Diagnosticos da America SA

BOVESPA:DASA3

Earnings Call Transcript

[Operator]

Good afternoon, ladies and gentlemen, and welcome to Dasa's conference to discuss the earnings results for the fourth quarter '24. This conference is being recorded, and the replay can be accessed on the company's website at dasa3.com.br. The presentation is also available for download.

[Operator Instructions] As a reminder, please bear in mind that the forward-looking statements made herein are based on the beliefs and assumptions of Dasa's management and on the information currently available to the company. These forward-looking statements are no guarantees of performance. They involve risks and uncertainties as they relate to future events and therefore, depend on circumstances that may or may not occur. Investors should bear in mind that general macroeconomic, environmental segment and other factors could lead results to be different from those expressed herein.

I give the floor to Mr. Licio Cintra, who will begin.

[Licio Tavares Cintra, executive]

Well, good afternoon, everybody. Welcome to our conference call for the fourth quarter '24. I'm meeting here with our Executive Board. But before I speak about our vision for 2024, I would like to thank all of our associates who worked arduously, enabling us to deliver important steps in the Dasa transformation.

I begin by recalling the commitment we took on at the year 2023. For those who follow up on us since that time, you know that we had other companies that took up the time of the executives and were a distraction for the work on the 2 main businesses, which was to have operational excellence. This is a topic we have harped upon quite a bit. And of course, it became clear to us that we could enhance this process and gain productivity, allowing the company to be more expeditious, lighter. Another point was preserving cash and of course, the strategy for our 2 main businesses.

Going from the first to the last regarding the core, I think our change in positioning has been very clear. Since the last quarter of 2023, we closed the diagnostics operation in Uruguay. We are working with healthcare. We no longer have that product. We separated the occupational unit. And now in December, we announced the sale of the company for BRL 250 million, BRL 190 million in the close, BRL 10 million for payment in 12 months with an adjustment of working capital and the rest extended during a period of 5 years.

Regarding our operational excellence, well, we have dozens of minor actions that we have been implementing in that search to have a company with better productivity, a drastic reduction in the administrative area as you saw in the past, organization of personnel, updating our policies according to market standards. We have done that, and we're now going to work with a new round of planning. We closed down diagnostic units that were not profitable as well as the technical areas. We have shown that we can increase our capacity even with a smaller number of NTOs.

In terms of NTOs, we're working with automation and more standardized processes, better negotiations using a scale, standardization of material and medication and the standardization of processes. So we have that set of actions as part of that pillar that we put in place during the year 2024, and that is part of the project that we described initially and that will extend for 3 years. So we have delivered 1/3 of the time of the project.

All of this contributed so that based on an equal basis, excluding non-recurrent events, to have an EBITDA growth in 2024 of 10% vis-a-vis our EBITDA of '23. Our EBITDA was BRL 2.5 billion.

Additionally to this, we're also focused on better using the assets that received heavy investments in the last year. You will recall that in my first participation in a call, we had a background where we had high levels of investment, and we carried out a plan -- a review of the investment plan internally to think again about those investments, both in structure and technology, and that's what we have been pursuing for the year 2024. And of course, there's more room to use those assets throughout 2025.

We end the year with BRL 547 million CapEx, 25% lower year-on-year. We already had had a reduction vis-a-vis the year 2022.

Regarding the financial movements, we continued with our debt profile enhancement. We amortized BRL 100 million in debentures. We consumed [ BRL 1.25 million ] in debt service. We had BRL 300 million from old M&As, and we reduced another item that was inconvenient, BRL 400 million for receivables. This was only possible for 2 reasons because of the funding that we discussed broadly last year and also because of the strong operational cash generation from the year 2024. We worked with BRL 910 million in terms of cash generation, 2.5x the cash generated in 2023.

And finally, regarding the strategic repositioning, we took an important step with the transaction announced mid last year, our joining Amil. As we announced at that time, we have created the largest platform of hospitals without operators in Brazil. And thanks to that decision and announced in June of last year, throughout the second half of the year, we drove into our processes, revised the structures to separate the management of diagnosis and hospitals. And I think this brought about positive key elements, enabling us to identify other opportunities for enhancement besides the operational ones we have already mentioned.

