We are going to begin our presentation with the earnings of the second quarter at Mater Dei. I am Henrique Salvador, the CEO, and it was a quarter where we started to notice the returns on our results with more consistent parameters than those that the network had historically. We have noticed a few important insights about our hubs and some important news. We can move on to the next slide, where we notice that in our hubs, especially in the Mater Dei Hospital in Betim-Contagem, which is connected to the Belo Horizonte hub, we had an important amount of hospital beds opened due to the arrival of a new payer, IPSEMG, which is the Institute of Social Pension in the state of Minas Gerais with 152,000 new lives, increasing the addressable market significantly in our region.
In the same way, in Uberlândia, we also had the arrival of the Hospital Santa Genoveva to be able to also join our network. We improved cost management through the integration, improving the management of our care team and operational improvements, significant increments in the EBITDA margin as well. The Hospital Santa Clara now is waiting on approval from the antitrust body, CADE. With this, we will be consolidating this hub in the Midwest region. We will also have an important entrance in the hospital in Goiânia as well, the Hospital Premium. In Salvador, we had the inauguration of our hospitals with 3. 5 months of operation. It is the first greenfield project in the company out of Minas Gerais, and it took place in May. On May 1st, we launched it.
The hospital started to operate with a team of over 600 employees, a full clinical team, many specialties, and already accredited for over 400,000 lives that have access to this hospital. Soon we will be inaugurating the Medical Mater Dei Salvador Hospital Center with 73 medical offices, setting up an integrated medical center next to the hospital. Moving on to the next slide. On slide five, we would like to also say that in the Grande Belo Horizonte hub, the metropolitan region of Belo Horizonte, there was an important external and very demanding audit process to provide proof of compliance with international standards of care, and the hospital in Contorno was once again certified by the Joint Commission International, where there is an assessment of the procedures in many different areas of the hospital.
I want to remind you all that the units in Santo Agostinho, Betim-Contagem, and even Porto Dias in Belém also all have this quality certificate. We also performed our first buyback program that was approved on 13th of July with an 18-month period, which intends to maximize value generation to shareholders. We believe that at the moment, the official value of the shares does not effectively reflect the real value of our assets, especially due to the combination that exists and the possibility of profitability and actual generation of positive results in the future. We have also published our sustainability report at the end of June with important information about ESG, environment, social and governance achievements regarding last year. They all follow the GRI standards and procedures.
There you can find information that is very relevant and very important related to the different attempts in this field. On page six now, we have some operational highlights that are very relevant in Mater Dei. We also notice a growth in the amount of beds. When we compare with the first quarter of 2022, what is interesting and very relevant is that despite in the second quarter of 2021, us having a bigger amount of operational beds, we observed that the amount of beds that are non-COVID beds increased significantly.
Basically, 100 beds increase from the second quarter of 2021 to 2022 and this demonstrates better productivity, but also an interesting effect that should take place from now on because contrary to the same period last year in the second quarter of 2021 when a bigger amount of operational beds ended operation due to the bigger demand from COVID, this time the increment of the hospital bed openings has been consistently done and especially due to the increase of non-COVID activities that our hospitals have had. This is a movement that we will notice with lower seasonality than what we have noticed in the past when the hospital beds took place more due to the pandemic than due to the increase of operational beds, in fact. This, of course, tends to be applicable for a little more time.
On page seven, another important point is that the occupation rate and the overall average reached 70%, really due to the fact that we still have an operation that is not very mature, which is the Salvador operation, pushing the rates a little downwards. But if we just consider the Belo Horizonte region, this occupation rate reaches 75%. If we were to use another methodology, which is different than ANAHP's, of course, that does not consider the day patient, and if we use this methodology that considers the day patient and not the ANAHP, the National Association of Private Hospitals method, we would be able to have an increase of about 4%-5%. I am highlighting this point here because I think that it really does demonstrate greater productivity in our operations.
It does demonstrate that from now on, we have the increase of the revenue, and we will start to notice results that are also growing when it comes to profitability and margins. We hope that in the next quarters, we will be able to get back to the levels we had before of margins in the Rede Mater Dei de Saúde . I am going to pass on the floor to Rafael Cordeiro, our CFO, and he is going to talk about our numbers a bit.
Well, good morning, everyone. Thank you for being present today. As we move on with our presentation here, now we are on page eight, and we want to highlight the revenue. We had a quarter that was really interesting when it comes to the average ticket. We already had expected an average ticket compared to last year's that would be a little bit lower due to the incorporation of new hospitals in regions where the practice tickets are lower than in the metropolitan region. Even so, we've had growing results. We had 206 compared to 203 last quarter. Here you have a mix of the transfer of prices compared to hospitals that have lower tickets.
