Good day, and welcome to the Q4 and FY 2022 earnings conference call of Healthcare Global Enterprises Limited. As a reminder, all participant lines will be in the listen-only mode, and there will be an opportunity for you to ask questions after the presentation concludes. Should you need assistance during the conference call, please signal an operator by pressing star then zero on your touchtone phone. I now hand the conference over to Mr. Ravi Udeshi from EY. Thank you, and over to you, sir. Thank you, Faizan. Good evening to all the participants of Healthcare Global Enterprises Q4 and FY 2022 earnings conference call. Today, we have with us Dr. B.S. Ajaikumar, Executive Chairman, Mr. Raj Gore, CEO, and Mr. Srinivasa Raghavan, Chief Financial Officer of Healthcare Global Enterprises Limited, along with the top management members to share the highlights of the business and the financials. Please note that we have uploaded the earnings presentation to the stock exchanges and have also shared the same through our mailers. In case anyone of you has not received it, please do reach out to us, and we will be happy to send over the presentation to you. As usual, the standard safe harbor clause applies, and without delay, I now hand over the floor to Dr. Ajaikumar for his opening remarks. Thank you very much, Ravi, and welcome to this investors call, and good evening to everyone. HCG has carved a niche as cancer care destination of choice across all key areas of clinical research and academic excellence. Our phenomenal growth over the years bears testimony to the fact that cancer can be considered just like any other chronic disease. However, it is the only chronic disease which is curable. This year, we have added over 40 oncologists to our growing team, which takes our doctor strength to over 450, which is largest in the country in this field of oncology. We continue to employ the latest and most advanced techniques of cancer diagnosis and treatment, enabling us to serve a greater number of patients with the objective of quality outcome. In a landmark development, we introduced Microsoft HoloLens, the next-gen holographic headset, heralding a new era of virtual reality at our enterprise. Through a pioneering industry initiative, we have brought healthcare training and medical education to metaverse by publishing over 200 hours of virtual reality content across multiple subspecialties. Patients are our most important stakeholders. To serve them more effectively, we have invested in a robust digital platform employing cutting-edge technologies for end-to-end patient engagement. The crux of our high quality of care across the length and breadth of the country is to ensure the right treatment the very first time for our cancer patients. Going forward, we believe our robust cancer care ecosystem will continue to deliver impressive returns. Cancer therapies are undergoing a defining change over 75 days through innovation and research. Thanks to our enhancement of knowledge and innovations, we are able to relentlessly manage cancer care in a progressive way. Backed by our research labs and clinical trials, we are uniquely positioned to enhance our diagnostic capabilities and offerings and also redefined precision medicine with the end-to-end expertise spanning bioinformatics, genomics and research. This will enable us to deliver tangible patient outcome with greater precision over a long term. Academics and research go hand in hand with patient care, and our capabilities in this regard makes us a benchmark in cancer care treatment. We are happy to share that our center of excellence in Bangalore has been ranked number one in the country by Outlook. I now turn the floor over to Mr. Raj Gore, our CEO, for his remarks. Thank you, Dr. B.S. Ajaikumar, for your continued guidance and support to everyone at HCG. I extend a warm welcome to all the attendees, and it's great to have this dialogue with you again. We are happy to share that we ended the last financial year, FY 2022, as a great resilient organization on the back of our strong financial and operational performance. We've also strengthened our senior leadership team during that last financial year by hiring the requisite expertise, which makes us future-ready to effectively implement our strategy going forward. We've embarked this current financial year with a greater ambition, and we firmly believe that the collective effort of our team will enable us to achieve our stated purpose of solidifying our leadership position in oncology. Furthermore, we are happy to share that we have delivered another quarter of sustained performance. This is our fifth consecutive quarter with all-time record revenue and third consecutive quarter with all-time record EBITDA. Our new centers also recorded their third consecutive quarter of positive EBITDA. The HCG team's execution focus and hard work were instrumental in achieving these accomplishments, and we remain committed to continue driving growth with the execution rigor in future. As stated in our last quarterly call, we are continuing with our journey on digital transformation and operational transformations, projects with the objective to enhance patient engagement and experience. We are happy to share that the company has started realizing its initial benefit, and we expect that we will realize its full potential in near future. With that, I would like now our CFO, Srini, to go over the important financial highlights for the quarter and year gone by. Thank you very much, Raj. Good evening to all of you. The highlight for the quarter ended thirty-first March 2022. Consolidated revenue was INR 3,646 million, up 22.8% from INR 2,981 million in the previous year's equivalent quarter. International business revenue is steadily growing on quarter-on-quarter basis and is returning