Aster DM Healthcare earnings conference call for the second quarter of FY 2026. Today with us, we have the senior management of Aster DM Healthcare, namely Ms. Alisha Moopen, Deputy Managing Director, Mr. T. J. Wilson, Non-Executive Director, Mr. Ramesh Kumar, Chief Operating Officer, Mr. Sunil Kumar, Chief Financial Officer, Mr. Hitesh Dhaddha, Chief Investor Relations and M&A Officer. We are also delighted to have Mr. Varun Kannan, Group Managing Director of Quality Care. Mr. Kannan is here solely in the capacity of a representative of Quality Care to give insights into the business and future plans of Quality Care, the entity which is in process to get merged with Aster DM Healthcare. It is to be noted that the merger is subject to further regulatory approvals. All external attendees will be in listen mode only for the duration of the entire call. We will start the call with the opening remarks by the management, followed by an interactive Q&A session. Certain forward-looking statements in this meeting involve risks and uncertainties. Aster DM Healthcare assumes no responsibility for actions based on these statements and undertakes no obligation to update them for future events. With this, I will now request Ms. Alisha Moopen to start with opening remarks. Over to you, Ms. Alisha. Thank you, Puneet. Good afternoon, everyone, and thank you for joining us today. Let me begin with a brief look at the broader environment. The Indian economy continues to show remarkable resilience amid global uncertainties, underpinned by strong domestic demand and prudent fiscal management. Within this macro environment, the hospital sector stands out as a key beneficiary. The Indian hospital services market is poised for healthy growth, driven by higher insurance penetration, expanding medical infrastructure, and growing demand for specialty and acute care services. The government's recent GST rate reduction on select healthcare consumables and diagnostics is a constructive step towards making quality healthcare more affordable while simultaneously improving cost efficiency for providers. This environment creates strong tailwinds for organized private sector hospital networks such as Aster. With a well-balanced presence across Tier 1 metros and Tier 2 growth markets, we are uniquely positioned to serve both mature urban centers where demand is shifting towards high equity and complex care, and emerging regional cities which are witnessing faster volume growth and expanding catchment potential. This dual market footprint provides stability, scalability, and a long runway for sustainable expansion. Amid this backdrop, Q2 FY 2026 has been a period of meaningful progress for Aster, marked by steady financial performance, recovery in a key market which is Kerala, and a continued advancement of our long-term strategic priorities. Taking a step back, our performance this quarter builds on a solid multi-year trajectory. For the last 20 consecutive quarters, Aster has delivered a year-on-year revenue growth, a reflection of our strategic foresight, discipline execution, and enduring resilience through varying market conditions. This consistent upward trend has translated into a 20% revenue CAGR and a 38% CAGR in operating EBITDA over the last five years, demonstrating our ability to grow both scale and profitability in tandem. As we are making progress towards the completion of merger, both Aster and QCL have demonstrated consistent and complementary growth across clusters, driven by efficient cost management, improved case mix, and continued focus on clinical excellence. The combined platform, on a pro forma basis, delivered a healthy performance this quarter with 10% growth in ARPP and revenues growing organically at 13% year-on-year to INR 2,390. On back of 8% growth in the total patient volumes and the 10% growth in the ARPP of IP, with the operating EBITDA growing at 17% to INR 550 and normalized PAT growing at 22% to INR 258, translating into a robust 23% operating EBITDA margin and an ROC exceeding 22%. This consistent strong performance reflects the underlying strength and scalability of the combined entity. As we move forward, our focus will be on unlocking the full synergy potential of this integration through clinical collaborations, shared technology platforms, optimized procurement, network rationalization, and talent mobility. These efforts will further enhance profitability and capital efficiency while enabling us to deliver consistent, high-quality, and affordable care at scale across India. Coming to the Kerala cluster, which is really a story of recovery and momentum. The Kerala cluster's journey over the past year has been one of transformation and resilience. After a phase of softness in Q3 and Q4 FY 2025, resulting from some leadership transitions, seasonal factors such as Ramadan, and a dip in international patient volumes, we have entered FY 2026 with a clear focus on rebuilding momentum. The team responded decisively, strengthening leadership, tightening operational processes, and re-engaging with key MVT partners and referral networks. These interventions began to bear fruit in Q1 FY 2026, with sequential growth in inpatient volumes in Q2 FY 2026 and confidence gradually returning across hospitals. The true inflection came in Q2 FY 2026 when Kerala delivered its highest-ever quarterly revenue of INR 620, growing a 24% increase over INR 499 in Q4 FY 2025. This was supported by a 13% sequential increase in inpatient volumes and a strong rebound in MVT, which grew 67% QoQ and 49% year-on-year. Occupancy improved to 69% in Q2 FY 2026 from 64% last quarter, reflecting sustained recovery in electives and high-acuity admissions. ARPP has grown 5% year-on-year, supported by a stronger specialty mix, increased share of complex procedures, and disciplined pricing. Profitability improved sharply, with operating EBITDA margins expanding now to 26.8% from 22.3% in Q4 FY 2025, supported by a stronger specialty mix as well as cost discipline. Overall, Kerala has not only recovered from last year's softness but has reestablished itself as a key growth engine for our India business, combining scale, profitability, and operational excellence with renewed momentum. Now, coming to the consolidated performance for the quarter, in Q2 FY 2026, we continue to build on the strong foundation laid in the first quarter, reinforcing both the growth and efficiency across our core performance metrics. Despite softer seasonal infections this year, the business has delivered a very resilient growth across clusters and sustained improvement in profitability drivers. Revenue has grown by 10% year-on-year to INR 1,197. Adjusting for temporary seasonal effect, our underlying revenue growth stood at a healthy mid-teen at 13%, demonstrating the strength of our underlying business momentum. The ARPP for IP has increased by 10% year-on-year by a richer specialty mix with stronger contributions from oncology and also the discontinuation of low-yield schemes. Our focus on complex, high-value care continues to deliver results, with oncology revenue growing 26% year-on-year and its share of total revenue increasing to 11% compared to 9% just a year ago. Given that we are in a phase of recovery post key leadership changes, it is also important to focus on the quarter-on-quarter changes in the performance for this quarter. On a sequential basis, our total patient volume grew by 15% QoQ, with inpatient volume growing by 12% QoQ and outpatient volume growing by 15% QoQ in Q2 FY 2026. Kerala's total patient volume increased by 17% quarter-on-quarter, with inpatients by 13% quarter-on-quarter and outpatient by 17% quarter-on-quarter. Andhra and Telangana had 16% quarter-on-quarter in both inpatient as well as the outpatient volume. Coming to occupancy, occupancy has grown to 64% in Q2 FY 2026 from 59% in Q1 FY 2026. With Kerala at 69% in Q2 versus 64% in Q1 FY 2026, Karnataka and Maharashtra cluster at 62% in Q2 versus 56% in Q1 FY 2026. Andhra and Telangana at 55% in Q2 versus 50% in Q1 FY 2026. The MVT segment has also shown strong momentum, growing at 60% QoQ and 26% YoY growth, led by higher international patient footfall in Kerala, with its MVT business growing by 67%, particularly from Maldives, the Middle East, as well as the North African countries. Now, moving over to the bottom-line performance, our operating EBITDA margin has expanded 200 basis points to 22% in Q2 FY 2026, compared with 20% in Q1 FY 2026, reflecting the combined impact of Kerala's recovery, enhanced cost control, better specialty mix, clinical efficiency across the network, and steady improvement in the labs and pharmacy business. Kerala cluster's operating EBITDA grew 19% YoY, with margins expanding to 26.8% in Q2 from 25.3% in Q1 FY 2026. Andhra and Telangana operating EBITDA nearly doubled QoQ, with margins expanding significantly to 13.2% in Q2 FY 2026 from 7.9% in Q1 FY 2026. The labs' operating margins have significantly improved to 17.8% in Q2 FY 2026 as compared to 7.6% in Q1 FY 2026. On a normalized basis, PAT has rose 23% sequentially to INR 110. Collectively, these trends reflect the tangible impact of the strategic and operational measures implemented earlier in the year, reinforcing our focus on sustainable, high-quality growth while enhancing efficiency across the network. Moving over to our CapEx and expansion. Our growth story isn't just about performance. It's also about preparing for the future. Over the past year, we have added more than 200 beds, taking our total capacity to 5,199 beds as of September 30, 2025. The Kerala cluster is also set for expanding its footprint in Q3 FY 2026 with the commissioning of our new 264-bed hospital in Kasaragod on October 2, 2025, taking our network to 20 hospitals across India, including our 2,900 beds in Kerala. This addition enhances access to quality care in northern Kerala and reinforces our focus on deepening regional presence and patient reach. The hospital has made a very promising start with daily OPDs already exceeding 150 and a steady increase in the inpatient admissions. We have also ensured a very strong clinical backbone from day one, with 50+ doctors already on board. Apart from Kasaragod, in the coming years, we plan to add another 2,300 beds, both through Greenfield and Brownfield projects, taking our capacity beyond 7,800 beds. During the quarter, we further strengthened our presence in Andhra Pradesh by acquiring an additional 13% stake in Aster Ramesh Hospitals, bringing Aster's stake to over 70%. This strategic move consolidates our regional network and deepens our footprint in southern India. Now, moving over to the merger. A notable development in the quarter was the continued progress in a merger process with Quality Care India Limited. The merger has now received a no-objection letter with no adverse observations from both BSE and NSE following earlier approvals. Over the last months, the transaction has advanced smoothly through key regulatory milestones. A quick snapshot of the progress on the merger process includes: shareholders have approved the preferential share issuance, the Competition Commission of India has granted its approval, we completed a strategic share swap, acquiring a 5% stake in QCL in exchange for a 3.6% preferential allotment in Aster. These shares are now listed on the stock exchanges. Most recently, BSE and NSE, no objection, have further advanced the merger process, paving the way for the next phase of integration. The company will now approach the NCLT to initiate the final approval phase. Post-application, a shareholders' meeting will be held to approve the merger, following which the NCLT sanction will make the merger effective, leading to the issuance of the new shares. Upon completion, the merged platform will have 38 hospitals across 27 cities, with a combined capacity of 10,360 beds, positioning us among the leading healthcare providers in the country. Q2 FY 2026 has been a quarter of very notable recognitions for both our leadership and institution. Our Founder, Chairman, and Managing Director, Dr. Azad Moopen, was honored across multiple national platforms, being named Healthcare Icon of the Year at the Economic Times Healthcare Awards 2025, legend in the Indian healthcare industry at the FICCI HEAL 2025, and receiving the Lifetime Achievement Award from Entrepreneur India, celebrating his visionary leadership and lifelong contribution to healthcare. He was also featured amongst Forbes Middle East Top 5 Healthcare Leaders 2025 and also recognized as one of Forbes Middle East Sustainability Awards for championing Aster's journey towards an equitable and sustainable healthcare future. At the institution levels, many of our hospitals were recognized at ET Healthcare Awards 2025 for their leadership positioning across complex specialties and procedures. Also, Aster Whitefield Hospital received the Technology Transformation Initiative of the Year Award at FICCI HEAL 2025 for its pioneering walk-in FAPI PET CT imaging services, reaffirming our commitment to advancing patient outcomes through technology and innovation. As we close the quarter, our performance underscores the strength of Aster's diversified healthcare model and disciplined execution across markets. Despite the softer seasonal trends, we've delivered healthy growth across clusters and expanded margins through operational efficiency and a sharper focus on high-value care. Our continued investments in capacity expansion, digital transformation, and clinical talent are building a future-ready platform designed both for scale as well as sustainability. The upcoming merger with QCL will further reinforce this foundation, creating one of India's most comprehensive and efficient healthcare networks. This consistency, agility to bounce back, and a strategic foresight reflects a resilient growth trajectory marked by steady earnings expansion, improving returns, and long-term value creation. With strong fundamentals, an expanding footprint, and a clear pathway to integration and innovation, Aster is well-positioned to deliver sustainable and profitable growth in the quarters ahead. Together, these developments mark an inflection point in Aster's journey. We are poised to deepen our clinical excellence and deliver greater value to patients, partners, and shareholders in the years ahead. I will now invite our Chief Operating Officer, Mr. Ramesh Kumar, to take you through the detailed cluster-wise performance. Thank you, Ms. Alisha, and a very good afternoon to everyone. I'll take a few minutes to share how each of our clusters performed during the quarter and how our operational and expansion priorities are shaping up. Actually, this quarter results once again throw a highlight that the strength of our cluster model and our disciplined execution across markets. Kerala, let me begin with Kerala because the cluster delivered a solid year-on-year performance with revenue increasing 11% year-on-year to around INR 620. The improvement was driven primarily