Global Health Limited — Q3 FY26

Global Health Ltd Q3 FY2025-26 Earnings Conference Call https://www.youtube.com/watch?v=1Bp8Wp5ACLw Published: 3 months ago

0:01 1 second Ladies and gentlemen, good day and welcome to Global Health Limited Q3 FI26 earnings conference call hosted by GM 0:09 9 seconds Financial Institutional Securities Limited. As a reminder, all participants line will be in listenonly mode and there will be an opportunity for you to 0:17 17 seconds ask question after the presentation concludes. Should you need assistance during this conference call, please signal an operator by pressing star then 0:25 25 seconds zero on your touchstone phone. I now hand over the conference to Mr. Amed Talke from JM Financial Institution 0:31 31 seconds Securities Limited. Thank you and over to you sir. 0:37 37 seconds Thank you PI. Good afternoon and warm welcome to all the participants on Global Health Limited PQFI26 earnings call hosted by JM Financial. Today on 0:46 46 seconds this call we have with us from the management Dr. Nareshan chairman and managing director. Mr. Pankut Sani group 0:54 54 seconds CEO and director, Mr. Yogesh Kumar Gupta, Chief Financial Officer and Mr. David Goal, head of investor relations. 1:02 1 minute, 2 seconds I will now hand over the call to Dr. 1:03 1 minute, 3 seconds Dhan for his opening. Thank you and over to you doctor. 1:08 1 minute, 8 seconds Thank you. Good afternoon to everyone and welcome to Maidanta's Q3 FY26 earnings conference call. 1:19 1 minute, 19 seconds I hope all of you have had the opportunity to review the results and presentations that were released yesterday. 1:30 1 minute, 30 seconds At Maidanta, our primary focus continues to be on delivering highquality patient centric care across our network 1:39 1 minute, 39 seconds supported by strong clinical governance, robust processes and continuous investment in medical expertise and infrastructure. 1:50 1 minute, 50 seconds During the quarter, the company remained firmly committed to strengthening its clinical program, spanning across 1:57 1 minute, 57 seconds tertiary and quarterly care and ensuring consistent clinical outcomes across its hospital network. 2:06 2 minutes, 6 seconds As doctors, we remain deeply concerned about the rising cancer burden in India where early detection continues to be the most effective intervention. 2:19 2 minutes, 19 seconds In this context, we launched the largecale cancer awareness program during the last six months, focusing on 2:26 2 minutes, 26 seconds breast and prostate cancers. The initiatives were aimed at dispelling prevalent myths, promoting 2:33 2 minutes, 33 seconds self-examination, and encouraging timely medical interventions. 2:38 2 minutes, 38 seconds To meet the growing demand for advanced oncology care, our gurug facility commissioned its first swift radiation 2:47 2 minutes, 47 seconds oncology machine significantly enhancing treatment capacity 2:54 2 minutes, 54 seconds and it adding some of the latest technology to the field. I would like to acknowledge the dedication of our 3:02 3 minutes, 2 seconds doctors, clinical teams and support staff whose collective expertise and commitment remain the central to 3:10 3 minutes, 10 seconds maintaining the highest standards of care while delivering personalized patient centric outcomes across our hospitals. 3:19 3 minutes, 19 seconds Our recently commissioned Douta Hospital completed its f first full quarter of operations during this period. 3:28 3 minutes, 28 seconds The hospital made encouraging progress across clinical on boarding outreach initiatives and infrastructure 3:36 3 minutes, 36 seconds activation thereby laying a strong foundation for the ramp up of business operations and the delivery of high 3:45 3 minutes, 45 seconds quality healthcare services not only to Nida city but also across western Bangladesh. 3:53 3 minutes, 53 seconds I am also pleased to share that meant Laknau has received the prestigious joint commission international short 4:01 4 minutes, 1 second form JCI quality accredititation in January 2026. 4:07 4 minutes, 7 seconds Medanta Lucknau is the first hospital in the region to be accredited by JCI. This certification reaffirms our commitment 4:16 4 minutes, 16 seconds to deliver the highest global standards of clinical quality and patient safety in the region where we operate. 4:24 4 minutes, 24 seconds With that, I will now hand over the call to Mr. Pankitani, our group CEO, who will take you through the financials and 4:33 4 minutes, 33 seconds operational performance in detail. Thank you. 4:39 4 minutes, 39 seconds Thank you Dr. Ten. Good afternoon everyone and thank you for joining us today for our Q3 FY26 earnings call. Let 4:47 4 minutes, 47 seconds me begin with the financial performance for Q3 FY26. 4:51 4 minutes, 51 seconds Total income for the quarter stood at rupees 11,428 million delivering a robust 19% 4:58 4 minutes, 58 seconds year-on-year growth driven by sustained momentum across all our hospitals and continued improvements in operating 5:05 5 minutes, 5 seconds metrics. IDA excluding NOIA grew by 11% year-onear to rupees 2814 5:12 5 minutes, 12 seconds million with healthy margins of 25.4% underscoring the resilience and operating leverage of our balanced portfolio. 5:21 5 minutes, 21 seconds ITA including NOA stood at rupees 2494 million with margins of 21.8% 8% 5:29 5 minutes, 29 seconds reflecting the expected impact of early stage operating losses from our newest hospital. Midanta NOA which commenced 5:36 5 minutes, 36 seconds operations in September 2025 completed its first full quarter of operations during Q3. 5:43 5 minutes, 43 seconds The hospital generated rupees 343 million in revenue and reported an aida loss of rupees 320 million in line with 5:52 5 minutes, 52 seconds the investment required to operationalize a facility of this scale and high standard. At NOIA we 6:00 6 minutes accelerated the ramp up with addition of 102 beds taking total bed count to 328 beds with nine new operating theaters 6:08 6 minutes, 8 seconds added this quarter taking the total count to 14 operation theaters. This is also supported by significant 6:15 6 minutes, 15 seconds strengthening of our clinical teams. We remain confident of steady improvement in utilization and financial performance over the coming quarters. 6:25 6 minutes, 25 seconds Consolidated profit after tax stood at rupees 950 million impacted by higher depreciation and finance costs related 6:32 6 minutes, 32 seconds to NOIA initial operating losses and a one-time statutory impact of rupees 366 million arising from the implementation 6:41 6 minutes, 41 seconds of new labor codes as an exceptional item. Adjusting for labor codes impact profit after tax was rupees 1,224 million. 6:52 6 minutes, 52 seconds We also saw encouraging momentum in international business. International patient revenue grew by 30% yearonear to rupees 703 million driven by higher 7:01 7 minutes, 1 second volumes while our OPD pharmacy business grew 30% to rupees 465 million. 7:09 7 minutes, 9 seconds Operationally the quarter demonstrated strong traction across the network. We added 144 beds including 42 beds in 7:17 7 minutes, 17 seconds Patna and 102 beds in NOA. Inpatient volumes grew by 14% while outpatient volumes increased by 20% yearonear. 7:26 7 minutes, 26 seconds Our average length of stay reduced to 3.02 days, a 7% year-on-year improvement while occupied bed days increased by 7% 7:35 7 minutes, 35 seconds translating into an occupancy of approximately 59% on expanded bed days. 7:40 7 minutes, 40 seconds A harp increased by 10% to rupees 67,361 supported by improvements in ALOS and 7:48 7 minutes, 48 seconds case mix. Moving on to matured and developing performance update. Our mature hospital consisting 7:55 7 minutes, 55 seconds of Mananta, Burugram, Indor and Ranchi delivered steady performance with revenue of rupees 7,20 million up 9% 8:04 8 minutes, 4 seconds yearonear and aida of rups 1,675 million up 7% with margins of 23.9%. 8:13 8 minutes, 13 seconds Matured margins during the period were impacted due to increase in employee costs and other operating expenses including repairs and maintenance. Our 8:21 8 minutes, 21 seconds developing hospitals excluding NOIA continue to outperform recording 22% revenue growth to rupees 3,651 8:30 8 minutes, 30 seconds million and aida of rups 1,156 million growth of 13% with strong margins of 31.7% in Q3 FY26. 