to pre-COVID levels. Hence, it has a substantial potential going forward. Consolidated EBITDA was INR 661 million, up from INR 438 million in the same quarter of the previous year, a YOY increase of 51.2%. Consolidated operational EBITDA was INR million, up from INR 394 million in the same quarter last year, a YOY increase of 16.4%. The existing centers operating EBITDA was INR 610 million, up from INR 440 million in Q4 FY 2021. That is 39% increase YOY, resulting in 22% operating EBITDA margin. This has been achieved by vigilant control in operating expenses, resulting in consolidated operating margin being at 17.3%, an expansion of 410 basis points from 13.2% of the year earlier. The operating profit for new centers was INR 21 million, compared to a loss of INR 46 million in the corresponding quarter of the previous year. Reported PAT was a profit of INR 60 million, compared to a loss of INR 1,022 million in Q4 FY 2021. Pro forma operating EBITDA was INR 676 million, compared to INR 394 million in the corresponding quarter of the previous year. Pro forma PAT was INR 67 million as compared to a loss of INR 155 million in the corresponding quarter of the previous year. I would now like to give a context to the said pro forma PAT in Q4 FY 2022. There was an impact of a one-time project fee of INR 25 million for support on value creation plans, ESOP expense of INR 19 million, and DTA recognized on tax expenses through the year on account of discontinuation of Kochi project INR 25 million. I now request your attention to slide 32. FY 2022 revenues grew by 37.9% YOY. HCG centers grew by 37.8% and Milann centers by 39.8%. FY 2022 operating EBITDA of existing centers was INR 2,308 million, 21.5% margin versus 17.4% margin in FY 2021. New centers witnessed an EBITDA INR 72 million versus a loss of INR 157 million in FY 2021. I now request your attention to slide 33. The revenue split for our business is 96% contribution by HCG centers and 4% by Milann centers. Within HCG centers, Karnataka's contribution to the revenue is 36%, followed by Western India, comprising of Gujarat at 26% and Maharashtra at 17%. I would now like to draw your attention to slide 34 of the presentation. Strong growth in revenue continues across centers in fourth quarter of FY 2022. Jaipur delivered 220.7% YOY growth. South Mumbai delivered 89.2% YOY growth. Nagpur delivered 49.3% YOY growth. Ranchi, 41.4% YOY, and HMS, 38% YOY. Revenue from new centers was INR 826 million in quarter four of year 2022 versus INR 535 million in quarter four in FY 2021, which is a growth of 54.3% YOY. Existing centers recorded a healthy revenue growth of 15.6% in quarter four of FY 2022 on a YOY basis. Moving on to slide 35. Increase in average occupancy rate in quarter four FY 2022 YOY basis of 59.9% versus 54.1% at a consolidated level. For existing centers, occupancy rate was 59.1% versus 55.5% corresponding quarter of last year. Increase in existing center ARPOB in quarter four FY 2022 was INR 39,725 versus INR 35,545, which is 11.8% YOY growth. Looking at key geographies in slide 36. In Karnataka region. Our Center of Excellence performance in Q4 with revenue growth of 39.6% YOY. Center of Excellence ARPA was INR 5,600 versus 4,800 in the corresponding quarter last year and 25.8% operating EBITDA margin. With respect to Gujarat region, we had a strong revenue growth in Q4 FY 2022 on a YOY basis, with oncology revenue growing by 33.2% and the multi-specialty revenue increased by 28%. As stated in previous calls, multi-specialty has resumed its growth trajectory. With respect to Maharashtra region, new centers grew by 79.3% YOY. South Mumbai DAU revenue continues to grow. For East India, existing centers revenue grew by 34.1% YOY. In Andhra Pradesh, we have witnessed a strong revenue growth across the region. Vizag and Vijayawada delivered a growth of 45.2% and 26.9% YOY respectively. Coming to slide 37, covering key highlights of Milann's business. Milann demonstrated good recovery in Q4 FY 2022 across all metrics. New centers revenue grew by 45.3% YOY. There was a big improvement in digital traction as a result of continued efforts on our digital campaigns and the focus on strengthening clinical talent across Milann. Milann is looking to consolidate and focus on market leadership in Bangalore and scaling up North Indian centers in near term for Milann going forward. Coming to slide 38 with respect to the CapEx table, we have implemented judicious control measures with respect to both routine and growth CapEx, with most of our expansion completed. Total CapEx for FY 2022 was INR 704 million. With respect to the net debt as on March thirty-first, total debt was INR 1,901 million, which is a reduction compared to the previous quarter of INR 2,025 million. I would now like to hand over the call back to Ravi, please. Thank you. We now start the Q&A session. Thank you very much. We will now begin the question and answer session. Anyone who wishes to ask a question may press star and one on their desktop telephones. If you wish to remove yourself from the question queue, you may press star and two. Participants are requested to use handsets while asking a question. Ladies and gentlemen, we will wait for a moment while the question queue assembles. Reminder to the participants, anyone who wishes to ask a question may press star and one at this time. The first question is from the line of Kaustubh Pawaskar from Sharekhan by BNP Paribas. Please go ahead. Yeah, good evening. Thanks for giving me this opportunity and congrats for good stuff. My question is on our operating EBITDA margin. This year we have crossed almost 17%. I think it was in line with what we were aspiring for. The audio is breaking from your line, sir. Please check. Now it is. Hello? Please go ahead, sir. I have a question on the EBITDA