Ladies and gentlemen, good day and welcome to Yatharth Hospital's Q4 and FY24 Earnings Conference Call hosted by SMIFS Limited. As a reminder, all participants' line will be in 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 touch-tone phone. Please note that this conference is being recorded. I now hand the conference over to Ms. Dhara from SMIFS Limited. Thank you and over to you, ma'am. Thank you, Sejal. Good afternoon, everyone. I'm Dhara from SMIFS Limited. Welcome you all to the Q4 Earnings Conference call of Yatharth Hospital. From the management side, we have with us Mr. Yatharth Tyagi, Full-time Director; Mr. Amit Kumar Singh, the Group CEO; Mr. Pankaj Prabhakar, the Group CFO; Mr. Deepak Kumar Tyagi, President, Strategy and Finance; and Mr. Neeraj Vinayak, Head, Strategy and Investor Relations. I now hand over the call to Mr. Yatharth for his opening comments and to take it forward. Over to you, Mr. Yatharth. Good afternoon and a very warm welcome to Yatharth Hospital & Trauma Care Services Limited's earnings conference call for the quarter and full year ended March 31, 2024. I have with me Mr. Amit Kumar Singh, our Group CEO, Mr. Pankaj Prabhakar, our CFO, Mr. Deepak Kumar Tyagi, our President of Strategy and Finance, and Mr. Neeraj Vinayak, who has recently joined as the Head, Strategy and Investor Relations. We have uploaded our presentation on the Exchange and the company website, and I hope you all might have received and have had an opportunity to go through it. In an ever-evolving landscape of healthcare, Yatharth Hospitals have stood resilient and showcased unwavering commitment to excellence. Throughout the fiscal year, our team's dedication, strategic vision, and operational efficiency have propelled us forward, enabling us to surpass expectations. Given the swift pace of modern lifestyle, patients increasingly prioritize treatments that ensure safety and swift recovery. I'm happy to share that robotic surgeries have now seamlessly integrated into our standard medical procedures, with around 115 robotic surgeries already completed till date. We have indeed taken the lead in conducting the first robotic surgery in the Greater Noida region. Till date, we have installed three Da Vinci X surgical robots and one Stryker Orthopedic Robot across our five hospitals. This quarter saw us perform some remarkable life-saving medical procedures, including Abdominal Aortic Aneurysm Repair (EVAR), for an African international patient. I'm also proud of the seven-hour neurosurgery on a young child for removal of a rare brain tumor expanding 2 kg for 18 excruciating months. Yatharth Hospitals have an unwavering commitment in upholding the most rigorous corporate governance standards, thereby ensuring utmost transparency and accountability to all valued stakeholders. Thus, I would like to highlight that our company is in advanced stages of finalizing a prominent Big Six audit firm and will be appointing them as statutory auditors in the coming time. Speaking on the performance, during Q4 FY2024, we invited state-of-the-art radiation oncology and nuclear medicine centers at our Noida Extension facility, marking a significant milestone in redefining cancer care services in the region. Equipped with cutting-edge technology and comprehensive facilities, including a linear accelerator, Elekta Versa HD, brachytherapy, and PET/CT scan capabilities, we aim to provide comprehensive cancer care services under one roof to our patients. With oncology now contributing nearly 10% to our revenue stream in Noida Extension Hospital, I anticipate significant growth in the current fiscal year with the establishment of a cancer radiation line. In addition to this, robotic surgeries and the expansion of organ transplant procedures, I am confident of a case-mix shift towards more specialty treatments, which we have already displayed and should further drive our higher ARPOB. With Asia's largest international airport, the Jewar Airport, expected to commence this year, we have already set up a dedicated team of international marketing professionals to expand the medical tourism business for the group. To cater to these international patients, our Noida Extension facility has undergone some renovations, including the creation of a dedicated international patient floor and a lounge designed to provide a comfortable and welcoming environment. Furthermore, we are strategically developing the infrastructure of the additional 200 beds at our Greater Noida location, with a focus on catering to international patients. Our team has been organizing facilitator meets, and our doctors are constantly going and doing OPDs in countries like Africa, Iraq, and CIS. I am glad to announce that Yatharth Hospitals have achieved industry-leading growth in revenue and profitability during the quarter and full year ended March 31, 2024. We have delivered stellar results, with our revenues surging by 29%, reaching INR 6,705 million in financial year 2024. This growth trajectory was complemented by a 35% increase in EBITDA, reaching INR 1,799 million, with the margin expansion of 113 basis points to 26.8%, further highlighting our balanced approach towards growth and profitability. Our profit after tax surged by 74% to INR 1,145 million during this period. In the fiscal year ending March 31, 2024, Yatharth Hospitals experienced notable advancements. Our expansion strategy, encompassing both organic and inorganic approaches, saw a significant milestone in February 2024 with the execution of a definitive agreement on the complete acquisition of Asian Fidelis Hospital in Faridabad, Haryana, now rebranded as Yatharth Hospital Faridabad. This strategic move, with the purchase consideration of INR 1,160 million, underscores our commitment to growth through inorganic mode and is in line with the commitment to acquiring one hospital each year through financial year 2024 to 2026. This share purchase agreement was completed on March 28, 2024, and the hospital was operationalized on May 12, 2024, thus expanding our presence in the North India region, particularly strengthening our presence in the Delhi and NCR markets. Throughout our hospital network, we have observed a consistent uptick in occupancy rates. Achieving an overall level of 54% for the fiscal year, our Noida Hospital stands out with an impressive occupancy rate of 89%. Furthermore, our Greater Noida facility has seen an increase in occupancy to 67% now. We anticipate this facility to achieve optimum utilization in this fiscal. Our Noida Extension has been growing rapidly, with current utilization reaching 44% versus 31% in the previous year, and this facility will be reaching optimized occupancy levels by the next year. Furthermore, our Jhansi Hospital is progressing well, with an occupancy rate of 34% in Q4 2024. As we continue to ramp