Max Healthcare Institute Limited

Abhay Soi

qa

Abhay Soi

qa

Abhay Soi

qa

Abhay Soi

qa

Abhay Soi

qa

Abhay Soi

qa

Abhay Soi

qa

Abhay Soi

qa

Abhay Soi

qa

Abhay Soi

qa

• Average Revenue Per Occupied Bed (ARPOB) for the quarter stood at INR impact of higher ALOS and 77,900.

— Abhay Soi

So, the impact of that is that shows up in both your ARPOB and occupancy – while the occupancy seems a little higher, your ARPOB comes through a little lower.

— Abhay Soi

And my second question is on the onco share decline that we have seen in Q4.

— Abhay Soi

So, that is the reason when we gave to the price impact of the CGHS, we netted off that.

— Yogesh Sareen

There was also an impact of GST, so net off it the total benefit was INR 140 crore.

— Abhay Soi

Tushar Manudhane: Understood, second, sir, are you seeing the risk of these medicines being taken directly by the, let us say, health scheme or CGHS in other therapies?

— Abhay Soi

The overall impact of the discontinuation of these drugs is INR 200 crore in the drug billing, i.e.

— Yogesh Sareen

Would it be possible to quantify the EBITDA drag with the new hospitals would have had in Q4 and for the full year '26?

— Yogesh Sareen

But on a consolidated basis, what we have seen is that there is no real pressure on margins.

— Abhay Soi

And Q1 so far -- I mean until now, you are seeing a full impact of this chemo drugs, at least, right?

— Lavanya

So, to that extent, quarter 4 has the full impact of discontinuation of all these chemo drugs.

— Yogesh Sareen

What we have not gotten yet is the full impact of the price gain on the CGHS side, which will come starting this quarter.

— Yogesh Sareen

I guess they are finding it difficult to source this, so we are facing a lot of complaints, and I am sure so is the CGHS.

— Abhay Soi

But asking for time lines, it is difficult to pin that down.

— Abhay Soi

Q

Good morning, everyone, and thank you for joining us on Max Healthcare's earnings call for fourth quarter and full year ended March 2026. Let me begin by highlighting that over the last 2 quarters, we have rolled out phased commissioning of more than 20% additional brownfield capacity across our hospitals in Mohali, Nanavati in Mumbai and Max Smart in Delhi. All the beds will be ready to be operationalized over the next 2 to 3 months. Further, we expect to add another 10% capacity once our 500-bed greenfield hospital in Gurgaon is commissioned during the year. We have already onboarded clinica

Management

Q

My first question is on the brownfield beds that we have added. When do we start seeing them contributing to EBITDA more meaningfully? Did I hear it correctly that all of these brownfield beds will be commissioned in the next two quarters. So, second quarter, third quarter is when they should start showing up more meaningfully on EBITDA?

Abhay Soi

So they are already contributing to EBITDA and it is not any form a negative contribution. But what happens is that you sort of get the better end of operating leverage as you go along because right now, for the total 1,000-odd beds, we have initiated a phased rollout of lesser beds. Say, if you have 400 beds at Max Smart, which are being rolled out in a phased commissioning, you would have started with about 100 beds over there. So, as you open up the balance beds over the next couple of quarters, you will see the entire operating leverage as the balance beds get occupied because your costs r

Q

Yes, thanks for the opportunity. So just again on Gurugram, how should we think about the operationalization of beds, assuming we commission towards the end of fiscal '27? What will be the Phase 1 operationalization? And what is the count that we should expect in fiscal '28? So, I think in fiscal '28, we will be looking at breaking even within the year. I mean, it is a greenfield, as you are aware. Having said that, our experience with the Dwarka greenfield, we operationalized it, we guided to a 1-year breakeven, but we actually broke even in 6 months. We had an operating loss, consolidated EB

Abhay Soi

this case, it is not a meaningful change to perhaps what the projections are going to be. But in terms of beds, are we expecting phase-wise manner of operationalization here, because it’s a 500 bed facility... Yes. You always do it, even tactically, in that manner. So physically, the beds come out in phases, but even so tactically because if you have 500 beds, day one, you are not going to have occupancy of 500 beds. So, you do not operationalize or staff all the 500 beds. So, if I take the example of Dwarka, we had 300 beds, we started with 140 beds. We ramped up occupancy, broke even with th

Q

My first question is clarification. Abhay, you mentioned you are rolling out beds in a phased manner, even for say facility like Smart. So, help me to understand this better. In the past, whenever you have opened or commissioned brownfield facility, I understand the ramp-up happened much faster than what we are seeing right now. So according to you, anything has changed since then? That is why you are going for more gradual phased way of prescribing beds. No, we have always opened brownfields in a phased manner. Whether brownfield or greenfield, it has always been opened in a phased manner. An

