Good morning and welcome to the Audio Conference of Oncoclínicas . At this point in time, all participants are connected as listeners only. Later, we will start the question- and- answer session when instructions will be given to you about how to participate. Please remember that the audio conference is being recorded. We would like to pass now the microphone to Dr. Bruno Ferrari, Founder and CEO of Oncoclínicas . Please, Dr. Bruno, go ahead.
Good morning, everyone. Welcome to one more teleconference of results of Oncoclínicas . We're following the period of transition, commercial transition, and operational adjustments of the company, which resulted in a second quarter, which was 2025, which was still impacted by many initiatives that are underway.
In parallel, the active macroeconomic environment, with the cost of capital very high, it continues to be very challenging. We continue to be confident that the measures that we have been taking will put the company on a trajectory that is sustainable from the point of view of the generation of cash. We're still not there. We believe we have to go through a job for several quarters, but the decisions and execution of the plan are being done, continue to be done. Starting with slide number three, you'll note that in the second quarter of 2025, the gross revenue remains stable in relation to the first quarter of the year. This happened because the company followed- we have discontinuing clients with capital cycles that are very poor and with the highest levels of non-payment.
This movement has been compensated with growth together with other clients and a movement of recycling of our portfolio of clients. Worth mentioning that the company interrupted the offering of services to Unimed starting on the 1st of August and is ending with the current commercial strategy, but this is still not reflected in the numbers on the screen. During this period, we had an increase, a one-time increase in doubtful receivables, which is principally related to the deterioration of the operation of the hospital operations and in lower clients that are being discontinued. Even in the same quarter, with a doubtful receivables much higher, we could see a sequential evolution of 2.5% in our gross margin, which demonstrates a recovery of profitability exactly due to the execution of our new commercial strategy, which includes an increase in the average ticket in the quarter.
Going to the next slide, we can see the growth of 38.3% of our EBITDA, of our adjusted EBITDA when compared to the previous quarter, a result of the recovery of gross profit. We have presented a consumption of cash flow of BRL 569 million, principally due to late payments from clients who have been discontinued. These expenses with interest expenses have went up by BRL 79 million, a majority growing CapEx for growth. The consumption of organic cash of BRL 569 million brought us to an increase of BRL 3.9 billion of our net debt. Since our adjusted EBITDA in the last 12 months has gone to approximately BRL 900 million due to a commercial transaction and operations underway, we have an increase of our leverage to 4.4x EBITDA. On slide five, we see a brief look at what the operations that we're involved in, focused on.
On our commercial front, we have an agenda of recycling our client base, discontinuing contracts with clients who have smaller margins or capital of working capital, which is punitive. In the operational environment, we're revisiting all of our contracts with our suppliers, seeking better efficiency, and associated with that, our plan of redimensioning and structuring of our personnel in the company, which brought us to an optimization of approximately 400 headcount since the third quarter of 2024. On the CapEx and assets, non-core assets, we are revisiting and reprioritizing our investments foreseen for the second quarter of 2025, which includes the hospital operations, non-oncological operations, hospital operations.
Before I pass this over to Cristiano, who will cover the rest of the presentation, I would like to once again thank all of our patients, our doctors, our collaborators, our investors, and partners who have supported us permanently in our mission, our daily mission of winning the war against cancer. Thank you very much.
Thank you, Bruno. Good morning. Good day to everyone. Following on slide six, we can see the evolution of our procedures and our average ticket. In the second quarter of 2025, the volume of procedures has reached approximately 169 million, marking a deceleration when compared to the previous periods due to the reduction in the volume of services to clients and through companies that we have discontinued or reduced our exposure. In the same period, the average ticket grew by 2.9%, the first sequential increase since the third quarter of 2024.
If we analyze the period of the last 12 months, the growth of these procedures was 3.5%, which is shown on the average ticket showed an advance of 1.5%, as we see on the graph on the right. On slide seven, the gross revenue of the company has reached approximately BRL 1.7 billion in the second quarter of 2025, presenting stability in relation to the first quarter. In an annual comparison, the fall in revenue is due to the commercial repositioning that the company has been putting in practice over the last quarters. It's important to remember that these numbers presented here do not yet reflect the interruption of our services for the Unimed Rio de Janeiro, a movement which was lined up on 1st of August 2025, and it is subsequent to the second quarter of 2025.
In a comparison of the last 12 months, the gross revenue presented growth of 12.9% with a CAGR of 25.5% of growth. When looking at slide eight, net revenue presented a small reduction of 1.9% in relation to the first quarter of 2025 due to doubtful receivables, which was higher. I'll give you more details about it on the next slide. In the analysis of the last 12 months, the net revenue has presented a growth of 5.1% and a CAGR of 25%, as we see in the graph on the right. In relation to the PCLD, the doubtful receivables on slide nine, we see there's an irrelevant increase, although one-off, principally related to the deterioration of our indicator in the hospital operations and the impact on clients who have been discontinued.