As a result of this process, we have reorganized our team. This is practically concluded, and we're quite optimistic with the opportunities we have identified and having diagnosis 100% focused on its own management.

Now the figures are very promising in supply, the people area, organization of the location of hospitals, and we believe that the deleveraging will happen faster than we had imagined.

We had the approval of CADE in mid-January, which means we had the opportunity to advance with more details and in a more detailed way in terms of synergy in supply and the commercial part.

More specifically, in the hospitals that will be part of the joint venture, the perimeter of the hospitals that are part of JV and Amil, we have an increase year-on-year of 28% on the estimated pro forma EBITDA totaling BRL 1 million and some for the year 2024, still much lower than that of our main competitors.

So we have 2 feelings here, one of frustration for the low performance, but on the other hand, optimism because of what the company has set up. And we have a vast capacity to reduce leverage.

Now even though the EBITDA levels are adequate, we began with BRL 3.65 billion. This company will have a leverage of 3.5x, substantially lower than what had been forecast upon the closing. And in 2023, we had BRL 770 million EBITDA.

Throughout 2024, we had several achievements in terms of the quality of our units. We had a significant increase in NPS in 2024 vis-a-vis 2023. This goes by unperceived, but it is a concern because we do want to focus on our main purpose, which is the quality of healthcare, quality our users are pursuing.

It's quite simple to generate results in G&A, worsening the perception of quality. Therefore, we have quite a bit of discipline, have managed this balance and the excellence plan, especially automation and changes of processes enable us to enhance the perception of patients and clients.

Very well, having done that presentation, I give the floor to our CFO.

[Andre Covre, executive]

Good afternoon, everybody. We begin on Slide 5, with the segments of hospital and oncology, our Business Unit 1. Gross revenue reached a growth of 1% in the fourth quarter '24. This growth was attenuated because of BRL 25 million in the fourth quarter of '23 as published at that time and because a lowering of services to invoice in oncology in that fourth quarter of 2024. If we exclude those effects, the gross revenue had a growth of 3%, thanks to a higher average ticket because of a better mix of procedures.

Now the volume of day patients in the fourth quarter '24 had a drop of 4% when compared to the fourth quarter of '23, especially due to the interruption of less profitable operations that initially reduced the growth of revenues by BRL 80 million, but allow for better results through time.

In 2024, net and gross revenues of Business Unit 1 had a growth of 7% in the comparison with 2023. Well, also thanks to the expansion of 2% in the number of day patients and an average ticket that is 5% higher, both influenced by the interruption of the less profitable operations and a better mix of procedures.

Adjusted operating costs for the hospitals and oncology totaled BRL 1.5 billion in the fourth quarter '25, BRL 53 million lower than in the fourth quarter of '23, leading to a growth of 46% in adjusted gross margin.

Now if we exclude onetime items that increased costs in BRL 56 million in the fourth quarter last year, adjusted operating costs for hospitals and oncology remained stable with the benefits of the operational excellence program underway, offsetting the higher cost due to the higher costs relating to nursing and inflation for the last 12 months.

Now with this, adjusted net revenue for B1, excluding the onetime items and the higher impacts were in the fourth quarter '23, were 4% higher this quarter compared to the same quarter last year. This allowed for an expansion of 0.6 percentage points in gross margin because of the initial gains in the reduction of less profitable operations and a growth of 2% in terms of occupation.

If we normalize the level of churns according to the statistical provisioning model revised in 2023 estimated at BRL 35 million per quarter as we have done this year to maintain the comparison base, adjusted gross profit would have ended up at 13% with a gain of 2.5 percentage points in gross margin.

Regarding the year '24, operational adjusted costs for hospitals and oncology were BRL 5.9 billion, 6% higher than last year, leading to a reduction of 10% in adjusted gross profit, an increase of 1.8 percentage points in the adjusted gross margin for the year.

We now go on to Slide #6 to speak about the diagnostics segment. Gross revenue for the fourth quarter was 18% higher than in the fourth quarter '23, driven by the exchange rate and the accounting of the international unit in Argentina due to hyperinflation in the fourth quarter '23. If we exclude the international operation in both quarters, gross revenue had a growth of 4% because of a higher number of exams.

