Aster DM Quality Care Limited (ASTERDM) Earnings Call Transcript

Good evening, ladies and gentlemen, and a warm welcome to everyone joining us today for the inaugural earnings conference call of Aster DM Quality Care Limited for the first quarter ended June 30, 2026. Today marks an exciting step forward as we bring together 2 health care leaders into a unified platform. To discuss our operational and financial performance for Q1 FY '27, we are joined today by the senior management team of Aster DM Quality Care: Dr. Azad Moopen, Executive Chairman; Ms. Alisha Moopen, Executive Director; Mr. Varun Khanna, MD and Group CEO Designate; Mr. Sunil Kumar, Group Chief Financial Officer. Before we begin, I would like to remind everyone that some statements made on today's call may be forward-looking in nature and are subject to risks and uncertainties. I would now like to request our Executive Chairman, Dr. Azad Moopen, to share his opening remarks. Over to you, sir.

Thank you. Thank you very much. Good evening. A very warm welcome to everyone. I am delighted to see this very important day. This is actually something which is much more than there. We have been there for 20 months or 2 years, we have been trying to do that. And with Blackstone and with our team as well as from our Varun Khanna, who is the Managing Director, along with Alisha and other people, [ Wilson ] as well as with Sunil, we are extremely happy. We have about 39 hospitals now and [ 45 ] (sic) [ 45, 000 ] hospital staff and about 7,000 doctors, and there are a large number of people around. I'm extremely happy to see you. We are happy to see Alisha to go ahead with that. Thank you. Please go ahead with -- Alisha.

Thank you. Thank you so much, Chairman. Good evening, everyone. A very warm welcome to all of you. I'm also delighted to address you on the very historic milestone as we celebrate the formation and our first call as Aster DM Quality Care Limited. By combining Aster's legacy of physician-led, as Chairman was mentioning, patient-centric care with Blackstone's institutional strength, we have built a very, very powerful platform. The overwhelming support from our shareholders underscores our strong confidence in our strategic direction and long-term value creation. As we unite, our overarching priority is elevating the standards of clinical excellence and standardizing best practices across every single bed in our network. We are approaching this in 3 distinct ways. First, scaling the super specialty care. We are deepening our capabilities in high-acuity domains like oncology, neurosciences, cardiac sciences and transplant, bringing complex care closer to home for millions. Second, expanding geographic access. We are actively taking very advanced clinical protocols into the Tier 2 and Tier 3 markets, ensuring that world-class talent, medical talent, and advanced technology are accessible to our patients' doorsteps without really requiring long-distance travel. And third, really driving patient-centric innovation, integrating digital health platforms and modern care delivery models. We are focused on improving clinical outcomes and enhancing the patient experience across the entire care continuum. So how do we move forward and keeping our core strong in terms of really bringing the best of ethical excellence and patient-centric care is really our focus. And with that, I will hand over to Varun Khanna, the Managing Director and Group CEO, to address all of you, please.

