't see anything too bad. We've seen a reduction in regards to the decision of the Supreme Court. It will gain maturity through time and judicialization is that. In the regulatory, a few discussions, they've announced the discussion on the participation. I think you should see that. And in regards to the other public consultation ongoing, we haven't advanced. What I've seen in a positive way, these are changes, discussions that can bring structural changes to the market and that need an update. And they need to bring a robust conversation with all the connections of this productive chain and the pain party. We reinforce that to the regulatory body before we make any decision in tempestuous way. And the payment party, 99% of the beneficiaries have access to the supplementary health care through the employers. So it's more relevant that the employers have a seat on the table and they discuss with the operators, but also with the regulators. So there isn't any evolution of the points that we are discussing. So far, so good.

Next question, Vinicius Figueiredo, Itau BBA.

I wanted to explore hospitals. This first quarter, even looking at the results of the pain party, this is a quarter that had a consolidated loss ratio that is very good. So when we see a dynamic quarter-on-quarter, I know it's more difficult for us to see these trends. But when we see the records quarter-on-quarter in hospitals, you always have some growth in revenue. And in this quarter, specifically, you've had a behavior that is very different. There is the effect of the sales, but this magnitude is different from the records. How do you see this January, February? Is there a frequency that is weaker than normal and is that limiting the growth of the revenue, but also leveraging of the operations that is higher -- that is higher. I know that the margin is more challenging. So the -- on that is invoiced would we make it -- the nominal EBITDA would grow. When we get that trend and we see the comparison base of the next quarter is ever more difficult, looking mainly at the third, fourth quarter, the base is more challenging. So can we carry over this to the growth of EBITDA even in the scenario of a base that is more challenging? Or anything that you can see that could unlock as long as the volume has a more normalized threshold?

Vinicius, look, we analyze this first quarter with normality, with consistency, consistency of growth. We avoid to do that comparison with the quarters with different seasonalities. I think that the best way to guide you for this first quarter against first quarter, looking at this way, we grew 4% in the volume. We gained 0.5 point of margin, even doing the adjustments of the one-offs. And even considering the point that you considered with a growth of honorarium, as you said, there is a few negotiations that we brought to the negotiations of the surgical packages. These were bought by the operator. That is part of the hospital bill, and there is a pressure in the revenue because of that. And there is a benefit of growth of ticket and top line that compensates, as you said, nominally the positive EBITDA, but can have an impact in that. Even with all the impacts that you mentioned, we could expand margin and always looking first quarter on the second quarter when we look at the second quarter with the second quarter, then we will continue to see this solid, consistent growth through time. Remembering that we have a CAGR in EBITDA over the last 10 years above 20%. So I believe that the company, even with a base that is higher to grow has consistently delivered this type of growth. I believe that the point that you mentioned, we see with normality. I don't see anything as outside of the expectation.

Next question, Gustavo Miele, Goldman Sachs.

I wanted to start by, when we try to do an analysis, just looking at the health care issue and even seeing the trend of ticket by -- there is a growth in ticket that is flat. There is a compensation. And it helps and the help that I wanted to ask Raquel is to understand the dynamic of ticket. What is the readjustment and what is the mix of these more efficient products, but with lower ticket getting into the base of the company. So maybe in the ticket, the readjustment understanding if that drop is reflected by the corporate. Is there a sensitivity in regards to the mature contracts that would help? And the second point that is more strategic has brought the attention to the market, how robust the growth of oncology has been over the last quarter. So I wanted to understand what is the implication that you can have with the possible capital allocation decisions of the conglomerate. So maybe dealing with more priority, the organic, inorganic, this is an entry point for the oncologic journey of several patients or even with future M&As, do you have a need of increasing the number of beds so you can do that integration ambulatory and hospital within the oncologic scope. So I wanted to understand how much that vertical can impact in the decision of growth -- future growth of Rede D'Or. Those are the 2 points.

