Healius Limited (ASX:HLS)
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Earnings Call: H1 2022

Feb 23, 2022

Operator

Thank you for standing by, and welcome to the Healius 2022 half year results presentation. All participants are in a listen only mode. There will be a presentation followed by a question and answer session. If you wish to ask a question, you will need to press the star key followed by the number one on your telephone keypad. I would now like to hand the conference over to Janette Payne. Please go ahead.

Janet Payne
Group Executive of Corporate Affairs, Healius

Morning, ladies and gentlemen, and yes, welcome to Healius and to our first half of our financial year 2022 results presentation. Malcolm Parmenter, our CEO and MD, and Maxine Jaquet, our CFO and COO, will take you through our presentation, and then we'll open up for questions. Without further ado, Malcolm, over to you.

Malcolm Parmenter
CEO and Managing Director, Healius

Thanks, Janette. Good morning, ladies and gentlemen, and welcome to our results presentation. I'm very pleased to announce our first half 2022 financials, which are a beat on consensus. Now, obviously, the large number of COVID PCR tests we undertook in the period was a prime driver of our growth, and this would not have been possible without the ongoing selfless efforts of our people, especially those in our pathology division. Once again, they've risen to the challenge of unprecedented demand for COVID PCR testing, which has been running strongly all period, but particularly in December and January. In recognition of this extraordinary effort, we've put aside funds to reward those who went above and beyond in this six-month period. The first half wasn't just about COVID testing.

Most pleasingly, our revenue was also driven by strong business as usual trading when assessed against the backdrop of the inevitable constraint that COVID outbreaks placed on core healthcare services. As impressive was our control of the cost base in an increasingly inflationary environment with labor, property and IT costs all well controlled. Labor costs were 37% of revenue compared to 44% in the prior comparable period, demonstrating economies of scale from high volumes and good control through our Sustainable Improvement Program or SIP. We've also had several very good procurement wins, although this is masked in the results by the sheer volume of the COVID consumables. Gross operating cash flow followed profits being strong in the period. Our cash conversion was over 90%, taking into account the high volumes over the year-end. Now, we'll come back to talking about growth later in this presentation.

For now, let me just expand on our returns to shareholders in this period. We completed our announced buyback in this half, spending just over AUD 100 million and paid a further AUD 40 million in dividends. In terms of dividends, the board has determined a payment of AUD 0.10 per share as the interim dividend, and this compares to an interim dividend of AUD 0.065 per share for the same period last year and AUD 0.0675 per share in the second half. Now, if you turn to the Pathology slide and turning to the performance there in more detail, I think Pathology's extraordinary results speak for themselves with EBIT up nearly 200% on revenue growth of 56%. I'd like to highlight just a few points.

First, our COVID revenue was up an extraordinary 267% from the Delta and Omicron outbreaks, and we certainly punched above our weight. Our ability to flex up and down to roll out new drive-throughs and respond to demand underpinned this increase. Equally critical to that success was the investment in additional testing capacity that we announced at the FY 2021 full year result. As importantly, our core or business as usual revenue was up 3%, a good outcome when you consider we achieved this on a significantly smaller ACC footprint. That smaller footprint was the result of a planned reduction over the last two years and is precisely what we've been aiming for.

Growth in the core business included a strong performance in our non-MBS revenue and especially our commercial channel, including specialty tests and genetics, and a rebound in hospital referrals in Victoria. The above market core revenue growth was particularly pleasing, given the many more weeks of COVID lockdowns and elective surgery restrictions across multiple states that we saw in this half compared to PCP. Lockdowns and the fear of infection both mean people access core healthcare less often, albeit offset by higher COVID testing. The reverse is also true with reasonably strong rebound in core services once those restraints are removed. Seeing this pattern of core growth slow through lockdowns and high infection numbers, then surge back as the threat recedes, gives us confidence that a backlog of routine testing does exist and will remain through this next phase of the pandemic.

Now, another exciting development in our pathology division has been the acquisition of Agilex Biolabs. As we go forward, the results for our pathology division will include Agilex. I'm particularly enthusiastic about this company as it is a great pathology business with an experienced team in the rapidly growing clinical trials market. We're confident we will see revenue growth above the 15% we mentioned in December when the acquisition was announced. Maxine will provide you with some more color on this later in the presentation. Turning to the imaging slide. Our Lumus Imaging results reflect what's been happening in the market over the COVID outbreaks, the lockdowns, and elective surgery cancellations. Against this backdrop, our trading has been above market in two of our biggest states, Victoria and Queensland, the latter assisted by the Axis Radiology acquisition, which came into our fold in this period.

Victoria was especially pleasing with a strong bounce back there in the early months of the period. As I've said before, our imaging hospital contracts, once won, are quasi monopolies. You do see a strong return of imaging volumes when activity comes back into the hospital. Our New South Wales operations were impacted in our Southwest Sydney heartland during the Delta outbreak. To give you an idea of the scale there, Southwest Sydney is about a quarter of Sydney Metro's revenue, and in that region, it was down about 25% during that period. In the medical center channel, greater telehealth consultations and GP shortages have affected referrals where we are co-located with the former Healius medical centers. In another area of that business, a significant contract for Lumus Imaging is the imaging contract associated with the Bupa visa immigration medical service.

With closed international borders over the last two years, there has been a dramatic reduction in visa applications, resulting in lower immigration medicals and imaging. With our borders opening up, we're already seeing volumes rebounding strongly in February, now well ahead of last year. Bupa, along with Lumus Imaging, as a subcontractor, has retained the visa immigration medicals contract for a further period of up to seven years from July this year. AI is very much a focus for our imaging and pathology businesses. But in imaging, the focus there is on X-ray and MRI, where we're already using Qure.ai, which can triage X-ray scans and allow radiologists to rapidly detect and confirm cases of TB. That's particularly useful in our immigration contract.

We've partnered with the Sydney Medical School, the School of Computer Science, University of Sydney, and the Western Sydney Local Health District to evaluate AI interpretation of chest radiographs for TB within an Australian migrant population. The solution is currently running across 250,000 immigration studies per annum, and we're exploring further functionality for this solution and other AI products on the market. On the imaging cost side, the team has done a great job controlling site labor in this half, which was down 4% year-on-year. However, this was somewhat offset by higher radiologist locum costs resulting from a national shortage of radiologists. As we promised, we've included our imaging SIP initiatives in underlying costs with about AUD 2 million difference to last year's figures baked into those numbers. Finally, our Axis acquisition is going very well with revenue and EBIT above expectations in the period.

Turning to that day hospital slide. Our day hospitals have delivered revenue in the year that is flat year on year, and that's an achievement in itself, given the COVID interruptions in the period. Pleasingly, Westside Private, our flagship hospital, was up 24% in the half continuing its strong growth story. In terms of cost, COVID brought an additional burden with staff retention during surgical restrictions, patient cancellations, and the like. We also added resources to help build the development pipeline, and this, of course, has impacted our corporate costs but will have its own rewards. The comparison to the first half of 2021 is impacted by support payments last year, and as you know, our JobKeeper payments were repaid in the second half.

We announced the development of the Murdoch Day Hospital at the AGM, and it's going well with the build scheduled to complete around July 2024. We have a couple of potential acquisitions in the wings in the near term and a good pipeline of greenfield and roll-up opportunities to help deliver the growth strategy. On the corporate front, the corporate slide, I won't dwell on our corporate costs, as Max will address that. Suffice it to say, the first half figures are where we expected them to be and in line with the second half of last year. In terms of the trading update, I wanna spend a little bit of time on this, as there are some important things I think to consider here. First, looking at our business as usual trading in January and February.

The second half started off in a similar vein to the first, with volumes now progressively picking up. We expect them to continue to get stronger with the Omicron peak subsiding, elective surgery resuming, and community concerns over accessing healthcare decreasing all at different times in different states. There is certainly known underdiagnosis of disease and a backlog of surgery which we will see coming into the pipeline. We anticipate an acceleration in demand for routine healthcare to drive growth over the near term, and Healius is well placed to deliver on this acceleration. With the opening of the borders, we should also see overseas trained doctors returning to our shores, to our hospitals and medical centers, especially in regional areas, and this will increase referrals to our diagnostics divisions.