Thank you, Alisha. Thank you, Chairman. Good evening, and thank you for joining us today. We are delighted to address you for the very first time as Aster DM Quality Care Limited. Today we come to you as one unified health care champion across India. In this new chapter, we are committed to keeping our core and value system unchanged, with continued focus on patient care, enabling doctors and hospital operations through technology, and best-in-class clinical outcomes. The merger between Aster DM Healthcare and Quality Care is much more than a combination of assets. It brings together talented teams, strong clinical franchises and a complementary network under a single vision. With an expanded footprint, a diversified portfolio and significant opportunities for operational and clinical synergies, we believe the combined entity is uniquely positioned to deepen the access to high-quality care across India while creating long-term stakeholder value. On July 1, we marked this milestone with our enterprise-wide Go Greater celebration. We brought together 45,000 people across our network, including doctors, nurses, paramedical workers and employees to drive an enterprise-wide alignment around our core cultural tenets of one team, excellence and accountability. Across all the sites, we achieved 0 operational friction, 0 service disruption, while executing cultural integration programs, driving employee engagement, shared behaviors and long-term integration success. Before diving into Q1 numbers, I want to clearly articulate our framework for value creation and the core strategic priorities that will drive our growth going forward: network expansion, clinical excellence and service excellence, driven through digital enablement and an effective and empowered team. Turning now to our financial and operational performance for Q1 FY '27. Considering that the merger became effective only on July 1, 2026, the numbers pertaining to the combined entity are on a pro forma basis. Q1 '27 delivered strong overall momentum. Revenue from operations increased 20% year-on-year to INR 2,597 crores. EBITDA grew 30% year-on-year to INR 576 crores. The EBITDA margin expanded 170 bps Y-o-Y to 22.2%. Revenue growth was driven by higher patient volumes, supported by higher realization driven by an increasingly complex case mix. We treated over 2 million patients in quarter 1, up 13% Y-o-Y, with a blended occupancy expanded 510 basis points Y-o-Y to 64%. This was supported by a 62% Y-o-Y growth in Medical Value Travel on account of addition of the new geographies. EBITDA growth, of course, was outpaced -- it outpaced revenue growth, unlocking operating leverage through material cost savings and stronger fixed cost absorption. Now let's look at the maturity touch for us. Growth across our unit mix remained robust with maturity -- with the mature units contributing 73% of our revenue. So mature units as a segment really contributed 73% to our total revenue. And that recorded a 19% Y-o-Y revenue growth, driven by steady bed throughput, higher ARPP IP driven by improved case mix, a better payer mix and a higher MVT contribution, as I mentioned earlier. The strong operating leverage led to the EBITDA growth of 29% in the segment and a sustained EBITDA margin at 30% expanding 230 bps Y-o-Y. The focus units, which contribute 15% of our revenue, delivered a 16% Y-o-Y revenue growth, benefiting from the expanding specialty programs, increasing occupancy and rapid margin expansion, further leading to EBITDA growth of 20%, with EBITDA margins expanding 60 bps. Emerging segment, which is the newer hospitals, registered the highest growth trajectory at 63% Y-o-Y revenue growth. This was propelled by fast-paced patient volume ramp-ups at newly commissioned facilities. And in our emerging units, EBITDA surged to 240% Y-o-Y, with margins more than doubling to 12.4% with a 640 bps improvement over last year. This underscores our operational execution speed, best highlighted by our newly commissioned Kasaragod facility, which achieved EBITDA breakeven in the month of June '26, within just 9 months of operation. Beyond our financial metrics, our true strength lies in our broader clinical platform, leveraging our 7,400 clinicians to scale high-acuity care where it matters the most. Over the last 12 months, our unified platform has served nearly 8 million patients across our network, a powerful reflection of the deep trust patients place in us. Spanning 28 cities, 9 states, we are democratizing advanced care. The centers in metro and Tier 1, including cities like Bengaluru, Kochi, Hyderabad and others continue to pioneer complex interventions, such as India's first robotic HAI therapy for noncurable liver metastasis, and Kerala's first transcatheter Fontan procedure performed in Kochi. While our hospitals in Tier 2 and Tier 3 cities bring advanced robotics, oncology and cardiac care directly to the doorstep. This is highlighted by our high-risk multidiscipinary surgery performed for Stage IV colon cancer at Nagercoil. Among [indiscernible] specialties, orthopedics, neurology and oncology had an accelerated ramp-up during Q1 FY '27. All of these specialties grew in excess of 24% this quarter. What will interest you is that our robotic volumes witnessed 80% growth over the same period last year. Joint replacements increased 39% over last year and transplants went up by 19% year-on-year. And this was enabled through investment in medical technology, strengthening of our clinical skills and capabilities across the network. In recognition of our clinical leadership and patient-centric philosophy, [ Care HiTech ] secured a JCI accreditation, becoming the first unit in care network to achieve the same. Aster was recently conferred with Healthcare Brand of the Year by Economic Times, while Care and KIMS Health got recognized for clinical leadership, nursing excellence and research focus by [ ADDH ] and Medical Dialogues. Demonstrating the extraordinary caliber of our leadership, we are the only hospital group in India honored with 2 lifetime achievement awards from Financial Express. One conferred upon our Executive Chairman, Dr. Azad Moopen; and Dr. M I Sahadulla, Chair, Medical Advisory Board, for their exemplary lifetime services to patient care. We have a clear road map to add 4,170 beds over the next 3 to 4 years, taking our total bed capacity to 15,000 beds. Crucially, you should know 53% of this expansion is brownfield [indiscernible], enabling us to leverage existing infrastructure and talent for faster gestation, lower execution risk and higher ROCE. Capital deployment will focus on deepening presence across core southern, central and eastern regions. Additionally, in April 26, we also commissioned the 159-bed Aster Women and Children Block at Aster [ Whitefield ], which is already seeing strong patient traction. In closing, the exceptional momentum across both platforms, backed by robust clinical growth, strong operational leverage and disciplined expansion gives us immense confidence as we step forward as one integrated enterprise. By combining our strengths, we are uniquely positioned to deliver long-term value for our shareholders while setting new benchmarks in quality, accessible health care across India. Thank you for your continued trust and partnership. And now I hand over to my friend, Sunil, for the financial performance.

