# 1. Financial Performance ## A. Key Figures * **Revenue:** **₹2,574 Cr** network gross (+27% YoY, +6% QoQ) · **₹231 Cr** contribution from New Units * **Operating EBITDA:** **₹613 Cr** network (+23% YoY, -3% QoQ) · **₹27 Cr** from New Units (+19% vs. prior quarter) * EBITDA Margin: **26.7%** Existing Units adjusted (ex-donation) · **24.9%** network * **PAT:** **₹345 Cr** network (+17% YoY) * **Free Cash Flow:** **₹389 Cr** · **₹435 Cr** invested in expansion * **Net Debt:** **₹1,755 Cr** (up from ₹1,576 Cr) · projected increase of **₹400–500 Cr** by FY26E ## B. Revenue Growth * **Sustained Momentum:** 19th consecutive quarter of YoY revenue growth, driven by strong volume expansion and pricing power. * **Like-for-Like Strength:** Existing Units delivered **16% revenue growth**, underpinned by **10% growth in occupied bed days** and **5% ARPOB increase**, signaling robust organic demand. * **Pricing Discipline:** Base hospital ARPOB grew **7%**, outpacing OBDs (5%), reflecting favorable payor and clinical mix trends. * **New Unit Ramp-Up:** Max Noida and Max Dwarka now contribute meaningfully, with Noida alone generating **₹24 Cr EBITDA** and **32% YoY EBITDA growth**. ## C. EBITDA & Margins * **Margin Resilience:** Operating EBITDA margin held at **9%** despite dilution from new unit ramp-up and annual cost increases. * **Underlying Margin Improvement:** Adjusted EBITDA margin for Existing Units reached **24%**, up **44 bps YoY**, with internal unit-level margins **500 bps higher** due to exclusion of HO allocations. * **Efficiency Focus:** Management emphasizes **EBITDA per bed (₹68 lakh annualized)** and **ROCE** over headline margins, with **7% YoY growth in like-for-like EBITDA per bed**. * **Non-Recurring Impact:** **₹12 Cr one-time donation** depressed reported margins; this cost will not recur and should be added back for normalized performance assessment. ## D. Profit After Tax * **Solid Bottom-Line Growth:** PAT expanded **17% YoY** despite higher tax outgo and QoQ decline from elevated prior-quarter base. ## E. Cash Flow & Debt * **Growth-Funded Expansion:** Capex of **₹435 Cr** reflects aggressive capacity build-out, fully funded via internal cash flows despite rising net debt. * **Controlled Leverage:** Net debt expected to rise by **₹400–500 Cr** by FY26E, but remains conservative with **Net Debt/EBITDA projected below 0x**, indicating strong credit profile. --- # 2. Occupancy & Utilization ## A. Key Figures * **Network Average Occupancy:** **76%** (Q1 FY'26) (+100 bps YoY) · **Existing Units:** **>78%** * **Operational Bed Count:** **+25%** YoY · **Occupied Bed Days:** **+26%** YoY (+4% QoQ) * **Direct Costs:** **₹1,015 Cr** (vs. ₹917 Cr prior) ## B. Occupancy Trends & Network Expansion * **Stable Network Utilization:** Despite 25% YoY bed count growth and integration of four new facilities, system-wide occupancy held flat at 76%, reflecting disciplined ramp-up and minimal dilution. * **Strong Core Performance:** Existing hospitals (ex-new additions) show meaningful utilization improvement, with occupancy rising to ~80% in the most mature base, signaling pricing power and demand retention. * **Dwarka Emerges as Outperformer:** Greenfield unit achieving 81–82% occupancy within 12 months, with **24% QoQ revenue growth** and **₹7–8 Cr EBITDA expansion**, now nearing capacity and triggering brownfield plans. ## C. Volume & Utilization Metrics * **Robust Volume Growth:** Occupied bed days surged 26% YoY and 4% QoQ, confirming strong patient inflow even as average length of stay declines, reinforcing revenue resilience. * **Capacity Absorption:** Addition of ~1,000 beds (Dwarka, Noida, Lucknow, Nagpur) increased occupied beds from 2,732 to 3,556, demonstrating effective integration and demand capture. ## D. Revenue per Occupied Bed (ARPOB) * **Resilient Pricing in Core Network:** Like-for-like ARPOB growth of 7% in pre-Dec-2023 hospitals confirms pricing discipline and mix benefits, despite overall headline ARPOB flattish due to new unit drag. * **No Degression in Acquired