up operations and enhance services offering, we expect to see continued growth in occupancy at our Jhansi Hospital. In summary, the quarter has been marked by impressive double-digit growth across most of our specialties and super-specialties. As part of our strategic realignment towards super-specialty treatments, we have observed a steady decrease in our share of internal medicine and a positive impact on our consolidated ARPOB levels by an increase in the high-end super-specialty departments. Among all hospitals, Noida Extension Hospital registered the highest share of revenue coming from super-specialties, and thus witnessing the highest ARPOB level of INR 35,074 during the quarter. I would like to hand over the call to CFO, Mr. Pankaj Prabhakar, with the financial updates for the quarter. Over to you, Mr. Pankaj. Thank you. Good afternoon, everyone. I am pleased to announce that Yatharth Hospital has achieved industry-leading growth in revenue and profitability during the quarter and full year ended March 31, 2024. Let me take you all through the quarterly performance first, followed by our annual performance. During the quarter, Yatharth Hospital achieved a revenue of INR 1,777.5 million, reflecting a substantial YoY growth of 24%, driven by an improvement across most of our specialties and higher ARPOB levels. Our inpatient revenues were up by 23% YoY, while outpatient revenues witnessed an improvement of 26% YoY during the quarter. Our company reported an EBITDA of INR 465 million for the quarter, up 21% YoY, while our margin stood at 26.2%. Our profit after tax exhibited remarkable growth of 121% YoY and 30% quarter-over-quarter to reach INR 383 million, primarily attributable to lower finance costs during the reporting period. As mentioned earlier, we are witnessing the full impact of debt reduction, which has reduced our finance costs by 93% YoY. During the quarter, we have secured a debt of approximately INR 800 million to facilitate the transfer of pending debt liabilities associated with the Asian Fidelis Hospital onto our books. This strategic move allows us to enhance cash efficiency for allocation towards other growth initiatives. That said, we remain committed to prudent financial management strategies and optimize our capital structure for future endeavors. As a result of our strategic initiative, our net margin expanded significantly by 953 basis points YoY and 390 basis points quarter-over-quarter, reaching an impressive 21.6%. Our average revenue per occupied bed (ARPOB) for the quarter was INR 29,266, up by 6% year-over-year. The improvement was driven by a consistent shift towards higher complexity procedures observed across various specialties, with gastroenterology, pulmonology, orthopedics, and oncology emerging as key drivers of growth. Furthermore, our bed occupancy for the quarter reached 57%, making a significant improvement compared to 49% in quarter four FY23, indicating enhanced operational efficiency and utilization of our facilities. Let me now briefly touch upon the consolidated full-year numbers of the company. Our revenues grew by 29% YoY to reach INR 6,705 million. Our inpatient revenue demonstrated a solid 30% YoY growth, while outpatient revenue witnessed an increase of 20% YoY. Our EBITDA for the full year remains at INR 1,779 million, up by 35% year over year, with margin expanding by 113 basis points to arrive at 26.8%. Our profit after tax increased by 74% YoY to INR 1,145 million, and net margin stood at 17.1%, expanding by 443 basis points. With our constant endeavor to shift towards more super-specialty treatments, our ARPOB for the full year is INR 28,571, an increase of 8% year-over-year. Our Noida Extension Hospital delivered the highest ARPOB of INR 33,994 for the year, witnessing an improvement of 12% year-over-year. Bed occupancy for FY24 stood at 54% versus 45% for FY23. During the quarter, the revenue contribution from government business remained on the higher side, at around 40% of our top line, which, coupled with the rise in outstanding receivables from government entities amidst elections, resulted in high receivables during the year-end. We are in touch with the department and expect receivables to come down significantly by the coming quarter. Our balance sheet continues to be strong, with a net cash position of INR 1,556 million. We remain dedicated to deploying these funds strategically to drive further growth and value creation. Our returns indicators remained healthy, with ROCE at 32% and ROE at 22% despite an expansion in our capital base. As we progress, we are well positioned to capitalize on the opportunities ahead and drive sustained value creation for our investors. Thank you for your trust and continued support. With this, I would like to hand it over to the moderator 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 one on their touch-tone telephone. 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. The first question is from the line of Pujan Shah from Molecule Ventures. Please go ahead. Sir, may I request you to please use your handset? Yes. Am I audible now? Yes, sir. Please go ahead. Sir, my first question would be on the Jhansi Orchha Hospital. Just wanted to know, in terms of ARPOB, if we are looking on a YoY basis, it has been degrowth. We are seeing a degrowth of 30%, while occupancy has been improved at 62%. Just wanted to know what we are visioning about this hospital and how we have been evolving, and what our expectation limits to for the next one to two years. Sir, for Jhansi Orchha Hospital, the occupancy has shown good growth. If we talk about ARPOB, ARPOB is increasing because some of the government-scheme business that we're doing in this hospital that we recently got aggregated with. In the last earnings calls, we mentioned that some departments like ECHS, railways, and Ayushman have been onboarded in Jhansi Orchha Hospital. With the occupancy of those government schemes increasing, ARPOB in those departments tends to be lesser. That is why there's a dip in the ARPOB. Overall, we are happy with the increase in the IPD volumes there. We feel that in the coming quarters, this hospital, in terms of occupancy, will rapidly increase also. Okay. So, any broad idea about what ARPOB we can achieve over this specific facility and what we can guide about in the next 1-2 years for this facility? I think ARPOB should be on an increasing trend in a year to a couple of years in this facility, reason being that now, as we have these government panels on board, now it is also giving us the chance to fully operationalize our critical care and ICU beds. And now, all the doctors there are complete. So, we feel that in the coming quarters, as our volume of critical care patients in Jhansi increases, the ARPOB should increase much further. And also, just to add, if