Thank you, Varun. Good evening, everyone. While Varun walked you through the overall combined pro forma performance, I would now like to share the performance of Aster DM Healthcare Platform for the first quarter of FY '27, which underscores the strong momentum. I am delighted to share that Aster DM delivered a strong start to FY '27 with revenue increasing 22% year-on-year to INR 1,311 crores, compared to INR 1,078 crores in quarter 1 FY '26. Operating EBITDA increased 29 percentage to INR 277 crores, while the operating EBITDA margin expanded 117 bps to 21.1 percentage. Normalized PAT, excluding exceptional costs, increased 39% year-on-year, approximately INR 125 crores, compared to INR 90 crores in the corresponding quarter last year. The exceptional expense of INR 114 crores, that is the INR 114 crores, pertains entirely to costs incurred towards the merger and related activities. These are onetime transaction-related costs and are not indicative of the underlying operating cost base. Return on capital employed improved by approximately 190 basis points to 22.6%, compared to 20.7% in the corresponding period last year. This improvement reflects both higher operating earnings and better utilization of the existing asset base. Our performance this quarter was firmly volume-led with total patient throughput expanding 16 percentage, alongside 10% uptick in ARPP [ for IP ] patients. Growth in ARPP IP was well-supported by case mix improvement led by center of excellence and high-end tertiary care, including robotic cases. Rather than relying on select units, growth was well distributed across our network and propelled by a healthy mix of clinical complexity, capacity utilization and steady realization gains. I would now -- to bring you to the quick snapshot of Quality Care platform performance in quarter 1. Quality Care delivered a standout quarter with revenue growing 19 percentage Y-o-Y to INR 1,287 crores, and operating EBITDA surging 32 percentage Y-o-Y to INR 299 crores, and margin expansion of 216 bps reaching 23.2 percentage in quarter 1 FY '27. This strong performance was driven by 656 bps jump in occupancy to 65.4 percentage, deeper clinical mix, robust growth in robotic transplants and joint replacements, along with the better payer mix, which boosted the ARPP IP reaching 144,000 in quarter 1 FY '27. We continue to maintain a strong balance sheet. At the combined level, there is a net debt of INR 1,162 crores as on 30th June 2026. Aster is net cash with INR 511 crores and Quality Care has a debt of INR 1,673 crores. As we look ahead, our unified platform give us unmatched operational depth, a robust brownfield expansion pipeline and a clear synergical potential. We remain committed to setting new benchmarks in clinical quality while creating sustainable value for all stakeholders. With that, I conclude my remarks and hand it over to Puneet to begin the question-and-answer session.

Thanks, Sunil. [Operator Instructions] Moving on to the Q&A session, the first question is from Mr. Tausif.