8:41 8 minutes, 41 seconds If you look at 9-month performance, both Lucknau and Patna facility continues to deliver double-digit growth in revenue and AIDA with Lucknau margins 8:50 8 minutes, 50 seconds registering over 150 basis points improvements year-on-year while Patna margins remain stable. Developing 8:57 8 minutes, 57 seconds hospital including NOA stood at rupees 3,994 million up 33% yearonear while Ibida 9:06 9 minutes, 6 seconds stood at rupees 836 million with margins of 20.9% reflecting the expanding expected drag from early stage 9:14 9 minutes, 14 seconds operations in NOA. Inpatient volumes across developing hospitals increased by 27% year-onear with overall occupancy at 9:22 9 minutes, 22 seconds 62% and ARPOP rising 8% to rupees 56,853. 9:30 9 minutes, 30 seconds Project update. During the first nine months of FY26, bed capacity increased by 18% year-on-year with addition of 537 9:39 9 minutes, 39 seconds beds comprising 99 beds at Patna, 110 beds at Ranchi and 328 beds at Midanta. 9:47 9 minutes, 47 seconds We continue to have meaningful headroom for growth within our existing network with the potential to add 496 beds 9:55 9 minutes, 55 seconds through brownfield expansions including 193 beds at Lucknau, 81 beds at Patna and 222 beds at NOA. These additions are 10:05 10 minutes, 5 seconds expected to drive near to medium-term growth with minimal incremental capex. 10:10 10 minutes, 10 seconds On the expansion front, our pipeline continues to progress well in Guhati. 10:14 10 minutes, 14 seconds Barricading is complete and drawings have been submitted for approvals. In Mumbai, land acquisition is complete. 10:21 10 minutes, 21 seconds Additional FSI approvals have been received and drawings submitted for approval. In South Delhi, construction activities are underway following the 10:29 10 minutes, 29 seconds completion of site surveys and soil testing. 10:33 10 minutes, 33 seconds Project is going through the regulatory approvals phase. Overall, nine months of FI26 reflect disciplined execution 10:40 10 minutes, 40 seconds across the organization. Our core hospitals remain stable. Developing hospitals continue to scale efficiently and Maidanta noa is progressing in line 10:48 10 minutes, 48 seconds with expectations during its ramp up phase. We remain confident that these investments will create sustainable value for all stakeholders. 10:57 10 minutes, 57 seconds With this, I would now request the operator to open the line for questions. Thank you. 11:03 11 minutes, 3 seconds Thank you very much. We will now begin the question and answer session. Anyone who wishes to ask a question may press star and one on their touchstone 11:11 11 minutes, 11 seconds telephone. If you wish to remove yourself from the question queue, you may press star and two. Participants are requested to use handsets while asking a 11:20 11 minutes, 20 seconds question. Ladies and gentlemen, we will wait for a moment while the question assembles. 11:36 11 minutes, 36 seconds The first question is from the line of Tushar from Modilal Oswal Financial Services. Please go ahead. Yeah, thanks for the opportunity sir. 11:44 11 minutes, 44 seconds Firstly on the clarification uh like in your opening remarks you highlighted about luckno and patna margins. If you could just 11:52 11 minutes, 52 seconds you know spell out again yeah should I go ahead or do you have another question? 12:01 12 minutes, 1 second Yeah first if you could address this and then I'll take the second I'll have the second question. 12:07 12 minutes, 7 seconds Yeah. So if you look at our developing hospitals uh performance if you look at the presentation on uh uh the investor 12:14 12 minutes, 14 seconds presentation I think it is on slide 16 you will see that we have seen a income growth of 28% from the one month period 12:21 12 minutes, 21 seconds this is excluding NOIA um where the revenue has grown from uh 812 crores to 12:29 12 minutes, 29 seconds uh 140 crores and if you look at the margins that has also increased in fact the margins have increased from uh 30% % 12:37 12 minutes, 37 seconds to 31.1% uh excluding NOA and then if you factor in noa that is uh because of NOA loss so that is coming to 25%. 12:47 12 minutes, 47 seconds So I hope that is the question you are asking sir on luckno uh particularly how has 12:54 12 minutes, 54 seconds been the margin scale up on luck now we've done very well uh over the course of the last 9 months or so as 13:01 13 minutes, 1 second I mentioned in the in the opening remarks we have seen a margin expansion of over 150 basis points when you look at it on a 9 month to 9 month basis. 13:13 13 minutes, 13 seconds Got it sir. And secondly now with respect to noa we've almost onboarded 220 doctors. Uh what is the f like more 13:22 13 minutes, 22 seconds are we more or less now done with in terms of onboarding doctors or what is the sort of target uh as far as doctors are concerned and how has it has been 13:30 13 minutes, 30 seconds like maybe the initial fillers with respect to no facility. 13:37 13 minutes, 37 seconds Yeah. So you know as you are aware we don't stop hiring doctors even after several years but of course the uh the 13:47 13 minutes, 47 seconds the hiring to be able to start the services is more or less underway. Um there are some departments which are 13:54 13 minutes, 54 seconds still not active in NOA. So some of the departments which are not active in NOA as at December 31 would be the 14:02 14 minutes, 2 seconds pediatrics department, the obstetrics department, uh liver transplant department. Um some of the departments 14:10 14 minutes, 10 seconds in uh some of the more niche specialties like vascular surgery. So we are still continuing to look at uh at these uh 14:19 14 minutes, 19 seconds departments and hiring. But I would say that the majority of the hiring has uh been undertaken um including adding in 14:29 14 minutes, 29 seconds some of the talent uh to support the the key teams. So we now expect that uh you know most of that hiring is is finished 14:37 14 minutes, 37 seconds but like I said if we do find that we need to bring in more talent we will not stop that hiring that will continue and 14:44 14 minutes, 44 seconds wherever the departments are not there as I mentioned that hiring will take place. I don't know whether it will happen immediately in the next few 14:51 14 minutes, 51 seconds months or whether that will happen subsequent to March 31 but that will be as per our availability of beds and our 14:59 14 minutes, 59 seconds availability of talent and our you know plans as we move forward. 15:03 15 minutes, 3 seconds Got it. And just lastly now that it's like three four months into operation. 15:08 15 minutes, 8 seconds So broadly what kind of ARP is like as a starting point so to say of course this will further improve with the change in casem mix but currently if you could 15:17 15 minutes, 17 seconds share what kind of AR pop we are having at N hospital. 15:22 15 minutes, 22 seconds So our our pops are I in Noa hospital are coming currently much higher than godam. Um but I would not necessarily 15:30 15 minutes, 30 seconds use this as a proxy for extending out into you know many months into the future because you know we have just 15:37 15 minutes, 37 seconds started so the we have now signed up uh about four or five major insurance contracts other insurance contracts are coming on board. um we have not yet 15:46 15 minutes, 46 seconds taken any of the uh panels in noa that may come on as we move forward in line with our broader philosophy of serving 15:53 15 minutes, 53 seconds every strata of society and every category of patients. So I don't uh I mean right now the AR pops are you know 16:00 16 minutes similar to Delhi AR pops but I just caution that we should not assume that that will maintain as we move forward. 16:07 16 minutes, 7 seconds Once we have a more balanced uh uh you know revenue mix then you will see a slightly more balanced R pop as we move forward. 16:17 16 minutes, 17 seconds Got it sir. Thank you. That's it from my side. Thank you. Thank you. 16:26 16 minutes, 26 seconds The next question is from the line of Dash Sha from Suridi Securities. Please go ahead. 16:31 16 minutes, 31 seconds Yeah. Hello sir. Thank you for the opportunity. 