Good morning. Welcome everyone to Hapvida first quarter 2021 earnings conference call. Joining us today we have Mr. Jorge Pinheiro, CEO, Mauricio Teixeira, Chief Financial and Investor Relations Director, and Guilherme Nahuz, Investor Relations Director. We would like to inform you that this event is being recorded, and all participants will be in a listen-only mode during the company's presentation. After Hapvida's remarks, there will be a question and answer session for investors and analysts when further instructions will be given. Should any participant need assistance during this call, please press star zero to reach the operator. Today's live webcast may be accessed through the internet address at ri.hapvida.com.br/en/. Before proceeding, let me mention that forward-looking statements made during this conference are based on beliefs and assumptions of Hapvida's management and on information currently available to the company.
They involve risks, uncertainties, and assumptions because they relate to future events and therefore depend on circumstances that may or may not occur in the future. Investors should understand that general economic conditions, industry conditions, and other operating factors could also affect the future results of Hapvida and could cause results to differ materially from those expressed in such forward-looking statements. For those of you who are listening to us on the webcast, the presentation will not move from one slide to another automatically. You can control the slides with the keys below the slides. Now, I'll turn the conference over to Mr. Jorge, who will begin the presentation. Mr. Jorge, you have the floor.
Good morning, everyone, and thank you once again for participating in our conference call. It is with great joy that we present to the market Hapvida's first quarter 2021 results. Let's start on slide number two. Here, I'll give you an overview of the main highlights of the first months of 2021. The first quarter of 2021 was a period in which our operational discipline and the strong execution of our teams were at the forefront.
We're very happy to deliver a quarter with growth in revenue, growth in membership and in income, as well as a reasonable MLR considering the challenging environment we're going through. The beginning of 2021 was marked by the worsening of the pandemic here in Brazil with new strains or variants of the virus that are more aggressive than the previous ones, and that reached a greater number of people. Therefore, our healthcare units have been impacted with a greater volume of COVID-19 related visits and admissions.
The results that we are now sharing show all of Hapvida's expertise and resilience, as well as the strengths of our business model. We have made strong investments in protection, reinforcing our infrastructure, purchasing materials, drugs, and investing in logistics. We were very quick to rescale our own care network in order to meet this rise in demand, adding over 800 beds since the beginning of the year. This flexibility is one of the strengths that we have in our business model. Once again, all of our medical teams involved in fighting this pandemic have been amazing warriors. I would like to take the opportunity to thank, once again, everyone who has been working in the front line as well as all of those who are working in the back office and who are facing so many uncertainties every day but continue moving onwards.
Hapvida is very, very thankful to you. We would not have achieved this performance without the unconditional commitment of our 36,000 employees and 30,000 healthcare professionals who work with us. Thank you, and congratulations on such a spectacular work. Let's now look at our financial highlights for the first quarter of 2021 that you can see on slide number three. Net revenue was BRL 2.3 billion, up 11.8% year-over-year, boosted by the addition of 477,000 healthcare and dental members, and by the increase in average tickets. Even with a strong impact of COVID-19 related care, the non-suspension of elective procedures and with the consolidation of over one million lives of the acquired companies that were operating with an MLR that was at a much higher level than ours, our cash MLR was quite reasonable at 61.1%. We're very happy about this performance.
Our sales expenses were 6.2% of the revenue and our administrative expenses, excluding depreciation and amortization, were 10% of the revenue. Our EBITDA achieved BRL 466.8 million in the quarter, keeping a level above 20%. Moving on to slide number four. We closed the quarter with a total of 457 care units, including hospitals, ERs, clinics, and diagnostic units. We now have eight hospitals in different stages of construction, some of them still in the design phase, others in an advanced stage of construction. We closed the quarter with 3,876 beds. That is 1,122 beds more than the same period in the previous year. This quarter, we made 1,567 beds available for COVID-19 therapy alone, an increase in 803 beds compared to the fourth quarter of 2020.