This is Tausif Shaikh from BNP Paribas. Congratulations on a good set of numbers and completion of merger. First few questions to Varun on the new organization structure. Varun, could you help us understand the structure of the merged entity, especially regarding the reclassification of business into 4 clusters? Can you let us know which are the region and state you have classified in each cluster? And what has been the thought process, whether it's a brand-centric approach or a cluster-centric approach we have adopted?

Yes, the performance has been very good, especially given the fact that we were all also tied up with enabling the merger. So I think it's worked out pretty well. See, the India leadership, and we are still in the process of putting all of the final touches to it, but we are looking at things like geographical continuity, business continuity, span of control as we start to manage the country. And I think the other thing that we are focusing on now, and I did allude to it earlier, many quarters earlier as well at [indiscernible], to us, the maturity cut matters a lot because we need to identify where the business has to be enabled from a continuity standpoint, where we need to add more firepower in terms of clinical programs, et cetera. So there are 4 maturity cuts that we've taken. And I think that is another piece that is overlaying the old structure that we've built. So we're breaking -- it's not really -- I can't tell you that I put 2 geographies in -- under one person, et cetera. So we are enabling this through multiple things that I just talked.

Okay. That's helpful. Second thing on the strategy and the priorities for the near term. Varun, what are the 3 things that you would like to implement in the merged entity, which can start showing the result in the near term in FY '27?

I think a very, very pertinent question, Tausif, and thanks for asking it. I think the first and the foremost thing is that we brought these 2 large companies together so that we could benefit from scale. And that is what draws me to the post-merger integration and value-unlocking from the synergies. And that's a big piece for us. And we did, by the way, allude to it again during our early part of the conversations. Second is really putting the operational and clinical excellence piece in order. For us, oversight on sustainability and patient-centered growth is extremely critical. And that would be a big priority for me. And defining the strategic road map for the combined organization. Because it's not about a few quarters, it's about the next few decades. So that continuity and that strategic foresight is extremely critical under Chairman's leadership, and I think that's going to be the third element that I want to play out.

Varun, do you see there's any clinical gap in the existing entities?

Clinical gap, it's never enough. So no, I won't ever call it as clinical gap. See, as science is progressing, as technology is progressing, and I said this earlier, maybe I'll repeat it, our business is about talent, technology and infrastructure. And there won't be a year, there won't be a quarter where we will not continue to invest in talent as well as technology. So we've said that we are focused on developing complexity in our networks because we want to be [ called ] care. We've said that we will drive programs which are institutionalized, therefore, large team movements together. And we will enable their work by implementing, I would say, the cutting tier of technology when it comes to medical science. So I don't see it as gaps, Tausif. I see this as a continuous upgrade that I think the industry will have to go through [indiscernible].

Just one question to Sunil. I think after a strong start for the year, I know we have guided a EBITDA margin improvement and reaching the levels of 24% to 25% in the next 3 years. How should one see the EBITDA margin in FY '27 after a strong start?

So Tausif, I think we have previously called out that we will not give a guidance on quarter-on-quarter or yearly basis. We still hold on to that -- you can see that the quarter has been a great start, and we still hold on to our broader guidance of 2 to 3 years post-merger. And we are on our way to hit that number of 24%, 25%.

The next question is from Damayanti.

Congrats to the team for merger. So taking the previous question a bit further, so as you spoke about your priorities for the merged entity, what we understand both Aster and Quality Care platform have been working on a lot of cost efficiency measures, et cetera, in the last few quarters, which was reflected in the EBITDA margin improvement. So from current level, if you can help us understand what kind of further low-hanging fruit you see to improve margins further? And apart from these low-hanging factors, in terms of the long-term strategic progress, how do you see things stacking up from current level?