So in the Belo Horizonte region, we have an interesting number. We grew 9% in our average ticket quarter-over-quarter. So we have BRL 2.52 million, which demonstrates our capacity and our resilience. Not all of the average tickets come only through discussions with the payers, but they're also a result of the new compensation models, the mix of the complexities. Also, we really believe we've had good results in [CAR], which is the Mater Dei Hospital before the IPO in Belo Horizonte and Betim- Contagem. This reflects the important growth of the net revenue. In the semester, we grew 57% compared to last year's. We grew 62% compared to the same quarter last year.
In the previous quarter last year, it was one of the strongest COVID periods, so the tickets were high, and the customer flow for hospitalization due to COVID involved a lot of ICU patients. This demonstrates a lot of growth and 27% quarter-over-quarter. So the entrance of the new hospitals, the opening of the beds, have all been responsible for this more robust revenue. Moving on to slide nine, we have the main message here about the costs, which is the reduction on the net revenue of our medical and operational costs for medical materials and hospital materials. This is due to our growth and our capacity to negotiate with suppliers, which of course, was one of the main items that helped us lower by 2.3 percentage points the significance of the costs over our revenue as a whole.
So I want to highlight this point with medical materials because I know this is a big concern due to the inflation. About expenses, the incorporation of new hospitals initially does bring an increase in the operational expense, but we have doubled some of the expenses, kind of double some of the expenses at the holding level with the arrival of new hospitals. Even so, quarter-over-quarter, we did have a reduction that was small, but it demonstrates that now we have this trend of this line dropping over time as we dilute our expenses. Now, with the EBITDA, we did reach BRL 213 million in EBITDA in the semester, but we had BRL 120 million in the quarter.
So the vision that we have at Mater Dei for the year, we have to, of course, look at the last quarters, and the last one was the second quarter, and we have to think of it as an annualized number because in each past quarter, we have a different story, different number of hospitals and beds. So the trend for the year is not doubling or just repeating our last quarter, but replicating the last quarter where we were a lot more robust with the closing of the year.
Margins went up a lot from 25.4% to 27.7%. We really do believe that when it comes to margins, the worst is left behind us in the first quarter. It is important to highlight two points. This consolidated margin of the Rede Mater Dei de Saúde , within it, there is the transfer of these medical fees. We compare with previous years in other bases. For example, in the Rede Mater Dei de Saúde , as you well know, in the Belo Horizonte hub, we do not have medical fees going through the results or the earnings. With the incorporation of the new hospitals, we have this shift. The numbers in comparison are really important for you to consider due to the significance that this represents in medical fees and the costs passing through the revenue. There is this kind of effect. It is null, but it does harm the margins.
We transfer 100% and then you have a loss of margins because you increase the net revenue. Another important point that we like highlighting is that we have adjustments. We did not adjust the stock options in this quarter, but we understand that the stock options are actually already at the company's run rate. This is an expense the company has. It already existed in the second quarter of 2021. When we compare with the second quarter of 2022, then we think it is already comparable and the values are pretty much the same. Those BRL 3 million you already know about for the quarter, but we did not adjust this in the value of the quarter.
Another important point I want to highlight is that the controller, we adjusted Salvador just for April, which is pre-op, but May and June, two months where we started our operations, which are negative EBITDA in the initial ramp-up operations, well, at the controllers, if we were to adjust Salvador, we would have over 30% margins. These are results that demonstrate resilience in our margins and our capacity to control costs and really have the creativity and the efforts necessary to set up a revenue, increasing the tickets as we demonstrated. This is a quarter of an operation that we were really satisfied with, considering the results in the quarter. Moving on to slide 11. We have an adjusted net margin of 14.3%, and most of this margin is a fruit of the goodwill for Porto Dias, which was BRL 18.7 million and this adjustment of BRL 27 million.
For the cash flow in the company, this was something that was studied during the acquisition and it is really an amount that is generated in the cash flow. We do not pay income tax at the controllers, so we adjust the goodwill and the margin because it is the real profit of the company. When you adjust this, you notice this. We have margins of 14.3% and in the quarter 15.4%, that are a lot more interesting at a moment where a lot of companies are really hindered by their financial results. We were able to have healthy results and we are going to show you this operation we have done that will really help us with our financial earnings in the next quarters. When it comes to cash flows, we had operational cash flow and there is a reduction in the company's cash position due to investments.