This was the result of the bed expansion conducted because of the pandemic. We continue engaged in finding the ideal size of our own care network, which enables us to achieve medical expenses verticalization gains. In April 2021, we opened a new hospital in Maceió with urgency care, emergency care for adults, children, and obstetrics care, in addition to an imaging diagnostic unit. Our investments in infrastructure have been seeking consolidation, increasing the offer of healthcare services with larger and more complex units. In the inorganic front, we concluded in February the transfer of members from Samedh and Plamed portfolios, both of them located in Goiás. Now we have added about 30,000 customers to our portfolio that are now part of Hapvida. Another important step that should be mentioned, as on slide number five, was the advance of another stage in the business combination between Hapvida and GNDI.
On March 29, 2021, the general shareholders meeting happened, and the shareholders of both companies approved the operation. This was a historical moment for the Brazilian healthcare industry. The possibility of providing people with high-quality healthcare at affordable prices is very consistent with the times we're going through. This will continue to be the purpose that will guide this combined company. The operations are still waiting for regulatory approval. On slide number six, we talk about innovation and ESG. Innovation is considered a very important topic here at Hapvida, and we believe this can be a tool to transform society. That's why Maida Health, Hapvida System Health Tech, is sponsoring a artificial intelligence research center at the Federal University of Ceará.
The goal of the center is to develop projects in healthcare involving Internet of Things, big data, and digital transformation focused on diagnostics, prevention, and therapy, all of that at a low cost. Our telemedicine platform that has now a facial recognition, is conducting over 85,000 appointments a month. Just so you have an idea of the size, this number accounts for about three times the number of appointments conducted in our greatest physical infrastructure unit, which is Hospital Antônio Prudente, located here in the city of Fortaleza. When it comes to sustainability, we've been advancing. We have made some public commitment to gather efforts, and so that we can put in practice respect and inclusion and diversity promotion. Our strategic plan of sustainability here at Hapvida is now prioritizing the strategic plans and defining sustainability indicators.
In the following weeks, we'll release our annual sustainability report for 2020. We have lots of news to share with you in this report. We believe Hapvida is just in the beginning of this journey, and we are sure that the advancement in the ESG agenda is key for the sustainability of our business. In April, we concluded successfully our second offer, our follow-on offer. Proceeds of about BRL 2 billion were added to the cash of our company, and they will be invested in strengthening our own care units and those of the recently acquired companies. We continue focused on acquisitions and we believe in the consolidation of the Brazilian market. We have a robust pipeline of assets being studied. Most of the proceeds of the follow-on will be invested in new acquisitions.
Another important fact is that the consolidated numbers of COVID-19 related care and admission have been showing a downward trend, as you'll see later on. In addition to that, with the vaccination campaigns running here in Brazil, we're hopeful that there won't be a third wave hitting us here in Brazil. We continue firm, engaged, and restless to provide the best service that our members deserve. I'm sure that our company is strengthened and prepared to make the most of the opportunities that may arise in the future. Having said that, I would now like to turn the floor over to our CFO and Investor Relations Director, Mauricio Teixeira, who's going to give you further details about our quarter results. Then we'll have a Q&A session. Thank you very much.
Thank you, Jorge. Good morning, everyone. On slide number seven, we can see that the number of healthcare members had a 5.5% growth compared to the same period of the previous years, boosted by the addition of 76,000 members coming from Medical and 52,000 coming from the Grupo São José. We also concluded the transfer of the member portfolio from the Samedh and Plamed operators, adding 30,000 lives to our own portfolio. Also, there's been an organic growth of 61,000 members of the Hapvida operator plus Grupo América, and a reduction of 14,000 from the Grupo São Francisco and RN Saúde acquired companies. The number of dental plan members grew by 9.9% compared to the same period of the previous year. Organically, there's been an increase in 135,000 lives in individual plans and 143,000 lives in group plans.