you see the super-specialties business are growing in Jhansi. So, this year would be the much more numbers we'll achieve in terms of super-specialty, which we want to add in our ARPOB. So, anything by this financial year, I think you will see a good ARPOB by the second or third quarters, probably. Okay. Got it. As on the commentary, we have said that we will try to add one hospital or one facility each year by FY 2026. So, let's suppose if we conclude, we can say that we will add two more facilities in the upcoming two financial years. So, any broad idea on what our Capex would be and what cost per bed we are eyeing in terms of and third, which area we have been looking to for acquisition of new facilities? Right. So, we are looking in the areas of primarily North India. And that too, if I talk about outside of Delhi and NCR market and Uttar Pradesh, Madhya Pradesh, Haryana, these are the areas where there's still a lot of potential, we feel, as the population is growing, urbanization is happening in these areas. There's a huge scope for good super-specialty hospitals. And there are a few hospitals that we are eyeing for acquisition in these areas. As far as the CapEx per bed is concerned, see, if you look at it, recently, we acquired the hospital in Faridabad. And it is when we expanded and we added medical equipment to it. So, we are paying roughly around INR 150 crores for a bed capacity of close to 200 beds. So, coming to the CapEx per bed of INR 60 lakhs-INR 70 lakhs, roughly. So, this is what we feel would be a similar CapEx per bed if we want to acquire an existing facility. But then, obviously, there are some options that are available on O&M, on lease model. That is something also we are exploring. Okay. So, just wanted to get a brief idea on the acquisition of the 200 beds of Faridabad. So, if we consider the total cost, it's INR 116 crores plus the machinery expense, which we have spent. So, on INR 116 crores, it seems a bit cheap compared to when we are looking at the similar facilities in the same area. So, we get a very good deal about this thing. So, just wanted to know, how was the hospital structure well before we have been acquired too? And what do we need to get ramped up on and on more than INR 150 crores? We need to spend anything else for this specific facility to keep running on? No. So, I think that is the total amount. I don't think INR 150 crore is the right amount that we feel for overall CapEx plus the purchase of this hospital. And primarily, that involves the robots that we are putting up. In fact, last week itself, this hospital has been commenced operations. And we have already placed a surgical Da Vinci X robot there. So, most of the CapEx is being done there, and some little is pending. And we feel that this hospital should ramp up very well. Faridabad in itself, being a huge hospital market, the drainage from the surrounding areas, including Mathura, Palwal, Sohna, is huge in Faridabad. So, we feel that it's a good catchment area. Plus, this hospital already has healthcare insurances and some of the government empanelments from day one. So, that is really helping us to ramp up the occupancy in this hospital in the coming quarters. And another point is the doctors that are available in Faridabad. And the doctors who have already joined us in this hospital when this commenced operation this month itself, these are some star doctors that we feel have a good clientele along with them. So, we are very optimistic about this hospital, and it should ramp up in occupancy very, very soon. Okay. Okay. Got it. Got it. Thank you so much, sir. I will turn back into you. Thank you. The next question is from the line of Deepak Singh from Barclays. Please go ahead. Yeah. Sir, congratulations for posting such a wonderful number. So, I just wanted to ask, for the next three-five years, can we expect this revenue like 40%, which you are growing for the last 40%? So, can we expect for three-five years, next three-five years? See, we have had a revenue growth of 29% year-over-year basis and an EBITDA percentage of 35% growth year-over-year basis. We feel quite confident in sustaining this growth for the years to come. We have occupancy ramp-up yet remaining. We have ARPOB that is growing on even quarter-over-quarter. So, we are quite confident of maintaining the growth margins that we have shown in the last few years, in the years ahead to come also. Okay. Are you planning to open a hospital in Bihar somewhere there, or you are targeting only Delhi and SER and Haryana? We are looking at North India. That includes Uttar Pradesh, and on the border comes Bihar. If there's a good opportunity there, it does sort of come within our territory of expansion. We will look into it. We have some leading doctors who belong to those regions. If there's a good opportunity available there for acquisition, that is something we will look out for. Okay. Thank you. Thank you very much. Thank you. The next question is from the line of Sumit Gupta from Centrum Broking Limited. Please go ahead. Hi. Am I audible? Sir, may I request you to please use your handset? Yeah. Am I audible? Sir, can you come near to the mic and speak, please? Yes. Is it fine? Yes, sir. Now it's loud and clear. Okay. Sir, I just want to understand about the receivables part. So, it is short of a lot this year. So, just want to understand a bit on that. Yeah. So, receivables have gone a bit up. The reason being that, as Mr. Pankaj mentioned in the commentary, there has been increase in the government business. So, earlier, it was close to one-third. And in the latest quarter and now, the fiscal has gone to roughly very close to 40%. So, with the government business increasing and also some delay from the segments that we receive money in, that is the reason receivables have gone up. And primarily, if you look at it, these are three government schemes. So, one is ESI, second is ECHS, and third is CGHS. Primarily, the debtors that we have are in these three government schemes. And yes, maybe because of the elections here, maybe because of the coincidence in quarter four, the payments have been slow from the government side. We feel, as government has displayed in the past, that in the coming quarters, this should normalize very soon. That's the reason for the receivables going up. Okay. So, just want to understand about the payer mix over the next three-five years. How do you see that panning out? Government scheme coming down or insurance catching up? So, just want to understand on payer mix. See, we've also mentioned this earlier, that we are focusing much more on increasing our ARPOB. Focusing on the payer mix and optimizing that is not something we are thinking right now, as long as our ARPOB is increasing. So, another reason why the government business has increased recently is