Good morning, ladies and gentlemen. Thank you for holding. Welcome to the Quali webcast to discuss the results for the fourth quarter 2022. With us today are Mr. Elton Carluci, the company CEO, Mr. Frederico Oldani, IRO and CFO, Mr. Eduardo Oliveira, company Director, and Franco Abelardo, Superintendent of Investor Relations. Some forward-looking statements in this webcast may be projections or statements about future expectations. These forward-looking statements are subject to known and unknown risks and can lead to results that differ materially from what was expected.
This event is also being broadcast simultaneously through internet and can be accessed at the address ri.qualicorp.com.br, where the respective presentation is also available. This event is being recorded and all participants will be in listen-only mode during the company presentation. Ensuing this, we will go on to the question-and-answer session when further instructions will be given.
I would like to give the floor to Mr. Elton Carluci, who will begin the presentation. You may proceed. Well, good morning to everybody. It is a pleasure to be with you in another Quali conference call. As a CEO, Quali is a company that I'm very fond of. I got here somewhat more than 2 decades ago, and during all those years, I had the opportunity of acting in different positions. I participated in important projects and have accumulated hours of experience.
I have always had that commitment for deliveries, for being objective, for transparency, and giving the best of myself with a deep sense of responsibility, especially in moments of change.
Well, to speak about changes, as we have already informed the market, our reference shareholder, Rede D'Or, transferred part of its share to Prisma, a professional manager, abdicating their seats in the board of directors with the view of having total transparency and improving the governance of the company. I would like to highlight the arrival of Carlos Vasquez, our CFO, and also underscore the promotion of Abelardo, who, I'm sorry, Eduardo Oliveira, who is our statutory director.
Now, all of these join the other directors that are always in that quest for the better short-term results, always with a view towards evolution and the strategic positioning of the company. I'm convinced that we're going to continue to work to guarantee the longevity of the business.
As people that work in a team, I can state that Quali has an incredible team, and it will be my role to motivate them always in that quest for the better results for Quali. To speak about results, before we get to the figures of 2022, I would like to highlight the important legacy, the achievements of the company in the last few years, especially in terms of cultural transformation with a focus on diversity, ethical relationships, a diversity of products, and of course, new partnerships and the digital transformation of Quali.
It's important to keep in mind that 2022 was a highly challenging year for the health sector in Brazil. The high interest rates, the period of inflation, we had a slow growth of the population and other specific challenges for the segment, an increase in claims.
Despite these challenges, Quali was able to enhance its operational cash results. In the fourth quarter, we reached somewhat more than BRL 110 million. Result of the entire team in terms of acquisition of clients, a control of costs and expenses, and a reversion in the consumption of working capital. We got to the fourth quarter, thanks to the result of everybody in the company. In more than 20 years in this sector, I can state that we faced the most challenging period in our history. Claims reached levels close to 90%, as you can see here in the ANS information.
I have participated in several processes. I have seen all of the players addressing these critical issues for the sector, the issue of fraud, overuse, operational efficiency, digital transformation.
I'm under the impression that all of the players are working with a view to have a more efficient and more sustainable sector, making the most of this rather challenging and complicated moment to discuss all of these issues. This does not make us lose our enthusiasm. Having a health plan is one of the greatest dreams of the Brazilian population. We know that the results are below what we deem to be the company potential. Notwithstanding this, I can guarantee that we can enhance the quality performance.
We have excellent commercial partners, and beyond that, we do have a strategy to address all of the present day challenges. To speak about strategy in 2023, that has already begun as another challenging year.
We're going to continue on with rationalizing our capital investment and of course, looking at our commercial teams with a great deal of austerity in terms of spending and cost, always attempting to optimize our working capital and keeping our eyes open for opportunities in our tax structure. On this opportunity, once again, I would like to reinforce our commitment. We're working towards surpassing the challenges and to guarantee a promising future for Quali. These complex situations motivate me to offer my very best with a great deal of work.
The entire team, through its competency, will address these topics that we have selected as being the most important topics for 2023, so that Quali can become ever more efficient, better, and of course, more sound.
This is what we all want, this is what we all expect. I'm convinced that we have an excellent plan to address all of these points. That is all for the moment. Thank you for your attention. I will be back during the Q&A. Thank you once again. I will give the floor to Frederico Oldani, who is participating as CFO in his first call. Well, a good day to all of you. Thank you for your kind words, Elton. We're all imbued here, working together at Quali, attempting to better understand quality and seeking alternatives to optimize the results through time.