In terms of COVID PCR testing, tests per working day seem to have settled to around 15,000-17,000 per working day, and this compares to about 10,000 per working day at the same time last year. The high volume of testing that was occurring in December and January in New South Wales has certainly dropped, but this is partially offset by higher levels of testing in the other states. It's likely, in our view, this base testing, base level of testing, will continue through to winter, barring further outbreaks. In terms of COVID, the disease, I know we all want to believe that it's going away and we'll go back to life as we knew it. Like everyone else, I've had enough of this virus. In fact, I had it myself, and my family did, as like, as many of you probably have as well.

However, Healius is a science-based organization and wishful thinking won't get us there. There are a few aspects of coronavirus that we now know with a reasonably high degree of certainty. The first is that the virus has a greater capacity for mutation and evolution than was initially thought, and variants of concern have been turning up every six months or so. The virulence of each new variant of concern is varied, some worse, some better. Alpha, more virulent than the original Wuhan strain, Delta more virulent than Alpha, followed by Omicron, which is less virulent but similar to the original Wuhan strain. The evidence suggests this pattern is likely to continue, with some variants worse, some better. We also know that vaccines are effective, but immunity wanes reasonably quickly, and immunity from infection also wanes reasonably quickly. What's more, the virus has shown itself capable of some vaccine escape.

The pattern of outbreaks is that they come in waves or epidemics, and when the scientific community talks about the virus becoming endemic, that is what they mean. Now, armed with this knowledge, the science says it's quite likely there'll be another round of COVID this coming winter in Australia. Unfortunately, this may be in tandem with influenza, given Australia has seen very little flu for more than three years. If this occurs, and particularly if the next variant is more virulent, PCR testing, along with tracking, tracing, and self-isolation, will again be the mainstay of our response to avoid lockdowns and limit spread as much as possible. Now, PCR consistently detects COVID two to three days earlier in an infection than a RAT does.

The problem with rapid antigen tests in the situation of more dangerous variants of the virus is that they leave infected people out and about in the community for longer. PCR testing also has the advantage of being able to diagnose whether the infection is COVID, influenza, or one of several other respiratory viruses, something that is important in a situation where not every infection in the community is COVID. When it comes to tracking and tracing, many people don't register their positive rapid antigen test result, as evidenced by the fact that now around half of registered positives still come from PCR testing. Keeping our economy open is not just about avoiding lockdowns, as we've discovered in a rather painful way in the last couple of months. It's also about keeping the number of infections under control.

In the event of variants more virulent than Omicron, that can only be done with effective testing, tracking, and tracing. Now, we probably have a window of opportunity between now and winter to learn from the past, improve the national PCR regime, and be ready for whatever comes in terms of variants. From a scientific perspective, RAT tests probably haven't added much value to the control of the recent Omicron outbreak. By the same token, PCR tests that take days to come back have also little utility, and I think we can do better. With the science in mind, Healius has been investing in improving both the efficiency, the cost per test, and the capacity of our PCR testing to allow our laboratories to flex up and down as required.

We've set our targets at consistently delivering PCR results in less than 12 hours in metropolitan areas and less than 24 hours in regional areas. There are new rapid PCR machines making their way through TGA approval, and this should improve turnaround times in regional areas in particular. In a world where COVID wishful thinking is the order of the day, this might all sound a bit bleak. I don't mean it to be. We've come a long way and there is a pathway to safety from COVID. It's just that I don't believe Omicron on its own is that pathway. Rather, better targeted vaccines are likely to be the solution, and we could start to see them before the year is out.

Even in that world, COVID will likely remain a dangerous infection, especially to the unvaccinated, and doctors will continue to use PCR tests to identify those infections. Now let me move to a couple of other matters before I hand over to Max. The emergence of inflationary pressures in the supply chain has been a theme this reporting season. At Healius, we are managing our costs well, and the financial metrics bear this out. The SIP program gives us further opportunities to improve. We're also very focused on enhancing our people development, recognition, and communications initiatives, as well as our green credentials. We need to be able to attract and keep the best people, and the improvements to our brand and value proposition will help us as we respond to the skills shortages in Australia.

Finally, I've said a couple of times in the closing remarks to our stock exchange releases, that I see this period of cash inflow, both from COVID revenue and from the lessening of capital requirements through the selling of medical centers, as a real opportunity to invest in leading-edge digital applications, which can permanently change for the better how consumers access diagnostic healthcare in Australia. These are not just empty words. We are now well down the path of bringing our digital initiatives to life. These applications, as they come to life over the next two to three years in our laboratories, in our imaging centers, our collection centers, in our doctors' offices, and on our doctors' and patients' mobile devices, will significantly improve the way we all access and experience healthcare.

At Healius, we have a great team and a great chance to jump to the front in our consumer and our B2B offerings over the next few years. We will need to invest some capital there, but we'll certainly benefit from these changes. With that, let me pass you over to Max. Thanks, Max.

Maxine Jaquet
CFO and COO, Healius

Thanks, Malcolm. Good morning, everyone. I'd like to spend a few minutes on our capital position, margin performance, and the portfolio. Turning to slide eight, the objectives of our December 2020 capital management review were to recalibrate our capital structure and minimize cost of capital while providing sufficient flexibility to meet business growth and shareholder returns. Underpinning our strong balance sheet and low gearing were the operating cash flows generated in the half. As you can see from the slide, gross operating cash flow increased by 43% to AUD 409.3 million. Our EBITDA conversion was well over 90% after adjusting for the significant revenue surge during the last two weeks in December when Omicron took hold.

The strong cash flows obviously reflect the significant revenue growth during the period, but also careful management of capital expenditure and working capital, focus on controlling operating expenditure, the lower capital intensity of the group following the divestment of Healius Primary Care. This has also allowed us to consider alternative funding mechanisms. For example, in imaging, we purchased new and replacement equipment to take advantage of better rates and our lower debt levels rather than leasing that equipment. As you can see from the slide, organic CapEx was AUD 42.4 million for the half, including AUD 26.3 million in imaging. Inorganic CapEx was AUD 48.6 million, and comprised AUD 36 million for the final Montserrat earn-out and settlement, and the AUD 12.6 million for the acquisition of the Axis Radiology business. In the next six months, we expect to spend approximately AUD 65 million.

A large proportion of this spend underpins the digital and LIS program in pathology. In addition, we are investing in lab capacity, some of which can be used to improve COVID testing efficiency. As mentioned by Malcolm, the group completed its on-market share buyback program in December 2021, purchasing 44.3 million shares at an average execution price of AUD 4.47 for a total purchase value of AUD 198.2 million. Net debt at December 31 was AUD 221 million, with our bank gearing ratio at 0.4x, the lowest in recent history. Our low levels of debt allowed us to significantly reduce finance costs to AUD 25.3 million in the half, compared with AUD 36.2 million in the prior comparable period.

At the end of January, net debt levels increased by AUD 293 million as we financed the acquisition of Agilex. Healius' strong operating performance and associated cash flow generation positions us well for growth in the future. Turning now to our margin expansion agenda. We have already made substantial progress across all levers of EBIT performance under phase two of the Sustainable Improvement Program, or SIP. Slide nine highlights the early results of these initiatives on cost. In the first half of the year, total business activity was up strongly, with revenue up 43% compared with the prior comparable period. Cost growth, in comparison, was well controlled despite increasing inflationary pressures.

In particular, labor costs half-on-half were up only 19%, and labor expense reduced to 37% of revenue, compared with 44% in the prior comparable period. This reflects the economies of scale implicit in the business, a number of SIP initiatives improving the productivity of our workforce, and careful management of wage inflation. Pleasingly, imaging delivered a 4% reduction in same-site support labor. The increase in dollar value of consumables expense was wholly explained by the increase in COVID testing volumes, despite achieving significant price reduction in COVID-related consumables. In addition, our SIP sourcing program achieved a 5% reduction in consumable spend in BAU pathology. As a percentage of revenue, consumables expense remained consistent with the prior comparable period. All other costs tracked lower, contributing to the strong margin growth. Property and IT costs, in particular, benefited from SIP initiatives targeting demand, sourcing, and spend control.

The increase in ROU asset depreciation reflects a full six months expense for the third-party leases for medical centers. Other depreciation costs increased due to equipment purchases in imaging. Turning to slide 10. Most of the SIP initiatives have been scoped and designed and are now in implementation. I'd like to describe some of the progress we've made in the first half. Imaging same-site revenue growth includes the national rebranding to Lumus Imaging, where we are aligning our online presence with our physical network. We have also expanded our capacity, invested in higher margin modalities, and are increasing our out-of-pocket fees. In pathology, our revenue performance highlights traction being made in non-COVID commercial initiatives and the specialist segment. As Malcolm noted, our BAU revenue growth was above market. For initiatives in our laboratories, we have paced this effort given COVID testing priorities and the requirement for a higher labor complement.