because of oncology starting. We have started radiation oncology. And so, that has also led to an increase in our medical and surgical volume. Now, oncology has good rates in CGHS and government. So, this is why it's okay to take government business when it comes to oncology and high-end super-specialties. So, as long as we are increasing business in those super-specialties like oncology, like transplant, and ARPOB is increasing, we are fine with the payer mix. But yes, we also do expect our healthcare insurances and cash patient segment to increase at a faster rate, given the brand recognition among this area and given the leading star doctors that are now in the pipeline to join us from the coming quarter onwards. Understood, sir. So, just one last question. So, if I look at the OCF to EBITDA conversion, so it is very low, just want to understand. Not for this year, but over the last three to four years. Just want to understand on that part. Why? Can you repeat? What is low? What to? Why is it low OPD to IPD conversion? Right. Well, ARPOB is increasing. I'm not following your question properly, Sumit. This is Deepak's side. Particularly, overall, if I compare it to the peers, so it is lower with respect to the ARPOB in the Delhi and NCR region only. So, just want to understand on this part. Why is the EBITDA to OCF conversion lower? Well, one thing, because the cash accumulation is low. One reason Mr. Tyagi did explain to you, because there is a significant investment going on on the debtor side. But if you are talking about the margins, the margins are pretty decent. Year-on-year basis, we are increasing. We are close to 27% now, which is around 200 basis points from the last year. So, yes, your question is right that how the EBITDA is turning into the cash accumulation. So, that's basically because in this year, not a happy situation. We are not liking it. And Mr. Amit Singh and Mr. Tyagi are working very hard to have these amounts realized as early as possible. But major, most investment of our operating cash flows are getting onto the debtor side. And that's why you were saying that the cash accumulation is slow. Understood, answer. So, sir, over the next three-four years or at least two-three years, how much EBITDA margin expansion do you see? EBITDA margins, we are quite good in terms of EBITDA margins are concerned. We expect the margins to be sustainable because, as our even though new hospitals are coming up, but there's still a lot of occupancy growth that is going to happen in our existing hospitals of Greater Noida Noida Extension. So, overall, EBITDA margins are quite sustainable even in the next three to four years that we have currently. Understood. Okay. So, last question on the ARPOB. So, basically, you were saying you are not focusing on improving the payer mix. It will be just on the basis of case mix as well as introduction of robotic surgery. So, that will lead to growth in ARPOB. Is it fine? Yeah. It's absolutely fine. So, as long as it's not hitting us badly. See, if you look at it, we have a bed capacity. And then, month-on-month, our super-specialties are growing. So, I think we are okay with this current mix as of now. Understood. Thank you, sir. Thank you. The next question is from the line of Tushar Manudhane from Motilal Oswal Financial Services. Please go ahead. Yeah. Thanks for the opportunity. Sir, just on the Noida hospital per se, we are now almost at 89% occupancy. Even the Greater Noida, we are at 67% occupancy. So, any scope to add more in terms of ICU beds so that we are able to have better realizations in these hospitals? So, first, we'll take Noida. So, as you said, 89% occupancy. So, only the first thing is that there is no bed capacity available that we can add. There's no space where we can increase our ICU beds or any of these things. Only thing Noida want to give us the growth is about the changing of the specialty and revenue mix. So, if you look at it, even IPD revenue and OPD revenue, the per-person realization has increased. And that is what we were working on. Coming to Greater Noida, yes, we are as Yatharth said earlier, stated in his commentary, that the 200 beds we are adding in Greater Noida. So, as of now, Greater Noida is still 67% occupancy. Still around 12%-15% occupancy is there. I mean, left that inventory is there. Adding a 200 beds is going to give us a good flexibility to add more critical and super-specialty beds. Understood. So, considering this and, in fact, even Noida Extension has a scope to expand the bed capacity. So, if I have to factor this, then how much of CapEx we will do in FY2025 and 2026? So, the CapEx that we have taken for the expansion of our existing brownfields because it's not a greenfield expansion, it's brownfield. So, we feel INR 60 lakhs-INR 65 lakhs per bed CapEx is required in terms of both Noida Extension and Greater Noida hospital coming up. So, if you know INR 65 lakhs approximately CapEx per bed for 450 beds, so that's there. And yes, again, for acquisition, as I mentioned earlier, that CapEx would be somewhere around INR 70 lakhs per bed that we're looking out for. Depends upon the number of beds of acquisition that we're going to add. Understood, sir. Lastly, sir, what kind of valuations, if at all, first of all, on the strategy in terms of acquiring, like the earlier in terms of earlier cases, you have done acquisition where the hospitals were sort of built but were available at a very good or compelling valuation. How do you think of acquiring subsequently now in the coming years? Are there any availability or now you have to pay premium? So, I mean, so far, we have acquired assets at a fairly reasonable valuation. And when I said that somewhere around INR 60-70 lakhs per bed Capex is what we look at while looking to acquire a hospital, so that sort of gives a fair value estimation. But see, it is for us also depends a lot on the area and what is the catchment. It is just not that we are looking at a certain valuation. That is what propels us to do an acquisition. It has to be fit in our overall strategy. And we have always had this strategy. We have been present in the areas which are growing, where the population is growing and which is catering to outskirts and nearby huge drainage areas. So, that is also key. And this is why Faridabad, we feel, has a huge drainage. This area of Greater Faridabad is coming up with a lot of societies, population increasing there. So, there are other factors that also go into when we decide an acquisition, not just the valuation. And we feel if those factors are catering to play, we can always look to increase and decrease certain valuation depending upon the geography that that hospital is located. Understood. Understood. Thank you, sir. Yatharth Manudhane. Thank you. The next question is from the line of Dhruv Bhatia