Good afternoon, ladies and gentlemen. Welcome to Dasa's earnings release conference call to discuss the results for the fourth quarter, 2025. This conference call is being recorded and the replay may be accessed at the company's website, www.ri.dasa.com.br. The presentation is also available for download. Please bear in mind that all participants will be in listen-only mode during the presentation. Ensuing this, we will begin the question and answer session when further instructions will be provided. We would like to emphasize that the information contained in this presentation and any statements made during the event regarding the business outlook projections and Dasa's operational and financial targets are based on the beliefs and assumptions of the company's management and on information currently available. Forward-looking statements are no guarantees of performance.
They involve risks, uncertainties, and assumptions as they refer to future events and depend on circumstances that may or may not occur. Investors should understand that general economic conditions, market conditions, and other operational factors may affect Dasa's future performance. I would now like to turn the floor over to Mr. Rafael Lucchesi. Well, good afternoon, everybody, and thank you for attending our earnings release conference for the fourth quarter 2025 and full year. Here we have Rafael Bossolani, our CFO and IRO, and our entire IR team. I will begin with a general overview of the period and then turn the floor over to Bossolani. On slide number three, 2025 is a turning point, an important turning point for Dasa. Throughout the year, we have a strategic turnaround, simplifying our portfolio with a focus on diagnosis and a focus on growth and efficiency.
Now, this movement included the creation of Rede Américas that separated the hospital business and an agenda of disinvestment of non-strategic assets. We're working in a focused way, and we began relevant processes, increasing our growth rate and obtaining productivity gains through the review of processes, digitization, standardization, and this begins to appear in our results. We go on to slide number four to share with you some main highlights. We continue to increase our growth rates, diagnosis with a significant increase in revenue in all of our channels and businesses. Besides this speed-up, we have made strides in profitability, thanks to our efficiency agenda and simplification during the year. We had an impact in the fourth quarter of default that will also be commented by Bossolani. We also made strides in deleveraging, strengthening our balance.
The company generated positive cash in 2025 after investments and debt costs, excluding the entrance of resources through the sale of assets. This is a very important point, a positive cash generation, excluding the sale of assets. It's also important to highlight that we have relevant fronts underway with an expansion of capacity to capture demand, advances in digitization, advances in the use of AI, and a control of expenses. All of this will contribute to our results in the coming quarters. We have already been able to see this at the beginning of the year in revenues and expense controls. Dasa is the largest platform internationally with leading brands and a differentiated structure made up of 480 units. We're present in 13 states, the Federal District, and we have processed more than 2,000 exams in 2025.
We trust the market dynamic and the capacity of our team. We have begun a new cycle where we are advancing in a highly sustainable way. We would like to thank our partners, shareholders, and others for their confidence, which is fundamental for the turnaround in the company. I will now give the floor to Bossolani.
Thank you, Lucchesi, and good afternoon to all of you, and thank you for participating in our earnings conference call. I would like to begin with domestic diagnostics. Now, besides the growth, what we do observe very clearly is an improvement in the quality of our results. We have significant strides in the operational, financial and cash generation fronts, with an improvement of margin, reduction of leverage and a better quality of the results, as mentioned by Lucchesi. Not only for the quarter, but for the last twelve months.
To begin with slide five, in diagnostics domestic, we had a consistent quarter of growth with a hike in revenues of 13.3% year-on-year, 9.6% for the full year. This growth is mainly driven by volume, an increase of 16% in the number of exams. When we look at the makeup, it is quite diversified. We see strides in the B2B segment, especially with lab-to-lab exams, significant expansion in home care and a continuity of growth in our premium segment. As a result of this revenue mix, we had a reduction of almost 2% in the total average ticket, which was an expected movement. As with these channels, we have a lower ticket, but with a larger scale. It's important to mention that the ticket in the private sector grew, pointing to increases above and beyond inflation.
While the main highlight is a margin expansion, we had a gain of 50 basis points in the quarter and 60 for the year, reflecting important gains, consistency in productivity and a better use of our installed capacity and of course, a decrease of our fixed costs. We continue to consistently capture the operational leverage of our business, and we have the growth followed by an improvement in profitability without leaving aside our services. Let's go on to slide number 6 for the oncology and northeast hospitals. I think that more clearly we can see an operational turnaround in the segment. We had a gross revenue growth of almost 15% in the quarter, thanks to oncology and the hospitals. This growth is accompanied with a relevant improvement in mix with processes with higher complexity from new accreditations and an increase in the average ticket.
