Good morning, everyone. Welcome to the earnings call of the second quarter of 2026 of Rede D'Or. We have here today with us Mr. Paulo Moll, President, Rodrigo Gavina, CEO of Hospitals, Otávio Lazcano, VP of Finance and IR, and Raquel Reis, CEO of Healthcare and Dental of SulAmérica. This event should take about one hour, and the recording will be available at the IR website. After the initial presentation, we are going to start the Q&A. Before we should continue, we would like to clarify that any forward-looking statements that are done during the earnings call regarding the business perspectives of Rede D'Or, projections and operational goals, financial goals, are based on beliefs and premises of the board of directors based on information that is currently available. Forward-looking statements are not a guarantee of performance, and they involve risks and uncertainties. They refer to things that may occur or not.
General economical conditions, industry conditions, and other operational factors may affect the performance of the company and may lead to results that are materially different from those expressed in the forward-looking statements. Now, I would like to give the floor to Mr. Paulo Moll. He will start the earnings call. Please, the floor is yours.
Thank you. Good morning. It is a pleasure to be with you. We have had a quarter of good results, very consistent. With an improvement in our financial indicators, the hospitals, even with an occupancy lower than the second quarter of 2025, we have had a gain of margin, which stems from the work that we have performed, the operational efficiency on several fronts. We have a focus in procurement processes, systems, technology, and we would like to highlight that we still have a big journey up ahead.
To get the benefits of all of this, we have a strong growth in oncology. As we have observed in the previous quarters, we see oncology as an important measure of growth and an opportunity to grow strongly. Recently, we have affirmed our expansion at the new hospitals or the brownfields, focusing on the hospitals that we have a higher occupancy. It is important so we can have the perspective and to continue to grow the company and grow our portfolio. At SulAmérica, we have a great improvement with the portfolio of clients, and I think it is interesting that we have a long-term view so we can create value for the company. With the consistency of the delivery of growth, we had the IPO in 2020.
In the five and a half years, when we look at the growth of revenue, EBITDA, from the view of two years ago, we are talking about a growth of the revenue of BRL 15 billion to BRL 60 billion. We are talking about the adjusted EBITDA that grew from BRL 3.2 billion to BRL 12.7 billion over the last months, and the net income that grew to over BRL 5 billion. I would like to congratulate our teams. A few months ago, we have had an award from Newsweek of best hospitals in the world. Rede D'Or was the network that got the most awards. Now we have had the news that in the ranking of sustainable green hospitals at Newsweek, Rede D'Or has 29 of the 250 hospitals that are most sustainable in the world. So it is fundamental to highlight the work of all the employees.
Now I'd like to give the floor to Raquel. I will be available at the Q&A session. Thank you.
Thank you, Paulo. Let's talk about the main highlights of SulAmérica in the quarter. We have 6.1 million lives in dental, a record in 9.7 in two months. In healthcare, 3.2 million beneficiaries, 136,000 additions net last year. Going into this quarter, we had a movement of one contract in the administered segment that reduced 50,000 lives, while the other portfolios prepayment, we had an addition of about 40,000 lives. When we compare the 40,000 addition with the first quarter of 2026, last quarter, this was 17,000. It shows a clear growth in the second quarter. Consolidated claims and just dental and health gain of three percentage points when you compare to the second quarter of 2025.
In the comparison for the first one, we had a worsening of 29 percentage, but it's the seasonality that we know, and it's more and more associated to the pre-pandemic scenario. Here, we would like to look at a different number, the consolidated loss ratio with a basis growing 9.7. This is irrefutable of a more controlled, consolidated loss ratio. When we like to look at the movies more than the picture, this is not just one quarter. This is stemming from 2023 reimbursement, for example, modularity. We have over 1 million lives in this segment. The growth of co-participation, renegotiation of providers, fighting frauds, consolidated of care, and the synergies with Rede D'Or. Nothing changes in our mantra. Growing with profitability and being responsible and sustainability. This is it. Now I will give the floor to Gavina.
Hello. Good morning. Great to be with you.