However, we have fast-tracked areas such as digital pathology and vets and commenced work in other areas such as anatomical pathology. Now turning to our digitization program. This covers the five key service areas of referrals, collections, tests, re-results, and billings. We have been prioritizing referrals and collections. To that end, we have built and launched an electronic referral solution for doctors to send pathology requests via SMS to patients. So far, we have launched the first release of the solution in Laverty. We've also built and launched a collections portal for staff in ACCs to register a patient when they come in, put through test orders, and collect specimens. Our rostering program will provide cost transparency, standardization, and opportunities to better flex labor according to demand. We have delivered the first phase of a four-phase process. Many productivity initiatives from sourcing are already delivering savings.

Over 40% price reduction on a number of consumables, over 20% cost savings from outsourced radiology reporting and transcription services, around 15% savings for facilities management, 3PL, and imaging software licenses. While a lot has been achieved, there is plenty more implementation to come and the financial benefits associated with that. As I've said before, the margin benefit should come through in the exit run rate out of FY 2023. Turning to the portfolio on the next page. Over the last 18 months, we have established the right capital conditions and flexibility to be able to pursue growth more rapidly. We are investing in our capabilities, technology, and assets to drive a higher return on invested capital from the core businesses. We have acquired Axis Radiology, Agilex, and commenced development of the Murdoch Drive Hospital .

The Agilex acquisition provides a platform in the high-growth global market of clinical trials. Having spent time with the Agilex management team, we are confident that the business will exceed our acquisition case, particularly in their largest and most established areas, which are mass spectrometry and immunoassay. We are also deepening the service offering in vaccines, toxicology, immunobiology, and gene therapy. Furthermore, Healius' general pathology and genomics capabilities will enhance Agilex's offering around areas such as immunohistochemistry and sequencing and genetics. Overall, the ambition is for Agilex to be a one-stop shop for bioanalytical services with the ability to compete all the way from pre-clinical through to phase III trials. To accelerate this, we are evaluating bolt-on opportunities, most likely in the U.S. and Asia Pacific.

We will spend some time on our plans for the portfolio, including Agilex, and provide you with an opportunity to meet the team at the Investor Day out of reporting season and in the next couple of months. Thank you.

Operator

Thank you. If you wish to ask a question, please press star one on your telephone and wait for your name to be announced. If you wish to cancel your request, please press star two. If you're on a speakerphone, please pick up the handset to ask a question. Your first question comes from Lyanne Harrison with Bank of America. Please go ahead.

Lyanne Harrison
Equity Analyst of Healthcare, Bank of America

Oh, hello, Malcolm and Maxine. Thank you for taking my questions. Can I start with the base business in pathology and also the imaging business? Obviously we understand that that's recovering as, you know, the different regions come out of COVID restrictions. Is there anything that you can point to that might suggest that Healius might recover faster than its peers?

Malcolm Parmenter
CEO and Managing Director, Healius

Look, hard to say the answer to that. I mean, pathology is not, and imaging are not sort of one uniform business that everybody has the same exposure to different components of the market.

Lyanne Harrison
Equity Analyst of Healthcare, Bank of America

Mm-hmm.

Malcolm Parmenter
CEO and Managing Director, Healius

It's those different components of the market that respond differently. If you think about Healius in pathology, for example, you know, we have a fairly significant business in public hospitals in Victoria, for example. What happens there, given COVID and elective surgery restrictions and things coming and going, actually, is different to what happens in community pathology, you know, in terms of how that works. It's a little hard to say through this period as to exactly who benefits and who doesn't, I think is the reality of it. The thing we do see, though, is as the waves of COVID go, you get significant bounce backs in between in terms of volume.

You're getting this swing from one to the other, and it's that that says there is quite a backlog of work that's there probably for everybody across the industry, I think. The reality is, I think it's there. It's certainly there in imaging. About 40% or thereabouts of our imaging revenue is in hospitals of one kind or another. Having elective surgery restricted significantly like it has been has a big impact on the amount of imaging. A lot of the imaging is pre- and post- operations. With that not happening or only limited to urgent stuff, that has a big impact on it. When the hospitals open up those imaging centers, the work simply flows back into them. It's as simple as that.

They sit there in a market of their own. It's that kind of environment that we're in. If we get a run now without another wave for a while, you know, my guess is that both businesses and day hospitals as well, for that matter, you know, rebound pretty strongly.

Lyanne Harrison
Equity Analyst of Healthcare, Bank of America

Thank you. If we could stay on, I guess for core testing in terms of pathology, you called out that commercial testing had some good growth in the first half. Can you provide some more color on that?

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah. Look, we count as commercial testing a range of things. This is non-COVID commercial testing, of course. I mean, there's commercial-

Lyanne Harrison
Equity Analyst of Healthcare, Bank of America

Mm-hmm.

Malcolm Parmenter
CEO and Managing Director, Healius

...in COVID as well. Our hospital contracts, we have, you know, although in terms of the total pathology business it's relatively small, we have a veterinary pathology business, and veterinary services have been pretty strong, as has veterinary pathology, in that space. Genomics has a commercial component to it that's non-MBS as well. That, they've been the key areas that have been growing quite strongly for us.

Lyanne Harrison
Equity Analyst of Healthcare, Bank of America

Okay. Thank you. Just if I could fit one more question in around COVID testing outlook. You know, you've mentioned that you expect a base load of testing to remain. Is this largely community testing or are there any sort of corporate contracts or travel arrangements that you have in place that might, I guess, prop up your COVID testing over the near term?

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah, look, the travel, I mean, a lot of COVID. There is a chunk of COVID testing that's determined by the regulations and what people are required to do for entry to various countries. We certainly do have a number of contracts in terms of travel that we've established over time that are part of that. You know, realistically, if you look at it, I mean, PCR testing is run pretty much as the disease has run, and it settles back into a sort of base load of testing. You know, without the restrictions in place, you end up with people with viruses other than COVID, and that needs to be identified.

People with colds and sore throats for other reasons end up having COVID testing, and a percentage of people have PCR. I mean, you've probably, I mean, everybody on this call has probably done a RAT test, that, probably doesn't surprise you to know that not everybody in the population is capable of doing that. You know, the elderly population, for example, being able to do a RAT test is, it's, you know, you've gotta have reasonably good hands, and if you're arthritic or any of those things, it actually becomes quite difficult to do. It's, it's just PCR testing also, you know, picks it up earlier.

You know, I don't know how many people on the call have been doing RAT tests and you kind of got a sore throat and you're feeling sick and for two days or so the RAT test is negative before it becomes positive. It's a pretty common event. People, you know, if they're worried in that situation, will go and get a PCR. You know, if you're going to visit your elderly parent in a nursing home, then you wanna know for sure. You don't wanna be going there with a sore throat and.

Maxine Jaquet
CFO and COO, Healius

A negative RAT test. There is this base load of PCR that will continue to happen. As other viruses come around and RAT tests are negative in those environments, sometimes people want to know what it is. I think it does get to this base load of PCR that just continues on in between until we lose all sort of fear of COVID. You know, as I was saying through the talk, I think that's a way off yet.

Lyanne Harrison
Equity Analyst of Healthcare, Bank of America

Thank you very much.

Operator

Thank you. Your next question comes from Gretel Janu with Credit Suisse. Please go ahead.

Gretel Janu
Equity Research Analyst, Credit Suisse

Thanks. Good afternoon, Malcolm and Maxine. If I could just start with the SIP program. It is getting very difficult for us to really unpick how you're going relative to the 300 basis points margin improvement target by 2023 outside of COVID. Are you able to give us some indication how progressed you are? Like, are we halfway there, 2/3 there? And particularly on imaging, because I think you were looking and targeting imaging EBIT of AUD 60 million-AUD 65 million in FY 2023. You've recorded AUD 12 million in the half. Yes, it has been COVID affected, but it's still quite a way off that target. Just some more color around this would be great. Thanks.