Assets:** ARPOB increased across all individual hospitals—including Lucknow and Nagpur—countering concerns of post-acquisition decline; integration proving successful. * **Growth Dilution Explained:** Inclusion of newer units (especially Dwarka and Noida) reduces system-wide ARPOB growth to 2%, but this reflects expected ramp-up phase dynamics, not operational weakness. ## E. Cost Structure & Margin Outlook * **Preemptive Staffing Driving Cost Growth:** Direct costs rose due to pre-commissioning hires and April salary revision, with new clinical and support staff onboarded ahead of revenue generation. * **Cost-Revenue Timing Misalignment Expected:** Management affirms no margin pressure as cost investments are front-loaded; revenue is anticipated to track closely as new units scale. * **Future Margin Tailwinds:** Improving payor mix and operating leverage from higher occupancy will drive down direct cost intensity, supporting margin expansion. --- # 3. Network & Capacity Expansion ## A. Key Figures * **Planned Bed Additions:** **~1,000** brownfield · **500** greenfield * **ARPOB Growth:** **~5%** increase in recently matured units (Lucknow, Nagpur) * **Occupancy Trend:** **Few percentage points** improvement in 15-month-old facilities ## B. Greenfield Projects * **Strategic Expansion Underway:** Board approves 130-bed built-to-suit hospital in Dehradun; multiple large-scale greenfield projects (400–500 beds) in Gurgaon, Zirakpur, Thane, and Pitampura advancing through planning and construction phases. * **Phased Commissioning Timeline:** 400-bed Max Smart (Saket) to begin phased operations by end of Q2 FY’26; 500-bed Gurgaon facility targeting full commissioning by year-end. * **Progress in Execution:** Zirakpur project cleared for construction with 24-month completion outlook; Thane and Pitampura sites progressing toward regulatory submissions and approvals. ## C. Brownfield Expansions * **Near-Term Capacity Infill:** Trial runs ongoing at 160-bed brownfield tower in Mohali; 268 beds at Nanavati in advanced commissioning; Max Lucknow to expand to 520 beds with 32 beds ready for immediate rollout. * **Execution Momentum:** Patparganj (397 beds) and Vaishali (140 beds) expansions moving through tendering and demolition phases, with 30-month completion horizon for latter. * **Sequential Development Strategy:** Max Vikrant (550 beds, Saket) awaits forest clearance; construction to follow only after 400-bed Smart facility is commissioned. ## D. New Unit Ramp-Up * **Maturing Assets Delivering:** Hospitals in Lucknow and Nagpur, added 15 months ago, show **stronger ARPOB and occupancy trends**, indicating successful ramp-up and market adoption. * **Proactive Institutional Integration:** New bed expansions initially constrain institutional patient inflow, but tie-ups are being secured ahead of scale to accelerate post-empanelment utilization. --- # 4. Segment & Service Performance ## A. Key Figures * **Oncology Revenue Growth (ex. new facilities):** **16%** YoY * **International Patient Revenue:** **₹208 Cr** (+32% YoY) * **Digital Revenue:** **₹744 Cr** (29% of total) (+61% YoY) * **Max@Home Revenue:** **₹60 Cr** (+22% YoY) * **Max Lab Revenue:** **₹48 Cr** (+19% YoY) * **Lucknow Growth:** **97%** YoY revenue · **191%** YoY EBITDA * **Nagpur Growth:** **27%** YoY revenue & EBITDA * **Noida Growth:** **14%** YoY revenue · **32%** YoY EBITDA ## B. Oncology Revenue * **Market-Leading Segment:** Oncology is the largest revenue contributor (25%–26%), growing faster than other specialties, driven by structural demand and not just new facilities. * **Expansion with Strategic Focus:** New 100-meter-adjacent facility in Dehradun to launch by end-2028, adding advanced oncology and radiation therapy currently unavailable. * **Future Share Uplift:** Oncology’s revenue share expected to exceed **30%** in coming years, supported by bunker installations at Dwarka and Lucknow in Q3. * **Outperformance in Acquired Assets:** Recent acquisitions show strong momentum, with Lucknow delivering nearly **doubled revenue** and **triple-digit EBITDA growth**. ## C. International Patients * **Resilient High-Value Growth:** International revenue grew **32% YoY** despite geopolitical headwinds, driven by expanded outreach to developed markets and direct-to-fly offices. * **Premium Procedure Mix:** Business increasingly focused on high-complexity, high-return procedures like robotics and transplants, which carry lower margins but enhance scale and reputation. ## D. Max@Home & Lab * **Digital Channel Strength:** Digital channels now represent **29% of total revenue**, with traffic surging **61% YoY**, reflecting strong online patient engagement. * **Home Care & Lab Expansion:** Max@Home and Max Lab both show solid double-digit growth, with **over 50% repeat transactions** in home care and a footprint across **55+ cities** and **1,300+ collection centers**. --- # 5. Acquisitions & Integration ## A. Key Figures * **Revenue Growth:** **16%** including Lucknow & Nagpur · **13%** excluding Lucknow & Nagpur (ex-donations) * **Operating EBITDA Growth:** **18%** including Lucknow & Nagpur · **15%** excluding Lucknow & Nagpur (ex-donations) * **Divestment Value:** **₹40 Cr** for Chitta and Anoopshahr hospitals * **Chitta Hospital Performance:** **₹5 Cr** revenue · **₹1 Cr EBITDA loss** (Q1 FY26) ## B. Recent Acquisitions * **Integration Driving Growth:** Strong financial performance underpinned by successful integration of Lucknow and Nagpur hospitals, with robust double-digit revenue and EBITDA expansion across existing units. * **Noida Integration Underway:** Post-acquisition integration at Noida focused on IT systems, management alignment, and re-securing critical licenses, indicating near-term operational complexity. * **Strategic ROCE Focus:** Acquisition strategy prioritizes **20–25% ROCE** over short-term margin or ARPOB metrics, enabling value creation from lower-performing assets in tier-2 cities. ## C. Divestment Plans * **Portfolio Rationalization:** Binding term sheet to divest Chitta and Anoopshahr hospitals by **September '25**, aligning portfolio with super-specialty focus post-Jaypee integration. * **Non-Core Asset Drag:** Chitta hospital generated minimal revenue and posted EBITDA losses, validating exit rationale due to limited strategic fit. ## D. Empanelment Progress * **Institutional Business Ramp-Up:** Significant growth in institutional revenue driven by new empanelments in Mumbai, Nagpur, and Lucknow, despite typical **six-month gestation period** post-takeover. --- # 6. Risks & Regulatory Factors ## A. Project & Operational Constraints * **Execution Delays Persist at Key Sites:** Max Nagpur project awaits environmental clearance despite civil work readiness, with **24-month completion timeline** post-clearance. * **Noida Facility Transition Complete but Constrained:** Full restructuring—including licensing and equipment orders—finalized, though operations were initially hampered by **outdated infrastructure** and legacy liquidation status. ## B. Supply Chain & External Risks * **6-Month Equipment Lead Time:** Overseas supply chain timelines now govern Noida’s operational ramp-up, with major orders placed and awaiting delivery. * **Seasonal Risk Postponed, Not Eliminated:** Vector-borne disease surge delayed due to **prolonged monsoon**, but risk remains elevated upon season onset linked to water stagnation. --- # 7. Guidance & Outlook ## A. Capacity Additions * **Noida to Drive Acceleration:** Noida operations expected to gain momentum in coming quarters, benefiting from prior foundational investments. * **ARPOB Recovery in Progress:** Overall ARPOB growth anticipated to trend toward high single-digit levels over multiple quarters as integration and optimization advance. ## B. Margin Trajectory * **Margins Poised for Recovery:** Despite seasonally weak Q1, margin expansion expected in subsequent quarters as direct cost growth moderates relative to revenue. * **Cost Leverage Improving:** Direct costs projected to grow slower as a percentage of revenue, supporting operating leverage through the year.