We've been paying for these investments that we worked on. The next one will be Santa Clara, where we'll leave in the next quarter. We had our operation approved in the Santa Clara together with Santa Genoveva and Premium Hub, which we call the Midwest due to its strategic positioning in the Minas Gerais region in Goiânia. We're going to have this result and our payment will be the last big acquisition that was expected by the Rede Mater Dei de Saúde incorporating the results for the next quarter. We'll finish with BRL 602 million cash in the quarter. Now moving on to page 12. When it comes to the debt level, the company has 1.8 x the covenant for net debt to EBITDA and I want to remind you that here we do not have the incorporation of 12 months for all of the investments we made.
We carry the payment of the companies we've invested in. But for the last 12 months for the calculation metrics of this covenant, we still do not have the incorporation of the EBITDA in 12 months. This covenant should drop a bit till the end of the year. We performed a swap operation for our debt with BNB. This is a debt that's very attractive for the construction in Salvador and we had this swap that is the debt of BRL 320 million and we got another BRL 52 million in this quarter. I think it was in July. It doesn't appear in the quarter, but it'll appear in the next one. We performed the swap deal considering CDI - 4.85%. The cost of debt in Mater Dei today is lower than CDI.
You have then the composition of our debt and we apply our cash above the cost of debt which demonstrates a really healthy debt level. It's also healthy when it comes to the schedule because we have a real extended payment schedule. 81% of our debt payments are above a five-year maturity and an average of 6.6 years. This demonstrates that we have a healthy balance position with group possible future growth and strategic operations that could occur in the next quarters or years. Our sector still has some room for consolidation and strategic operations. In equity and in debt, we still have the opportunity to perform this growth. I think what's most important is this.
Now I'm going to pass on the floor to Bruno, our IR head, and he's going to be communicating some details. But soon we'll open up for Q&A as well. Thank you so much for your participation, and we'll be available now.
Thank you all. Good morning, and welcome to this second quarter earnings call. I want to just tell you some important reminders so we can proceed with Q&A. This earnings call is being recorded, and it's going to be available on the IR website of the company after it's ended. This presentation will also be available on our IR website. I want to remind you all that possible statements regarding future events are subject to risks and uncertainties that could lead to material differences than what was expected. These expectations or forecasts issue opinions on the date they are made, and the company is not forced or obliged to deliver them.
If you have any questions, please raise your hand, and then we'll call you all one by one, and we'll open up your microphone. First, following this order of who raised their hand, we'll call Samuel Alves from BTG. Samuel, please. Good morning. Can you hear us, Samuel?
Well, now I think so. Can you guys hear me?
Yeah, I think Samuel is back now.
Anyways, good morning, Dr. Henrique, Rafael, and everyone. We have two questions on our side. The first one's about the ticket in the Belo Horizonte market. You guys already actually made a comment about this during the presentation. Just so we can understand this, what was the ticket like in Belo Horizonte now in the second quarter? Can you give us an idea about the growth? Just if this consolidated ticket in the second quarter, we should expect some significant improvements in the ticket. The second question is about the mix of complexity in the region. When we take a look at the complexity mix ex-COVID versus 2019, how is this behaving now if you look at the Belo Horizonte market? Is this similar in this complexity mix or not? Thank you very much.
Well, I'll start off here with this ticket, and then I'll pass the floor on to Dr. Henrique to talk about operational aspects about the ticket. We did mention BRL 2.52 million per bed per year, and this is what we operated with in the second quarter. What we're trying to open up in this number is that it's really healthy, our Belo Horizonte operation, because we've been able to have the transfer of the inflation, new compensation models, and we really have room for this growth, which is a request from the operators. But we're always going to be working on a consolidated ticket because our earnings release is really all consolidated. Since you do have a concern with inflation and growth and the capacity to transfer prices, we wanted to mention that our growth of 9% comparing the first and second quarters really demonstrate significant resilience.
For your expectations and forecasts, you can consider this number as a base number. Then I'll pass the floor on to Dr. Henrique so he can talk about the operational aspects and the current complexity of them versus 2019.
Somehow our hospitals are traditionally hospitals with high complexity levels and hospitals that work with the full process. Ever since pediatrics and emergency rooms, all the way to robust maternity services in Santa Clara and Betim-Contagem. We clearly notice a return to the same operational standards that we had back in 2019. With an additional point here about Mater Dei Betim-Contagem within the greater metropolitan region of Belo Horizonte, as you mentioned, with IPSEMG's arrival, we will have some procedures that are more complex, concentrated at the Mater Dei Betim-Contagem. One interesting fact that I think is an important response to your question is that some of the units that are not located in Belo Horizonte have been going through a diversification in the role of medical specialties. One of the biggest examples is the Hospital Premium in Goiânia.