from AUM Fund. Please go ahead. Yes, hi. Can you hear me? Sir, can you come near to the mic and speak, please? Yes. Can you hear me now? No, sir. May I request you to please use your handset? Hello? Yes, sir. Now you're audible. Sir, congratulations. We have a good set of numbers on the P&L. But the balance sheet doesn't look too good because if I analyze between 2023 and 2024, your sales have gone up by INR 150 crores. But your debtors have gone up by INR 120 crores. So, the operating cash flow after working capital changes is zero. Though you have a very healthy EBITDA, in terms of cash collection, has been almost negative from operations after working capital. So, I'm not understanding that even if I take 33% of your last year's sales going to the government where you have a receivables issue, and this year, it's increased to 40%, the sales to government have increased by INR 120 crores. And the debtors have also increased by INR 120 crores. So, basically, for your incremental government sales, you have not collected at all. Is that the way to understand it? No. So, I mean, definitely, there has been an increase in the government business and some delay from those payments side. That's one aspect. And also, the other of the total debtors we have, that also includes some private insurances also, some TPAs. So, overall, is what you see. Yes, a minority would be in the private insurances side. A majority would be on the government side. But that is how it's coming up. Yeah. On the P&L, it's looking very good. On the operating cash flow side, the performance has been pretty poor given that almost the entire incremental sales, INR 150 crores, usually INR 120 crores has become debtors. Can you provide us some sort of aging for these debtors? They are due for how long? You have INR 220 crores out of debtors? See, the total debtors we have, as I earlier mentioned, these are primarily from three government schemes: ESI, CGHS, and ECHS. These three government schemes have a UTI portal, which is an online website where each detail of each patient is visible, with the exact amount. And on the UTI portal, there's also a mechanism where you can see at what stage the government is checking the bill and what stage the funds are about to be released. So, there's usually stage one, stage two, stage three. All these three stages are available on the UTI website for our debtors to see. And we feel that with the oncology business increasing, that is and coupled with the slow payment from the government, it has increased. But it is only a quarter for reflection, which is reflecting the overall year-end balance sheet. As we proceed further with the new financial year coming up with quarter one, quarter two, this debtor will significantly come down, as always does with these three government schemes. Plus, with the addition of cash and insurance revenue increasing, we are quite confident in the coming quarters that revenues that are being generated in terms of the cash flow would be at an optimized and at a good level. Sure. Good observation. But numbers are to be seen. See, you were saying that there is an increase from INR 180 crore to INR 227 crore. But you have to appreciate that in the same time, the revenue has also grown up by 30%. So, even if you take the same thing, that number should have been anywhere between 145-146 kind of thing. So, if you subtract that, it would be in the range of. I'm not saying that debtors have not gone up. But saying that the entire revenue generation has gone into that, that's not correct. So, there is a question that what is this INR 80 crore kind of thing is coming? And as Mr. Tyagi mentioned, that there is a slackness from the government side, and it happens. At times, the government comes and they release the fund, and immediately, the debtor inventory comes down. We are cognizant of the fact. We are basically putting it across very clearly that we are working very hard, and we are trying to bring this down. There is a significant effort on our top-line side, on our profitability side. The same impetus we are putting onto the debtors' collection as well. But debtors' increase is to be seen in the light of the increase in the revenue as well. It's not in the absolute numbers only. So, sir, I've looked at that. Sales have increased by INR 150 crore, and debtors have increased by INR 120 crore. I am looking at the increase as well. That's why operating cash flow after working capital changes is negative. Yes. As we said that in the coming quarters, operating cash flow will increase as the debtors will come down. We are in contact with those departments. You will see a significant change in the cash flow from the coming quarters ahead. Okay. Thank you. Thank you. The next question is from the line of Srirama Amana from PNA Capital. Please go ahead. Yeah. Am I audible? Yes, ma'am. You're audible. Yeah. Yeah, sir. Hi. Congratulations on a good set of numbers. You all have been very consistent since IPO time. So, my first question is, what has been the payer mix for FY2024? So, the payer mix, as we mentioned, that the government category is very close to 40% now in terms of the total top line. And the remaining is then equally divided between cash and TPA segment. So, somewhere around, let's say, 33% for both cash segment as well as the private insurances segment. Okay, sir. And my last question is, I think last quarter, we saw that the Supreme Court was talking about standardization of rates in private hospitals. So, how do you see this? Is it going to benefit us, or how do you see this? If and so, if this law is implemented, how do you see this going forward? So, I mean, so this already the body of the private health segments, AHPI and NatHealth, has already made the representations. And I think recently, if you've heard that the Supreme Court had sounded observation about the PIL filed by the [Association of Surgeons of India], then said that it's not practically possible to have a same rate across the specialties and across this thing. So, it's a matter going on. And we are pretty confident that observation will not be, I mean, applicable for an across same rate for across this thing. So, we are not worried at that. Okay, sir. Okay. Okay. That's all I had. And congratulations, and all the best luck for the next financial year. Thank you. The next question is from the line of Prateek Poddar from Bandhan Mutual Fund. Please go ahead. Yeah. Hi. I have two questions. Sir, why are we going to look at our? Sorry to interrupt you, sir. May I request you to please use your handset? Is this better? No, sir. Your voice is very less. I hope this is better, right? Yes, sir. Please go ahead. Okay. Just one question. When I look at ARPOB for Noida Extension, on a YoY basis or let's say even on a QQ basis, the expansion is not material versus