Ladies and gentlemen, welcome to the Q3 FY 2023 earnings conference call of HealthCare Global Enterprises Limited. This conference call may contain forward-looking statements about the company, which are based on the beliefs, opinions and expectations of the company as on date of this call. These statements do not guarantee the future performance of the company. It may involve risks and uncertainties that are difficult to predict. As a reminder, all participant lines will be in the listen-only mode. 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 0 on your touch-tone phone. Please note that this conference is being recorded. Now I hand over the conference to Dr. B.S. Ajaikumar, Executive Chairman of HealthCare Global Enterprises Limited. Thank you. Over to you, sir. Thank you, good evening and a warm welcome to all present on the Q3 FY 2023 earnings conference for HealthCare Global Enterprise. Today, I'm joined by Mr. Raj Gore, our Chief Executive Officer; Mr. Srinivasa Raghavan, Chief Financial Officer; besides a few members of the HCG senior management team, to share our operational and financial highlights for the quarter ended December 23. HCG has been not only a cancer destination for clinical services, but also a destination in research and academic excellence. We have been very successful in creating hub-and-spoke model across the country, I'm happy to report that we have made long strides in academics and research, where we nearly have 150 students at present spread across areas of. You is breaking from your line, sir. It's unclear. Can you hear me now? Yes, sir. Okay, good. Okay, I'll try. We have been very successful in creating a hub-and-spoke model across the country, and I'm happy to report that we have made long strides in academics and research, where we have nearly 150 students at present spread across various oncology programs in Bengaluru and nationwide. Recently, we have published the third edition of the dedicated journal named Physician Oncology, talking about the closing gap in cancer care, including one-of-a-kind journal called Antimicrobial Policy in Cancer Management with our own data, which will help to treat cancer patients with infections the right way for the first time in our own country. We have collaborated with institutions to augment the accessibility of new-age surgical technology and robotic-assisted surgery across India, including non-metro cities, by now going into installation the fourth generation da Vinci surgical robot, U.S.-based institute in Vadodara, Mumbai, Kolkata, to make this technology accessible to wider population in the country to further yielding fruitful results with better clinical outcomes. Our Ahmedabad center, I'm proud to say, has completed 700 robotic surgery. GI and Hepatobiliary Thoracic Oncology Department completed 500 robotic surgery, possibly the highest type of surgery in the country as far as we know. In academic and research, we are proud to announce that our doctors, Dr. Lohit Reddy and Dr. Kritika from Bangalore, have been named in the prestigious National Cancer Institute of U.S.A. as working committee members in their i mmune Division. This kind of recognition is taking HCG to newer, higher levels globally. In clinical trials, we have been one of the few in the phase I trials and several other investigator-initiated trials are also ongoing. There are many more studies in the pipeline, go through a lot of iterations under guidance of our solid ethics committee. We have taken a leadership role in genomics-driven tumor boards and provide complete 500 gene sequencing for over 1,500 patients, which is the largest in the country to best of our knowledge. This has given insights into patient-centric approach, particularly for advanced and recurrent tumors, not only from India, but from Africa and Middle East, making HCG a destination of cancer care. With the wealth of data emerging from cancer genome studies and data lake which we have created, HCG is just the beginning of our journey in the precision medicine and to win the war on cancer, not only in early stage, but in advanced cases to convert cancer to chronic disease. I now hand over to Raj Gore to take you through the strategic initiatives and financial highlights. Over to you, Raj. Thank you, Dr. Ajai. A very warm welcome to all the participants on the call. fourth February was the World Cancer Day, and this year's theme was Close the Care Gap. Being an oncology player, I would like to spend couple of minutes on this important matter. The global burden of cancer is growing steadily. India is no exception to this trend. More people died due to cancer than COVID in last three years across the world. In 2020, there were eight to nine lakh deaths due to cancer in India. An estimated economic burden in terms of GDP losses is in the range of $11 billion, that is 0.4% of national GDP in 2020. I would like to highlight four major gaps in India that we must address. First, awareness and prevention gap. While awareness levels about tobacco-related cancers is high in India, we still need to create awareness about other risk factors such as HPV, alcohol and obesity, and drive implementation of prevention measures. Number two, screening and diagnosis gap. Only one or less than 1% of India's population is covered under screening programs for major cancer types such as oral cancer, breast and cervical cancer. More than 2/3 of cancer patients get diagnosed late at advanced stages of the disease. Number three, access to treatment gap. Population living in more than 70% districts in India do not have access to comprehensive cancer centers. Of the 480 comprehensive cancer care centers available in the country, about 40% are concentrated in metros and state capitals. We need to add another 570 comprehensive cancer care centers by 2030 to meet the demand. Fourth, outcome gap. Challenge of growing incidences is further intensified due to suboptimal outcomes compared to global counterparts across all major cancer types due to all other gaps. While these gaps and challenges seem daunting, together we can change that by forging alliances, uniting our voices and taking action. HCG has been a pioneer and a leader in addressing all these gaps with our 21 comprehensive cancer centers, largest in India. With 2/3 of these centers