Paulo was talking about the results. I share the same idea. I would like to thank the employees, physicians, our full team, and our patients that choose us evermore, every month, our investors, and the other stakeholders that are with us. Talking about, I'm on page five. Talking about our issues of volume and occupancy. Paulo mentioned if we compare the volume of patients in regards to the previous quarter, we grew 6%. We got 770,000 patient days. But if you compare it to the same time of last year, we drop a bit. We have to remember the seasonality. There was more diseases last year than this year. This seasonality happens year-on-year. Besides that, you will remember a situation, Paulo, we reduced exposure, and it had a reflection in this volume of patient days, and therefore an occupancy that is slightly less.
We continue to grow the volumes on lives and other procedures. Volume of surgery 10%, and if we look just at the elective surgeries, we grew 11%. More patients, physicians, they believe in quality, and they look for us with a higher volume of elective procedures. We are verifying that in general in our operations. 11,000 Brazilians that were born in this quarter. The number is not huge, but it represents something for our society that is very important. We're also happy with that. It's a moment that the hospitals work with, one can say with happiness, with a party, and most of the times. This is a volume that brings a lot of happiness. Sometimes, you get worried, of course, but it's a moment of a great pride and joy for the families. I'm on page six. Let's talk about the evolution of the hospital beds.
We got to 13,617 hospital total beds. We grew 183 beds year-on-year. We are always growing beds and with responsibility. We grow beds wherever they are needed, where the occupancy allows. Our records show that we are growing with responsibility where there is demand. The fact is that we grew 183 beds year-on-year, 110 beds on the last quarter. I would like to highlight that we are working firmly and reinforcing the words of Paulo in a continuous search for efficiency. We are getting to a better margin, and the result in the last line is better, even financial. It is a reflection of all of this movement, and also guaranteeing safety and quality for users so that more and more people choose Rede D'Or, and Rede D'Or being an option for our patients, our physicians.
Guarantees of security and efficiency, and in the search of that efficiency to control the waste in the system. That is it. Thank you very much, and I will give the floor to Otávio.
Thank you, Gavina. I am on page seven. The average ticket growth in the hospital services. The company reported in the second quarter of 2026 in this segment BRL 9.869 billion, a growth of 9.9% in the year-on-year, and the increase of a ticket and the reduction of the day-to-day patients. The quarterly comparison, 7.8%, an increase of the average ticket, and then an increase of the patient days in 6%. In the center, the accumulated in the six months and the FY, the total revenue, BRL 19 billion, a growth of 12.5% in the same period, and a result in the increase of the average ticket 11.5% and an increase of 1.3% patient days.
Here is the evolution of the LTM average ticket since June 2020. CAGR 7.3%, the CAGR of IPCA tax in this timeframe is 6.1. Page eight, same set of information for oncology, infusion and therapies. Second quarter of 2026, the company reported a gross revenue of BRL 1.149 billion, a growth of 22.3% in the annual comparison, an increase of the ticket 6.6%, and then an increase in 15.2% in volume. Comparison quarterly, an increase of the average ticket 2.9%, and an increase of volume 3.9%. In this segment, accumulated in the six months in this FY, the gross revenue of BRL 2.2 billion, growing 23%, an increase of the average ticket of 6.4%, increase of the volume of 15.6%. On the page on the right, the evolution of the average ticket of that segment since the second quarter of 2025. Page nine, the cost and expenses of hospital services.
Company reported for the second quarter total cost of this segment of BRL 6.423 billion, a growth of 6.5%, and a growth of 2.2% in the comparison with the previous quarter. The gross revenue in the two time frames grew faster than the expenses, so that allowed us for the expansion of the gross margin of the company in 2.3 percentage points in the annual comparison or 4.1 percentage points in the quarterly comparison, a margin of 6.1%. The net revenue grew 21% in the annual comparison. We saw a reduction of the relevance of the lines of expenses of the company once you measure as a percentage of the gross revenue. On your right, we present graphically the general administrative expenses. In the second quarter of 2026, we registered BRL 402 million in general expenses.
In the cold analysis of the numbers, they point to a growth of 23.1% annual comparison, 10.5% in the quarterly comparison. The other data of this record are polluted, impacted positively by non-recurring events, all positive. Once you do the necessary adjustments to allow for the interpretation of the numbers, we have a growth of 12% and a growth of 2.3%, a growth that is inferior to the growth of the revenue in that timeframe. The SG&A, it is still stable in the second quarter of 2025 with these adjustments, 3.7%, a fourth quarter of 26.6%. On the right, we have the accumulated in the six months of 2026, the expenses of BRL 765 million, a growth of 17.2%, but with the same adjustments to allow for the correct analysis, there is a growth of 11.2%. Now, the next page. EBITDA and net income.