I'm going to refer to the highlights for the fourth quarter and the company, and offer you some figures. Well, we begin with the free cash flow.
We achieved BRL 116.8 million in the fourth quarter, a growth of 134% quarter-on-quarter, representing 60% of the free cash generation for the 2022 period, totaling BRL 188.9 million. The lives portfolio ended the year with 1,005,000 beneficiaries, with a drop of 14% year-on-year and 5.4% quarter-on-quarter. We had organic add-ons, 71.2 thousand lives. These are organic additions with a drop of 40% year-on-year and 24.9% quarter-on-quarter. We reach 135.9 with a drop of 13.9% year-on-year. This is part of the challenge of the company.
The cancellations have dropped and year-on-year, we have a scenario where the add-ons drop less than the cancellations. The net revenue of the company totaling BRL 430 some million, a drop of 10.7% quarter on quarter, 13% year-on-year. If we observe the revenues, they suffered pressure in the fourth quarter due to some one-time commercial concessions that the company made.
The company, of course, is not insensitive to the market moment, the issue of claims, access to our operators, and we have to work jointly connected so that at this moment, our partners and ourselves can come out of this market moment much better. The total OpEx, the COGS plus SG&A, a drop of 3% year-on-year. I would like to highlight a drop of 7.7% quarter on quarter.
While we're seeking better efficiency standards in the company, we have very low tolerance towards inefficiencies. We're expediting processes and seeking all the possible opportunities to become more agile. All of this led to an adjusted EBITDA of BRL 215 million, with a drop of 8.2% quarter-on-quarter and 17% year-on-year, with a margin of 47.6%. A healthy margin, although lower adjusted net. We are going to speak about this in the next slide, was BRL 21.9 billion for the quarter. I would also like to underscore the capital structure of the company.
We began the year with BRL 1.5 billion in net debt and BRL 2.2 billion of gross debt, BRL 1.7 billion in the company cash, ending up in this BRL 1.5 billion net debt.
EBITDA, ending at 1.6x. Because of these difficult moments, there is a great deal of inflation in the sector, but there's also a macro situation with higher interest rates. We believe that the company has a sufficiently robust capital structure to navigate through these moments. Our next maturity, the great maturity of the company, is only in 2Q 2024. This year we have no maturity obligation to pay. Now, to look more closely at our EBITDA adjustments, the company reviewed some of its provisions, some of its processes, worked with risk management because of the market moment.
As a result of this, we have made some decisions to protect our balance. The total adjustments were BRL 164 million, linked especially to provisions of BRL 97.1 million. Referring to credits, accounts receivables from operators.
As I mentioned previously, we have had some situations where it was necessary to merge commercial concession and accounts to pay to other entities or associations. We came up with provisions of BRL 97.1 million because of the operators and entities. In the write-offs, we have deployed efforts to enhance the country controls. We have made accounting adjustments, especially after legal controls review, enhancing the controls on that front.
We also had provisions with personnel, severance payments, adjustments of the company that were carried out in 2022, ending up in BRL 154 million. Once again, these are our main adjustments. As was mentioned, our cash flow is always very important and will continue to be important. In moments such as this, becomes ever more important to work with the details and these KPIs linked to cash flow.
I spoke about the free cash flow of BRL 166 million growth quarter-on-quarter, representing 60%. I would like to highlight the level of our commissions already reduced to BRL 69.9 million, a drop of 31.3% year-on-year, 23% quarter-on-quarter. There's the effect of this company decision to seek maximum efficiency in its capital. Another thing worth pointing out is our working capital, our efforts to recovering and increasing working capital. The positive scenario in the third quarter, of course, does not happen every quarter.
When we look at the company, this is how we have designed our working capital. This is the efficient way of working, whether we did have a recovery.
At the end, we had a consumption of BRL 42.7 million, of course, as part of a historical process that we observe in the company. Very well. I would now like to return the floor to Elton Carluci to proceed with his closing remarks. Well, I think we'll go straight to the Q&A. Well, thank you. At this point, we will begin the question and answer session. Should you wish to pose a question via audio, please write in your name and the company name in the Q&A icon. The questions will be answered in the order in which they are received.