Maxine Jaquet
CFO and COO, Healius

Thanks, Gretel. Look, you're right. The targets for imaging were the combination of base revenue, which we talked about before, and the SIP program. Look, we are where we expect to be in terms of implementation. I know it's hard for you all to see through. These are not quick-win initiatives. It is about implementing infrastructure across, you know, a network of 140 sites, and the change management that goes along with that, as well as getting to that return of the base business in imaging. Look, we are where we expect to be in imaging. Look, we're still pretty confident about those targets. I think in the last call, we talked about the exit run rate of being FY 2023.

Look, we should see some improvements, assuming we get that base load capacity coming back in imaging, to see that build up in terms of margin improvement. Pretty comfortable where we are, at this point in time. Look, in pathology, as I said, and in some of those highlights, I mean, that was a pretty concerted effort, our focus around non-MBS growth, and also the ACC network optimization piece, and we're pleased with how that's translating into revenue. We see more opportunities in that area. In terms of the other initiatives around the digitization and the LIS program, again, trying to accelerate that, and comfortable with the progress that's been made there with those couple of highlights I gave earlier.

The only area that has been deliberately deprioritized at this point in time is rightsizing pathology lab labor for very good reasons, because we are not at normal labor levels within pathology, as I'm sure you can appreciate. That doesn't mean we are slowing down the core tool that is required, which is the dynamic rostering program in pathology, which so we're phase I and phase II will be in the next couple of months. Again, not pushing the technology and the enabling capabilities that we need on that side of things. Look, comfortable where we are, and it will be good to see a normal return of normal trading activity, particularly in imaging, so we can see some of the results, particularly on the margin side in imaging.

Gretel Janu
Equity Research Analyst, Credit Suisse

Thanks, Maxine. That's helpful. Just following on to collection centers there. You did do further network optimization in the half. Was there any revenue leakage from this? Just from your comments just then, you expect to do still further optimization ongoing. Is that right?

Maxine Jaquet
CFO and COO, Healius

Yeah. That certainly doesn't mean cutting more centers. We're at 2,027 sites. Look, we probably don't wanna say too much on the call, but we do see this as an opportunity for growth. You can read from that what we will. Yes, there was some revenue leakage, but revenue that was highly unprofitable. Again, with a good retention of some of that revenue going to our existing ACCs. Still very comfortable with the decision that we made around that network footprint.

Gretel Janu
Equity Research Analyst, Credit Suisse

Thanks. That's very helpful. Then just finally on the dividend, only a 24% payout ratio in the half. Have you departed from the payout ratio target of 50%-70%?

Maxine Jaquet
CFO and COO, Healius

No, we haven't. Obviously, our payout ratio sits between 50%-70%. Look, this is obviously a challenging one. This is a period of, you know, supernormal profits. As a result of that, we've got a dividend which we feel is an appropriate return to shareholders given what we see as the ongoing growth needs of the business. Trying to obviously balance that, it's never easy to get that exactly right for everyone. Not stepping away from that policy. I think when we get to the investor day, we will be talking more about capital management, and perhaps that's the time to address that question more fully.

Gretel Janu
Equity Research Analyst, Credit Suisse

Great. Thank you very much.

Operator

Thank you. Your next question comes from Andrew Goodsall with MST Marquee. Please go ahead.

Andrew Goodsall
Senior Healthcare Analyst, MST Marquee

Oh, good morning, and thanks very much for taking my questions. I was just going to ask, on the M&A front, just post Agilex, how you're thinking about your capacity for M&A in terms of both your debt metrics and also your ability or capacity to integrate further M&A.

Maxine Jaquet
CFO and COO, Healius

Thanks, Andrew. Look, a couple of things. We are going through a refi at the moment, and we will probably lift the facility a bit from where we are today. The kind of acquisitions that we are looking at with the Agilex business are acquisitions that they had on their radar, which are highly complementary in terms of additional capacity in their growth areas. They are pretty small scale. We have essentially about AUD 300 million to hand, and that's not what we have earmarked, by the way, but it's just the capacity when we go through the refi. They are small scale. They will be incremental.

Again Andrew, not to put you off too much, but that's probably something that we would love to go into a lot more detail at the Investor Day when we get the Agilex team up, and we can talk about the core areas of growth and both the organic growth and the inorganic growth opportunities in that segment.

Andrew Goodsall
Senior Healthcare Analyst, MST Marquee

Outside of that segment, is there other M&A that you'd, I guess, consider or look at at the moment?

Maxine Jaquet
CFO and COO, Healius

Yeah. Look, we're constantly running the ruler over imaging acquisitions. It's still a reasonably fragmented market. It's a competitive market. But still running the ruler over imaging acquisitions, particularly where they're complementary to our existing business, the long hospital contracts and things like that. And similarly in the day hospitals, we've got a pipeline of good acquisitions that we're currently working through. Definitely some thinking around how we continue to grow that business.

Andrew Goodsall
Senior Healthcare Analyst, MST Marquee

You take your gearing ratios back up to sort of normal.

Maxine Jaquet
CFO and COO, Healius

Yeah, I think so.

Andrew Goodsall
Senior Healthcare Analyst, MST Marquee

sort of conventional ratios to do that?

Maxine Jaquet
CFO and COO, Healius

Yeah.

Andrew Goodsall
Senior Healthcare Analyst, MST Marquee

Okay.

Maxine Jaquet
CFO and COO, Healius

That's right.

Andrew Goodsall
Senior Healthcare Analyst, MST Marquee

Great. I think Malcolm just was talking about the recovery, particularly in the day surgeries business. I was just wondering whether you'd start to see any forward theater bookings improve at this point, as the states remove their restrictions.

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah. Look, I think absolutely, Andrew. There clearly is a backlog there. Look, we would expect that, you know, some of the other things that we used to see a lot of in the past that there's been less of in the last six months have been kind of public work that's referred into the private sector as well. We would expect to see that start to come back as well as we look to catch up. I mean, there is a big backlog of surgery out there, but a whole lot of routine stuff that just needs to be done around colonoscopies, eye surgery and things.

During, you know, there is a general reluctance to access healthcare when the sort of news feed is basically telling people you can go to hospital and you can, you know, like going to McDonald's and getting fries with that, you get COVID with that. It's that kind of environment where, you know, we're talking about sort of not isolating hospital staff when they're exposed to COVID and still coming to work does tend to frighten people off. That fear is going away quite quickly at this point in time. We're starting to see those bookings extend out and surgeons extending their lists.

Maxine Jaquet
CFO and COO, Healius

We did, just to add to that.

Andrew Goodsall
Senior Healthcare Analyst, MST Marquee

And, uh-

Maxine Jaquet
CFO and COO, Healius

In-

Andrew Goodsall
Senior Healthcare Analyst, MST Marquee

I'm sorry.

Maxine Jaquet
CFO and COO, Healius

Yeah. I might just add a couple of points to that. We actually have in Westside, we've seen actually some of our highest procedure days. You tend to get a lead time of, you know, you get a month, obviously a month out and then two weeks out. What we have seen is lists can be completely full and then you get a lockdown or you get staff shortages from sickness and the lists get canceled, right? I, you know, we think as soon as you get that clear air, we've seen moments through the last six months where not only returns to what was budgeted, but also there is rebound.

Andrew Goodsall
Senior Healthcare Analyst, MST Marquee

Okay. Just a final housekeeping from me. Just trying to understand CapEx in the second half. You did mention the 65, but I didn't quite catch sort of how you're thinking about CapEx second half.

Maxine Jaquet
CFO and COO, Healius

Yeah. Look, the CapEx for the second half, the lion's share of that will be in pathology and will be, so there's a chunk that will be spent on the LIS and the digital piece. You'll notice CapEx for pathology in the first half was quite low. That will pick up in the second half as we enter into these contracts and spending out on some of the infrastructure, particularly for digital and LIS.

Andrew Goodsall
Senior Healthcare Analyst, MST Marquee

Do you have a sense of the absolute number there in terms of group CapEx?

Maxine Jaquet
CFO and COO, Healius

For the second half? We said 60, we said 65.

Andrew Goodsall
Senior Healthcare Analyst, MST Marquee

Okay. Got it. That's great. Thank you very much.

Operator

Thank you. Your next question comes from David Low with JP Morgan. Please go ahead.

David Low
Equity Research Analyst and Executive Director, JPMorgan

Thanks very much. If we could just start with the day hospital. Just wondering, just understanding where IVF is at, given the failed transaction. While I'm on the topic, I mean, I see revenues were flat overall, but Westside was up 24% and presumably something went backwards. Could I get you to elaborate a little bit on that, please?