We have also included members that had dental coverage, but that were only considered as healthcare members because we had sold this product as a combo at the time. Also, we now have customers with service provision contracts with a fixed price table. As a result, we have added 144,000 lives to our membership. We can also see the evolution in the average number of members in every quarter, and we use these numbers to calculate our average ticket. On slide number eight, you can see the monthly average ticket for healthcare and dental plans. The healthcare average ticket grew by 6.8% compared to the first quarter of 2021, mainly boosted by new sales, readjustments of existing contracts, and the addition of members coming from Medical and Grupo São José that have a higher average ticket.
For dental, the average ticket had a drop of 0.7% compared to the same period of the previous year because of a lower average ticket of all operators, with the exception of São Francisco, which had a 1.6% growth compared to the first quarter of 2021. On slide nine, we can see net revenue that grew by 11.8% in the first quarter of 2021 compared to the same period of last year, of 2020. We had 318,000 lives being added to our membership in healthcare and dental and an increase in the average ticket of healthcare reflects of the readjustments in prices and new sales. There's also the revenue of the acquisitions consolidated in 2020, BRL 45.7 million from Medical and BRL 46.1 million from the São José Group.
The acquisitions consolidated in the first quarter of 2021 with 13,600 lives from Samedh and 15,500 lives from Plamed. On slide 10, we'll talk about the COVID-19 scenario for the company. Since the beginning of the pandemic, thus we want to be able to explain the MLR numbers. When the WHO declared COVID-19 as a global healthcare emergency, all the elective procedures were suspended. This fact, added to social distancing measures, led to a drop in medical care services demand in the period. All of the volume caused by COVID-19 in our healthcare units during the pandemic was offset by the suspension of the elective procedures. With the advance of the pandemic in the end of 2020, we were able to see a significant increase in the number of admissions in the first quarter of 2021.
We reached a peak in mid-March with a high number of daily admissions that was 32% above the previous peak. That led to a higher demand in healthcare services that were already at a historical level of usage before the pandemic because of the government flexibilization and the non-suspension of elective procedures. On slide number 11, you can see a breakdown of our MLR. Cash MLR in the first quarter of 2021 was 61.6%, a 5.3 percentage points increase, especially due to the second wave, with an impact of BRL 85 million. We had an impact of the higher level of MLR of the acquired companies that led this number upward. That's going to be seen until we conclude the integration plans and reduce MLR to our own levels.
We had a total MLR of 65.5% in the first quarter of 2021, a 3.9 percentage points increase year-over-year. There was a reduction of the SUS provisions and IBNR reversion due to the elective procedures that were suspended in our accredited network because of the second wave of the pandemic. We still have great operational efficiency with our projects to manage MLR, and we were able to increase our verticalization with a 1.9 percentage point increase in the volume of services provided in our own network in the first quarter when compared to 2020. On slide 12, you can see a breakdown of the SUS reimbursement provision. In the first quarter of 2021, ANS capped the process to regularize the flow of invoices. The net impact was of BRL 71 million on claims.
Although there was a new lot of notices issued and an increase in the historical level of charges, the notice provision had more reversions than constitutions in the quarter because of a faster invoicing process. On slide 13, you can see the percentage of representativeness in SUS reimbursements that has been dropping compared to the total claims of the company. We use the number of notices and the quarter to which it refers. This drop shows the results of the projects we have implemented to reduce our claims. On slide 14, you can see our operational expenses that had a reduction compared to the first quarter of 2020. Selling expenses was of 6.2% of revenue in the first quarter of this year, a 1.2 percentage points drop compared to the first quarter of 2020.
The reduction happened because of operational leverage and a lower level of delinquency, which had a reduction of BRL 12.4 million in the allowance for loan losses. We increased the average term of contracts. One month for individual plans and two months for corporate plans, with a positive impact of BRL 10.5 million. In addition, the recently acquired companies have a lower selling expenses level than Hapvida's. The administrative expenses level was of 10% of revenue in the first quarter of 2021. At the same level of the first quarter of 2020. On slide 15, you can see our EBITDA numbers that were aligned this quarter with the levels that we achieved in the first quarter of 2020. This is aligned with our strategic goal, although we were hardly hit by the pandemic.
