investor presentation - best multispecialty hospital in india · •knee replacement - us vs india...
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Investor Presentation
Important Disclosure
No representation or warranty, express or implied is made as to, and no reliance should be placed on, the fairness, accuracy,
completeness or correctness of such information or opinions contained herein. The information contained in this presentation is
only current as of its date. Certain statements made in this presentation may not be based on historical information or facts and
may be “forward looking statements”, including those relating to the Company’s general business plans and strategy, its future
financial condition and growth prospects, and future developments in its industry and its competitive and regulatory
environment. Actual results may differ materially from these forward-looking statements due to a number of factors, including
future changes or developments in the Company’s business, its competitive environment and political, economic, legal and social
conditions in India. This communication is for general information purpose only, without regard to specific objectives, financial
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disseminated in any manner.
2
…because passion drives perfection…
…and perfection drives
performance
“
3
Outline
• Indian Healthcare opportunity at inflection point• Legacy problems, Recent transformation, Rising aspirational middle-class, Effect of health insurance and government
schemes driving demand for better healthcare
• Total opportunity size in Rs. 11.7 trillion, other industry data
• Shalby - A proxy for the huge opportunity of growth in the Indian Healthcare space• Profile and brief timeline, About the Promoters, Proven track-record of growth and expansion, Pioneer in joint
replacements in India, Well-poised for the next phase of expansion and growth
• Snapshot• No. of Hospitals, No. of Beds, FY18 Revenue/EBITDA/PAT (absolute and %), IPO, 10-Year CAGR Revenue, 10-Year CAGR
EBITDA
• What makes Shalby deliver a superior performance – our unique Business Model• Lowest Capex and Opex per bed due to optimal use of real-estate, in-house planning teams, fully-committed team of
doctors, focus on surgeries with higher ARPOB, Centralised procurement, Gradual ramp-up of operational bed capacity
4
Outline
• Relevant and Low cost Expansion• Role of OPDs and SACE in identifying where to go, optimal capacity of ~200 bed capacity, catchment area, focus on
underpenetrated markets in India and continue with OPDs to expand reach into newer geographies
• Current Expansion in Progress: Nashik, Vadodara, Mumbai
• Case of Expansion & Specific Growth Drivers for Shalby• Knee Replacement - US vs India comparison, potential for 10 years, Cardio growth cycle – case study, Shalby’s leadership in
joint replacement, huge scope for organic growth and operating leverage, 5x growth on current infra possible without major
capex
• Developing similar expertise to capitalise on next growth cycles in other specialties
• Performance Review• Revenue mix, Operational parameters, maturity profile, profitability and B/Sheet snapshot
• Key developments during the period
• Strengths and Differentiators• Global leadership in Joint Replacement, Experienced promoters with hands-on involvement, strong brand, optimized
business model now being replicated, unleveraged Balance Sheet
5
is at an Inflection Point
1 Indian Healthcare
6
The Opportunity Set
Source: National Commission Population Frost & Sullivan analysis.
Population and Population Growth Rate of India
(Historical and Expected)
0%
20%
40%
60%
80%
100%
2014(E) 2016(E) 2018(E) 2020(E)
54+ years
35-54 years
20-34 years
0-19 years
1.27 billion 1.29 billion 1.32 billion 1.35 billion
CAGR (2014-2020)
0.9%
2.6%
1.6%
0.7%
-0.04%
100%=
68%
6%
13%
9% 4%
Healthcare Delivery-Hospitals Diagnostics
Pharma Medical Devices
Health Insurance
Spilt of Indian Healthcare Industry by Segments
Total market size (2016): INR 9.2 trillion
7
The Opportunity Size
Source: Frost & Sullivan analysis.