Maxine Jaquet
CFO and COO, Healius

Maybe. Yeah. Okay. Thanks, David. Look, the areas Westside was up, and the areas that were down were the sites which were impacted in New South Wales with lockdown and also some of the government contract work which was canceled.

David Low
Equity Research Analyst and Executive Director, JPMorgan

Okay, just the IVF business that's still to be sold.

Maxine Jaquet
CFO and COO, Healius

We would have hoped to have said today that it's sold, but it's, we're hoping that it's imminent.

David Low
Equity Research Analyst and Executive Director, JPMorgan

Okay. That's very clear. Thank you. The other question I had just around COVID testing margins in recent weeks and months, I mean, we've certainly seen positivity rates go up. We hear talk about pooling being pulled out of the system because it's just not viable with high positivity rates. Just wondering what that means for margins. Perhaps if I could broaden that into a discussion of if we see COVID get back to that base level that Malcolm talked about, what does that mean for margins, given there are a few moving parts in there with private reimbursement down, seemingly consumables cost down, maybe pooling at lower levels? I'll stop if you could give us a little bit of insight, please.

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah. Thanks, David. Look, we in terms of pooling in our pathology business, we rarely went above pooling two- in-one . It's not a massive shift for us in terms of where it is. There's clearly a manual component to pooling in terms of the people required to do that as well. Plus, you know, the investment that we're currently doing in terms of efficiency around the kinds of machines we use, the number of people that that requires, et cetera. I think that, you know, yes, pooling does make a difference to it. If the numbers of cases drop right away, then you can go back to doing some pooling. You know, we'll need to take that as it comes.

I mean, clearly, if where we were in late December and early January, where the positivity rate on PCR testing was running in the high 20%, you know, it's pooling becomes pretty much a useless exercise in that kind of scenario. Look, I think, you know, we've obviously got a fee cut as well in for COVID testing in this in the second half that's in there. All of those factors together mean, you know, the margins on PCR testing are still reasonable.

David Low
Equity Research Analyst and Executive Director, JPMorgan

Do you think they'll be lower, though? I mean, given volumes were so high in the New South Wales lockdowns and then into the end of the year, I presume, you know, when volumes are that high, margins go up pretty nicely as well. In the absence of that sort of level of demand, we would expect lower margins just because the fixed cost leverage.

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah. Look, it's true. I mean, but high volumes mean you've got labs running 24 hours a day, lots of overtime, lots of casual labor. There's a bunch of other costs that actually go with that kind of running. The collection center's also running in, at least the drive-through is running at significant overtime as well. It is a mix of things. I mean, at the moment, we're running at levels that are in the sort of 15,000-18,000 per working day, that sort of number. I think this time a year ago we were running at 10,000.

For a good chunk of the last six months we were running at similar kinds of numbers as to what we are now between waves of infection. You know, yes, the numbers were. You know, we would, I think at our peak we were doing something like 65,000 a day in December. But it's a relatively short period of time that you're doing that for. You know, most of the six months you're running at that sort of lower number, you know, or at least for good parts of it, you're running at that lower number, and then it comes in periods of running at super high numbers. So I don't know whether that answers your question.

David Low
Equity Research Analyst and Executive Director, JPMorgan

I'll take that all on board. Last question. The CapEx has stepped up, or the inorganic CapEx has stepped up from, what, AUD 60 odd million last year to, you know, comfortably over AUD 100 million this year. What should we be thinking about over the next two or three years given the digitization programs, et cetera, are continuing? Will it stay at that sort of higher level?

Maxine Jaquet
CFO and COO, Healius

Yeah. Look, I think so with that running out. I mean, I think our latest forecasts on the digitization and the LIS program are pleasingly coming in, the forecasts are coming lower. I think we had talked about it coming in below the AUD 90 million and we are comfortable that it is gonna come in much lower than that. We are targeting, and don't take this number as gospel at this point, but it is more around that sort of AUD 65 million mark in total. Right? If you said we spent AUD 20 million before in 2021, up to 2021-2022, about AUD 15 million in total on that program. Then another AUD 20 million-27 million for FY 2023. That gets you to sort of a total number for that program. That's the major component of the CapEx.

Now, as I said, we have shifted quite a lot of the leased arrangements in imaging to buy for both existing and new. We will look at that in this next six months again as we go through and looking for better leasing rates on some of our equipment. That, I don't expect that to continue for imaging at that higher CapEx level.

David Low
Equity Research Analyst and Executive Director, JPMorgan

Okay. Thank you very much.

Operator

Thank you. Your next question comes from David Stanton with Jefferies. Please go ahead.

David Stanton
Head of Healthcare Equity Research of Australia, Jefferies

Good afternoon, and thanks very much, team, for taking my question. Just two from me. You talked to a base business increase in revenue terms in pathology of about 3%. You know, when COVID, I don't know, it's difficult, but when COVID finally ends and people go back to requiring more pathology and doing and having more operations and procedures, could you talk to, you know, what you think the at least the near-term increase in what you see as revenue upside from base business testing going forward? Like, should we be thinking over the medium term that it goes from 3% that you've seen to, say, 5%, 6% in terms of base business pathology increase? Thank you.

Maxine Jaquet
CFO and COO, Healius

Yeah.

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah, look, I mean, I get my crystal ball out now.

David Stanton
Head of Healthcare Equity Research of Australia, Jefferies

Sure.

Malcolm Parmenter
CEO and Managing Director, Healius

Look, what we see in between, and we monitor this sort of certainly on a. You might have seen them on a, on Medicare stats, et cetera. When the waves of COVID disappear, pathology growth on the MBS rebounds back to sort of 5%, 6%, and 7% in those in between months that it's there. There clearly is growth that's sitting there, that's backlog in terms of where it goes. Thinking that the pathology goes back at least for a year or two at sort of 5% or thereabout is, I think, perfectly reasonable based on what we've seen from the way the sort of growth comes and goes with COVID lockdowns and then recovery in between.

Maxine Jaquet
CFO and COO, Healius

When you look at some of the areas in pathology which are definitely lower and you know they're lockdown related or lower community activity related. If you took that as, and you've seen the MBS stats of where they are being lower, that absolutely should be rebounding. You add that to our growth and what we're getting on the commercial and specialist side, we'd certainly be expecting that kind of growth that Malcolm's talking about.

David Stanton
Head of Healthcare Equity Research of Australia, Jefferies

Thank you. Then a two-parter from me to finish with. NRIs for 2022, they've been low in the first half. We should be seeing anything major into the second half?

Maxine Jaquet
CFO and COO, Healius

I'm sorry, what was that?

David Stanton
Head of Healthcare Equity Research of Australia, Jefferies

First part. Second part, I guess, non-occurring items.

Maxine Jaquet
CFO and COO, Healius

Sorry, what was the first part?

Malcolm Parmenter
CEO and Managing Director, Healius

We were just talk-

David Stanton
Head of Healthcare Equity Research of Australia, Jefferies

Underlying.

Maxine Jaquet
CFO and COO, Healius

Underlying, sorry.

David Stanton
Head of Healthcare Equity Research of Australia, Jefferies

Yeah.

Maxine Jaquet
CFO and COO, Healius

Oh, okay. You're talking about null.

Operator

Yeah.

Maxine Jaquet
CFO and COO, Healius

Look, this is a pretty conscious effort to try and get that as low as we possibly can.

David Stanton
Head of Healthcare Equity Research of Australia, Jefferies

Yeah.

Maxine Jaquet
CFO and COO, Healius

You'll see we've taken the position of putting what we had in non-underlying for imaging into the underlying results. Look, it's the main item obviously is the digital OpEx expenditure for the second half. That will be part of that. Look, I don't see it as being materially up on the first half, but probably continuing at that level for the near term.

David Stanton
Head of Healthcare Equity Research of Australia, Jefferies

Right. Thank you. On that basis, you know, tax rate for the FY 2022, any guidance on that, please? That's it from me. Thank you.

Maxine Jaquet
CFO and COO, Healius

30%.

David Stanton
Head of Healthcare Equity Research of Australia, Jefferies

Thank you.

Operator

Thank you. Your next question comes from Chris Cooper with Goldman Sachs. Please go ahead.

Chris Cooper
Healthcare Equity Analyst, Goldman Sachs

Afternoon, everyone. Thank you very much for taking my questions. Just one on labor costs, if you don't mind. I mean, I appreciate here you've grown quite some way below sales growth, but it's still up 19% in the period. I'm just really interested, I guess, in how much flex you have in the current market. There's all sorts of debate around the labor market currently, of course. I'm just kind of trying to have a think forward about how we sort of predict forecast COVID volumes and the interplay of the recovery in the base business.