Now this growth in revenue was attenuated by 2 decisions with a strategic focus on one of profitability. As Licio mentioned, the home services were no longer a priority. And secondly, as we mentioned previously, the closure of 36 diagnostic units that after an extend working plan for recovery did not attain satisfactory profitability.

For the full year of 2024, gross margin for BU2 was BRL 8.8 million, 9% higher than in 2023. Once again, if we exclude the international operation from both years, gross revenues were BRL 7.7 billion with a growth of 5% compared to 2023 due to a higher level of operations.

Adjusted operational costs for the diagnostics segment in the fourth quarter '24 were BRL 1.2 billion, 12% higher than the fourth quarter of '23, a significantly lower evolution than the 18% growth in revenue, allowing the gross margin to grow 34% and reached BRL 599 million. Now this positive evolution is thanks to an increase in the volume of operations, the benefits of the operational excellence program, and the performance of the Argentina operation.

There was a weak base of comparison in the fourth quarter 2023 when we had significant exchange rate problems because of the hyperinflation of the country. If we exclude the international operation, adjusted gross profit was BRL 521 million, a growth of 14% compared to the BRL 458 million in 2023, with a gain of 2.8 percentage points in the adjusted gross profit.

In the year 2024, adjusted operating costs were BRL 4.9 billion, representing an increase of 7% vis-a-vis 2023, especially due to the growth in the volume of operations and the accrued inflation. These were partially offset by the benefits of the operational excellence program and the investments. With this, adjusted gross profit in '24 totaled BRL 2.6 billion, 11% higher than that of '23, with an increase of 0.9 percentage points in adjusted gross profit.

Now for this evolution, the initiatives of operational excellence were fundamental. It includes operational technicians and the closing of 36 diagnostic units already mentioned. As we had mentioned, the reduction of NTOs is part of our plan that is seeking a cost reduction, reducing the capacity to process exams through reallocation and other methods.

Now the closed units were based on very careful work. They had a minor contribution to revenue, and they were in a situation of deficit when thinking of our profit. All of them were outside of the priority areas for our segment.

We go on to Slide #7, where we see the evolution of our adjusted expenses and EBITDA. At the top of the slide, we present adjusted expenses totaling BRL 565 million in the fourth quarter '24 and BRL 2 billion for the year 2024, in both cases, higher than the respective previous periods because of 2 aspects, mainly relating to the base of comparison.

In the fourth quarter of '23, we had events that reduced the expenses onetime as published at that time. And we had the exchange rate effect in the accounting of the international operation in Argentina undergoing a hyperinflation. In the fourth quarter '24, we had a negative result in the sale of Dasa Empresas and expenses of the agreement for hospitals, representing BRL 47 million. Now if we exclude those items, adjusted expenses were 2% higher in the fourth quarter '24 vis-a-vis the same quarter '23, a lower evolution than the period inflation.

In 2024, adjusted expenses, excluding the items I mentioned was 4% lower than in 2023. These evolutions reflect the initial benefits of our operational efficiency program. As a result of this, adjusted expenses as a percentage of net income had a reduction of 14.5% to 13.4% in the fourth quarter '24, a benefit of 1.1 percentage point. For the full year, the reduction was 13.9% to 12.5%, a drop of 1.4 percentage points.

Now let's look at the bottom of the slide, the EBITDA reported for the fourth quarter 2024, BRL 403 million, practically stable compared to the same period in '23. This is because of the 2 aspects I just mentioned. First, onetime items that benefited the result in BRL 25 million in the fourth quarter '23, and secondly, the BRL 32 million from the sale of Dasa Empresas and BRL 15 million in the association agreement, both of which took place in the fourth quarter '24. If we exclude those events, EBITDA increased 18% in the fourth quarter '24 following the trend that we observed until the third quarter of '24.

If we exclude those onetime events, we continue on in the same growth trajectory for EBITDA that we had in the first, second, and third quarters. This expansion was driven by an increase in revenue in both business units and due to the implementation of our efficiency rules. EBITDA margin reached 3.2% in the fourth quarter '24, an expansion of 1.1 percentage points vis-a-vis the same quarter in the previous year.