If we look at the average of the last 12 months, the indicator is 3.4%, slightly below the average presented in the same period of the previous year, 2024, even with the effect or extraordinary effects which I have just mentioned. On slide 10, the gross margin in cash reached 30.3% in the second quarter of 2025, an important increase in relation to recent quarters, the previous quarters, with a sequential expansion of 250 basis points in the margin and growth of 6.6% in the cash gross profit, reaching BRL 443.5 million at the end of the period in question under analysis, demonstrating a recovery of profitability, as we see in the graph on the left. In the last 12 months' analysis, the gross revenue grew, cash revenue grew by BRL 1.9 billion with a margin of 1.1%.
Looking at the next slide, number 11, we see the operational expenses still being impacted by non-recurring items of approximately BRL 30 million. If we exclude this effect, the expenses for the quarter would have been 16.6% of gross revenue. It's worth mentioning that the fall in the revenue during the period caused a deleveraging, operational deleveraging, a factor which contributed to the expenses reaching a higher level as a proportion of revenue. Looking at the EBITDA on the next slide, number 12, we can see a sequential growth of 38.3% with an expansion of 360 basis points on the EBITDA margin, adjusted EBITDA margin. The fall of the margin in relation to the same period of the previous year is due principally to the deleveraging, operational deleveraging coming from lower revenue and high expenses due to the process of transition mentioned previously.
On slide 13, we see that a loss of BRL 136.8 million reflects not just the factor, commercial factors and operational factors already addressed in this presentation, but also a level of leverage, financial leverage of the company, with financial expenses of BRL 267 million in the period. Looking at the next slide, on number 14, we present the working capital, which has remained stable, sequentially stable in 41 days of working capital, net working capital in the second quarter of the year. On slide 15, we show a cash flow, operational cash flow, which is negative of BRL 196.1 million, a dynamic coming principally from the late payments of clients who have been discontinued. The cash payments of interest in the quarter came to BRL 265 million due to the higher concentration of semiannual coupons.
On slide 16, we see the leverage impact by the consumption of cash, organic cash consumption, which has generated an increase in the net debt in the quarter and an adjusted EBITDA in the last 12 months lower due to the commercial transition and operational, which is still underway. Finally, on slide 17, we have a chronogram for the amortization of the debt, of the financial debt, and of acquisitions. With that, we close this here, the expository part of our presentation, and we open for the session of questions and answers.
Ladies and gentlemen, we will now begin the session of questions and answers. To make a question, please feel free, please raise your hand through the button available in the video conference. Our first question comes from Felipe Amancio from Itaú BBA. Felipe, please go open your microphone. Thank you.
Okay, thank you very much.
Thank you for taking my questions. I have two from our side. First, it's about the mix of operators. You commented here that you are being able to mitigate the effect of the exit of several operators, increasing your volume in others. If you could share with us a little bit, what type of client has gained space in the mix of the company? If these are other Unimeds or other operators, other smaller companies, what is the profile of the mix, this new mix of the company? My second question, you commented in your results that they do not yet reflect the ending of services for Unimed and Unifers in August. What can we expect for the next quarter? If it makes sense for us to think that a deceleration of revenue is possible in the question of volume or average ticket. Thank you.
Hi, Felipe.
This is Cris speaking. I'm going to start addressing your question of the mix of operators. We've been working on what we call, what we're calling recycling of the base of clients of the company. As we discontinue and/or reduce our exposure to certain payers, the company is seeking to substitute this volume with new clients or increasing the participation with clients that we already have in our base and with whom we have been growing. A few examples that we can cite are growth with Porto, growth in the Bradesco, growth with Hapvida, especially due to the new contract, national contract which we established with them and which started to be phased in, which is focused on certain locations, but has a calendar of expansion of this scope. These are a few examples of clients with whom we have been increasing our exposure.
I will also talk about the self-management. Yes, without a doubt, Bruno, we also have growth with self-management, growth with Amil. We've seen these names in our portfolio growing from the standpoint of revenue in a consistent way. In relation to the second part of your question, Felipe, the answer is yes, we should have a deceleration on a sequential basis in revenue starting in August because it has an impact, which is important from the standpoint of representativeness that Unimed Ferj has as a company. However, as part of our plan for commercial repositioning, we imagine that in the medium term, this will be softened, the impact will be softened, and this growth in the volume to recover this and replace this revenue will continue happening. The answer is yes, yes, you should have an impact and a sequential falloff in revenue starting in August.
Very well, thank you.
Thank you for the questions. Have a good day.
Our next question comes from Renan Prata from Citi. Renan, please go ahead.
Good morning. Thank you for the space. Question that's a little more related to the perspectives of growth and to understand what do you see the opportunity to try to mitigate a little bit the deceleration of growth in relation to the margin. I'm not sure if you have any plan of contingency plan or anything like that. Thinking of these future decelerations. A second question, very quickly, if you could give us a little bit of an update on the Santa Group. In a few past conversations, we've seen this happening, but there's still some details missing the perspective and updating of this. Thank you very much.
Thank you, Renan. This is Isaac.