I'm just curious to hear, you know, the scope to which you have the ability to move labor up and down to match what is still gonna be a very volatile period on the volume side.

Maxine Jaquet
CFO and COO, Healius

Yeah. Okay. Great question. Look, in that first half number, there were a number of EBAs which were locked away. We're happy that they've been locked away, and they were locked away at very attractive rates. But the rest of the increase is wholly explained by the COVID increase in casual labor. Look, we've shown obviously we can scale up labor. That labor is of a casual basis, overtime through, and obviously overnight labor. We will, if COVID, depending on where COVID goes, that we basically run scenarios around, okay, what does our labor need to be at these various levels? That's what we will be continuing to do as we get the inevitable ups and downs in COVID.

Chris Cooper
Healthcare Equity Analyst, Goldman Sachs

Okay. There's no scenario here, Maxine, where labor cost is gonna be more sticky than COVID volumes. If COVID volumes fall quicker than you expect, then you'll be able to at least match that by taking labor out as quickly.

Maxine Jaquet
CFO and COO, Healius

Yes. Look, we've moved some.

Chris Cooper
Healthcare Equity Analyst, Goldman Sachs

Okay. All right. Cool.

Maxine Jaquet
CFO and COO, Healius

Yeah. We've moved some labor across from other areas in the lab. As those areas in microbiology specifically rebound for normal testing, then with that labor, we'll shift back into that area, and it's the casual labor which will come out.

Chris Cooper
Healthcare Equity Analyst, Goldman Sachs

Thank you. Just one other, please, on the procurement wins. You mentioned at the start you had several good wins there, but these are kind of being masked by the growth that we saw in the consumables costs associated with COVID. Could you just give us a bit more color on what and how you've delivered these procurement wins? What sort of lines, and can you give us some sense of materiality?

Maxine Jaquet
CFO and COO, Healius

Yeah. I mean, look, just to give you a little bit of color on the COVID consumables, 'cause I think it's, I mean, it's an astronomical number in terms of our overall increase, just volume-related, was something like AUD 120 million, right? We took out some substantial savings out of that, but still, we were still ahead, obviously, given where volume was. Look, how we have done it, we've actually changed our whole sourcing structure in the group. We certainly in the past, like everyone else, looked for, you know, price discounts, but what we are doing, I think, much better now is actually managing the contracts and managing actually to those contracts. That has been a material change in the way we're sourcing.

Look, that's probably been one of the best outcomes of the SIP Program to date, has been those savings that we've achieved.

Chris Cooper
Healthcare Equity Analyst, Goldman Sachs

Thanks.

Operator

Thank you. Your next question comes from Craig Wong-Pan with RBC. Please go ahead.

Craig Wong-Pan
Director of Equity Research, RBC

Thanks. Just in pathology, could you help us understand how large or significant that commercial segment is? With the growth that's been achieved there, has that been like a recovery across the whole industry, or is that sort of specific things that you've done to get to that good growth?

Maxine Jaquet
CFO and COO, Healius

Look, we don't split out our commercial and specialist segment. But they are, as a result of specific tenders and specific wins, that growth. Yeah, that's probably all I'm comfortable to say on the call at this point.

Craig Wong-Pan
Director of Equity Research, RBC

Okay. In the imaging, the market performance you mentioned in Victoria and Queensland was above the industry. If we excluded the Axis Radiology acquisition, could you talk about the performance you've done on an organic basis?

Maxine Jaquet
CFO and COO, Healius

That's more in line with market. Victoria's obviously done substantially better than market and Western Australia as well. New South Wales, look, when we take out, it's actually only four sites, but four large sites in the southwest of Sydney, which, as Malcolm said, we're down 25%. That's on market as well.

Craig Wong-Pan
Director of Equity Research, RBC

Okay. Just my last question. The cash collection got impacted by the high volumes. Was there a slowdown in the payments by the government for those COVID tests, or is that just the sheer volume of tests that were being done in that last quarter?

Maxine Jaquet
CFO and COO, Healius

It's yeah, look, it's mainly the two weeks and the Omicron surge. There was a tiny proportion in like 2 percentage points in outstanding DSO on New South Wales Health, but it was minor in comparison to the two weeks.

Craig Wong-Pan
Director of Equity Research, RBC

Okay. Thank you.

Operator

Thank you. Your next question comes from Sean Laaman with Morgan Stanley. Please go ahead.

Sean Laaman
Executive Director, Morgan Stanley

Thank you. Good afternoon, Malcolm and Maxine. Thanks for taking my question. Just to clarify on the trajectory of collection center rationalization. I think you said at the beginning of the SIP process, there was roughly, I think it was 100 centers and to be rationalized. I think a year ago, there was about 2,089. Today you're saying there's 2,027. But I checked in the full year report, it says 2,010. So is that a step back up from what was reported the full year associated with Agilex, for example?

Maxine Jaquet
CFO and COO, Healius

It's got nothing to do with Agilex. There are a couple of labs in there, and I think it was basically 17 new sites. It's not, to be clear, this is not a rationalization program overall. It's a network optimization program. In the first instance, it was rationalizing those that we thought were unprofitable, and where we could collect the work in our existing network. But we don't, we're not focused on. I mean, I know it's obviously helpful for you to understand the numbers, but what we're trying to do is actually get to a network which we think is gonna give us the biggest best yield. So look.

Sean Laaman
Executive Director, Morgan Stanley

Sure.

Maxine Jaquet
CFO and COO, Healius

It may be that collection centers go up. There might be areas where they come down. The number's not important from our perspective.

Sean Laaman
Executive Director, Morgan Stanley

Right. Sort of forget about the 100 for now as a sort of marker or a measure of cadence?

Maxine Jaquet
CFO and COO, Healius

Yeah, look, I think so. I mean, I think we worked. I think when we were talking about that, we were highlighting what we thought the tail of sites that were underperforming. We continue to review each site and each area and make a decision around what's the right strategy.

Sean Laaman
Executive Director, Morgan Stanley

Great. Is there anything you can share on rent, is the second question. Very lastly, just you mentioned the implementation or the rolling out of e-referrals and, you know, is that sort of a catch-up with other programs that might be offered by other providers? Is it a differentiator, and does it lead to less leakage of referrals and/or testing?

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah. Thanks, Sean. Look, on the e-referrals, look, I, you know, as a pathology business, I think, you know, we probably haven't done that as much as others, but it's coming pretty quickly now. Yeah, look, there is a level of catch up from that perspective. I think, you know, we've part of those, the digital enhancements that I talked about before will deliver, we believe, some additional benefits on top of, you know, traditional e-referrals. It's not just about data entry, but it's about sort of accessing those referrals and, you know, the significant number of people who get a referral and then don't present with that referral to anywhere, to any pathology provider.

There are some ways, you know, we're working on some really exciting things around being able to do that. We think that, you know, I know other providers think this as well, that there are a significant number of people who get referrals for pathology who never action those referrals, and it's around how we encourage those people to participate. Yeah, look, I think it's, you know, it's a potentially real growth area for pathology more generally, but specifically for us with some of the applications that we hope to bring online over the next year or two.

Maxine Jaquet
CFO and COO, Healius

Yeah, improve that leakage in the pilots, what we've seen.

Sean Laaman
Executive Director, Morgan Stanley

Thanks, Malcolm. Pathology rents?

Malcolm Parmenter
CEO and Managing Director, Healius

Yes, the pathology rents. Look, it's always difficult to say much about this because, you know, there's always competitors on the line, so you're kind of where you go to with this. I mean, there are markets that are potentially where competition's likely to increase, I think. You know, Queensland's possibly one of those. I think in terms of where it goes, there's some markets that are pretty stable in terms of where they are. It varies around the country depending on where you go.

Sean Laaman
Executive Director, Morgan Stanley

Great. Thank you both. That's all I have.

Malcolm Parmenter
CEO and Managing Director, Healius

Thanks, Sean.

Operator

Thank you. Your next question comes from Saul Hadassin with Barrenjoey. Please go ahead.