Operationally, we made improvements in efficiency and the use of our beds, and we had a relevant increase in the occupancy rate with an increase of 8.5 points, reaching 36% in the fourth quarter. The highlight, however, is profitability. We had 20 percentage points increase in gross margin, 20 percentage points for the year. Now, this evolution generally reflects that combination of an improvement of mix, improvement in services rendered and the optimization in our operating structure, especially in the beds. We had a reduction in cancellations observed this quarter vis-à-vis the fourth quarter of 2024 contributing to this evolution. Beyond growth, what we see here is a structural growth and higher profitability. This reinforces the strategy of the company to prioritize higher added value products. Let's now go on to the results of Rede Américas on slide number seven.
We begin at the top of the operation. In the fourth quarter, gross revenue was BRL 3.4 billion, BRL 10 billion for the full year. It's important to carry out a slight adjustment here. As a result of the integration process of Rede Américas, in the fourth quarter, we had to harmonize our accounting practices, which is what gave birth to this company. This had a negative accounting impact of BRL 200 million without a cash effect, but of course it does affect EBITDA and other indicators. The EBITDA for the quarter would be 368 million, with a margin above 12%, which would more adequately reflect the operational performance of Rede Américas. In the cash front, operating cash generation in the first months of the operation and we have been in existence for nine months.
We had operating cash generation of BRL 475 million, free cash of BRL 308 million, considering the investments carried out in the period. When it comes to capital structure, we ended the quarter with 2x EBITDA within the covenant threshold and a balanced cash position for this operation. In sum, therefore, we had a quarter with relevant accounting adjustments. They were necessary, but with the operation showing its capacity to generate cash and expand profitability and of course, create value through time. Let's go on to the next slide, number eight, to speak about SG&A. In the quarter, the commercial expenses, SG&A as a whole, totaled BRL 393 million, a reduction of 41% year-on-year.
It's important to highlight that this variation can be explained by the deconsolidation of hospitals after the creation of Hegia Medica, impacting comparison. If we exclude this effect of the perimeter, we had a reduction of 2.5%, reflecting the advance of our program and our new focus on productivity. This evolution arises from very important initiatives of process reviews, optimization of the organizational structure, contract renegotiations. Despite having observed an impact on the PDD of the quarter, which represented approximately 10% the allowance for doubtful accounts and 2 percentage points when it comes to the company's net revenue. For the year, this trend was maintained with a consistent capture of efficiency gains through the different fronts and initiatives in the company.
In other operating incomes and expenses, we had a negative impact for the quarter associated to the sale of the Hospital Santa Lúcia, with a write-down of BRL 400 million. This is a non-recurring impact without a cash effect, and it's linked to the simplification agenda of the company and the new discipline we have in capital. Let us now move on to EBITDA in the next slide, number 9. The company results for the quarter was impacted by relevant non-recurrent impacts linked to net equity of the Hospital São Domingos and other factors. Now they distort the reading for the period. The more representative indicator of the operational performance of the company, which we have called recurring EBITDA.
When we eliminate that, we had recurrent EBITDA of almost BRL 400 million in the quarter and a growth of 21% vis-à-vis the fourth quarter of 2024, with an expansion of 2.5 percentage points in margin. The operation sold in the third quarter of last year of 2025 no longer contributed to the EBITDA of the fourth quarter 2025, reducing the comparable base and making the growth ever more relevant organic growth. For the entire year, recurring EBITDA totaled BRL 2.1 billion, a growth of almost 17% with a margin expansion of 2.2 percentage points. Now this performance reflects a combination of growth of revenue, operational gains on the different fronts and of course, a capture of efficiency throughout all of our operations.
