Welcome to Aster DM Healthcare earnings conference call for the fourth quarter and full year of FY 2026. Today with us, we have the senior management of Aster DM Healthcare, namely Ms. Alisha Moopen, Deputy Managing Director, Mr. T. J. Wilson, Non-Executive Director, Mr. Ramesh Kumar, Chief Operating Officer, Mr. Sunil Kumar, Chief Financial Officer, and Mr. Hitesh Dhaddha, Chief Investor Relations and M&A Officer. We are also delighted to have Mr. Varun Khanna, Group MD of Quality Care. Mr. Khanna is here solely in the capacity of a representative of Quality Care to give insights into the business and future plans of Quality Care, the entity which is in the process to get merged with Aster DM Healthcare. It is to be noted that merger is subject to further regulatory approvals. All external attendees will be in listen-only mode for the duration of the entire call.
We'll also we will start the call with the opening remarks by management, followed by an interactive Q&A session. Certain forward-looking statements in this meeting involve risks and uncertainties. Aster DM assumes no responsibility for actions based on these statements and undertakes no obligation to update them for further events.
I will now request Ms. Alisha Moopen to start with the opening remarks. Over to you, Ms. Alisha.
Thank you, Puneet Maheshwari. Good morning, everyone, and thank you for joining us despite being Labor Day. As we move closer to completing the proposed merger with Quality Care, I would like to thank our shareholders for their continued confidence and support in approving the scheme. With this milestone behind us, the transaction now awaits final approval from the NCLT. Even ahead of the formal completion, the combined pro forma in performance provides a very useful view of the potential scale and the operating profile of the two organizations together. It highlights how the complementary footprints, aligned clinical philosophies, and a disciplined execution can translate into operating leverage and capital efficiency over time, providing visibility into the longer-term earnings potential of the combined platform over the coming years.
With that context, I will begin with the combined pro forma performance of all Aster and Quality Care before moving on to Aster's results. Turning to the pro forma performance, the combined view indicates a very steady and broad-based trajectory supported by very strong patient volumes, improving case mix, efficient cost management, and a continued focus on clinical excellence. What is particularly encouraging is how these factors when viewed together point to the potential for both scale and as well as improving the quality of earnings.
Coming to the quarter's performance, on a combined pro forma basis, the revenues have grown 18% year-over-year to INR 2,361 crore for the quarter, supported by a 12% increase in total patient volumes and an 8% improvement in ARPP IP. More importantly, as the benefits of scale and mix begin to play out, operating EBITDA has outpaced the revenue growth, increasing by 25% to INR 517 crore. This operating leverage translated into margins of 21.9% and a ROCE improvement of 293 basis points to 21.1%, reinforcing the underlying strength of the model.
Coming to the full year, this interplay between scale, mix, and profitability becomes even more evident when we look at the full- year performance. For FY 2026, the combined platform has delivered revenue of INR 9,273 crore, growing 14% year-on-year, with growth supported by a balanced increase both in patient volumes as well as ARPP IP. The improvement in ARPP IP was underpinned by a 200 basis points in our combo mix expansion, which now stands at 55%, along with a very healthy payer mix of cash and insurance at 83%. As a result of this, our earnings continue to outpace our revenue, with operating EBITDA growing at 21% to INR 2,013 crore and margins expanded by 116 basis points now to 21.7%.
Importantly, this performance reflects sustained momentum rather than a one-year outcome. Over the past three years, the combined entity has delivered a revenue CAGR of 14.5% and an operating EBITDA CAGR of nearly 20%. This has been achieved even as we have continued to add capacity and manage inherent business seasonality, reflecting a very well-aligned and consistently executed operating philosophy.
Coming to capacity expansion. To support this momentum, our capacity expansion has remained very disciplined and closely aligned with long-term demand. Over the past year, we have added 373 beds, taking the combined capacity to 10,620+ beds across 28 cities. Our pipeline includes 4,445 additional beds, which will take our total capacity beyond 15,000 beds through a balanced mix of greenfield and brownfield expansion. This calibrated approach ensures that scale is built with precision, optimizing capital efficiency, as well as supporting long-term shareholder returns while strengthening our position as a leading pan-India healthcare platform.
Coming to the update on the merger. Against this backdrop, the progress on the merger with Quality Care marks a very important strategic milestone. During the quarter, the merger received overwhelming approval from shareholders and creditors with 96.7% of shareholder vote cast in favor, reflecting strong alignment and confidence in the strategic direction. From a regulatory point and standpoint, the transaction has progressed through all key stages, including the receipt of the CCI approval and no objection letter from the NSE and BSE with no adverse observation. The merger application was subsequently filed with the NCLT on December 11, 2025.
With the shareholder and the creditor approvals also now in place, the merger is currently before the NCLT for the final approval. The next hearing is expected in May, and upon receipt of the order, the merger will become effective. Based on current timelines, we expect the process to be completed within this quarter.
Overall, the combined pro forma performance, along with the progress on the merger, reinforces a consistent message that we're not only scaling the platform, but we are doing so in a way that enhances the mix, drives operating leverage, and improves capital efficiency in a very sustainable manner.
Turning towards Aster's performance for the final quarter of the year. Despite macro headwinds, we delivered strong double-digit growth across our core hospitals, clinics, and lab businesses, driven by robust patient volumes and a continued shift towards higher- acuity care. The combination of volume growth and improving case mix remained the key driver of performance during the quarter. Revenue from operations stood at INR 1,182 crore, reflecting an 18% year-on-year increase.
This growth was supported by a 15% increase in total patient volumes, a 9% improvement in ARPP IP, and the contributions from the recently operationalized Kasargod Hospital. Importantly, the growth was not just volume-led, but also a mix driven with a higher share of specialized tertiary care, particularly in DBS and robotic procedures, which saw a very meaningful increase during the quarter. This shift in case mix is also very evident at a specialty level. If you look at cardiology revenues, those grew by 25% year-on-year, with contribution increasing to 15% in Q4 FY 2026 from 14% last year. Oncology revenues have grown 23%, contributing to 11% of the overall mix. Together, these segments continue to anchor the transition towards higher- acuity, higher- value care.
Alongside this, the medical value travel segment maintained strong momentum, growing 41% year-on-year on the back of increased international patients footfall. Within Kerala, MVT revenues grew 51% with stronger inflows from Maldives, helping offset macro-related softness from the Middle East, demonstrating the resilience and diversification of the platform. In our ancillary businesses, the labs continue to scale steadily, with revenues increasing 18% year-on-year.
