Immediately after, we are going to start the question and answer session, when further instructions will be provided. We would also like to highlight that forward-looking statements that may be made during this call with respect to business prospects, forecasts, operational and financial goals of the company, are all based on beliefs and assumptions of the executive board of the company, as well as currently available information. These beliefs and assumptions involve risks and uncertainties, since they relate to future events, and therefore depend on circumstances which may or may not occur. Investors should understand that general economic conditions, the market, and other operational factors may affect the future performance of the company. I would like now to hand it over to you, Mr. Rafael Lucchesi, who is going to start the presentation. Mr. Lucchesi, you have the floor.
Good afternoon, everyone. Thank you for being here with us once again for our earnings release call. I have here Rafael Bossolani, our CFO and Investor Relations Officer, in addition to our investor relations team. I am going to start by giving you an overview of the quarter, and then Bossolani is going to go into financial details. Starting from slide three. The message that I would like to share with you is of consistency and disciplined execution. We have been focused on implementing a very detailed plan. In addition to bringing important operational and financial improvement in 2026, it will ensure the growth of the company in upcoming years. As we have said in previous calls, our priority is financial discipline and reduction of leverage, especially considering the cost of capital in Brazil. We have been working consistently, but we have also been obtaining very significant operational advances.
At the same time, we progress in the economic agenda of the company. Slide four. Numbers of the first quarter. We had 9% growth in Diagnostics over a very good basis of growth in 2025. We have highlight for the premium segment, also home care, and growth of volume in B2B compared to last year. In terms of cost and expenses, we have been optimizing and obtaining a bit of growth over 50% in the quarter considering our current scope. As we have said before, we have grown our volume of revenue with very controlled CapEx, using the existing assets with very good operational leverage. At the same time, developing a structuring agenda, such as the implementation of new production of clinical lab tests, which has brought some impact on costs and very good perspectives of productivity gain thanks to digitalization, which will probably be accelerated due to AI.
Now, concerning cash, we have had an operational cash generation, operating cash generation, reducing net debt, even in a quarter with negative seasonality. We have also had improvement in our financial leverage. We have completed the issuance of the debenture, which helps us extend the debt profile of our company, and also meeting our short-term delivery, expanding our financial performance, and reinforcing the conditions for best strategy implementation. At the same time, we have been strengthening one of our key differentials, innovation in patient experience and medical excellence. The advances that we have had, especially in the launch of new products and the use of AI, have been recently recognized as ranking second in Valor Inovação Brasil 2026 in medical services. I would like to acknowledge our medical and technology team for this great achievement. It is also important to highlight the progression of Rede Américas in the quarter.
The operation is developing as planned, reflecting our continuous capture of synergy and the progression of operational indicators. It reinforces our potential of creating value for the assets and also the quality of team execution. We got into the second half of 2026 reinforcing our confidence on the execution of our team and building Dasa, which is becoming stronger, more resilient, and prepared for the next cycles of growth. Handing it over to Bossolani, who is going to go into the financial results.
Thank you, Lucchesi. Good afternoon, everyone. Thank you for participating in our earnings release call for the second quarter 2026. Lucchesi has talked about our strategic view and the key highlights. I am now going to go over the financial and operating results, which have supported our performance during the period. The key message of the quarter is the quality of the progression of our results.
We are confirming an improvement that we have started observing the beginning of the year, with expansion of margin, good results, and management with discipline, especially of the company's cash position. Going over our key operation diagnostics, slide five. One more quarter of consistent growth. Gross revenue increased 9.2% over the comparable scope and reaching BRL 2.2 billion. The growth is still driven by increase in volume, especially B2B and premium. It is also important to highlight that the growth did not require expansion of capital. In terms of profitability, adjusted gross margin was 33.2%. It is important to show 1.6 percentage point decrease, which can be explained primarily by accounting allocation between cost and expenses aligned to our new organizational structure, and one-off effects on production costs due to the implementation of new equipment in our new diagnostic centers.
Part of this variation also shows the effect of the mix because of an increasing participation of B2B channels in our business. Even though B2B has percentage margins which are smaller, it contributes to nominal gross profit. It helps us dilute fixed costs of the platform, and it is an efficient growth vector requiring very little investment. We are also moving on with our initiatives of digitalizations, favoring our installed capacity and improving patient's journey. We have been growing sustainably with efficiency and attractive return on investment. Now moving on to slide six to present the results of Hospitals and Oncology Northeast Hospital da Bahia and our Clínica AMO. It is a very good example of our strategy to identify profitable growth.
Gross revenue observed 4% decrease to BRL 208 million as a result of restructuring of our payers, especially in the operation of oncology, and more commercial discipline overall in the area.