This is a unit that has been attracting more specialties, creating the opportunity for procedures with greater complexity, such as those related to orthopedics and neurosurgery, trauma, so that they can be absorbed. This is the culture of our hospitals in the Belo Horizonte region, and we've noticed an interesting movement as well than what we had in the pre-pandemic phase.
Well, thank you, Dr. Henrique and Rafael. Have a great day.
Now we're going to pass on the floor to Vinicius Figueiredo from Itaú BBA. Good morning, Vinicius.
Can you guys hear me?
Yes, we can. You can move on, Vinicius.
I think I can't hear you guys. I'm having some technical issues, but I can't hear you, but I think you guys are hearing me. Well, good morning, everyone, and thank you for taking my question. I wanted to know about the improvements in the gross margins, and if we could maybe kind of break down the composition per hospital, then considering that we have a profile that's a little different of hospitals, is there some hospital specifically that has more mat med medical material expenses? Could you maybe talk about what would the margin environment from an individual perspective for each hospital, not necessarily for each hospital, but if this improvement was something more general or not?
Could you also talk about the accreditation environment and the acquisitions you've recently acquired? Is there room to win and gain results? I remember in Porto Dias you had a payer that you have a super good relationship that still wasn't accredited. Is this the same case as other acquisitions as well? Thank you.
Thank you, Vinicius. Let's start by parts here. As I mentioned to Samuel, our results are consolidated, and certainly this is a sum of many different stages of operation. We wanted to disclose the margins of the controller because we're talking about the three hospitals in Belo Horizonte plus Salvador, removing the negative EBITDA in Salvador to demonstrate that the core of the operation is very healthy and really in line with the historical results of the company. We normally don't disclose this breakdown per hospital. You know about the margins we have and the acquisitions you've already heard about as well. You know about the level of margins that Porto Dias has, so you can work on your own forecasts and expectations. But what we can mention as like the cherry on the cupcake of this analysis is that a hospital like Hospital Santa Genoveva that operated with a zero EBITDA, close to being negative.
We've already had an operation that's close to about 20%. This gives us a real satisfaction and comfort to know that our operational model is replicable in these operations. Hospital Santa Genoveva started being operated by our team in February, and it's already operating with this kind of level of margins, which demonstrates we can continue our process, believing in our culture and our philosophy for operation that's really focused on costs. Now with Hospital Santa Clara's arrival, this is going to be a city with real high GDP and capacity for growth of really leading the GDP of Brazil, which is agribusiness. We're really satisfied for that.
Hospital Premium is a hospital that in the fourth quarter we're going to see operating and we are in the middle of a process to reformulate the hospital to be able to attract the specialties with a hospital that already has an emergency room, all of the equipment, the surgical block, and working with all the different specialties. We preferred to work on this restructure before we change the profile of the hospital. So in the second and third quarters, we'll see a quite timid operation because we're expecting, and this for the region, and we're very confident. Hospital EMEC is another hospital where we have a lot to do to improve margins. We have some interesting indicators, but other severe problems as well that really get in the way of the margins.
For example, a lot of contracts that are rental contracts that are within costs, and instead of investing, who's making the money is the supplier. So there's a lot to do to improve the margins of these hospitals. Salvador is the initial operation that has a negative EBITDA at the moment, but has results, as Dr. Henrique mentioned, that are very positive. We had excellent levels of accreditation, over 400,000 lives. So the hospital's been growing month after month. This is really in line with what we always discussed about our Rab and Pub capacity. So generally speaking, this is a bit of our vision and for our operational margins. Vinicius, about the acquisitions. The biggest acquisitions were already done, but now as I mentioned, Santa Clara is entering its third quarter, and we're going to have the closing now in August or September.
We're going to be completing that first cycle where we deliver all of the beds we promised for three to five years. We can't forget this because we actually went over the market's expectations. So we consolidated this a lot better than what the market expected, and so now there's a bit of pressure that we've been able to overcome, and it's bigger than something that's fragmented. So this is a real success case. We continue this day to day. There's no easy task. It's something constant. We have productivity committees, the integration committees that Henrique Salvador , as our CEO, leads. So it's constant work that we can't keep our eyes off. If not, operations will be accommodated, and they won't reach the levels we want. As I mentioned, we also have the capacity to have even more acquisitions, but now we're a lot more selective.
Interest rates in the country are about 13.75%. We have levels of values of the publicly held companies at a whole other level. We're one of the best in the performance of the stock performance, and we have a significant drop in the purchase power.