margin. We have reached operating EBITDA margin of more than 13% in FY 2022, and I guess that was in line what we are aspiring for. In coming year, considering the fact that now even the new centers are, you know, putting consistent EBITDA for past few FY quarters and our occupancies and ARPA were also increasing. Going ahead, you know, where do you see this EBITDA margin, you know, inching up to? EBITDA margin. EBITDA margin going forward. Yeah. Yeah. Got it. Yeah. Yeah. Yes, we have recorded a good EBITDA margin of about 17.5% in the current year. We expect to kind of, you know, maintain this kind of a margin and likely to improve in the coming quarters as well. It will be driven by various factors. One is, of course, the growth in revenue, the mix of revenue, and of course, you know, the trajectory of the new centers growing in the right direction. That will help us to improve the overall EBITDA margin. Right. Sir, second question is on Milann. This year, the registration grew by around 29%. Now, the scare of COVID has almost receded. Correct me if I'm wrong. Mr. Pawaskar, the audio is now breaking from your line. Please check. Yeah. Just a second. Maybe you can re-login, and then we can ask the next participant. He's asking for COVID. Is it better now? Yes. Better now. Yeah. Yeah. My question is on Milann. Second question is on Milann. This year, we have clocked around 28% growth in registration. Now, scare of COVID is almost receding. Correct me if I'm wrong. Considering that, should we expect this registration number to go up in FY 2023 and FY 2024? Yes, certainly we expect the numbers to go. You know, after the downturn in COVID, we have recovered. We really look at a very healthy growth going forward. Okay. Sorry, on CapEx, beyond our expansion in Milann, anything specific you would like to highlight for FY 2023-2024? We are, as I said, in a consolidation phase this year. We are not going to look at any other expansion, particularly any greenfield or anything. At this point, our board has taken a decision to primarily look at consolidation. Strategically, we may do something. As and when we do, certainly we'll report it. Right, sir. Our depreciation should remain at current level, whatever the quarterly we are achieving at around INR 41 crore kind of a depreciation. It should remain into that range, right? It should be in similar levels, in the current year. Okay. I will get back with you. Thank you. Thank you. The next question is from the line of Vikas Mistry from Moonshot Ventures. Please go ahead. Congratulations, sir, on good set of numbers. I have a couple of questions, specifically on registrations. As we are trying to expand into tier two, tier three towns, what will be the strategy to drive registrations and making affordable cancer care to every person? Yeah, we are, as we know, HCG is possibly the one of the groups, only one maybe, which has penetrated through tier two, tier three cities, not just putting a, you know, linear accelerator or all that, a comprehensive cancer centers. We are certainly once the consolidation phase is over, because with 20-21 oncology centers, we have taken a decision to consolidate. We'll be certainly looking in future at more centers in tier two, tier three cities. It could be either in form, mostly in the form of maybe acquisitions or so as the time comes. At this point, I want to reiterate that we are looking at more consolidation, bringing them to maximum capacity utilization. At that point, because we are now going through, as we explained, through digital and through, you know, transformation and sales, we are looking at increasing the capacity of each center, and that is where we are focused on. That is where Mr. Raj Gore is focusing on and his team. We will certainly look at where we should go in terms of tier two, tier three cities once the consolidation phase is over. Okay, sir. My next question is on the digital initiatives that you described in opening remarks. As we try to expand into tier two, tier three cities, then how will operating levers would play out by using digital initiatives and intensity of CapEx for the new centers or maybe small expansion? How the payback period will reduce and how it will really perform? What your opinion on that? Look, the digital initiative is aimed at 2, 3 things. One is create HCG's brand awareness online digitally, create leads, and therefore drive footfalls. As that happens, the revenue will keep growing. We feel we'll get bump in our revenue growth. As that happens, you know, all financial ratios will automatically improve. Okay. Thank you, sir. That's all from my side. Thank you. The next question is from the line of Anurag Jain from Green Lantern Capital. Please go ahead. Yeah, thank you so much. Am I audible? Yes, please go ahead. Yeah. Thank you so much. I had a couple of questions. One was just a follow-up on the previous question itself. By when do you think these digital initiatives should start delivering results for us? Yeah. It has already started. Last few months, we are seeing an increase in our traffic on our website, leads we are getting, the conversion that is happening. I think the journey has started. I think with each month we'll keep improving it. You know, we look forward to reporting to you specific numbers in coming future. Great. Thank you so much. The other thing was on international, you know, patients. You did mention that they've normalized to pre-COVID levels. Can you share what percentage are they now? At what rate are they growing, and how much- Yeah. More do they contribute to profitability versus normal patients? It's a good question. International we feel is a very good opportunity for HCG because we have a clearly differentiated product for that market. Unfortunately, through the year, as soon as we started showing