Home / Transcripts / Rainbow Children's Medicare Limited (RAINBOW) · July 31, 2026

Rainbow Children's Medicare Limited (RAINBOW) Earnings Call Transcript

July 31, 2026

NSEI IN Health Care Health Care Providers and Services earnings 73 min

Earnings Call Speaker Segments

Operator operator
#1

Ladies and gentlemen, good day, and welcome to Rainbow Children's Medicare Limited Q1 FY '27 Earnings Conference Call hosted by IIFL Capital. [Operator Instructions] Please note that this conference is being recorded. I now hand the conference over to Mr. Rahul Jeewani from IIFL Capital. Thank you, and over to you, Mr. Jeewani.

Rahul Jeewani analyst
#2

Hi. Good morning, everyone. This is Rahul from IIFL Capital. I welcome you all to the first quarter earnings conference call of Rainbow Hospitals being hosted by IIFL. From Rainbow, we have with us today, Dr. Ramesh Kancharla, Chairman and Managing Director; Mr. Abrarali Dalal, Group CEO; Mr. Vikas Maheshwari, Group CFO; and Mr. Saurabh Bhandari, Head of Investor Relations. Over to you, sir, for your opening comments.

Ramesh Kancharla executive
#3

Thank you, Rahul. Good morning, everyone, and thank you for joining us for Rainbow Children's Medicare Limited Earnings Call for the quarter ended June 30, 2026. The FY '27 has begun well for Rainbow. We delivered another quarter of healthy growth driven by sustained demand across all our core specialties and balanced contributions from both our mature and newly commissioned hospitals. More importantly, this performance reflects that the investments we have made in expanding the network, strengthening our clinical capabilities and building leadership across organizations are translating into consistent growth. Revenue grew by approximately 33% year-on-year, driven by balanced contributions from our mature hospitals and the new facilities. Our key operating metrics, including inpatient admissions, outpatient consultations and deliveries continues to witness healthy growth. We also maintained a healthy EBITDA growth of 29.9% year-on-year, supported by operating discipline, improving -- and improving the efficiencies. Our expansion journey also gathering further momentum with the signing of definitive agreement for 100-bed brownfield hospital in Malad, Mumbai. We expect the hospital to commence operations in Q1 FY '28. This marks our entry into Western India, an important strategic market where we see significant long-term opportunities. We're also strengthening our trends in Andhra Pradesh through the acquisition of 70-bed Prime Children's Hospital in Nellore, along with an additional 30-bed Maternal Care Block expected to commence operations in 6 months' time. We have also signed a long-term lease for a 50-bed brand-new hospital ready to operate in Guntur and this facility will commence in -- commence operations in a couple of months' time. With these additions, the bed capacity in our ratio reached to 500 beds. On the clinical milestones that we made -- on the milestones that made us particularly proud during this quarter was a successful rescue of an 8-year old child from Guwahati who are critically ill with the severe Influenza pneumonia and an acute respiratory distress syndrome with the ECMO being the only option for survival, our ECMO retrieval team flew over 1,800 kilometers to Guwahati, initiated ECMO and stabilized the child. Our team meticulously planned and executed airlifting of this child over 3 hours of flying to the Hyderabad Rainbow. The child remained on ECMO for 36 days before making a full -- remarkable recovery and return back to Guwahati. This mission time among the longest periodic ECMO retrieval undertaken in the country and it's a perfect example how the timely intervention and advance of critical care and the seamless multidisciplinary teamwork can transform what one seemed impossible into a life saving reality. We were humbled to receive an appreciation from the Honorable Chief Minister of Assam for recognizing the efforts of Rainbow in saving this child. In another case, defining all the odds, a 30-year old boy with an accident fall from 5th floor of residential building arrived in our emergency with a short notice. And rapid treatment assessment, the change from to being shock and into coma. He was assisted and commenced on ventilation will address in the short. Very soon, he was further discovered to have sustained thoracic iota care, lung injuries, pancreatic gooses, multiple fractures. Our cardiologists made an extraordinary decision to address the bleeding iota by placing a stent graft through angiogram. The bleeding stopped with a graft stent basement, the rest of the organs will be addressed by different themes subsequently. The child spent about 5 weeks in the hospital to meaningful recovery. Though it was a devastating and emergency, our team worked like effective choreographed show, this is how it appears once -- and the recovery when people presented in the clinical meeting. The [indiscernible] with a smile to present handmade hard work made by himself to the team of doctors. Extensive progress received for this big phase and also our team received a huge appreciation from the public. These challenges made us a robust and ready to deal with the most complex emergency case. Rainbow is now entering an exciting phase of its growth journey. Over next 5 years, we plan to add 2,500 beds to expand our network capacity to 5,000 beds through an estimated CapEx of investment around INR 2,200 crores. We already have visibility of 1,200 beds under various stages of development, giving us confidence in our expansion road map. Regarding our projects and progress, we are on track to commence operations in Indore hospital in Q3 FY '27. Our regional hub hospitals in Coimbatore and a spoke hospital in Gurgaon Sector 56 are expected to commence operations in Q3 FY '28, followed by our hub hospital in Gurgaon in Sector 44 in Q1 FY '29. Development is in progress with our Pune hospital of 150 beds and spoke hospital in Bangalore, [indiscernible] both are expected to commence operations in FY '29. We will continue to strengthen our established network across Southern India, while selectively expanding into high potential market across Western, Central and Northeast of India. Our entry into Mumbai marks an important milestone in this journey. We see significant opportunities to further strengthen our presence in the city over the coming years. Alongside our expansions, we will continue to strengthen our clinical systems, attract and mentor the best digital talent and build a strong medical leadership across the network so that every new hospital delivers the same standard of care across the group. With a strong balance sheet and a differentiated model and have proven execution capabilities, we remain confident of delivering sustainable growth and creating long-term value for on our shareholders. With that, I now hand over the mic to Mr. Abrarali Dalal, our CEO, before passing the mic to Mr. Vikas Maheshwari for financial update. Thank you.

Abrarali Dalal executive
#4

Thank you, Ramesh. Good morning, everyone. We have started FY '27 with strong momentum, delivering broad-based growth across our hospitals, while maintaining healthy operating margins. This performance reflects the strength of our differentiated care model and our continued focus on disciplined education, operational excellence and sustainable profitable growth. We have entered '27 with a significantly expanded operating footprint. Over the past year, our total bed capacity has grown by 26% to 2,435 beds, while our operational bed capacity has increased by 22% to 1,862 beds. This expanded platform, coupled with disciplined execution across our hospitals has enabled us to deliver growth while maintaining healthy operating margins. This reflects in our operating performance. Occupancy improved to over 41%, inpatient discharges by 28%, outpatient consultations by 25% and deliveries by 23%. We also delivered a 6% improvement in ARPOB while maintaining an efficient average length of stay. Together, these metrics demonstrate our ability to scale the business while improving productivity and operating leverage. Over the last quarter, we have worked closely with our hospital leadership teams to strengthen our operating rhythm through structured business reviews, sharper performance monitoring and greater accountability. These initiatives are helping us identify opportunities earlier, close operational gaps faster, and drive greater consistency across our hospitals, resulting in quicker decision-making and improved execution. I'm particularly encouraged by the continued performance of our newer hospitals, which are ramping up well and contributing meaningfully to the overall growth of the business. At the same time, we remain focused on seamlessly integrating our recently acquired hospitals into the Rainbow ecosystem by embedding our clinical protocols, operating systems and culture while steadily progressing them towards our profitability benchmarks. Technology continues to be an important enabler of this journey. During the quarter, we further strengthened our digital ecosystem through enhancements of our CRM platform, patient conversion capabilities and digital engagement initiatives. These investments are helping us create a more connected patient journey, improve operational visibility and enable faster data-driven decision-making across the organization. Another key point has been strengthening collaboration across our clinical operations, nursing, marketing and corporate teams as our network expands, sustained performance depends on every function working towards common goals with clear accountability and shared ownership. We have made good progress in building this operating discipline, and I believe it will become an increasingly important competitive advantage as we the scale. Looking ahead, our priorities remain unchanged. We will continue to drive profitable growth, accelerate the maturity of our newer hospitals, successfully integrate acquired facilities, strengthen our digital capabilities and execute our expansion pipeline with the same discipline that has defined Rainbow's growth over the years. Supported by a strong balance sheet and an experienced leadership team and a differentiated operating model, we remain confident of delivering sustained long-term growth and creating value for all our shareholders. With that, I now hand over Vikas for the financial update. Thank you so much.

Vikas Maheshwari executive
#5

Thank you, Abrar. A very good morning to everyone, and thanks for joining us today for the earnings conference call for the first quarter June 30, 2026. Our operating revenue is INR 470 crores, reflecting a robust 33% year-on-year growth, driven by healthy contribution from both our mature and newly formed hospitals. Our EBITDA for the quarter amounted to INR 134.6 crores, registering a 30% year-on-year growth despite the initial rating losses at the newly commissioned hospitals. We maintained a healthy EBITDA margin of 28.6%. This demonstrates the resilience of our operating model, disciplined cost management and ability to manage growth without significant stress on balance sheet or return ratios. Our profit after tax for the quarter stood at INR 62.5 crores, reflecting a 16% year-on-year growth. Operational performance remained a strong during quarter. Inpatient discharges, outpatient consultations and deliveries grew by 28%, 25% and 23%, respectively. This broad-based could reflect sustained patient demand across our network, including the acquired units and continued ramp-up of our newly commissioned hospitals. Our payer mix continued to remain balanced and resilient. Cash and insurance contributed approximately 48% and 42%, respectively, and remained consistent as in the past quarters. The company continues to maintain a strong balance sheet and healthy liquidity with cash, cash equivalents and the investments stands at INR 613 crores as of June 30, 2026. This provides us the strong financial stability and the flexibility to fund our ongoing capital expenditure program, support our expansion pipelines and pursue strategic inorganic opportunities while continuing to execute all planned investments through internal accruals. During the quarter, we invested approximately INR 56 crores towards capital expenditure, primary focused on expanding and strengthening capabilities across our existing hospitals and upcoming projects in line with our long-term growth strategy. With these remarks, I conclude my financial update. We will now be happy to take your questions. Thank you.

Operator operator
#6

[Operator Instructions] The first question comes from the line of [indiscernible] Asset.

Unknown Analyst analyst
#7

A couple of questions. Firstly, now that we are on 1,862-odd beds operational and given the pipeline that we have -- we are looking for after the acquisitions, is it right to understand that by the end of this financial year, our operational beds should be around 2,050 plus? First is that. And second is, if you can share the strategy we are looking for this year or next year further acquisitions? And given our presence that we are trying to build in North in India as well, so are we also looking for something, say, in Noida or something, say, in West near NCR region, say, Jaipur, that kind of...

Ramesh Kancharla executive
#8

Yes. I think the -- as I've kind of given the overall road map, I think we have a visibility of 1,200 beds. Those are the ones which have already been in execution phase. And we are also exploring the opportunities in the geography, what you clearly mentioned about Noida and the central parts of the India. And having find in Mumbai, I think this is the first opportunity for us to get into Mumbai. I think this is a great strategic move for us. I think the Mumbai, we believe it's a great opportunity for us to kind of expand ourselves to a larger network in the years to come. So this is how we look at it. And also, there is a lot of growth markets like in Bhubaneswar, Raipur and those we are exploring opportunities where there is a need of children's health care, where Rainbow can play a significant game. like we went in Guwahati doing very well. And we are trying to kind of strengthen our footprint further in the Northeast area. So once we get into geography, we'll try to play a kind of a larger game. This is how we do it because that is where we can actually have a better operating model and also kind of a clinical as well as operating model can actually be strengthened.

Unknown Analyst analyst
#9

Yes. So just a follow-up on the same thing. So I was looking from the churn perspective. So I think the strategy and the kind of work that we do in Child Healthcare it's tremendous. And I think the churn would be more from the perspective of how can we explore into a high, say, ARPOB or I don't want to quote in the terms of ARPOB, say, high in the terms of revenue models that we can do because if we see logically something like Gurugram when comes in or Mumbai when comes in or say something we do in Noida or some other territory like that, that eventually will lead to higher revenues per patient kind of thing for us other than what we can organically do. I was looking from that perspective. And also that should we see going forward, like the operational efficiency improves we can reach the higher EBITDA margins from here as well? Yes.