So there's a whole other profile for a swap of shares and negotiations, and this takes a little while so that you can reach a new level of negotiations. But we're always really keeping our eyes open to the structuring deals, but as long as this can really change the levels of the company. So maybe some occasional deals that may lead to robustness in the hub of a specific region, that could happen, but this is more like an adjustment for the local operation.
Vinicius, just to add on one point about the accreditations, because I think this is important. The commercial aspects you mentioned, especially the Beneficente Portuguesa hospital in Belém. We've had important work to diversify the portfolio of accreditation in Portuguesa. We've already certified, but that's currently the outrageous town. We have historic activities of over 40 years with the self-managed payers and insurance companies, and this has been very important. Some of them have already reached very advanced levels of negotiation for the Beneficente Portuguesa hospital in Belém. Of course, the objective is to diversify our portfolio of customers. Hospital Santa Genoveva in Uberlândia just recently also was accredited to be able to work with IPSEMG. Hospital EMEC in Feira de Santana was also recently accredited. At the Hospital Premium also, we are at an advanced phase of negotiation with some very relevant operators that are our historical partners.
What I think is really interesting and is probably one of the biggest showcases of our commercial work at Rede Mater Dei de Saúde is really the accreditation of 400,000 lives in Salvador in a market that's really competitive. This is a greenfield project, so it's not something that's very common. It's very difficult for you to accredit greenfield hospitals at the moment in Brazil and in many different markets. In Salvador, thanks to the relevance of this project and the activities of our commercial teams and the image that the Rede Mater Dei de Saúde has with the health plans, that's really an ethical approach and reputation that we really respect customers, and we sit down at the negotiation desks with a level of understanding where we're searching for constructive relations.
I think the biggest example was this, the accreditation of a hospital with 370 beds in a short period of time, and we've already been able to have a roll of another 400,000 lives that have the right to this hospital.
Perfect. Very clear. Thank you very much for those points, Dr. Henrique and Rafael. Thank you very much and have a great day.
Now we're going to move on to Gustavo Miele from Goldman Sachs. Gustavo, good morning.
Hi, guys. Can you hear me all right?
Yes, we can. Thank you.
Great. Good morning, Dr. Henrique, Rafael, and Bruno. Thank you for your presence. These are two very quick questions on our side. The first one is just to get back to the medical material topic. I wanted to understand a bit more if the dilution that you've delivered in this quarter is a fruit of a negotiation scope increase with the current suppliers, or if you were able to bring in new suppliers to your base that also helped reduce costs. Just to understand a bit of the dynamics and just getting into a bit of the expectations here for the end of the year, and if you still imagine a reasonable dilution or if we're already looking at levels that are maybe a little bit more normalized for the COGS. My second question is more related to Portuguesa. I wanted to get a bit of an update on this asset.
Dr. Henrique, in his previous answer, talked about the relevance of these self-managed insurances in this hub to understand if the accreditation profile will be more focused on the self-managed plans or if there are other types of payers that are very relevant that you are talking to in the region, and if you could give us maybe an update on the schedules. It would be really interesting for us to hear. These are the two points. Thank you very much.
Well, I will start here with medical materials, and then Dr. Henrique can add on some strategic points. It is really difficult to separate this sum of effects. What we need to work on is a little bit of everything you mentioned. A chain that had about BRL 700 million in 2019 and then 2020, and we finally reached a pace of maybe BRL 1.5 billion or BRL 2 billion. This is like 3x more, and of course, it does help you if you have better bargain power. Of course, you have major opportunities in the unit that buy very badly. They use a lot of consigned agreements. You have no idea about the amount of opportunities. Another important point is the cross synergies, where you have an important opportunity to improve your strategy with suppliers and also improve very much.
But you can also have hospitals that are benchmarks, like Porto Dias, where you already have a full lab of other suppliers operating there that we take on in this network here. You can also gain this in Belo Horizonte, but something you would not change in the initial moment. But you already have this lab that is operating really well. There are some trustworthy results and you can already consider this as a policy for the chain. It is really a mix of everything, and we know there is a lot more work to be done. We have been searching for more suppliers. This is work that is not stopping here. It is really an ongoing process, and now I will pass on the floor to Dr. Henrique if he wants to highlight anything else, so that he can also talk about Porto Dias.
I think that Rafael mentioned this very well when it comes to the medical material topics. But we have permanent management of supplies, and we try to expand our supplier base. Of course, following the standards of quality and adherence to the clinical teams. We of course have forums where whenever we incorporate technology, we can include the clinical team and engage the clinical team so that there is adherence to this new supplier. Just recently, we performed some negotiations that were related to bariatric surgeries, just to give an example, in the Belo Horizonte region, and the clinical team helped us with this negotiation. This, of course, increases our capacity to be able to have prices with a cost ratio that is better.
