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Rainbow Children's Medicare Ltd
NSE:RAINBOW
Rainbow Children's Medicare Ltd
NSE:RAINBOW
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Earnings Call Transcript
Transcript
Other Earnings Calls
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.
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.
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, the 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 and quarternary 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.
Product Financials 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 crores. 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 mature hospitals achieving 52.2% occupancy and new hospitals recording 35.6% occupancy rates.
Let me share some updates on the key projects. Regional 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 the Electronic City of 90 beds and Hennur, 60 beds, the operation are -- operations are likely 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 [Foreign Language], which is groundbreaking at both the land parcels in Sector 44 and 56 in Gurugram 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 a very fable 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 respiratory (sic) [ ventilator support ] 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 neurodevelopment 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. 5-year-old child who had come to Rainbow'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 mediastinal, 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 quarternary 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?
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 volume 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 crores 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 crores in the capital expenditure. For the full year, the CapEx is INR 145.7 crores.
With these insights, I conclude my financial update. I now invite questions and suggestions from the participants. Thank you.
[Operator Instructions] The first question is from the line of [ Mahesh Atal ] from [ Patel Investment Advisors ].
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.
There are 2 hospitals, which would basically move from the new hospital category to mature 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 mature category by end of this year.
And how many new would be added to the new?
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.
Okay. Fair enough. My second question would be more on -- we could see that you are -- I mean, I'm not -- I'm trying 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 mature hospital thing?
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, [ incidents ] 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.
All right. Is there any change in the insurance rate that you have taken?
I think there is a once in 2 years supposed to be kind of all the renewals happen. 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. Bangalore is due now and also Hyderabad is going to be done now.
Any guidance you'd like to give on the broader margins for the FY '26?
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 the premise 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 been on the guidance of that -- this is the 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.
Just to add what Dr. Ramesh has just told 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%.
Do you foresee any competition coming in your main scope, I mean, main Hyderabad market?
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...
Sorry to interrupt you, sir, any inorganic thing that you are looking at in Hyderabad?
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 Instructions] The next question is from the line of Anshul Agrawal from Emkay Global.
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?
Yes, occupancy for the mature hospitals, 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 expectation. 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 very busy, which will further lay our foundations for the growth for the coming quarters.
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, this is just a one-off kind of quarter?
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, take 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 occupancy is clocking 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 mature hospitals. These are all the combinations for the [indiscernible].
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?
Yes. So Anshul, the Hyderabad is broke even as per the guidelines, which we say is the 1 year for us and then 15 to 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.
From all the 4 new hospitals, right?
For the 3 hospitals which opened last year, 1 each at cluster, Hyderabad, Bangalore and Chennai, the INR 12 crores to INR 13 crores was on the track.
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?
Yes. I think, 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 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 time we are looking at it now. This is what our project team is promising unless there is any other headwinds comes in between.
All right. Very clear. Just one last question, if I can squeeze that in. So 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?
Yes, more or less remains same. There is no change on that. So the same time lines.
[Operator Instructions] The next question is from the line of Damayanti Kerai from HSBC.
Just wanted to understand for the upcoming units at Rajahmundry and 2 units in Bengaluru, have you started doctor recruitment, et cetera?
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.
Okay. So for all the 3 units, it's underway. And Rajahmundry, as you mentioned, is broadly completed?
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.
Okay. But 70 new additions were across the network, not specific to...
Hyderabad, Bangalore, Chennai and Delhi.
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?
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 the care, and we're looking for more development pediatricians, a service which we are actually trying to see that how do we cost it, how do we kind of 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 -- it would take a little bit of time 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.
Okay. And on the IVF business?
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.
Okay. So right now, like under 3% of your total revenue, but it's growing obviously much faster?
Correct.
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?
Yes, that continues -- 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 an 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 that 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 Instructions] The next question is from the line of Alankar Garude from Kotak Institutional Equities.
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?
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.
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?
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%.
Okay. So basically, a few percentage points here and there?
Yes. Plus/minus here because both the facilities are growing, right?
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?
It should, theoretically, yes. But our focus in growing the pediatrics also because if you have gone through our -- we are adding the super facility 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.
This is -- Alankar, I'm sitting here. So the pediatrics is our main forte. 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 obstetric is a part of the pediatrics. We always say that a child is one large entity, comes along with the pediatrics. So which is why we don't talk so much about advancing the gynecological side, and going into too much of 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 multispecialty 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.
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?
Yes. It made a very small 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, now 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 focused on ARPP is important to judge our performance.
Understood, sir. So broadly, a 5%, 6% number on ARPP should be something which we can pencil in?
Yes. Yes -- over ALOS, then ARPOB will go up.
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.
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 ] 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 huge differences. 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 hospital in the country, which works in a very similar, which works in a hub-spoke truly urban-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 Instructions] The next question is from the line of Rahul Jeewani from IIFL Capital.
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?
Yes, Bangalore is fairly kind of doing very well, not very far from the breakeven. And Chennai will take a little longer time because a little CapEx 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.
Okay. So sir, this INR 12 crores, INR 13 crores 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?
Yes. Exactly, yes.
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 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?
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 that benchmark, which we have kept it. I mean that's where it is, we feel that is something is not right to rain go. 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 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.
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?
So let's look at this broadly, I mean, the seasonality always will be there. 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 quarternary care. That's a long-term story, quarternary care.
So as we mature more and more to an extent, we'll start behaving more like towards like a multi-specialty hospital, multispecialty hospital. But it would never be like this, will be like multispecialty, 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 ARPOB 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.
Sure, sir. So a mid-teens kind of a revenue CAGR is what we should expect going forward as well?
I would expect it to be kind of late teens to 20%.
Okay. Sure, sir. And sir, obviously, our cash generation has been very good, and we have INR 700 crores 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?
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&A. It's a bit premature for me to talk about that.
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 multispecialty 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?
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 multispecialties 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 proprietary 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 patients to do that, and 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 a multi-specialty hospitals and how you build a pediatric hospitals, which are very community inclusive and also kind of a very emergency based.
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?
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...
[Operator Instructions] The next question is from the line of [ Manik ] from [ Fin Investment ].
Sir, I'm pretty new to this company. So can you please help me with the OPD revenue and volume for FY '25?
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 come 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?
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?
As far as OP revenue you are saying?
Yes, yes.
Or overall revenue?
For OP revenue.
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.
The next question is from the line of Nitesh Dutt from Burman Capital.
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?
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.
Is it for both the hospitals, October, November of '27?
Yes, more or less a couple of months plus or minus. I don't think there's going to be huge variability because there have been projects. And also the teams work -- project teams and everyone works together in [indiscernible].
The next question is from the line of Rahul Jeewani from IIFL Capital.
Yes. 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?
Full year.
This is for the -- okay. So for the full year, Rahul, it was 2.6%. For the quarter 4, it was 2.9%.
Okay. Sure, sir. And when you are talking about this, sir -- so this is of the overall company revenue or the IPD revenue?
Overall revenue, Rahul.
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?
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-alone 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 in obstetrics refer to another obstetric hospital.
[Operator Instructions] As there are no further questions from the participants, I now hand the conference over to the management for closing comments.
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.
Thank you all.
Thank you very much. Thank you.
Thank you. On behalf of IIFL Capital, that concludes this conference. Thank you for joining us, and you may now disconnect your lines.