Ramesh Kancharla executive
#10

Yes. Certainly that when we go into the markets like the Gurugram, NCR, definitely, your -- the price points will do better, will do better. Abrar, you want to?

Abrarali Dalal executive
#11

Yes. So see, specifically talking about Gurugram and Mumbai, okay, Gurugram already is a very high up market because there are large players in multi-specialty there, you know who they are. And when we enter Gurugram, our large strategy is going to be around quaternary care. Our hospital there is going to be -- is equipped with high-end tertiary quaternary care like liver transplant, kidney transplant, we're going to do oncology. These itself are high ARPOB, high ARPP procedures. Also, Gurgaon is a large international market, international medical tourism market. And almost 10% to 15% of that market is pediatrics, which currently does not lie captured because there is no real expertise specialized pediatrics is there. So with that coming in, I think that is something that will happen. And we will see a lot of these pediatric -- international or medical tourism patients coming to us. So it is going to be a very higher market. If you look at Mumbai, again, our hospital being in Malad, and it rains almost Kandivali, Dahisar, Borivali. And there are only -- there are not -- there's not much -- there's a lot of need for specialized pediatric care in Mumbai. Rainbow comes with a very differentiated kind of an approach. We are outreach driven. We go and we look at transporting babies. So on Niku and our PIC will be very, very highly intensely operational in Mumbai. Again, these are high ticket, high ARPOB kind of procedures. So that makes us believe that Mumbai and Gurugram automatically will be higher for good markets.

Unknown Analyst analyst
#12

Great. That really helps. Just trying my luck on the last one. So now from next quarter, we'll have a higher base for the revenue part. Should we expect similar kind of at least mid-20s growth? Or should we look for lower number?

Abrarali Dalal executive
#13

See, I think we are -- as I said in my earlier speech that we are really leveraging our operational capabilities, digitizing, doing a lot of lead-driven conversions. I think the first quarter growth was very good, but we'll surely be in the range of 20s for sure in quarter 2, not less than that.

Operator operator
#14

Next question comes from the line of Prithviraj with Unifi Capital.

Prithvi Raj analyst
#15

I just have a couple of questions. The first one, a year back, we used to be predominantly in Chennai, Bangalore and Hyderabad. But now we got into Northeast, we have plans for NCR and then Mumbai. So how should we look at Rainbow, say, in the next 5 years, given that you have another 1,200 beds to be announced over the next few quarters? Is the company going to enter new metros in Northwest or it will add more of hospitals in South? So how should we look at the business model from geography standpoint?

Ramesh Kancharla executive
#16

Yes, the site is the country is one, for India. So -- and the opportunity is actually when you look at it overall, and there is -- the South is demand premium. North is an opportunity. That's how we look at it. When you see overall, about the northern 4 states, which is Uttar Pradesh, Bihar, Rajasthan and Haryana put together produces about 62% of the India's birth, which is about almost of 28 million babies who are being born. So obviously, that is a market where there is a need of children's health care. There is a need of acute care. So obviously, we need to explore much more significantly. And also the cities which we have been looking at it like Indore, Raipur and Bhubaneswar, all these cities are actually buzzling. They are actually growing significantly. There is a significant improvement in the economic status on those things. If you look at our multi-specialty players, people have entered into these markets have done very well. Obviously, we're being the leader in children's health care, for us, the boundaries is within the country for the moment. So wherever there's opportunity, we went to Guwahati. And I think what we were able to do is actually on an existing platform, we were able to build more capability. Now we are looking at a kind of make it much more larger multi-specialty hospital. And in future, in years to come, we'll try to do some spoke hospitals also. So it is an opportunity which geographically, there may be difficulties in operating models. But of course, we do understand cognizant with that difficulties and we try to play our -- our playbook.

Prithvi Raj analyst
#17

Okay. That's clear. And just a follow-up on this. So does this mean the payer mix will eventually change as you get into new geographies because right now, it's predominantly cash and insurance. But to get some footfalls in new geographies, will you consider looking at government scheme patients at some point of time?

Ramesh Kancharla executive
#18

I think the -- this is -- we are working on it. I think when there's a capacity, there is excess beds are available, and we are exploring to have some portion of the government business, which we will -- which -- again, it depends on the price points and those things because we are not surgical specialties. We are more of medical specialties. We'll be careful on that front. While improving occupancies and doing a service for the larger number of people, we need to be conscious about price points, service delivery and the outcomes as well.

Prithvi Raj analyst
#19

One final question from my side. Could you give some sense on the profitability of the new hospital, say, the Assam, Rajahmundry and the new Bangalore one, how it is doing with respect to EBITDA?

Abrarali Dalal executive
#20

Yes. See, these are new hospitals. Guwahati, the acquisition is well established. I don't think there's any margin issue there. It's doing well. If you look at some of the new hospitals, like you mentioned in Bangalore and Rajahmundry, we are still building capacity there. Having said that, our top lines are doing good. Occupancies are increasing. And of course, there will be some margin pressure given that these are new hospitals. But we don't look at a very long time line to actually neutralize this and get back into or drive profitability positively.

Prithvi Raj analyst
#21

Is it possible to give some number for Rajahmundry, the new Bangalore on the margins?

Abrarali Dalal executive
#22

Rajahmundry is breakeven right now.

Ramesh Kancharla executive
#23

Yes. Rajahmundry is sort of breakeven right now. And EC will be a couple of months or 3 months before we break even there. But -- so we are not far from breakeven.

Operator operator
#24

Next question comes from the line of Bala Murali Krishna with Omar Investment Advisors.

Unknown Analyst analyst
#25

[indiscernible]

Abrarali Dalal executive
#26

Sir, your voice is a little unclear.

Unknown Analyst analyst
#27

Is it better now?

Ramesh Kancharla executive
#28

Better. Better. Yes.

Unknown Analyst analyst
#29

Yes. On the bed addition front, you have given a guidance of 2,500 beds over the next 5 years around 15% CAGR. So how do you think this will translate to top line perspective 20%, 25%...

Vikas Maheshwari executive
#30

The revenue projection, if we were to add 2,500 beds in the next 5 years, what is the revenue growth that you are looking at 5 years? That's the question.