Thanks to this adherence that we have from the clinical team, especially the physicians, with greater movement related to these negotiations with specific suppliers. This is an important point to mention, and it is permanent negotiation for the contracts also, so that we can reduce our costs with materials and medication. Now, about the accreditation process, especially Porto Dias, which was one of the questions you had. We have been investing in this accreditation process. Some of them are very relevant in Belém do Pará as well, but also with insurance companies that are partners traditionally, such as Banco Bradesco, that's always already accredited Porto Dias after Porto Dias joined the Rede Mater Dei de Saúde .
They're already operating with some products in Belém. Our trend is that we'll really have an expansion in our base of accredited customers at Porto Dias. About quality, which is another question you had. The construction work is up to date, and about quality, we have to consider what's the type of inauguration we're going to be working on. What's most probable is that we'll have a scalable negotiation process, opening up some services so that we can have a complementarity in the operations from Porto Dias and quality, so that we can generate more value for the hub in Belém gradually. If not, you're going to perform the costs too quickly and you won't have the related revenue. This, of course, depends a lot on the base of customers. Each market has a different dynamic. Each market has an addressable market that's different.
We always work on discussing this in the operation strategy, the exact moment that we should open up more or less units in a specific asset. I don't know if I answered you, but I think that's pretty much our strategy.
That's very clear. Thank you, Dr. Henrique, and thank you, Rafael. Have a great day.
Now we're going to call Estela Strano from JP Morgan. Good morning.
Hi, guys. Good morning. I wanted to talk about the average ticket a little bit more. How have you seen the evolution from now onwards of this ticket? Could you give us a little more visibility of what will be done as acquisitions and what will be done organically by the company? Besides this, when it comes to M&A, what's going to be the profile of the acquisitions and what are the target regions for you guys? Thank you very much.
Hey, good morning, Estela. We're not talking about acquisitions, and we don't have specific information to disclose right now about the profile. We always look at this in a more strategic way. We always mention that we do have the capacity to work on this expansion at the right moment with some asset that could make sense for Mater Dei, even to increase the size of operation or significance in a region we're not in yet. This is something that we still don't have anything on our pipeline for, but it's part of our mid to long term planning in the company. The first question was about the ticket, and today, when we work about this, we always consider the mature operations and being able to transfer the inflation so we don't lose margins, and I think this is the biggest objective.
With the high inflation, it's a lot more difficult. Because you have, in an economic chain in the country, especially in a sector like ours, where you have a group of medicine and all the hospitals, you have this huge price transfer process, and you can't always transfer everything. So that's why you need to have this strategy in high inflation moments so that you can work with new compensation models and improve the complexity, even in mature hospitals. In hospitals that are entering our base, you have this full scope, right? We even discussed this in our press release. You can have a real opportunity to bring in complexity, new procedures, and new equipment in cities that have a lack of certain procedures, and they have to move around. Notoriously, Uberlândia has opportunities. Goiânia has many opportunities.
The Bahia hub also has many opportunities to work with Salvador. So Porto Dias is already a mature operation, also has a lot of opportunities. So we can take this expertise that we have with the beginning of our operations, 42 years of history. So this makes effects. It's not easy. It's really simple to answer and say, "Oh, just transfer inflation." But behind all of this, you have very careful and tireless work done by our commercial teams. You have to have a lot of work done by the suppliers and all of the strategy for medical materials per city, per region, and operational costs as well. The clinical management that we have, that's really unique compared to other chains in Brazil, which helps us a lot with this partnership with physicians. So it's really complex.
But to summarize, our objective is to have the growth of the inflation and the increase of the average ticket operations that are not mature. All right, Estela?
Okay, thank you.
Now we'll move on to the next question here, and I'm going to call Ricardo Boiati from Safra.
Hey, good morning, guys, and thanks for the presentation. The first question I have is just to have a follow-up on the operation of Belo Horizonte. So despite that slight growth of the non-COVID beds, the company had more operational beds. You mentioned about this new accreditation process in Belo Horizonte. I wanted to understand if this increase in the number of operational beds without the occupied beds in the second quarter growing proportionally, is this in some way related to preparation for a bigger demand expected for the third quarter or not?