in non-metro locations, we have been making quality cancer care more accessible and affordable in India since our inception. We have not only provided latest technology and treatments available across the world, but also been able to deliver outcomes compared to leading institutions across the world at a fraction of cost, as acknowledged in a Harvard Business School case study. Coming back to the quarterly performance, we are very happy to report yet another strong financial performance for quarter ended December 2022. We have continued our streak of highest ever revenue for the eighth quarter in a row and highest ever EBITDA for seven quarter in a row now. Our consolidated revenue for Q3 FY 2023 stood at INR 425 crores, growth of 19% year-on-year. Over the last few quarters, we have been regularly informing you about our efforts to drive growth on several fronts, like enhancing our clinical services portfolio, increasing our clinical bandwidth, and our go-to-market initiatives to increase reach online and offline, retail and institutional accounts, domestic and international fronts. We are making encouraging progress on all these fronts, resulting in a steady growth in new patient registration, higher utilizations across all modalities of treatments across metro and non-metro markets. In our emerging geographies, our priority is to create scale and grow revenue with an objective to improve capacity utilization and create higher visibility for HCG. In this regard, the company continues to make operating investments in engaging quality clinicians and brand building. We have started implementing few modules of our digital platform across key functions of patient services, sales and marketing successfully. We have recorded highest ever revenue in both digital and international business. On the margin front, we've been able to improve our margin from 17% in FY 2022 to adjusted EBITDA margin of 19% in Q3. Our efforts during the last 12 months on pricing optimization and cost rationalization have started to yield. Major benefit will flow in FY 2024. We are confident of maintaining our leadership position in our mature markets and gaining market share and leadership position in our emerging geographies. With this, I hand over to our CFO, Srini, for financial highlights. Thank you. Good evening to all of you. We have uploaded our Q3 FY 2023 results and updated investor presentation on the stock exchanges and company's website. I do hope everybody had an opportunity to go through the same. We are delighted to share that we have been able to grow our revenue ahead of the industry growth due to the trust and brand created for HCG. On the revenue front, our consolidated revenues for Q3 FY 2023 stood at INR 424 crores as compared to INR 358 crores in Q3 FY 2022, a growth of 19%. Our revenues for nine months FY 2023 stood at INR 1,252 crores, a growth of 21% year-over-year. Revenue split between HCG and Milann stood at 96% and 4% respectively for Q3 FY 2023. Revenue growth for HCG stood at 20% year-on-year and for Milann stood at -1% year-over-year. As mentioned in slide 8, revenue for the mature centers stood at INR 306 crores, a growth of 17% year-on-year basis for Q3 FY 2023. Revenue from emerging INR 101.5 crores, a growth of 29% on year-over-year basis for Q3 FY 2023. We are delighted to state that our emerging centers are inching towards maturity and are seeing good traction across geographies. I now request your attention to slide nine, where we have disclosed our operational parameters across our mature network and emerging centers for Q3 FY 2023. Our company-wide AOR stood at 65.7% and AOR for mature versus emerging centers stood at 63.2% and 71.9% respectively. Our ARPOB on company level stood at INR 37,014, and our ARPOB from mature centers stood at INR 40,154, and for emerging centers stood at INR 13,057. Across geographies, we have given our revenue break up in slide number 10. Rajkot grew by 110%. Revenue from Jaipur grew by 104%, and Mumbai grew by 28%. Our new center of excellence grew by 15% year-over-year for Q3 FY 2023. Our Milann customers is also doing well. Revenue stands at INR 16.8 crores in Q3 FY 2023, and new registrations grew by 53%. On the EBITDA front, our consolidated reported EBITDA stood at INR 75.5 crores as compared to INR 61.3 crores in Q3 FY 2022, a growth of 22%. Reported EBITDA for nine months FY 2023 stood at INR 222 crores, a growth of 27% year-over-year. Adjusted EBITDA for Q3 FY 2023, that is after adjusting the one-time value creation cost and adjustment of ESOP expenses stood at INR 81 crores as compared to INR 63.6 crores in Q3 FY 2023, a growth of 28%. Adjusted EBITDA margin stood at 19.1% as compared to 18% in Q3 FY 2022, a growth of 556 basis points. Adjusted EBITDA for nine months FY 2023 grew by 35.3% year-over-year with margins of 19%, a growth in margins of 200 basis points. We have also given bifurcation of our EBITDA across mature and emerging centers. I would request the participants to view slide number eight for further details. On PAT, we have been delivering positive PAT for the last four quarters now. PAT for this quarter stood at INR 7.45 crores as compared to a loss of INR 0.3 crores in Q3 FY 2022. nine months FY 2023 PAT stood at INR 20.9 crores as compared to a loss of INR 9 crores in nine months FY 2022, adjusted for one time exceptional gains or losses in FY 2022. Our PAT pre-India adjustments for Q3 FY 2023 stood at INR 11.3 crores as compared to INR 3.1 crores in Q3 FY 2022. PAT for nine months FY 2023 pre-India adjusted stood at INR 31 crores as compared to a profit of INR 1.6 crores in nine months FY 2022. ROCE for mature networks stood at 19.7% annualized for nine months FY 2023 as compared to 15.7% in FY 2022, an improvement of 400 basis points. ROCE before corporate allocations for mature centers stood. ROCE for emerging centers stood at -5.3% annualized for nine months FY 2023 as compared to -8.3% in full year FY 2022. This is again an improvement of 300 basis points. ROCE before corporate allocations for emerging centers stood at -1.4%. Our net debt position excluding capital leases as on 31st December stood at INR 212 crores as compared to INR 211 crores as on 31st September 2022. Our expansion of existing facilities in Ahmedabad phase 2 and Whitefield extension of Bangalore COE is on track. Total planned CapEx for Ahmedabad is INR 85 crores. Expected date of operations being Q1 FY 2025, and for Bangalore COE is INR 25 crores. Expected date of operation being Q4 FY 2024. With this, I would now like to open the floor for Q&A. Thank you very much. We will now begin the question and answer session. Anyone who wishes to ask a question may press star and 1 on the touchtone telephone. If you wish to remove yourself from the question queue, you may press star and 2. 