Saul Hadassin
Head of Healthcare Research, Barrenjoey

Good afternoon, Malcolm and Maxine. Now just a question about some comments you made regarding another potential variant emerging with COVID. At a national level across all providers, infrastructure clearly couldn't cope in late December. You mentioned there were learnings that you'd have taken away, but I'm trying to work out if there was a surge of similar nature, why would the infrastructure be any better placed? How much of the issue was just lack of access to labor at the time? Wouldn't that just be a similar issue if people were furloughed, et cetera? What can you tell us what those learnings were and why the infrastructure would be in a better position, say, you know, come winter, if we had a similar presentation of a more virulent strain? Thanks.

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah, good question, Saul. Look, right at this point in time, I guess the point of my comments were that I don't think we would be any better placed to deal with it. I think, you know, if we went down that route, exactly the same thing would happen again. We, as a single provider or any other pathology provider for that matter, can't solve this problem on their own. It's largely a state-based phenomenon. You know, to my way of thinking, we're sitting here thinking it's all gone away. That was the comment around wishful thinking. Look, you know, maybe that's right, but the science doesn't really support that.

You know, if we were into risk management and planning, we would be looking on a state-by-state basis as to what we need to do to testing, tracking, tracing, isolation systems, that in the event of that occurring, which, you know, as I said, the science says is quite likely, what we need to have on a state-by-state basis in terms of where that goes, and engaging with industry, engaging with everybody around how we as a health system does that. You know, without that, we just sleepwalk into another chaotic event like we did over December, January. I think, you know, to some extent that's what it's calling for, to kind of, we've got this window of opportunity. We are working at improving our efficiency and increasing our capacity, but we can't solve the problem for the whole country on our own.

You know, that's the reality of it.

Saul Hadassin
Head of Healthcare Research, Barrenjoey

Understood. Great. Thanks. That's all I have.

Operator

Thank you. Your next question comes from Steve Wheen with Jarden. Please go ahead.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

Yeah. Good afternoon. I just had a question with regards to the quarterly run rates that you achieved during the half. When you disclosed your first quarter, it was a particularly profitable quarter. Then as we go to second quarter and just sort of back out that first quarter number, it looks like the profitability declines quite considerably, somewhere in the order of 200 basis points. I know there'd be lots of moving parts in there, but I'm just sort of wondering if you could help me reconcile what the efficiencies were lost in second quarter, given that there was so much more high margin PCR testing during that quarter.

Maxine Jaquet
CFO and COO, Healius

Yeah. Thanks for that. Look, there's probably a couple of factors. One is that you are seeing a bit of a scale effect, right, between Q1 and Q2. Q1 revenue is higher. And in Q2, what happened in December was that base business did decline quite dramatically as Omicron hit. It's really a function of those two factors.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

Understood. Going into the next half, you would expect, you know, that inefficiency around the base business, that then starts to correct coming into the second half. Is that right?

Maxine Jaquet
CFO and COO, Healius

Yeah, look, our daily trading is looking very favorable. We obviously need that base business to be trading at more normal levels to get those kind of margin levels.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

But it wouldn't necessarily, the base business improvement as you're going into the second half wouldn't be enough to necessarily offset what you're losing in PCR profitability? Would that be fair?

Maxine Jaquet
CFO and COO, Healius

Look, PCR profitability. Per PCR testing is actually pretty stable. I think you've got to look at, you know, historically what our margins were when we're at the same level of PCR testing, which is what we are, is more of where we were for the last couple of years. You've got two factors there. One is, yes, you have a slightly lower fee, but we've also got better consumables costs. We, as Malcolm said, are investing in some additional equipment in labs which is more broadly used in the labs, but could also be used to improve the efficiency of our COVID throughput. Look, not necessarily. I wouldn't say necessarily.

Look, it's pretty hard to predict what's going to happen over the next period, but I hope that gives you a little bit more color.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

Yeah, it does. I'll leave it there if that answered enough, I guess.

Operator

Thank you. Your next question comes from Rod Sleath with Rimor Equity Research. Please go ahead.

Rod Sleath
Equity Analyst, Rimor Equity Research

Thank you very much for taking my questions. A lot's already been asked and answered. I was just wondering if I could come back to the laboratory information system or the laboratory information system upgrade. I was just wondering if you could possibly give perhaps a little more detailed update on what stage that project is at. Has it been fully scoped? You know, when do you expect to start rolling out modules? That sort of thing.

Maxine Jaquet
CFO and COO, Healius

Yeah.

Rod Sleath
Equity Analyst, Rimor Equity Research

I had a couple of other questions after that, if that's okay.

Malcolm Parmenter
CEO and Managing Director, Healius

We have the project scoped at this point. We have a plan moving forward in terms of where that is and we're in the process of starting to move towards implementation during the sort of second half of this financial year. Look, we think that project is a modular approach to it. We think that project is around two years from there, and it may take a little longer than that, but it's that sort of timeframe.

Maxine Jaquet
CFO and COO, Healius

I highlighted before just the five modules, right? The referrals and collections, that's two out of the five modules which are built and being rolled out now. The other part, which is the testing and the lab instrumentation, is being rolled out in our first lab in Q2, so in the next few months. That will be the first lab for that module, and then we will follow on subsequent labs. The remaining modules are the billing modules. Look, yeah, it's gonna be a progressive rollout.

Rod Sleath
Equity Analyst, Rimor Equity Research

I mean, it's now a couple of years ago, but at the time, you were concerned about the capacity on the databases that you were operating, and that database technology was, you know, a few decades old, is my understanding.

Maxine Jaquet
CFO and COO, Healius

Mm-hmm.

Rod Sleath
Equity Analyst, Rimor Equity Research

There was a fix that was found, so suddenly you weren't so concerned about that capacity.

Maxine Jaquet
CFO and COO, Healius

Yeah.

Rod Sleath
Equity Analyst, Rimor Equity Research

Is part of this project completely replacing the back end and the databases that are being used, and has that happened? Is that like a precursor that has to happen before the project carries on, or is that something that happens sort of in line with other things?

Maxine Jaquet
CFO and COO, Healius

No. There's been a lot of work that's focusing on the back-end infrastructure, and the database capacity issue has been dealt with.

Rod Sleath
Equity Analyst, Rimor Equity Research

Okay. With regards to the serum work area upgrade, am I right that there's only a small part of that that was sort of left to be completed in this latest financial period? On the whole, the benefits of the serum work area upgrade are already flowing through the P&L.

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah, that's correct. We've basically finished that. Now, in this last half, we've largely completed that. From here on in, there's nothing left.

Rod Sleath
Equity Analyst, Rimor Equity Research

Yeah. You're already having the majority of the benefit, if you like, already coming through in the previous half. The last half was just a finish off of certain facilities.

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah. Look, as we rolled through the last couple of locations during that half, so that those benefits, you know, were there for part of the half. Yeah, look, from here on in, all the benefits of that serum work area are in.

Rod Sleath
Equity Analyst, Rimor Equity Research

You mentioned with regard to pathology imaging equipment that there had been a reasonable amount of purchasing taking place, but that you were reviewing the leasing. I didn't quite catch that whole comment, so I just wanted to understand what your decision process is between owning and leasing equipment. Is that just purely down to the terms of the leasing, or is there some equipment that you would prefer to own?

Maxine Jaquet
CFO and COO, Healius

No, it's just an economic decision.

Rod Sleath
Equity Analyst, Rimor Equity Research

If the re-negotiations on leasing come out the way you expect, you'll do more leasing and less purchasing.

Maxine Jaquet
CFO and COO, Healius

Correct.

Rod Sleath
Equity Analyst, Rimor Equity Research

Okay. All right, just two more very, very quickly. On artificial intelligence in the diagnostic imaging, you mentioned the use of the TB detection algorithm. I mean, obviously we're seeing and hearing from some of your competitors that they're rolling out, you know, more and more algorithms, and it looks like that whole process is accelerating. Do you kind of have a rollout timeframe, a number of different algorithms that you're looking at incorporating into your current business?

Malcolm Parmenter
CEO and Managing Director, Healius

Yes, is the answer to that. As we work with those same suppliers and a number of partnerships in terms of where we go with that as well. You know, it is difficult to pick winners in this space, so we are trying to get to the position where we have the best products available as we move forward with that. It is an area that is moving at a great rate of knots. There are some other areas, particularly in pathology, where we're looking at investment in that space. It's not significant, but some investment in that space to look at partnering.