by a richer specialties mix and a 5% year-on-year increase in ARPP IP, supported by a higher contribution from complex procedures and MVT business growth. With a lower incidence of seasonal illness this year, which kept absolute volume growth moderated, the cluster maintained a strong throughput in elective and specialty-led admissions. Operating EBITDA increased 19% year-on-year to INR 166 crores, with margins improving to 26.8% from 25% last year. The improvement in profitability was driven by disciplined cost controls, stabilization of the leadership team, and a more balanced payer case mix. This reflects a meaningful recovery from the softness seen in the second half of FY 2025. Karnataka and Maharashtra cluster has reported around 10% year-on-year revenue growth, supported by a continued ramp-up in Aster Whitefield and a strong ARPP, especially in the inpatient area. Improvement led to high-value programs, including oncology, neurosciences, and other complex surgical care. However, it's important to note that the shift towards medical oncology has also led to a higher material cost, driven by immunotherapy and targeted therapy services. As a result, operating EBITDA grew 6% year-on-year during the quarter. Andhra and Telangana revenue grew by 8% year-on-year, supported by a 4% growth in inpatient flow and a 4% growth in ARPP IP, driven by a better case mix. Year-on-year, our operating EBITDA growth also grew, reflecting a higher replacement of cost of the clinical talent. However, on a quarter-on-quarter basis, operating EBITDA has almost doubled. These investments were necessary to enhance the long-term clinical capability of the cluster. In summary, this has been a strong quarter of execution and growth across clusters. Kerala delivered a record high performance. Karnataka and Maharashtra maintained steady double-digit growth, and Andhra and Telangana continued an upward trajectory despite the impact of the lower seasonal incidents. With approximately 2,300 additional beds planned across these regions over the years, we are extending a phase of accelerated scale, deep penetration, and a strong operating leverage. Thank you, and I'll now hand it over to Sunil for a detailed review on the financial performance. Thank you, Mr. Ramesh. Good morning, everyone. I'm pleased to share Aster DM's financial performance for quarter 2 FY 2026. For the quarter ended 30 September 2025, revenues have increased to INR 1,197, up by 10% from quarter 2 FY 2025. Operating EBITDA has increased to INR 263 with a margin of 22% compared to FY 2025 quarter 2, with a growth of 13%. Normalized PAT post-NCI for quarter 2 FY 2026 is INR 110 compared to quarter 2 FY 2025, with a growth of 14% YoY. For the half-year ended 30 September 2025, India revenues have increased to INR 2,275, up by 9% from H1 FY 2025. Operating EBITDA has increased to INR 478, with a margin of 21% compared to INR 410 in H1 FY 2025, with a growth of 17%. Despite lower incidence of vector-borne diseases, which typically carry higher margins, I'm pleased to share that our EBITDA margin improved 13% year-on-year. It's important to note that quarter two FY 2025 had unusually high base, driven by elevated seasonal medical admissions. In contrast, quarter two FY 2026 saw a softer medical case mix. Yet, even against this backdrop, we achieved an EBITDA margin improvement of 53 basis points year-on-year. This margin expansion is driven by multiple key levers. In line with our focus on driving sustainable profitability, we have continued to execute on our cost optimization and operational efficiencies. During the quarter, we made meaningful progress through initiatives such as centralized procurement of services on non-medical consumables, as well as adoption of renewable energy across our hospitals. These actions, supported by benefits of operating leverage, delivered nearly 100 basis points reduction in our OREDs. Our renewable energy program is already delivering tangible results. We have commissioned 13 MW of project across three hospitals in Kerala and Karnataka, with visible savings flowing through to our OpEx costs. We are on track to go live with an additional 21 MW across seven more hospitals during the second half of this year and early next year. We also achieved 30 basis points efficiency manpower cost. These gains, the OpEx cost gains and the manpower gains, were partially offset by an 80 basis points increase in medical cost, primarily due to strong growth in core specialties, particularly oncology, which grew 26% year-on-year and lower incidence of vector-borne diseases. Turning to our diagnostic business, I'm pleased to share that Aster Labs has achieved a strong turnaround since the start of FY 2025. EBITDA margins have expanded sharply from 11% in quarter 2 FY 2025 to 17.8% in quarter 2 FY 2026, driven by robust 31% year-on-year growth in external business, enhanced operating leverage, and improved metal cost efficiencies. This turnaround also translated a healthy ROC for Aster Labs at 23%, a remarkable recovery from negative levels a year ago. As of H1 FY 2026, our total CapEx stood at INR 302, nearly 50% allocated towards expansion projects. We continue to maintain a robust liquidity position with cash and cash equivalents of INR 1,276, with our gross debt moderated at INR 639. Additionally, we have seen a significant improvement in ROC, which has increased by 290 basis points year-on-year from 18%- 21%. With this, we have laid a foundation for future growth. As we move into the future, we are confident of building on this momentum with the same discipline and focus. On that note, I conclude my remarks. Now, I request Mr. Varun Kannan to take you through the performance of Quality Care India Limited. Thank you. Thank you, Sunil. Good afternoon, and thank you for joining us today. This quarter reaffirmed our unwavering commitment to our patients and excellence in care. Our focus on the fundamentals has enabled us to deliver strong clinical and financial outcomes in quarter 2, demonstrating our resilience and reduced dependence on seasonality. During the quarter, we witnessed several of our key initiatives not only delivering strong outcomes but also being institutionalized within our operations. These initiatives are now gearing up for scale, reflecting the strength of our strategic direction and execution capabilities. This progress gives us added confidence in sustaining growth and driving long-term value creation as we look ahead to the upcoming quarters. On the Q2 financial performance, overall performance in Q2 has been strong, with revenue growing 15.1% YoY to INR 1,193, while post-index EBITDA rose 21.6% YoY to INR 287. The EBITDA margin post-index improved by 130 basis points YoY to reach 24.1% in Q2 FY 2026. The strong performance was primarily driven by growth in ARPP and volume expansion. ARPP grew by 10% YoY to approximately INR 125,000 in Q2 FY 2026, supported by an improved specialty mix, with CT share rising 80 basis points to 58.5%, and a very favorable shift in payer mix as the share of cash and insurance business rose by 240 bps to 81%. Mind you, this is easier said than done. The EBITDA growth further reflects the early success of key synergy initiatives across procurement centralization and F&B in sourcing implemented in the second half of FY 2025. Our clinical. Efforts, talent recruitment, and management, and the strong ramp-up of Nagarkoil Unit, launched in October 2024, also contributed meaningfully to our EBITDA growth. Our mature