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 1. The first question is from the line of Kaustubh Pawaskar from Sharekhan by BNP Paribas. Please go ahead. Yeah. Good evening, sir. Thanks for giving me the opportunity. Couple of questions. First, ARPOB for this quarter, is down. Any particular reason for this? hi Kaustubh. Raj here. look, as I mentioned in my opening remarks... In our emerging centers right now, we are going for volumes, we're going for scale, we're going for higher utilization of our capacity. It's reflected on a very good growth in Rajkot, Jaipur, and across various emerging centers. That's the reason, you know, ARPOB is lower. I would like to draw your attention, this is still an improvement over the Q2. You know, as we've always stated, first we will go for volumes, and then we will go to improve the quality of the business and go for ARPOB. Right. My second question is on the consultation fees. This has been there for past two quarters. When should we expect this or till what time it will continue on your books, you know, to be reflected? Because you are stating it as a one-time expense. Correct. Correct. This last quarter, Q4 of this financial year would be the last quarter. Okay. Q4 of this financial year. Your base, last quarter it was around 1,794 beds. This quarter, it has increased by around 36 beds to 1,833. Any news, which where this addition has been done, bed additions, you know, 36 beds? We have just operationalized more beds in Jaipur. These beds were always there. It's as an installed capacity. We just operationalized them. Okay. My another question is on your fertility, you know, business part. There we have been, you know, seeing the revenues at around INR 16-INR 17 crores. Even, you know, on registration side, we are not able to understand, like, whether there would be improvement in terms of operation in that business or whether company wants to focus on that part of business. Any thought process on that? look, I know that Q3 was flat, but if you look at year-on-year, we have about 9%-10% growth. you know, Q3 could be just a matter of seasonality. There has been certain regulatory changes as well. The whole industry is adjusting, new regulatory requirements. We feel that, you know, going forward it will continue to grow. What is expensive? What is the regulatory you want to explain? Yeah. Yeah. Explain. Explain, man. Presently this Government of India has brought a new regulatory act called ART. I think in like in the state of Karnataka, it has to be board has to be formed. I think probably in the month of March or April, our board is going to form and the next set of patients are going to get engaged. That is because 30%-40% of our donor programs are being held. Going forward in probably Q1 of FY 2023-2024, you could see the big numbers growth from that perspective. Sorry. Okay. This is a temporary thing. Maybe by quarter one things would improve for this business. Q1 of 2023. Okay. Okay. Thanks for that. Thanks. Thank you. Thank you. All the best for future. Thank you. Thank you. The next question is from the line of Anil Sarin from Centrum Asset Management. Please go ahead. Hi. good evening, everybody. Am I audible? Yes, sir, you are. Yes. Hi, Anil. Hi. First of all, good job once again. I would start with a request that if you can postpone the call for the next day post declaration of results, that would give all of us a time to go through the presentation in more detail, and we can ask better questions that way. If you could consider that for next time, that would be great. The question I had. Yeah, sure. The question I had was whether next day there is. No, we will do next day because last time there were some requests we did on the same day, there's conflicts and all. We certainly take your request and see how we can accommodate. Okay? Sure, sure. At least, you know, giving a gap of, you know, a few hours, you know, as you know, I mean, there is result season, lot of results coming, but, you know, some time, the quality of questions would improve if we've had time to go through. Well, good point. Good point. We'll take a note. Sure. Thank you very much. Yeah. The question I had was that there has been a steady improvement, on a sequential quarter basis for the last, seven or eight quarters that I've been seeing. This is perhaps the ninth quarter. But on a sequential quarter basis, you know, the EBITDA margin, has not improved in any material fashion, unless I'm mistaken. If you can just throw some light on that. Revenue has grown, but the EBITDA margin post adjusting for these one-time costs, I doubt if it has gone up. If I'm inaccurate, you can please point out. Yeah. I mean, good question. One reason is, you know, our one-time expenses in our value creation plan. The second reason is we are disproportionately investing in hiring clinical talent and building brand for our emerging centers. To drive scale, to drive volumes across those centers. We are seeing the results of those, you know, efforts in the revenue growth across emerging centers. That's a, that's a upfront investment, you know, to ramp up the utilization going forward to take it to a next level. Okay. Okay. Great. Post this coming quarter, that will be the last time when you will have these, occupancy charges, unless you go. Absolutely. -a new project. Yes. Next year, what kind of overall growth can one expect? What kind of overall EBITDA margins can one expect, including Milann, including, you know, all the constituent parts? I mean, without the one-time expenses, we are about 19% in the last quarter EBITDA margin. You know, we are confident maintaining our growth momentum going forward on a quarterly basis. We usually don't give forward-looking guidance on numbers. Okay, great. Thank you very much, and all the