Once again, in the segment of hospital services, always starting with the information on your left, company reported in the second quarter of 2026, an EBITDA of the segment accounting of BRL 2.291 billion, a growth of 11.3% year on year comparison. A growth of 8.1% in the quarterly. The margin EBITDA in the quarter of 26%. For the adjustments of the elimination of the non-recurring events, we have a growth of 18.3%, a growth in the quarterly comparison of 25.7%, and an EBITDA margin of 26.6%. Center of the page, the accumulated EBITDA by the segment in the first six months, BRL 4.411 billion, a growth of 18.2%, a margin EBITDA of 26.2%. On your right, we have the net revenue consolidated. Here we have a net income adjusted for amortization. The portfolios of SulAmérica at the time of incorporation in 2023, BRL 1.239 billion over BRL 1.283 billion, respectively.
The net income had a growth of 9.7% in the annual comparison or 6.9% in the quarterly comparison. Here is a highlight in the second quarter of 2025. We have had two one-offs positive, adding BRL 774 million during this adjustment. Once again, the net income of the company in the second quarter of 2026 had a growth of 17.9%, when the necessary adjustments for the analysis of the data is present. On your right, the net income adjusted reported in the first six months of 2026 was BRL 2.398 billion and BRL 2.487 billion respectively. Now I am going to page 11, data of SulAmérica. Paulo and Raquel already talked about the numbers, and let us start with the graph on the top on the left. We have a net income net revenue of BRL 8.706 billion, a growth of 6.9% in the annual comparison.
Moving clockwise, a consolidated loss ratio in the second quarter of 78.1%, 3.2 percentage points lower than the second quarter of 2025. On your right at the bottom, we have a growth in the health and dental beneficiaries of growth. On the left, the adjusted EBITDA in the second quarter of 2026 of the segment SulAmérica, BRL 1.117 billion, a growth of 53.2% when compared to the same metric reported in the second quarter of 2025. The consolidated EBITDA in the second quarter was BRL 2.904 billion, a growth of 18.2% in the annual comparison. The consolidated EBITDA adjusted by the financial revenues over the consolidated assets was BRL 3.392 billion, a growth that is 23.6%. Page 12, debt profile. On your left, we see a cash position of BRL 47.864 billion and technical reserves of BRL 28 billion. A net debt of BRL 22 billion and a net debt over EBITDA 1.71x .
Stable when you compare it to the last two quarters. For the analysis of the exposure of this company to monetary shocks and interest rates in the local economy, we have to add the technical provisions of insurance, the cash position, and recalculate the net debt over EBITDA because the technical provisions represent an asset that is relevant for the company and generate a return of Selic and the spread over the IGP-M. The adjustment of EBITDA of 12 months, 1.1 time. Center of the page, we see the data amortization of six years. The stability, the average term is six years. We have total assets of BRL 113 billion, all substantially are free of any pledge agreement collateral. The company doesn't have covenants, which allows us to do the financial management of the company.
The company is very net, with a lot of liquidity to navigate the scenarios and geopolitical scenarios that are more cumbersome, which is evident when we compare the schedule of amortization. The information is on the right. The cash for the technical provisions, they allow to face the amortization of the debt until 2032 included. Last page, 13, where we see the reconciliation of the EBITDA of six months with the cash flow. Starting on the left, the reported EBITDA for six months, BRL 5.8 billion. Then we have the variation of the working capital of BRL 199 million. Here, Rede D'Or consumed BRL 340 million from the nature of the business. SulAmérica contributed with the positive of BRL 539 million. Then we have other balance sheets, negative BRL 214 million. Basically, here we eliminated the EBITDA, the impact, the transfers of Glória Hospital and the maternity.
We have the payment of rents, BRL 393 million leasing. Then we have BRL 802 million for the payment of taxes. In the first quarter, we added amounts, Rede D'Or and SulAmérica, BRL 586 million. Second quarter, BRL 217 million. Then we have the financial activities variation, positive BRL 1.7 billion. This is the result of captures of BRL 5.3 billion in the semester, amortization of debt, BRL 266 million, repurchasing of shares, BRL 907 million. The disbursement, the payment of interest over capital, BRL 1.2 billion, and the financial expenses net in the company of BRL 1.884 billion. Then, cash variation derived from investments, negative BRL 1 billion. Here we have investments in maintenance, BRL 238 million. Big and small expansions, BRL 1.3 billion. Acquisition of Biocor Instituto, BRL 129 million. Here we have the receivables on the D'Or Consultoria one year ago, and the transference, the cash impact of the Glória Hospital , positive in BRL 676 million.