First of all, I have to emphasize on this. As far as merged entity, synergies haven't played out. Because as I told you, we've not started working on the merged entity synergies previously. So the performances that we've seen at both Aster level and Quality Care level were driven by the independent working of these 2 entities. And there was no degree of cohesive working that happened. I think that has started as of this month. And therefore, the synergy realization for the -- or the scale-based synergy realization for the merged entity is yet to be playing out. And I'm also not saying it's going to play out this quarter, but you will start to see significant results on our synergies this financial year onwards. And that will get annualized as we go forward into the next year. It's a 10-point synergy deal that we created. And I had mentioned this about a year back as well, that those are the things that one should work on. And first and foremost, of course, it is led by the benefit on consumption. Consumption can be [indiscernible] and that's a rather large piece. So when you become -- or when you get to that scale, we will have a significant leverage coming with that. I think I'll draw your attention back to something that we had guided on earlier, and maybe Sunil can come in as well. We had said that, about a year back, that we hope to bring in 10% to 15% incremental EBITDA on account of synergies. And we still stick to that. We are closer to the ground. We know exactly what kind of initiatives will get us there, what are the revenue synergies, what are the cost synergies. So all of that, Damayanti, will start to kick in now and this financial year onwards. So I think I just wanted to clarify that because you alluded to the previous performance, but I want to categorize -- categorically say that that performance was driven by the 2 independent factions, and now onwards, it will be [indiscernible].

Okay. And also wanted to understand on the synergy for the clinical talent, which you have across the network now, so we understand your footprint in terms of the site locations, et cetera, apart from Kerala, it's a bit more diversified. So do you foresee synergies on the better utilization of clinical talent as well?

Absolutely. So there are programs and there are -- there are programs that we'd like to do at the hospital level. For instance, on [ cardiomyopathy ], on neurosciences, urology, neuro, we'd like to do things at every hospital. So we'll build a team at every hospital. When it comes to complexity, let's take an example of [ DBS ]. You won't need a team or you won't even find a team for DBS in every hospital. So you could have the collective team or a team which is doing DBS across multiple hospitals. So I'll give you an example. We have one of India's best or rather Asia's -- it must be the top 5 programs of Asia, based out of Kochi. Previously, we couldn't use that for any part of our network. Today we can extend them to Kerala. I mean, if I look at Kerala, we can extend that to KIMS, we can extend that to parts in Hyderabad. So the extension of complexity becomes much easier for us. There's another example I can give you, liver transplant, for instance. It's very difficult to develop liver transplant programs in every single hospital. We have 39 of them. But the patient load is coming into every hospital. And that is one team that you can develop that can go on and handle multiple units. So there is a huge leverage that we will have in terms of our clinical programs when it comes to managing complexity.

That's very helpful. And my last question is on the international patient business, Medical Value Tourism. I think very exceptional growth. So what is helping you to achieve, I'll say, much higher growth than the industry peers? A bit of elaboration on that part will be helpful.

So while I'd like to take the compliment and go home happy, but the reality is that our base and contribution is low, right, as compared to some of our peers. Our contribution of MVT to the total business is lower. So there's a little bit of a catch-up we're doing. So we'll continue to be faster growth than most of the others. Two, I think we've done a lot of work in terms of building our capability around that, whether it is capability through teams, whether it is capability through resources who are now able to access geographies that we did not do earlier. And three, I think we are getting structure in our sales teams now which is very significant. I mean if you look at -- we've spoken about CRM earlier, now the lead tracking, digital interventions around it, our websites coming together, all of that is, again, helping us garner a lot of patients. I think one more thing, Damayanti, while we may do a lot, we are a clinical business. If we continue to have outcomes which are better than everybody else or benchmark globally, we will continue to get more patients. And that's what is happening. When you have 2 million patients a quarter, 8 million patients a year, come back to you, go back happy, they talk about it. When they talk about it, we get more patients. It's simple as that. So I think our outcomes are playing to our advantage as well, and that is something that we are very, very proud of.

Moving on to the next question. The next question is from Mr. Nitin.