Please hold while we poll for questions. Our first question comes from Pedro Lima, from BTG. You can proceed, Pedro. Your microphone is on. Pedro, once again, we have unmuted your microphone. You may proceed.
Once again, we're waiting for you to ask your question. Very well. The next question comes from Emerson Vieira from Goldman Sachs. Your microphone has been unmuted. Good morning. Can you hear me? Yes. Yes, we can. Thank you. Well, good morning, Elton, Carlos, and other directors. We have two questions at our end. The first, this is the second or third time that you mentioned in the release a pressure in your take rate because of more restricted commercial situations.
Which has been the behavior of the take rate? Has there been a recovery in the first months of 2023? Because of the challenging claim scenario, will you still have pressure in take rate? This is the first question. Secondly, about your incentives to the channels. For months, you have been working to reduce allocations in channels.
Now, based on the tests that you have made, how much of a commission do you pay? Which is the level of commission that will become recurrent in 2023? How does this reflect in the new level of growth sales? These are our two questions. Thank you very much. Good morning, Emerson. This is Elton. I will begin, then the team can complement to the answer if necessary. Let's begin with the take rate. What we have observed is basically a market moment in terms of claims. This is not something structural. We do foresee a resumption as soon as there is an adjustment in the market.
This is a one-time event. Nothing has been done definitely, there is adjustment with a permanent effect. This is the first point. Well, we're waiting for the market to recover and resume its normalcy.
To go on to the second question about the tests that we are carrying out with CAC and commissions, what is it that we have observed in the last few months with very stringent discipline in capital allocation, especially in CAC? Well, this is the item that most consumes the company resources. We have been working with extreme discipline, looking at the ratio in the portfolio, relating this to CAC, seeking an optimization.
What we have also observed in some classes that are larger in the market, and we do have some examples, that the results will become more clear as the coming quarters are reported by the company. In CAC, we have seasonal elements, we have awards, and this happened last year. We have a specific quarter where we deliver awards and the CAC always increases. We normally work with it normalized.
I think this will become clear. When we speak about allocation, we do have a metric which is CAC per life. Of course, this is easy for the market to accompany this metric. We have a internal metric that is more difficult. We do look at this LTV CAC on the premium that we're bringing in. It's not necessarily that ratio cost per life. The better data that the market can have is that one. In-house, we have other metrics, other ratios that we work when prioritizing our expenses. In the coming quarters, the markets and the investors will be able to see exactly what is happening.
I can guarantee that this discipline will be maintained throughout 2023. This is a joint discussion, not only the commercial area, but the FP&A area as well.
LTV CAC ratio to always seek the best allocation and the best results for the company in the long term. Thank you. Thank you very much, Elton. That answers my question. Our next question comes from Pedro Caravina from Credit Suisse. Your microphone has been unmuted. Well, good morning, everybody. Elton, Carlos Vasquez. We have two questions at our end. Well, the first you have already mentioned, working capital. If you could give us more color in terms of what happened in 2022. Although there was an improvement in the fourth quarter, there is a negative working capital.
This is not common. You mentioned you're working on this for 2023. What has happened in this first quarter? Which are the efforts that you are deploying to enhance this? If you allow me another question. We have spoken to several players in the sector.
In fact, 2022 was a very challenging year, and 2023 will also remain challenging, requiring adjustments. Well, I understand that Quali will continue on with these readjustments, which is the company's strategy to conciliate this with a reduction of churn. Thank you. Well, working capital, I will begin answering. It was a challenging year for the sector. If we look at some players, they publish average terms of receivables, increasing the number of days, and we have more than BRL 12 million in premiums.
There is a flow of that we follow based on our invoices, and because of this, the scenario has become more burdensome with some of our partners. Well, this is something the company has been addressing. I think this is one of the great points when Frederico Oldani arrived. We conversed about this, and I devoted myself to this.
Of course that in the company, we had had something that was not very normal happening, and this is being addressed by the team. I'm going to give the floor to Frederico Oldani, and then I will return to speak about the readjustments. Pedro, good morning. Regarding the working capital, it was a very difficult year. The sector as a whole suffered with the lengthening of terms. The company perhaps suffered somewhat more or took longer to foresee these effects. We saw fragmented effects on several fronts with several operators.
I cannot underscore any specifically, but this is the situation we observed on several different fronts. What is it that we're working on? We're enhancing some details of our working capital. We work on this day after day. We're very attentive to maturities, collections, and cash flow.