Indian Healthcare Delivery Industry size (2015-2020)
2015 2016(E) 2017(E) 2018(E) 2019(E) 2020(E)
5.46.2
7.3
8.5
10
11.7
Public Hospitals Private Hospitals
30%
70%
Spilt of Public and Private Hospitals in India
Private
Corporate
Hospitals
account to less
than 10% of the
total Private
Hospitals
8
Legacy Issues of India Healthcare
• Always been an underdog due to lack of infrastructure and expenditure from the government
• In the private space, it was charitable trusts who contributed to healthcare, but even this has waned
from 1980s
• Tier II and Tier III towns are served by Nursing Homes – started by doctors themselves
• The burgeoning population of India poses a serious challenge to healthcare access
• And yet…
• …the Healthcare space in India is undergoing a paradigm shift
today…
9
Conducive Government PoliciesDespite Challenges
Wide procedure penetration –
to Tier 2 and 3 cities
Swastha Bharat, Smriddha Bharat. Demographic
dividend realization impossible without proper
healthcare
Rashtriya Samaj Beema Yojana: 100 mln families
will get Rs 500,000 per year for their families to
cover secondary and tertiary hospital expenses
100% depreciation on capex incurred, MAT
credit can be availed for 15 years, all
healthcare education and training services
exempted from GST
State Policies include capital subsidy on purchase of
medical equipment, capital investment subsidy on
construction of tertiary-care hospitals and interest
subvention, along with several other benefit
10
Recent transformation
• Private sector investment has been increasing due to change in mind-set and better returns on
investment
• Healthcare businesses can also be profitable as long the costs are affordable
• The advent of information technology has given a fillip to the healthcare business making it both
controllable and scalable
• Rising aspirational middle-class today is not averse to paying for quality healthcare services
• Impact of health insurance, government schemes and emergence of medical tourism - key drivers
of positive change
• Healthcare today in India is evolving to be a larger consumer
story than ever before
11
A proxy for growth in the Indian Healthcare space
Shalby Limited2
12
Promoter
Dr. Vikram ShahChairman & Managing
Director
Qualifications
Academic Qualifications:
• MBBS
• MS (Orthopaedics)
Professional Qualifications
• AO Basic Course
(London)
• F.A.O.A.A (Switzerland)
• F.A.I.S.F (Germany)
Achievements
• Over two and a half decades of professional work experience
across UK, USA and India. Serving as Director, Department of Knee
Replacement at Shalby Hospitals since 1993
• Dr. Shah innovated zero ‘0’ Technique in 2011 and was awarded the
Double Helical Award 2017, for the innovation
Reduction of surgery time: 2.5 hours to 22 minutes
Reduction in patient stay: 15 days to 3 days
Drastic fall in infection rates due to minimum incision
• Invented the OS Needle, which is thick bore reverse cutting needle
used in attaching soft tissues to the bone. Before the invention of
the Needle, surgeons had to use complicated soft tissue
procedures that had a very high failure rate. The needle can be
attached with commonly available vicryl thread
• President of Indian Society of Hip & Knee Surgeons (ISHKS) for the
year 2010-11
• Part of joint international faculty for development of new joints by
Zimmer Inc., USA
• Receiver of several awards and accolades by reputed organizations
13
Management Structure
CEO
CFO
Group GM –Finance & Accounts
Head -Commercials
Chief Information
Officer
Chief Human Resource Officer
Regional COO
Western India
CAO SG Unit CAO KrishnaCOO Surat
Cluster
CAO Surat
CAO Vapi
Regional COO North &
Central India
COO North Cluster
CAO Mohali
CAO Jaipur
COO Central Cluster
CAO Indore
CAO Jabalpur
VP ProjectsDirector
International Business
EA to CEO
14
Our Journey so far…
1994
6
2007
228
2004
27
2015
907
2011
674
2017
2012
Started professional
practice with a 6-bed
facility
Operationalized First
Multispecialty Hospital of the
group Shalby SG
[Bed Capacity: 201]
Commissioned Shalby Jabalpur
[Bed Capacity: 233]
Commissioned Shalby Indore
[Bed Capacity: 243]
Acquired Shalby Mohali
[Bed Capacity: 145]
Revenue growth – 100
times in first 10 years
Incorporation of Company
Acquired Shalby Vapi
[Bed Capacity: 146]
Acquired Krishna Shalby
[Bed Capacity: 220]
Bed capacity grown 10 times
in 10 years – to 2012 beds
Commissioned:
Shalby Jaipur [Bed Capacity: 237]
Shalby Naroda [Bed Capacity: 267]
Shalby Surat [Bed Capacity: 243]
15
Reach and Presence - Hospitals
Ahmedabad
SG – 201 beds
Krishna – 220 beds
Vijay – 27 beds
Vapi – 146
beds
Jabalpur – 233 bedsMohali – 145 beds
Indore – 243 beds
Hospital (operational)
Jaipur – 237 beds
Ahmedabad
(Naroda) – 267 beds
Surat – 243 beds