If there's any other factor about the day halls or something else that's impacting this, and I wanted to understand this point a little bit more. But also, if you could give us an idea about what would be the occupation differential between the hospitals in the metropolitan region of Belo Horizonte. You don't need to give me the exact details here, but if you have a qualitative analysis about if Mater Dei Betim-Contagem is still way below the others, and what's been the convergence of the occupation from Mater Dei Betim-Contagem and the hospitals in the capital region. Just one more point here about, well, I think Rafael made some interesting comments about possible new movements that are strategic for the consolidation.
And now just to understand this from the execution perspective, this is a question that sometimes is recurrent on behalf of investors because the company appears to have a lot of things on their plate, and they've been executing this very well. But this, of course, becomes a concern. From the perspective of the execution for possible new movements and the capacity to have the right people in the right positions and the implementation of the culture and these new strategic movements, is the company completely certain that these new movements won't place at risk the execution that's already underway? If you could give us an idea about this, that would be perfect. It always helps us with this qualitative analysis. Thanks, guys.
Well, I'm going to start with this first, and then about Betim that you are asking about specifically. Mater Dei Betim-Contagem has had a growing increase in the movement due to the increase in the customer base that we were able to capture specifically for that unit. I think the biggest example is what I presented here, which is the arrival of the IPSEMG, which is the Institute of Social Pension in the state of Minas Gerais, with 152,000 lives in the Belo Horizonte region, which has been very relevant. Also, this brings in more needs for opening up beds. So Mater Dei Betim-Contagem especially is a unit that actually ended up having levels that were almost touching the ceiling when it comes to occupation and in regards to the beds we had, which is not very good from an operational perspective. So this motivated us to open up new beds. Obviously, we have an occupation rate that's really high still.
As I mentioned also, the three hospitals in the Vale do Sereno hub have been operating together with occupation rates that are above 75%, and that's different than the average in the network. Certainly, this is an aspect that's considered in your question that I think is very relevant. We don't open up hospital beds with future perspectives for occupation. We open up beds as demand is clearly already indicating or suggesting the need for such and really motivating us to do so that we don't have the costs without the revenue guaranteed. This is a very important point. So, another important point that you can also bring in. Could you repeat the second part of your question to make sure I got it?
Yeah, no problem. My question was about the new activities with acquisitions and mergers and possibilities when it comes to the actual execution and the capacity to get this done with the implementation of the culture, because the company kind of already has a lot underway. If these new movements would maybe bring in any risks of the things that are being done not maybe happening at the right measure.
Well, one thing we've been very disciplined with is really in regards to the integration of these new assets in our network. So first of all, with the actual operational diligence we've been working on. The conclusion we've reached is that there are some assets that simply will never be able to achieve integration in the Rede Mater Dei de Saúde because of values and even because of other operational model aspects that sometimes you can't really integrate. What we try to do is kind of make us, and it makes us really happy, is that we have these operations that have more than integrated, but there's a real quick moment where they already led to the results we expected. Rafael just mentioned the example of Uberlândia and the Hospital Santa Genoveva.
We have investments that are very significant in personnel, and we're actually starting some interesting work at the moment to review the culture and expand our work with personnel based on the culture we desire to have. With the arrival of these new assets to the Rede Mater Dei de Saúde, we had an operation that was more regional with two assets in Belo Horizonte and Betim-Contagem. But we quickly had a multi-state operation set up, and we've been able to have executives that really have the strong culture in our company.
This is something that always really made us stand out, which is our spartan cost management. We've already mentioned this in other reports. We actually started off in a very complex environment with a very relevant pair, Unimed, which kind of sets the parameters for the market. This taught us to be very careful with costs. This is a model we've tried to take to other units and taking these executives that already have the strong culture and are used to this modus operandi of the network is something very important, as well as attracting from the market professionals that have talents and that can complement certain capacities we need in the network. Also internally, we have a development project and program for leaders, which is a program that's really active. We call this [Lidera].
There's three different stages for the development of leaders. This, of course, depends on the maturity that professionals have. But this has allowed us to have managers travel and move on to other assets to operate them. In Salvador, we have key positions of nursing supervisors, for example, that were developed and trained in Belo Horizonte that agreed to move to Salvador to work there. In other units, it's also the same case. This is, of course, together with very close relationship with the corporate office. We have professionals that have been working with us for 20 or 25 years that have been going on to the new units acquired and that have implemented strong cultural work.
At this moment, our administrative superintendent that's been working with us for over 30 years has been living in Salvador to be able to work with a local culture as well. This is a concern that we have with the development of our teams. First attracting talents and then developing these talents and really retaining them. You really are right when you consider this is a very important point, and we've been working on this with a lot of depth.
That's excellent. Thank you very much, Dr. Henrique.