Ramesh Kancharla executive
#31

Yes. I think the way we are -- I think we will probably kind of go past way beyond the INR 2,000 crores by end of the year. And I think from 4 years from that point, we will double. This is how we look at it, looking at the trajectory of our growth of the past and also the pace of our next phase of bed additions and the geographies based on all those things. And that's how ballpark. I think we'll have to come back to you later on, on the business plan more clearly.

Unknown Analyst analyst
#32

Okay. So on the ARPOB front, sir, so normally in the other specialty hospitals when they do very critical specialization related treatments, the ARPOB will increase, but how it will improve in our case in franchise care? So how ARPOB will be driven as we grow?

Abrarali Dalal executive
#33

Yes. As I said in the earlier question, the gentleman asked, so as we are adding larger cities like Gurgaon or Bombay, and we are looking at continuously driving into quaternary, tertiary care, larger procedures for pediatric, as I earlier mentioned, pediatric liver transplant, pediatric kidney transplant, pediatric cardiac surgeries, automatically, the ARPOB will be driven because of case mix. So it's a question of getting into newer geographies, driving more of these procedures.

Unknown Analyst analyst
#34

Okay. Usually, when we start the new hospital, so how big the ARPOB levels and when it become mature, maybe 5 years down the line, so how it looks like any numbers ballpark number?

Ramesh Kancharla executive
#35

I think let's put it this way. We are the pilot project in the country for the pediatrics. Every number, whatever we have driven or delivered so far is a fresh number. Can you compare with others apple-to-apple, we cannot. So that's what. So we are discovering ourselves. For example, at this point of the time, if you look at the ARPOBs Rainbow compared to any other peer groups, and we are not far behind. and we are in the top 4 organizations. So what drives the ARPOBs for us is that what is the kind of the quality of the hospital, whatever is being done, whether it is what proportion of intensive care bed, what is the traction of those patients, how much of the comes in with that. And the later stages in the building stage of the super specialties, then the ARPOB further will be driven because of the high ticket items. So this is how we look at it. And as I said clearly -- as kind of we put it clearly, the next 5 years, we are going to make reach 5,000 beds with the 5 hub hospitals along with Hyderabad, Bangalore, Chennai, Gurgaon and Guwahati. These are the hub hospitals. They will drive the complexity and the higher ARPOB businesses. At the same time, and our spoke hospitals, wherever we have done it, they were kind of fairly kind of do very high ARPOB business because of the rapid churn, high outpatient footfalls and the short ARRs and high obstic in deliveries, generic intensive care, those drive the ARPOBs. So this is how our mix so far, our understanding of our business and the numbers and the ARPOBs play out. So we have been in the last 5 years CAGR, if you look at it, our ARPOBs have grown about 6%, 5%, 6% CAGR -- that's how we'll get it.

Vikas Maheshwari executive
#36

And also, if I can add here, if you look at our presentation, we have given the breakup of our ARPOB of new units and the old units. New units or mature units -- definition is 5 years. If you look at the ARPOB difference is roughly 18%, right, for the quarter first. For the new hospital, which is less than 5 years is INR 59,000 ARPOB. As the mature, which is more than 5 years is INR 70,000. So the answer which you are looking for is that whether the new hospital, when they mature, whether the ARPOB will grow disproportionately, the answer is yes. As the hospitals continues to mature, the complexity of the businesses which they handle, the ARPOB is expected to go up, which we have demonstrated over a period of time.

Operator operator
#37

Next question comes from the line of Damayanti Kerai with HSBC.

Damayanti Kerai analyst
#38

My question is on your Mumbai market entry. So you spoke about your focus segments, et cetera. Just want to understand a bit on your thought on the potential challenges in this market, which you can face. And then you can also elaborate a bit on the doctor engagement model, which you intend to do for this market. And after, say, a few years down the line, should we assume Mumbai market will be as profitable as your home market of Hyderabad? So how should we look in terms of profitability profitability profile for this part?

Ramesh Kancharla executive
#39

Yes. Currently, we have a fairly good understanding of the Mumbai market. I know it's a little -- it's a high-priced market and the HR costs are high, doctor costs are high. And at the same time, you can also -- the pricing also will be different in Mumbai. So the important thing is that for us to be in Mumbai and to see that, obviously, we can add a huge value to value -- can bring a huge value into Mumbai. That's definitely the job, number one. Number two is that the clinical play, what we'll be able to do is very different from any other people currently in Mumbai. That's number two. When you're able to kind of play your strength in Mumbai, obviously, that you will become a kind of a premium. In terms of driving the profitability, margins, I think we'll have to study multi-specialty hospital those things because it is a high-priced, high-cost models on those things. I think I'm not very sure at the moment to put a number on it. I'm sure it will be north of 20%, but I don't know exactly where it will stand. I think that requires some time for us to understand. So this is how I see it now. But we are very excited about our Mumbai opportunity, and that opens the door for us to kind of build on a stronger in Mumbai.

Damayanti Kerai analyst
#40

Sure, sir. And the doctor engagement model, will that be similar like doctors will be on payroll or it will be something different than your usual model?

Ramesh Kancharla executive
#41

We always try wherever it is to say that the doctors who have to be kind of on the full-time model will be full time. But to run an efficient children's hospital hospital, you require the large set of doctors to be full time. There could be some hybridization can happen in a different level in some of the specialty doctors. But core theme has always to be a kind of.

Damayanti Kerai analyst
#42

Sure. That's helpful. And then I wanted to check on one of the markets where you had interest a few years back, Chennai. How has been the experience there? I just wanted to understand is that turning out to be the way you expected when you entered Chennai market?

Ramesh Kancharla executive
#43

Yes. Chennai has done well initially, and then there is some dip in 3 years ago, it is building on well now.

Damayanti Kerai analyst
#44

Okay. And my last question is your plan for spend towards digital ecosystem. So you -- in the initial comments, we heard about your initiative there. So a bit more there, what kind of spend you foresee to build this part of the business? And how soon we can see the system which you are working to achieve?

Abrarali Dalal executive
#45

See, most of our infrastructure is already in place as we speak. So what we've done in the first 3 months, we have actually gone and -- as I said earlier, we have gone and closed the CRM. So we have a CRM, we have a lead management software into place. We have increased our spend into digital acquisition that is getting more and more patient-facing new digital applications. We have a conversion system in place. The architecture will largely be differentiated in the HIS and a SA model and the patient interface will be connected to middleware. That's what we are working on. We're looking at a BI and a data lake, which will kind of streamline our data and improve our reporting efficiency. Again, as I said, we already embarked on this mission. I think in the next 3 or 4 months, we will perfect it.