the case mix where oncology has become 10%. So, can you just double-click and help me understand as to why that has happened? Because oncology, I would have thought, would be at least 2x of the base ARPOB. And to that extent, the numbers look slightly muted, at least in the Noida Extension side. No. So, if you look at it, last year, the Noida Extension ARPOB was close to INR 30,000. And if you look at Q4 of this year, that is very close to INR 36,000. So, that is an increase of roughly more than 5,000 in that. Yes, in the overall year, the ARPOB looks a bit less than that. But if you look at the Q4, that is where the significant volume of oncology has come up. So, this is why we feel confident. And now, with the new fiscal and new quarters coming up, this is much more there'll be much more visible. And an increase of INR 5,000 of an ARPOB is primarily because of the shift in the case mix. Yeah. But when I look at it sequentially, right, it's just gone up from INR 34,000 to INR 35,000. And you are saying that in Q5, we have seen a material ramp-up of oncology. So, in that case, the ARPOB should have increased further, right, isn't it? And even on a YoY basis, if I see exit to exit, which is Q4 FY 2023 to Q4 FY 2024, the number is 32,173 to 35,000. So, it's just an INR 3,000 increase. So, slightly puzzling over here. So, we feel that this amount of increase, it is significant when it comes to these treatments. And then you have to also see in line that when these treatments have recently started, the volume that they have to generate. So, medical and surgical oncology is what we were doing earlier, right? And that is what the government business has increased in. But when it comes to radiation oncology, that is what boosts up ARPOB quite a lot because it is mostly on an OPD basis. That radiation line has just started in Q4. So, once those volumes increase, that is where you also see much more impact. But the impact that we still feel, if you compare it with the group average, what we're doing there and this, so I think we are on the right track as far as the ARPOB increase in Noida Extension is concerned. And I am quite confident that in the coming quarters, this ARPOB in Noida Extension will even touch INR 40,000. Understood. Thank you. Thank you. The second question is, with insurance, has there been any change in card rates? Have you gone on for any increase in FY25? Yeah. So, for one of the hospitals, because once you freeze the rate, the two years, the rates are frozen. So, this year, we had a negotiation for our Noida Hospital. I think three months back, we did that. So, in the impact, we will see. And probably next year, we'll have a Greater Noida and Noida Extension. How much was it, what the increase for Noida Hospital, sir? Sir, totality, I think it's difficult to say because it's 135-odd procedures are being discussed and got the rate. But I think anything we're doing, it will have an impact of 6%, 7%, 8% kind of impact will come. And because there is an annual revision of the rates as well, every hospital does it. So, we have also had some corrections of our own SOC. So, it will also have some impact. Got it. And just last question on the debtors. I think it has been asked multiple number of times. Is this slightly seasonal because of elections that you are seeing an increase, or this is a year-end phenomena? Or how should we think about the increase in debtors? Is this something which will always happen, that in quarter four, you will see a rise in debtors, and then it liquidates in quarter one, quarter two? That is the way to think about it as long as your payer mix remains at 40% from government? No. I think even at a payer mix of 40%, the debtors should come down much lesser. It could see, as we said in the commentary as well, that elections could have an impact on this. It's a very quarter-on-quarter. It really depends upon when the government is getting funds. Sometimes, in March itself, some funds are released, sometimes in April. It's a very subjective thing, the government payout that is supposed to be. We are pretty sure that this level of debtors that are currently there should significantly reduce in the coming quarters. Since 45 days have been passed, can we assume that there has been some liquidation to the numbers which have been disclosed as of 31st March? Definitely. Definitely. There's been a reduction in that. But because we can talk about the full fiscal but and that's why I'm saying a significant decrease you will see in the coming quarters is based on that same thing. Okay. Thanks. Thank you. The next question is from the line of Jayesh Shah from OHM Portfolio Equi Research. Please go ahead. Hi. Thanks for the opportunity. Am I audible? Yes, sir. You're audible. Okay. I think the first question is, again, on the debtors' issue. What are generally the payment terms for government and insurance? So, for the government, usually, anything between 90-120 days, I mean, that's kind of the agreement, right? And for insurance, it goes around 45-60 days. So, this is what the on a paper, right? But we have seen it, particularly the government side, if you see it, once they start to give you payment, that's at one go I mean, there's so many backlogs get cleared. So, sometimes, it's a two, three months, four months delay. We have experienced this in previous years as well. So, I don't think so. But this next coming 2 quarters, I think you will see a drop in these numbers, right? But yes, I think we are keeping an eye on it. And the team is working to see how to reduce this number. Are you able to confirm to us how much has got liquidated till now, which is 20th May, out of INR 220 crore? So, that is something, I think, that can be a detailed share. It would not be right to share on a public call like this. But when we're saying that in the Q1 of the new fiscal, there will be significant reduction in the debtors, so that is yes, some liquidation have already started happening. I would request this is a very important key number. So, if you share publicly, I'll appreciate it. Otherwise, I would like to get this offline. Sure. Okay. We'll reach out to you this time. Okay. Secondly, out of those INR 220 crores, how much of debtors are more than six months? Well, for that, often, I'm not remembering. But yes, because the accounts are being done, so we will be uploading our full balance sheet. We'll share that offline with you, and then we can speak out to you. In a interest of time, we will share it. Okay. Okay. Because of this debtors' level that you have on the government business, what is the price difference between what you sell on cash or insurance versus government? So, usually, typically, the cash rates are so, let's say, private insurance rates are somewhere close to 15%-20% lesser than the cash rates. Then even the government