More than the growth, we see a significant evolution in the quality of results, margin expansion and, consistency throughout the year. Let's go on to slide number 10, referring to our investments for the quarter. Total investments totaled BRL 112 million, a significant reduction vis-à-vis the same period last year. Part of this drop is explained by the deconsolidation of hospitals after the creation of Higia Médica. By making adjustments of this perimeter, we see a consistency in investments and a greater discipline in capital allocation. Investments continue to be concentrated in technology, expansion and streamlining of our operational structure with a focus on productivity and efficiency and of course, a better use of our assets. We continue to improve the quality of investments, prioritizing projects that will have a higher return and that are more aligned to the value creation in the company.
Let's go on to slide number 11. Free cash flow will begin with operational cash generation, representing BRL 460 million for the quarter. There is a drop vis-à-vis the fourth quarter 2024. In that period, we still had a broader perimeter of operations with the presence of hospitals that are now allocated to the joint venture, and the working capital was more intense, and we were subject to receivables. It's important to highlight that the cash generation of the quarter is more aligned with the present-day company. We have a strong conversion of results into cash, with results equivalent to 115% of EBITDA this quarter. In the free cash flow, after our investments in CapEx, we had BRL 351 million for the quarter, practically stable in the year-on-year comparison.
For the full year 2025, we reached BRL 942 million, a growth of 3.5% even with that change of perimeter in our portfolio throughout this period. In free cash flow, we reached BRL 651 million for the full year, a growth of 75% vis-à-vis the previous year. Now this performance points to a structural improvement in our working capital. We have a reduction in our cash conversion cycle. It also shows the new profile of the company with a lower intensity of using CapEx when compared to the year 2024. We have a lighter, more disciplined structure, and we can convert operational cash into free cash flow in a better way. Finally, let's go on to our capital structure.
We ended the year with a relevant reduction in the company leverage, going from 4x in the fourth quarter of 2024 to 2.67x in the fourth quarter of 2025. This movement shows the active management of the portfolio, the operational improvement of the company, and a consistent move in cash generation during the year. We delivered our deleveraging guidance for 2025 as an indicator to measure covenants. We ended the year in 2.5x EBITDA, with quite a bit of leeway in terms of our covenant thresholds that were 4x. This guidance was issued last year, and we reached the guidance, and yesterday had a material fact referring to that. Regarding our financial position, we ended the quarter with BRL 5.4 billion in debt.
We ended with BRL 2.7 million in cash, approximately 1.4 times our obligations, with maturity until the end of the year 2026. We have a comfortable liquidity position, with the right size, in terms of our debt. We're managing our liabilities, and in February 2026, last month, we used part of these resources that come from the divestment of Hospital São Domingos to carry out the payment of some debentures, reducing the full amount for 2026 and BRL 800 million. The debt is balanced with an average debt term of 3.5 years and with an average debt cost of CDI + 2% approximately. We're ending the year with a more balanced capital structure. We're ready to begin the new cycle in the company. We are a different company compared to what the market knew in past years.
We have made strides in the portfolio simplification. We had significant captures in operational efficiency and a strengthening of our financial position and our capital structure. We have a more efficient, more focused company with a better capacity for cash generation. When we speak about 2026, we're entering the year with a very sound base, and cash generation will advance, as mentioned by Rafael Lucchesi.
Very well. With that, we can go on to questions and answers. We will now go on to questions and answers for investors and analysts. Should you wish to pose a question, please press on the Raise Hand icon. Once your question has been answered, you can withdraw from the queue by lowering your hand. If you want to pose a question in writing, type this into the Q&A icon. The first question is from Leandro Bastos from Citi. You may proceed, sir.
Good afternoon and thank you. We have three questions at our end. The first refers more to the Rede Américas. You just brought a new disclosure of the debt in this quarter. What draws attention is the increase in net debt of Rede Américas in the quarter, and a rather shy cash position considering the size of the company. I would like to understand which is your plan and the trajectory for deleveraging for the group. If you could share with that, it would be important? A second question referring to the operation in hospitals. This quarter, we had a good resumption of growth and margins. If we could have an idea of the company's vision for those assets that are outside of the perimeter? If you could point to the portfolio of diagnostics, ex-diagnostics?
Hello, Bastos. This is Bossolani. Thank you for the question.