16:35 16 minutes, 35 seconds So I wanted to understand like could you uh typically state the employee to W ratio for the hospital because as per my 16:44 16 minutes, 44 seconds understanding uh the employee to W ratio varies for the different specialtity. 16:50 16 minutes, 50 seconds So, so on the overall basis, what would it be for your hospital? 16:58 16 minutes, 58 seconds So, we don't look at I mean I'm not very sure they were where you are getting these baselines from. We don't normally 17:05 17 minutes, 5 seconds look at employee to bed ratios in any one area because it varies very drastically depending on the nature of 17:13 17 minutes, 13 seconds the specialty. So neither have we ever ever published it nor do we nor can I tell you that this is a standard number 17:20 17 minutes, 20 seconds for a hospital. Just to give you a sense a liver transplant department may have fewer beds but very high number of clinical talent whereas a internal 17:29 17 minutes, 29 seconds medicine department may have high number of beds and very few number of doctors. 17:33 17 minutes, 33 seconds So it is not a very meaningful metric for us to look at uh in terms of any of the operational parameters. So unfortunately we don't have anything 17:41 17 minutes, 41 seconds which we report out which I can share with you. I'm not sure if you have something deeper in mind in the question. I can try to assist but this metric as such we don't report. 17:51 17 minutes, 51 seconds Okay. Okay sir. Uh and the second question was like could you uh tell the total census beds for the each units? 18:04 18 minutes, 4 seconds The total census beds in each unit. Yeah. 18:10 18 minutes, 10 seconds Uh I think that was in the investor deck. Let me see if I can find it. So Nida census beds right now is 187. 18:20 18 minutes, 20 seconds Uh right. Let me just pull out the census beds for uh our total is about 2,427. 18:30 18 minutes, 30 seconds And maybe I can get this sorry uh 2,665 as at December. Uh and maybe I can get 18:38 18 minutes, 38 seconds this sent across to you from our investor relations team so we don't waste everybody else's time on the call. 18:43 18 minutes, 43 seconds Um each of the units will get the bed sent to you. Sure. 18:48 18 minutes, 48 seconds Yeah. Gorgo is about 1220. Uh I remember that number and I think Lucknau currently is operating at around 5 600. 19:00 19 minutes Okay sir. But another big facility is 569. 19:04 19 minutes, 4 seconds Sorry. Uh 386 is the census but we will get this sent. I think it's in the deck also. Yeah. Okay. 19:18 19 minutes, 18 seconds Thank you. 19:20 19 minutes, 20 seconds To ask a question please press star and one now. Participants who wish to ask a question may press star and one this 19:28 19 minutes, 28 seconds time. The next question is from the line of Bansi Desai from JP Morgan. Please go ahead. 19:36 19 minutes, 36 seconds Yeah. Hi, thanks for taking my questions. So firstly on NOIA um how should we think about the losses from 19:43 19 minutes, 43 seconds here on? I'm assuming these would be the peak kind of losses that we report in the quarter given you know we've added you know doctors and you know large part 19:51 19 minutes, 51 seconds of commissioning expenses would be sitting in this quarter and therefore as the unit ramps up you know uh should we see losses coming down and also you know 20:00 20 minutes given the fact that we are uh expected to add you know another 200 plus bed here over the next one year how should we see the loss trajectory? 20:11 20 minutes, 11 seconds Yeah. So, you know, um I I mean I hope so uh that we've seen the peak of the losses. Uh you're right. If you look at 20:18 20 minutes, 18 seconds our uh scale up of clinicians, um we've added in uh a whole bunch of clinicians from September to you know November and 20:27 20 minutes, 27 seconds even within this quarter if I was to really see uh you know the performance really was more in terms of volumes growth more started towards the uh 20:37 20 minutes, 37 seconds second half of this quarter. So you don't even see complete three months of you know run rate. So we are seeing now especially uh December and as we move 20:45 20 minutes, 45 seconds into January a better run rate trajectory on the revenue. So of course that will help with the uh loss containment. I don't know exactly when 20:53 20 minutes, 53 seconds it will be uh fully concluded. Um one thing I just want to clarify for one of the earlier questions I had mentioned uh 21:00 21 minutes on the specialties. uh one thing which I forgot to mention is our radiation oncology and our nuclear medicine department which is on board in terms of 21:08 21 minutes, 8 seconds the talent and the machines that hasn't started yet. So that is another thing I forgot to mention that the department which is currently missing. Um but 21:16 21 minutes, 16 seconds you're right as we scale up we should see now the business coming in our insurance contracts coming on board our corporate and paranoids coming on board. 21:23 21 minutes, 23 seconds Uh and really now the question is you know getting down and actually ensuring that we are able to service the people of NOA and western UP. So much of the 21:31 21 minutes, 31 seconds initial work is done although some of the project work is still undergoing but the hospital is fully functional now subject to the departments that I mentioned. 21:40 21 minutes, 40 seconds And when we think of adding 200 beds here you know I would assume those would largely get absorbed you know with with 21:47 21 minutes, 47 seconds these 300 beds get you know ramping up by by that time. 21:52 21 minutes, 52 seconds Yes. So the the additional beds would largely get absorbed with the teams which we have plus some element of the teams which we are adding. So I can tell 22:01 22 minutes, 1 second you for example that we are already underway of creating our dedicated transplant unit. So although it was not completed and commissioned by December 22:10 22 minutes, 10 seconds 31 that is one area which we will be be having is so some of these additional beds will come into that. So with the exception of really transplant which has 22:18 22 minutes, 18 seconds dedicated infrastructure and maybe obstetrics or pediatrics the rest of the infrastructure will more or less just scale up as and when the need is there 22:26 22 minutes, 26 seconds and will be part of the existing clinical team. So we don't see that there's any real need to hire new departments for filling those beds. 22:36 22 minutes, 36 seconds All right, that's clear. And and my second question is on the mature units. 22:39 22 minutes, 39 seconds Um you know uh we've seen significant decline in a loss there uh 2.9 days. Is it a quarter phenomena or you know uh do 22:48 22 minutes, 48 seconds we expect you know structurally a loss you know you know coming off there and you know so so that's one and the second 22:56 22 minutes, 56 seconds is you mentioned on margins you know we had higher employee cost and certain maintenance related expenses so with those behind uh should we expect you 23:05 23 minutes, 5 seconds know the the overall unit to see improvement in margin um you know from the upcoming quart you know from from 23:13 23 minutes, 13 seconds the next quarters as you see your revenues is growing. 23:17 23 minutes, 17 seconds Yeah. So, um let me take that in two parts. First, you know, when you look at the ALOS, I think uh just picking up one or two quarters may not be always 23:25 23 minutes, 25 seconds appropriate because there is some effects of how the seasons play out, how the Diwali holidays play out, how the um 23:33 23 minutes, 33 seconds you know certain seasonal diseases like etc play out. Sometimes it's more in September, sometimes it's more in October. So I would I would you know 23:41 23 minutes, 41 seconds suggest we look more at a annual or a 9-month basis at a minimum rather than quarter on quarter uh just to get the numbers correct. That being said um the 23:49 23 minutes, 49 seconds ALOS uh reductions are uh also driven a lot by you know the increasing work for cancer and given the growth which you'll 23:58 23 minutes, 58 seconds see on the on the sales mix uh and I think it's phenomenon across the country where cancer treatment and cancer detection is increasing. So a lot of the 24:07 24 minutes, 7 seconds cancer work is in the nature of uh radiation oncology or medical oncology which has a daycare component to it. So there is an increase in daycare. Uh 24:16 24 minutes, 16 seconds there is also some amount of difference this year versus last year with respect to patients who are more in the deni and 24:24 24 minutes, 24 seconds some of the other respiratory diseases which tend to have a slightly longer length of stay uh visav some of the 24:31 24 minutes, 31 seconds shorter procedural uh departments. Um other than that I don't see any very significant structural change. I mean we 24:39 24 minutes, 39 seconds already have a very aggressive length of stay. Uh that being said we continue to work especially in some of the uh units 24:46 24 minutes, 46 seconds like Patna and maybe even in Gorga uh to actually ensure that we are optimizing on length of stay and uh we will 24:55 24 minutes, 55 seconds continue to try to see if we can you know convert a lot of the work from night stay to daycare. So we want to 25:02 25 minutes, 2 seconds work on uh how we also do things like improving discharge processes, streamlining the the discharges for 25:09 25 minutes, 9 seconds patients who are credit patients. So I mean there is still some operational efficiencies I think we can bring in but I think a 3 days length of stay for a 25:18 25 minutes, 18 seconds ecosystem as complex as ours is is very very robust. 