Healthcare Global Enterprises Ltd - Mar 2025 Earnings Call Transcript Analysis

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Earnings Call Transcript Analysis Report #

HCG Q3 FY'25 Earnings Call Analysis #

Financial Performance #

  • Key Financial Metrics:
    • Revenue: Q3 FY ‘25: INR 559 crores (highest ever quarterly revenue), 19% YoY growth. 9 Months FY'25: INR 1,638 crores, 16% YoY growth.
    • Adjusted EBITDA: Q3 FY ‘25: INR 92.3 crores, 15% YoY growth.
    • Adjusted EBITDA Margin: Q3 FY ‘25: 16.5%.
    • PAT Growth: 23% YoY.
    • MG Hospital (Vizag) Revenue: INR 25 crores, with a 24% margin.
    • ARPOB (Average Revenue Per Occupied Bed): Grew by 3.5%, standing at INR 44,284. Established centers: INR 42,798 (2.8% growth). Emerging centers: INR 66,000 (12.3% growth).
    • Effective Tax Rate: 3% for a 9-month period.
    • South Mumbai Center Losses: INR 10-12 Crores for FY'25
  • Comparison with Previous Periods:
    • Q3 revenue showed a 19% YoY increase.
    • 9-month revenue showed a 16% YoY increase.
    • Adjusted EBITDA grew by 15% YoY in Q3.
    • Bed occupancy improved from 52% in Q3 FY24 to 55% in Q3 FY25
  • Revised Guidance/Forecasts:
    • Expect stronger growth in Q4 FY ‘25 (revenue and EBITDA).
    • Expect EBITDA margin to expand by 1% to 1.5% in the next financial year compared to FY25.
    • South Mumbai center expected to break even by Q1 of next financial year.
    • Capex for the year estimated to be INR 275 crores, with INR 172 crores already deployed.
    • Maintenance Capex to be around 100cr per annum.
  • Areas of Growth/Decline:
    • Growth:
      • Oncology business (post MG Hospital Vizag acquisition): 24% growth.
      • Emerging centers: 25% YoY revenue growth.
      • Kolkata centers: 40% growth.
      • South Mumbai center: 28% growth.
      • Chemotherapy sessions: 19% growth.
    • Established centers: 20% revenue growth, 14% EBITDA growth.
    • Core HCG Centers (excluding Milann): 21% revenue increase. 16% EBITDA growth, with a 20% EBITDA margin
    • Oncology Centers (excluding Milann, multispeciality, and MG Vizag): 18% revenue increase, 14% EBITDA growth, 21% margin.
    • Decline:
      • Milann revenue continues to decline, although management is optimistic about a turnaround.

Strategic Initiatives & Business Updates #

  • Major Strategic Announcements:
    • Ownership Change: CVC sold a majority stake to KKR. KKR is expected to hold 54-77% equity stake post-transaction and open offer. Dr. B.S. Ajaikumar will be a co-promoter. CVC will be a public shareholder
    • Focus on Precision Oncology: Emphasis on personalized treatment, genomics, proteomics, research, and academics.
    • Restructuring of diagnostic business, Triesta.
  • New Products/Services/Markets:
    • Continued focus on expanding the hub-and-spoke model with infusion clinics.
  • Operational Changes:
    • Dr. B.S. Ajaikumar will transition from Executive Chairman to Chairman of the Board, focusing on clinical excellence, research, and academics, with limited involvement in daily operations.
    • Consolidation of MG Hospital operations in Vizag.
    • Strengthening the andrology department at Milann.
  • Ongoing/Completed Projects:
    • Two new brownfield centers in Bangalore are expected to be operationalized in FY ‘26.

Market & Competitive Landscape #

  • Industry Trends:
    • Oncology is growing rapidly in India.
    • Indian genomics is different from Caucasians, necessitating localized treatment approaches.
    • Infertility is becoming a major issue in India.
    • Medical Tourism impacted due to the Indian government restricting medical visas.
  • Competitive Positioning:
    • HCG positions itself as a leader in comprehensive cancer care.
    • Focus on asset-light model for efficient expansion.
  • Market Challenges/Opportunities:
    • Opportunity: Growing demand for oncology services in India.
    • Opportunity: Potential for mergers and acquisitions.
    • Challenge: Geopolitical issues impacting international business, specifically mentioned for the South Mumbai center.
  • Market Share/Positioning:
    • Indicates growth in market share across regions.

