Slides
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August 02, 2023 Earnings Update Q3 FY25
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2 Index Our Footprint 03 Narayana Health at a Glance 04 Q3 FY25 Highlights 05 Capex 13 NH Integrated Care and Insurance 14 Digital Transformation Initiatives 15 Narayana Health ESG Vision – “Health For All” 16 Shareholding Pattern 17 Topic Slide No.
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East Hospitals - 7 | Clinics - 4| Dialysis Centre - 1 Operational beds - 2,039 West Hospitals - 2 Operational beds - 351 As on 1st January 2025 Our Footprint 3 South Hospitals - 6 | Heart Centres - 2 | Clinics - 12 | Diagnostic Centre - 1 Operational beds - 2,021 (Hospitals) - 128 (Heart Centres) North Hospitals – 4 | Clinics - 1 Operational beds: 1,200 Mumbai Kolkata Ahmedabad Raipur Jamshedpur Guwahati Kakriyal, Jammu Shimoga Bengaluru Mysore Delhi NCR Jaipur (1) Davengere is considered in the Hospitals and not in the Heart centres as it is a multi-specialty hospital now. Davanagere
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Facility Details No. of Facilities Operational Beds Owned / Operated Hospitals(1) 19 5,611 Heart Centres 2 128 Clinics and Dialysis Centre 19 0 Cayman Islands 2 169 Healthcare Facilities 42 5,908 Total 19,687 Clinical : 11,938 Non-clinical : 7,749 5.7 Mns(2) Average Effective Capital Cost per Operational Bed 6,313 Capacity Beds 4,255 Doctors (1) Owns the P&L responsibility (2) Based on (Gross Block for Fixed Assets (adjusted for non-cash government grant provision impact, non-cash financial lease impact for Dharamshila unit, non-cash EPCG license impact )+ Capital Work in Progress (CWIP)) / Number of operational beds as of Dec 31, 2024 but excluding Cayman facility Narayana Health – At Glance 4
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Key Highlights – Operational & Financial Performance (Q3 FY25) Clinical & Operational • Narayana Institute of Cardiac Sciences (NICS), Bengaluru has successfully performed the following procedures : • 93 Robotic Cardiac Surgeries • 34 Transcatheter Aortic Valve Implantation (TAVI) • Mazumdar Shaw Medical Centre (MSMC), Bengaluru has performed following procedures during the quarter: • First case of Total Shoulder Replacement. • Performed 15 Renal Transplants. • Rabindranath Tagore International Institute of Cardiac Science (RTIICS), Kolkata has performed Mechanical Thrombectomy and clot retrieval from occluded vessel in Cath Lab on a 33-year-old on ECMO support. There are only 5 published case reports of ECMO patients undergoing mechanical thrombectomy. • MMI Narayana Super Speciality Hospital, Raipur has introduced self-service kiosks for registration, payments, and appointments for the patients. Achieved 85% adaptation for consultation booking via kiosks & NH CARE App and a 5% increase in payment via online transfers. Financial Performance • Consolidated operating revenues of INR 13,667 Mn in Q3 FY25, an increase of 13.5% YoY and -2.4% QoQ. • Consolidated EBITDA of INR 3,254 Mns in Q3 FY25 at margin of 23.8%, and consolidated PAT of INR 1,931 Mns for Q3 FY25 at a margin of 14.1%. • Consolidated Total Borrowings less Cash & Bank Balance and Investments of INR 2,837 Mn as on 31st Dec 2024, i.e. net debt to equity ratio of 0.08 (Out of which, debt worth US$ 85.0 Mns is foreign currency denominated). 5 5
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India Operations – Revenue (Q3 FY25) Domestic International Integrated Care - NHIC and NHIL 803 762 397 0 100 200 300 400 500 600 700 800 900 Q3 FY24 Q2 FY25 Q3 FY25 6 6 54 99 107 5 25 45 65 85 105 Q3 FY24 Q2 FY25 Q3 FY25 8,729 10,816 10,365 4 2,004 4,004 6,004 8,004 10,004 12,004 Q3 FY24 Q2 FY25 Q3 FY25 9,585 11,677 10,869 4 5,004 10,004 15,004 Q3 FY24 Q2 FY25 Q3 FY25 Total* 18.7% YoY -50.5% YoY 98.8% YoY 13.4% YoY -6.9% QoQ -4.2% QoQ -47.9% QoQ 7.3% QoQ *Note - Total revenue is excluding ATHMA and Medha. INR Mns