Now, very gradually, we're trying to disclose more about the operation, bringing evermore clarity about the quality of our results. In the quarter, net debt of Medicas had an increase of BRL 373 million when we compare the fourth quarter with the third quarter of 2025. When we look at the net debt variation for the quarter, it's associated to interest rates and the operational dynamic of the period. There is no structural change in the company. When we look at the upward of interest rates, it represents one-third of that variation, BRL 150 million, of course, impacting cash. But it impacts the debt position. The other two-thirds are operational cash consumption, BRL 200 million, aligned to the seasonality of the business and the operational dynamic of the hospital platform.
It contemplates a recomposition of inventories and a dynamic of receivables for the period which do have seasonality. Looking forward, we should have normalized working capital, always keeping in mind seasonality and a progressive improvement in the cash position of the joint venture. It's also important to broaden our vision when we compare the Rede Américas operation now with the initial moment of the joint venture. There has been a significant enhancement in operational and financial indicators. We have reached half a billion BRL, free cash generation above BRL 300 million , and a reduction of net debt that went from BRL 3.1 billion to BRL 1.8 billion , representing 2x EBITDA net debt. We understand that this is adequate for that operation at present.
Thank you.
This is Lucchesi, Leandro. I would like to refer to the operations of hospitals in Northeast.
Well, what is happening there is what we desired, an operational advance in operations, in revenues and margin. We had spoken about a change of mix of operators with positive results and an advance vis-à-vis the same quarter last year, a reduction of cancellations that had an important impact last year. All of these line items today allow us to have a significant advance year to date. Our main focus is the operational advance of the assets. We will always assess the best opportunities and market moments, but there's nothing novel. Our full focus is on operational advance and higher profitability.
Thank you. Thank you very much.
Our next question comes from Mr. Maurício Cepeda from Morgan Stanley. You may proceed, sir.
Hello, Lucchesi and Bossolani. Good afternoon. Thank you for taking our questions.
If you allow me, I would like to provoke you a bit more in terms of your capital structure. You had a clear improvement. Now, how much more cash leverage do you have from the operation to help you in deleveraging despite all of these enhancements? The debt is sufficiently high to have an impact, so you're at the mercy of variations of the operation if you were not so leveraged. In terms of capital structure, you spoke about assets outside of the perimeter. Do you still have the possibility of some disinvestment that could be of aid? Besides hospitals, you have diagnostic operations throughout the country. You have 50% of the JV, or perhaps you could think about other options to obtain new capital from operations and to be less subject to that debt that you have. Thank you.
Hello, Maurício Cepeda. This is Rafael Lucchesi.
Thank you for the question. We have clarity that the operational strides may be extremely relevant for the progressive deleveraging agenda that we desire. The level of discipline and focus that we have here, we had some impacts in the fourth quarter. We have the one-time impact, of course, of the doubtful payments. We can continue to deleverage the company and moving forward in our agenda of capital structure. We have several options, of course. It's not an agenda that we are assessing at present, but we do have several options going forward if we would like to reinforce the company capital. Our main priority are operational advances for the time being and the investments that we have already made. The focus at present is very clear for us. There will always be other options going forward to reinforce our capital. Anything to add, Bossolani?
Simply to complement and thank you for the question, Cepeda. Our deleveraging is one of the main pillars of our financial strategy in the company. We have a front that will make it feasible to follow this line with a consistent growth of EBITDA. We also have stringent discipline and capital allocation. We invest insofar as our operational financial capacity allow for this. This is another important point. This discipline will be maintained, maintaining the SLAs, but with great stringency and selectivity in capital allocation. Going forward, of course, we will continue on with de-leveraging sustained by cash generation, a focus on efficiency and strategic alternatives always at the right moment.
Thank you. Thank you, Lucchesi. Thank you, Bossolani.
Our next question comes from Mr. Gustavo Tiseo from Bank of America. You may proceed, sir.
Thank you. Good afternoon, Lucchesi, Bossolani. We have two questions at our end.
They're linked together. I'd like to further explore the SG&A. Quarter-over-quarter, it grew 13%. Why, and is this structural? Another question refers to the cancellations. You were able to grow and show relevant growth, and there seems to be a vacuum. Some service renderers don't wanna work with some operators. Is there a risk that this cancellation will increase suddenly because of those operators that have a higher risk? Or, is this something that happened with the review of impact, a one-off in the fourth quarter, and that we will see a more balanced structural position going forward?