Net income ex value added totaled about BRL 300 million this quarter, a 14% increase compared to 2020. This was mainly due to the maintenance of our EBITDA, even in this scenario that was hardly hit by the pandemic, a lower level of net income, and also a reduction of income taxes. The last slide 16, you can see our cash flow. Free cash flow generation ex acquisitions was BRL 343 million this quarter, a BRL 62 million reduction compared to last year that was mainly due to a CapEx of BRL 134 million invested in the expansion of our own network infrastructure. We're now open for questions.
Thank you. The floor is now open for questions from investors and analysts. If you have a question, please press star one. If at any point in time your question is answered you may remove yourself from the queue by pressing star two. The questions will be taken in the order they are received. We do ask you to pick up your handset to provide optimum quality when asking a question. Please hold while we pull for questions. Our first question comes from Vinicius Ribeiro, UBS. Vinicius, you have the floor.
Good morning, everyone. Thank you for taking my question. I would like to explore two points. First, the competitive dynamics for the coming quarters. Removing macro scenario, what are the competitive trends that you see in each region? Do you expect a significant change compared to previous quarters?
Now, when it comes to individual plans, what are the initiatives that you're planning to take in order to mitigate the readjustment's impact that will probably be negative, considering that the competitors are also under pressure? Now, a question more about the results. I would like to explore Jorge's comment in the beginning of the call about the operational flexibility. We see many players in the healthcare industry is working strong. Do you think that the COVID-19 demand has impacted your operations? Do you think that your business model helped you to deal with that demand, helped you more than the competitors? I would like to understand your business model and the potential synergies of the merger as well.
Hello, Vinicius. Thank you for your question. These are all great questions. Now, talking about competition, we see that the Brazilian market is increasingly consolidated.
In the past, we had over 1,000 operators in the market, today we have around 600 operators in the market, we think that we will have stronger operators in the future in this more mature market. Today, we see a very competitive environment, especially in the hospital area, more than the operators area. There are operators that are more aggressive in the specific regions only, we question the sustainability of these players that are more aggressive locally. We are very confident about our business model to deal with all of that. Once again, with our solid and robust results that we have shared with you. The pandemic numbers are quite impactful in the first quarter, as you saw in the chart.
Considering that we have over 1,200,000 lives with a higher MLR to our portfolio in a very short time, and with the effects of the pandemic, it was our business model that enabled us to have this stability and a very small variation in our MLR. That gives us a very strong commercial power that will enable us to grow organically and will enable us to be competitive. What we want is to provide the population with high-quality healthcare, but thinking about the affordability as well for families and companies. I believe that after this first quarter is over and after the second wave of the pandemic is over, which impacted the market because many companies are closed and not hiring new people. We had a spectacular growth in the fourth quarter last year, and we were boosting the growth in the country.
Considering our competitiveness and our business model, we believe we'll continue gaining share organically. Now, talking about our operational flexibility, that reflects the strategic decisions that we've been making for a long time now. Our company has our own network units in all the strategic regions for us, and that gives us a lot of agility. We have an amazing expertise in hands that enable us to allocate resources, to hire people, and to have a very well-designed logistics operations. All this agility makes us more independent. We don't need third-party resources. We only need those resources in recently acquired companies that are still maturing, which is quite natural. This is something that has a greater impact on the numbers. Considering that we have our own network that can still be expanded, enables us to mitigate or to buffer impacts of the changes in care volume.
We are very confident that we have great chances of continuing gaining market share, considering the strengths of our products.
Thank you so much, Jorge, for your answer. I will now give the chance of our colleagues asking questions. Thank you so much.
Our next question is by Ricardo Boiati from Banco Safra.