Damayanti Kerai analyst
#46

Sure. So in terms of the EBITDA margin profile, how should we look at, say, FY '27, '28 number given the kind of spend which are currently ongoing?

Ramesh Kancharla executive
#47

So presently, we have added a lot of beds and almost 40% of the beds we added in the last 2 years' time, which is why you see some margin pressure, which I already indicated to the markets in my last earnings call. But overall, your EBITDA pool has increased, but there will obviously be some margin pressure. But towards the end of the year, we will still come back between 24% and 25% pre Ind AS. That's what we always guided.

Operator operator
#48

Next question comes from the line of Rahul Jeewani with IIFL Capital.

Rahul Jeewani analyst
#49

Sir, we are now expanding aggressively into markets outside South India. So now, let's say, we have Guwahati, Indore, Pune, Mumbai and then the Delhi NCR commissioning as well. So given that we are now aggressively going outside core markets, what kind of a management bandwidth we have put in place or we are targeting to put in place to manage expansion across, let's say, these diverse markets?

Ramesh Kancharla executive
#50

Okay. See, I think we have -- our managerial bandwidth is significantly improved. And so this is a company which is driven by the CEO and also the vision of promoters. And also, you've got a very strong functional heads and including the project teams. So I think our corporate team is pretty solid and strong. They have been here with us for the last 3, 4 years' time. We strengthened further. And with the addition of some -- the service excellence head and new projects head, I think we are pretty robust. We have a sales and marketing head. I think we have very robust. And also regional structures also we strengthened significantly like in the Bangalore, Chennai, Andhra Pradesh and Hyderabad, anyway that all of us here is home ground. And we will actually be looking at kind of creating some -- the regional structure as we move forward in Mumbai -- in Delhi as well. So we are very kind of comfortable with the aligned team and also high-end execution, and we look forward to see that there's a lot more strength coming in.

Rahul Jeewani analyst
#51

Sure, sir. And in terms of the regional clusters, can you define in terms of what kind of clusters would these be? So maybe Delhi, NCR and Maharashtra to manage hospitals across these markets?

Abrarali Dalal executive
#52

So Rahul, we have a very strong front line of hospital heads who are driving the business, supported by a strong corporate back end with functional like Dr. Ramesh mentioned. Going forward, we will be dividing cities into clusters and hospital heads will be looking at 2, 3, 4 hospitals depending on the maturity. That's what it's going to be. So it's going to be a large city, which, for example, has, say, 6 or 7 hospitals, there might be 2 clusters headed by 2 cluster heads who would also be handling hospital directly and looking at 2, 3 other hospital. It's typical structure, that's what we're going to look at.

Rahul Jeewani analyst
#53

Sure, sir. And let's say, out of these 2,500 incremental beds which we are planning to add over the next 5-year period, we have visibility for 1,200 beds. But for remaining, let's say, 1,200, 1,400 beds, would we go into other cities or would look to add hospitals within the cities which we have already identified. So would we go deeper, let's say, in Mumbai, Pune or Central India or look to further spread across the country?

Ramesh Kancharla executive
#54

That's right, Rahul. I think anyway, 30% of the beds go into the southern markets to strengthen our hub-and-spoke model and the new areas and micro markets. The rest of the 35% to 40% of the beds will -- 70% of the beds will be in the new markets. New market in the sense, it will be at Delhi NCR, more focus, and some of the northern cities and Central India plus Mumbai. This is where it's going to be roughly. Our bed strength is going to be built on the next 5 years' time.

Rahul Jeewani analyst
#55

So sir, roughly then the new expansion would happen in all these new markets which have already been identified and laid out to the market?

Ramesh Kancharla executive
#56

See, Rahul, one more thing is we have always been always -- we are -- as an organization, we want to go in and try and address the larger and wider -- address the large cities, large markets more comprehensively and try and build an hub and spoke model. and do the wider coverage of the city. That is how I think children's hospitals, I believe in that be efficient in both in terms of delivering the outcomes to the city and also you manage your cost optimization, manage your bandwidth, all these things could be built much more strongly because it's a medical hospital and an emergency-driven hospital. So in a market where you are, for example, in Hyderabad, we have about close to 1,000 beds. I mean the 1,000 beds going to be stopped there. We'll continue to add beds in Hyderabad. We'll continue to add beds in Bangalore. That's the power of hub-and-spoke model. And because your reputation is at the highest level and people would look forward to have you in multiple places presence.

Rahul Jeewani analyst
#57

Sure, sir. And sir, last question from my end. I think you referred to the fact that obviously, near-term revenue growth will be 20%. But did you indicate that target is to double top line over the next 4-year period?

Ramesh Kancharla executive
#58

Yes. I mean if we are looking at the growth of 20%, obviously, you would reach the doubling your revenue in 4 years' time, right.

Rahul Jeewani analyst
#59

Sure, sir. So essentially, 20% is the target for the medium term in terms of revenue growth?

Ramesh Kancharla executive
#60

Yes.

Operator operator
#61

Next question comes from the line of Sucrit D. Patil with Eyesight Fintrade Pvt Ltd.

Sucrit Patil analyst
#62

I have 2 questions. The first question to Mr. Dalal is beyond the regular outlook, I just want to understand what are the top 2 to 3 execution priorities you are focusing on in the immediate quarter. And alongside that, what do you see as the biggest risk in patient demand shifts or competitive pressures? And how are you preferring to manage them while strengthening Rainbow's position in the pediatric and maternity space? That's the first question. I'll ask my second question after this.