Nashik – 113 beds
Vadodara – 150 beds
Hospital (recently set up)
Hospital (upcoming)
Has a total bed capacity of 2,012 beds across 11 multi-specialty hospitals
Network of Hospitals in India with bed capacity
Mumbai – 50 beds,
to be increased to
150
16
Reach and Presence - OPD and SACE
Has a network of 40 patient outreach centres and 7 SACEs in India
Network of Outpatient Clinics in India International Footprint Presence in Africa
Eldoret
Kisumu
Nairobi (1)
Dar es Salaam (2)
Nairobi (1)
Kenya
Rwanda
Tanzania
Ethiopia
UAE (2)
Presence in UAE
International footprint consists of 6 outpatient clinics and 1 SACE in
Africa, and 2 SACEs in UAE, 1 OPD each in Bangladesh and Cambodia
SACE
OPD Clinics
SACE
Outpatient clinics
SACE
Addis Ababa (1)
Rwanda (1)
Sudan
Sudan (1)
17
3 Shalby - a snapshot
18
11 Hospitals 55% Operating bed to total bed capacity
2,012 Total Installed Bed Capacity
1,100 Operational beds
48 Outpatient clinics
36% Bed Occupancy
31% 11 year CAGR Revenue
40% 11 year CAGR EBITDA
Double-digit return ratios against industry trend of single-digit
Consistently superior ROCE of mature hospitals
400+ Doctors & 3,500+ Support Staff
19
Current Scale of Operations
Best in class financials
• Best in class operational metrics despite lower operating bed/ bed capacity ratio and lower occupancy rates
• Based on current infra 5x Revenue and EBITDA growth possible without any major capex
Years represent Financial Years EBITDA calculated on total revenue FY 12 to FY 17 – Data as per restated consolidated financials
Growth achieved without any outside equity funding
Revenue CAGR – 31% for 11 years EBITDA CAGR – 40% for 11 years
Revenue EBITDA
149%
55%
38%29% 26%
36%
14%6% 5%
13% 19%194
482 745
1,030 1,332
1,685
2,298 2,617 2,776 2,927
3,305
3,923
FY07 FY08 FY09 FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18
Growth (%) Revenue (in Mn)
11%
16%14% 14%
20%
26%
21%
25% 25%
20%
24% 24%
22 77 107 142
262
439 482
660 687
579
778
925
FY07 FY08 FY09 FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18
Margin (%) EBITDA (in Mn)
Dip due to new units
20
Best in class economic returns
• Double Digit return ratios against industry trend of single digit
362 203 259 345 481 844 1,041 1,461 1,835
2,508
7,615
2%
9%
17%
28%31%
18%
32%
17.0%20.0%
11%
6%
FY08 FY09 FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18
RoE %
Shareholders' Equity (Rs in Mn) RoE (%)
362 354 330 309 428 1,104 1,257
2,496
4,003
5,420
6,870
15%
26%
51%
88%
66%
20%
36%
22%14% 14% 12%
FY08 FY09 FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18
ROCE %
Net Block (Rs in Mn) ROCE (%)
21
is the key to our outperformance
Our Unique Business Model4
22
Our Business Model – featuresOptimising Capex and Opex
• Lowest Capex and Opex per bed dueto optimal use of real-estate
• Equipment planning and utilitiesplanning
• In-house planning teams
• Focus on surgeries with higherARPOB, better margins and returnratios
• Centralised procurement
• Gradual ramp-up of bed capacity
• Fully owned or O&M on revenuesharing (no fixed rentals, no securitydeposit or MG)
Optimize capex
planning with
Inhouse projects
team
Utilities
planning
to optimize
capex
Better
utilization
of space [and
expensive real
estate]
Cost per bed ~
Rs. 4.5 millions
for fully owned
set-up. Lower for
leased premises
Operational
Efficiency due
to
better capex
planning
Low consumable
cost
Leveraging
economies of
scale through
centralized
procurement
EBITDA upwards
of 20% which is
higher than
industry average
23
Our Business Models…
Fully ownedOperate and Manage [Revenue Sharing]
AcquisitionOperate SACE and Outpatient Clinics
Efficiency is paramount
No fixed rental
No security deposit
No minimum guarantee
Unique revenue sharing model
24
Typical concept of 200 (±20%) bed capacity set-up
Facilities 10-15 kms away
Local and Natural Footfalls from 4-
5 kms radius helps to fill up ~70-80
beds
Balance ~70-80 beds – patients
come in the name of doctors
reducing thereby dependency on
star doctors thus controlling
doctor payout %
25
The Shalby Way
Strong record of consistently being EBITDA positive and ARPOB of ~Rs. 32,000/ day (amongst best in the industry)
Profits reinvested for growth - No dividend payouts
Growth until recently, financed only through internal accruals. In recent times debt used for aggressive expansion
Current turnover and EBITDA largely contributed by older units. Growth from newer units to begin now
26
Expansion Strategy5
27
Low Cost and Relevant Expansion
• Role of OPDs and SACE in identifying where to go
• Optimal capacity of ~200 bed capacity
• Focus on underpenetrated markets in India for hospitals
• Continue with OPDs to expand reach into newer geographies
• At Shalby, our market is ready before we begin!