One of the questions I had was about your expectations about the readjustments or price increases in individual plans. When will this happen? Or is this readjustment negative, and how will this impact the company? That's my first question. The second question about the future M&As or future acquisitions. I would like to know whether you see some type of asset inflation, to acquire operators or hospitals, for example, because of a greater competition in the market right now. Do you see any type of inflation for possible acquisition of assets? These are my two questions. Thank you very much.
Thank you for your questions. Now about the individual plans. This topic has been addressed by our company here. This is something that we were already planning for the year. We did not have any expectations in terms of price composition because of the decision that ANS made last year to suspend elective procedures. Now, if there is no readjustment this year, next year, this is going to be offset. Our company has a great cash position, and we have a business model that enables us to absorb any cost variation much better than the rest of the market. I think this is not a major concern for us. However, I understand that for smaller operators, the smaller HMOs, this can be a great challenge and less capitalized players will suffer much more for sure.
About your second question about M&As. No, we don't see many operators conducting acquisitions in the market. In the hospital area, we do see a run for assets. This is an area that has been more impacted, but this doesn't affect us much. We like to grow by building our own hospitals, and we rarely acquire hospital assets available in the market. We don't see a lot of pressure there. This is not a concern for us. There are other operators with expertise and know-how and access to capital. We also have a know-how for M&A and for this integration, and I don't see many other operators in the market with the same expertise and know-how, so that's not a major concern for us.
Okay. Thank you very much, Jorge.
Our next question is by Mauricio Cepeda from Credit Suisse. Mauricio, you have the floor.
Hello, this is Mauricio. Thank you so much for your presentation. Now about the commercial part. Companies are now trying to reinforce their plans. Do you think that this cooperative market--
I'm sorry to interrupt, but we can't hear you well. Maybe you could speak a bit closer to the microphone so that we can hear you.
Is it better now?
Yes, much better. Thank you.
Okay, I think it's a problem on my phone. I will speak a bit louder. I would like to hear about the commercial environment. If you feel that companies are willing to rethink the healthcare plan benefits that they provide to employees. About individual plans, do you think that the individuals are still affected by the pandemic and they're going after individual plans? What are your perceptions in terms of that?
I also have a question about elective procedures. Is there a backlog from the first quarter that you will need to address in the rest of the year? Thank you.
Okay, thank you. Much better now. About the wish of having a healthcare plan here in Brazil, that is something that is only growing. We know that Brazilians value healthcare plans here in Brazil. The second wave of the pandemic was really harsh, but we see clear signs that the second wave is being left behind, thankfully, and that requires a lot of effort and opening units. We were hiring over 3,000 employees, I don't know exactly what the right number is, but to provide the best service during the pandemic. We did that. We never lacked beds in any of the cities we operate.
Since the healthcare industry is in the limelight, is now part of the everyday lives of Brazilians and actually everywhere in the world, the population is increasingly interested in acquiring a healthcare plan. Now, with the recovery of the economy and the decrease in the number of cases, the possibilities to sell a healthcare plan are greater now. Users are now seeking our products, not only in retail and individual plans, but also in corporate plans. With the reduction in the number of cases, we see a natural trend for sales to happen. We see many business people considering investing in their businesses now because the vaccination pace is going up and the economy is recovering and COVID-19's impact is decreasing. I think that the individual channel is probably going to grow.
Also from the corporate level, we have contracts that have just been signed with major companies, large companies. This happened really strong in the fourth quarter of 2020. I'm very optimistic when it comes to our organic growth that can be accentuated with the recovery of the economy. About elective procedures. You probably remember that last year, with the first wave of the pandemic, all elective procedures were suspended, and that includes appointments, tests, and surgical admissions that were not then performed. The backlog of procedures that happened in the beginning of the pandemic was actually provided in the third and fourth quarter of 2020. ANS has not defined a suspension of the procedures, and the operators could make the decisions their own by themselves. We decided not to suspend elective appointments, tests, and procedures.