Gustavo, so your question has brought the 2 points that are generating this reduction of the growth of the average ticket. So yes, there is a reduction in the readjustment you can have an idea of what happens to the other portfolios from the information that I gave you of the contracts until 29 lives. The readjustments were of SulAmerica 15.2% and 15.8%. The readjustment of -- well, it reflects in the numbers in general, the reduction that is consistent quarter-on-quarter of consolidated loss ratio, and it generates a drastic readjustments. And remember that we always try to bring tools that reduce readjustment. Even the client that is in-house, there is a client that we can do an exchange of product that can bring more profitability in terms of reimbursement, so modular reimbursement or an extension of contract. We do an agreement with the client that gets them and that reflects in the readjustment that is weaker, lower when we have a long-term partnership. On the same side, when we launch a new product that will get into a new region, we've done that with products that are defined for every region, regardless that, most of the time, these are national products. And the logic is more consistent, looking at the region that we are getting in. There wasn't any type of sale with co-participation. The co-participation depending on the percentage can reduce the price and up to 22% in some cases. So when I have a sale in 40% of this segment of wholesale, retail with co-participation, of course, that has an effect in the mix for the growth of the ticket. Here, speaking of the last 12 months of sales, 85% of everything that is sold with co-participation, these contracts that are 3,200 lives 55% with co-participation. And adherence since the end of 2023, 100% of what we are selling are products with co-participation that is necessarily with a modular reimbursement. So there isn't a single reason. You replenish this and you get to a growth of ticket that is lower, and we are very at ease with this. So our objective, main one, along with maintenance and the increase of the margin is the growth of the margin. And we're being very successful with that, as we discussed at the beginning of the conversation. I hope I answered and there isn't a single reason we see both sides and the explanations for the reduction of the ticket.

Let me get the second one here, Paulo. There isn't any change in the strategy of capital allocation. You've seen our preference over the last years by the organic growth. Historically, in oncology, we have going to grow organically. And the capital allocation for growing in oncology is much more lower than what we have in the hospital. We are very well positioned. As we've said, the clinics are integrated. There is a big search for new physicians. So we are trying to structure our units at see the demands, but without any change in the vision of growth. Same thing with the diagnosis. We've grown through the diagnosis, the hospitals, and we are growing in this area on the organic growth, the same thing in the hospitals. Now having said that, we assembled this company through M&As. You know our strategy or good assets that make sense, keeping our discipline of the return for the capital allocation. Obviously, we're going to pay attention to assets that are good opportunities.

Next question, Joseph Giordano, JPMorgan.

I wanted to explore 2 quick points. You talk about M&A, well, this is very robust. And I wanted to explore oncology. We see players with difficulty in the industry. Have you seen more this includes clinical bodies that are relevant for the operation. And in your -- at SulAmerica, we see the big players they're working. And I wanted to understand how do you see the competition in the different products, even though the growth is very healthy?

Well, talking about the hiring of physicians in oncology, due to everything that is happening in the market, we are at a moment that is a record of demand on the side of physicians, oncologists that wouldn't join our group. We have even difficulty trying to absorb all the clinical body that we would have the potential for absorbing. And obviously, we are being very selective and bringing more alignment with our oncology group. This is a moment of growth, very robust in the addition of physicians, a record in our history, and we're trying to bring the best ones to compose our team, which is stronger.

Thank you for the question. In regards to the premium sector is a sector that we say that we are going back to the origin since 2023, we increased more and more the concentration. When we look at retail, the products that are sold in the middle of the pyramid and upwards. Honestly, I haven't seen any changes, structural changes in the scenario that is competitive with these announcements of marketing other operators, and we haven't changed that. We have a level of retention that is very good when we do a breakdown by the product, mainly in these products of M&A. And since 2023, we've seen that increase in commercialization and retention of these products. In regards to the growth of ticket versus the consolidation that is ever higher, it's what we are discussing. This reflects and this gives us a higher possibility of competition even in these products due to all the strategy that we have, not only of products but also management of the liabilities that is being managed by our team.