Looking at the aspect of growth going forward, obviously, we can't point the size, we can't point out the size of what we can tell you what is on our mindset, what's our strategy. We have a very strong focus on commercial transition, so we're working very strongly in bringing the self-managing plans to increase our volume with this Porto Seguro, Hapvida. Amil has been growing quite a bit, Bradesco. This trend, this commercial transition, we start to see in our results, and this should gain traction over time.
It is also good to mention that there are three assets which we should inaugurate soon, which will collaborate with our growth and our perspective of growth, which is the cancer center, which we're going to inaugurate shortly of the Casa San José in Rio , and here in São Paulo, we have the inauguration of the medical center in Avenida Paulista and also our medical center on Avenida Angélica. All of these assets should contribute to a trajectory of growth and collaborate with this trajectory of transition from revenues in the medium term and also within our plans.
As far as the perspective of margins, if we normalize the effect of the loss, doubtful receivables of this month, we have a very important recovery in our margin in this quarter, which was 27.8% of our margin in the last quarter, and it came a little bit closer to the norm. In this quarter, it came in much higher, and we see even so we had an expansion, an important expansion in our gross margin. Had it not been that, we would have had even a bigger expansion. This already starts to demonstrate to us the fruit of various efforts, internal efforts, which we have done in these last 12-1 8 months, very much due to internal adjustments which we have done, not just in personnel, but also in the flow of processes, the patient journey.
I think this will also contribute to a recovery of our margins, and we'll start to see this in this second quarter, now in the second quarter. We're very excited to see the root results and fruits of this happening in the company, and we're certain that these efforts total will be all materialized and re-oxygenate our base of revenue, and we will bring to us good fruits in the short, medium, and longer term.
Very good. Thank you very much.
Our next question comes from Mr. Joseph Giordano of JP Morgan.
Thank you for taking my question. Three points. First, you already spoke quite a bit about the question of the revenue. I wanted to examine how it is in these latest cancer centers. That's my first question.
If you could give me a little context about the Saudi Arabia and also a little bit technical on the question of the company. We've seen a question of cash very pressured with the accounts receivable of BRL 2.8 billion. We have almost BRL 900 million with one supplier with a very stable provision year- on -year. What we're looking at in your contract, I want to understand how you mentioned that the negotiation has been a little bit difficult to see how that will behave. The second point is to look at the model going forward. How do you compare your period for receivables, from your different paying sources, your different payers going forward? Thank you very much.
Thank you, Joe. Thank you for your questions.
First of all, speaking a little bit more of the ramp-up of the cancer centers, we're going to remember that principally what we've had some several delays in the inauguration, especially in Casa San José, which we should be inaugurating in the next 30 days- 60 days. This is the biggest ramp-up that we should see from the standpoint of revenue in the coming months. Our head, our mentality, the direction that we are heading, and we've been excited about in these first results is exactly as fruit of this commercial transition. We're moving into with good fruits in terms of a margin. We are accessing clients, new clients, clients that are growing quite a bit, Porto, and so forth.
You can see you've been accompanying this very closely, and this has been animating us quite a bit because this also has a margin, which is a good margin, and a cycle of capital, working capital, which is much lower. We understand that this next cycle that we will be seeing in these next months and quarters will be a cycle of revenue, more stable revenue, revenue that will grow together with our clients. Beyond that, a revenue with a capital of cycle, working capital, which is lower, and with margins that are very accretive for the company. We're very animated about these first signals of this, and these are still incipient. They're still in the beginning stages, but we're very excited about these small signals that we've already seen.
As far as the cancer centers, yes, we're going to have this inauguration in the next 60 days, remembering that Casa San José is one of the most recognized names and more preference of the local population. We're going to grow quite a bit with them. We have a lot of confidence that this cancer center, in partnership with Casa San José, will also collaborate in this new phase of growth of the company. Any more questions, Joseph?
It's about the question of the receivables. These BRL 900 million, about the BRL 2.6 billion compared to the BRL 2.6 billion of receivables.
Cristiano, were you going to answer that?
I had Joseph, which is Chris. Could you just repeat, please repeat the question for us to address it?
When we look at the balance, we see BRL 2.8 billion of accounts receivable, and the net is BRL 2.6 billion.
Only when you came in, which is BRL 876 million, with a provision that that will fall on the balance at the end of last year. Due to the end of this contract, I wanted to see what is the perspective of the receivable of this, of the possibilities of receiving this. Also, if you could quantify a little bit better, what is the period of time with the other operators? Because even with this change in mix, we have a, we don't see a fall in gross margin. Is this something related to a better operational profit or if we have other operators with lower tickets?
Okay, that was clear. Let me start addressing the question of the receivables from [Ose Oferj]. This is a confession of debt. What we wound up doing was renegotiating the values that are late, and which had become a debt, a long-term debt.
This was negotiated with them in such a way that the payment, the flow of payments will fit into the capacity of the payment capacity of this payer, of this specific payer. If everything goes as planned, we should see a gradual reduction of this balance over time. It's a situation that we're going to have to monitor.
We're now closed at this point, the question and answer period. We'd like to pass the microphone back over to Bruno for his final consideration. Thank you very much. Please go ahead.
Once again, thank you all very much for your participation in our teleconference and having a good day. Thank you very much.
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