Now for the full year, EBITDA totaled BRL 2.5 billion, a growth of 11% higher than that of 2023, leading to an increase of 0.6 percentage points in EBITDA margin. This growth in EBITDA once again is due to a higher volume of operations and our operational efficiency gains, attenuating the effects of the higher levels of churn and more expenses in the new nursing legislation and inflation for the last 12 months. If we exclude these onetime events that reduced the expenses in BRL 177 million in the fourth quarter and the result of the sale of Dasa Empresas and the expenses for the association agreement in 2024, the EBITDA would have had an expressive growth of 23%.

Let's now go on to Slide #8, where we will refer to the investments made. In the fourth quarter of '24, consolidated investments totaled BRL 272 million, practically the same amount in the fourth quarter '23. For the entire year, we invested BRL 547 million, 25% less than in 2023. And with this, we are 3% below the budget approved by the Board of Management, which was a reduction of 23% vis-a-vis 2023 and 56% when compared to 2022.

These lower investments reflect the new priority. We have expansion projects with higher returns in the long term, maintenance projects for the existing assets and the strengthening of our technology that plays a fundamental role in operations and in the maintenance of quality and excellence in the rendering of medical, hospital, oncological, and diagnostic services. And that is why we are acknowledged by our patients, customers, and physicians.

On Slide #9, we see the capital structure. At the top of the slide, we show you the evolution of leverage considering the net debt after acquisitions and the anticipation of receivables. As you can observe, the indicator for the fourth quarter '24 is 4.08x, representing a comparison with last year, a reduction of 7% in leverage.

At the end of December, the cash position, securities and real estate titles was BRL 2 billion, representing 2x the amount of debts that will mature until the end of 2025. The leverage for covenant ended the fourth quarter standing at 3.55x, stable when compared with the third quarter of '24.

Now average term of receivables maintained the same position at 112 days, stabilization of the average term of receivables. We think this was an important achievement with a relevant impact on the company cash flow, but this is a very long term. And as you know, this is a sectoral aspect that we are addressing on the one side with internal enhancements of processes and systems and on the other hand, with growing creativity in our hospitals.

Now with this, I would like to conclude the analysis of our results, and I return the floor to Licio.

[Licio Tavares Cintra, executive]

Well, thank you, Andre. We continue here on Slide #10. As we mentioned previously, we had 3 fronts, a regulatory front. We received the approval of the antitrust agency on January 14, 2025. So we have begun to focus on synergies in supply and the commercial part.

We had another front mentioned by Andre, the definition of our debt and the allocation of our debt based on the agreement, debentures of BRL 3 billion on February 27, and we're at the final stage of segregation of businesses to have a final stage, which should happen very soon.

What is interesting on this slide is the advance in the performance enhancement year-on-year. In 2023, the revenues were somewhat below BRL 10 billion surrounding the transaction, including the hospitals of Amil and Dasa. And for the year 2024, the delivery will be BRL 10.6 billion in revenues here, still without exploring the new volumes that are growing on average according to the market.

We have a great opportunity of an increase in occupation with this and a substantial improvement of EBITDA of 27%, as mentioned, with a margin of 9.4% of EBITDA, still much below our competitors in the sector.

I would like to thank the associates not only of Impar involved in the process, but those of Americas, Amil and Dasa as a whole. For the last 6 months, they have focused to ensure that precedent conditions and segregations could come to a positive closure.

With this, we get to the end of the presentation, and we will now go on to the questions and answers. Thank you.

[Operator]

[Operator Instructions] Our first question comes from Gustavo Tiseo of Bank of America.

[Gustavo Tiseo, analyst]

There are 2 questions at our end. First of all, I would like to further explore the JV. You have spoken about covenants and EBITDA. But how will the split work, especially in terms of SG&A, if there will be a guidance, a split of revenue, something specific, if it is proportional, if there is a heavier weight of G&A for Dasa than Amil?

The second point, your cash generation was improving. In the third quarter, it was flat. If you take away Dasa Empresas, there is a certain cash burn. Now we would like to gain an understanding of which are the levers going forward to understand where the improvement in receivables will come to understand the dynamic and what your mindset is like for this improvement? These are the questions.