This is [ Nitin Shakta ] from the Green Capital Single Family Office. I'm not sure if Alisha is still there or she's left, at least my screen. Yes, she's here. And thank you, Mr. Moopen and Varun for excellent performance and congratulations on the merger. There's a lot of hard work which goes in. My question is not as an analyst, but as an investor who's been investing in capital markets for the last 20 years. Alisha, as a promoter, what's your vision in terms of this year and the following years? I know we've spoken about integration and hospital expansions and the standard strategies. Is there something that you would like to do on Medical Value Travel or on working on diagnostics and pharmacy distribution, or it could be on oncology, which is a very, very upcoming field, robotic surgery, organ transplants? If I could just hear you out in terms of medical tourism pipelines from Middle East on to the western and southeastern hubs, that will be helpful to hear out your mindset and vision and strategy on that.

Sure, Nitin. See, I think this is a really important year ahead for us, and I cannot underpay how important it is for us to just get these 2 platforms to run cohesively and synergistically, right? So I think that's definitely the primary goal that, of course, Chairman, myself, Varun, the whole team will be focused on. And that's really just making sure our 40 hospitals are working well, working better because of now the size and scale as well. So a lot of effort, I would say, will continue to go in making sure how we can strengthen that further. Just getting to this merger itself has been a herculean task for us, but now making sure we are able to kind of go from that 1 plus 1 equals 11 is really the goal. So of course, parts like MVT is important for us. And I think Varun mentioned in the previous comment as well, our base on MVT specifically is lower than a lot of the peers. So of course, there is efforts that we are doing to make sure that we are able to kind of make it a bigger proportion of our overall revenue. I think trying to get it to double digit is sort of a goal that we'll have over the next couple of years. But the point that you made on focusing on some of the specialties, I think that's spot on. And for us, building these super specialty and some of the advanced care in sort of oncology, the transplant programs, cardiac services, taking this to the Tier 2, Tier 3 cities while building on our strategy in the main cities, like whether it's in Kochi, whether it's in Trivandrum, whether it's in Bangalore, using these teams, leveraging these clinical teams and taking it to sort of the 28 cities and the 9 states we are in is going to be the most important thing. Again, going back to what Varun said, like showing these clinical outcomes that is possible in the Tier 2, Tier 3 cities, this is going to be the true success metrics of our merger. So I think that's going to be our collective goal. Because we believe that taking that health care that's possible in the metros to these cities is going to be the magic of this merger, and we want to enable it sooner rather than later.

The next question is from Mr. [ Siddharth ].

Congratulations on the merger. And just to understand a little deeper in terms of the current quarter's performance. On Kerala, I think some really strong growth there. Maharashtra and Karnataka, would the relatively slower growth compared to the company average come essentially from the previous quarter's decision of doing away with schemes, or are there other factors playing out there? That was question one. The second one would be to understand, you've classified 4 maturity categories for hospitals, right? For each of these, is there a focused KPI that you are looking at? And how should one think of your reporting going forward as a merged entity, right? Will it be more around those maturity hospitals? Or would it be continuing on the geographical segmentation that was there with Aster? And the third one was in terms of clinical talent synergy that you spoke about, Varun, if you could share opportunities that you see beyond just the program. You spoke about setting up sort of individual programs. So is there cross talent that you're seeing your ability to be able to take -- move talent around? And sorry, also on that, the India 1, India 2, India 3 CEO structure, if you could also explain that. Yes. Those are the 3 questions.

All right. So a lot of questions. Thank you, Siddharth, and thanks for complimenting us for the merger. Sunil, do you want to take the performance side of it, which is the Maharashtra, Karnataka, and I'll come in with the specialty and I'll come in with the opportunity that we have around that?