Thank you for the question, Gustavo. I'm gonna begin with the SG&A, and I'll give the floor to Lucchesi to speak about cancellations. When we look at the SG&A quarter-over-quarter, there are natural fluctuations because of base effects and adjustments that were carried out.
When we look at a like-for-like comparison, excluding the perimeter transfer to the JV, there's a reduction of approximately 2.5% quarter-over-quarter. What is important is the trend, and there is a trend to have a simpler structure, one that is more efficient with a better cost discipline. In the quarter, we had an increase in the sequential comparison with the previous quarter because of specific operational adjustments. We had a higher pressure of our allowance for doubtful accounts on operations in a specific city. We increased provisions for that, and of course, there's a typical seasonality for the end of the year, some expenses that tend to occur with greater frequency. We should not see a change in the structural trend.
We continue with that focus on the control of expenses and efficiency, and as the company reduces complexity, naturally we will see an improvement in SG&A through time.
Tiseo, this is Lucchesi. To speak about your second question, cancellations. We have not detected a problem in cancellations. Sometimes there's a one-off increase. We have a good relationship with the main operators. We have invested in our resources and invoicing model. We have a team devoted to that with a great deal of discipline. When there's an increase in cancellations, we're able to make recoveries or adjustments. This is a constant dynamic. We don't see a trend for the increase in cancellations, and there is no great variation among operators compared with what we had a year ago, that clients continue to be the same, and we have very active management to ensure this indicator will not worsen.
Thank you for the question.
Thank you. Thank you for the answers.
Our next question comes from Samuel Alves from BTG Pactual. You may proceed.
Well, good afternoon, Lucchesi, Bossolani. Good afternoon, everybody. We have several questions here. The first question, more specifically for the diagnostics segment. You were speaking about trends. There's a significant trend for expansion in gross revenue for that segment. In the fourth quarter, there was a favorable seasonality, but a drop in margin quarter-on-quarter, more than 700 basis points higher than in previous quarters. What are the reasons for this performance that is below what the company was delivering, compared to the third quarter? That's our first question. The second question, you spoke about a greater pressure of allowance for doubtful accounts, a specific operator in the city. Could you speak about the amount and the impact of that amount?
A third question, if you allow me. Those assets that were taken out of the joint venture, what was the rationale for that? Shouldn't there be an adjustment in the fair value of the JV because of this? If we could further explore this topic? Thank you.
Hello, Samuel. This is Lucchesi. I'll answer the first questions. Regarding gross margin, EBITDA margin, we continue to have an increase in gross margin. In the third quarter, of course, we have to remove the operation of Argentina. When we look at gross margin of diagnostics, it grew 0.5 points. It grew less than we were growing due to some effects of cost and mix. But we do see the possibility of expanding gross margin and a balancing of growth and margin.
We grew more in the B2B margin that has a lower gross margin, so we're very attentive to ensure that the margin will be positive. We can grow at a faster pace but increase the gross margin less. We're very attentive to this, and we continue to have growth. Regarding the EBITDA margin between the third and fourth quarter, you're right. It's seasonality that reduces the EBITDA margin of our main business diagnostics, but it reduces it less than we reduced it. The main impact was that allowance for doubtful accounts, two percentage points in the fourth quarter, where we created a provision to reduce future risk. Part of that drop, therefore, is the consequence of these two points, that allowance for doubtful accounts and seasonality and expenses contributing to a lower margin going forward. We don't like to speak about projections.
We could have an allowance for doubtful accounts better in 2026 than in 2025. Now we have initiatives for productivity, digitization, reduction of fixed costs and expenses. There's a good outlook to continue growing our EBITDA vis-à-vis the previous year at a constant and positive pace in the coming quarters. This is the main analysis of that margin drop that you mentioned. Samuel, this is Bossolani. Now, regarding that information on assets that went from the JV back to Amil, this is a small business, highly specialized, focused on maternities, and that alternatively could work better in a vertical network. This didn't make sense for the joint venture. Once again, it's a small business, and looking forward, it will contribute positively to the results of the debt. It's a business with deficits. There was no adjustment in the shares.
It was a symbolic sale, as it had no value for the two companies.
Thank you very much. Have a good afternoon.
Our next question comes from Gustavo Miele from Goldman Sachs. You may proceed.