Abrarali Dalal executive
#63

Yes. So I think one is 2 of the main levers that we're looking at currently are strengthening while we are working on all the levers, tech being a big part of it, increased investment in social media, and we have already borne good results in the first quarter. That's one. Second is we are looking at largely increasing our market, our doctors referring more and more to our hospitals. I think that's one very important aspect we are working on. We are making our doctors visible to the markets, to the corporates and actually communicating what we do. So these are the top 2 levers at this point of time that we are working on in terms of driving in volumes. What was the second part, sorry? On the competitive landscape? Yes, on the competitive landscape, number one, I really think that we are a niche hospital. I don't think that there's real, real competition in our category, okay? If you look at our business, we are largely pediatric, super specialty, pediatric driven. We, of course, do participate in mother and child. So actually, from that point of view, there's no real competition that I would perceive. But -- and if you look at the patient demand shift, I think people want to come to specialized hospitals for deliveries and for pediatric care for their children. I think where deliveries are concerned, we are a comprehensive solution. We also have fertility. So if someone wants to come for a complete comprehensive solution. I think we are the place to go to right from IVF to burning to pediatrics, neonatology, pediatric intensive care, pediatric super specialty. It's a complete circle. So I think this is where it is. So I think as patients get more educated about our comprehensiveness, which we talk about, I'm sure the shift will be more in our direction. I think it's about educating the patients more digitally and through ATL activities.

Sucrit Patil analyst
#64

My second question is to Mr. Vikas, again, from -- along a similar line. From a financial point of view, what key risk or challenges you anticipate in the immediate quarters? And what specific measures are being taken to manage the margins, ensure consistent cash flow and strengthen the balance sheet, especially areas that are cost pressure incentives and the receivables part and any regulatory compliance issues.

Vikas Maheshwari executive
#65

It's a very exhaustive question, which you have asked. So as far as the cost is concerned, you have seen we have added 780 beds in the last 2 years' time. We plan to add any other further beds as we are acquiring Indore and so. So as the acquisition comes, the first priority becomes the seamless integration, streamline the system processes and the cost structure of the new units, which we are acquiring. If it is a greenfield, obviously, how to optimize the cost and make sure that the growth which we have planned, it's accordingly that. And if it is better than that, how to streamline the cost accordingly. And if it is less than that, how to manage that cost. I think the cost management remains a very, very good part. As far as another challenge is concerned is because the company is cash surplus, we have some sizable treasury investments. There has been a lot of turbulence period in the debt market or the credit market, how to manage your treasury yield, et cetera, and make sure that the liquidity plus the safety is not compromised with the reasonable returns as per the industry standards is being maintained. I think these are the 2 broader challenges in terms of acquisitions, greenfield and the treasury management. Obviously, the company is investing a lot of money. The cost management in terms of the project, project track record plus the cost of the project management, that remains the top 4 or 5 priorities on this.

Operator operator
#66

Next question comes from the line of Bansi Desai with JPMorgan.

Bansi Desai analyst
#67

So my first question is on our expansion into newer markets. Very keen to understand from you when we have expanded in the past outside our core markets and when we enter these newer markets, in your opinion, in your experience, what has been that single hardest element to replicate in the newer markets? Is it setting up the doctor referral systems? Or is it creating that brand trust in that market? If you can share some thoughts on that?

Ramesh Kancharla executive
#68

I think it's creating the clinical ecosystem, which is the doctors and making a kind of a team, which is the high potency teams. Number two is our ability to communicate to the city and include the parents of the city into your -- what's your capabilities on those things. And that is where it is our main thing. Of course, your doctors who are referring to you and connecting with them through the education programs, CMEs, workshops and various other things, being a medical hospital, that is a major thing. And other than actually our referrals because the children's hospital is always be a kind of an emergency care hospital. And also, there is nothing like a predictable number of knee replacements, number of cardiac operations, a number of those things. Those metrics don't work for children's hospitals. It is your quality, deliverables and outcomes are going to determine your success. So the -- obviously, when you go to geography, which is completely kind of a community is not aware of you, you have to put an extra efforts to ensure that you deliver and you communicate.

Bansi Desai analyst
#69

Understood. And when we think about setting up these referral hubs outside of South India in, say, Guwahati in Delhi, what will make you double down in those markets? So what are those things that you look for? Is it just the initial ramp-up and success that you receive in your country projects? Or is it also a function of availability of, say, acquisition opportunities?

Ramesh Kancharla executive
#70

I think it's more of a -- for a children's hospital to develop what we call hospital is kind of a multi-special children's hospital is a journey. It takes its own time to kind of build it. But places like Guwahati, which is already the platform is well set and also only if we can -- there is a demand, there's a need, there's an opportunity, all those things are there. But there is a paucity of the doctors in the Northeast. So that's where we are trying to see. If we are able to get the teams right and there is patients are ready available in Guwahati. In places like Delhi NCR, yes, you will be able to have better teams. And also you can recruit better teams from the -- not only from India, outside India. So that is a leverage you can take it. And also there's a market opportunity how you actually play your clinical model is more important. But I don't think it will take such a long time in those markets compared to the kind of southern markets because in southern markets where there is a fragmented mature multi-special -- mature markets and also there are many other hospitals like government trust hospitals also there in competing with you. But we have cracked in southern markets being a pure-play private children's hospital on high-end deliveries. So that's where we are able to do it. So the markets which we are going to enter in is that the opportunities are much bigger, much very different.

Bansi Desai analyst
#71

Understood. And my second question is also what is your initial read on seasonality this year given monsoon is in deficit. So we are entering very strong quarters from a seasonality standpoint. So if you could comment on that. And in the past, we've mentioned that we've also taken some steps to reduce our mature hospitals dependency on seasonality. So will some of those also play out?

Ramesh Kancharla executive
#72

This is exactly -- if you look at our last 2 quarters, we have definitely overcome to an extent of the seasonality. Seasonality will play -- will obviously play in children's hospital because of the disease patterns and those things. But what is important for us now is to kind of become independent of seasons. We continue to kind of. But seasonality will become icing of the cake.

Bansi Desai analyst
#73

Understood. So we've seen very good -- we've seen increase in occupancies in our mature hospital in Q1 on a year-over-year basis. So should we expect that to continue in Q2, Q3 irrespective of how season plays out?

Ramesh Kancharla executive
#74

I think as Abrar was explaining in detail about how we are connecting to our -- the communities and parents and a greater degree of inclusively, digital play, all those things are definitely going to kind of strengthen ourselves to be kind of a little more independent of seasons. Abrar, do you want to?