Siddharth, thank you for the question. And I think on the Kerala bit of it, if you recall, quarter 4, I remember, where we shown a degrowth, right, 5% negative growth, we have shown in quarter 4 FY '25. From there, you have seen, last full year, every quarter, we've grown 5%, 10%, 15%, right? And I think quarter 1, I think whatever the leadership changes we had, after that, we've built a very robust system now. It's not truly completely people-dependent, but it is more of a system which people are enabled to it. And that's where we had a great recovery of the -- how we are driving the top line. For example, Kerala seen that 25% growth we had. And excluding Kasaragod, we have still done a 20% growth. And also when you look at the growth of 20%, 25%, everything is driven by volumes, right? You look at IP, IP is driven by more than 16% volumes. OP has been 19% volumes. So it's not just an ARPP driven. It's a volume-driven growth what we brought in. And also, I'm happy to announce that, specifically in Kerala, our hospital, like Medcity, has clocked, only in quarter 1 I'm talking about, clocked more than INR 100 crores of revenue in 2 months within the quarter. And also very important thing is that you know we are doing very well in the greenfield projects. And you've seen the last greenfield project, which is a Whitefield, we've done well. And you can see Kasaragod also, which started in October, within 9 months, June is the month we have broken even and clocked more than 2% to 3% of EBITDA. That's within -- broke even within 9 months. That shows that we do really well in greenfields, and we are able to come back very quickly. Next on the Karnataka. Karnataka, yes, you're right, you look at FY '26, I think the first 2 or 3 quarters, we had a little bit of attrition in some of the doctors and we went into even a single-digit growth. And from there, we even called out saying that we started hiring doctors. And I would like to also call out very clearly, only in quarter 1 I'm talking about, we have been acquiring clinical talent over the last second half, H2 of FY '26. And even in the H1 -- sorry, quarter 1 FY '27, we added more than 18 doctors only in Bangalore, right, both in Whitefield and in CMI. And I'm very happy to say in quarter 1, in the month of June, all the 3 hospitals, that is Aster CMI, Aster Whitefield, Aster RV all clocked the highest revenue, right, from inception. That is a tremendous growth and recovery we have done. And I think from single digit moving to a 16% growth, and again, 5% to 6% of volume growth we have done in such a competitive environment, that shows that we have done a great recovery. Yes, over to you, Varun, on the maturity.