We got your cash variation of the company of BRL 5 billion, without the effects of the technical provisions and BRL 5 billion here. I will close the presentation, and we are open to receive your questions. Thank you.
We will start the Q&A session for investors and analysts. Should you want to ask any questions, please submit your questions and then raise your hand. If this question is answered, you can lower your hand. We would like for you to limit to two questions. Our first question is Samuel Alves, BTG Pactual. Samuel, your microphone is released.
Well, good morning, Paulo, Otávio, Raquel, Gavina . Two questions, two on the hospital part. First, on the operational ramp-up, which is concentrated, that ramp-up would be the occupancy and drop to see where do we ramp up to get more color. Second question is margin of hospitals, medical materials.
You mentioned a movement for the mix of surgery, and here the number improved a lot. To understand well, if you think that the quarterly logic is more adequate to project for the future, what really happened in the second quarter, was it a mix but more favorable? You do that comparison in the medical materials over the revenue in the first quarter and the second quarter.
Thank you, Samuel. In the second, medical materials. At the end of the question, you gave the answer. We suggest that you look at longer periods to avoid oscillations in the quarter. Of course, we have a strong work of recording new products, stimulating products that are not in Brazil, and that we have quality and that have worked in expanding our relationship with a lot of the big providers that have the potential of bringing a more complete line.
We are working with that, and we are getting great results in our negotiations. What ends up influencing this number over the revenue is a mix, and that mix, we can have variations as oncology gains more representativeness and more surgeries. It's a number that for us to normalize the trends, it's better that you look at longer periods. In regards to the growth of beds ramp-up, we have a concentration in a few hospitals that have a high occupancy. If you look in a way that you add to the company São Paulo, Rio, and the Federal District, where we have a bigger concentration, and we ran with assets with a high occupancy, and we have the expansion of those beds. Some specific assets in the Northeast, we had an impact in discontinuing a few contracts.
For these hospitals, there is some representativeness, and there is a negative effect. When you look at the aggregate, sometimes you have the question: How are you building the bed and how do you have places that you discontinue contracts, but the management has to do hospital by hospital. Now to capture the opportunity of capturing the hospital, and you have those pinpoint adjustments. You know how much we try to be specific with the relationship with the operators to protect our receivables. The cycle we have, well, you're giving credit to the operator, and we are very careful with this management. We have to make a few decisions to discontinue the contracts along the lines of what we've done before. An impact that is more concentrated in a few units, and we have the impacts of looking at year-on-year and the second quarter.
Thank you very much.
Next question, Vinicius Figueiredo, Itaú BBA. The floor is yours.
Good morning. I wanted to explore the results of SulAmérica. Something that really brought our attention looking at this quarter was the consolidated loss ratio showing quarter-on-quarter a result that is better looking at a quarter of advancements of improvements when you can see your competitors not showing that trend of the cost benefit. I wanted to understand how is your posture, especially in the dynamics of pricing, where we have other players that are with a worsening of consolidated loss ratio, and even a point that we've observed, the representative of Rede D'Or is growing, and this does not hinder the consolidated loss ratio. There is dejudicialization. I wanted to understand the qualitative.
It is something sectorial, natural that you have pinpointed, but I wanted to understand what has been the main contributing factors for this increase. Did you see any impact because of the changes in the judicial powers? There is more rationality in the sector, in the industry. Those are the points.
Hello. Thank you for the question and the results that we are presenting when we compare to the other players in the market. As I told you, we always talk about the same thing. We do not have a silver bullet. There is a regulation that is very consistent. It does not matter that you fight frauds if you do not have the other points.
A series of things that we have done for many times involve the service providers in new models of remuneration for sharing the risks and to have a sustainable result, to have a description that is rigid, is the word. We have used that. We had a zero tolerance to fraud. That is connecting to your second question, judicialization. New products, exploring regions that are not obvious. When we add these points, in fact, it makes us very happy. The main point is that there is a reduction in consolidated loss ratio, but there is a passing of that gain to the beneficiary. We see a readjustment to the beneficiary that generates a higher permanence of these beneficiaries and an increment in lives. Here I can add the readjustments that year-on-year, we dropped four points.