As this growth and mix improvement flows through, operating leverage is becoming increasingly more visible in our financials. Operating EBITDA for the quarters stood at INR 244 crore, growing 26% year-on-year, with margins at 20.7%, despite the addition of the new capacity. Core hospitals and clinics delivered particularly strong performance, with operating EBITDA growing at 32% and margins at 23.1%, which reflects very steady execution across all our mature assets. Normalized PAT grew by 32% year-on-year in Q4 FY 2026, with margins up by 120 basis points.
While the Kasargod facility remains in its initial ramp-up phase, the underlying performance of the core network continues to demonstrate very strong operating leverage. Excluding Kasargod, revenue and EBITDA grew 17% and 31% year-on-year respectively, with margins expanding by 239 basis points to 21.7%. Within core hospitals and clinics, excluding Kasargod, operating EBITDA grew 36%, with margins improving to 24.3%, reflecting a 345 basis- point expansion.
Coming to some of the non-core business performance, this has also been encouraging, with improvements also visible in all these ancillary businesses. With the lab segment saw a sharp increase in profitability, with operating EBITDA growing 181% and margins expanding to 14.7% from 6.2% last year. Coming to the cluster-wise performance highlights, across clusters, the same operating philosophy continues to play out with each region at a different stage of maturity. Kerala continues to anchor stability and profitability despite a temporary and modest impact from the nurses strike. Inpatient volumes grew 11% year-on-year, indicating sustained demand. Excluding Kasargod, revenues grew nearly 18% year-on-year, while operating EBITDA margins remained strong at 25.6%, supported by cost efficiencies and operating leverage. Kerala continues to serve as a core earnings and cash generation pillar, supporting investments across other regions.
In the Karnataka and Maharashtra cluster, operating performance continued to improve, with revenue growing 11% year-on-year. This was driven by a strong increase in ARPP IP, supported by a strategic shift towards higher- value procedures in cardiology and neurosciences, and the de-empanelment of low-yielding schemes at Aster Aadhar. Operating EBITDA grew 25%, with margins expanding by 270 basis points, reflecting the combined impact of revenue growth, operating leverage, and disciplined cost management. The Andhra and Telangana cluster delivered strong performance with revenues growing 30% year-on-year, driven by both higher volumes and improved ARPP IP. Operating EBITDA more than doubled during the quarter, with margins expanding significantly by 700 basis points to 18.3%, highlighting the sharp operating leverage in this cluster.
Moving to capacity and expansion. Our growth strategy continues to balance near-term operating performance with long-term capacity creation and current disciplined expansion and return-driven capital deployment. Over the past year, we added 290 beds, taking Aster's total capacity to 5,449 beds as of 31st March 2026, and expanding our India network to 20 hospitals, including Kasargod. This expansion has been both measured and demand led, ensuring that capacity addition translates to sustainable growth. As part of this roadmap, we launched 159 beds at Block D in Aster Whitefield in April 2026, a dedicated women and childcare facility that strengthens our specialized capabilities in Bengaluru and addresses a growing demand segment. In the same month, we also operationalized 75 beds at Ramesh Ongole, further augmenting our presence in the region.
Looking ahead, we plan to add nearly 2,500 beds over the coming years through a balanced mix of greenfield and brownfield expansion, which will take our total capacity to over 8,150 beds. This includes planned brownfield expansion of 150 beds in MIMS Calicut, as well as 130 beds in MIMS Kannur. Importantly, our expansion plan pipeline remains phased and closely aligned with demand visibility, ensuring that growth is delivered with capital efficiency as well as supporting long-term returns.
Beyond our operational performance, this quarter also brought along strong validation of our clinical and leadership excellence through several prestigious global and national recognition. At an institutional level, our hospitals continue to be recognized across leading platforms. In the Newsweek World's Best Hospital rankings 2026, our facilities secured prominent positions in India, with Aster CMI Hospital ranked number 12 and Aster Medcity ranked number 28. This was further complemented by strong national recognition in The Times of India All India Rankings 2026, where Aster Medcity and Aster CMI were ranked 2 and 5th respectively, while Aster MIMS secured the 9th position.
At the leadership level during the year, Dr. Azad Moopen recognized recognition on global platforms, having been featured among the Top 5 Forbes Middle East Sustainability Leaders 2025 and in The 100 NRIs 2026 by Entrepreneur Middle East. This was further reinforced at the national level, where he was honored as A Legend in the Healthcare Industry at the FICCI Heal 2025.
To conclude, this quarter reflects the strength of a well-defined and consistently executed model, with scale is driving improvements in case mix, operating leverage, and ultimately capital efficiency. The combined pro forma performance reinforces the strategic merit of our merger with Quality Care, demonstrating that the benefits of scale and disciplined execution are already translating into stronger and more sustainable earnings. As we move through this final stage of regulatory approval, our focus remains firmly on execution excellence, capital efficiency, and attracting high-quality medical talent as we continue to build clinically superior, scalable platform positioned to deliver sustainable long-term value for all stakeholders.
I will now invite Mr. Varun Khanna to take you through the performance highlights of QCIL. Thank you.
Thank you, Alisha. Good morning, and thank you for joining us today. I'm actually pleased to report that this quarter is yet another testament to the power of disciplined strategic execution and operational focus across Quality Care India Limited. Our unwavering commitment to placing the patient at the center of every initiative and our relentless focus on clinical outcomes has once again translated into strong business performance. This quarter, we are proud to report a double-digit volume growth across the company, with several of our key markets delivering even stronger results. This reflects a consistent pattern of doing things right in the right way. Beyond volumes, our strategic priorities continue to gain meaningful traction. We are making deliberate and measurable progress on enhancing clinical complexity, positioning QCIL as the destination of choice for advanced and high acuity care.
Our work on CONGO-T is progressing well, and we are seeing the early fruits of that focus reflected in our operational metrics. KIMS Health strengthened its position in transplants, performing the first heart transplant in Q4 of FY 2026. CARE Banjara installed a cardiac laser, which is the first of its kind in the QCIL system. Our payer mix continues to be extremely key for us, and the team's disciplined execution here continues to yield results quarter on quarter.