progress, the COVID wave two came, then it dipped again for obvious reasons. Then again we picked up. Then in January, I think November, December, we reached to pre-COVID levels on a monthly basis. Then again, January, February we had an impact. March, we ended up at a higher level than pre-COVID level at about 4% of our top line. We are very encouraged with it, and we're hoping that we'll continue to go that, grow that percentage in the coming year. Understood. Because, I think full-fledged flights were started only sometime in March. Yeah. This number actually going forward should potentially improve, right? You made a very important point. I think the sky opened, you know, all out in first week of April. In spite of that, the March was, for us, the highest ever month, above the pre-COVID levels. We are really encouraged with, you know, how resilient our capability is to pulling patients from all corners, due to our differentiated product and outcomes. This is something that we are really looking forward to in the coming year. Got that. In terms of profitability, they would be adding a couple of percentage points more to EBITDA, right? Yeah. It is biologically a higher margin business, and as that, you know, share of revenue goes up, it will reflect in higher margins. Got that. Just last question from my side, and this is on the occupancy of onco hospitals in general. In compared to a multi-specialty, there is a gap as to how much onco hospital can get occupancy at the peak level. What's your sense how much, for example, Bangalore, you know, center of excellence, what's the peak of occupancy that we can reach? At that level, what is the kind of, you know, margin which is possible? Yeah. I, you know, as you know, our verticals of oncology, diagnostic, medical, radiation, and surgical, only the surgical vertical requires overnight occupancy in most cases. That also, you know, the length of stay is coming down as we are using more and more in minimally invasive and robotic techniques here. In spite of that, you know, you've seen a very big jump in the current year in our occupancy because our volumes are growing. I think, you know, going forward we'll, you know, I don't see it as a constraint in our growth in near future in, you know, next couple of years. I think that's probably the upside that we don't need to worry about, you know, capital spending on expansion or addition of capacity. Got it. Essentially, occupancy may not be like a very high number, 70% or so, but we'll still reach a margin which would be comparable to the multi-specialty. Absolutely. Is that fair to say? Absolutely. Yeah. Thank you so much. That's all from my side. Thank you so much. Thank you. The next question is from the line of Ankit Agrawal from Yellowstone Equity. Please go ahead. Yeah. Hello. Thank you for taking my question. Yeah. Hi. My first question is on the Ahmedabad center. Are you doing any kind of renovation or expansion there? Yeah. In Ahmedabad center, it has been there for last almost over 10, 11 years, and we have reached a capacity there. Because of the type of specialty we do there, strong surgical groups as well as, you know, medical oncologists and radiation. We are now. We actually announced this a few quarters ago also, that we are now building a phase two. A new dedicated cancer center work has started. With that work, we expect major part of our oncology will be done there. As we know, the Ahmedabad center is very surgical oncology-focused with Aastha Group with 16 surgeons there. With this, we expect this new center to take place around 2024. You know, work is done and yes, we are doing that at this point. Okay. Just a follow-up to that. What is the kind of CapEx involved and are we doing in the same partnership like the one we have like with Aastha? Yeah. Certainly, we are doing with the same partnership. Some of the CapEx, obviously what we have will be used there. There is an additional CapEx which is involved. Yes. Okay. Okay. That's all I had for you. Thank you so much. Thank you. The next question is from the line of Praful from BPS Group. Please go ahead. Hi. Thank you for taking my question. My first question is on slide 36 I'm referring to. For East India I see that the overall regional growth is around 30.9% compared to 30.1%, which is overall the existing centers. I'm interpreting it by saying that maybe the new center in Kolkata has de-grown this year. Is that a fair statement? And if yes, then what are the challenges you are facing in the new center? Yeah. Can you please repeat your question? We're not able to hear it clearly. The question is on East India. I'm looking at slide 36. For East India region, I'm looking at the growth for the region compared to the growth for the existing centers. The existing centers have grown slightly more. Yes. than the region itself. 34.1% compared to 33.9% for the region. The Kolkata center has also grown in the similar line. It's slightly lower than our existing centers, but Kolkata center has also grown over 33%. Yeah. Correct. My question is, like, the initial margins because the new center, I'm assuming that's the reason the margin for East India is a bit less compared to other regions. Is it that going forward the margins for East India will also improve to more like Maharashtra region? Yeah, Praful, as you know, Kolkata is our newest center. We just opened it prior to COVID pandemic. It's still, you know, we are still working on turning it around in terms of breakeven. As that happens, you know, this region will also start showing higher EBITDA margin going forward. Got it. Other question is just to understand, again, I'm looking at the same slide by region. So the average revenue per occupied bed, like, for Gujarat, Karnataka, it's very high for the more mature centers compared to like Maharashtra