28
Expansion strategy across the country
Patients visit ourclinics across
India and abroad
We analyze patient trends andaccordingly decidewhere to expand
Simultaneously hire local doctors and train them at Ahmedabad who conduct OPDs in
and around that city
So we can startthe facility with
low brandingbudget but high
brand recall
Set-up outpatient
clinics where we have a strong
brand recall
Operating such Outpatient clinicsfor 15 years now
Rajasthan
Madhya Pradesh
Gujarat
Maharashtra
Punjab
Ahmedabad
29
Expansion Plans in Progress
•Bed Capacity 113
•Capex – Rs 250 mnNashik
•Bed Capacity 150
•Capex – Rs 350 mnVadodara
•Bed Capacity 175
•Capex – Rs 1 bnMumbai
[Santa Cruz]
•Current bed capacity 50. Addition 100 beds
•Capex – Nil
Mumbai [Ghatkopar]
Investment Plans for Upcoming facilities
Total capex planned – Rs. 1.6 bn for addition of 538 beds @ Cost per bed – ~Rs. 3 mn
30
Case for Expansion6
31
Case study - the Cardiac growth story in India
Source: Industry reports
2014 ~ 2,00,000
surgeries and 8,00,000
angioplasties
2004 ~ 50,000 surgeries
1994 ~5000
surgeries
1984 ~500
surgeries
Facilities 10-15 kms away
CAGR – 29% in 30 years.
Currently growing @ 2-3%
Wide procedure penetration –
to Tier 2 and 3 cities
32
Surgery Count CAGR @32% in 23 years
Knee Replacement - the big opportunity
2017~1,75,000 surgeries
2010~54,000 surgeries
2000~6000
surgeries
1994 ~300
surgeries
Last year, In United States ~0.8 mn knee
replacements in a population of
~300 mn
Asian population 15 times more
prone to Arthritis of knee
than their western counter
parts
India has a similar affording
population. Hence, direct potential to
grow to 8 lacs Knee
replacements
Hence huge potential for growth based
on incidence rates
Source: Industry reports
33
Specific Growth Drivers for Shalby
Advantage Shalby
Shalby is pioneer in Joint
Replacements in the country, best
positioned to capitalize on it
Increasing focus on high-end
specialties like oncology and
organ transplants such as Liver,
Heart & Lungs, etc.