This year, we witnessed the coming together of a team and the power of our people. People who are accountable have the ability to motivate teams and lead with purpose. The team at QCIL has come together in a cohesive way and a very meaningful one, and delivered industry-leading growth in FY 2026, while simultaneously working towards a merger that will create value for all of us. As a team, we are excited for the journey ahead of us and are geared up towards a robust performance in the coming year as well.
Let's get to the financial performance. Q4 FY 2026 witnessed a strong growth. Overall revenue growth by 18% year-on-year to INR 1,178 crore. EBITDA grew 23% year-on-year to INR 272 crore. The EBITDA margin expanded 103 basis points YoY to 23.1%. Revenue growth was driven by an increase in IP and OP volumes. QCIL treated and discharged 10% more patients in Q4 FY 2026 over the same period last year, serving 62,500 inpatients. OP footfalls grew 9% to 8.8 lakh consumers, patients in that period. ARPP grew 7.4% to INR 135,000.
Our efforts to strengthen clinical offerings and clinical teams has resulted in 97 basis points increase in CONGO-T revenue, which now forms 58% of the total revenue. CONGO-T revenue grew 20% in Q4 FY 2026 over Q4 FY 2025. Payor mix moved favorably to 79% from cash insurance, up 98 basis points YoY. EBITDA growth represents our concerted efforts in synergy realization across the network, including procurement, centralization, continued focus on clinical talent recruitment and management. Along with strong controls and turnaround in our focus units, where the EBITDA contribution has improved to 19% from 14% in Q4 FY 2025. Let's talk about the focus units first, and then I'll get to mature and emerging. Focus units, which contribute to 29% of our revenue, delivered a major turnaround this year. Focus units recorded a double-digit revenue growth.
I see more than double-digit, 21% revenue growth, all while improving efficiency to post a robust EBITDA growth of 66.6% year-over-year, resulting in 422 basis points EBITDA margin expansion to 15.4%. A function of our continuous emphasis on patient centricity and operating excellence in every aspect of our business. Let's get to the mature units, which is the large part of our business. Fifty-nine percent of our revenue comes from mature units, that delivered a 13.5% revenue growth year-over-year, along with 20.7% EBITDA growth year-over-year. The resulting EBITDA margin witnessed an expansion of 198 basis points year-over-year to reach 33.2%, driven primarily through synergies and cost optimization efforts.
Emerging units, which is the newer units that we have, they contribute 7% of our revenue. They ramped up strongly, 62.4% YoY revenue growth and 44% quarter-on-trailing-quarter EBITDA growth. The margin actually moved to 17.9% for this category. On a like-to-like quarter, the EBITDA stands at INR 15 crore, which was INR 70 lakhs in Q4 FY 2025. For the full- year financial performance, consolidating the strong quarter-on-quarter performance, QCIL registered 17% revenue growth year-on-year to INR 4,630 crore. The FY 2026 revenue growth has been supported by improvement in volumes, focus on strengthening clinical programs and teams. IP volumes grew 7%, while OPD volumes grew 10% to 35 lakh footfalls in our hospitals for the year. CONGO-T revenue increased 23%. CONGO-T mix improved 270 basis points to 59% of the total revenue.
QCIL recorded an EBITDA of INR 1,066 crore, first time ever breaching the INR 1,000- crore mark, which represents a growth of 24.1% year-on-year. EBITDA margin for the year stood at 23%, which is 136 basis points expansion over the previous year. EBITDA growth was bolstered by activities to realize synergies across all our units, including procurement centralization, which contributed to INR 85- odd crore to the bottom line. The FY 2026 EBITDA has been supported by the best-in-class operating EBITDA breakeven at Nagercoil, which became EBITDA positive in three months of operations. Nagercoil contributed INR 30 crore to the EBITDA and currently stacks up at 28.5% EBITDA margin for FY 2026.
Continuing our clinical augmentation, we maintain focus on doctor engagement models, talent acquisition, and have onboarded 100+ doctors, clinical teams in FY 2026, which has aided the performance and volumes and specialized procedures. In Q4 FY 2026, we reduced our ALOS by 2% to 3.9 days. KIMS Health making significant strides in transplants. KIMS performed its first cardiac transplant on a 10-year-old girl. In this quarter, KIMS Health has conducted two dual- organ transplants, a simultaneous kidney and pancreas transplant on a chronic diabetic, as well as a combined liver and kidney transplant on a four-year-old child. The team at CARE Hospitals performed a robotic procedure for a case of abdominal cocoon syndrome, an extremely rare cause for intestinal obstruction.
CARE Hospitals has strengthened its cardiac and vascular programs with the installation of its first cardiac laser at the Banjara Hills facility. CARE Banjara performed the group's first dual- chamber leadless pacemaker implantation. CARE Hospitals Bhubaneswar operated on a four-year-old with subaortic VSD. The child was successfully discharged within four days of the procedure. Among CONGO-T specialties, orthopedic, neurology, and gastro had an accelerated ramp- up this year, with each growing minimum 25% for the year. The focus on high- equity care is visible across our specialties. Robotic procedures more than doubled in FY 2026 and moved to 1,300 procedures for the year, which is a 152% growth.
Initiatives to accelerate growth for the next year and beyond. Expansion continues to remain a key strategic focus for our leadership. We are committed to growing our footprint both within our home markets and in new markets through greenfield builds, brownfield additions, and M&A. We have upgraded our near-term to mid-term expansion plans and intend to invest INR 2,000 crore to add 1,700 beds in the next three to four years. Staying true to the mission that we have to improve accessibility to healthcare, we plan to add 1,300 of these 1,700 beds in non-metro markets. Of the total, 1,500 beds are planned to be added through brownfield expansions, while the balance 200 will come from greenfield.
We got a few awards, which I'd like to mention. CARE Hospitals crossed a million subscribers on YouTube, which is making us the second hospital in India to have done so. QCIL received the Green Health Award at the International Patient Safety Conference 2026. CARE Hospitals and KIMS both received multiple awards and recognitions in clinical care, patient safety, and nursing excellence. We thank you for your participation this morning.
Thank you, Varun. I would request Mr. Ramesh to take through the detailed cluster-wise performance of Aster DM.