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69% 28% 1% 1% Owned Hospitals Operated Hospitals Heart Centres Other Anciliary Businesses 45% 30% 21% 4% Domestic Walk-in patients Insured Patients Schemes International patients Business Mix(6) Specialty-Profile(4,7) Payor-Profile(4,7) (1) NH owns on freehold basis and operates with the P&L responsibility (2) NH operates the hospitals on rental/revenue sharing basis and owns the P&L responsibility (3) Includes clinics and dialysis centres etc (4) As percentage of operating revenue, excluding NHIC (5) Insured Patients include Insurance-covered patients, corporate patients (including PSU’s on hospital tariff) (6) Schemes include CGHS, ESIS, other state government schemes (7) Percentages might not add up to 100% due to rounding off 31% 13% 17% 9% 8% 4% 17% Cardiac Sciences Medicine and GI sciences Oncology Renal Sciences Neuro Sciences Orthopaedics Others India Operations – Revenue Mix (Q3 FY25) (1) (3) (2) (6) (5) 7
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Operational Review – India (Q3 FY25) ALOS Patient Footfalls (IP & OP)(1,3) ICU Occupied Bed Days INR ‘000 Days ‘000 OP IP 604 705 620 57 65 59 Q3 FY24 Q2 FY25 Q3 FY25 (1) OP figures include day-care business. (2) ARPOB for the period Q3 FY25 was INR 15.3 Mns as against INR 14.1 Mns in Q3 FY24. (3) Footfalls for IP correspond to Discharges. (4) Due to transition in our data capturing system during Q2 and Q3 of this FY, the IP and Daycare discharge numbers for Q2 FY25 have been reclassified resulting in changes as updated. 8 8 ‘000 4.2 4.3 4.4 123.0 129.6 133.5 Q3 FY24 Q2 FY25 Q3 FY25 Average Revenue Per Patient (IP & OP) (1,2) OP IP 93 104 95 80 85 90 95 100 105 110 Q3 FY24 Q2 FY25 Q3 FY25 4.4 4.4 4.3 3.7 3.9 4.1 4.3 4.5 Q3 FY24 Q2 FY25 Q3 FY25
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Cluster Split – India (Q3 FY25) This considers owned/operated hospitals & heart centers in India (excl. Jammu (1)) (1) Katra (Jammu) Hospital reported operational revenues of INR 309 Mns and EBITDA of INR -2.7 Mns in Q3 FY25 (2) OP ARPP includes day care. 5% 24% 13% 8% 34% 10% 10% 15% % of Hospital Operating Revenues YoY Revenue Growth OP ARPP(2) (INR ‘000) YoY Hospital Discharges Bangalore Southern Peripheral Kolkata Eastern Peripheral Western Northern Regions 11% 5% • NICS • MSMC • HSR • Mysore • Shimoga • Davangere • Dharwad • Kolar • RTIICS • Barasat • NMH • NSH • Jamshedpur • Guwahati • Raipur • Mumbai • Ahmedabad • Gurugram • New Delhi • Jaipur 26% 9 25% 2% -6% 11% 27% IP ARPP (INR ‘000) 5.0 3.7 4.5 4.1 4.3 4.6 198.3 67.9 121.4 114.7 128.3 5.1 3.8 4.7 4.3 4.2 4.8 206.7 76.4 147.8 129.1 123.5 122.6 4% -10% 4% Capacity Beds 1500 825 1453 725 389 880
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10 Profitability Snapshot – India Hospitals (Q3 FY25) Excludes NHIC, NHIL, ATHMA & MEDHA (2) EBITDA and EBITDA Margin (1) Cost Structure INR ‘Mns % of Operating Revenues (4) Consumable Expenses = Purchase of medical consumables, drugs and surgical equipment net of changes in inventories of medical consumables, drugs and surgical equipment (5) Doctors and Nurses = Employee benefits + Professional fees to doctors (6) Other Expenses = Overhead expenses + All other expenses (7) Effect of IND AS benefits is not considered (1) Denotes EBITDA for entire India hospitals business excluding NHIC, NHIL, ATHMA & MEDHA. (2) EBITDA for Q3 FY25 including NHIC, NHIL, ATHMA & MEDHA stood at INR 1,911 Mns (17.6%). EBITDA for NHIC and NHIL stood at -INR 144.0 Mns for Q3 FY25. (3) Q3 FY24 numbers is also adjusted for NHIC and ATHMA. 10 1,800 2,438 2,058 18.9% 21.0% 19.1% 15.0% 16.0% 17.0% 18.0% 19.0% 20.0% 21.0% 1,000 1,200 1,400 1,600 1,800 2,000 2,200 2,400 Q3 FY24 Q2 FY25 Q3 FY25 (1) 29% 27% 28% 23% 23% 23% 18% 18% 19% 12% 12% 12% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Q3 FY24 Q2 FY25 Q3 FY25 Chart Title Doctors and Nurses Consumable Expenses Other Expenses Other Manpower Cost Rental / Revenue Share (7) 3% 2% (5) (6) (4)(3) (4) (5) 2% (2)(3)
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Operational Review – Cayman Islands Average Revenue Per Patient (IP & OP) Operating Revenues Discharges Out-Patients US$ ‘000 OP IP US$ Mns 11 1.2 1.4 1.3 30.7 31.9 34.9 0.0 10.0 20.0 30.0 40.0 Q3 FY24 Q2 FY25 Q3 FY25 30.6 29.0 35.1 24.0 26.0 28.0 30.0 32.0 34.0 36.0 Q3 FY24 Q2 FY25 Q3 FY25 9,558 8,819 9,910 7,500 8,000 8,500 9,000 9,500 10,000 10,500 Q3 FY24 Q2 FY25 Q3 FY25 620 524 630 450 500 550 600 650 Q3 FY24 Q2 FY25 Q3 FY25