and other regions. Once these existing centers also mature, then by region also, do we see that the ARPOP are pretty much similar or are there still a regional flavor where maybe Karnataka will always have a higher ARPOP compared to maybe East India center? Yeah. It's a factor of couple of things. One is Bangalore and Ahmedabad are our mature centers and centers of excellence. So they are, you know, they have a higher cash business. They do more complex, high-end, high realization treatment. Bangalore gets more international patients. So, you know, because of that, you know, mix, their ARPOP is higher. Now, going forward, we feel that Mumbai and Kolkata both fit that profile, and we expect them to move along similar lines as Bangalore as well as Ahmedabad. They both are bigger cities. Affordability is better. Payer mix can be better. Their ability to attract international patients due to their connectivity across the world is better. Therefore, we expect those two cities and therefore those two regions also to move in a similar direction. That makes sense, sir. Thank you very much. Just last question on the cash on the balance sheet. We are on INR 200 crores cash. In terms of from this year, like is the plan to utilize the cash to either retire some of the debt or are we looking at, you know, some other maybe inorganic growth or some other capital allocation for this time? The loans we want to retain. No. The debt would get retired by our free cash flow generation in the business, and after that debt would get retired. Cash would be used for various growth activities in terms of asset requirements or for any inorganic growth opportunities. Okay, sir. Sir, lastly on the CapEx. There's INR 70 crore CapEx in FY 2022. For FY 2023, is there any, like, guidance, like will the CapEx be a similar amount? I think even more of like a maintenance CapEx than growth CapEx. Yeah. As you can see, the CapEx in 2021 was very low. CapEx in 2022, and as we move forward, we have taken a position of consolidation only. For this year also, the CapEx will be mostly replacement CapEx and in the center of excellence bringing in new technology. Those will be the new CapExes, since we have not planned for any other greenfield project for us. Except for Gujarat, which I already stated, there will be some CapEx allocation this year. As we go to next year and year after, there will be CapEx for the new center which is coming up in Gujarat. Apart from that, we don't see any other new CapEx coming. Prash? No. The only thing I would like to add to what Dr. Ajay said is our focus since we are in a consolidation phase. Our CapEx focus will also be to drive the growth of our existing hospitals. That makes sense. Thank you so much for taking my questions. All the best. Thank you. Thank you. The next question is from the line of Bharat Celly from Equirus Securities. Please go ahead. Mr. Bharat Celly. Yeah. Yeah, hi. Thanks for the opportunity. Good evening, everyone. Sir, just wanted to understand on our center of excellence. What sort of ROI return profiles we have for this center, if you could provide any color on that. On the center of excellence. Yeah, our Bangalore center of excellence will be about 25%-26% ROCE. Sorry, I didn't get it. Our Bangalore center of excellence will be around 25-26% ROCE. Okay. Sir, will it be similar for something like Ahmedabad as well, and you will be trying to build similar for Mumbai as well as Kolkata? Ahmedabad is actually higher than our Bangalore. It's close to 30% ROCE. It's higher than the Bangalore center. Mm-hmm. Uh- Okay. Yeah. Just wanted to understand on that note only. We have been focusing a lot on tier two, tier three cities lately. When we go for these cities, do we work around considering that the CapEx's involvement is relatively lower than what we require in these tier one cities, and on the top of it, even the ARPO will be relatively lower. Venk, how we look at these ROICs when we move to tier two, tier three cities? No. Look, I think the uniqueness of what HCG has done is the business model is viable, scalable in big cities as well as smaller cities. Some of our tier two, tier three existing centers delivered EBITDA margin in mid-20s%. They have ROIC about 20%, because the model is evolved like that. We still invest the contemporary modern medical equipment in those cities, but our focus is little different there. Our cost structure is little different, so we end up having EBITDA margins and ROIC in a similar level, even in tier two, tier three cities. No, I just want to add. See, the important thing to remember here is ROIC for mature centers, even in tier two, tier three cities, will be in the high teens or more, even more than 20, which is there at this unit level. We are able to achieve that even with the ARPO, as you said. The reason ARPO is maybe lower, like we explained before, is because we have technology but not the highest technology. Center of excellence will have more. Naturally, the ARPO will be more. The differential, some points is there, but still even with this, one of the achievements of HCG in tier two, tier three cities, unlike some belief that in tier two, tier three we cannot achieve, we have been able to successfully achieve, as Raj Gore said, good EBITDA, good EBITDA margins and ROIC for mature centers. Yeah. It's a function of two things. One is lower cost structure, you know, because we are in tier two, tier three cities, and higher asset turnover. Right. Just on higher asset turnover, sir. Just wanted to understand. Obviously COVID was a time when we were seeing a lot of, you know, disruption related to travel, and many people would have been going to the nearby hospital for their radiation process. Since the lockdowns and things have been started getting normal, how do you see the patient flow? Do you