25:24 25 minutes, 24 seconds Understood. And just on margin uh you know are we done with you know uh our investments into you know maybe adding 25:31 25 minutes, 31 seconds you know employees and um you know maintenance expenses or we expect that to recur. 25:37 25 minutes, 37 seconds Yeah. So I don't think that there is any kind of I mean obviously the employee costs are recurring costs they they incur every month but I think if you you 25:44 25 minutes, 44 seconds know if you go back to last three four quarters I had been mentioning that you know there is some amount of uh war for talent that is coming is likely to come. 25:55 25 minutes, 55 seconds Um we are also aggressively hiring across the units. So there'll be some amount of optimization and balancing out of this as we stabilize uh our hiring as 26:04 26 minutes, 4 seconds well as how other hospitals look at hiring in the market. Um we'll also look at operational efficiencies where we can bring about as much as possible uh both 26:13 26 minutes, 13 seconds on the manpower cost as well as on the uh some of the other expenses. Some of these are cyclical in nature. So you 26:20 26 minutes, 20 seconds know for example we do notice in our P&L that repairs and maintenance costs whenever we have annual maintenance contracts coming up which is out of 26:28 26 minutes, 28 seconds warranty new equipment comes out of warranty after maybe 3 four years of of procurement uh you know those come in and then they balance out over time. So 26:36 26 minutes, 36 seconds depending on which Verizon you're looking at they more or less balance out. I don't see any very significant structural issues on the margins. Uh I do believe there are efficiencies 26:45 26 minutes, 45 seconds especially in some of the older units that we can ek out. uh and we will work towards that. Uh you will see some of those efficiencies are already playing 26:52 26 minutes, 52 seconds out on some cost items. So material costs have been are currently in the process of being optimized as we move uh and we seen some of that captured in the 27:01 27 minutes, 1 second numbers so far. We hope that will continue. So you know there'll be some up and down across cost items but overall I think that we'll be looking at 27:10 27 minutes, 10 seconds trying to see whether we can get couple of 100 basis points of efficiency out of the system as well. 27:16 27 minutes, 16 seconds All right, I have more questions. I'll join back with you. Sure. 27:22 27 minutes, 22 seconds Thank you. The next question is from the line of Manish Podar from Invesco AMC. Please go ahead. 27:30 27 minutes, 30 seconds Uh so uh just one question. So uh I heard that uh you know you said I hope so for the peak losses to be behind uh 27:38 27 minutes, 38 seconds for dya. uh how are you thinking actually of the ramp up the other way around you know let's say you know versus the initial expectation uh you 27:45 27 minutes, 45 seconds know versus what you would have seen in the last few months you know how are you think about getting to utilization let's say 40 50 60% and you know how how is 27:54 27 minutes, 54 seconds the journey faster than earlier expectation just any color that will be helpful thanks so I think um Manish the the journey is 28:03 28 minutes, 3 seconds very much as per our expectations uh I think that as we look at getting uh you know everything settled not only 28:11 28 minutes, 11 seconds operationally but also uh some of the project teams moving out of the system uh you know we we started out this hospital while it was in the currently 28:20 28 minutes, 20 seconds being constructed as well so some of these things will stabilize you know like I mentioned just as an example our radiation oncology doctor is on board 28:28 28 minutes, 28 seconds but the machine is not yet live because we are waiting for the approvals from AB so there will be some teething issues around this next couple of weeks maybe 28:36 28 minutes, 36 seconds months but I think that you know for the most part we are now ready to fire on full cylinders. Uh what that time frame 28:43 28 minutes, 43 seconds exactly will be I'm not sure but I don't think that we are we have seen anything happen in NOA which is totally counter 28:51 28 minutes, 51 seconds to what our expectations was either on the you know hugely negative side or on the hugely positive side more or less moving in line with what we expected. 29:02 29 minutes, 2 seconds Okay. Thank you. Thank you. 29:08 29 minutes, 8 seconds The next question is from the line of Damianti Kerry Kai from HSBC. Please go ahead. 29:16 29 minutes, 16 seconds Hi. Uh good afternoon and thank you for the opportunity. Uh my first question is again on NOA uh where you mentioned it's 29:23 29 minutes, 23 seconds ramping up for your expectation. So just to clarify uh the additional bed uh addition plan which you have that will 29:31 29 minutes, 31 seconds only be done once you have uh achieved cost break even at the existing bed set. Right. or how do you think? 29:39 29 minutes, 39 seconds No, I don't think that's the right way to think about it. So, um you know again without getting into too much specifics, our NOA facility is a single tower 29:48 29 minutes, 48 seconds facility as opposed to uh Gurong Lucknau and Patna where we had two towers where we were able to build one tower then 29:56 29 minutes, 56 seconds wait then fill it then operationalize the second tower. because of the structure of this building, we intend to complete the project work as and when we 30:03 30 minutes, 3 seconds uh as and when the project teams are able to do it. So we will not actually demobilize and start again once the occupancy increases. We will continue to 30:11 30 minutes, 11 seconds build out uh throughout it just ends up being more efficient that way. And while it may be beds coming in you know a few 30:18 30 minutes, 18 seconds months before we need it uh we feel it's the most efficient way. So uh we would not stop the buildout is the answer to the question uh that we had. 30:27 30 minutes, 27 seconds Okay. Both will happen simultaneously, right? Uh the ramp up on the adjacent bed. Yeah. Yeah. 30:33 30 minutes, 33 seconds Correct. So we'll ramp up the adjacent beds. We will build out. Now you may not hire every department. You may not hire the nurses for running one ward if the 30:42 30 minutes, 42 seconds ward doesn't have patients. But the infrastructure and capex and the and the fit outs and all we will conclude and then we will see as and when we we move 30:51 30 minutes, 51 seconds out. We may also have you know some things in the back pocket for you maybe one floor or so depending on whether we 30:58 30 minutes, 58 seconds need more ICUs or more OT's you may need to optimize there we are now seeing this after about four years performance in 31:06 31 minutes, 6 seconds Patna we are actually realizing that we may have a demand for additional procedure rooms as opposed to beds so we 31:15 31 minutes, 15 seconds may actually redeploy some of the spaces which were allocated for beds to procedure rooms So today I believe Patna 31:23 31 minutes, 23 seconds is about 560 beds. So from the remaining 8000 beds I may choose to redeploy some beds to procedure areas or we are trying 31:31 31 minutes, 31 seconds to find if we can optimize there. So barring this small adjustments we will continue to build out NOA. 31:39 31 minutes, 39 seconds Got it. Uh my second question is on uh the update which we heard on the CGHS uh 31:46 31 minutes, 46 seconds rate division uh some time back. So anything uh you're picking up on that part in terms of your operations? 