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Consolidated Financial Performance Figures in INR Mns, unless stated otherwise (1) Figures might not equal the reported numbers due to rounding off. (2) Net Block includes non-cash government grant impact of INR 1,066 Mns, non-cash financial lease impact of INR 475 Mns and non-cash EPCG license impact of INR 210 Mns As on December 31st 2024, the Total Borrowings less Cash & Bank Balance and Investments was INR 2,837 Mn, representing a net debt to equity ratio of 0.08 (Out of which, debt worth US$ 85.05 Mns is foreign currency denominated). Particulars (INR Mns) Q3 FY25 9M FY25 Total Operating Revenue 13,667 41,076 Consumption 2,763 8,648 Doctors Expenses 2,366 7,177 Employee (Excluding Doctors) Expenses 2,773 8,357 Other Admin Expenses 2,695 7,702 Total Expenses 10,597 31,883 Other Income 184 655 EBITDA 3,254 9,848 Depreciation and Amortization 700 1,968 Finance Costs 366 1,057 Share of (loss)/profit of equity accounted investees - - PBT 2,188 6,823 Tax Expense 258 889 PAT 1,931 5,933 Total Comprehensive Income 2,294 6,330 Profit and Loss Statement(1) Key Balance Sheet Items(1) Particulars 31st Dec 2024 Shareholder Equity 34,368 Total Borrowings 17,006 Lease Liability 1,911 Net Block + CWIP (2) 35,260 Goodwill 1,190 Right to Use Assets 2,059 Net Receivables 5,630 Current Investments 9,525 Cash and Bank Balance 3,934 12
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13 0 0 0 00 00 0 ec SR ore R rh t o t e tr ore So th ore R r e e 0 Expansion: Progress Status & Capex Strategy Building to strengthen our presence in flagship regions 13 Location Type No. of Beds Project Cost (INR Mn) Completion Current Status HSR Bangalore Greenfield 215 4,900 FY28 Approvals, Plan Sanction process WIP; Vendor finalization in final stages; Construction to commence in Feb-25 Rajarhat Kolkata Greenfield 350 9,000 FY28 Sanctions, Approvals in place, Construction to commence in Feb-25 Central Bangalore Lease 220 1,600 FY28 Binding MoU Executed; Lease & Construction Agreement to be executed by Feb-25 South Bangalore Greenfield 350 8,000 FY29 Purchase Registration Done. Plan Sanctions and Approvals process to start Raipur Expansion 300 5,400 FY28 Sanctions, Approvals in place, Construction to commence in Feb-25 Current Bed Capacity Bed Capacity Addition Bed Capacity Target CAPEX (INR Mn) FY25 (P) FY25 (A) Greenfield/Inorganic 9100 1842 Brownfield/ Capacity Addition 1350 243 Replacement/Maintenance 3237 2163 Cayman 2748 2740
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10 106,261 ₹104.2 Mn As on 31st December 2024 Q3 FY25 Q3 FY25 Points of Presence Patient Transactions Revenue - Integrated Care Program running since September 2022 at select Bengaluru locations NH Integrated Care and Insurance: Snapshot Integrated Care now available at ten locations in Bangalore Aditi Health Insurance piloted in Mysore and now expanded to Bangalore Arya Health Plans (Comprehensive Health Insurance including OPD and IPD) piloted in Bangalore 14 14 ₹6.5 Mn YTD Q3 FY25 GWP - Insurance
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Digital Transformation Initiatives 15 Impact | Mobile Apps Initiatives | Business GTM | Athma • 75% in patient documents digitized with mobile app • All nursing assessments are now digitally enabled • NH patient app crosses 2.4Mn installs with an Appstore rating of 4.9/5. • Digitized service workflow from booking to reporting • Chatbot for inpatient convenience implemented • 250K+ radiology reports certified digitally with <2% amendments • Lab QC enabled to ensure high- quality data control in reporting • India: 100 beds added • 600+ Beds in pipeline • 200 bed hospital enabled in Africa • Middle East and Southeast Asia pilot projects underway Launch | New Products • Mobile-based reporting app for Consultants launched • Clinical viewers replace CDs/USBs for procedures like angiogram