We can see the result here in profitability. Gross margin expanded 1.5 percentage point, going to 32%. It shows our focus on improvement in procedures, reduction of cost in provided services, and optimization of our operating structure. In the hospitals, we have been moving on in bed management, occupancy rate, and operational efficiency. In Hospital da Bahia, there was a 7% increase and average increase of ticket of 15%. So average ticket increased 15%. As you can see, we want to grow with discipline and always improving return on investment. This quarter reinforced this path: more efficient, well-balanced operation with better profitability. Moving on to Rede Américas, slide seven. Before going into the numbers, I would like to make a clarification about comparability. As Rede Américas was created as of the second quarter of 2025, this is the first quarter where we present quarter-over-quarter comparison.
The joint venture is still presenting a very positive operational development. We had 12% increase in net revenue. EBITDA increased 39% in relation to the second quarter 2025, getting to BRL 441 million. 2.6 percentage point expansion of margin, reaching then 13.7%. It shows our strategies of integration, capture of synergy, and improvement in procedure mix. In addition, we also have ongoing initiatives to improve the digital journey of our patients, in addition to review of commercial conditions and progression of all the process related to the revenue cycle. We have a program where we are going over processes and standardization of system, contributing to reduction of denials and gradual improvement of days of payment outstanding. For Dasa, the result of Rede Américas is accounted for as equity equivalents.
Even though the last line is still marginally negative, the operational progression of the asset shows the potential of generational value in this long-term partnership. In terms of cash, operating cash generation, we had BRL 435 million in the first months of 2026, showing operating profitability and self-sustained joint venture, even though there was some one-off consumption in that specific quarter. Net financial debt closed the period at BRL 2.8 billion. Financial leverage was 1.69x , aligned with the previous quarter. Now moving on to slide 8 for expenses. This is a point that deserves a highlight. Selling general administrative expenses, excluding depreciation, totaled BRL 279 million, or 25% decrease compared to the second quarter 2025 current scope. It shows a number of structure gains in efficiency and strong discipline in cost management. At the same time, it's important to have the right comparison.
The base last year was subject to more pressure because of the doubtful debt provision. Even so, we would have a reduction of about 50% in expenses. The message is we are really creating a lighter, more efficient structure, because in the line of other expenses and operating expenses, we can see a positive balance of BRL 8 million compared to BRL 25 million in the comparable base of last year, which shows a lower revenue of shared service because of the joint venture. In general lines, the understanding is still very positive. We are moving on in our discipline of expenses, capturing operational synergies, considering growth of our operations. This combination of growth, efficiency, and profitability leads to consolidated EBITDA in slide nine, BRL 446 million, 53% growth as opposed to second quarter 2025 current scope. EBITDA margin expanded 5.8 percentage points, reaching 21%.
This growth results from the operation of diagnostics, improvement in profitability of hospitals, and also the capture of efficiency and cost discipline that we have just shown in the previous slide. Now moving on to slide 10 about investments. As we anticipated in the previous quarter, the investments are now getting at a expected rate, executing all projects that we have planned for the year. Investments totaled BRL 59 million in the quarter, 43% increase over the comparable period last year, with gradual resumption of some initiatives which tended to be slower in the beginning of the year. With such normalization, CapEx level is within appropriate levels, with selective allocation of resources and prioritization of projects that have better return and impact on efficiency, productivity, and quality of our services.
Resources were directed to technology, modernization of infrastructure, which are initiatives that improve profitability and improve also the experience of our patients. We can show that our business model can grow without requiring too much capital, prioritizing projects that have a high potential of return on investment. Investments were concentrated primarily on diagnostics and some corporate initiatives which are correlated with productivity digitalization. It is important to highlight that part of the investments in our service units, the so-called NTOs, is being made through strategic partnerships. So it is reduced the need of making use of capital without impacting modernization and expansion of the operation. Clear logic. We have been investing selectively with discipline, focusing on productivity, value generation, efficient management, preserving the level of our businesses. Slide 11, free cash flow. Operating cash generation went from BRL 44 million to BRL 297 million.
It was due to greater operational margin because of EBITDA and efficient management of working capital. It is important to bear in mind that the first half of the year historically is more subject to pressure of working capital, especially because of monies coming from the operation and some specific expenses during this period. Despite growth of the operation, our cash conversion cycle had a reduction of seven days, showing a structured improvement of our accounts receivables. In free cash flow line, there was even more relevant data. We went from a consumption of BRL 18 million in the second quarter 2025 to positive generation of BRL 292 million in the second quarter this year. BRL 310 million+ in the period.