Abrarali Dalal executive
#75

Yes, I think as we said that, see, we are working on all our levers very strongly. Really, we are not taking any seasonality into account. It's not a part of our plans. Obviously, as he said, it's icing on the cake. In the last 6 months, we've driven a lot of levers which have actually borne fruition to the volumes that we've been able to actually garner in this quarter. And I'm hoping that as we continue pressing on those pedals, we'll continue delivering those results in the next 2, 3 quarters. And if seasonality were to kick in, it would be great. I think that's the way we look at it.

Operator operator
#76

Next question comes from the line of Anshul Agrawal with Emkay.

Anshul Agrawal analyst
#77

Sir, would it be possible to strip out the inorganic growth in the current quarter numbers? Could you help me with the organic growth in the current quarter?

Abrarali Dalal executive
#78

When you say inorganic, do you mean acquisitions?

Anshul Agrawal analyst
#79

Yes, that's correct, sir. Would be present in the quarter basically Guwahati and Warangal?

Ramesh Kancharla executive
#80

Guwahati and Warangal are EBITDA positive, both of them, think of Guwahati was EBITDA positive company. It is almost close to kind of a company EBITDA Guwahati. And Warangal is ramping up. I think it will come in probably a year down the line to the company level EBITDA.

Anshul Agrawal analyst
#81

I was asking from the top line perspective in terms of contribution, organically, how much have we grown in the current quarter? I understand 33% is the overall reported growth.

Ramesh Kancharla executive
#82

I think there's about 20% growth in Guwahati as well as Warangal, right?

Vikas Maheshwari executive
#83

Yes. So Anshul, if you're looking for a contribution, roughly INR 38 crores of the revenue, which came from these acquisitions.

Abrarali Dalal executive
#84

10% EBITDA contribution, that's what you're asking came from acquisitions. So on the revenue growth, Anshul, if you remove this, 24% growth on a like-to-like basis.

Anshul Agrawal analyst
#85

Yes. And any particular reason why ARPOBs in the mature cluster have increased by about 10%? Has there been any insurance price hike, cash hike or anything to add?

Ramesh Kancharla executive
#86

I think it's a combination of -- combination pricing as well as the case mix. These are 2 reasons.

Anshul Agrawal analyst
#87

Got it, sir. Second question, if you could just highlight, quantify the losses that we would have incurred in the Bengaluru units in the current quarter. The reason why I ask is that I think Abrar mentioned that we're close to breakeven in Electronic City after, say, probably a quarter, whereas our original guidance in Electronic City was roughly 15 months breakeven. And again, losses, considering that competitive intensity in that particular cluster, I presume would be up because of the consolidation in the industry.

Ramesh Kancharla executive
#88

No, obviously, the losses are there in the new launches like HRBR, Electronic City and this will take -- this will take -- general guidance is about we breakeven in Bangalore 15 months' time. That's the time we breakeven. Some of them come a little early, some of them may come a little later. But within 18 months' time, we kind of breakeven those hospitals. That's how it is. I think we have a very good doctors in HRBR and the Electronic City, I think we still need some more doctors. And we're very optimistic about Bangalore. I think the Bangalore is now is going to kind of play -- going to do very well for the years to come.

Anshul Agrawal analyst
#89

Got it, sir. And the acquisitions that we have sort of relayed yesterday, those would be positively contributing to EBITDA? And do we expect any losses from these units as well going ahead whenever they get commissioned?

Abrarali Dalal executive
#90

Yes. Yes. So I think among the acquisitions that we declared yesterday, I think those are running businesses. And we do not really see those businesses pulling EBITDA down. Having said that, it may take us some time to ramp up further. But surely, these are not units where we will have any EBITDA drain.

Ramesh Kancharla executive
#91

Yes. So for example, Nellore is an existing business. And also the doctors are well known to us. And we will -- we can add significant strength to those doctors and to build business on. Adding uppstris in 6 months' time, will definitely kind of make it more -- a lot more comprehensive of 100-plus beds in Nellore. So the -- let's say, in Nellore and Guntur and Andhra Pradesh, we are a household name. So that is the Rainbow brand function is going to be significant. So in Guntur as well, that it's a 50-bed hospital. At the same time, in 40 kilometers, we have a Vijayawada about 135-bed hospital. So that's more of multi-specialty hospital. So this will complement to the Vijayawada. And also, we will be able to get a lot more deliveries to -- and also the neonatal care in Guntur. All the emergency care will be sorted out. 50-bed is very good enough good acquisition, great facility will complement to the Vijayawada. This is how we look at it. There may not be a huge losses or anything. It just take about 6 months' time to settle down and then start firing. So overall, Andhra Pradesh, whatever is about 5 hospitals, whatever we have, I mean, they will do very well in next -- by end of the year.

Operator operator
#92

[Operator Instructions] Next question comes from the line of Ankit Shah with White Equity Investment Advisors.

Ankit Shah analyst
#93

I have a question on the strategy side. So you called out 5 hub hospitals that we have identified. I wanted to understand your strategy for Mumbai. So do we also plan to have a hub in Mumbai, let's say, in the next 5 years or so? Like in case of Gurgaon, we have a proper strategy with a proper hub hospital coming up, a greenfield hospital and then we can play that market well. So can you shed some light on the Mumbai piece?

Ramesh Kancharla executive
#94

We certainly would love to have in Mumbai because such a massive city. But Mumbai, as you all of us know, the challenges and opportunities there's an opportunity, I would definitely do a large hub hospital in Mumbai, and we will work on that. We are working on it.

Abrarali Dalal executive
#95

Yes. But having said that, obviously, the first priority will be to strengthen and launch [indiscernible]. That's going to be the first priority.

Operator operator
#96

Next question comes from the line of [indiscernible] with PL Capital.

Unknown Analyst analyst
#97

My question was on the seasonality actually. For us, Q2, Q3 normally are strong quarters. How has been the start for this quarter? I mean could you please highlight 2, 3 indicators that we can watch out for?

Ramesh Kancharla executive
#98

I'm sure this is too early to kind of comment on that, considering that the monsoon has got delayed, everyone knows about it -- but we'll have to wait and see how things work because July is too early to kind of comment on that.

Unknown Analyst analyst
#99

Right, right. Okay. The second question was on recent acquisition. You have already answered, but then I would like to know about the Malad unit. What would be the growth levers for this unit? And is there any lock-in noncompete or buyout arrangement with the 3 doctor promoters? And is there any part to 100% ownership going forward?