expect some cannibalization happening or even the people moving from tier two to going for treatment in center of excellence, so that sort of trend can emerge again or so how do you look at it? And what will be the key area why patients will come to tier two hospitals rather than going to a center of excellence? Yeah, you are absolutely right. During the COVID time, we saw reorganization of the patients. When our footfall fell in our major centers at that time, we saw the footfall actually increase in tier two, tier three cities, as you said, going to nearby centers. But one of the positive things which has happened for HCG is our centers, main centers and cities have got back to pre-COVID level or even higher now. And also our tier two, tier three cities have continued to grow and possible reason could be patients now have better awareness about healthcare. The COVID could have created that awareness. People are looking to come to centers which are dedicated, like oncology centers for focused care and all. This could be the reason we are still collecting the data because we thought at one time it could be the previously held patients who are coming forward. It is not so. Actual footfall month-on-month it is increasing. We feel that the reorganization happening, where people are seeking better healthcare and coming across to centers like HCG. Raj, you want to add anything? No. By being a center of excellence, our main centers in big cities offer certain differentiated products like CyberKnife, like robotic surgery, like BMT, complex surgeries, you know, and that will continue to draw patients from all parts of India irrespective of these demographic flow pattern changes, because those are differentiated products. You know, forget like tier two and tier three cities, even big cities, you know, may not have them available easily. Sure. With your permission, if I could squeeze last one. Sir, just wanted to. In fact our market share in big cities has actually grown post-COVID. Oh, that's wonderful to hear, sir. Sir, just wanted to understand on one part. What is exactly the things we are doing to actually increase awareness in these tier two, tier three cities, especially, when there is a case that the overall insurance penetration is on a lower end. The second part which I want to understand is how easy it is to find a surgeon or a doctor or an oncologist in a tier two, tier three cities where we have seen over the past that the skewness is towards metro or tier one city. No, as I said, you know, we have recruited 50-plus oncologists itself in the recent. One of the things we have. We have our own training program, residency program, approved program, DNB programs. Because we train them in several centers, some of them may be coming from Ranchi, Cuttack, and areas, so we post them. The other thing is, when you just look at oncology practice in the past, doctors would like to have technology. Doctors would like to have ability to be empowered and run the infrastructure. Because these infrastructures are lacking in people like Ranchi, Cuttack or Angul, people are moving to big cities. One of the things we are seeing is if I am from Cuttack or Ranchi, I would like to go back, and realizing that infrastructure is there, oncologists are moving back. This kind of reorganization is also happening. Because of that, we are very happy to say that most of our centers are fully staffed with radiation, medical, and surgical oncologists. Sometimes even like Cuttack Center has several surgical oncologists, several medical oncologists and radiation. When we first started, we didn't have a single medical oncologist, you know, years ago in 2008, 2010. There is certainly change happening, and people are looking at technology, infrastructure, of course, HCG's brand name and all to be part of it. That is what driving people to come and be there in these cities. Okay. Something else? Yeah. Coming back to the awareness issue. Look, you know, we all know urban-rural disparity in health infrastructure in India. The demand-supply gap is even higher in tier two, tier three cities. You know, historically these patients would have to go travel, you know, several hundred kilometers and stay for a few weeks in big cities. We've had a first-mover advantage. We've invested in a comprehensive cancer center in these locations. I think, you know, just by, you know, having that demand-supply gap and we providing that comprehensive treatment there, it's never been a challenge to, you know, create awareness and have patients coming to us. The other thing is we have a multidisciplinary clinic using the, you know, for example, information technology, video conferences and all. We have been able to link telemedicine, teleradiology. We are the pioneers in digital pathology, teletherapy planning. All of this has helped us to give the same level of care to patients in tier two, tier three cities even though they may not come to tier one city. That word also is gone, so the patients are feeling comfortable staying in those cities themselves. That's helpful, sir, and wish you a very best of luck for the future quarter. Thank you. Sure. Thank you. The next question is from the line of Nitin Agarwal from DAM Capital. Please go ahead. Hi. Thanks for taking the question. Sir, I just have a couple of questions around the Nashik hospital. Can you just help me understand, I think, what is the structure of a partnership in Nashik, and how has the business done over the last couple of years? Oh, yeah. How was Nashik, the structure of the partnership. The structure of the partnership, it is a partnership with Raj Nagarkar, where we are 51%, he's 49%. As you know, Nashik started as a small center in 2008, 2009, 2010, when we became partners in non-onco, non-surgery. You know, a few years ago we decided to