It shows a structured improvement in cash generation sustained by our operating model, which is lighter, more efficient, and less capital-intensive. To close, going into Slide 12 about capital structure.
We connect all the operating structure, cash conversion. Our debt was BRL 6.4 billion, average maturity of 3.7 years, and average cost of CDI + 2.14. In the end of the period, our cash position and investments totaled BRL 959 million, maintaining appropriate liquidity for the profile that we have. Net financial debt, as a consequence, after acquisitions payable and advance on receivables, closed the quarter in BRL 5.6 billion. In terms of leverage, looking at our current comparable scope, the second quarter 2026 leverage was 3.52x below the 3.09x observed in the first quarter 2026. It is a consistent path of reduction. It is also important to observe that the total leverage has different trends, and it does not show at all deterioration of our performance.
It is a result of the EBITDA of the past 12 months because it is a different comparison base because of the hospitals that migrated to Rede Américas and some disinvestments that we had last year, in addition to accounting effects related to all these actions. It is a mathematical effect and should be observed in upcoming periods until our EBITDA can reflect the new operating structure of the company, which will be in the fourth quarter of this year. When we analyze comparable basis, the trend of the leverage maintains still very clear. Per covenant, the leverage closed the semester in 3.39x below the limits that was expected in our debt covenants. We are still moving on in active management. In July, we concluded the 23rd issuance of debentures BRL 700 million, average term of two years.
Resources were used for anticipated redemption of the 2026 issuance of debentures, which was approximately BRL 708 million. In practice, it has refunded our short-term obligations, reducing the concentration of the maturity dates and helped understand the predictability of our operations, including all relevant payments to be made in 2026 and 2027. As you can see, very positive perspective. We are still moving towards the leveraging of the company, building on three main pillars: growth, expansion of EBITDA, cash generation, and active management of our liabilities. We observe improvement in cash conversion cycles, as shown in the previous slide. Combined with a well-balanced maturity and liquidity has created a solid basis to reduce leverage throughout time. With that, I close the presentation of our figures, and now we can go into the question and answer session. Thank you.
We are going to start now the question and answer session for investors and analysts. If you have a question, please click Raise Your Hand. If your question is answered, you can leave the queue by lowering your hand. If you want to ask a question in writing, please type it in the Q&A icon using your name and company name. The first question by Flavio Yoshida with Bank of America.
Hello, good afternoon. Thank you. I have two questions. They are both referred to the diagnostics area. First, growth. We've seen there was a slowing down of growth compared to the previous quarter. Still operating at good levels, but below what had been the first quarter comparing year-over-year. Is there any specific impact? Is that market share loss? Or should we start considering this level of the second quarter as being the recurring one from now on? Second question concerns gross margin. There was a reduction quarter-over-quarter. You've talked about the mix effect, allocation between lines. Could you please tell us how much each of these effects have impacted that, and to what extent the mix can still impact margins?
Lucchesi speaking here. Thank you for your questions. I'm going to talk about growth, and then Bossolani can talk about gross margin. Growth. We've been showing good growth, considering it's all organically based. There was a reduction in number of service units, especially small units, which were not very productive. But same store sales, basically. We are doing quite fine in the main avenues of growth, such as premium care, home care, and B2B.
B2B, compared against last year, is somewhat smaller than what we observed in the first quarter, but still doing okay. The second quarter of 2025 had a base that had grown significantly compared to 2024 because of the seasonality of the second quarter. Considering all these points, therefore, I think we've reached a very good growth rate. We felt the impact of the World Cup in June and July. Even though the games were played at late hours, it impacted somewhat the business, especially the next day early in the morning. 1.5 point, I would state for. But we are very confident in the growth that is coming. July was a very good month. We've seen some acceleration in recent weeks. There are some additional initiatives that are very consistent with good commercial agreements, and we expect growth in all segments.
We are very confident despite the impacts we have had in the second quarter. We believe that we can have this positive perspective of numbers from now on.
Bossolani speaking. Thank you, Flavio. I think that the first point that we observed is that expansion of revenue and decrease of profitability does not mean that they are related. Not at all. There was a different allocation between cost and expenses, which amounted to 1 percentage point of net revenue. This is a result of what we have been doing in our organizational structure, focused on productivity. There is one second effect, which is less relevant, which is associated with some duplicated costs resulting from the installation of new equipment, which are more efficient. It is the initial cost, right? Thirdly, and less relevantly, there is the effect over the channel mix. We have observed growth of B2B.