best. Thank you. The next question is from the line of Dhara Patwa from SMIFS Limited. Please go ahead. Yeah, thanks for the opportunity. I have two set of questions. Despite higher occupancy of 72% in the emerging centers and now ARPOB of INR 30,000, which is flat on the sequential basis, still the EBITDA margins have now seen a decline to 7.5% as compared to the average of 10.5% in the previous two quarters. Is it the new normal should be expected, or going forward it will increase to 10%, 12% or let's say 15%? What should we assume for the emerging markets, emerging centers, sorry? Again, I, we don't give forward-looking guidance on numbers. As I explained, you know, lot of our growth in emerging center is coming because we've hired clinical talent. We've increased our clinical bandwidth. We are investing disproportionately higher in our sales and marketing activities. As a result, we are seeing revenue growth. It's a upfront investment. The margins will follow. On question of ARPOB, again, you know, initially we would go for scale, we would go for volume. Usually the playbook in hospitals is you fill the hospital first, and then you optimize your mix, your payer mix, your, you know. That will drive your realization, all, you know, operating performance indicators going forward. We are following the same playbook, center by center in emerging geographies. should we expect at least a 10% plus margin for the emerging centers for going forward? Like, at least a direction, like it won't be, you know, below 7%, but it will be above, you know, in the range of 10% or something. Yeah, it will start, you know, moving towards our mature center bucket, you know, slowly. Uh. Thank you. The current participant has left the question queue. We'll move on to the next question from the line of Aditya Khemka from InCred PMS. Please go ahead. Yeah, hi. Thanks for the opportunity. Hi, Raj. Hi, Dr. Vijay. First question, if you could help us with what is the current EBITDA margin we do, let's say at our flagship facility in Bangalore? I think, the... Yeah. Go ahead. The EBITDA margin in Bangalore, you are talking about center of excellence. Yeah. That's right. Yeah. It's, you know, quote in there is about 28%. 27%-28% is our EBITDA margin. Right. And this number would not include any corporate overhead, am I right? This would just be the unit economics. Yeah. Yeah. It can improve by a couple of basis points. As you know, we are reaching the top in terms of the EBITDA margin for the center of excellence. Okay? Got it. Got it. It's at a unit level, Aditya. Yeah, it's at a unit level. It does not include corporate overhead, right? Yeah. Right. Right. Okay. Therefore my question is that, you know, ideally the endeavor of the company would be to move as many units as possible closer to the EBITDA margin that we do at our flagship facility over a period of time. Obviously, it can't happen as soon as you open the facilities. It takes time to ramp up and mature a facility to get to an EBITDA margin of 25% plus. Which would also imply that at a time when a majority of the capacity of your 1,800 odd beds, let's say when 1,500 of those 1,800 beds actually become mature, quote-unquote, then at a unit level, ex corporate head, we should be at an EBITDA margin of 25% ± then the corporate overhead, which I don't know how much it is, but I'm guessing it would be around 5%-8% of pay. My question to you is, when do we see that happening? When do we see a lion's share of our beds, let's say it's more than 80% of our beds maturing to a level of profitability that we do in our most flagship facility? Yeah. Aditya, good analysis. Our model, our business model has been able to deliver a mid-20s EBITDA margin in mature metro markets, non-metro markets when the center becomes mature. We will, you know, we will drive the performance of individual units to get to that level. We are looking at about three years span for the, you know, entire current base to move in that direction. As you know, we are at close to without the one-time charge, we are at 19% already. This is including the corporate cost. If you kind of take out the corporate cost at a unit level, we are already in the low 20%s. Yeah. For them to reach 25%, it should be doable. I think we are on track to do that, I can say confidently. Sir, at a unit economic level, are we already at 21%, 22%? Is that what you mean by low 20%? Yeah. Yeah. At the unit economics, we are already at 21%, 22% because our 19% includes the corporate cost. Which is about 2%-3% is what we imply. Yeah, yeah. Okay. Okay. I get it. This is not unreasonable. No, no. Thank you. I think we can have a lighter note. We can take your assessment of 5%. It is not 5%, but I'm saying No, that's awesome. If you're doing it on the leaner organization, it's actually excellent because, you know, I understand hospital business. The fracture facility would actually include a lot of corporate costs, which gets culled out at the unit level. I get that. I get all that. I understand you're at 2%- 3% corporate cost. Which means, Dr. Ajai, Raj, it essentially means that it is not unreasonable for a shareholder today to believe that in the next two to three years we will see 200- 300 basis point expansion in EBITDA margin. Am I right? Yes. Yes. Yes. It's certainly not unreasonable. We hope, our hope, you know, though we can't guarantee we can even better that. That is what we will strive for, and at least a lot of effort is going on in terms of operational efficiency and doing. If all the centers come to mature and we have a, you know, good efficiency as we are planning and our revenue growth is there, the fixed costs remaining, and as you said, our corporate costs, we should be able to reach that and hopefully even better that. Oh, that's awesome. That's very good to know. My second question is, essentially on the cash flow. I heard the net debt number, and correct me again if I'm wrong, this would be excluding these liabilities. I think it is around INR 210-INR 212 crores for the past two quarters. Am I right? Yeah, that's right. Dr. Ajai, where is the free cash flow? I mean, ideally the net debt number should have gone down given that we have had a very profitable quarter. What are we investing in? This is coming off after your tax. Obviously, we have investment