Thank you. Thank you, Mr. Varun, good morning, everyone. I'll begin with the cluster performance for the quarter and a full year, followed by a few operational updates. To begin with Kerala, let me begin at the cluster has delivered a resilient performance this quarter, sustaining its contribution to the growth. In quarter four FY 2026, the cluster reported a revenue of INR 604 crore, reflecting a healthy 31% year-on-year growth. Despite the nurse strike during the quarter, the impact of which was limited. Excluding Kasargod, the revenue grew by 18% year-on-year to INR 587 crore, demonstrating the consistent strength of the core hospitals. The current quarter highlights a stable demand environment and marked improvement in the quality of revenue. Growth was significantly bolstered by around 51% year-on-year surge in Medical Value Travel.
While the macro headwinds led to a decline in the MVT from the UAE, this loss was efficiently neutralized by the business from Maldives and African markets. Where renewed focus at a stronger local partnership have kept the patient flow steady. Furthermore, performance was supported by consistent traction in oncology, a growing contribution from the Kasargod facility, and 11% increase in inpatient volume. A more complex case mix further drove a 5% increase in ARPP IP, rounding out a strong quarter four FY 2026.
On the profitability side, in quarter four FY 2026, operating EBITDA grew by 27% year-on-year. While excluding Kasargod, EBITDA increased by 35% year-on-year, with margins expanding by 330 basis points to 25.6%. This was driven by a combination of operating leverage across mature assets, continued focus on reducing average length of stay, and disciplined management of manpower and overhead costs. With 3,000 beds and expansion and pipeline for over 800 beds, including the recent brownfield addition, 130 beds in MIMS Kannur and 150 beds in MIMS Calicut, Kerala is well-posed to sustain the growth momentum.
Karnataka- Maharashtra cluster reached INR 394 crore in quarter four FY 2026, representing 11% year-on-year growth, fueled by the robust realization. This performance was underpinned by a 21% increase in ARPP IP, driven by a higher volume of complex procedures in cardiology and neurosciences, and the de-empanelment of a low-yielding government schemes at Aster Aadhar continued. The cluster operational efficiency and the clinical expertise were further evident by the continued traction in the MVT segment, alongside a significant growth in advanced interventions.
By focusing on the targeted hiring for the key doctor position, the Karnataka sub-segment successfully improved its operating metrics and achieved a 3% year-on-year growth in inpatient volume for the quarter. This shift towards a high clinical complexity and talent acquisition resulted in a 25% increase year-on-year in our operational EBITDA at the [current] cluster level. Consequently, margins were also expanded by over 260 basis points to reach 24.5%, positioning the cluster for more consistent and sustainable growth moving forward.
AP and Telangana cluster also reported a strong growth in quarter four FY 2026, with the revenue increasing by 30% year-on-year, driven by higher inpatient volume and a 13% increase in ARPP IP, supported by a 200 basis point improvement in combo mix. Operating EBITDA registered a sharp 113% year-on-year growth in quarter four FY 2026, with margins improving to 18.3% in quarter four FY 2026, with over 700 basis points expansion. Within the cluster, Aster Ramesh Hospital Group had a strong revenue growth at 32% year-on-year in quarter four FY 2026, with a robust 118% year-on-year EBITDA growth in A&T cluster. We have operationalized 75 beds in Ramesh Ongole as per our planned expansion strategy.
Overall, the quarter reflects a steady progress across Kerala and Karnataka cluster and a sharp turnaround in A&T. We are seeing benefits of the focused efforts on our case mix, capacity utilization, cost discipline translating into improved operating performance. With strengthened clinical team and a clear expansion roadmap, we are well positioned to sustain the growth trajectory and deliver consistent performance going ahead.
Thank you. I'll now hand it over to Sunil for the detailed review of the financial performance.
Thank you, Ramesh. Good morning, everyone. I'm pleased to share the Aster DM Healthcare financial performance for quarter four FY 2026. For the quarter ended 31st March 2026, excluding our newly launched Kasargod Hospital for the first six months. Despite the global headwinds, the Aster India's revenue increased to INR 1,166 crore, reflecting a strong growth of 17% from quarter four FY 2025. Operating EBITDA increased to INR 253 crore with a margin of 21.7% compared to, you know, INR 193 crore in quarter four FY 2025, registering a growth of 31%. Normalized PAT post NCI for the quarter stood at INR 153 crore compared to INR 106 crore in Q4 FY 2025, reflecting a growth of 45% year-on-year.
For the year ended 31st March 2026, again excluding the newly launched Kasargod Hospital, India revenues increased to INR 4,634 crore, up by 12% from INR 4,138 crore in FY 2025. Operating EBITDA increased to INR 969 crore with a margin of 21% for the full year as compared to FY 2025, registering a growth of 20%. Normalized PAT post NCI for FY 2026 stood at INR 451 crore compared to INR 357 crore in FY 2025, reflecting a growth of 26% year-on-year.
Moving to segmental performance, our hospitals segment continued to deliver consistent and strong performance during the year. Revenues grew by a healthy 17% and operating EBITDA grew by 31%, leading to 240 basis points improvement in the margins. Importantly, the performance was consistent across hospitals at different stage of maturity.
Our mature hospitals, which are about seven years old, contributing almost 80% of the total hospital and clinics revenue, delivered 16% revenue growth and 26% operating EBITDA margin operating at a robust ROCE of 36.5%. Hospital in the three- to seven- year maturity bracket recorded 23% revenue growth and strong 21% EBITDA, with the ROCE improving by 470 basis points to 23.8%. Our new assets, which are less than three years old, saw revenue growth of 15%.
Turning to our diagnostic business, I'm pleased to share that Aster Labs has successfully delivered turnaround since the start of their FY 2025. Operating EBITDA margins have expanded from a - 7.6 in FY 2024 to a - 7.6 in FY 2025 and further to 12.8% EBITDA margin in FY 2026, driven by a robust 32% year-on-year growth in external business, enhanced operating leverage and improved material cost efficiencies. This turnaround has translated to a healthy ROCE of 27%, a remarkable recovery from negative levels two years ago.
For the year ended 31st March , 2026, our capital expenditures stood at INR 549 crore, with approximately 45% allocated towards expansion projects. We continue to maintain a robust liquidity position with cash and cash equivalents at INR 1,327 crore, while our gross debt remains at a moderate INR 701 crore. Additionally, we have a significant improvement in ROCE, increasing by 180 basis points from 19.5% to 22.8%, excluding Kasargod.