units, which account for 60% of revenue, delivered a 14.4% YoY revenue growth and a 27.4% YoY EBITDA growth, achieving a margin of 33.2%. Meanwhile, our emerging units, which are 6% of the revenue, continued to scale effectively, reporting a 16.3% quarter-on-trailing quarter revenue growth and a 90.1% quarter-on-trailing quarter EBITDA growth. Our focus units, which are 29% of our revenue, also recorded a robust 30.4% quarter-on-quarter EBITDA growth, reflecting our continued emphasis on operational excellence and disciplined execution across all facets of our business. Another important aspect is leadership. We continue to attract exceptional talent from across the industry. Dr. Pawan Kumar recently joined us as the leader of CARE Hospitals. He's designated as the CEO of CARE Hospitals. He's a graduate from JIPMER and PGI Chandigarh, with an MBA from ISB. Dr. Pawan brings extensive leadership experience from his previous roles at Max, Cloudnine, and Livasa. With this, we have onboarded over 10 CXO-level leaders to our team over the last few months, each bringing unique and complementary expertise, enabling us to drive our next phase of growth and excellence in care. On the clinical side, we've been continuously advancing our doctor hiring models in a structured manner and have onboarded over 100 clinicians across the network during this quarter. While these initiatives were launched a few quarters ago, this quarter has shown significant progress, with the monthly recurring run rate or revenue run rate coming from the newly hired cohort of clinicians reaching INR 20. Moreover, these new hires have been instrumental in driving a shift towards higher acuity, with our case mix share increasing 80 basis points to 58.5%. Our drive to advance clinical excellence has led to several milestones. The first robotic-assisted CABG in Andhra Pradesh, the first cardiac transplant in Vizag, the first TAVI with real-time CT integration at KIMS, awake beating heart CABG on a high-risk 71-year-old patient with triple vessel disease and chronic total occlusions. We continue to place unwavering focus on improving our ability to manage clinical complexity so we can create the best outcomes for our patients. Our continued focus on clinical protocols has also enabled us to reduce our ALOS by 6%, decreasing from 4.08 to 3.85. With the launch of new clinical programs, we've also invested in advanced technologies, including one linear accelerator to support our oncology ramp-up in Nagarkoil, as well as commissioning two cath labs, two OCTs, and two MRIs in various micro markets. Additionally, we continue to strengthen our robotic program with a new installation in Hyderabad. To accelerate growth, expansion continues to be a key strategic priority for us. We remain committed to strengthening our presence in existing markets and entering new ones through greenfield developments, brownfield expansions, and strategic M&A. Our enhanced near-to-medium-term growth plan includes an investment of about INR 2,000 to add over 1,700 beds in the next three to four years. In line with our mission to improve accessibility to high-quality care, 1,300 of these 1,700 beds will be added in non-metro tier 2 markets. We also remain steadfast in our focus on improving access to state-of-the-art clinical infrastructure. This is reinforced by our investments in setting up five to seven LeanAx systems across Tier 2 markets, strengthening our oncology capabilities in these regions. To enhance outcomes and support ALOS reduction, we are also expanding our robotic programs. In the last quarter, we rolled out a series of operational initiatives driving growth, including the first phase of our call center modernization in partnership with Tech Mahindra and the beta launch of a CRM-based patient enrollment system to enhance engagement and service efficiency. I'm actually very pleased to share that we are already 100% on track to achieve the target. For the group, we plan to extend this initiative to the entire KIMS network in the coming quarter. We've been recognized and awarded. Quality Care India Limited received the Visionary Healthcare Leadership Award from the Honorable Governor of Telangana at the AHPI Annual Conference. India Health Summit and Awards recognized us as the best hospital network by the Times Group. KIMSHEALTH Trivandrum earned Platinum Green OT certification for all operation theaters, meeting global standards in energy efficiency, patient safety, and sustainability. With that, I'll pass it on back to Hitesh. Thank you so much for joining us this afternoon. Thank you, Varun. Dear participants, during the Q&A session, you will get a chance to ask a question by raising your hand through the raise hand icon in Zoom application at the bottom of your window. We will call out your name, after which your line will be unmuted, and you will be able to ask your questions. I would also like to request all the participants if you can introduce yourself with your name and the company that you are associated with before asking the question. If you're not associated with any company, if you're an individual investor, you can highlight that as well. Moving on to the Q&A session, the first question is from Mr. Tawseef. I'm audible? Yes. Yeah, you are audible. This is Tawseef from BNP Paribas. Thanks for the opportunity and congrats on a good set of numbers. My first question is to Ramesh. Can you give us some qualitative update on the Kerala business, especially when Aster DM has focused on the last one year in the clinician program? Also, this quarter, we have the growth which you have seen in Kerala business, whether it pertains to your flagship hospital, Aster Medcity, or the growth was broad-based? Thank you, Tawseef, for that very good question. I mean, in fact, as I mentioned about Kerala. Has been performing very well. In fact, it is not only Medcity alone, it is across the board. Now, just to give a throw some highlight as far as the overall business has been very good as far as the case mix is concerned. You find that it is all high-end and Congo T mix is really doing very well. You see the MVT business has grown by 49% growth has come in there. We have all high-end procedures happening, especially in Medcity. You will find that robotic procedures, which has been doing exceedingly well. In fact, some months, we have crossed even 80 numbers per month. That is a kind of high-end procedures what we have started doing. Oncology has been doing exceedingly well across the board and especially in Aster Medcity. The leadership you'll see. Whomever we have hired, especially in MVT. And the unit-wise leadership is stabilized. You'll find efficiency is hidden, especially when it comes to manpower optimization or cost optimization as far as the material consumption is concerned. I think overall, Kerala has been steadily doing exceedingly well. It'll continue to do well. Unlike FY 2025, we had some vector-borne disease at that time. The volumes were very high as far as pulmonology, internal medicine, and pediatric is concerned. Q uarter 2, FY 2026, you'll find that quality electives' surgical numbers have really gone up. That's where the specialty mix has changed and the performance is really good. Ramesh, anything on the MVT patient footfall, Ms., the growth of 26% which you have seen YoY? Yeah. MVT, especially there are two, as we said, Middle East, especially from Oman, we had a significant growth. That is one area. Maldives have also refocused on Maldives, have brought a lot