Next question, Flavio Yoshida, Bank of America.

I have 2 on my side. First, SulAmerica. First, we see an improvement that is very significant even with a technical reserve that is very robust. But on the other side, we saw an addition of lives that is a bit weaker than what you are presenting. So I wanted to understand how is management thinking about this growth in profitability because what the sentiment that grow that lingers is that you could grow in a more robust way and you have more robust provisions. And the second question regards to the hospitals. When we look at the medical materials, we see a mix of procedures that has more loaded medical materials. So I wanted to understand how you want to optimize this. It will be more of a renegotiation contracts is their capital allocation to try and make it more vertical, the costs. What do you see to try and include that? Is there any space?

Well, I think that we need to reinforce that we never look at just 1 quarter. The trajectory of a beneficiary is a consistent movie that for several quarters, we've included -- we've brought in the share of the market. And everything that we mentioned in our mantra of responsible management with profitability without fighting the price war. And sacrificing the profitability, we are always going to try and get the maintenance of that profitability and more so. We saw a few contracts and the big movements of companies, of the companies that are in the market and eventually, they would have left here, in many cases, is a cleanup. So it's -- these are clients that are not generating positive results, and we don't do any effort to withhold them. So this is isolated. But in the picture as a whole, when you look at -- the number will continue to be positive and the maintenance.

Flavio, let me get the medical materials part. There is -- it is completely explained by the mix. The mix surgeries, more complex and some negotiations, as I commented on the packages. Surgical packages that included materials, oncology, of course, growing within participation, the income over oncology, very high. All of that added -- there is an increase in the revenue. If we look at the materials, we have a stability or even reduction of price. So our purchasing area is working well. Of course, we have the opportunities with all the scalability that Rede D'Or is adding. We have the opportunity of doing better of concentrating more volume in the big partners that we have, and in our arm of distribution, we've tried and we've done that with a series of products to bring alternatives and register more products, mainly in areas that we understand that we are not well served and the price conditions are not aligned with our expectations. We have a strong focus in bringing new products that are not in Brazil. So this has been positive. The focus of this distribution area is not to be a big giant of the distribution sector, but looking at benefits that can benefit Rede D'Or and even other players in the market.

Well, the next question, Caio Moscardini, Santander.

The first question is in regards to the hospitals. I wanted to understand your mindset on the addition of operational beds throughout the year. We have the impression that the addition of beds is a bit weaker than expected because it was a full month, and that didn't translate into a significant increase versus the beds that were already opened, as you commented, January and February. So I wanted to get your opinion on that. And the second question is in regards to the products with co-participation. How is the design of these products? How much percentage of co-participation have you implemented in the new products? And how is that compared to the products that are at the base today? Those are the 2 questions.

Well, I'm going to get the first one of the beds. In fact, we could have had a more -- a stronger growth at the end of the quarter, growth of operational beds. The decision was to discontinue or reduce our volume with 2 very specific self-management that we're facing in a few financial programs. There is a weight when we look at Rede D'Or, it doesn't have a significant weight. But when you look at the expectation of the operational beds that are going to be incremented, there is an impact. So it was our decision aligned with what we've done with a higher impact for volumes, but in line with the discipline of the company. We are always looking at what makes more sense. Is it growing beds or protecting more your accounts receivable and that relationship just with partners that have a balance and sustainability on the long term. Sometimes these are operators that go through difficulty. Eventually, we can reduce the relationship. And at a second point, we can grow in more balance. But in this first quarter, the decision was to reduce the exposure and having that impact in our addition of operational beds.