Thank you. Siddharth has asked us 2 questions, but literally asked us almost everything that anybody also needs to know. So Siddharth, let me get to [ future reporting ], that seems to be the easier one to handle. So I think the maturity cut is extremely critical. That also helps you all to understand as to how is the network performing, what's the kind of growth that is happening. Let me try and explain the maturity cuts a little bit. So mature is the biggest part of our pie. It's 73% of our total revenue today. And the idea is that everything should be mature. The idea is to get the network to be -- to maturity. And it's a 4-quarter business, I've always said that, and which clearly means that we should be able to do 25% EBITDA in every asset. If the asset doesn't qualify at 25% EBITDA, then it becomes another category to handle, right? And those categories could be on account of various things. The first one is on account of tenure. It's a new hospital, time to scale up. And our endeavor is -- and we've shown it in the past as well. Let me give you a few examples. Our endeavor is that time to profitability should be shrunk. And therefore, you open it right. Right? I've given you the example in Nagercoil earlier. Nagercoil was opened about -- I mean, I could be wrong by about a month or 2, but it was 18 to 20 months ago, right? It's 18 to 20 months ago. The hospital turned profitable in 4 months. And today, if I have my numbers right, I think it's already reached about INR 180 crores on run rate revenue, right? And does EBITDA closer to 30%. So by keeping focus on maturity or trying to move every asset into maturity, we were able to catalyze the scale-up of a hospital. I spoke about Kasaragod earlier. It is the eighth or ninth month of operation, and we have brought down -- it's already profitable. So I think, again, the maturity focus, doing it right is helping us. So that is the second category. Third category, there will always be hospitals that move into focus. I mean these are old hospitals, but need something -- some work to be done. Could be highly competitive markets, could be a turnaround, et cetera, et cetera. And we call them focus. Focus are large assets, which may be under-delivering. I mean they're, let's say, somewhere in the teens on EBITDA. We think we can do more. This is where a lot of the clinical program piece that I spoke about earlier, moving clinical programs from one place to the other, developing more, et cetera, adding capabilities, sometimes you need more in terms of technology or infrastructure into those assets. And some of our Hyderabad assets in the past have been in that category. We looked at it like that and, therefore, worked harder to make investments into that asset to get them to move from the focus category to the mature category. And we've succeeded immensely. I mean just to give you an example, a couple of years ago, [ Hitech ] was in the focus category, [ not a small ] hospital, very well located. And guess what, today, we make more than 25% EBITDA, and we got a JCI accreditation for the same hospital, right? So therefore, that cut is extremely critical for us. And then there are some that need, I mean, for lack of a better word, surgical intervention. These are always the smallest buckets, but I call them underperforming. And therefore, sometimes a leadership transformation or more managerial focus, et cetera, to be able to get them. So therefore, that cut is extremely critical. And this also tells you that whenever I talk about these maturities, we'll understand where the EBITDA is. In terms of reporting, we will also share a little bit in terms of geographical top line. It's not that we'll move away from geographical completely. So if you guys want to know something, we'll certainly bring that to you. So be assured. On the clinical side of it, I think I want to take a little bit of time, and I'm sure many of you will have these questions. So there was a previous question also on strategy. Oncology is a big play, and we said that earlier. And that is where deep pockets are required to enable that as well. Now we figured out a need gap in the Tier 2, Tier 3 cities on oncology in India. India today is a metro tier oncology country. And we are the ones who are challenging that. We are investing in oncology, and we've shown it earlier as well. We've taken oncology to Tier 2, Tier 3 cities. Over a period of time, you'll see that oncology is where the big brownfield play is happening for us. It is accretive on ARPOB, it's accretive on complexity. It's accretive on patient load. And the most important part is closer to home for people. I mean the fact in India is that you need to deliver health care closer to home, and that's what we're trying to do. That's where I think Alisha was posed this question. The primary purpose for us continues to be that, to take health care closer to people, right? Who wants to be away? So I think all of that for oncology, we are delivering. We are delivering cardiac at a scale, which is not seen in India. We would be the, if not the top, maybe the top 2 on cardiology volumes in this country. And that continues to be a very big focus item for us because we're known for cardiology across the network. We're adding to transplants. We are adding to robotic cases. We told you our robotic surgery has grown 80%. And of course, the most important part is we are ensuring that each one of our hospitals are ready for critical care. And this critical care is not just getting the emergency right. This critical care is about getting multiple specialties in every hospital where the doctors are available throughout the day and night. And that is how we deal with complexity and critical care in our hospitals. So I think that's where the whole strategy is falling in place. And I'm assuming that I've answered your question.

Yes. I think that was a very, very detailed and informative response. And thank you for that, Varun. Wish you all the best. Look forward to keeping in touch.

So next question we are having from the line of Mr. [ Vino ].

Double congratulations, first on a great set of numbers performance and second on the transaction, successful conclusion of the transaction. Just a follow-up from the previous one. Sunil, you mentioned the factors that led to the very strong growth in Q1. I understand that there were some factors which helped it, but this kind of growth [indiscernible] Bangalore, et cetera, do you think that is -- that kind of growth rate is sustainable for the rest of the year?

Yes, [ Vino ]. See, we have always seen, whether it's in Kerala or Karnataka, whenever there is a neighborhood competition coming in, you will have some softness in the growth for 1 or 2 quarters. And slowly, it will come back, right? That's what it is all about. And also good thing is that we have a very good clinical practice. We have got very good doctors. And also, we have got a very good brand together. And also just to give you an example, we had lost some general surgery team maybe 8 or 9 months back. Four months back, they came and joined back to us. That shows very clearly the credibility in which we run the operations. So I think we are talking about anywhere double-digit growth, right, even the lower to mid-teen growth. I think that is something which is sustainable. And also, we have always told you, if I were to generate a 24%, 25% of EBITDA margin in 2 to 3 years' time, we should be able to generate at an organic level 5% to 6% volume growth and maybe 7% to 8% of the ARPP growth. And if we are able to drive that, I think that's very much possible.

Understood. So since you just mentioned about competition, which -- are you seeing competitive intensity picking up in select markets, especially the Bangalore market? And does the combination of QCIL give you any extra muscle power to deal with competition in those markets?

Varun, do you want to pick this up, question?