rates from the private insurances would be 10%-15% lesser. So, roughly around, I would say, 25%-30% lesser is what government rates are compared to a cash rate. But then, of course, that also depends upon the case mix. So, as we said, the reason why we are okay with doing this business now is because our super specialty, especially oncology, when that increase, in oncology, the rate difference is not 30%. It is much, much lesser than that. So, that's how the government business works. Understood. Understood. In your own targets, over the next one or two years, this government business, will it continue to be between 30%-40%, or it should come down? It should come down. It will come down. See, today, we have occupancy to ramp up, right? We can take it. But once it's given a choice between a cash and insurance patient, and if you have restriction on the number of beds, then priority is always given to other segments. Jayesh, yeah, I would add. So, as of now, we have got negligible share of international business as of now. And we have set up a dedicated team, so there should be traction in that, which should automatically bring up the cash category business and reduce the government share. And we are pretty confident we have hired the best team in that department. So, you'll see those results flowing in in the quarterly numbers. Fair enough. Fair enough. I get it. Lastly, what is the annual rate hike that you would normally get? Is it higher than inflation as to 9%-10%? Because you just mentioned about some annual increase that you get in our hospitals. So, the cash patient, if you see, as I stated earlier, so every year, there are the corrections on the Schedule of Charges which you do. It depends on the services and the kind of utilization and also the various your competitive analysis, what you do it. But I think roughly, so it has various factors. When we change it, that's not only the inflation. So, I think roughly, I would say 6%-7% can make an impact on the cash patient, 6%-8% kind of. Okay. Okay. On insurance and government, do you get annual increase, or how the rates are being held? So, insurance, it totally depends on there is a one-to-one negotiation happens with the, it's GIPSA who does negotiation on your current card rate and your previous the GIPSA rate, right? So, keeping those two rates in mind, and then you have a negotiation, and you try to get the by showing the good volumes and others. So, this is how the negotiations happens. I see. They're normally for what, for a period of two-three years? Sorry? Come again? Are the rates fixed for two-three years for insurance? Two years. Two years. Two years. But they're two years for a GIPSA, for a government insurance company. For private insurance, totally depends on one-to-one negotiation, be it one year or two year. It totally depends on your discussions with them. Right. Right. Right. I guess, yeah, I think that's it. Fantastic numbers in a way, which is why you have more questions coming on the cash flow because your profits have not really got converted into cash flow. But hope to connect with you offline. Thank you and best wishes. Thank you. Thank you. The next question is from the line of Rohan Advant from Multi-Act Equity Consultancy. Please go ahead. Yeah. Thanks for the opportunity. Just one question on the margins. If I look at EBITDA margins, sequentially, they have come down a bit in spite of a good sequential pickup in the revenue. And that's largely led by, I think, the increase in consumables. So, what has caused this? Is this the payer mix that has caused it or something else? So, the margins is a point here and there. It's not that of a significant difference. But yet, yes, there has been increase in the material consumption consumables. That is because now we are, as we are shifting towards more specialized treatments like transplant program, oncology, cardiac. So, more consumable cost is required for these specialized treatments. And that is one of the reasons for just a minor dip in EBITDA margins. We are confident that we still feel that these EBITDA margins are at an optimized level, and these should be sustainable in the quarters ahead. Okay. So, next year, we'll have the new 200-bedded hospital that we've acquired coming up. So, there could be some upfront cost there. But in spite of that, this 27% kind of EBITDA margins for FY25, you think are sustainable? Yes, quite sustainable because the existing other hospitals that we still have the occupancy to ramp up, their EBITDA margins will grow. So, in overall consolidated level and group, the margins would be sustainable. Got it. Thanks and all the best. Thank you. The next question is from the line of Madhav Agrawal from SG Investments. Please go ahead. Hello. Yes, sir. Hi. Thank you for the opportunity. Could you give some guidance on how we are seeing the Asian Fidelis to ramp up during the current year and the next? So, we feel that the ramp-up should be very, very soon there, this hospital that we have just started this month itself, in the month of May. And all the doctors are already recruited there. We are just waiting for the cardiac machine Cath Lab because that is something it was not having earlier, as well as an MRI. That is why we did an additional CapEx of close to INR 25 crore. So, only those two machines are remaining to reach the hospital. And then the full cardiac, as well as the radiology department, will be ready there. So, we feel that because the healthcare insurance is already there, some star doctors are there, this hospital should ramp up very, very soon. And we are quite confident about the geographic area, about where the hospital is located. Okay. What kind of occupancy are we targeting for FY2025? See, I think the hospital where it is, we already have a strong brand presence there. Faridabad is one area where we are also quite present in the ADNCA market. So, some of our doctors are from there. Some of the patients are already coming to another hospital from Faridabad. So, we feel the occupancy there should ramp up very, very soon. Let's say what we feel is what Jhansi is able to do in a couple of years in occupancy, we feel that Faridabad should be there much, much more earlier than that, probably in a year. So, we feel quite confident on the occupancy at Faridabad Hospital. Okay. Also, could you tell me what's been the improvement in our international patient volume over the? The international patient volume has been increasing given the fact that we have done around 150 kidney transplants. And in the last year and a half, and 90% of those kidney transplants are international patients. We are now also targeting international liver transplant, international bone marrow transplants. Already, infrastructure has been renovated to cater to those patients. There's been a new professional