[Licio Tavares Cintra, executive]

I'm going to try to answer the first one. The second one, I will give to Covre. As we mentioned in the past, because of the decision of creating the JV in June last year, as part of the Dasa structure, we are literally separating the business when it comes to management. And this ranges all the way from the first levels up to the more operational levels.

We have been doing this work because the results are somewhat contra-intuitive. In general, when you separate 2 companies, you have an increase in G&A. But we identified opportunities to having expressive amounts, areas that would not make sense if the 2 companies operated separately.

And this is a project that is in its final stage of conclusion. The approval of JV will still have some services rendered by Dasa, but for volumes that are quite low and with a date for the conclusion of this. So in the coming periods, we will have a hospital company that is completely separate with a structure devoted to, and the same will hold true for the diagnostics unit.

[Andre Covre, executive]

Regarding the cash flow and the debt, Tiseo, in fact, with the sale of the company, we had the entrance of BRL 195 million. Nevertheless, this factor has the same dimension of the mark-to-market of the hedge that we mentioned. If we had designated accounting for indebtedness, this amount would not have happened in our accounting and the debt consequently would be lower. Well, if you exchange one thing for the other, the result is the same. Net debt was BRL 10 billion in the fourth quarter, and it was BRL 10 billion in the third quarter. This is one more quarter where, considering everything, we did not consume cash. We did not allow the debt to grow, even having higher disbursements and expenses.

Now this is the third consecutive quarter showing that we are now in a pace where between EBITDA, working capital and CapEx, we have sufficient resources to pay the service of the debt. The next step is to generate more than the interest on the debt, which means we will reduce the amount of the principal as well.

Now how is this going to happen? We have the operational plans to enhance results. Licio referred to this oftentimes as did I, the program for operational excellence. But additionally to that, we have the opportunity created by the segregation of the companies. This has allowed us to be in a position to see which should be the management structure for diagnosis as a separate company and for hospitals as another separate company.

Finally, when it comes to working capital, we're going to continue to tackle the several line items in the balance that are outside of the operational focus, accounts receivables, inventories and suppliers.

Last year, we had a significant evolution in our ability of taking credits on taxes. The company was entitled to this. But because we didn't have an organized process, we did not do this. And this shows you the enhancement of internal controls and will allow for a better cash flow.

Finally, we have plans to continue improving the working capital accounts, operational working capital, accounts receivable, inventories and accounts payable. And in accounts receivable, specifically, we will have a doubling of figures in hospitals and diagnosis because of the sectoral situation. And we'll have to end up finding a solution.

[Operator]

Our next question comes from Artur Alves from Morgan Stanley.

[Artur do Amaral Alves, analyst]

We have 2 questions at our end. The first is a recurrent question. How are the negotiations doing with the part of assets, especially in the part of hospitals? What was not recovered in the JV? How is the demand if you have obtained a price that you deem to be adequate?

And to speak about JV, there was an improvement in margin in the JV figures. What did you do that led to this enhancement? We see this in the Business Unit 1. But what have you done to have these results? And what has Amil done on its side to have that operational improvement and strong growth of EBITDA year-on-year because of the JV?

[Andre Covre, executive]

Regarding the disinvestment, at this moment, we have no new element that we can disclose since the last written disclosures we carried out.

[Licio Tavares Cintra, executive]

I will go to the second question. In the final account, the delivery of EBITDA improvement during the year make up what we announced at the end of '23 and '24. These are structural actions, and there hasn't been a significant change.

We had a significant adjustment from a significant payer, a deficit. It's a set of actions of standardization. And as we mentioned in the past, we had a low level of integration among the hospital units. We have worked with standardization goals, indicators, practices, and throughout the year, this is what we have followed.

It's just the beginning of the enhancement. It follows what has been done at Dasa as a whole, and it shows us the magnitude of potential for coming periods.

I can't quantify the actions carried out by Amil, unfortunately, but I see in the same spirit several actions towards optimization, reduction of waste. And in the next period, we will be able to speak about this more clearly and try to bring together the actions that Amil has undertaken, the ones that we have undertaken in the last period, and to identify our priorities to see if they're within the limits of the JV.