of attraction of patients. Overall, we have a pan-India, we have taken a leadership for MVT now. More focus on each of these cluster-wise focuses has been happening. Thereby, even African countries have been one of the, a good number of patients have been coming from the African belt as well. Overall, MVT business, you'll find a good growth across 23% growth across the board across India. Thanks, Ramesh. My second question is to Varun. Just wanted to understand your expansion plan beyond FY 2028 for the merged entity, whether we plan to pursue aggressive M&A in areas like Western India and Northern India, where we do not have much present. Tawseef, good afternoon and thanks for the question. Tawseef, I just highlighted that we're very clear in terms of brownfield and greenfield expansion. I think that's been laid out very clearly. Strategic M&A, that you can't really make plans, but we'll always be open for it. Thanks. I think I'll get back on the queue. Yeah, sure. Thanks, Tawseef. Thanks, Tawseef. The next question is from Mr. Ameh. Ameh, can you please unmute your line and ask the question? Hello, am I audible? Yes, you are audible now. Thank you. Thank you for giving the opportunity and congrats on a good set of numbers. First question I have on the Karnataka and Maharashtra cluster, which is showing around 10% growth. I believe the Whitefield you have written in the PPT that is doing well or delivering 25% plus growth during the quarter. Which is the hospital which is overall affecting the performance here and the reason for the sale? Yeah. Ameh, thank you. Thank you for the question. I think the main unit which is giving us the growth in Karnataka right now is still Whitefield because it is obviously a newer unit. When you look at the growth on Whitefield, there is a significant, I think it is almost 27% growth that we are seeing. Ramesh, do you want to expand more on what? Yeah. Like you said, there is good growth as far as Whitefield is concerned with 27% growth happening there. Especially oncology has grown very well. The contribution from oncology is almost 17% towards the total revenue of Karnataka. You find that overall performance has done very good as far as Whitefield and as far as RVs, as to CMI. It's likely we are having a single-digit growth, but definitely it is also growing as for the market. What do you call the traction has been very good in and around North part of Bangalore. You can see a better growth. Definitely, there should be a better growth as to CMI as well. If you compare with FY 2025, again, I did mention about the vector-borne disease, we had a higher volume there. In last year, FY 2025 is second quarter. That is a reason you'll find a moderate growth happening this year over FY 2025. In FY 2026. Just to add to that, just to give you a number so that can be sort, basically you flatten seasonal impact. Overall India, the internal medicine, Palmo, and Peds, right? There we have got a 12% T growth across India. Kerala impact is a little lower than compared to Karnataka. Kerala impact is only 6%. Karnataka, very specifically the Bangalore impact is almost 26%. Right? That is a huge impact. That is where year- on- year, we are used to go to the mid-teens or higher-teens growth. That is not visible because of that. Just giving the numbers on that. Got it. Thank you so much. The second question I have is on the FY 2027. Guidance on the expansion side. We have three greenfield units coming up. Obviously, on a long-term basis, it is quite positive. Specifically for 2027 modeling on the margin side, what EBITDA impact should we take into account? Is there a possibility of QCL brownfield expansion helping these margins to have a lower impact? If you can give some clarity on FY 2027. Yeah, if I can take up this question, I mean, see, I think we are not giving guidance just for one year, right? I think even in the last call also or even in the previous meetings, we have always told that as a combined entity, we are now at 23% for the quarter. On a YTD basis, we are somewhere around 21.5%. Post-merger, right, we are looking at in two to three years to be near 24%-25%. Now, very specifically with respect to the greenfield, you'll see that, see, both the greenfield, the major greenfield, Hyderabad is anyway one which is coming, which is more of women and children. The important one is our Sarjapur, which is coming quite in the end of the year because the brownfield just commenced the work there. It'll take at least somewhere in the end of the H2. The capital should come around middle of the year. That is what we put across as H2 FY 2027. We have seen that wherever we have a strong cluster, we tend to do well. We expect not to have too much drag on the EBITDA margin. Also, it is very, very important by then, I think, with merger on the way, we should also have synergies coming into the picture. That should also help in a very big way in addressing any initial losses there. Sure. Should we assume that combined entity margin should be well maintained with accounting for the synergies during that year? Yeah, as I said, I do not want to give a guidance exactly on the particular year. I mean, Got it. No problem. I think, I mean, what's important is, yeah, maybe we haven't, we might not be able to say exactly how much the margin will be maintained or if there's any dilution. I think what's really helpful to note is how complementary this is, right? The Trivandrum asset, which is coming, 500 beds, it's almost going to be now with the presence that KIMS has in Trivandrum. It's going to really help us kind of expand that capacity and create that cluster in Trivandrum, again, building on the leadership that KIMS has, building on the brand that Aster has. I think that's a really powerful story for us to kind of double down on. Even in Hyderabad, now with women and child, again, with the network that CARE has in Hyderabad, once a merger is complete, you will be able to see that network effect coming through. So we do see that both of these are positives from a merger standpoint. To the point you're making, we see this should definitely help us accelerate the performance of both these units on account of the merger as well. Sure. Thank you so much. I just have a last question to Varun. He mentioned that there is a 700-bed expansion for the QCL asset. 300 beds are in tier two. Just wanted to understand the thought process here when we have to choose the expansion between metros and Tier 2, what is generally the thought process? I believe the metros typically, although it has competition, it has quicker turnaround timelines as well as higher EBITDA per bed. Tier 2 typically have longer timelines as well as lower EBITDA per bed. ROCs might be better, but it takes time for you to achieve those ROCs. How should one think about it when it comes to expansion? How should we balance it going ahead? What's the thought process there? Ameh, thanks for the question again. I think there are two, three ways to see this. One, the numbers are 1,700, 1,300. So we're looking at those many bed ads over the next three to four years. I think on the point that tier two markets take longer. I want to quote an example. We opened Nagarkoil, our hospital in Tamil Nadu, in October 2024. We were profitable from an EBITDA standpoint in the third month. I think one year into the hospital, our current margins are in excess of 20%. Tier two markets, if done right, the opportunity to scale them up fast is, in my opinion, better than many Tier 1 