Hello, Lucchesi, Bossolani. Good afternoon. Thank you for the presentation. We have two quick questions. The first, you spoke about the seasonality of the fourth quarter that is natural, and it impacted the results. Which will be the level of frequency at the beginning of the year? Compare this with the historical average, the volumes in the diagnostics and the network. This is the first question. A second question, perhaps more strategic, without speaking about numbers. Which are the main pillars to foster growth in the diagnostics business unit. We know it's very difficult to think about greater flexibility when it comes to adjusting costs for operators.
Could you perhaps increase the scope of services, have more mobile services? Or are you thinking about specific cities or the opening of new units? This would have a relevance for your CapEx. If you could speak about your growth plans, that would be very important?
Thank you for the questions, Gustavo. This is Lucchesi. I will begin with the second question, then speak about the second quarter. We have several initiatives for revenues. We do not have a sole one when we see the acceleration of profitability. It comes from the different projects that we're putting in place. We continue to grow strongly in the premium segment, above the average of our growth, with an enormous surge on the part of clients and with services in our own units. We are thinking of expanding our premium network, and we do have discipline in capital allocation.
This is a priority for us. We're thinking of doing this year. Perhaps not in an aggressive way, but we are considering this expansion of services of our own units. We have some demands for this. We have been expanding. We work with the optimization of some units. We closed down some units. We don't have details in terms of expansion, but this has also brought about more revenue. We have unified brands in São Paulo. This has brought about the benefit of having a single brand, and it brings about a significant recurrence with the expansion of services. We have an increase in revenues from home care growing above our average care. We have expanded to other cities, and we're investing in technology for service. We're better exploring B2B vis-à-vis the past. We have new operational technicians.
We have a significant logistics project for the enhancement of routes. Now we're investing in working closer with the clients and being more competitive in this business. When we sum all of this, there's a good outlook in diagnostics in terms of growth. We have additional services that are being ramped up, infusion of non-oncological medication that we carry out in our own structures, as well as other services that will add to our growth. Presently, to grow in diagnostics is a possibility, of course, and everything else that I have mentioned. Now, regarding the first quarter, without giving a forecast, we see a strong year in terms of demands. Operators did well last year in terms of demand, and these operators are our main clients. There are many people with health plans that access our network.
Based on the service expansion, all of these segments have had a good response for the beginning of the year. We're quite enthusiastic with the results of our efforts. They're fully complying with our expectations.
Thank you. Have a good afternoon.
The question and answer session ends here. We would like to return the floor to Mr. Lucchesi for the company's closing remarks.
I'm going to close here in a somewhat different way. I think it's worthwhile self-summarizing how we look upon Dasa. It was more difficult this quarter to explain the impacts, the accounting impacts, and much more. Now, how do we look upon the company at present? We have a smaller company that is lighter, more focused, more profitable. It generates cash and has a lower leverage.
One-time accounting impacts that we clarified do not alter the operational prospects that we have going forward. We spoke about margin difference between the third and fourth quarter. This is a one-time effect. We have positive impact as we go forward. We have been growing at a rate above the market. We're gaining gross margin with the possibility of continuing that way. With several fronts open that way, we have growth of revenue and margin in the fourth quarter. In expenses, as we mentioned, we have that one-off impact of two percentage points in allowance for doubtful accounts. The situation is promising compared to 2026. We continue with a strong commitment of diluting expenses through revenue gaining profitability. Our recurring EBITDA grew more than 20% in the fourth quarter, despite the sale in Argentina. We have full possibilities of moving forward in this.
Going forward, we begin the year with a very good outlook in terms of revenue and margins because of all of our plans. All of this with a high customer retention, strong brands present in the main products of operators who are also accelerating their sale of health plans of HMOs, and with strong growth in our B2B, which is an indirect market when we think about operators, but they do use our infrastructure. We have an edge in that sector. We have a highly engaged and aligned team with a long-term vision. We're very proud of them, and we look upon a highly promising scenario with Dasa that we would like to share with you. We're truly convinced that in coming quarters, everything we mentioned here will appear in our figures. We're focused, we have a great deal of energy and confidence going forward.
Thank you all for your attendance. We will meet again in May. The Dasa earnings conference call ends here. We would like to thank all of you for your attendance. Have a very good afternoon.