We know that the percentage margin of B2B is lower than some premium channels. It is not the right metric to use to consider the financial attractiveness of the business. It adds volume on the installed infrastructure, it requires low incremental CapEx, and it generates incremental growth profit, which leads to dilution of fixed costs. Our priority is to optimize everything and return on capital, and not really just focused on the percentage margin of each channel. Observing the effect and the expenses for total profitability of the company, we can see a very material expansion, excluding our total cash equivalents of 300 basis points.
Thank you. Just a quick follow-up on what Lucchesi said. You said, Lucchesi, that July has picked up. Do you think it is just a result of the repressed demand that you had because of the World Cup, or do you think that it is more than that? It is more than what you had expected.
It does not seem to be just the missed appointments, so to speak. It has been strong since the beginning of July. It seems to be consistent, and also a result of other initiatives that we have put in place. We can see a positive trend overall.
Great. Thank you.
Next question comes from Leandro Bastos with Citi.
Hello, good afternoon. Thank you. I have two questions. First, Diagnostics. Just to follow up on what has been said. I understood all your explanations about growth margin and some of the offenders, right? That you have reported are kind of temporary. What would be an expected recurring margin for the Diagnostics to be used in our modeling? Secondly, concern Rede Américas. We have observed an improvement in the EBITDA in terms of margin, but there was some cash use and a cash position which was kind of low for the size of the company. How can we reconcile the best EBITDA, the debt levels, and what would be the expected liquidity levels that you could have to run at a comfortable pace?
Thank you, Leandro. I am going to just answer the first one, and Bossolani will pick up. We are not going to talk about the trend of growth margin, but we can talk about the impact of the second quarter between expense and cost. There is 1 percentage point in the change of geography.
The centers, the overlap of cost because of implementation of new modern lines, but there is a ramp-up for the new equipment that would be 0.5 percentage point. The mix between B2B and B2C, you can project based on what Bossolan i has said. It tends to be more volume of B2B with a lower percentage margin, even though it is very positive in terms of return on investment and profitability at large. I think that with this overall information, I believe you can have a good prediction of how the margins will be. Now your question to Americas.
Thank you, Leandro, for the question. Let me tell you about the performance of Americas. First, Americas had a very positive performance in terms of results, growth, EBITDA expansion, nearly 40% in comparable data. It is an operation that has been following the financial plan in a very diligent fashion.
Just going over one small or one single quarter, it may not really show the best picture because hospital cash has some relevant volatility in terms of working capital. Especially because of commercial negotiations that may impact receiving in one single month or period. Considering the second quarter, we can see a consumption of BRL 60 million of operating cash, which is associated with the working capital dynamics of the period. It is a phase within the half year. In analyzing the six months, it generated BRL 435 million of operating cash, and this is really important. It shows that despite quarterly volatility, it is a platform that can really self-fund the net debt in 2026. When compared to the beginning of the year, it has been in line in BRL 2.8 billion, whereas EBITDA has been growing nearly 40%.
We can see a very strong de-leveraging, 1.5x the company EBITDA. In terms of liquidity, though, we are a company with comfortable liquidity position. We closed with BRL 360 million in cash, and we are actively working on managing our liabilities and future maturity bonds, which is not what is really requiring most of our attention right now.
That is great. Thank you.
Next question from Felipe Amancio with Itaú BBA.
Good morning. I have two questions. First, about the premium segment. What can you tell us about the brand Alta? Also understanding how you plan to expand the brand. Any specific geography with growth potential? My second question about cash generation. We can see an improvement in conversion cycle, so I would like to pick your brain to understand cash generation and the second half of the year. Please correct me if I am wrong, but considering seasonality of the business, I suppose the second quarter or second half of the year will probably sustain more of that. Hope it makes sense. Thank you.
Lucchesi speaking here. As you know, we do not share the numbers, but we have been growing at Alta much stronger than what it used to have in the past. Based on the market gains, we have also experienced really an improvement. Alta is in São Paulo and Rio. We have the plan of expansion, but it is based on occupancy, occupying the units we already have. That is where we expect to capture more revenue. We have a map of where we need more square meter. In recent quarters, our focus on de-leveraging and running better our existing assets has led to limited expansion.
But from now on, we know where the avenues of opportunity are, and we are planning some new units in São Paulo and also in Rio de Janeiro, less than in São Paulo, of course, so that we can keep on capturing these market gains. Bossolani, please.
Thank you, Felipe, for your question. Analyzing our cash flow, it's important to see the two steps of our financial progression. First, recovery and operating capacity that we have to have cash generation. We have performed quite relevantly. We went from free cash flow, which was negative in the second quarter, to BRL 300 million. First quarter, and now BRL 300 million positive in the second quarter, maintaining our discipline of investments. BRL 310 million in the free cash generation. It can really overcome our financial cost and be translated into our net debt.