We have operationalized Whitefield Block D with 159 beds on Ramesh Sanghamitra Ongole, at a brownfield expansion with 75 beds in April 2026. Over the next four years, we plan to add approximately 2,500 beds at the cost of INR 2,700 crore. Of this, INR 350 crore has been invested up to March 2026, with the remaining amount to be deployed over the next three to four years, supporting our next phase of growth while remaining our focus on disciplined capital allocation and sustainable profitability. With this, we have laid a foundation for future growth.
As we move forward, we are confident on building on this momentum with the same discipline and focus. On that note, I conclude my remarks and hand it over to Puneet to begin the Q&A session. Thank you.
Thanks, Sunil. Dear participants, during the Q&A session, you will get a chance to ask a question by raising your hand through the Raise Hand icon in Zoom application. We will call out your name, after which your line will be unmuted and you will be able to ask your question. I would also like to request to all the participants if you can introduce yourself with your name and company that you are associated with before asking the question. If you are not associated with any company and you are an individual investor, you can highlight that as well. Moving on to the Q&A session, the first question is from Mr. Tausif.
Good morning. Am I audible?
Yes, you are audible, Tausif.
This is Tausif from BNP Paribas. First question is to Varun. Varun, can you tell us where does the industry currently stands with the common insurance and empanelment with private insurers and where which gives uniform pricing with private insurers? Any of the hospital Aster, QCIL has been on board in this policy? Do you see this is a threat for the private hospital chains in coming years?
Morning, Tausif. Tausif, first of all, I think the empowerment piece has been in play for a while. It's not new. Two, from a data standpoint, I don't think, well, I'm sure that between QCIL, at least in QCIL we haven't signed up on this, and I'm assuming Aster hasn't as well. I have also not seen large-tier hospitals get onto this platform. I think fundamentally, while a lot of conversations have happened, there are two things that are bothering the industry around it. One is data privacy. Still, I don't think the insurance companies have really figured out a way to ensure data privacy across so many hospitals. The other is transparency as to how this is being done.
Right, till that gets sorted, I think this is still a framework that's been worked upon, is the way I see it.
Varun, do you see this as a threat for private hospitals if it's completely adopted by the industry?
It cannot be done unilaterally, Tausif. It can only be done if private hospitals want to accept it. And that, you know, there are two ways to see this. It can actually save you a lot of costs on empowerment, et cetera, et cetera, if it is done right. There are benefits and merits to doing it as well. In the current avatar, is somebody gonna get onto the bandwagon? My answer is no. I, I would—
Thanks.
It's not coercive. If that's the question.
Thanks, Varun. That's helpful. Second question to Ramesh on the Kerala piece. I think despite the month of Ramadan, the MVT business has grown significantly, especially in Kerala. Ramesh, can you give some color? Also, what's the current status of MVT patients? Has this started flowing in last couple of weeks?
Thank you, Tausif, for that question. Kerala piece is —Kerala story has done well again. You can see that overall performance has been really good and especially MVT has grown 41% year-on-year growth has been registered. We have seen attraction from across Middle East as well as what do you call Maldives and of course, African countries. There is a flow of patients coming in from all these areas. The last few days, Middle East we have found that a few, especially from Oman and UAE, a few less number of patients are flowing in.
We have tried to keep that boat steady by more number of Maldives patients started focusing on African countries and there is a steady flow which has been happening. We are trying to mitigate the losses through through the expanded coverage what we have now. We are trying to ensure that the impact is much not much felt and still continue to perform well. Maldives have been contributing more now.
Thanks, Ramesh. just last piece of question on Kerala. where do we stand currently on the nurses issue? Has there been any negotiation between the private hospital and the nurses? Can you highlight what are the total number of nurses in Kerala for Aster Healthcare and how many of them are currently working with a minimum wage of INR 20,000?
When we talk about minimum wages and the strike which has happened in Kerala, this started sometime in the mid of March. At that point of time, their demand was they wanted the government —every five years the government of Kerala issues a gazette, a government notification for the basic pay is being issued by the government. At this point of time, we have around 4,300 nurses approximately in Kerala. All these nurses are paid the basic pay according to the government notification. The new notification is yet to come. They first started the strike asking the government to release the G.O.
They're, they have the government of, at that point of time Kerala government had released the interim G.O., which will take 60 days for them to go back and rectify the same. The nurses, of course, the UNA didn't want to wait for that time, and they've continued with the strike, demanding the private hospitals to take it up to INR 40,000 per per nurse. As such, we have all the private hospital association and, of course we also were part of it and we ensured we requested them.
On April 13th, we had a negotiation with them as well. The government has asked, or the court had redirected us to, especially the private hospital, to mediate and get the things done. We have spoken to them and, on April 13th, we have come to a settlement with them and the strike was called off.
Maybe. Thanks, Ramesh. Can I just ask Mr. Wilson also to add to on this?
Yeah, yeah. That's. Thanks, Tausif. That's a good question actually. Even though the demand there was they were asking for a basic salary of INR 40,000, actually we were able to conclude by giving a small increase only. Like, the overall impact may not be significant actually like that. We used to give an annual increment every April. This time we have to give something more than that one actually. Our total impact in Kerala will be INR 5 crore-INR 6 crore. That's what we have given. Our total increment what we have offered is actually at Calicut we have given INR 3,500 per nurse, which is in Kochi that became INR 4,000 and the remaining places at INR 3,000 to [INR 250]. That increment we have given.
They were asking for a significant amount, like Ramesh said, INR 40,000 as the basic salary. We were able to negotiate and conclude that one in a very nice manner. All the nurses are back.
That's helpful. I have more questions. Will get back in the queue.
Thank you.
Thanks, Tausif. The next question is coming from Damayanti. Damayanti, can you please unmute yourself and ask the question?
Hi, good morning all, and thank you for the opportunity. My first question is on your ARPOB and IP volume trends, very strong across the clusters. Just want to understand from the management first, what are the key initiative which is currently underway and which should help Aster to continue similar momentum in coming quarters? What kind of headroom you have in terms of growing the CONGO-T contribution for your business? That's my first question.
Sunil, you wanna come in?
Yeah. Thanks, Damayanti. I think for the Aster, for the quarter four years as you called out, we had a very good IP, almost 7%. But also this includes - 8% growth in the K&M cluster also. I just want to call out in advance that the 8% negative growth is because of the de-e mpanelment of the low-end schemes which even Alisha called out. If you remove that, you're going to get into the + 3% growth. That way, I think all our clusters, whether it's a Kerala cluster, K&M cluster or A&T cluster, everyone has done really well.