31:57 31 minutes, 57 seconds So CGS rate revision has of course been beneficial for the industry. Uh it has been a long demand after many many 32:04 32 minutes, 4 seconds years. Uh there has been uh positive movement across the group uh on that in terms of tariff increases. Um we we have 32:13 32 minutes, 13 seconds captured some of that in the 9 month numbers that you see. I think uh you know high singledigit uh in terms of 32:20 32 minutes, 20 seconds growth uh is the impact on that and uh you know hopefully some of that will fall to the bottom line also uh as we 32:28 32 minutes, 28 seconds roll out because these increases I think came middle or late Q2 so it's not even a full 12 months of impact yet so if I 32:38 32 minutes, 38 seconds remember correctly it was maybe sometime around October and then uh you know also what happens is some of the other uh 32:47 32 minutes, 47 seconds institutional uh companies that follow CJS rates. They then follow up with their own orders like the railways who will follow up saying we we also will 32:55 32 minutes, 55 seconds activate these rates and so on and so forth. Uh and also we are working with our partners in Bihar that those rates 33:03 33 minutes, 3 seconds are where we have PPP those rates also get adjusted. So the full year impact of this I think is not yet played out but so far it's been positive. 33:11 33 minutes, 11 seconds And uh did you mention some high singledigit impact or uh that's right I think your case will correct me if I'm wrong is I think it's somewhere in the 33:19 33 minutes, 19 seconds range of 7 to 10 crores of impact in 9 months I oh 7 to 10 cr okay 33:25 33 minutes, 25 seconds that's and my last question is on your plan for uh price increase which is obviously not your focus but uh as you 33:34 33 minutes, 34 seconds focus more on the volume growth but uh in terms of taking price height for some of your units where you haven't taken price height for long. Uh are those done? 33:45 33 minutes, 45 seconds So um if I remember correctly from our last call in September till December, I 33:53 33 minutes, 53 seconds think no real price increases have been taken. uh except maybe in in Patna 34:00 34 minutes Patna we haven't taken Gurau and Lucknau we have taken but I think more important than that is that some of the insurance 34:08 34 minutes, 8 seconds contracts which were not uh renewed for almost two to three years they are now getting renewed uh across the group so 34:16 34 minutes, 16 seconds there will be some potential benefit for those price renegotiations as we move forward so I think you know probably 34:24 34 minutes, 24 seconds when we come to maybe June or September of next year, you'll see more of a realistic picture of a full year of pricing impact across CGHS, our increases and insurance negotiations. 34:36 34 minutes, 36 seconds Okay. Uh just a clarification on these rates which you renegotiated with your insurance partner. U what kind of u you 34:45 34 minutes, 45 seconds know hike you might have got just some indication say compared to the last contract when you uh signed the new contract. What is the difference? 34:56 34 minutes, 56 seconds So let me put it this way. When we when we sign up the contracts with the insurance companies, they were on a on a 35:04 35 minutes, 4 seconds tariff list which I think was somewhere around uh 2 years or 3 years ago 2024 tariffs I think or 2023 tariffs. So now 35:13 35 minutes, 13 seconds when insurance companies negotiate they negotiate it with our 2025 tariffs which was what we had done last year. So 35:21 35 minutes, 21 seconds depending on how those tariffs increase uh we we kind of renegotiate basis tax. 35:28 35 minutes, 28 seconds So it would be different in different units depending on when the insurance company signed up but typically insurance companies will sign up for a 2-year time frame and now it's already 35:36 35 minutes, 36 seconds been little over two years. So you can say about two years plus of increases and then insurance companies ask for you know different levels of support in 35:45 35 minutes, 45 seconds terms of discounting etc. But on the whole I think it will be a positive uh benefit for us from a tariff point of view. 35:54 35 minutes, 54 seconds Sure. Thank you. I'll get back in the key. Thank you. 36:01 36 minutes, 1 second Before we take the next question, we would like to remind participants that you may press star and one to ask a question. 36:09 36 minutes, 9 seconds The next question is from the line of Ashto Nimani from GM Financial Office. 36:14 36 minutes, 14 seconds Please go ahead. Yeah, thanks for the opportunity sir. My question is on the earlier uh answer you told that war war 36:21 36 minutes, 21 seconds of salad coming up in the next three to four years. So I wanted to understand more about it like in particularly what 36:29 36 minutes, 29 seconds locations do we see this doctor supply nurse supply more severe as compared to other on the national level if you could just a highlight on that. 36:40 36 minutes, 40 seconds I mean I'm I'm not uh fully an expert to tell you at a national level in which city there will be more or less war for 36:48 36 minutes, 48 seconds talent. I think this is a phenomenon the industry is facing to the best of my knowledge across the board. I can tell you in the regions where we operate 36:56 36 minutes, 56 seconds which is more on the northern side. Um there are two ways in which we look at it. One way is where there are existing 37:04 37 minutes, 4 seconds facilities where there are lots of doctors and there's lots of demand for for talent. Uh there it is a little bit driven by you know some forms of 37:13 37 minutes, 13 seconds competitive intensity. Uh doctors are trying to get coached by other hospitals. Obviously we would be also 37:22 37 minutes, 22 seconds looking at hiring doctors from other institutions. Some amount of uh retention also we have been very lucky. 37:28 37 minutes, 28 seconds We've been able to retain most of our senior doctors if not all uh even after 15 years in good now. Then when you come 37:35 37 minutes, 35 seconds to units which are in cities where there may be a slightly shorter uh you know tail of talent in terms of super 37:43 37 minutes, 43 seconds specialists uh we've been able to get in doctors from other cities. Sometimes you have to pay for uh getting doctors to move into certain locations or you're 37:52 37 minutes, 52 seconds actually looking at uh building up a talent base over there visa we taking time to build that specialty. So just to 37:59 37 minutes, 59 seconds give you an example uh if I bring in a very talented uh say robotic surgeon from one part of the country they may 38:06 38 minutes, 6 seconds not have a patient base say in in a Bihar or in a UP. They build up that. So that takes little time to build up. So these are the kinds of things that we 38:14 38 minutes, 14 seconds have seen uh from my conversations with colleagues in the industry. I think this is a phenomenon everybody's facing. 38:21 38 minutes, 21 seconds Obviously there's a lot of talk about uh hospitals. So everybody getting very excited. Um one thing though we have seen is that I think clinical talent 38:29 38 minutes, 29 seconds understands the value of strong brands and strong institutions. Maidanta has been very lucky to be a kind of what we 38:37 38 minutes, 37 seconds believe is a preferred employer for clinicians. 38:39 38 minutes, 39 seconds Uh so we've been lucky on this front. Um but I do believe that given the talent is scarce this is something that the industry and the country will face for 38:48 38 minutes, 48 seconds you know some years to come. I don't think this is something going to get solved in the next quarter. 38:56 38 minutes, 56 seconds Understood. Understood. Then my second question is in the next two to three years what should be the like growth that we could assume for maidanta? 