in manpower, center of excellence, R&D, scientists. You know, all that is, this cash flow is after those investments. Where are we making those capital expenditures which is not helping us reduce our net debt further? Okay. Point number one, I think it is largely flat if you see, you know, over the last couple of quarters. Having said that, you know, we have invested for revenue generating activities. For example, we have invested about close to INR 18 crores in solar in our Karnataka center. You know, that's that. Which is this. That is giving us some savings in our electricity bill. We have also invested in Iridium equipment in our center of excellence for 52 which we talked about in the last quarter. We are also investing in robotic surgery. These are the places where we are investing. As I mentioned earlier, these are all revenue generating CapEx, which will kind of give benefits to the business in the future quarters. I understand that. Could you give me like a capital expenditure number for the nine months? This fiscal. About INR 96 crores. About INR 96 crores is the CapEx for nine months. INR 96 crores. Okay. Very, very clear sense. I understand. My last question is on the technology side, so slightly technical. I think Dr. Ajai, you would be the right person to respond. This da Vinci robot, you know, that the presentation that you said you are acquiring. First of all, is the acquisition of these robotic machineries. I am assuming these are on lease and not out of the outside purchases. Am I right? Yes. We have created a first of a kind model with them. It is not really a lease. It is our model of pay per use models, where, I think first time da Vinci is, has, best of our knowledge in this country. Where we have, you know, say without any minimum guarantee making, there is a model where, we share in our revenue a certain fixed amount, and we found that is doable and that is, we can penetrate tier 2, tier 3 cities apart from doing where we expect the volume to grow over the next year or two. This is the model. We are trying it out with the new da Vinci 3 units we are putting. Understood. We are using the da Vinci model. The da Vinci robots, to my understanding, first benefit is obviously cosmetological because the arms are flexible and you can have lesser holes in the body of the patient than, let's say versus a laparoscopy. Right? The da Vinci came about two decades ago because of the precision surgery. We talked about precision radiation targeted, but surgery was always not precise. You know, extensive surgery was done. With the da Vinci unit, what happens is you get that microscopic look, and we use the, you know, the da Vinci handles to really do precision where the normal tissue is not hit. The normal tissue doesn't suffer, and it is precise excision of the tumor or whatever your target is. Thereby, the patients recover fast, complications are less. Overall, as you said, the cosmetic scar also will be less. Based on all this, more and more da Vinci users have come compared to the time when it came for oncology first. For doing prostate was the first time it came. We are doing significant... Like I said in my opening remark, we have done in Ahmedabad one of the highest removal of esophagus using da Vinci. It is a remarkable feat because it is almost in three days the patient can go home, literally no pain and no complication. We used to have these, you know, leakages at anastomotic site. We don't see all that. It is a near perfect you can reach in terms of surgery and outcome will also be good and less scar and less hit on the normal tissue. Hernia also we are beginning to do without any scar. Imagine doing hernia surgery, oral surgery where there is no scar and good outcome. We also have a kind of an agreement with the da Vinci, where we will be doing not only training, but we together will create some innovative platforms. That is what I personally as a doctor am looking at. How do we innovate new techniques, new technologies? Sorry, I have two more questions on this platform, Dr. Ajai. Firstly, how many clinicians or how many doctors or surgeons do we have certified by da Vinci to operate and use the da Vinci system? Yeah. Today in Bangalore we have about five surgeons who are certified, and we have our own training program with da Vinci. In Ahmedabad, we have another five people, four to five people who are trained in not only hernia, but GI. We have others, like one doctor in Cuttack who's already training, waiting for da Vinci. We have two or three trained in Mumbai who are ready to do surgery now. We have quite a few, and we intend to increase this number not only for HCG doctors, and we want to make sure even outside doctors can come and train precision, so that essentially the patients at large can benefit. That is what we are looking at. Okay? That's an awesome objective. Last question on the da Vinci platform. Intuitive also has this new system or this new, sort of a diagnostic machine that helps in diagnosing lung cancer early for the smoking population. Any thoughts on that, Dr. Ajai? Have you explored that option with Intuitive? No. We have not explored that. We will certainly look into that and explore. We have explored this low level of a CT scan for smoking population. We are thinking of launching that on Sundays, where we can do lower CT scan. This is the big trial which was done in US years ago. Very successful. We have been working with a radiology group. We are bringing in possibly a new radiologist who is experienced in that. da Vinci part, I have not explored. I will certainly look into this. Yeah, they call it the liquid biopsy or something, I think. When I studied it, I found it really exciting. Maybe something, you know, or because it's very. I think, I know what you're talking about. It's a robotic-guided liquid biopsy where there is very minimal intervention. There are parallel units available, so certainly we'll look at it. They did come and make a presentation few months ago. We are evaluating what is suitable for our people here. Okay? Makes a lot of sense, Dr. Ajai. Thanks a lot. More power to you guys to help our country and our society. Thank you. Thank you. Thanks a lot. Thank you. Thank you. The next question is from the line of Rishabh Sisodiya from Sameeksha Capital. Please go