Thank you, Paulo. So in regards to the products with co-participation, I think that when we look at the previous years, we saw an incidence of percentages of co-participation that are lower. So we talked about 10% with co-participation in regards to the company. So smaller values that focus more in elective consultation and exams and any other things. So today, we see the co-participation that encompasses more procedures. So going to the elective therapies that about 2 years ago was ever more relevant, the co-participation in therapies. And we always discuss with our clients that it's fundamental that you have it. So the emergency room, it generates an appointment that is more expensive than the elective. And many times, depending on the segment, we look at, I don't know, the sector can have the -- in the auto parts, we see this type of behavior, so it's fundamental that we have the co-participation and the companies have been doing this. This is one of the examples that I've given you. And the question on C of adjustments that we do. We have clients that have been with us 5, 10 years, 20 years and still have a space to do adjustment in the products and even of participation. Today, what we have sold the most is the 4 groups of procedures and about 30% of co-participation in these procedures. In the retail, we see a type of limitation in the total value that can be charged of co-participation to give more predictability for the client and facilitate the format of selling for these products. And in the corporate, we see a co-participation of 30% and not necessarily at the limit. A few cases, we have a co-participation that is fixed in reais, BRL 200 for the appointment, and we started to see this more common in the exams and therapy and 30%.

Next question, Leandro Bastos, Citibank.

Very quick question on the hospitals and tickets. We see that the level, the number of surgeries, it appears at a higher threshold and they're contributing a lot. And I wanted to get your perspective for the year. How do you foresee this line? The growth of the ticket that is running above the inflation? And how is that being translated with the hospitals? What is the perspective for the year, thinking about the margin for the hospitals? That's it.

Well, historically, we always say that the best way of looking at our ticket is 1 or 2 points above the IPCA tax. Due to this growth that you mentioned in surgeries, complex surgeries and the participation of oncology within the whole, we had an acceleration. And also, I would like to highlight the negotiations of packages, surgery, the back that we start to have the material within the hospital account that has an impact in the ticket. And we are seeing with expectation of continuity of this pattern due to this combo of impact. So this is what we can tell you thus far, obviously, for the long term, after we have part of these impacts already normalized, we suggest that you will see the IPCA plus 1 or 2 points.

Next question, Marcio Osako, Bradesco BBI.

I have 2 questions on hospitals. First, on those -- the year-on-year increase is there anything pinpoint on this quarter so we can justify the negative, the remarks. And we've seen that on the 2025. And the second one is, can you see the evolution on the revenue of hospitals amongst the other pain parties? In this quarter, contrary to what we've seen in the last year, the elimination line, the revenue that comes from Sul to the hospitals is stable year-on-year. It's growing and it makes sense due to the maturation of the greenfields and with Sul and the other pain parties, but if you can discuss on how you see this evolution in the revenue of hospitals and other pain parties. Those are the questions.

Thank you, Marcio. Thank you for the question. On the penalties, we see that this is explained by the mix of hospitals. So we have a provision of penalties for every hospital depending on the recent history of the hospitals. And as you grow the volume and the mix, in a different mix, you can have small variations. In this case, the growth was higher in the hospitals that we had a provision that is higher, and this impact is not material and nothing that worries us. In regards to SulAmerica, we had a growth since we started with SulAmerica, there is historically a few areas that we didn't have all the relationship that we wanted to have, and we had an increase of relationship. But at the same time, we continue to have big -- the most of its revenue from other operators and big partners, long-term ones. So it's our work of the commercial team to keep our volumes of growth and our relationship growing with the other clients. So when we can grow in SulAmerica and the other ones to keep the participation of SulAmerica stable, we see this as a great piece of news, and we are working well with all the market. Thank you for the questions.

The Q&A session is closed. We'd like to give the floor to Paulo Moll to close the session.

Well, thank you for the support of our investors and also thank you to our teams. We've delivered important results in the company. We have a lot of efficiency gains and growth, and we are happy with the delivery of the results. Thank you very much to all the team of Rede D'Or, SulAmerica. They're doing a brilliant job. Thank you and see you on the next call.

The earnings call is closed. Thank you for your participation. Have a nice day.