Huge scope for organic growth and operating
leverage, without any
significant capex
Emphasis on Processes &
Doctor Selection
Way forward to move to other
potential markets where the
demand supply gap is significant
34
Q4 and Year Ended 31.03.2018
Performance Update7
35
11 Hospitals
2,012 Total Installed Bed Capacity
1,150 Operational beds
48 Outpatient clinics
Double-digit return ratios against industry
trend of single-digit
Consistently superior ROCE of mature hospitals
400+ Doctors & 3,500+ Support Staff
Snapshot
Ahmedabad
SG – 201 beds
Krishna – 220 beds
Vijay – 27 beds
Naroda – 267 beds
Vapi – 146 beds
Jabalpur – 233 beds
Mohali – 145 beds
Indore – 243 beds
Jaipur – 237 beds
Surat – 243 beds
Mumbai – 50 beds,
to be increased to
150
Reach & Presence
Hospital (operational)
Hospital (recently set up)
36
Key Developments of the Year
Wide procedure penetration
– to Tier 2 and 3 cities
Historically highest revenue
during the quarter & year
Successful conclusion of the IPO of INR 5,048
million and listing on the stock exchanges
Jaipur, Surat and Naroda units
operationalized in FY18
37
Financial Highlights Q4FY18
• Drop in EBITDA and margin by 16.4% and
7.3% respectively inter alia due to higher
advertisement spend for commissioning of
new units ,launch expenses for the same
174.20
145.42 20.75%
13.42%
Q4FY17 Q4FY18
Operational EBITDA (in millions)
EBITDA Margin
78.70
182.86
9.10%
16.50%
Q4FY17 Q4FY18
PAT (in millions) PAT Margin
• PAT grew by 132.4%
• PAT margin expanded by 7.4% due to
higher revenue and operating
leverage and normalization of taxes
• Total Revenue grew by 27.9%
38
868.15
1110.36
Q4FY17 Q4FY18
Total Revenue (in millions)
2
(INR in million)
Operational Performance Synopsis
Note: The operational bed count of 1,150 considers 50 operational beds at Zynova-Shalby Hospital, Mumbai, for which no other operational parameters
are tracked
ParticularsQuarter Ended
31-03-18% of Revenue
Quarter Ended
31-03-17% of Revenue Growth
Total Revenue 1110.36 868.15 27.90%
Total EBITDA 172.09 15.50% 202.69 23.35% -15.1%
Bed Capacity (Nos.) 2,012 1,265 59.05%
Operational Beds (Nos.) 1,150 781 47.25%
Average Length of Stay 3.6 days 3.9 days N.A.
Occupancy (Beds) 396 253 56.52%
In-Patient Count (Nos.) 9,998 5,818 71.85%
Out patient Count (Nos.) 64,189 42,060 52.61%
ARPOB ( In Rs.) 30,625 36,941 -17.10%
40
(INR in million)Financial Highlights Q4FY18
ParticularsQuarter Ended
31-03-18% of Revenue
Quarter Ended
31-03-17% of Revenue Growth Variation
Revenue from Operations 1,083.69 839.48 29.09%
Expenses
Materials & Consumables 264.44 24.40% 188.67 22.47% 40.16% 1.93%
Fees to Doctors and Consultants 300.13 27.70% 222.48 26.50% 34.90% 1.19%
Other Operative Expenses 111.81 10.32% 80.03 9.53% 39.71% 0.78%
Employee Costs 139.06 12.83% 99.5 11.85% 39.76% 0.98%
Administrative Expenses 122.83 11.33% 74.61 8.89% 64.63% 2.45%
Total Operational Expenses 938.27 86.58% 665.28 79.25% 41.03% 7.33%
Operational EBITDA 145.42 13.42% 174.20 20.75% -16.52% -7.33%
Other Income 26.67 28.67 -6.98%
Total EBITDA 172.09 202.87 -15.17%
Finance Cost -3.13 26.47 -111.82%
Depreciation & Amortization Expense 64.13 45.00 42.51%
Profit before tax (PBT) 111.09 131.22 -15.34%
Tax Expense -71.77 52.52 -236.65%
Profit after tax (PAT) 182.86 78.7 132.35%
• Factors contributing to increase in profitability
a. Growth in Revenue of 29.1% over Q4FY17 inter alia contributed by price increase, occupancy growth of 56.5%, In-patient and
Out-Patient growth of 71.8% and 52.6% respectively
b. Normalization and restatement of deferred tax expense on first time implementation of Ind AS
• Factors responsible for dampening profitability growth
a. Reduction in ARPOB by 17.10% due to change to the specialty mix and geographical expansion, which has enabled de-risking
b. Increase in ‘Fees to Doctors and Consultants’ by 1.2% of Revenue
c. Increase in costs of ‘Materials & Consumables’ by 1.9% of Revenue on account of price cap on stents and knee implants
pursuant to NPPA orders during the year
d. Initial temporary operating losses of recently commissioned units
e. Increase in ‘Employees Cost’ of 1.0% of Revenue due to recruitment for new units
f. Increase in ‘Administrative Costs’ of 2.45% of Revenue due to higher ad spend for new units
g. Increase in ‘Other Operative Expenses’ by 0.8% of Revenue
h. Foreign exchange loss of Rs 16.8 million on buyers’ credit against import of medical equipment
41
Financial Highlights Q4FY18
Financial Highlights FY18
716.39
843.55
22.26% 21.88%
FY17 FY18
Operational EBITDA (in millions)
EBITDA Margin
303.62
440.15 9.24%
11.16%
FY17 FY18
PAT (in millions) PAT Margin
3284.29
3942.35
FY17 FY18
Total Revenue (in millions)
42
48
(INR in million)
Operational Performance Synopsis
Note: The operational bed count of 1,150 considers 50 operational beds at Zynova-Shalby Hospital, Mumbai, for which no other operational parameters
are tracked
Particulars YTD Mar’18 % of Revenue YTD Mar’17 % of Revenue Growth
Total Revenue 3,942.35 3,284.29 20.04%
Total EBITDA 930.67 23.61% 782.43 23.82% 18.95%
Bed Capacity (Nos.) 2,012 1,265 59.05%
Operational Beds (Nos.) 1150 781 47.25%
Average Length of Stay 3.7 days 4.0 days N.A.