There is interest from AI startups and other companies in accessing, in imaging, the kind of volume of imaging that we have, and certainly in pathology in terms of hematology and histopathology slides that we have, the catalog of that can assist, you know. There's also some products that enhance reporting within sort of pathology and pathology more generally, not just in histopathology. There are a range of products that we're looking at there and some potential co-investments in that space, but.

Rod Sleath
Equity Analyst, Rimor Equity Research

Yeah. Okay. All right. The final one is in early January we spoke to several industry contacts from a number of different industry companies. With regard to the sample pooling, I guess I was just a bit surprised when you said that your sample pooling was sort of really only running at about two samples per test, 'cause we'd certainly heard that in eastern states, and again, from multiple companies, that the norm was more like four to six samples per test. I guess when I say eastern states, really I mean Victoria and New South Wales.

That part of the big problem that happened in late December, early January, was that effectively by removing sample pooling because it was no longer economically sensible or even a time saver, that the capacity was significantly reduced across the system.

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah.

Rod Sleath
Equity Analyst, Rimor Equity Research

You know, by something like 30%. Just wondering if you could expand on that sort of

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah.

Rod Sleath
Equity Analyst, Rimor Equity Research

Two samples per test across the group rather than in particular areas which were highly stressed at the time.

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah. Look, I mean, as I said, the vast majority were done at two- in-one . You know, when in the Laverty business, when it got to its peak, we got to four- in-one before that came for a short period of time. There were anecdotes in the industry, though, of companies pooling up to 50 in-one . You know, I guess, look, to be perfectly honest, our microbiologists were telling us we shouldn't be doing that. We made a choice not to go to that kind of level of pooling, and then it's clearly one-to-one now with the positivity rate that's there. Look, I'm not sure on what basis others went to that.

I don't know that that was as widespread in the industry as you might think, but I think it did exist.

Maxine Jaquet
CFO and COO, Healius

We were pooling

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah.

Maxine Jaquet
CFO and COO, Healius

We were taking work from other states. For example, we took work from Victoria to New South Wales, so we had tests coming in with higher positivity rates as well into Laverty. We used the full capacity of the national network as best we could. You know, that played a factor in how comfortable we were with pooling, given the different levels of positivity rates between the states.

Rod Sleath
Equity Analyst, Rimor Equity Research

Mm-hmm. Sure. Okay, great. Thank you very much.

Operator

Thank you. Your next question comes from John Copley with E&P. Please go ahead.

Speaker 16

Good afternoon, and thanks for squeezing me in. I'll try and be brief. You made some comments in the half yearly report and during today's presentation that highlight you intend to invest in more or additional PCR capacity. I'm asking whether you could tell us what that dollar figure involves in terms of investment in CapEx and OpEx, please?

Maxine Jaquet
CFO and COO, Healius

Yeah, happy to do that. Look, I think the first thing to say, it's not just COVID capacity. It's capacity that can be used for other tests within the lab, so it's extraction capacity, et cetera. We had equipment from BGI which we are now looking to purchase. We're on a leasing arrangement with BGI, so we will be purchasing that equipment and then investing in some additional extraction equipment. Currently, we're looking at a CapEx of around AUD 8 million, which is in that AUD 65 million, and over AUD 40 million for pathology for the second half. Then there'll be some OpEx we spend in terms of just some fit out as well.

Speaker 16

Okay. Thank you. I mean, just quickly, that would then imply you were doing a fair bit of your extraction manually prior to this. Is that right?

Maxine Jaquet
CFO and COO, Healius

No.

Speaker 16

No? Okay.

Malcolm Parmenter
CEO and Managing Director, Healius

No, no.

Maxine Jaquet
CFO and COO, Healius

No.

Malcolm Parmenter
CEO and Managing Director, Healius

It's just the kind of volume capacity of those extraction machines and the number of people it takes to operate them.

Speaker 16

Mm-hmm.

Malcolm Parmenter
CEO and Managing Director, Healius

In terms of where it is that

Speaker 16

Okay.

Malcolm Parmenter
CEO and Managing Director, Healius

We have the potential to change that.

Speaker 16

Understood.

Malcolm Parmenter
CEO and Managing Director, Healius

That's where, you know, it's the lower headcount and the higher sort of throughput that improves the efficiency.

Speaker 16

Okay, understood. Just quickly as well, I mean, could this capacity be flexed? Because, I mean, assuming COVID test volumes continue to fall off, I mean, look, there's two schools of thought, but to use your phrase, following the science, you know, looking overseas, looking at what governments or which directions they're heading in, it seems as though the testing of asymptomatic people for COVID is ending as infection fatality rates, you know, do appear to be approaching, or if not already, the seasonal influenza levels. How does that make you feel about the investment in PCR testing capacity? Do you think it can be utilized elsewhere, or do you think that potentially you need to flex that up and down?

Malcolm Parmenter
CEO and Managing Director, Healius

Yeah, look.

Speaker 16

Based on what COVID volumes do?

Malcolm Parmenter
CEO and Managing Director, Healius

Look, probably not all of that capacity can be used elsewhere, but it, some of it certainly can be. Look, I think with where COVID testing goes to even now with what we're seeing right at this point in that we're not doing that much in the way of screening asymptomatic people. Right? I mean, I don't know sort of the clinical histories of everybody who turns up, but the vast bulk of testing that's going on now is absolutely symptomatic people. I think that's the way it will continue. When you get to these kinds of numbers of kind of 15,000-17,000 a day, they're people with upper respiratory tract symptoms and who think they might have COVID. That's why they turn up.

I don't think, I mean, testing of symptomatic people, I don't see that falling away. You know, I don't. I mean, I'm a doctor by background. I don't see any reason why that would actually fall away. I know, you know, everybody, the, you know, the requirements around travel and, you know, testing and various other things from a government perspective change from time to time, and that does have an impact on it. You know, I think where you're forcing people to have testing before they go to work, now, clearly, you know, as we were back in the Delta outbreak, then that drives very large numbers of tests.

This baseline level of testing, I think, is the level that we saw last year as being the level it kind of falls to, and it seems to sit at around that when it's spread around the country. You know, New South Wales, we were doing the peak in December, something like 35,000 tests a day in New South Wales, and that's come back to, you know, 3,000, 4,000, 5,000 tests a day. That's where it was in New South Wales through a fair chunk of the first half, too.

Maxine Jaquet
CFO and COO, Healius

Mm-hmm.

Malcolm Parmenter
CEO and Managing Director, Healius

The numbers actually pick up, have picked up elsewhere and certainly WA, where we were doing a few hundred tests now, is sort of 2,000 and 3,000 tests a day. Because you've got this background of COVID and people start to worry about it. I don't think it falls away. You know, I think, maybe it does eventually, but I think there'll always be. You know, COVID is not gonna disappear. You know, when we talk about it being endemic, it'll be around on a pretty constant basis, and it will be dangerous to some people in the community, you know, unvaccinated, elderly, immunocompromised. Doctors will keep looking for it, and there will be a background of COVID testing that stays.

Speaker 16

Okay. Just to round this discussion off, I note in your latest accounts or this half year accounts, there's a line, instrument equipment hire, that's jumped up. It's AUD 23.2 million versus AUD 3 million in the prior corresponding period. Was that due to or was that necessary to meet the COVID testing demand in December? Or is that something that we'll see continue on in terms of perpetuity, something we should be thinking about in future periods?

Maxine Jaquet
CFO and COO, Healius

No. Yeah.

Speaker 16

Okay.

Maxine Jaquet
CFO and COO, Healius

Look, that is the BGI equipment. When I talked about purchasing that equipment, that will come out of that leasing line. That's the COVID testing equipment.

Speaker 16

Right. Okay. That was expensed?

Maxine Jaquet
CFO and COO, Healius

Yes.

Speaker 16

Yeah. In that period, so it won't reoccur?

Maxine Jaquet
CFO and COO, Healius

No. Look, we'll have some in the second half.

Speaker 16

Okay.

Maxine Jaquet
CFO and COO, Healius

It will come off.

Speaker 16

All right. Noted. Thanks, Maxine.

Maxine Jaquet
CFO and COO, Healius

Yeah.

Speaker 16

Thank you, Malcolm.

Malcolm Parmenter
CEO and Managing Director, Healius

You're welcome, John.

Operator

Thank you. There are no further questions at this time. I'll now hand back to Janet Payne for closing remarks.

Janet Payne
Group Executive of Corporate Affairs, Healius

Thank you, everyone. We won't hold you up any longer, so thank you for your time and attention, and we look forward to talking with you on the roadshow.

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