markets. Again, it depends on how you roll out a hospital, right? If you are able to bring the clinical team, the infrastructure, open it right, and the market is something that knows the brand, like Alisha mentioned on Trivandrum, the scale-up will be significantly faster. That is one way to look at it. When it comes to expansion also, I think one of the good things about expansion is that we are expanding where we are already present. If you see, we are adding Indore, we are adding beds in Bhubaneswar, which is where we are constrained for capacity. Any bed addition will get occupied sooner than later. We are adding oncology capabilities across Raipur, in Indore, in Bhubaneswar. I just told you about Nagarkoil. We had initially planned that we would expand beds in Nagarkoil probably in FY 2028, but the way we have grown in Nagarkoil, the sense is that we will be adding beds in FY 2027. I think all of that will play well for our expansion as well as margin story. Sure, sure. Thank you so much. I will join back. Thank you. Thanks, Ameh. The next question is from Mr. Harith. Hi. Hope I am audible. Yeah. Firstly, on QCL, the margin profile that we are at currently, around 22%-23%, if I look at on a one-half basis. Varun, if you could talk about some of the additional levers that we have to take this further up, keeping the synergies aside. What were the levels before you took over at the beginning of FY 2025 or towards the end of FY 2024? What was the margin level that we were operating at on a pro forma basis for all the three platforms within QCL put together? Hi, Harith. Margin is a good story, Harith. I think. We've done a lot of work on this. I just announced that we were at 24.1% for the last quarter. At some point in time, we had given that as guidance as well a few quarters back. What's impacting? I told you that we have a synergy wheel. Of course, we do not talk about the entire wheel, but there are 10 initiatives that we focus on. I cannot put synergy outside because this is a constant endeavor that will continue to happen. Synergy is generally not when you only merge companies. It is a synergy that you continue to play from one hospital to the other. From a margin expansion standpoint, there are three, four things that have really helped us. One is the procurement side of it. We've been able to create efficiency, and that efficiency is outside of what the planned efficiencies are post the merger as well. We've also done things that KIMS as a network had F&B insourced. We knew that that was the right thing to do because there are two elements around it. Patient complaints around food in Indian healthcare sector are number one. If you're able to enhance that quality, it augurs very well for the patient experience. It also does good to the P&L. That's another piece that we've rolled out in QCL across the network. We've started to insource F&B. Outside of that, there are multiple things. We are working on CapEx procurement, on enhancing or working on group strength, on. The AMCs, etc. One of the other things, the second part outside of procurement and the synergy wheel is really the payer mix. That is one thing that I mentioned in my commentary as well is easier said than done. The fact that we've been able to move the payer mix by 280 basis points is phenomenal. I think there is business focus and operating focus. When you do things right, you're able to grow the right payer pretty well. Our cash and insurance payer is doing extremely well, which is a very healthy sign for the business from a long-term standpoint as well. Needless to say, that is margin accretive. We are today at about 81%. Do I see this continue to grow? Absolutely. I think the third part is that w e've always broken our business into the four categories that we spoke about. We've been very focused on that. We know that there is a maturity. Part of our mature part of our network, which is about 60% of our business. There, what we try and do is we try and enhance the performance metrics there. There should be growth. That part of our network is growing about 15% currently from a top standpoint with a very significant EBITDA upside. We've started to see turnaround in most of our focus units as well. That's a large component. 25%-27% of our business comes in from there. We've seen significant upside there. Our Hyderabad assets are now performing much better. When matured units, which are underperforming, start to do better, the translation to EBITDA is quite significant. I think all of that. Is giving us the traction and will continue to, i n the foreseeable future. Also, the fact that we've been able to launch our new hospitals well and we are able to get to 25% profitability in the third, fourth quarter, the question that was asked to Sunil earlier. I think we know how to scale up fast. And that will keep us in good stead even when we add capacity going forward. Yeah, that's that. Got it. By keeping synergies aside, I meant the synergies with Aster. That's a very helpful one. Yeah. On Aster standalone, Sunil, I understand this question has come up in the previous quarters, but looking at the ARPP growth. It's quite strong. When I think of FY 2027, some of the drivers like the Whitefield ramp-up or the ALOS reduction, the payer mix optimization, these might not be as relevant or significant as we have seen in FY 2026. Is there guidance or some indication directionally that you can give for FY 2027 for our ARPP growth? Thanks, Harith. If you know, I've always never given a one-year or one-quarter growth. I've always given an extra two to three years where it could be. Also, we want to see ARPP also is very camouflaged with a lot of things. Making that particular KPI move, right? For example, ALOS also, right? ALOS also moves. For example, our ALOS is being efficient. I think this is our third quarter where from 3.2, 3.3, we have come down to 3.1, right? Even in the 5% ALOS reduction, and that 5% directly moves to the ARPP. I think we should start moving out of ARPP and move to more of an ARPP for IP. Even in ARPP also, right? ARPP for IP patients. There also, we've seen a movement even in the current, I would say, quarter or the first H1 also. There are important things. One is that specifically in Karnataka Maharashtra cluster, scheme is very, very important. Wherein our Aadhaar, where our Kolhapur is there, we stopped the scheme because we already reached around 75% occupancy. We did not have the space to occupy for our cash and TPA patients, right? On there, 1,500 patients, right, for the quarter, or 1,600 patients for the quarter was the reduction, right? That has really moved the ARPP up. Second, Whitefield, see, Whitefield is just a second year. Oncology is still driving the growth. Neuro is doing really, really well. Cardiac is doing well there. That is also driving the ARPP. Also, specifically because oncology is driving, 60% of our oncology comes from MedOnc. Today, in MedOnc, 40%-50% of that revenue is derived by immunotherapy and targeted therapies. Their middle cost is quite high and also ticket sizes are high. That is where you are seeing that ARPP up. Second, I would say third or fourth item is the season. I think I called out in another question that even though overall season impact for specifically these three specialties is 12% degrowth, what we have seen in Karnataka, the impact is quite high, right? Year- on- year, it is on 26%. We had too much on the last year, and that is where the whole growth has come only from contiguous