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NH ESG Vision – “Health For All” 16 16 Actual FY 24~25 9M (T – Target FY 24~25 9M) A Healthy Society By improving access to care, digitising patient safety & experience and building the workforce for tomorrow 25,000+ Doctors, nurses, and paramedical trained by 2030 Digitization For enhancing patient safety & experience 5000+ Decreasing disparities in access to care 5000 BMTs by 2030 5000 Heart Procedures for Children every year with Treatment Cost Waiver 4000+ Underprivileged academically bright students, aspiring to become doctors by 2030 Touching lives of 20,000+ Govt. school children through cleanliness and hunger Feeding program by 2030. 5,60,000+ hours Person hours invested in Associate Development Programs, including upskilling by 2030 A Healthy Institution- By fostering a culture of innovation & strong governance 100% NABH & enterprise level JCI certified hospitals by 2025 Industry leader Best in Class risk management Robust Risk Management Process Cyber resilience Zero Trust Architecture by 2025 Greater than 1000 publications in Peer Reviewed Indexed Journals (in the 5 years ending Calendar Year 2025). 1000+ Publications In clinical Governance A Healthy Planet By being conscious about impact on the environment, prioritizing consumption efficiency and resource optimization Renewable Energy (Electricity) mix by 2030 35% Carbon Neutral By 2040 Waste-water recycling by 2030 100% Optimized Waste management processes 50% less Paper use across patients by 2025 from 2023 On Plan (T 1300) 1690 (T 1110) 6750 (T 10716) 2847 (T 2888) 5.20 Pages/ Patient YTD (T 5.67) On Plan Ongoing 140 Publications (T 150)Ahead of Plan On Plan Ongoing On Plan OngoingOn Plan Ongoing Ongoing 1.21 KL Water Per occupied bed (T 1.29) 1.71 KG Per occupied bed (T 1.64) 34.83% (T 30%) 2.84 L Person Hours of training (T 2.93 L)
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Shareholding Pattern As on 31st Dec 2024(1) Key DIIs Nippon Life India Asset Management Axis Asset Management DSP Asset Management SBI Life Insurance Co. Ltd. Unifi Capital Key FIIs Vanguard Index Funds Franklin Templeton Investment Funds Simcah Partners LP iShares by Blackrock Kuwait Investment Authority Fund (1) Percentages might not add up to 100% due to rounding off Total Number of Shares 204,360,804 17 Promoter Group 63.9% Others 15.9% FIIs 9.4% DIIs 10.2% ESOP Trust 0.7%
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Disclaimer and Contact Details No representation or warranty, express or implied is made as to, and no reliance should be placed on, the fairness, accuracy, completeness or correctness of such information or opinions contained herein. The information contained in this presentation is only current as of its date. Certain statements made in this presentation may not be based on historical information or facts and may be “forw rd looking st teme ts” including those relating to the om y’s general business plans and strategy, its future financial condition and growth prospects, and future developments in its industry and its competitive and regulatory environment. Actual results may differ materially from these forward-looking statements due to a number of factors, including future changes or developments in the om y’s business, its competitive environment and political, economic, legal and social conditions in India. This communication is for general information purpose only, without regard to specific objectives, financial situations and needs of any particular person. This presentation does not constitute an offer or invitation to purchase or subscribe for any shares in the Company and neither any part of it shall form the basis of or be relied upon in connection with any contract or commitment whatsoever. The Company may alter, modify or otherwise change in any manner the content of this presentation, without obligation to notify any person of such revision or changes. This presentation can not be copied and/or disseminated in any manner. For further Information, please contact : Mr. Nishant Singh Vice President – Finance, Investor Relations, M&A +91 8369353821 nishant.singh@narayanahealth.org Mr. Vivek Agarwal Senior Manager – Investor Relations, M&A +91 9510756827 vivek.agarwal@narayanahealth.org investorrelations@narayanahealth.org | www.narayanahealth.org 18 18
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