I don't know if Rafael has anything to add on.
No, I think your answer was great, Dr. Henrique. That's the point really. We have to notice how the network really operates. We only open up beds at a moment when we actually have a high occupation rate. If you open up the bed, it's because the operation's doing very well and we're reaching a level of occupation that's really high. So that's when we open up the beds and thus we can reduce a bit of the occupation rate. It's a cycle, but we're very disciplined to be able to reach the margins expected. So yes, there's a very good level and very healthy level in operations. We've talked about this many times during the call, but this is a bit of the message we would like to share.
Very clear, Rafael. Thank you so much.
We're going to move on to our next question, and I'm going to call Gustavo Tiseo. Hi, good morning, Gustavo.
Hey, good morning, Dr. Henrique and Rafael. Thank you for the possibility for my question. We have two on my side. The first one is if you could explore a little bit more about the Mater Dei Betim-Contagem and a bit of the accreditation processes. There were some other questions, I think, about this, but I was saying. Could you maybe give us a little bit of information on what the hospital bed operation level is and if you've been operationalizing this quicker, and also understand how this is being operationalized. So if you could maybe just share a bit of what the new accreditation process has been and what's the pipeline like? The second question is about the new bill for employee salary base. But I wanted to understand how in Pará and Porto Dias it's impacting your business. Is there a relevant impact or is this a low impact in your vision?
Well, I think the accreditation, yes. So, you can cover the first part. But our unit in Betim has an interesting characteristic because it's located in a region where there's a big amount of companies, and the biggest one is Fiat Automóveis S.A. and all of the ecosystem surrounding Fiat, with all of the industries that supply equipment and components to Fiat, the OEM. So this is an opportunity for the market payers and health insurance funds. We've been contacted frequently by some payers to develop specific types of products for the Betim-Contagem region, and we have been working on this. So the biggest example is SulAmérica Direto, which was developed for the region, where we work together to generate more sales. And even for Banco Bradesco, we've also implemented new sales models there.
And we also have other operators and some other vertical players that have also tried to have the accreditation of our hospital. And since we have this mid to long-term vision, we've tried to conduct this with a little more care, and we're being a little more careful as we talk about the more verticalized health plans or payers. But Betim has some flexibility to have products and apartments and infirmaries, and so the number of operational beds in the hospital have to kind of represent this or contemplate this. But I think that very quickly in Betim we'll reach about 200 operational beds in a very short period of time.
We've just certified a few additional products or plans that are quite pioneer, such as Alice, which is a digital health operator, CASSI Vida , which is a market product as well that CASSI Vida has, and that can also sell up to the fourth generation of employees and families in Banco do Brasil. CAIXA is also in a really advanced negotiation phase with us. I am just mentioning a few of the health insurance plans that are already working as our customers so that you can see the potential the unit has. Of course, you need to have some time for maturity, and in our vision, this time has been fulfilled even above our expectations. The second part of your question, I will leave up to Rafael to answer.
Thank you, Dr. Henrique. Well, Tiseo, about the bill for the salary base for nurses is something that is very present in the media, and for the first time, there is a very strong union, many entities and associations in our sector. There was a set of initiatives with the National Association of Private Hospitals. We began a direct unconstitutionality measure in the Supreme Federal Court. Minister Barroso was chosen as a rapporteur, and we also have another injunction process because our demand or our justification is really based on how the process was conducted. The process was done in an election year, close to the election period, done very quickly, and it promises and writes in the law that there will be a way to provide some kind of a subsidy to the BRL 16 billion that they calculate as costs.
There is no equality between public and private entities, and there are many vices in this process that we believe that Planway and us and all of the other hospitals, we have been united in this process. We are being very rational because we are talking about a systemic risk. Just yesterday, there was an interesting article from El Beltrão also talking about this, and people are just saying, "Look, if it was easy to work on the economy, setting a base salary, that would be great." I want to say that many different categories of professionals deserve more, but we have a scenario of a system and an economic situation that this will destructure the health sector as a whole. Not for the big chains like ours that will suffer but can kind of keep our feet on the ground.
But we have a huge hole in the health system as a whole. The companies have already performed many different analysis, so we really believe that we will be successful in a judicial level. We do not want to give you any kind of estimates, but we believe that there will be clarity and a bit of a vision so that we can preserve the sector overall.
Thank you very much, Dr. Henrique. Rafael, very clear. Thank you for the answers.
Well, guys, since we have no more questions, we want to thank you all for your participation in this call, and have a great day.
Thank you. Bye-bye.
Good day. Have a nice day. Bye-bye. Thanks.