39:08 39 minutes, 8 seconds So you know again next two to three years I don't know how things will play out but we have always maintained that 39:15 39 minutes, 15 seconds uh our cops grow typically 5 to 7% a year as opposed to what we have seen maybe uh you know last three four years 39:23 39 minutes, 23 seconds where we've seen much higher growth again our pop is little bit dependent on length of stay and case mix but we don't 39:30 39 minutes, 30 seconds project anything more than a 5% to if you're very enthusiastic maybe a 7% growth in our pop on an annual basis. 39:38 39 minutes, 38 seconds U in fact maida typically projects much lower 3 to 5% is what we tried to think about um but again that's more on for us 39:47 39 minutes, 47 seconds on tariff or realization side our pop again if you optimize length of stay then our pop will grow but I think that 39:54 39 minutes, 54 seconds of 10 15% our pop growth uh or realization growth which we were seeing maybe a year and a half to two that has 40:02 40 minutes, 2 seconds already stabilized you can already see it in the results of all companies last maybe year to 18 months, you'll see a 40:10 40 minutes, 10 seconds significant slowing down of the ARPA growth that was there 2 three years ago. 40:13 40 minutes, 13 seconds So I think 5 to 7 is a reasonable number to project out if you're thinking about building a model. I would not go more 40:20 40 minutes, 20 seconds aggressive than that. Definitely not single digits. I would keep it to uh not double digits. I would keep it to single digits. 40:28 40 minutes, 28 seconds Thanks a lot. This was very helpful. Thank you. 40:37 40 minutes, 37 seconds The next question is from the line of Rahul Givani from IFL Securities Limited. Please go ahead. 40:45 40 minutes, 45 seconds Uh thanks sir for uh taking my question sir on the noa hospital for let's say these 300 orbits which we have 40:53 40 minutes, 53 seconds operationalized what kind of an exit occupancy we would have seen either for the December month 40:59 40 minutes, 59 seconds or the Jan month and uh if you can also talk about the occupancy which you which you need to achieve to let's say hit 41:08 41 minutes, 8 seconds aida break even on these 300 bits. 41:13 41 minutes, 13 seconds So you know we don't normally look at occupancy from a break even point of view because of the fact that uh we 41:21 41 minutes, 21 seconds believe more much more in the volumes in the procedures rather than the midnight occupancy. So at least Maidanta doesn't 41:28 41 minutes, 28 seconds necessarily look at that. That being said, I think normally what we find is in a big system somewhere in the range 41:37 41 minutes, 37 seconds of 40 to 50% or maybe 40% plus occupancy typically breaks even uh on a long run basis for the kind of fixed cost model 41:45 41 minutes, 45 seconds that Midanta employs. It may be very different in other industries. Uh our goal is very simple in NOA. Our goal is 41:52 41 minutes, 52 seconds that we have put everything that is required to deliver the highest standard of care that is investment in the infrastructure the technology the 42:00 42 minutes clinical talent the processes the IT systems etc. Our goal is to drive this occupancy through and through. So uh 42:08 42 minutes, 8 seconds sorry to drive this volumes and this business through and through. Once we do that whatever occupancy falls out of that it falls out of that. Our focus is 42:17 42 minutes, 17 seconds that we must be ensuring that we invest to deliver the highest end of care. We have done that and based the trajectory 42:24 42 minutes, 24 seconds we see in the last few months uh including post December uh we are pretty happy with how things are moving and 42:31 42 minutes, 31 seconds pretty confident of the success of this institution. So whether this occupancy will break even at 30% or 40% or 50% I 42:39 42 minutes, 39 seconds don't know. It's also not a percentage number which we are chasing. Our goal is to ensure that we are able to drive as much patient volumes into the system and 42:48 42 minutes, 48 seconds we are pretty confident given our track record these things will then work out well. 42:54 42 minutes, 54 seconds Sure sir. And for let's say these another 200 bits which you would commission at NOA how many incremental 43:01 43 minutes, 1 second doctor hirings would we need to do given that obviously for the the the the initial phase of 300 beds we have already onboarded 200 odd doctors. 43:12 43 minutes, 12 seconds So not many as I mentioned um I think in response to an earlier question we have some departments which we may add so they of course are not linked to beds uh 43:21 43 minutes, 21 seconds they would have addition so OBS speeds is an example of that which is a totally new department the rest of the departments all the seniors or most of 43:29 43 minutes, 29 seconds the senior talent is already there so when you add in beds it's really more of the junior staff who need to you know do more of the maintenance management and 43:37 43 minutes, 37 seconds taking care of the care nurses of course will get added and other stuff but the senior doctors I don't aren't necessarily linked to the two bed edition. 43:46 43 minutes, 46 seconds Sure. So then the Okay. So the incremental optics for these another 200 beds obviously would then be lower. 43:54 43 minutes, 54 seconds Yes. Correct. 43:56 43 minutes, 56 seconds Sure. And sir, last question from my end in terms of the mature hospitals where we have seen some sort of a margin 44:03 44 minutes, 3 seconds pressure this year while you alluded to higher employee and maintenance cost. Is the Raji O&M hospital also led to some 44:12 44 minutes, 12 seconds sort of a margin drag for the mature units? 44:17 44 minutes, 17 seconds Uh I mean definitely the new Ranchi hospital also has a little bit of impact. I'm not sure it will play out in the numbers which you're seeing because 44:24 44 minutes, 24 seconds it's very small. It's only about 100 beds on a you know 2,000 3,000 bed uh overall base. So I don't think it has 44:32 44 minutes, 32 seconds impact as to what you see. Of course it is a drag but I don't think it's significant or material on the financial on the absolute rupee amount. 44:41 44 minutes, 41 seconds Okay. Sure sir. Thank you. That's your comment. 44:43 44 minutes, 43 seconds Just uh I mean just to let you know obviously Ranchi and margins are of course lower than uh you know Gorgo and 44:50 44 minutes, 50 seconds Lucknau. So uh and and Gorgo sorry Lucknau is coming in developing still but other than that I don't think it's a very significant drag. 45:00 45 minutes Okay. Sure sir. Thank you. Thank you. 45:04 45 minutes, 4 seconds The next question is from the line of Nitina Agraal from Dam Capital. Please go ahead. 45:09 45 minutes, 9 seconds Thanks for taking my question. On the you know over the last few months and quarters we've had uh in multiple sort of media items news flow around you know 45:18 45 minutes, 18 seconds increased tiff between hospitals and insurers. Uh a I mean two two questions here. One is a is there a change in 45:25 45 minutes, 25 seconds relationship between uh between insurers and and corporate hospitals uh in a sense as insurers become larger in cloud and two what kind of implications does 45:33 45 minutes, 33 seconds it have for uh you know for for for rates and business as we go along. 