ahead. Sir, audible? Rishabh Sisodiya, your audio is slightly breaking. Sir, am I audible now? Yes, please go ahead. Sir, one question on the growth guidance that we have. Given that we are reaching, you know, almost 70% occupancies now, so, and our new bed capacity that you mentioned is coming up in by end of FY 2024, so how confident are you for the growth momentum for the company? At the same time, where do we see our ARPOB growth going ahead for both the centers, emerging as well as mature? Yeah. Thank you for that question. The occupancy numbers we report are on operational beds. If we do, not all the beds in some of the emerging centers have been operationalized. If we take this occupancy on an installed bed capacity, it becomes 66%. We don't expect bed capacity being a constraint in our growth, especially since, you know, our chemo modality is a daycare modality. Radiation doesn't require bed. It's only the surgical patients who require largely overnight admission on inpatient beds. We don't see bed being a constraint for us going forward in terms of driving growth. Yeah, I just want to add what Raj said is absolutely right. Just want to say in oncology historically, it has been more and more outpatient. Less hospital stay. As you look at ALOS, it tends to come down as we move forward year-on-year. That is the reason the bed is not the way we feel to measure the growth. There are other parameters we should take into consideration to look at the growth. Okay, sir. That's helpful. Sir, on the Mumbai center, the current growth even as compared to other centers like Jaipur, Rajkot, they are very high growth. Why is the Mumbai center having a bit of low growth even we acquired new assets recently? Yeah. I think the Mumbai growth it looks subdued because last year we had a significant vaccination revenue in our Mumbai center. These were the emerging centers. COVID came, we couldn't go out and, you know, build brand HCG among the communities that we serve. Vaccination was a good opportunity to respond to nation's call as well as, you know, reaching out to the community to build our brand. We drove that very well. You know, if you adjust that, this growth will look, you know, better. The other part is in Mumbai, we go for a better payer mix compared to Rajkot and Jaipur. You know, it's more cash TPA, corporate-driven growth rather than, you know, government-driven growth. That's also another reason that this growth will be a better quality business growth yielding better ARPOB eventually and better margins. Okay, sir. Just a last question. On our entire company base for the transfer price, what would be our payer mix, if you could just break it down? Pardon? Yeah, yeah. About almost 65%, 70% will be cash plus insurance. Remaining will be government as well as corporate business. Okay. Are you facing any repricing issue with the insurance companies or with corporate? Do we see that any further repricing ahead that would help us in the ARPOB growth going ahead? Sorry, can you repeat your question? Asking, given that insurance corporate parts, are we looking at, increasing the rates with them and that could help our ARPOB next year growth? Yeah. you know, usually this comes for renewal every two years. you know, it will come up for renewal next year in some of the centers. It's center by center, you know, thing. After the contractual period, we go for a rate increase. In general, if you look at historically, we have a larger presence outside big cities, outside metro cities. Many of our new centers, you know, are in bigger cities co-relatively, two in Mumbai, in Kolkata, Nagpur. These are better markets. As this share of these emerging centers grow, as a share of total revenue, our ARPOB will automatically start growing to a higher level. Okay. That's it. That's it from my side. Thank you. Thank you. Thank you. The next question is from the line of Urmil Shah from Ageas Federal Life Insurance. Please go ahead. Yeah. Thank you for the opportunity. My first question is, you mentioned a 56% occupancy on installed bed. That's at the company level, or, if you could split between mature and emerging centers? Yeah. 56% on our total capacity. Yeah. Oh, sure. What would be the, you know, same number for mature and emerging centers? It's like whatever you see on the slide as far as established center or mature center is concerned there, I mean, there we don't have any difference between operational and capacity beds. It's primarily the new centers where there's a difference of about 250 beds where we have installed 250 beds less in our emerging centers. Therefore, if you take capacity utilization in terms of beds at established you know, at emerging centers, it is around 56%. Sure. Sure. From a medium-term perspective, 65%, which is the occupancy for the mature centers, that's what should be doable. Of course, it will be depending on each center. But from a 3-5 year point of view, your current beds should be reaching that kind of occupancy. Sorry, we missed your question. Is it a bed question or bed. Bed question. Bed. You mentioned that the occupancy level in your mature centers, it's similar for when calculated on operational beds or installed capacity. My question was as regards to emerging centers from a next three to five-year point of view, these would also be getting to 65% kind of occupancy level and, you know, where, if in your case generally, at what kind of occupancy levels you would further need to add capacity in a particular center? Yeah. We do expect emerging centers to start reaching to, you know, mature center occupancy. Usually around 75%. When the occupancy hits 75%, we start looking at how do we, you know, create capacity. See, one of the things you must understand, as I mentioned earlier, that, you know, it's only surgical specialty which largely uses overnight inpatient beds. That average length of stay is going down with minimally invasive techniques, robotics. What we've seen in our experience, what is happening is we are converting inpatient beds into daycare beds. On daycare beds, we have ability to increase number of shifts in the same day. You know, for us, bed is not as much a concern as, you know, one would think in a multi-specialty environment. Sure. Sure. Sir, my second question was more on the emerging