Because of everything that we see, we do not see a trend of inversion of curves. Another point that we have discussed is co-participation. It was an absolute truth for the new selling and co-participation, but that is truth. In collective contracts, 100% of the sales, 60% in the PME, which is more challenging, more complex for the seller. We see an important elevation of 35% in the small companies which are the contracts 30 to 190 lives, 50% come with co-participation. Over 1 million lives implemented with modularity reimbursement. A logic of utilization that is less susceptible to fraud, adding reimbursement where it is due, especially for appointments and honoraria, still getting the part of exams. All of that is combined, and we are getting close to the seasonalities that we have seen. In regards to judicialization, your evaluation is correct. We have reviews for contingencies.
They have increased, and that reflects the environment of the judicialization of the sector as a whole. There is a change in the behavior, but there is an important growth in retail, which is a niche with a consolidated loss ratio that is better, but it brings more litigation. When we look at the economic math, it is no surprises, and it is not different from the strategy that we are pursuing. Thank you.
Our next question is Flavio Yoshida, Bank of America.
Good morning. Thank you for the opportunity. I wanted to talk about the impact of the high management. But when you remove those, we understand that movement. So what is the occupancy? Maybe if you have kept more recurring volume to talk about the impact of that, and if there is any operator that can follow that path in the short to long term.
My second question is in regards to the second quarter. The third quarter was very strong. It was a positive effect that is repeated in the third quarter of this year. I wanted to understand if this is an important quarter. We have the comparison very high, but I understand that there are some favorable winds. I want to know if there is something that maybe can go against that trend.
If it wasn't for these contracts, we would have had a healthy growth of patient days in the second quarter. This is the direction that we can give you. As the third quarter, we don't have any information to share with you. You know that the second and third quarter are the ones set for the hospital, but we don't have any information to anticipate. Thank you.
Next question, Gustavo Miele, Goldman Sachs.
The floor is yours. Hello, Paulo, Otávio, Raquel. Thank you for the presentation. I wanted to explore two themes. First, regarding the ticket. We come from a few quarters that the discussion of the tickets is very much focused in the while the surgery is getting more, but I wanted to get more of a ticket in the optics of the readjustments with the operators. Paulo did a reflection at the beginning of the call. Maybe a qualitative reflection is that the assortment of services of Rede D'Or is broader. We see a gain of market share, not only in the hospital part, but also in oncology. That leads me to believe that today you're a partner that is ever more important for the paying parties that we have here in the country.
I wanted to understand that, at least in the short to middle term, can we think about the company passing on the price and at a higher threshold, more than what you're coming with the market, the IPCA? Do you position yourself as a player with more bargaining in the sector, and is that something that can play in favor to the ticket? Well, again, not in the shortest term, but more for 2027. That would be the first question. Second theme maybe is a question that has been asked many times, but it's ever more relevant for every quarter. The allocation of capital. We have another quarter, deleveraging once again. We know that in the second quarter we have a payment that is relevant for the dividends, extraordinary dividends, so we have an oscillation at the end of the year.
But it seems at a level of threshold that leads us to believe that other decisions for capital allocation should be taken. I wanted to understand if this makes sense, and do you see opportunities that are more interesting for the rest of 2026?
The first question about the ticket. You always have to look at the ticket in the longer periods, preferentially nine months, 12 months, so we don't have an oscillation. But we've seen, in fact, the ticket working well. This is not due to the readjustments of two digits, as you may imagine. This is connected to the mix. We've done more surgeries, complex surgeries, and it's a mix of hospitals. Since we're growing Rio, São Paulo, we are getting share in the mix, and this has an impact in the growth of the ticket.
We continue with the same policy in this sector, passing on a bit above the IPCA, and it's not an issue of bargaining power, it's sustainability. Many years ago, we made a decision that we wanted to grow with scalability. For that, we try to have a strong control of our expenses, allowing us to protect our margins with gains of efficiency, getting growth and margin. With a record, we have the intention of continuing to grow and to protect the sector in terms of sustainability. At the end of the day, you have the families working with the system, and our vision is not just to maximize the gains for the next quarter and for the next year. We want to grow the sector. About the capital allocation, we are going to continue to look at the several opportunities that we have.