45:40 45 minutes, 40 seconds Yeah. So I think maybe I'll I'll you know give three four specific points on this. I think first of all you know as with many things the media likes to 45:48 45 minutes, 48 seconds sensationalize things much more than they are in reality. Uh so I wouldn't always necessarily go with either the 45:55 45 minutes, 55 seconds substance or the tone of what we hear in the media. Uh that's point number one. 46:00 46 minutes Point number two uh just again at a higher level. See every player in this industry whether it is a provider like 46:08 46 minutes, 8 seconds us whether it is a insurance company or whether it is even the government authorities including at every level of government they all understand that our 46:17 46 minutes, 17 seconds collective responsibility is first and foremost towards the patient. Neither can we survive without the insurance companies. Neither can the insurance 46:24 46 minutes, 24 seconds companies survive without the uh providers. And by the way, the same logic applies to the pharmaceutical and medical device companies which are also 46:32 46 minutes, 32 seconds part of this ecosystem and also part of some of these conversations that you're alluding to. Right. So I think we all get it and everybody is reasonably 46:40 46 minutes, 40 seconds mature in that. That being said, um there is always a commercial negotiation and a commercial discussion that happens 46:47 46 minutes, 47 seconds between uh any two parties engaged in a commercial conversation. Now we have so far been very very clear on our approach 46:54 46 minutes, 54 seconds that we are open and ready to talk to anybody and we have we have been successful with those activities and all conversations in good faith between two 47:03 47 minutes, 3 seconds parties in a professional and in a non uh collusive manner are something that we stand for and we have been successful 47:11 47 minutes, 11 seconds in moving that forward. Of course, if I would like to pay 10 rupees and you would like to pay 5 rupees or I would like to charge 10 rupees, you would like to charge 5 rupees. Of course, we will 47:20 47 minutes, 20 seconds negotiate on that price. Nothing wrong in that. And we've been successful in closing out many of these contracts and many of these negotiations. We I think 47:27 47 minutes, 27 seconds that we could have been faster and more efficient. I think that some of the players in the industry who are maybe trying to project that uh you know we'll 47:37 47 minutes, 37 seconds we'll only talk as one body or that we that you know only it's only the hospitals that are making money and the insurance companies are make not making 47:44 47 minutes, 44 seconds any money. I think these are facts which are being a little bit manipulated one way or the other. I think the truth is obviously somewhere in the middle as with most cases. 47:52 47 minutes, 52 seconds uh we do realize that the insurance companies have challenges but many of those challenges are also linked to their operating model and some of the 48:01 48 minutes, 1 second issues in the industry. Similarly, I think they understand that uh while you look at Ibida many times, but the real 48:09 48 minutes, 9 seconds money at the bottom line coming on the profit after tax, which is the money that has to go into capex refresh and investing in all of these areas is 48:17 48 minutes, 17 seconds required for hospitals to be able to grow and for frankly speaking people like us to invest in places like Patna 48:24 48 minutes, 24 seconds and Bihar and Ranchi and Northeast and the government also understands that that it's very important that they encourage private investment in all 48:31 48 minutes, 31 seconds these areas because that's how the care will get delivered. So I frankly speaking see that there is no long-term 48:38 48 minutes, 38 seconds relationship impact between the two parties. We have been very comfortable interacting with everybody. But of course we will negotiate on price. I 48:47 48 minutes, 47 seconds don't see that stopping this year, next year or anytime in the future. As any entity has feels they have more power, they would like to be stronger in a 48:54 48 minutes, 54 seconds negotiation position. It is exactly the same thing that I would do with my suppliers. So it's normal. I I think some of it is blown out of proportion 49:02 49 minutes, 2 seconds and some of it as few stakeholders in the ecosystem on both sides are probably you know mischaracterizing misusing one 49:11 49 minutes, 11 seconds party or another party on their side of the industry uh for their own personal benefits which is also not correct. 49:19 49 minutes, 19 seconds Thank this was very helpful and secondly sorry if I missed it uh did we guide to a a time period when we expect NA to break even on IDIA? 49:27 49 minutes, 27 seconds No, we don't guide on on future uh earnings uh as a policy. Um all I did allude to was the fact that you know we 49:36 49 minutes, 36 seconds are pretty hopeful that uh we are now in a position to see strong positive momentum into the system. I do not know 49:43 49 minutes, 43 seconds when that break even will happen but uh you know we are not worried that it is you know all slipping south or something 49:50 49 minutes, 50 seconds like that. It's very much as per our expectations on how the ramp up of these units will do. 49:57 49 minutes, 57 seconds But it's fair to say that this quarter eida loss is kind of close to the pkida loss will do on the asset and that is the question which I said I 50:05 50 minutes, 5 seconds hope so. I don't want to commit to you one thing or the other but I leave that to you guys to figure out but yes we are feeling confident that things are moving in the right direction. 50:15 50 minutes, 15 seconds Thank you so much. Thank you. 50:20 50 minutes, 20 seconds The next question is from the line of Naman Bhaga from IFL Capital Service Limited. Please go ahead. 50:29 50 minutes, 29 seconds Hello. Hi, we can hear you. 50:33 50 minutes, 33 seconds Uh thanks thanks for the opportunity. Uh sorry to press on the mature hospital margins again. So if you look earlier we 50:42 50 minutes, 42 seconds used push to make almost around 24 and a half 25 kind of margins. But is it because of now the incremental cost or 50:51 50 minutes, 51 seconds war on talent etc is uh one should look at let's say a lower 50:58 50 minutes, 58 seconds margin structurally let's say 100 bits lower versus what was the strategy earlier for nature hospital 51:06 51 minutes, 6 seconds no you know I think that I mean so I wouldn't necessarily agree with that right I mean if you look at the margin profile um which we have in the 9-month 51:15 51 minutes, 15 seconds period then the mature facilities It's just under 24%. We have maintained for a long time and I have maintained for a 51:22 51 minutes, 22 seconds long time that you know anything in the range of 22 to 25 is is very strong performance for a system like this 51:29 51 minutes, 29 seconds especially uh such a big system uh like the ones which we have. Uh I think that 51:35 51 minutes, 35 seconds you know 100 190 80 basis point swing here and there especially in one period over the other is fairly insignificant. 51:43 51 minutes, 43 seconds I mean our industry you have to look over this over you know three to four years not 9 months or even one year um and even within the nine months the 51:52 51 minutes, 52 seconds swing to me doesn't seem very significant so I I don't think there is a structural difference I there was a structural reset postcoid uh which we 52:00 52 minutes have talked a lot about on various calls I think we are now in a fairly balanced way around that I also had always maintained that I don't see this margin 52:08 52 minutes, 8 seconds profile jumping up every year 30% uh or 300 basis points to head towards the 30% margin. I had always said that those 52:16 52 minutes, 16 seconds were expectations that were being incorrectly set in the market. This is a fairly balanced range. You know, 22, 23, 52:24 52 minutes, 24 seconds 24, 25. This number is a very balanced range. You do a little bit better, it could go up. Um, but I don't think see 52:31 52 minutes, 31 seconds there's any big structural issue between one period or the other. You try to ek out as much in efficiency as you can. We 52:38 52 minutes, 38 seconds will see this, you know, stabilize in these ranges only. I don't I don't think they're going to change significantly. 52:44 52 minutes, 44 seconds The only thing in Madanta's case in this how we report out is uh which is a little different uh just so that you're aware is all our corporate costs are 52:53 52 minutes, 53 seconds loaded in our GDAU unit. So what you see as the margin of the individual units uh is a little bit deflated because of the 53:00 53 minutes corporate costs. probably if you took out those copper costs and you allocated them across you would see a slightly 53:07 53 minutes, 7 seconds more balanced margin profile between all of the bigger units at least in in our group. 53:14 53 minutes, 14 seconds Fair fair thanks thanks and just uh one question what would be our net cash position as of uh December? 53:24 53 minutes, 24 seconds Net cash as a December 600 crores about 600 crores. Go ahead. We have a 53:30 53 minutes, 30 seconds loans of about 600 cr rupes and a cash position of about 500 cr. So that cash is about 600. 53:39 53 minutes, 39 seconds Okay. All right. Thanks. Thank you. 53:45 53 minutes, 45 seconds The next question is from the line of Eban Benny from JM Financial Institution Securities. Please go ahead. 