In terms of the growth capacity, there are multiple things which we're working on. We strengthen all our processes, whether it's doctor engagement programs or whether it's the OP to OP, you know, the processes or OP to IP conversion process or say, the call center management. We're looking into all those things and we're driving it. The primary thing will be the doctor acquisition. Doctor acquisition is something which we are very, very strong. We also called out saying that in the last six months, we have added more than new, I'm talking about the, other than the replacements, only the new doctors are mostly around 36 plus doctors we added in the last six months alone. That is something which we are expecting the ramp-up to happen.
I think, with the continued growth, what you're looking at, whatever we have done currently with the 7%, that's a fantastic growth to continue to happen over the next, medium term.
Sure. Yeah.
Sorry, Damayanti. Just to add to what Sunil said, I think you're asking about the CONGO mix, right? This is where I think there's a huge room for us to kind of improve. We are sitting at, I think, at a blended level now 55% CONGO contribution. We think we can definitely take it up to 60% and then 65% as well. You see a lot of the groups in that direction. That's something which will actually give us the good headroom to sort of further improve the numbers, especially on the acuity and ARPP and stuff.
Sure. That's helpful. Thank you for that. Continuing the point on doctor engagement. Again, I think I want to have some more color on what is helping you to get doctors, because what we understand in markets like Bengaluru, the competition is really intense. What are the key strategy again, which is helping you to attract the best clinical talent and also the strategies for retaining the talent which you have in your network?
Ramesh, would you like to come in?
Yeah, surely. Overall, I think the last few months we have added a good number of clinicians that I think that some of the star clinicians were onboarded. They're pretty much the reason, I mean, why they were convinced to join Aster, simple reason one, we had a bigger vision for Aster. Especially, when it comes to, as you rightly mentioned about Bangalore market, it is very competitive and thanks to we are having not only three units now, and we are adding another two more units in Bangalore. It's quite visible for them that what is vision of Aster. That is one attraction to all the clinicians who have joined.
Secondly, we are also looking at, you know, high-end procedures and niche segments. The high-end work has been happening, like the robotic transplants. There is a good amount of what do you call, kind of faith in the in Aster and Aster's work which has been happening. That has also been attracting most of the clinicians. They find that, especially when it comes to CONGO mix, we are in certain areas, we are truly leaders, especially in neurosciences. Oncology, we are getting there. Some of the CONGO mix also, I think we have good clinicians on board. That is also attracting other clinicians to join us and expand the each department and also attract more patients. That's where I think reinforcing these clinicians.
Of course, we have our, you know, vision for each and every specialty very clear. The clinical excellence pathway, what we have, what we have been engaging them, be it, technology, be it, you know, investment in whatever and also the branding and, you know, taking it to the next level. I think that is where the clinicians are quite happy about and, they are pretty much with Aster.
Sure. Just I think, want to hear Mr. Khanna's thought also on the clinical talent engagement. Again, anything or similar strategy for QCIL as well, which is working for you.
Thank you, Damayanti. Essentially I'll go back to why a clinician would join more than, what we are succeeding with, because it is a lot to do with four or five elements that a clinician looks at. I think the first and foremost is relationships. Our relationships in the market, the transparency that we operate with, is probably top tier. The second part is we are developing a model. In fact, in one of the previous quarterly results I've spoken about developing CliniQ because our focus on clinical independence and outcome is so significant that that is also yielding a lot of gains in, you know, from a volume standpoint, and that is what the clinician wants. The clinician really wants that you should allow them clinical independence.
You should be focused on outcomes. You should be able to draw referral volume into the center because of the good work that you're doing. That coupled with the technology investments that we're making, is another big reason why clinicians really want to move. I think the last part is largely commercial, and we are top tier in that too. I think that is the holistic mix. Now it depends from one to the other as to which one plays out more than the other. I think our ability to connect, to forge alliances, relationships, partner, is better than anybody else today in the market.
Yeah, that's helpful. Thank you, team. I'll get back in the queue.
Thanks, Damayanti. The next question is coming from Mr. Kunal. Kunal, can you please unmute yourself and ask the question?
Yeah. Hi, good morning. My first question is on, you know, Quality Care. I see that the mature units have grown 14%, as have the focused units. Just wondering what the growth drivers can be going forward, because some of the things seem to be very well optimized, like payer mix or ALOS. Would it be the case mix, or will it be the expansion, you know, going forward? Just want to get your thoughts, sir.
Oh, thank you, Kunal. Kunal, the growth drivers for each one of those categories is slightly different. Let me try and give you some color on that. The good part is our mature has continued to grow. The mature hospitals are currently growing 13.5%, 14%, on the top and 20%+ on the bottom line. They are in excess of 30% of EBITDA profile as well. What's working for us there is still enhancing complexity. Alisha spoke about it, and let me just reiterate the same thing. We are currently at about 59% CONGO-T mix.
My sense is we will continue to grow that because I told you that we are under-leveraged on oncology, and that is one piece that we've still not got our investment flowing. In fact, this year onwards, onto the next two years, you'll see a significant growth in oncology volume in our network. That'll play out from a mature hospital standpoint. If you look at our emerging and let's say the focused assets, we're still sub 20% of return in there. We've done extremely well. The runway is, you know, still a long way for us to grow.
Various player things are playing out. One, wherever we have under- occupancy, I think we're bringing in the clinical talent that is required to fill up the gaps that we have. It's called the golden fuel in our parlance. If we have missed out something in one of those hospitals, we try and bring that talent. What is interesting is that, you know, our brands have a long legacy, and some of the work that we're doing in Hyderabad, essentially in CARE Hospitals, is bringing doctors who left us back. Because we've always stood for ethics, we've always stood for integrity. The consumer value perception is phenomenal around the brand. With the investments that we are making, some of these assets are doing extremely well. In fact, you know, the Hyderabad sticky market, you've always known that.
In fact, two years back, when I came in, most of you would ask me about what will happen to Hyderabad. Hyderabad has started to grow so significantly. We are now seeing huge growth on the top, in terms of volume and EBITDA has grown 66- odd percent. I think different levers for each one of those categories, and currently all seem to be firing.