specialties. That is one of the reasons why it looks very, very high. I think these are the factors which Whitefield, anyway, once it gets normalized in just one more year. Other things, yeah, you'll always have. My future thing will be is that look at ARPP growth somewhere between 7%-8% from a long-term point of view, like two to three years. Thanks, Ameh. I'll get back in a bit. Thank you. Thank you, Harith. I'll request you to please raise your hand for any queries. The next question is from Mr. Beenu. Mr. Beenu, can you please ask your question? Hi. Good afternoon, all of you. Congratulations on a great set of numbers and the recovery in Kerala cluster. Just one question remaining was around GST. In your opening remarks, you mentioned that. The reduction in GST augurs well for the cost of service. Have you tried to quantify the benefit to margins that this can accrue? Beenu, thanks for the question. If I'm trying to get that question right, we are talking about the GST impact. See, GST impact, there's no impact in the OP services because we always used to take the input and pay output to the department. So there's no impact on whether it's in the top line or in the cost from the OP. Only in case of IP, very specifically open cases, where you have also seen the benefit also because with the MRP going down, there is a GST is coming down in both in sales and the cost, right? So the both way impact is there. From an Aster point of view, the top line impact, overall top line impact on a monthly basis, around 1.1%. Out of that, 35-40 bps impacts our EBITDA. At the same time, it's very important, Beenu, that recently, I think sometime in October, we also seen the CGHS price increase, right? After more than a decade, more than 2,000 procedures price increase happened. There, we usually do ESI, ES, ECHS, where they follow the CGHS rates and also other PSU corporates, what we do. We do approximately INR 20 of revenue every month. There, we see a positive INR 2 crore impact in the revenue. EBITDA out of that impact in the incremental revenue, around 7%5-80% should flow to EBITDA. With that, whatever the negative impact what we are seeing in the GST should get compensated by the CGHS EBIT increase. Sorry, just a clarification. Why would there be a negative impact from the GST? I would assume that your cost will come down. It would positively benefit the EBITDA? Beenu, I can always share the mathematics later. What also happens is that, if I want to give an example, right? For example, if you're, specifically in the open billing, what's happening is that on the MRP is what we used to sell, right? The MRP, for example, all the medicines used to be approximately 12%. Now it has come down to 5%. What is the, on the MRP, the GST has come down by 12%. We used to have a margin of approximately 50% in the medicines, specifically. There, it has come down by 50%. You got my point, right? Whatever the revenue or the loss what we are seeing on the MRP, only the 50% has come down. The balance 50% was going to hit your P&L. It is very natural. Also, if you want, we can offline give you the mathematics to explain to you how it is impacting our EBITDA. Understood. Thank you. That is fine. One question about what is the thought behind shifting of the headquarters from Bangalore to Hyderabad? Hitesh, you want to just come in on? Yeah. Thanks, Beenu, for the question. As part of the merger, we just felt it is better to have the NCLT application for approval going from one state so that the process timelines can be better. That was the key reason why we just thought that rather than because the head offices currently are in two different states. We just felt it's better to have happening so that the efficient process will be more efficient. That was the reason why we did this. Understood. Thank you. Thanks, Beenu. We request you to please limit your question to two, but not more than three at a time. Moving on to the next. The next question is from Damyanti. Damyanti, can you please ask your question? Yeah, hi. Thank you for the opportunity. Most of the questions have been answered. I have two questions. First. Now you have majority stake in Dr. Ramesh's hospitals. So with that. Is there any change in the broader strategy for the Andhra and Telangana cluster? Because although it's a small cluster, but it's one of the least profitable in your network. So any comment will be helpful. Hi, Damyanti. So we are working with Dr. Ramesh to kind of build a strategy for. Andhra. I think. Probably a bit too early to say it. We are doing some of the market studies on the potential. So there are a few proposals under review. We'll see how, I mean, there is potential for the cluster. It's all about prioritizing where we want to put the capital, right? We will come back maybe in the next couple of quarters to you on that. Sure. I think it's logical to assume that the margin profile could significantly improve from here because, again, it's like other two clusters. It's in low double digits. Maybe there is more room to improve on this cluster. I think we've seen some growth recently. There have been investments made in the doctors as well. Of course, there is potential. We're trying to see. There's also a lot of competition that's come in the market. We are making sure that we keep improving in each of the clusters as much as possible. Let us come back to you. I think we are seeing improvements in the cluster anyways, I think, over the last year. Sure. My second question is actually, how do you see your medium-term EBITDA margin in view of very strong performance in your core clusters like Kerala and then having great visibility on drivers like oncology, etc.? Where do you see your margins, say, in the next three to five years from now? Damyanti, again, we would like to resist on the cluster-wise EBITDA margins, but we already given a broad guidance on a merged entity. Post-merger, we are looking at 24%-25%. Still, you understand that margins are indirectly linked to the ARPP for the IP patients, right? The higher the ARPP because the middle cost is where we get the leverage. At the same time, you have seen the Kerala cluster has done really well because of the capacity which we added. Almost a brownfield expansion happened both in Aster Medcity and in Kannur. We have seen that Kannur, which used to be in high teens, has gone beyond 20% margins. Our Medcity, where it was around 750 beds, we added another 100 beds. There, the margins have gone beyond 30%. Also, it is a very big hospital where we are inching towards more than INR 90-100 crore of revenue per month. With all this, I think it is all about the brownfield expansion and how we can bring the efficiency. As I said, yes, I understand where we are coming from. With the oncology happening, yes, with the middle cost being higher, there could be some stress, but also we're looking at not specifically trying to grow only one specialty. We are also interested to grow across the contiguous specialties, right? With that, I think we will be able to manage the EBITDA margins better. Yeah, actually, I was wondering if it could be higher because oncology, although there is high material cost, but the realization I understand is better than many specialties. I was just thinking more than 24%-25% if you can achieve. To give this statement, right? Even if you look at just the last quarter with the GST change, with the CGHS price change, so many things keep happening in the sector, right? Rightfully so. I think our commitment is