Occupancy (Beds) 335 271 23.62%
In-Patient Count (Nos.) 32,967 24,704 33.45%
Out patient Count (Nos.) 222,970 166,519 33.90%
ARPOB ( In Rs.) 31,564 32,671 -3.39%
44
(INR in million)Financial Highlights FY18
Particular YTD Mar’18 % of Revenue YTD Mar’17 % of Revenue Growth Variation
Revenue from Operations 3,855.23 3,218.26 19.79%
Expenses
Materials & Consumables 947.71 24.58% 784.87 24.39% 20.75% 0.19%
Fees to Doctors and Consultants 898.06 23.29% 774.76 24.07% 15.91% -0.78%
Other Operative Expenses 398.38 10.33% 315.56 9.81% 26.25% 0.53%
Employee Costs 447.96 11.62% 376.89 11.71% 18.86% -0.09%
Administrative Expenses 319.57 8.29% 249.79 7.76% 27.94% 0.53%
Total Operational Expenses 3,011.68 78.12% 2,501.87 77.74% 20.38% 0.38%
Operational EBITDA 843.55 21.88% 716.39 22.26% 17.75% -0.38%
Other Income 87.12 66.04 31.93%
Total EBITDA 930.67 782.43 18.95%
Finance Cost 121.34 102.15 18.78%
Depreciation & Amortization Expense 224.32 160.08 40.13%
Profit before tax (PBT) 585.01 520.20 12.46%
Tax Expense 144.86 216.58 -33.11%
Profit after tax (PAT) 440.15 303.62 44.97%
45
54.2%
10.8%
9.8%
6.1%
4.1%
15.0%
Specialty Mix
Arthroplasty General Medicine & Critical Care
Cardiac Sciences Other Ortho
Onco Sciences Others
60.3%21.0%
16.4%
2.3%
Payee Profile
Selfpay TPA Corp-Govt Corp-Private
Revenue Composition FY18
60.3% 62.3% 59.5%51.2%
39.7% 37.7% 40.5%48.8%
FY15 FY16 FY17 FY18
Revenue Mix
Knee Replacement Others
30.44% 28.99% 24.39% 24.58%
24.90% 26.12%24.07% 23.29%
6.94% 7.85%9.81% 10.33%
7.20% 9.96%11.71% 11.62%
6.02%7.98%
7.76% 8.29%75.50%
80.89%77.74% 78.12%
FY15 FY16 FY17 FY18
Cost Structure
Administrative and Other Expenses Employee Benefit Expenses
Other Operative Costs Fees to Doctors and Consultants
Materials & Consumables
Revenue Composition & Cost Structure
46
4 Year Trend
695
576
716
844 26.4%
20.1%
22.3%21.9%
FY15 FY16 FY17 FY18
Operational EBITDA (in millions)
EBITDA Margin
2,627 2,868
3,232 3,824
8.9% 9.2%
12.7%
18.3%
FY15 FY16 FY17 FY18
Revenue from Operations (in millions)
Revenue Growth YoY
Operational EBITDARevenue from Operations
47
907
1,295 1,265
2,012
593
823 781
951
196 252 271 335
FY15 FY16 FY17 FY18
Bed Capacity Operational Occupied
39,904
34,173 32,671 31,564
4.03
4.14
3.99
3.70
FY15 FY16 FY17 FY18
ARPOB (in Rs / day) ALOS (Days)
4 Year TrendBed Count Split Operational Parameters
• ARPOB dropping is due to de-risking by way of expansion to newer geographies and increased multispecialty focus,
which has altered our specialty mix
• Decreasing ALOS is a positive sign as it means early discharge for the patients and increased bed turnover rate for us 48
Maturity
Stage
% of Operational
Revenue
% of Operational
Beds
Operational
Beds Occupancy ALOS (Days) Bed Capacity