become partners with a new center, 220-bed center. We are doing very good with the top line growing. I think with the new centers, you know, they are really come up to mark and we have put in new technology. We have almost three linear accelerators, PET scan. The center is certainly growing and there is lot of clinical trials happening. We are definitely going to see a good growth there. Okay. That's helpful. Sir, in this context, how should we read about this announcement about Dr. Raj Nagarkar tying up with KIMS to set up a new hospital? Yeah, I will explain this. See, Raj Nagarkar, is an ambitious surgical oncologist, and he had a niche area. He wanted to come up with a multi-specialty hospital, and he approached us to see whether we could partner. As you know, we are a very focused in oncology, and we made it very clear in Nashik area we would like to remain focused in oncology. We gave him the liberty to see what he would like to do in the multi-specialty. He really chose a partner with KIMS where from our understanding, you know, he's also a partner like what we have done with our HCG group. At this point, that is what announcement and he also called to say that he is doing it, which was okay with us. You don't see any challenge there? I just want to add, there is a non-compete clause with oncology only with us, so they cannot do any oncology. Raj Nagarkar is fully dedicated to us as surgical oncologist. He said he is going to be only a passive investor and a partner there in terms of multi-specialty. The entire management from what he said will be run by KIMS. Oncology is completely excluded from that, and we are comfortable with that. Okay, that's helpful. Sir, on the Borivali hospital, how is it ramped up? Is it now the two Mumbai hospitals, South Bombay and Borivali, are they both in positive EBITDA territory now? Mumbai has been a good improvement this year. Our domestic business has grown. Our international business is significantly growing over last few months. Both for Colaba as well as Borivali. We have done several corporate TPA insurance, PSU empanelment. You know, you will see that we'll continue to ramp up our Mumbai business in this year. Okay. Thank you. The next question is from the line of Shyam Srinivasan from Goldman Sachs. Please go ahead. Good evening, and thank you for taking my question. Just the first one, Raj, Dr. Ajay, 38% growth this year. If I do a two-year CAGR, it's about 12%. Just help us understand what is the revenue growth outlook for fiscal 2023. If there is some, you know, directionally, if you can help us. If you can also help us break it down into what do you think about ARPOB? We have seen about 11, 12% growth this year. Also existing plus new. How should we look at fiscal 2023's revenue growth outlook? Revenue growth of that? Entire center. So Shyam, as you know, this growth is year-on-year, and prior year, we had a severe lockdown. You know, I think that's the higher growth of 38% is also a function of the suppressed, you know, numbers due to COVID lockdowns during the prior years. However, I think, you know, if you look at our recent quarters, we feel that we'll continue our growth momentum. We, you know, I mean, both existing centers, new centers, we've shown growth on both sides. You know, we're pretty confident that we'll continue to grow. It's just that 38% is a function of, you know, suppressed growth in the prior years. Got it, Raj. That's why I said a 2-year CAGR of 12%. Do you think that's the number, like a low teens to mid-teens, do you think that's the growth we should look at for the path forward? I'm not looking at just fiscal 2022 or 2021. CAGR 12%, you know, we are confident, you know, continuing that momentum. Probably our aspiration is to beat that number. Got it, Raj. How would you split that into, like, ARPOB, ASP versus, say, volume? How should we understand that? Is it gonna be? Can we still do this 12% ASP increase that we have seen year-over-year, even in existing centers? Do you think the environment, either competitive or regulatory, does it allow us for either price increases? How much more mix change can we drive in the ARPOB? I think ARPOB will continue to drive growth, you know, about 3%-4%, and rest will come from volumes. The other thing is, you know, regulators now are not really, in the last few years, are not coming in the way of any interfering with our pricing. At this point, we don't see any because all the drug issues and all are behind us. Hopefully, we are hoping there won't be any more of these issues going forward because most of it has been beaten down significantly at this point. Raj, the 3%-4% is the price hike or is it a mix change? It's both. In our mature existing centers, we are optimizing our mix, you know. Not just payer mix, but also the modality mix, going towards more higher-end, you know, treatments in radiation, et cetera, in chemotherapy. It's a combination of both. Price in terms of realization, in terms of payer mix, as well as moving towards more higher-end modalities in treatment. Got it. Very helpful. My second question is similarly on margins. Again, we have done margins two-year CAGR of 17%, so higher than revenue growth. Help us benchmark it more. You have existing centers which are north of 20%. You have new centers which are below this number. You have center of excellence at 25%. Do we think like 50 or 100 basis points, at least from the oncology side, it's going higher and higher based on our operating leverage? Or you think there is a chance for us to do higher than 100 basis points? What could be some of the levers on margins? I mean, we would like to go for higher, you know, margin going forward. As I mentioned, as we've covered in previous calls as well as this call, look, our payer mix is improving. Our international business is