to always, kind of like what Varun was saying earlier, looking at each lever constantly, dynamically, seeing what can be optimized, what are the options that we have. Of course, even with the merger, there will be a lot of synergies that come in. We maintain this balance of which clinical programs to run, what makes sense for the different clusters for each unit, detailing out what clinical programs to kind of focus on, and then also making sure at the same time we are able to improve the efficiency and the margins as well. I think it is really hard to then say specifically this will improve by 100 basis points or 200 basis points, but obviously the commitment is to always kind of beat the peers and be at par with the peers as well. Sure. That's helpful. Thank you very much. Thanks, Damyanti. We request you to please limit your questions to two, but not more than three per participant. With this, the next question is from Sumit. Sumit, can you please ask your question? Hi, thank you for the opportunity. My question is to Varun. Sir, what was the FO of QCL in 2Q? Sorry, Sumit, you are not audible properly. Hello? Yeah. Can you be a bit louder? Yeah. I just want to ask two questions. First is, what is the FO of QCL in 2Q? And second question is on. I'm extremely sorry, Sumit. We are not able to hear you properly. Hello? Yeah. Can you be a bit louder? Your voice is very low. What was the FO of QCL in 2Q? Okay. If I could hear it properly, he's asked what is the ARPP of QCL? Yes. Hey, Sumit. All right. So. Again, I think. Sometimes ARPPs, Sumit, Sunil mentioned about it. We've released the number, which is the ARPP number. The ARPP growth is 10% for this quarter. The ARPP number would be about INR 44,000. If that's the number in specific you're looking at for Q2, for QCL. Sumit, we're finding it very difficult to understand what you're saying. Just hold, sir. Just hold. It seems to be your mic. Sorry, Sunil. There are more questions. I guess we can take it offline with you because I think we're having some communication challenges. Puneet, in the meanwhile, do you want to move to the next one? Yeah, sure. Thanks for it. Yeah. We have the next question, again joining back to the queue, Mr. Tawseef. Tawseef, can you please ask the question? Hey, thanks for the follow-up. Ramesh, can you share some color on the recently commercialized Kasaragod hospital, how the early trends are? And does this hospital stop current patients in Kerala to travel to Karnataka for treatment? Tawseef, we had a, on October 2nd, we had launched the hospital. It is a 264-bedded hospital. Right now, we have opened 100 beds. The other two would be shortly commissioned as well. The OPD numbers are anywhere between 150-200 on any given day. That is a head start what we had. If you look at inpatient, we are talking around 35-40 inpatients. IP admissions, we are around 7 to anywhere between 10 admissions are happening. Discharges are also on the same. We have the best of the clinicians onboarded. It is a higher tertiary care center. Kasargod, I do not think in and around Kasargod you have such a higher tertiary care center, which even oncology where. MedOnc and even surgical oncology, we have started there. Right now, all patients are accessing Kasargod Hospital. I do not think the patient now. Once the awareness is pretty high, we have started a good amount of campaign, a good amount of public, what do you call, awareness programs. I am sure patients have started flowing into the hospital. I do not think they are cutting across Karnataka now because this is one of the state-of-art centers we have come up. Thanks, Ramesh. That is helpful. Thanks, Tawseef. We have Sumit joining back to the queue. Sumit, now you can ask the question. You are on mute. Hello? Yeah, Sumit. Yeah. Now we can hear you. Okay. Yeah. My question is to Varun. Sir, what was the performance of the mature and the focus units in this quarter? And have you witnessed any margin improvement in the focus units? Yes. Sumit, first, it's good to be able to hear you now properly. Sumit, I gave some numbers earlier. Our mature units actually, from a top standpoint, grew 14.5% YoY. Our emerging units grew 85% YoY. Our focus units grew 9% YoY. Sure. How should we look at the units over the next three to four years, and kind of margin improvement in at least the focus units and the mature units? Of course. In the emerging and the focus units, margin expansion is the reason why they are in that category, and that certainly will happen. I don't see a question around it, as I mentioned earlier. A couple of units, or actually more in our focus group, have started to do extremely well. Our Hyderabad units were a bit challenged last year, if you recall. That's where we've started to see, in fact, the last month of the second quarter, our numbers were mid-double-digit growth rate for our Hyderabad assets. I think that's looking good. There's a significant turnaround underway in the focus units. Emerging, of course, the newer units will do well. Also, another hospital in Perinthalmanna, where we had challenges around it, was a part of the focus unit, is doing extremely well now. In fact, we are now looking at adding complexity there. One of the linear accelerators that I spoke about is getting into Perinthalmanna. We've just ordered a robot for Perinthalmanna. Again, the strategy continues to be the same. Bring in more complexity, more modalities, ensure that. Anything and everything that the patients want are delivered in our centers. With that said, you will continue to see patient retention in a significant way, and therefore complexity, paired mix, etc., growing, leading to an evolved margin condition. Understood. Thank you. Thanks, Sumit. I will request two attendees, please raise your hand for any question to the management. The next question is from Mr. Gaurav. Gaurav, can you please ask your question? Yeah. Thank you. My question is to Mr. Varun. Broadly, if I look at healthcare and quality care, all the parameters are comparable. In fact, quality has been better. If you look at the ALOS, Aster at 3.2 and Aster at 3.9. Just wanted to understand why is this delta there? Is it because of the case mix or something? How low can this go? How will that help our capacity in the future? If I start defining as to why the 3.9, I think may not be fair. It is driven by multiple factors. It is driven by the specialty that you focus on. It is driven by what kind of surgical mix you have, etc., etc. How much is the medical mix? If you are able to do sometimes medicine can stay longer, etc. I think, Gaurav, the way I would look at it is not really compare to the second part of your question, the way I read it is, is there scope to enhance it? Yes. Our focus will be to continue enhancing that. We have bettered over the last year by 6%. As I told you that we were in excess of 4, we have come down to about 3.85. Will this continue to improve? My sense is yes, if that answers your question. Thank you. Sure. Thanks, Gaurav. If anyone has any other attendees who would like to ask a question, please raise your hand. Okay. That has been the last question. There is no more question to the management. Thank you all. This concludes the earnings call for this quarter for Aster DM Healthcare. I thank the management and all the attendees for joining us today. If you have any further questions and queries, please do get in touch with us. Thank you. Thanks, everyone. Thank you. Thank you. Good afternoon. Bye-bye. Thank you. Bye-bye.