centers. We've discussed about the, margin performance, over there. What could be the drivers for getting, the margins, if not to the mature center levels, but at least, you know, to mid-teens? What could be the drivers, keeping into account the current ARPOB and, the AORs which we are currently doing? Urmil, as we mentioned, right now we've invested in clinical talent. We're bringing them out in our outreach markets. We're investing in branding and marketing, sales activities. Basically, you know, driving more new patients, driving utilization of different modalities, driving capacity utilization, driving revenue, that's the sure short way to improve margin, in these centers. Sure. just to dissect on the AOR for emerging centers, of course, this is an average. does the emerging centers also have a few centers which where the AOR would be 75%+? Yeah. Yes, like for example, Jaipur, where we just mentioned earlier that we commissioned more beds, you know, because we were reaching higher occupancy. Yes, in that bucket we do have center which is, you know, a higher capacity, higher occupancy. Sure. In such centers or like the Jaipur centers, how different is the profitability as compared to the emerging center category as a whole? Jaipur in a span of year has gone to EBITDA margin of mid-20s posting basis. Oh, sure. Sure. Okay. Yeah. sir, my last point was on, you know, the free cash flow question, which was there. This year we are having the investments for new high-end equipments, also in talent, also on the consulting fees, which are there. Next year, if we look into, we've already talked about the CapEx for the capacity addition. adjusted for the one-timers and the investment which has gone in this year, would it be fair to assume that that's the bare minimum increase in free cash flow on NOPAT that should come in? Yeah, see, the way to look at it is, you know, we have to look at our ratios of, you know, our debt to EBITDA kind of a ratio, which is at a very, very acceptable level as well as the overall business is concerned. If you see we are at about 2.3 and you know we should be around that, maybe slightly come lower as well in the future quarters. Having said that, the key point is there will be some amount of CapEx. While there won't be any VGP costs next year, there will be some amount of CapEx towards maintenance CapEx, growth-oriented CapEx. Those will be there in the future years as well. The key point to note is these will not come at any additional extra borrowing. We'll be able to manage out of our internal accruals, point number one. Number two, we will be able to maintain some of our key ratios at an acceptable level which is acceptable to the market. Sure, sir. Thanks for answering my question and all the best. Thank you. The next question is from the line of Sagar Shah from PhillipCapital PCG. Please go ahead. Good evening, sir. Actually, I just had one question. Actually, we were looking to open our 203 inpatient beds in the time to come. Can you specify a time that in which in the... Something like in six months or in 12 months or in the next 18 months, are we going to open up the beds? My second question was related to our growth drivers. For FY24, what would be our key revenue drivers for the same? Sagar, I mean, the answer to your first question really depends on it will change from hospital to hospital. As a total bucket, in next around 18 months we'll have to deploy all our installed capacity which is not operational, and we'll operationalize it. In terms of revenue growth drivers, look, the growth drivers for next year will continue to be the same growth drivers that have helped us this year also. Just to add on that, the growth drivers, obviously we are looking at the ones which are not mature. Those which are not mature center will grow faster obviously than those who are mature. That could be and also the technology we are investing and the like what our CFO said, new technology we have brought, those will be also drivers for the future. Basically you are saying the improvement in the utilization of the emerging hospitals, improvement in the volumes of the new patient volumes in the emerging hospitals would be the same growth driver for emerging hospital for the company in FY 2024, right? Yes, sir. Yes. Okay. Thank you, sir. Thank you so much. All the best. Thank you. Thank you. The next question is from the line of Pallavi Deshpande from Sameeksha Capital. Please go ahead. Yes, sir. Thank you for taking my question. Just on the part which where you have mentioned about, you know, adding talent, et cetera, will we be done with that this year or will we be, you know, will this be a continuous process on the clinical talent side? Pallavi, I don't think we'll ever stop adding clinical talent. You know, in new centers you will first make sure that your clinical services portfolio is complete. When those start, you know, growing, their bandwidth starts getting choked, you will add more clinicians under each. You know, as the program evolves, we'll start creating vertical specialization, head and neck, breast, et cetera. This is a continuous process. We'll continue to, you know, invest in talent going forward. You know, just to add to that, for us, being a very specialty focused, as you know, where oncology is growing is in the multidisciplinary clinic, tumor boards. For this, we definitely not only have to have training the doctors and also add additional talent, and that is what we are doing, not only in big centers, but even in, you know, tier two, tier three cities. Our talent pool is increasing and definitely increased, and that will definitely add to our overall growth. We have proven that again and again. Got it. My second question was on the ROC for the emerging centers. We've just seen a small decline quarter-on-quarter. I guess not material, we are doing it just the direction seems to. Yeah. As Raj said, it is non-material and for the fees, as Raj said, we have sort of, you know, invested more on operating expenses related to clinical talent adding and business promotion. This will start translating into higher revenues going forward. However, it is temporarily impacted there. Okay. Sir, you mentioned about the mix for the government and corporate at 30. Within that, would it be consultation or just