53:53 53 minutes, 53 seconds Hi sir. Uh thank you for the opportunity. Am I audible? Yes. 53:58 53 minutes, 58 seconds Hi sir. Yeah. Uh so sir uh while you did allude to the kind of AROB growth that we can be expecting but uh in the new my question was regarding the newer 54:06 54 minutes, 6 seconds clusters uh while we add more complex specialities while we add on to the newer ones uh what kind of dynamics do 54:13 54 minutes, 13 seconds you see regarding the kind of art for that can change in these specifically and kind if you can give some color on that dynamics. 54:24 54 minutes, 24 seconds So I mean let I don't I don't have a number for you but let me just give you a little bit of perspective right. So 54:31 54 minutes, 31 seconds one of the things the industry has been uh commenting on for the last couple of years or maybe you know six quarters is 54:39 54 minutes, 39 seconds this entire shift to say robotics. Now robotics means a higher realization but also potentially a lower length of stay because the patient gets to go home 54:47 54 minutes, 47 seconds faster. So obviously that has a disproportionate increase on RPOP because your A loss will fall and your realization will increase both. So it's 54:56 54 minutes, 56 seconds one example of something that may boost up when you look at it at a ROP level rather than a ARP level. The second 55:04 55 minutes, 4 seconds thing as I said earlier was that when you get into increasing work in cancer especially if it is cancer work in the daycare nature like radiation oncology 55:13 55 minutes, 13 seconds where you may not admit the patient or medical oncology where the patient just stays for one day for treatment uh you 55:20 55 minutes, 20 seconds will find a disproportionate growth to our pop because the occupancy is not that long as opposed to say somebody coming in for cardiac surgery. So I 55:28 55 minutes, 28 seconds think that these things are actually in favor of ARPOP growth because ARPO is a derived metric. I think if you look at 55:36 55 minutes, 36 seconds it and step back towards realization which is what the patient bill actually is. I think as I mentioned earlier you 55:43 55 minutes, 43 seconds will see a more balanced realization growth. Uh there will be some growth towards realization because of complex 55:50 55 minutes, 50 seconds work. uh some amount of increase in complex work across uh our newer units 55:57 55 minutes, 57 seconds in Patna and even in NOA as that gets uh ramped up to some of the services including transplant and things like 56:05 56 minutes, 5 seconds that. We are also starting to see some of this complex work coming into places like Indor with robotic surgery happening there uh now uh reasonably 56:14 56 minutes, 14 seconds well. So you will see some of this and then some of the uh changes of the CGHS rates as I mentioned earlier uh which 56:22 56 minutes, 22 seconds happened in October and the tariff increases will play out over you know maybe the course of the next six to 12 months. So you'll see some positive 56:31 56 minutes, 31 seconds trajectory towards this um but I think again it will be measured. I I would I would not assume you would see 10%. I 56:39 56 minutes, 39 seconds would say single digits is a fair number to be looking at. 56:44 56 minutes, 44 seconds Got it. Thank you. Uh and sir, uh if possible, can you give us the kind of expectations on capex outlay for next year given given that majority of the expansion will be there? 56:56 56 minutes, 56 seconds Yeah, I think there was a slide, correct me if I'm wrong, Aish on the capex plan in the presentation slide 23 I think lays out the capex. 57:05 57 minutes, 5 seconds Um we have been somewhere in the thousand cr range I think on a next year capex. So this is uh 3,000 over the next five years. 57:16 57 minutes, 16 seconds Yeah. 57:17 57 minutes, 17 seconds Next year maybe bit less actually now that a lot of the cost was already NOA is already so last year we had I think announced 57:24 57 minutes, 24 seconds about a,000 cr capex in the year out of which almost 600 700 was no if I'm not mistaken am I right? 57:32 57 minutes, 32 seconds And uh I don't see that this year's this FI27 capex will be of that range. It will be much lower than thousand crores. 57:40 57 minutes, 40 seconds Maybe some maintenance capex in the new in the older units. Some capex on the margin in NOA. There will be not much 57:48 57 minutes, 48 seconds capex on the other units because they're still in the digging and construction phase. So a lot of the capex in the new 57:56 57 minutes, 56 seconds projects is backended towards maybe two three years from now. So next year capex is probably I don't know maybe below 500 crores I would say below 500 crores would be our estimate. 58:08 58 minutes, 8 seconds Sure. Thank you. Thank you. Thank you. 58:15 58 minutes, 15 seconds The next question is from the line of Chir Gupta from Aligro Capital. Please go ahead. 58:21 58 minutes, 21 seconds Yeah. Thanks for taking my questions. I just wanted to understand why the margins in your developing facilities are higher than your mature facilities. 58:36 58 minutes, 36 seconds Yeah. So I I mentioned I think to one of the earlier speakers um one reason of course is that our corporate costs are 58:43 58 minutes, 43 seconds fully loaded in Gurong which is part of the major city right. Um yeah the second question if you look at our 58:53 58 minutes, 53 seconds historical performance is that our Lucknau unit and our partner units have been doing a exceptionally good 59:00 59 minutes performance right through and through barring you know one or two quarters in lucknow so what we've actually seen is a 59:07 59 minutes, 7 seconds good amount of uh growth a good amount of operating leverage come in so just to contextualize for you luck now is about 59:16 59 minutes, 16 seconds a six-year-old asset um patna is about four years old now and we've continually 59:25 59 minutes, 25 seconds been adding beds to these facilities. So what you're seeing in these facilities in addition to the 59:32 59 minutes, 32 seconds you know strong growth in these regions you're also seeing improvements in newer specialties getting added just to give 59:39 59 minutes, 39 seconds you an example we have added three or four robots including orthopedic robots in Lucknau so you're getting more complex work we have uh we adding more 59:48 59 minutes, 48 seconds complex work into our facility in Patna and you are also seeing the benefits of operating leverage kick in depending on 59:56 59 minutes, 56 seconds which year you are looking at uh in after a couple of years now would have kicked in, lucknau would have kicked in 1:00:02 1 hour, 2 seconds plus we would have added I think last maybe year or 18 months ago we added almost 200 additional beds taking luck 1:00:11 1 hour, 11 seconds now from about 400 500 to about 700 census beds. So those beds operating leverage also kicks in after some months. Uh so I think these are the 1:00:20 1 hour, 20 seconds three four reasons why there's a difference between the uh developing and the mature. And then the last reason although it may not be very significant 1:00:28 1 hour, 28 seconds in absolute terms is that our develop our mature units also include indoor and ranch which are significantly smaller scale and have a significantly lower margin profile. 1:00:39 1 hour, 39 seconds Okay. Thanks a lot. 1:00:46 1 hour, 46 seconds Thank you ladies and gentlemen. Due to time constraints that was last question for today. I now hand over the call to 1:00:54 1 hour, 54 seconds management for closing comments. Over to you. 1:00:59 1 hour, 59 seconds Uh thank you. Um thank you everyone for your questions and for joining us today. 1:01:03 1 hour, 1 minute, 3 seconds Um please feel free to reach out to our investor relations team in case you have any questions that remain unanswered. I know there's one question on census 1:01:10 1 hour, 1 minute, 10 seconds beds. We'll get that information out to you. Um but if you have any other questions, please feel free to reach out to the team. Uh thank you once again and we look forward to speaking with you all soon. 1:01:22 1 hour, 1 minute, 22 seconds Thank you on behalf of GM Financial Institution Securities Limited. That concludes this conference. Thank you for joining us and you may now disconnect your lines. Thank you.