improving. Our new centers in Mumbai and Kolkata are improving. As the new center bucket grows, as our share of revenue from big cities grows, it will all be, you know, EBITDA margin accretive going forward. So, you know, we're pretty optimistic that we'll continue to grow in our EBITDA margin percentage going forward. Got it. Last question is on competition. You have reported very sound numbers. Margins are improving. We're also picking up some, you know, this is like a renewed refresh thing that key other hospital chains are gonna look at oncology again. Are you seeing any increased activity on the ground in terms of, you know, multi-specialty starting to increase focus back on oncology? Or do you think large enough market, you have penetration in rural, which they may not necessarily pursue. How should you look at competitive dynamics and how your footprint is versus others? Shyam, I think as far as competition, as you know, this question, it comes up quite frequently. We see nearly 120,000 new patients a year. There is no other similar organization in India, so many comprehensive cancer centers, particularly the footfall in tier two, tier three cities, we really don't have any other people. We really feel as far as the competitors, you also are right, there is enough work for all of us to do. At the same time, if you look at our market share in a city like Bangalore or in Ahmedabad, is only increasing, you know, from where we started even a year ago, two years ago. With all this, we are very confident. We are taking market share, we are growing, and there isn't an issue for us. We want to remain a focused factory approach, focused on providing the right care to the patient, focused on the first-time right treatment, outcome, research, the academics. All of this, when a cancer patient comes, what do they look at? Really outcome. How we're going to grow word of mouth and the digital initiatives which we have taken. All of that will only add to our growth, so I don't think that will be an issue. I don't know, Raj, you have any I think the best way to test this hypothesis is look at our center of excellence or our key market in Bangalore. This is a hyper-competitive market with most big players having multiple hospitals with oncology focus. Over the last two years, we've grown our market share by 2%. That's the strength of the differentiated product, you know, we have, the outcomes we have and the strength of the brand. I know that, you know, everyone is focusing on oncology, but we are confident that, you know, we will continue to solidify our leadership position in this specialty. Yeah. Thank you for all the answers and all the very best. Thank you. Thank you. Thank you, Shyam. Thank you. The next question is from the line of Bhagwan Chaudhary from Sunidhi Securities. Please go ahead. Yeah. Hi, sir. Thanks for the opportunity. Can you please share what was the average occupancy rate in the quarter, and what was the ARPOB in the quarter? Just occupancies. Average occupancy. Fifty-eight. ARPOB in the quarter. INR 32,000. 56,800 center of excellence had ARPOB of INR 56,800. He's asking for Q4. I'm asking for Q4 for the consolidated number. Give us few seconds. We're just pulling the. 56 consolidated. Across centers. Yeah. Intersection. Are you asking for only center of excellence? No, I'm asking for the overall. Overall ARPOB. 36,697. INR 36,697. INR 36.7 K in Q4 ARPOB and occupancy. Overall occupancy. Q4 is about 37 thousand. No, for occupancy. Q4 occupancy. 60%. No, again. I will say 60% and ARPOB a little less than INR 37,000. I ask this because this number 36,697 you had mentioned in that presentation. That is for the year. Yeah. It is for the year or it is for the quarter? For the quarter it is 38,805. For the- For the quarter it is INR 38,805. My next question comes that for the entire all the four quarters when I'm looking the ARPOB it's INR 37,000+. While for the year this 36,700 number is for the year. Lower than even average of all the quarters. No, no. The first quarter was lower. First quarter was around INR 36 thousand. Okay. I'll recheck that. Secondly, just one more question. This is on the margin side. In the last three to four quarters our margins are almost stable around 17.something%. I'm looking by putting the other income outside. How do you look at going forward? Meaning for FY 2023 and FY 2024, do you have some number in mind that we'll head towards this? Yeah. We covered it in our initial thing. Look, we are investing in our future growth. Part of that is our value creation plan, which is our digital transformation journey. That's the investment we are doing today for the future growth, future margin accretion. It's a function of that. That investment will continue in the coming year? No. I think we'll complete the, you know, our transformation project this year. Okay. Yeah. Will there be some improvement in the margins or by some means? Yeah. I think we answered this even earlier. Yes, we should kind of start seeing improvement in margins driven by, you know, the new centers growth, some of the value creation activities they are taking place and of course the increase in the international business as well. All this would kind of help in driving the overall margin in an upward trend. Got it. Thank you. Thank you. Thank you. Ladies and gentlemen, that was the last question for today. I now hand the conference over to the management for closing comments. Okay. Thank you very much. Thanks for all the investors who have been on the call and, once again thank you. Wish you all the best. Thanks again for HCG team today. Thank you. Thank you. Thank you very much. Thank you. Ladies and gentlemen, on behalf of HealthCare Global Enterprises, that concludes this conference call. Thank you for joining us and you may now disconnect your lines.