5 years +
(SG; Vijay;
Krishna; Vapi)
2-5 years
(Jabalpur, Indore)
< 2 years
(Jaipur; Naroda;
Surat; Mohali)
Maturity Profile - FY Mar’18 (Annual Performance)
38% 476
59442%
89223%
22%
14%
30%
32%
418
335
347
3.94
3.58
3.26
38%
62%
49
50
Balance Sheet Standalone(Rs. in Millions)
Statement of Audited Assets and Liabilities STANDALONE
As at As at
Particulars 31/03/2018 31/03/2017
EQUITY AND LIABILITIES
EQUITY
Equity share capital 1,080.10 874.09
Other equity 6,672.36 1,711.34
Total Equity 7,752.46 2,585.43
NON- CURRENT LIABILITIES
Financial liabilities
Borrowings 749.83 2,854.04
Other Financial Liabilities 46.23 22.47
Provisions 13.71 15.18
Deferred Tax Liabilities (Net) - -
Other Non-current Liabilities 128.41 88.77
TOTAL NON-CURRENT LIABILITIES 938.18 2,980.46
CURRENT LIABILITIES
Financial liabilities
Borrowings 157.16 229.72
Trade Payables 479.93 391.78
Other Financial Liabilities 445.30 577.81
Other Current liabilities 45.04 43.51
Provisions 6.06 7.51
Current tax liabilities 3.54 3.71
TOTAL CURRENT LIABILITIES 1,137.03 1,254.04
TOTAL LIABILITIES 2,075.21 4,234.50
TOTAL EQUITY AND LIABILITIES 9,827.67 6,819.93
(Rs. in Millions)Statement of Audited Assets and Liabilities STANDALONE
ParticularsAs at
31/03/2018As at
31/03/2017ASSETS
NON- CURRENT ASSETS
Property, plant and equipment 6,480.55 3,120.37
Capital work-in-progress 376.48 2,207.02
Goodwill 81.97 -
Intangible Assets - 1.61
Intangible assets under development 2.24 2.27
Financial Assets
Investments 9.10 94.10
Loans 77.70 -
Other Financial Assets 229.37 19.12
Deferred Tax assets 111.56 71.61
Other non current assets 74.79 363.69
Total Non-Current Assets 7,443.76 5,879.79
CURRENT ASSETS
Inventories 118.81 75.58
Financial assets
Investments 13.54 4.30
Trade Receivables 601.49 334.58
Cash and Cash Equivalents 108.83 115.82
Other Bank Balances 1,042.29 41.21
Loans - 86.07
Other Financial Assets 158.94 153.69
- -
Current tax asset 97.03 81.30
Other Current Assets 111.06 47.59
Assets classified as held for sale 131.92 -
54218 2,383.91 940.14
Total Assets 9,827.67 6,819.93
Shareholding Pattern
• Total Number of Shares: 108,009,770
Promoter79.41%
FIIs/ DIIs and Retail19.49%
FIIs – 6.28%DIIs – 6.28%
Retail – 6.93%
Trust 0.94%
Others0.16%
Promoter Group Public Trust Others
Shareholding as on 31st March 2018
51
Our Strengths and Differentiators
Experienced
promoters with
hands-on
involvement
Strong brand,
global
leadership in
Joint
Replacement
Optimized
Business Model
now being
replicated
Unleveraged
Balance Sheet
Even after the
IPO promoter
holding is ~80%
Professional
management
Strong emphasis
on governance
and compliance
Leadership and
succession plan
in place
52
Thank you
Opp. Karnavati Club, S G Road, Ahmedabad – 380015, Gujarat, India