However, in March, some health departments suspended elective surgeries only. We do not have a backlog of medical appointments or of tests, but we do have a small backlog of elective surgeries. In some of the cities, we have already resumed those elective surgeries. I'm talking about a very small backlog, much smaller than the backlog that we had after the beginning of the pandemic last year. We are already conducting elective procedures in almost all the cities in Brazil.
Okay, thank you very much, Jorge.
Our next question is by Samuel Alves, BTG Pactual.
Good morning, Jorge, Mauricio, Guilherme. I would like to explore two topics. The first one, about your membership base. The number of legal entities in the company, is it growing? Is the net loss of lives and corporate plans explained by employees being fired? now, what about the ex-COVID-19 MLR? You said that in this quarter, elective procedures have not been suspended. The ex-COVID MLR has gone up quite significantly. I'd like to hear from you. Do you think that the MLR of acquired companies has already been decreased since they were acquired? Thank you very much.
Hi, Samuel. Thank you for your questions. The audio was not very good. I'll try to answer your questions. If there is anything missing, just please let me know. About our membership base, the good news is that we don't see any companies dismissing employees right now. They have made headcount adjustments in the beginning of the pandemic. After that, we haven't seen any other headcount adjustments. I believe that they now have adjusted to the lower volume of the pandemic.
This gives us good expectations that with the vaccination and the slowing of the pandemic, we can have a growth when companies start hiring the employees to the same level they had before the first wave of the pandemic. My answer is, companies are no longer dismissing employees, and we expect them to start hiring back employees once the economy recovers. About the MLR, we have great news. Our company has prepared for that. We have a complete team for integrations. Also, our operations area has been reinforced. That was so that we could make multiple integrations at the same time, and the results can be clearly seen with results that were even better than expected. Yes, we've been able to reduce every medical costs of every acquired company.
Just by combining Hapvida, which has around 60% MLR with 2,400,000 lives and adding the 1,200,000 lives that came from the acquired companies, this simple combination would lead to a result in MLR of almost 66%. We delivered 61.1% cash MLR. This is a very dramatic reduction that was due to the customized monitoring of each integration process. There is still a long way to go. Many companies are not mature enough yet with hospitals under construction, with outpatient departments. We haven't yet implemented our system in all of the acquired companies, and that requires a lot of technology, protocols, standardization, and so on and so forth. The package of the acquired companies have had their MLRs reduced. However, we are going to add new companies to our base.
We expect to receive the operations in Belo Horizonte with over 300,000 lives of a company with an MLR above 80%. The same integration process will be implemented. That's the beauty of our work. We want to keep MLR under control. The new assets that are added go through this adjustment process so that they can achieve an MLR that is closer to our own MLR. The new acquisitions are coming, and we've been very disciplined to implement this flow.
Okay. Thank you, Jorge. That was very clear.
Our next question is by Gustavo from Bradesco .
Good morning, everyone. Thank you for taking my question. I actually have two questions. The first question is about cancellations and migrations in the first quarter, especially focusing on April, the gross adds coming from the acquired companies.
Can you please tell me a bit about that so that we can understand a bit about the future? My second question is about the merger with GNDI. Are you considering short-term partnerships or anything else that you can share about that? Thank you very much.
Thank you for your question, Gustavo. Well, the first quarter was aligned with what our company usually presents in the regions where we operate. The pandemic has led to a slowdown. Many companies shutting down during this process, and this is quite natural. What we expect is once the number of cases decreases, we can grow just like we did in the fourth quarter of last year, which was quite impactful. In the first quarter this year, we had the loss of one large contract.
It wasn't actually a loss, we let this contract go because their MLR was really high, above 100%. We do expect this contract to come back at a more appropriate price. I think this company is now with an operator that will find it really hard to keep the MLR at an acceptable level. That was nothing different from what we expected, and we're very confident about our growth and the retail and corporate business starting in the second quarter. Now I'll give the floor over to Mauricio to talk about the GNDI merger.