[Unknown Executive]

I would like to answer a question that came in writing. Nikola from JPMorgan. He has asked us to remark on the liability management strategy for Dasa going forward. I will divide the answer in 2 parts.

First, with the creation of the new hospital company, we will have a dis-consolidation of the Impar company, and that will hold true for EBITDA and the debt. At that point, we will have a reduction in the level of indebtedness of Dasa stand-alone.

Going forward, we have a volume of maturities in 2025 for which we do have sufficient cash. So we're now looking at 2026 and 2027, but without any haste, because the debt that we have, have attractive prices compared to the present day market prices. The average cost of debt of Dasa CDI plus 1.8%. Therefore, any movement to anticipate this significantly to refinance them would generate additional costs.

So in the coming months, we're going to look around in the market for funding, funding that will be carried out during the second half of the year to cover the debts that mature in 2026.

[Operator]

Our next question is from Yan Cesquim from BTG Pactual.

[Yan Cesquim, analyst]

We have 2 questions. The first is a follow-up on Impar. I don't know if you have an expectation for the timing of closing and conversations to define the final team for Dasa. Well, we do know some of this, we have Licio and others. But have you defined the nomination of other directors?

And the second question is on the recurrent results of the diagnostic unit and JV assets. Can you quantify recurrent levels of imaging, Impar, and your ambition in the mid and long term for the company?

[Andre Covre, executive]

I will attempt to answer the first one.

In the first question, as I mentioned previously, we have 99% of the plan already set up. At the right time, we will disclose the team for both sides. But all of the Executive Board shares have already been filled in. And with this, we consider that we're ready to begin that management focused on each of the different businesses. We have followed a schedule of operational actions to make the closing more feasible, and we're getting very close to that date.

[Licio Tavares Cintra, executive]

Yan, I would like to speak about diagnostics. You mentioned margin, and I will offer you additional details. Now how do we see the margin of diagnostics? You saw a significant increase in gross margin in 2024. We have worked with a focus on enhancing profitability. We reduced some units. We closed down the non-profitable units. We reduced the number of new technicians of operations that we had acquired. And in terms of systems integration, we can optimize that network. But we still see plenty of opportunities.

The main levers here are digitization of the service platforms. This has brought about efficiency in the call center as well as in units. Our service units have dropped year-on-year. We have a process front that is extremely well structured that is advancing in our operations. We also detect opportunities here. And we have a master production plan. It foresees new bids with suppliers, optimization of our production network, optimization of equipment, substituting old equipment for newer equipment.

We have significant provisions here, and the gain of scale because of the increase of volume we have brought in year after year and that we continue to forecast going forward, a gain of scale with the growth of volume in the coming years. In gross margin, good possibilities, we're always seeking to enhance margins. And with the separation of the structures, opportunities in terms of G&A.

As was mentioned here, when we set up the new structures, we can set up more lean structures. We're seeking a structure that is appropriate to the size of the company, creating efficiency fronts in G&A. It's a good possibility for the coming quarters to continue to enhance, improve efficiency, and seek profitability. We have good front in the operation as well as in the administrative structure.

[Operator]

The question-and-answer session ends here. We would like to give the floor to the CEO for the closing remarks of the company. You may proceed, Mr. Cintra.

[Licio Tavares Cintra, executive]

Thank you all for your attendance. Once again, we want to reinforce the commitment of the management. Of course, the management's desire is to enhance performance as soon as possible, pay off the debt, deleverage as soon as possible. But what we have done here since the last quarter of 2023 is to forge a mid- to long-term process where we have implemented those measures, always thinking about the impact they will have in the medium and long term for the organization as a whole.

2024 was quite challenging. Despite our cuts in G&A, we had an increase in the debt. And because of this, our total net debt that should be dropping is maintaining its level, but we're proceeding on firmly, motivated, highly convinced that we're putting Dasa on the right track to become a more sustainable company for the long term, a company that, yes, will balance quality, healthcare, and adequate financial performance. Thank you all very much.

[Operator]

The Dasa conference ends here. We would like to thank all of you for your participation. Have a very good afternoon.

[Statements in English on this transcript were spoken by an interpreter present on the live call.]