Risk Factors & Challenges #

  • Concerns/Challenges:
    • Seasonality impacting Q3 performance.
    • Geopolitical issues impacting international patient flow, particularly from Bangladesh.
    • Decline in Milann revenue due to increased competition.
    • Operational losses from new centers.
  • Regulatory Issues:
    • Mention of regulatory processes related to the KKR acquisition and open offer.
  • Operational Constraints:
    • Mention of subdued international business
  • Market Uncertainties:
    • Uncertainty regarding the open offer participation.

Forward-Looking Statements #

  • Outlook and Projections:
    • Expect continued strong growth in emerging centers.
    • Expect recovery in international business by the upcoming quarter.
    • Anticipates normalization of modality mix and revenue scale-up, improving margins.
  • Commitments/Targets:
    • Focus on long-term growth with KKR.
    • Aim to minimize cancer recurrence.
    • South Mumbai center expected to break even by Q1 of next financial year.
  • Planned Investments:
    • Continued investment in medical infrastructure, specialized treatments, and clinical talent.
    • Capital expenditure of approximately INR275-280 crores for FY25 and FY26.
  • Sentiment:
    • Positive sentiment about future performance, and “gung-ho about the potential of the organization”.

Q&A Insights #

  • Most Pressing Analyst Questions:
    • Clarification on the shareholding structure post-acquisition.
    • Dr. Ajaikumar’s role in the organization after the transition.
    • Margin trajectory and impact of new centers.
    • Growth rate of established centers.
    • Performance and turnaround plans for Mumbai centers (Borivali and South Mumbai).
    • Impact of the KKR acquisition on business plans.
    • Outlook on international patient business.
    • Capex guidance and debt levels.
    • Strategy for Milann.
  • Challenging Questions & Responses:
    • Debt Levels: Management stated they are comfortable with current debt levels and banking covenants.
    • Milann’s Performance: Management acknowledged the decline but expressed optimism about a turnaround due to new strategies and leadership changes.
    • Y-o-Y Margin Pressure in Established Centers: Management attributed this to lower operating leverage due to revenue reduction and a higher proportion of pharmacy business, expecting normalization in Q4.
  • Indirect Answers:
    • Specific details on the timeline of the open offer were deferred, citing regulatory processes.
    • Details about profit/loss contribution on the PBT level for MG Hospital was not disclosed.
  • New Information:
    • Confirmation that Dr. Ajaikumar will be a co-promoter with KKR.
    • CVC will be classified as a public shareholder.
    • South Mumbai center’s EBITDA loss for FY ‘25 is estimated at INR 10-12 crores.
    • Andrology focus as a growth driver for Milann.

Management Tone & Sentiment #

  • Overall Tone: The overall tone is very confident and optimistic. Management repeatedly emphasizes the company’s strong performance, growth potential, and strategic direction.
  • Changes in Language: No significant changes were noted compared to hypothetical previous calls, as this is the first analysis. However, the language is strongly positive, emphasizing achievements and future plans.
  • Confidence/Concern:
    • Confident: Growth prospects, clinical excellence, operational efficiency, new partnerships, and market leadership.
    • Concerned (but optimistic): Milann’s performance, although management is actively addressing the challenges. Impact of geopolitical issues on international business, but expect a quick recovery.

Key Takeaways #

  1. Strong Financial Performance: HCG reported its highest-ever quarterly revenue and solid YoY growth, demonstrating resilience despite seasonality.
  2. Strategic Shift: The KKR acquisition marks a significant strategic shift, with Dr. Ajaikumar focusing on clinical excellence and research, while KKR takes a majority stake.
  3. Growth Focus: HCG is committed to both organic growth (existing centers, brownfield expansions) and potential inorganic growth (mergers and acquisitions).
  4. Turnaround Potential: While Milann faces challenges, management is optimistic about a turnaround. The South Mumbai center is also projected to break even soon.
  5. Positive Outlook: Management is highly confident about the future, expecting continued growth, margin expansion, and a strong performance in the coming quarters.
  6. International business is expected to rebound.
  7. Effective tax rate is low (3%) due to the recognision of a deferred tax.