We continue to find good opportunities to allocate capital in organic growth. We see opportunities of M&A that have been, over the last years, we've had less opportunities in this field, but of course, we are paying attention to any opportunity that may appear, whether if it's in the organic growth or inorganic growth of M&A, opportunities of repurchasing the shares. We're always looking at the options and seeing what creates value for our shareholders, and what talks to our strategy as well. Of course, with the level of cash generation that we've delivered and with the growth that we observe in the company, we have the options of working with all these fronts and still paying interest over capital. We're going to have this on look, and we're not lowering the bar for the level of return that we seek in our investments.
This is the same discipline of capital allocation that you know for many years. Thank you.
Next question is Joseph Giordano, JP Morgan. Joseph, your microphone is on.
Good morning, everyone. Otávio, Gavina, thank you. Two points. First, the issue of volume and complexity. You talked about the management, so I wanted to understand if you see a seasonal effect, and we saw the sectors with lower flows. We have an impact in the second quarter of June. We see the side of the hospitals in the side of SulAmérica, we talk about working capital. We saw the improvement in receivables. We wanted to explore this to the levels below 100 days. So what can you tell us about that?
Well, about volume and complexity, some impact on the World Cup, I would like to say that we had that, but I wouldn't say that it was significant.
If you look at the days of the games of Brazil, we had weekend games. There was an impact. But I don't think that this is very significant and that it demands us highlighting these as impact and volumes. We have the discontinuity of contracts that were more heavy. On the working capital, we've had the improvements. They go through the decision of the discontinuity of contracts. For us to discontinue the contract that is from an operator that gives difficulties, and they have a negative impact in the mix. So when we make that decision, we see an improvement in the working capital. Linking to, we don't have a signal today with other operators. This is always very dynamic. It's a management day-to-day, month by month.
We don't see any operators that will lead us to the discontinuity, but of course, we are going to continue to do our management with all the discipline. About the working capital, I wouldn't like to direct you for this to continue to drop or improve within this threshold. We're happy to have the maintenance of this threshold that we are delivering. Thank you.
Our next question is Leandro Bastos. Your microphone is on.
Good morning. Thank you. I have two questions as well for hospitals. The first one is a follow-up on operational beds. You commented that the expectation was an increase in being operational. Now, given the first quarter, usually the seasonality for the second semester of the company, we still have that mindset.
The second one is talking about the self-management, and I wanted to understand those geographies that were more affected, the companies that had. Well, they surprised with the volume that was very quick. If you can bring the discussions, what do you see in terms of volumes that were more lower in the quarter due to the unregistering?
Okay, Leandro, about operational beds. At the beginning of last year, we are pointing to the growth of operational beds that is stronger than what we presented in this quarter. We don't have in the expectation, we had contracts, and we had to discontinue. So really in that aspect, we are delivering less growth. Obviously, we're doing adjustments in every hospital where we had that impact in the contracts, so we can try and find the profitability of these hospitals with making them adequate with their size.
The replenishment of the volume is case by case. I would like to say that in all of them, we will be able to find the previous profitability, even with a loss of volume. Given that we are talking about the discontinuity of contracts that were less attractive, you don't need to recover all the volume to bring all the profitability. We want to recover the margins in the places that are more affected by the loss of volume.
Thank you.
Next question is Maurício Cepeda, Morgan Stanley.
Good morning, Paulo, Gavina, Raquel. Thank you for the opportunity. I have two questions as well. First, about margins. We talked about the medical materials, and you've mentioned the importance of the mix. That issue of the margin of the hospital versus the mix is a debate. We're trying to separate the fixed cost versus the variable cost importance.
Obviously, this quarter shown that you have a strength in high complexity. From now on, we should change what is participation in medical honorarium and the participation of cost. If you can comment that effect of the mix versus the operational lever in these main lines of cost. What is the composition of cost for you? The second question is the opportunity in oncology with the weakening of Oncoclínicas, I imagine that you capture these volumes. If you can wait or adhere to models of re-sharing and alternatives to penetrate in simpler plans that have been commercialized. Thank you.
Thank you, Cepeda. You said very well. We have, on the one side, an operational lever that is very important due to our better negotiations and our scalability, the work that we've done in standardization, purchasing, et cetera.