We still have relevant interest rate levels, something that we have been improving. Cash improvement is a structured point for the company. Historically, the first half is more intensive in terms of capital, and cash generation tends to be more favorable in the second half of the year. Still, when we consider the operating improvement that we presented in the quarter, we can see that it was also translated into a reduction of our net debt, nearly BRL 23 million. This is why we've been considering cash conversion, final cash conversion in the net debt. The next step is something that is going to be more evident in the balance and the second half, and more positive and a decompression of our net debt for the year.
Thank you very much.
Next question from Mauricio Cepeda with Morgan Stanley. Please move on.
Lucchesi, Bossolani, thank you very much for that. Let's build up on what we've heard, and that was also mentioned before, capital allocation. You are working on this leverage thing, but would it make sense in organic expansion for going into deleveraging? Would it be possible? What would come first to go into more investment? We've been talking about brand Alta as having good performance. There are other brands in Brazil. Would you be willing to be more aggressive towards that? What would be your criteria in terms of return, and how would that help you deal with this bottleneck, considering what you've been experiencing?
Hi, Cepeda, thank you very much for your question. Yes, we've been very careful in our approval of expansions. We've seen a very good installed capacity to bring revenues. This is the best of all worlds, right?
Because then you can have operating leverage, bringing down cost. We've been expanding quite well in recent periods, even without expansion. Your question is good because this is exactly what we are analyzing. To what extent we can reach to some specific regions and some specific brands at a point in which the ramp-up would be so positive that it would help us in deleveraging, in improving EBITDA, and what would be the expected return on investment of such ramp-ups. In our analysis, this possibility is still something that requires attention to get good return on investments, but it seems that some specific expansions can contribute to deleveraging if properly implemented. Said that, and reinforcing my answer to some previous questions, we have a plan of expansion by square meters in existing units with no services and in new units.
And we will probably start showing you in upcoming quarters our initiatives towards that. We know the market. We know where the opportunities are. We are highly confident that this is going to improve and help us have a better performance.
Great, thank you.
The next question comes from Gustavo Tiseo with XP.
Good afternoon. I have two questions. First, lab-to-lab. It has been growing, but when you look back, there were some investments, then you discontinued, then you resumed. So how can you improve that in terms of operational performance? What kind of margin can we expect just compared to the past? Because in the past you had stronger operation, and the margin was higher. But right now, is it better, or is there still a lot to be done? Just to understand how much expansion can be expected from lab-to-lab. GLP-1 analogs. We've been hearing that GLP-1 is going to impact a lot diagnostics. Do you think it's really impacting your volume? Is it relevant? If it's relevant, how much is it impacting you?
Hi, Gustavo. B2B first. Yes, there is still a lot to be captured there. We have now more focus on this business. It's a market that it's growing fine. We are well-positioned, but we needed some structuring actions, as I pointed out before, integration of systems, for example, use of our centers throughout Brazil, logistics. We have a plan being implemented commercially, service level, utilization of NTOs. We are starting capturing those synergies now. There's still a lot to come. In the past, it was a service that used to be separated from the operation when we acquired it at first, then it just got fully implemented, and it has diluted costs.
But it has become like a side business. Right now we are seeing things differently. We believe it can be a very good business, considered to be very relevant to our company. So we are taking the right actions to have better performance and to be more and more competitive, just bringing all the benefits, in terms of cost reduction and gains in margins. Concerning your second question, it's no. We have no statistic data that confirms any changes in volume because of GLP-1 analog use. It is a trend, though. But no statistics confirm that.
That's great. Thank you.
Our question and answer session is closed now. The questions that have been submitted in writing are going to be answered later by email. I would like now to hand it back to Mr. Lucchesi for his closing remarks.
Let me thank you all very much for being here with us. We are consistent, as you can see. We've been implementing our plan. We have clear priorities. There was some impact of seasonality in volume and revenue, but still showing growth. It's also important to talk about our restructuring initiatives, doing quite well. We are focused on the deliveries of the year. Very strong commitment, of course, but always building a company prepared for future growth, well-positioned, so that our competitive advantages are reinforced, such as quality, excellence, innovation. With an increasing number of patients, high-reputation brands, a number of points that we have focused on so that Dasa can become stronger. We are very optimistic with the upcoming quarters. We are highly confident that we'll be able to present better and better results to all of you. Thank you all very much. See you in the next quarter.
The earnings release call of Dasa is closed now. Thank you all very much for your participation. Have a good afternoon. Thank you.