We're working in terms of payments, in terms of receivables, lengthening payments in some cases, guaranteeing the payment of assets. We're enhancing this process. It's a teamwork involving the commercial area, the financial area, and of course, our operators. As I mentioned, the fourth quarter was positive, thanks to initial adjustments. Going forward, we hope to have a working capital more similar to what we saw historically. We do observe a working capital that is less relevant, BRL 160 million, and in the year, in BRL 146.6 million.
Not so different from what we foresee as we move forward. The second question about readjustments. What we have been observing here, Qualicorp has carried out more readjustments in the first quarter. They're serving as our guidance. We have between 20 and 29.
We began the year as 2022 ended with these efforts in the market as a whole, the new taxes, the claim indices, post-pandemic, understand what is structural, what refers to the situation per se, and readjustments. Readjustments in tables, in prices, all of them have increased in all of the products. We do have to hold a conversation with the sector for this. Last year, we began with lower readjustments that were accelerated during the year. This year, the contrary will happen. We are holding conversations with the sector.
We're beginning with higher readjustments, and as we begin to see the impact, a balance, we will perhaps head for lower figures vis-à-vis those we began with. All of this based on what the sector is saying. I don't guarantee that this will happen, but it is a consensus.
We speak with the main operators, and this is what everybody expects. We began with a strong adjustment that should taper out, become more normalized. At least this is what we have heard from our partners. Of course, in a more complex year with higher interest rates, there is that challenge of retention, the challenge of cancellation. We're working arduously on that, and we do expect a certain base point that will be reduced eventually. I don't want to anticipate the first quarter.
We're looking at this with an eyeglass allocation and the retention as well because of the readjustments and prices and gross ads are somewhat more under pressure, perhaps because of the products, new products that are being unharnessed. To respond to the last question, we're doing very well in terms of commercial incentives. After several tests, we have ascertained what we're doing.
We need more tests. We're going to have to work more in terms of retention and speed up what we're doing in terms of loyalty. We do expect a reduction in the coming quarters, and this will begin to appear. Of course, I can't promise to give you any guidance, anticipating figures, but we have been working arduously to reduce the line item, the percentage of churn to help us in the company's cash generation. That was very clear. Thank you. Thank you very much. Our next question comes from Estela Strano from JP Morgan.
You may proceed, ma'am. I have a question. Given the new company's strategy, we understand that your cost and expense structure will change, especially in terms of the commission's dynamic. Besides the variable part, are there any additional changes that could lead to a savings, perhaps? Thank you. Hello, Vinicius.
This is Elton. I will begin by answering your question. We have been working on operational efficiency based on leveraging everything that we have already invested in technology. There's a huge front in terms of digital transformation. We're beginning to test some AI tools for some processes. Besides working with robots, we do have a great deal of room for this, especially when we begin to bring in our customers with a more digital experience. We have a specific director working with the board.
We have a CTO working specifically on that, and the main goal of this person for this year is to increase engagement in the digital part, offering the customers a digital journey where they can resolve all of their problems.
Quali has made investments in the last two and a half years, almost three years, where it is practically possible to do everything in our digital products. Of course, there are some pending doubts, and if the customers wish, they will be serviced as well. We do have a loyalty structure that can be used for this, but we have a very interesting digital journey where customers can do practically everything. We have a good engagement. Small number of these tools were concluded a few months ago, and we do have room for a reduction in COGS and SG&A based on technology.
This is an important front for us. Of course, we're going to look at all the line items, and we have interesting work being carried out by Frederico Oldani in terms of the closing of our results.
I can bet, and I trust in the digital transformation team to enhance engagement. We have low engagement levels, and I deem this to be an opportunity. If engagement increases, we will certainly see a better process and an increase in the company's P&L. Thank you. That was very clear. We would like to remind you once again that should you wish to pose a question, type in your name and the company name in the Q&A icon. Please hold while we poll for more questions. The question and answer session ends here.
I would like to return the floor to Mr. Elton Carluci for the company's closing remarks. You may proceed. Well, thank you. Thank you all for having attended the call. Once again, I would like to thank you very much for your attention with Quali.
Have a very good day. We hope to see you in the next call or in our next investors event. Thank you again for your attendance. Thank you. We would like to thank all of you for your attendance at the release of the fourth quarter 2022 results. Have an excellent day.