Ramesh Kancharla executive
#100

Yes. Obviously, there will be any joint venture or any subsidiary. We will have the options. But we would like to have them because they've been friends to us for a long time and good doctors. So they have been -- they will be part of the journey for at least a decade.

Unknown Analyst analyst
#101

Okay. And what will be the growth levers from the Malad hospital?

Ramesh Kancharla executive
#102

I think the most important thing is that based on our expertise and also our proactive nature in actually addressing the sick kids and a strong medical model, strong intensive care, both pediatric intensive care, neonatal intensive care. We will -- we believe it's a large opportunity of at least if we elect at 10 to 12 kilometers radius from Malad, there's almost a kind of 80 lakhs population. So you're addressing 80 lakh population when you look at really that how many pediatric beds are there, high-quality beds, is a serious shortage. So that's why we see it kind of -- there is a huge need and demand for such a high-quality care, so for children. So obviously, we need to go and prove ourselves that we are the best guys in business to do the job what the babies and children are requiring. So that's where our strength lies to do a high acuity care to the transports more aggressively, our capabilities in doing -- driving intense care services and also there's some specialty like ECMO services, all those specialty things we can do it. So that's why we are pretty confident about what -- on our capabilities. I'm sure there is a huge need in Mumbai.

Operator operator
#103

Next question comes from the line of [indiscernible] with Unicorn Asset.

Unknown Analyst analyst
#104

So I just wanted to understand when we see Cloudnine as a competitor in the NCR market, they follow a very different approach to what we are building. I understand that we are planning a hub unit in Sector 44 and then maybe we will try to widen our approach in the city. But just wanted to understand how management see what they are doing as a strategy versus what we are planning to do.

Abrarali Dalal executive
#105

Cloudnine. So see, again, as I said that it's a very different category of hospital, okay? We are a tertiary, quaternary, pediatric, super specialty hospital who drives a lot of deliveries. Having said that, we are almost, I think, #2 for sure in number of deliveries. Cloudnine has a different structure altogether. If you look at what Cloudnine does, it's largely a digitized model, and they drive in deliveries and conversions, where we are a much wider spectrum. So while we obviously do drive deliveries in, and we have also multifold increased our investment in digitization, which we've been talking about since morning. So that's where there's a severance of maybe some competition or similarity, but otherwise, largely 65%, 70% of our model is completely different. So it wouldn't be a correct platform in my mind to compare.

Unknown Analyst analyst
#106

No, that is absolutely correct. I understand that. But my question is coming from a different approach. Yes. My question was coming from a different approach. How I was looking at it is, say, a parent, so they go to a hospital, they try and having a care, then they actually have a kid with the hospital. They form a relationship there with multiple doctors and they have a memory there. They try to be like going there mode even as the child grows, right? So that kind of forms a pattern of going and you get out of, say, more out of same patient, you could say or whatever. So it becomes a family approach in that sense. So that was my approach to look at this.

Ramesh Kancharla executive
#107

I mean I have an answer for this. Yes. Here, the Rainbow is kind of -- when it comes to delivery, we have safety -- built a lot more safety networks, and we try to sell ourselves to kind of -- we do normal deliveries. We have a lot more competence than normal deliveries to address the high risk pregnancies and because of your backdrop of a strong neonatal systems, which you don't need to kind of look out for anything to come in and do it. So it naturally is there in the system, embedded in the system. So the people who deliver with us, they absolutely stick to us. I mean, because it is a seamless transition. People who deliver outside, which are multispecialties are the centers things. In the present today, people knows about the capabilities of what everybody can do it. The large number of people automatically shift. They might go for 1 or 2, 3 months time vaccinations. After that, it's kind of -- there's a disconnect comes and people will try to go because, for example, a child in the middle of the night would choose where -- choose a place where there is an acute care with an emergency with a consultant service that cannot be provided by neither fertility centers nor multispecialty. That can only be done by children's hospitals, children's hospitals because our focus on acute care and emergency is a lot more stronger and also depth. So this is what makes us different from the working models versus multispecialty hospitals.

Abrarali Dalal executive
#108

No, I think you're talking of stickiness, right? So I think that answers your question. See, between what I said and what sir said, even if there is a family which has initially delivered with a competitive single specialized chain, okay, post delivery, any pediatric issue can only be or largely be addressed by Rainbow. For example, there's a pediatric emergency, we have a ER at night, anything pediatric. And that is the point where the shift will happen. If that answers your question.

Unknown Analyst analyst
#109

Yes, that does. So more -- I don't want to push it further just getting my approach right. So don't we think that if we have a wider network of, say, BirthRight in that sense that we can -- so because it's like 10 to 15...

Abrarali Dalal executive
#110

Yes. We already do have BirthRight is available in all our 24, 25 hospitals. It's already there. And in a capacity than most of the things it's already there.

Unknown Analyst analyst
#111

Yes. Same on extending on that, I was asking that, okay, do we want to actually expand it horizontally the BirthRight part of ours versus the axle specialty or the pediatric specialty part?

Ramesh Kancharla executive
#112

Well, this hospital is being promoted by a highly skilled super specialty doctor. So I mean, we always vary about what we deliver to the patients because anything what we do, we should always be strengthen our medical systems. In the smaller places, building a strength, medical strength is not going to be that easy. While it may look appearance-wise better, but something runs into an emergency is disastrous. So therefore, I wouldn't build a hospital 20, 30 beds. I would only build a hospital. Basically, even 50 beds is nowadays is painful for me to even acquire it. I always feel comfortable to have 80-beds systems to support whether it's the expected mother or during the delivery or a newborn or child because this is how we envisage the health care to build much more on the stronger platforms.

Operator operator
#113

Ladies and gentlemen, due to time constraints, we have reached the end of question-and-answer session. I now hand the conference over to the management for closing comments.

Vikas Maheshwari executive
#114

Thank you for joining today's conference call. Your continued support and thoughtful questions is instrumental to our strategic journey. If there are any questions, do write to us or connect with us at investorreelationship@rainbowhospitals.in. Thank you very much.

Operator operator
#115

Thank you. On behalf of Rainbow Children's Medicare Limited and IIFL Capital, that concludes this conference. Thank you for joining us. You may now disconnect your lines.

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