marketing team for international patients that have been recently joined us from a Delhi-based hospital. So, we feel that in the years to come, international patients should be contributing close to a double-digit contribution in our overall revenue. And we are quite confident at this time that that is what we are targeting in the time ahead. Okay. What kind of steps are we taking to change our payer mix since we have a significant share of the government business, around 40%? What would be our aspiration three to five years down the line? As you have just said, these numbers as a government business, it's around contributing 35%-40% as of now because we have a bed capacity there. So, as these bed capacity is going to come and more and more super specialty see, if you look at it, what we have said that at the Noida Extension Hospital, it's a story of around 20-24 months only. And that's the kind of super specialty if you see. So, word of mouth is spreading very rapidly. That catchment area has grown really far. So, we expect that as we move into the tier two and tier three cities and patients coming from those regions, and those patients are mainly, if you see this, for cash or TPA segment. So, in fact, our up-country marketing and the kind of couple of OPD centers we are setting up in various parts of the country. We believe that this segment is bound to grow. Since these two segments will grow, and the third segment will automatically go down. As of now, it is not significantly impacting. That is what I think you see in this number. Okay. So, my last question would be, as you mentioned that we are planning to add a hospital every year for a couple of years going forward, how do we plan to fund those? Are we looking to take up some debt as well, or are we focusing on internal accruals to fund this? So, it'll be a mix of both. As our finance cost has gone down significantly, so the internal accruals are more now. So, I think we'll be able to fund it, a mix of that, as well as a debt. But I think overall, we still feel the because there's a strong cash position also at the balance sheet. So, overall, net debt, we'll still be net debt-free even with a certain little bit of debt. Okay. That's all from my side. Thank you so much. Thank you. The last question is from the line of Suneel from VK Investments. Please go ahead. Good afternoon, sir. Am I audible? Yes, sir. You're audible. Okay. So, I had a question. In your financial statements, there is a footnote mentioned where an income tax has frozen INR 70 crore of our amount and created a lien on the banks for that specified amount. I'd like to know that when was this done? And going forward, won't it affect our growth since our capital is going to be blocked? And for how long do you think would it be blocked? That is my first question. Yeah. So, we had already informed the stock exchange. In October 2023, we had people coming from Income Tax. So, they found that we had that because we were through with the IPO money and a lot of cash we had been having, which was basically for the specified purposes. So, in the scheme of things, they had kept this money. Now, this money is with us. They have not taken it away. It is still with us. So, it's not that they have taken this money away. Now, your second question that when are they going to settle it? We wanted to settle it. We had done our things with them. But interestingly, this investigation team, they said that they don't have any assessment, right? Government procedure. We can't help it. So, we are already with the next stage now on the proceedings. We have been told that because not much of the things were there, so very quickly, they haven't given the timelines that when they are going to pass it. But we expect that in this financial year, that thing should be behind our back. And this blocked money would be given back to us. So, at this point in time, it's basically frozen in our account. The account is still we are having. Not that they have taken the money out. Basically, the account is frozen, the money lies with you, but you cannot use it, right? We are not allowed to use that much of money. Beyond that, we can, pending the full assessment by the Income Tax. Would that not put stress on the working capital cycle because INR 70 crore is? No, no, no. No, no. See, the thing is, if you see our overall cash position, so we do have much more lying in our cash position. So, working capital is not an issue. Important is that we should settle the queries of income tax as early as possible and bring this money back into our system. Okay. And, sir, I'm aware of the October disclosure you all had made about the income tax search at your premises. But I would appreciate if you could have also put up a disclosure regarding the INR 70 crore freeze because this just came into the financial statements now. It's been quite a few months since income tax freeze. It happened post our disclosure. So, we were not aware that they have done it. We got to know it later because now we were finalizing the accounts. So, we thought that it would be that we should apprise our investor in the full light. You feel that it should be done in this financial year, the queries? Oh, yeah. Pretty certain. We wanted to in fact, the agencies who had done it, they said very clearly that they don't have any assessment power. So, that's why they cannot do the assessment. Otherwise, we wanted to close the assessment in this system and have this money back into our channels. So, they have not found anything suspicious, you are saying, but they have done it as a procedure. They have just frozen this amount as a procedure? Yes. Yes. Yes. Okay. My second question will be on the Faridabad. The OpEx cost will be higher for the next few quarters on this since you must be hiring or must have hired. Will it affect the margin in the nearby quarters? So, I mean, see, any new hospital starting does require a certain investment to be done until it's ramped up. So, as I said, that yes, I mean, even though we do feel that margins should be dragged a bit from Faridabad, but overall, because other hospitals are growing, at the consolidated level, it will still be sustainable. Okay. So, it won't really materially affect your margins going forward? Yes. Okay. Okay. That would be all, sir. All the best. Thank you. Thank you. As there are no further questions, I would now like to hand the conference over to the management for closing comments. Okay. I think, thank you to SMIFS. Thank you for all the people for your questions. We look forward to your next funding call. If any questions are there, you can reach out to us individually and offline, and we'll be more happy to answer. Thank you. On behalf of SMIFS Limited, that concludes this conference. Thank you for joining us. You may now disconnect your lines.