So on the same mix, I could guarantee that we would be diluting this line substantially. At the same time, we have a change in mix. We had a growth in surgeries, which is interesting because you have a growth of top line, but eventually you have a growth of the usage that is also bigger. I commented that not necessarily in a hospital you growing the revenue over income is bad as long as you have a counterpart in the top line. So there's hospitals that delivered their budgets, even delivering a study under revenue. At the end of the day, we grow the nominal EBITDA. So as long as we are delivering the real projected, if it has less margin, percentage of growth in top line, I don't have a problem with that.
It's difficult to do a prediction on how that will behave over the next quarters. But we are keeping with the nominal margin, and we are going to deliver growth as we delivered in the IPO and in the longer series throughout the history of the company. There is a second question about oncology. We have here several models of relationship with the operators. I would like to say that as a service provider, we are going to take the actuarial risk of the oncology, the answer would be no. We understand that the actuarial risk is not a part of the risk that the service provider should take. And we are growing in these models of relationship that we have. We discuss it a lot beyond price protocols. We have a team of oncology that is fantastic.
I am very proud of them, led by Dr. Paolo Rossi. And we are respected with the operators and the type of service and the seriousness and the efficacy of the protocols that we implement. With these strategies, we are building with our position and the strong integration of oncology and the hospitals. This is the big differential that we can offer for the patients and the physicians. We can treat all the needs of the patients with cancer, the window of radiotherapy, surgery. So that integration is the big differential that we have to offer, and this is the big growth in oncology. This growth is based on operators that we already have a relationship. Of course, there can be a different operator that is having a relationship with us, but our relationship is part of the key here. Thank you, Cepeda.
Next question is Gustavo Tiseo, XP.
The floor is yours.
Thank you. I have two questions as well. First, I wanted to go back to the self-management and the non-accreditation, the unregistering. Well, that grew in the intercompany, which is a positive situation. But correct me if I'm wrong. It seems that you prepared, you had SulAmérica with a higher volume to try and be sufficient in those regions. So I wanted to understand if you're more aligned in the sense that you can accelerate the beds at a point that Sula is anticipating the future. Well, this is Sula growing with Rede D'Or, and it doesn't really make sense, that logic. Still with the MatMed, there is a benefit in the second quarter, and we wanted to understand the mindset of the company going beyond.
Well, in that sense, the level of quarter, but I wanted to understand what is that reduction that happened over the last years to see if there is any percentage that we can gain in the medium to long term.
You gave the answer at the end of your question. SulAmérica has a presence that is stronger, where we, not only SulAmérica, but Bradesco Seguros. The insurance company is stronger with the Brasília market, and they have a strong. I commented in the questions of your colleague, we have brownfields in the region. And that discontinuity of contracts, the self-management, there are difficulties. They are concentrated in the Northeast, in hospitals where the presence of SulAmérica is not so strong as Rio, São Paulo, and Brasília.
When we look at the aggregate numbers, we have a growth of operational beds that is smaller, but we have the hospitals growing stronger, and a few of them that you had to do adjustments for the contracts so we can protect our receivables. In regards to medical materials, as I commented, with Cepeda, we have an impact of the mix. Within the same mix, I could guarantee that we're going to have the dilution of this line. Our revenue growth higher than what we adjust in the price with the scalability and with the medical materials. When you add the mix, you can have variations, and if there is a negative, what we observe is that there is a compensation with the growth of top line. That complexity, because you have oncology, more complex surgeries, they have a compensation in the revenue.
This movement that you have the revenue of the hospital, it would be compensated by the top line, and we could deliver the EBITDA in that sense. I'm not going to give a guidance where the interest over capital comes. We are getting in the same base of the same mix of the same type of surgery and procedure. We are keeping a stability of price and efficiency always less than the revenue. Thank you for your question.
The Q&A session is closed. We would like to give the floor to Mr. Paulo Moll to do the closing of the talk.
Thank you very much for your support and your participation of our investors, and briefly, we will be together. We are very much motivated to continue to grow, and we have a very special moment in the company, even in a sector that presents challenges.
We're growing and navigating very well, delivering quality, above all, getting the patient in the center, getting consistency with the growth.
Earnings call over at Rede D'Or is closed. Thank you very much for your participation. When I say.