Abhay Soi

Yes, I think it has pulled around very well. And in terms of EBITDA, also, it is a substantial growth that we have seen over there. It is well on its way. It is in line with our expectations, right? Yes, absolutely. We are very encouraged by the last quarter and more. Okay. And it can very well go to the Network level occupancy of say 75% or so? Absolutely. I think maybe shortly, we will need to do a brownfield over there and add more beds as well. Okay. Good to hear. And my second question is a clarification on discontinuation of oncology drugs. You mentioned 5-6% OBD got knocked off because

Q

The first question is with respect to doctor costs. So, we see that our doctor costs have gone up and we have hired in advance. But just wanted to get a sense on for which all expansions have we hired and like which are the hospitals where further doctor additions are still pending, which might hit the cost line item in the next one to two quarters? That is a very good question. So, there are two things. End of 2024, we essentially added close to 25% to 30% more capacity. This was whether through Dwarka, whether through the Jaypee acquisition, Sahara done some time before that or Alexis in Nag

Karan Vora

Okay. Got it. The reason I mentioned in end of '24 is that when you do sudden acquisitions, it is not as if you are able to do all your hiring in the next 6-12 months. It takes time and moves in a phased manner, particularly if there is competition in those areas. Okay. Got it. And sir, just to better understand, so this INR435 crore for doctor fees in Q4, that should not materially change going forward, at least for the next few quarters. Is that the fair way to think about it? Yes, it should actually start getting operating leverage in fact. My belief is that marginally all of this percentag

Q

understand that the Board has given sort of approval for Shaheed Path. But if you could help understand how are we going to sort of utilize both the land banks and build up Lucknow sort of hospital network. So, I think it is a very good question. We have a land bank of about 27 acres of land at Gomti Nagar, which is right in the heart of Lucknow, and 5-plus acres, which is on Shaheed Path. We are expanding our capacity over the next few months, you will see our capacity of Gomti Nagar go up to about 570 beds. What we intend to do is we intend to start another hospital. We want to have a multi-

Abhay Soi

Absolutely. Yes. Also, on this Shaheed Path, the capacity can go up to roughly 900 beds. So, I mean, there is more we can build there even after these 700 beds. Tushar Manudhane: So, I mean, it reflects the kind of confidence you have on this Lucknow as a location, building up such a strong almost it will be about 1,000, in fact, more than 1,000 plus sort of a bed size eventually and not like immediately, but over a period of time? Absolutely. Let me put it this way, over the next decade, I see even probably Gomti Nagar going close to perhaps 2,000 beds, in just that one location. We will do i

Q

Hi, thank you for the opportunity. It seems like confusion regarding the discontinuation of chemo drugs due to MoU conditionalities, this is specific to Max Healthcare in a region or this is industry-wide pan-India. And if I understood it correct, it had a knock of negative impact on revenue to the tune of INR130 crore, and they had around 16-17% EBITDA margins, if you can help clarify that?

Abhay Soi

Firstly, this is an industry-wide phenomenon. Secondly, as a proportion of its business, Max perhaps does the maximum amount of oncology business. And then within that, if you actually see, we probably do the maximum amount of institutional business as well, which is CGHS, ECHS, etc. So, although it is an industry-wide phenomenon, the impact would be felt maximum by us for these reasons. The overall impact of the discontinuation of these drugs is INR 200 crore in the drug billing, i.e. top line. Is this the quarterly impact? This is the annual number. Annual billing of chemotherapy drugs will

Q

Obviously, there's a lesser impact on the beds for this. These chemotherapies are billed in the daycare. When you discontinue these drug billings or providing these drugs to the patient, there's an impact on the revenue but there's no impact on the beds. Nevertheless, there are some of these patients who also then avail surgeries in the network and some of these patients are also then admitted in the hospital. To that end, the Occupied Bed Days (OBDs) for oncology patients have come down by 6% YoY. Now your question is that within the overall CGHS business, how much is oncology? That'll be pro

Keshav Gupta

It used to be 50% as it is reduced to 40% now. Abdulkader Puranwala: Understood, sir. And sir, then on your existing Network that is prior to any bed additions that you have done, in terms of the steady state revenue and EBITDA growth, sir, how should we look at in terms of your, say, bed network, what you had developed for '25 or for '26. And the levers of growth, would it be more ARPOB driven? There is some element of case mix as well, which can help to at least post a single digit kind of a growth. Basically, there are two elements which make the revenue go up. One is the ARPOB and other is