pure government? I think the last time I had the number, it was 14%. Pallavi, historically our presence outside metro cities was larger, where we had a mass market strategy, low price, higher volumes with government schemes. Many of our emerging centers are in bigger cities. We have, you know, for example, we have two in Mumbai, one in Kolkata. They will have a better payer mix, better ARPO, better price realization. As share of emerging centers to the total revenue goes up, all these parameters will start improving going onwards. Gotcha. Thank you so much. Thank you. Thank you. Ladies and gentlemen, due to time constraints, we will take one last question from the line of Naman Bhansali from Perpetuity Ventures. Please go ahead. Hi, sir. Thank you for the opportunity and continued growth in your business. Just one request was that, you used to give in FY 2022 a good breakup of ARPO, EBITDA margins and occupancy on a region-wide basis. It would be great if you could continue giving that in the presentation, if possible. So that was the request. My first question relates to the international patients. How much of the business as a percentage of contribution was international patients? What do we do to attract these patients? Are these all organically driven or are we hiring any agencies to attract these patients from international borders? My second question is on the industry and on HCG, that how is HCG different from Proton and other hospitals in the industry who also have a high-end oncology machines like, CyberKnife and et cetera. What risk do this industry in oncology face in terms of newer technologies being introduced in coming future? These are my two questions. Thank you. Naman, this is Raj here. Let me take the first part and Dr. Ajai will take the second part on the difference between different technologies. One, we'll take your suggestion into consideration about the breakup. Second, international business, look, we drive international business through all channels that are present to us. There are agencies, there are direct institutional tie-ups, there are tie-ups with international insurance agencies, and there is direct business generation which we do by taking our clinicians, you know, to these cities, to these markets. We have information centers in these markets. We have permanent team members in these markets. It's a combination of both. For us, international business is doing really well. We are about 1.5x-1.6x of our pre-COVID high numbers. In fact, last quarter was our highest ever. We are close to about 5% of total revenue in our international business. I'll request Dr. Ajai to take your question on proton and everything else. Yeah. In terms of proton, as you know, proton has been around since 1970s. It is mainly because the efficiency was precision with brachy. A lot of issues that are in the maintenance of proton, apart from the cost and other things. There is no exit and entry dose. As the time has advanced, now we have some units which are better than proton. In fact, HCG considered proton a few years ago, and I myself being an oncologist and radiation oncologist, I was looking at it. After careful evaluation and looking at the global usage of proton, why it is coming down, attending the conferences and all, primarily because alternatives had come. One of the things we have installed in Bangalore, of course, we have two CyberKnife, which is precision medicine radiosurgery, one in Bangalore, one in Mumbai, doing extremely well in terms of precision. Retreatment also can be done with literally very little exit dose. Now advancement on this has been the Ethos, which is adaptive radiotherapy using the model of AI-based. This has been a game changer for us. We have recently installed it. We have done significant number of patients in the three months. What we are seeing, you know, in fact, I am involved in partially the research with Dr. Sreeni and Krithika. What we are seeing is as the tumor changes, day to day, we can make the change in the tumor radiography and also change the treatment. We are also studying what is the exact dose required. This is a study in progress called radiosensitivity index. With this kind of major developments, technology obviously becomes very important. Added to that, we are looking at how do we connect genomics to technology, where certain tumors respond well, certain tumors do not respond, why, and what is the genomic story behind it, so we can decide on the proper dosing of not only radiation, but also targeted therapy, immunotherapy, everything. Today, cancer treatment, as you may know, is multidisciplinary, and our outcomes based on this has been very good, very encouraging, not only in early stages, but even in advanced stages. Today, a lung cancer patient can live for even with advanced disease, 8 to 10 years. A patient with breast cancer similarly can live for 8 to 10 years. A lot of changes have taken place. Technology is going to complement. AI is going to complement the way we treat, and that is why in HCG we have become, you know, really progressive on it. We are spending significant money also on this to see how this can translate to precision patient therapy. You are absolutely right in terms of technology going to play a very big complementary role for doctors to see what should be the right treatment for the patient at the right time. I always believe first time right treatment will give the best prognosis. This obviously technology, virtual tumor boards are going to be big factors in future along with AI, of course, as we go forward. Okay? Got it. That answers my question. Thank you. Thank you. Ladies and gentlemen, that was the last question for today. I now hand the conference over to Mr. Raj Gore for closing comments. Yeah. Thank you everyone for joining the call and all those, your interest in HCG. Hope we've been able to address all your queries. We'll continue to keep you updated on regular basis on developments in HCG. For any further information, please get in touch with us or Strategic Growth Advisors, our investor relation advisors. Thank you once again and have a good evening. Thank you. Ladies and gentlemen, on behalf of HealthCare Global Enterprises Limited, that concludes this conference. Thank you for joining us. You may now disconnect your line.