Good morning, Gustavo. Thank you for your question. After the approval in the end of March, we started working with CADE and ANS. We have opened the previous protocol with CADE, and we are about to file the final protocol.
We have some regulatory due dates that can be shortened or not, we're going to monitor that from up close. At the same time, we are at the final phase of hiring a consultancy company that will help us map all the synergies and the value generation potential that can come from this merger. Of course, we need to wait for CADE's approval. We think that we are going to hire this consultancy this week or next week. We're going to sign the contract. As soon as we have any news, we're going to let you know.
Perfect. Thank you very much for your answer.
Our next question is by Gustavo Miele, Itaú BBA.
Good morning, Jorge , Mauricio, and Nahuz. Thank you for taking my question. I want to talk about two points very briefly. The first one is about the COVID-19 admissions component on your MLR.
We see the impact of the number of admissions on your results, but were there also changes in the dynamics of COVID-19 admission costs in the industry? Is COVID care now more expensive than it was in the beginning of the pandemic? My second question is about selling expenses. That was one of the highlights of the quarter in my point of view. The resilient B2B dynamics is something that we've been seeing in recent quarters, you also said that there was a positive impact of the acquired companies. About the M&As that you have to integrate, especially Promed, do you also forecast a positive impact in the dilution of the selling expenses? Can you please tell us a bit about the assets that are to be included in your P&L? Thank you very much.
Hello, Gustavo. Thank you for your question. About COVID-19 admissions.
Yes. The new strain not only affects younger patients than the first strain. When we look at the ICU, we saw that the patients affected were usually older or patients with overweight or with other comorbidities. Now the second wave was different. It affected older patients with a more severe disease, and it also affected younger patients, even patients without any comorbidity. Yes, the cost of care is higher, and the length of stay in hospital is also longer. On the other hand, we have good news because the results are increasingly better. As time goes by, even with the virus being more severe, we are able to deal with that. Yes, there is an impact on costs because hospitalizations are longer and the cost of care is also higher. Now, about selling expenses. I'll give the floor over to Mauricio to answer that question.
In general, in Belo Horizonte, we have not yet decided which commercial model to use. On the other hand, we have already mapped the possibilities of cross-selling. Many companies that are our customers could benefit us with a much lower commercial cost. We provide services to many retail companies in Brazil and different states, and major industries as well. Let me give the floor over to Mauricio to talk a bit more about that.
In the first quarter, we saw a drop in delinquency rates, and I think that everyone has been giving priority to healthcare plans, especially during the pandemic, and I think this is going to remain in the future because of this memory of the pandemic. In the list of priority of payments, the healthcare plan is always at the top of the list.
Now, for people who do not have access to a private healthcare plan, with the recovery of the economy, more people will be able to afford this in the future. Our business model aims to provide affordable healthcare plans, so this is also going to help us with our strategic goals. About selling expenses and commissions, we're giving extended terms of the contracts, and our customers usually remain with us now for longer than they used to stay with us in the past. That's great news for our results and for retention. About M&A, yes, we want to dilute the selling expenses. Commercial in Belo Horizonte is being defined with the entrance of Promed. That's the major integration that we had ahead of us.
Our history has shown that we are able to reduce the selling expenses of the acquired companies, and the consolidated selling expenses usually decreases as a result.
Okay. Thank you, Dr. Jorge and Mauricio.
Thank you. If there are no further questions, I'd like to turn the floor over to Mr. Jorge for his closing remarks. Mr. Jorge, you have the floor.
I would just like to thank everyone for joining us today to hear about the results of a quarter that was very intense in our lives. I would like to reinforce, once again, our commitment with life and commitment to resistant, providing high-quality healthcare. We are going to work really hard in order to find solutions and achieve our mission of providing care to all of our patients who have been affected by this terrible disease that is COVID-19.
I would like to thank our managers for their restless work. They work day in, day out so that we can fulfill our mission. I would like to thank our partners and our investors for believing in our business. Thank you very much, and I'm always available to you. Have a great day.