Max Healthcare Institute Ltd

- Ongoing expansions include 2,600 beds with 300 beds expected by FY24-end and approximately 819 beds in FY25 (Nanavati 329 beds, Mohali 190 beds, Gurgaon 300 beds). - Max Shalimar Bagh brownfield expansion operational with 78% occupancy; brownfields have quick EBITDA breakeven (within quarter or two). - Greenfield projects comprise 10% of expansion with breakeven expected within 12 months. - Max Smart at Saket: 350 beds delayed but work to restart by Dec 2023. - Max Vikrant at Saket and Patparganj expansions progressing with approvals underway. - Strategic focus on fiscal discipline while deploying cash; acquisitions considered at right price but prefer built-to-suit, asset-light models over Greenfields. - Developer of Dwarka hospital (300 beds) applied for occupancy certificate, expected commissioning Q4 2023. - Planned capital deployment on both capacity expansion and inorganic opportunities; accumulation of cash with intent to invest soon.

- Occupied bed days grew 3% YoY and 5% QoQ with average occupancy at 77%; inpatient discharges up 7% YoY. - Network gross revenue increased 17% YoY, driven by ARPOB growth and higher occupied bed days. - Revenue from international business grew 25% YoY and 11% QoQ; international revenue now ~9% of hospital revenue. - Oncology specialty revenue growing faster (26%-28%) than overall business (17%), driven by higher disease burden and insurance penetration. - Capacity to expand with 2,600 beds coming online over next 3-4 years, adding significant growth runway. - Institutional business ARPOB up 28% YoY due to mix change rather than price hike. - Expect continued multi-decade growth opportunity due to under-penetration of quality healthcare in India. - EBITDA and cash flow expected to maintain robust growth trajectory with bed expansions and operational efficiencies.

- Expectation of continued strong revenue and EBITDA growth trajectory of around 20% per year over the next 3-5 years, supported by both organic expansion and inorganic opportunities. - Network EBITDA grew 20% year-on-year in H1 FY24, reflecting operational efficiencies and improved payor mix. - EBITDA per bed increased by 15% indicating improved profitability and operational leverage. - Upcoming capacity expansion of ~2,600 beds over the next 3-4 years, mostly brownfield projects with quick breakeven typically within 1-2 quarters, will drive higher cash flows and earnings growth. - The recent brownfield expansion (Shalimar Bagh) reported EBITDA growth of 48% year-on-year, showcasing strong margin expansion. - Continued improvement expected from payor mix upgrades, specialty focus (oncology growth of 26-28%), and international patient revenue growth. - Management highlights disciplined capital allocation to sustain 20%+ earnings growth and long-term value creation.

- The company has a significant development pipeline with 2,600 new beds coming up in the next few years. - Specific projects under progress include: - 329 beds at Nanavati: Excavation and raft work complete; ground level structure expected to be finished within the current quarter. - 300 beds at Sector 56, Gurgaon: Site excavation almost done; EPC contractor on board; project on schedule. - 190 beds at Mohali: D-wall completed; excavation underway; statutory approvals all received; project on time. - 350 beds at Max Smart, Saket: Delayed due to tree transplant permissions but work to commence from December 2023. - 300 beds at Vikrant, Saket: Environmental clearance received; municipal submissions in process. - 250 beds at Patparganj: Drawings submitted; environmental clearance application submitted. - All projects are progressing on schedule without delays. - No new project acquisitions have been added in the last two years, but the company is actively looking at 20+ cities for expansion, including acquisitions and partnerships, with expected announcements soon.

- The management did not mention any immediate plans for fundraising through debt or equity during the call. - They highlighted accumulating cash and being conscious of fiscal discipline in deployments. - Cash and leverage capacity are viewed as limited relative to large acquisition opportunities available at high valuations (15-16X EV/EBITDA). - They intend to deploy capital carefully, balancing expansion and acquisitions with fiscal prudence. - No explicit mention of upcoming debt or equity issuance was made; instead, focus is on organic growth, brownfield expansions, and select acquisitions. - The existing cash and balance sheet strength are considered adequate for near-term expansion, with plans to announce acquisitions soon. Overall, no current or immediate new fundraising through debt or equity was disclosed.