Right, sir. I assume you meant it's across their units, right? The emerging, the new ones, and, you know, even the, you know, the focused units, right? Mature units.
Yes. If you see the growth, if you see the growth percentages, it's across all units. Our, our focus units have grown, top, 25- odd percent. Our, mature have grown 14- odd percent. Our emerging have grown, 60- odd percent. Yeah, the play out is across the network.
Sure, sure. Sir, second point is on, sir, just synergies between the two companies. I was given to understand that a lot of these synergies will start flowing in once the merger consummates between the company. I think in your presentation you mentioned almost 200 basis, I think INR 85 crore of synergy that you're seeing in CARE. Are we seeing something similar in Aster also? If that is the case, then going forward, you know, once the merger completes, could there be even more synergies, more than what you have booked so far?
Kunal, first of all, the synergies that I've alluded to are pre- Aster-QCIL merger, right? You got to understand that within QCIL also we are in a way merging three companies. We acquired CARE, Evercare in Bangladesh, and KIMS in Sri Lanka and Tamil Nadu. That's the synergy that I'm referring to. Bringing the three entities together has also given us synergies on account of procurement, on account of insourcing of food, a lot in terms of RMC, et cetera. That is the INR 80 crore that I alluded to, INR 80-85 crore that I alluded to. We've still not started the work on Aster-QCIL synergies really. They will start to flow in post-merger.
Great. Great, sir. Just one more, if I can, on Aster. Sir, on the greenfield expansion, you have around 20 capacity beds in the next couple of years. Just wondering how will the, you know, cost profile move going forward and the margin impact, if any, you know, that we should expect only in Aster's business in the next couple of years?
Kunal, if you look at the last year, right? You saw only Kasargod, you know, commencing the operations sometime in October. If you looked at the margin profile, the impact is hardly 60 basis points, right? Because we closed at 20.4%, including Kasargod. If you remove the Kasargod, which approximately I think we have, you know, EBITDA losses somewhere negative of around INR 8, INR 19-INR 20 crore. From the 21%, it's only 60 basis points which is impact. Again, it's our own cluster, we expect to bounce back very quickly and break even in a quarter or two. Next, in the FY 2027 you look at, we have got already two brownfield expansion which has started, right? One is the, our Aster Whitefield Block D, which already commenced operations in April.
Also the other unit is in Ongole, which is another 75 beds on the existing hospital. We commenced that also in April. We got almost 200+ beds of brownfield expansion, which is usually, you can see that it's EBITDA accretive. Just to give you an example, a year back in Kannur, we were running at 300 beds. We added 100 beds. The margin expanded by 400 basis points. It went from 18.5% to 22.5%, right? Keeping that, good thing is that in this year already we're starting with the brownfield expansion, which is a, you know, EBITDA accretive. Secondly, only this year we are expecting only our Trivandrum to commence sometime in October. That's only the H2 beginning. You know already in Trivandrum it's part of the Kerala cluster.
Second, QCIL entity KIMS already is present there. It's very under-penetrated. We expect to do really, really well. Even whatever the losses comes in, it's hardly any dilution. Even with that losses, I expect from the current year EBITDA margin should only grow. The third point which also to be very important to noted is that with the merger, very much I would say hindsight, sometime in the quarter one, you should see that majority of the period will be under the merged entity, right? We'll also have, we also already I think Varun called out the synergy is going to start after the merged entity, right? That's something which we're already working on, and I think we will hit the ground from the day one.
That should also, you know, bring and help us in ensuring stability in the margins, also growing the margins also. That way, with all these levers being there, from the cluster presence to the brownfield expansion already there, and also towards the synergy coming in, we don't expect any margin dilution. It's year-on-year we'll grow in the margins.
Good to hear that, sir. All the best.
Thank you.
Thanks, Kunal. We would request you to limit your question to two, but not more than three per participant at a time. With this, the next question is coming from Sir Siddharth. Siddharth, can you please unmute yourself and ask the question.
Hi. Thank you for the opportunity. Congrats on a good set of numbers, fairly strong set of numbers. I have a few questions. I'll take my top three. What was the primary challenge in the slow growth even in Karnataka IP volumes, which were at 3% versus, you know, 8%, 9% in the overall group, right? Within that, if you could give us some understanding. You mentioned that there was a degrowth because of Aster Aadhar. Was that a negative margin scheme that you took away? How should one think of recouping that set of patients? That was question number one.
Question number two is, on, you know, if you could give a sense of what's the share of chemo and dialysis within onco and macro, which I would assume is more daycare and therefore, you know, brings down the ALOS, you know. That is one. That was question two. Question three was, if you could share any specific AI or robotics implementation that you're doing, within Aster or QCIL.
Let me jump in, Siddharth, with the first two questions. One is on the Karnataka year. You're asking, saying that if IP volume for other thing is at least in the high single digit to a double digit, why at Karnataka- Maharashtra cluster is at 3%? Yes. As I called out very clearly, one what we exited is a low-yield scheme. I think we have very clearly called out it's a government scheme. It's a low-yield scheme. The [ARPP] compared to a cash market, it's less than 50%. That's how it's been. Good thing is that we exited that. Also we, one of the reason we exited also is that there's a capacity bottleneck in Aster Aadhar. It's already running at 75% occupancy. We will be looking at how to expand in Q4 also.
At the same time, we want to see that whatever the capacity we have, we optimize for the cash and TPA patients. Second, in the K&M, yes, we have a + 3% growth. There are two parts, right? One is that competition intensity is very, very high, right? Maybe before that, let me take a step back. If you look at the FY 2024 and 2025, in K&M cluster we've been growing more than 20%, right? That's mainly because of our Aster Whitefield Hospital, which started two years back, and the ramp-up was really, really good, right? We achieved INR 44 crore per month in less than two years. That is a ramp-up, if you want to compare, CMI took more than six years to achieve that, right? That's a very, very fast ramp-up.
We can't expect the same revenue ramp-up at 20%+ when a unit is already reached to a mature phase now. Keeping that in mind, that's the reason why, also one of the reason why the revenue growth has tapered down to around 10%-11% and volume has been around 3% growth. At the same time, we also had competition intensity, especially in north of Bangalore. We had attrition of one or two teams also. Good thing I also called out saying that we got them back already. Second most important thing, I think we didn't call out, one of the general surgery or other team which left in Q3 due to the competition, joined back in Q4, right?
That basically shows the strength of our clinical ecosystem. The management, what we do there, that's a very, very strong. We don't expect this to be the norm. We expect to go to mid to high single digit. Good thing is that all the doctors what we have gotten now, already they're in the stability, so we expect the volumes to trickle down in next one to two quarters. Second also is that you see that April already we launched the brownfield hospital also, which is the Block B, Whitefield Block B, which is Women and Children Hospital. We have doubled the number of doctors there. We had around 10 or 11 doctors in Women and Children. We have added another 11 doctors there. That is something which ramp-up is expected to be really good.
Whatever you see as the 3% is just a one-off thing. It's not a structural issue. We should bounce back very easily. Second, on the onco, usually the broad contribution is that med onc is approximately 50%-60%, 30%-35% is coming from surgical oncology of the overall oncology, and 10%-15% from radiation. Out of the medical oncology, you can see 60% will be chemo and 40% usually is in the immunotherapy and the targeted therapies, what we do. I hope that answers the question. Alisha or someone want to take up the AI—
Yes. Let me take the AI question. Sid, thanks for the question. You know, this is more of an academic question than currently in terms of what's happening on the ground. Essentially, AI will in the near term to midterm impact patient safety, the operating world, financials and clinical. As a company, we've already started working on all four tiers. If you ask us what are the early successes, we've been able to bring in CDSS, which is AI-enabled. We've been able to bring in call center support, which is AI-enabled. We're looking at solutions that can actually save time for the doctors when the patient comes into the OPD by prepopulating some of the EMR work through AI. We're looking at significant clinical augmentation happening through AI.
There are two parts to that. One is looking at radiology getting more efficient. We are, as I told you last time, we are setting up Asia's first radiotherapy platform, which will be AI-enabled. This is the first EOB platform that Elekta has sold in India, as well as in Asia, which is AI-enabled. A lot's happening on all four of these sides. They will. We are also mindful that some of the newer technologies on AI are currently a huge cost, and their use cases from a revenue generation standpoint haven't seen the light of the day.
I think, we are being very particular in terms of, because technology is galore, but in terms of what we can really use to enhance our metrics, is something that we are mindful of. On the sales front, we've seen significant improvement, with our CRMs now getting AI-enabled, our call centers getting AI-enabled, and our conversion ratios have gone significantly better. All of that is playing out, and that's how the volumes have gone to a 10% kind of a growth, as you see on the IP, and double-digit growth on the OP as well. I don't know if there's a specific question that you wanted to ask, but it's a broad-based question that you touched upon, so I'm probably giving—
No, I think this does give, Varun, I think this is fairly helpful in terms of, you know, what you're, what you're planning. I concur with you that AI is probably fairly early stage and theoretical today. Given, you know, given that there is a merger, you're, you know, going to be leading the entity, it does help to get a color from you. Thank you so much for that.
Just a follow-up on what Sunil mentioned on, you know, on some of the challenges in Karnataka. I get the capacity bottleneck in Kolhapur. For the rest of the hospitals, you also called out some other, sort of capacity utilization. Is there a bottleneck elsewhere? Because that seems to be more like mid-50s occupancy, so there does seem to be capacity, right?
Yes, Siddharth. In K&M we have capacity. For example, Aster CMI is at 60% of the soft occupancy. RV is at 69%. Our Whitefield, we added 150 beds, right? If you include that, it has got still only 55% of occupancy. I think we have got a great runway in Karnataka cluster to add beds. Also you know that we are also coming with Sarjapur in next one more year, and we have Yeshwanthpur in three more years. I think we've got a very good runway towards it.
Thank you.
Thanks, Siddharth. The next question is coming from Mr. Amey. Amey, can you please unmute yourself and ask the question?
Yeah. Am I audible, Puneet?
Yeah, Amey, you're audible.
Yeah. Thank you for giving an opportunity to ask a question, and congrats to the management on good set of numbers. First question I have for Varun Ji. We were intend to spend close to INR 500 crore in Hyderabad cluster to get that cluster to its potential. Has that investment over and where it has been spent? Also along with this, if you can give us the CapEx guidance for the QCIL for next two years. Thank you.
Amey, thanks. I don't know where the INR 500 crore number. Essentially what the work that we are doing in Hyderabad is starting at the asset around. We've completed Banjara. Let me stick to Banjara for a minute. We are also now working this year to enhance oncology service in Banjara. We'll be able to bring in radiation in Banjara, which is gonna be a significant bump- up. We operate an OPD building there, and the OPD building will also be an IPD building going forward. Those are the plans that we've laid out for Banjara. Therefore, a significant transformation is gonna happen there. Hi-Tech, as I mentioned to you earlier, is doing extremely well as an asset.
We've grown 65%, 70% of the top, over the, over quarterly averages, last year, to this year. That's been a significant upside as well. Now we are working on the Nampally asset. We're sprucing it up because I think it needs a little bit of work, which will allow us to enhance our R4 and also be able to take significant R4. This also comes along with adding clinical capability across the board. Right. Every asset will see clinical enhancement. As I told you, Hyderabad is one market where we are being seen very favorably.
It's not a market that has grown volumes very significantly, but the fact that we've been able to grow the market well ahead of our competitors should give you a sense that I think we're being preferred both by the consumers and doctors alike. That's happening. In terms of the overall bed capacity expansion, I think I give you a sense about 1,700 odd beds will get added, INR 2,000- odd crore of expense will happen for those 1,700 beds, and this is what we call the project CapEx. This will be revenue accretive because 1,500 of these 1,700 beds are actually brownfield.
It's only 200 which is greenfield, therefore I'm desperately looking forward to these beds coming in because they're coming in assets where we need more capacity. As I mentioned to you earlier, wherever we are in the mature setup, our strategy has been add more beds, add more capacity, bring more complexity. We are kind of firing all cylinders onto that, so far so good. We are hopeful that Bhubaneswar as well as Jaipur, both the assets will get incremental capacity and clinical complexity from oncology standpoint as well. Outside of that, our guidance on CapEx have always been clear.
You know, we've stuck to the same number. Five- odd percent is the CapEx spend when it comes to the annual CapEx spend to spruce up either new clinical programs or to spruce up the existing facility or to add clinical programs. Generally, the breakup is 3/2. you know, which is 3% is spent in terms of refreshing what we've already spent, and 2% becomes incremental every year. That's the cost of running the business. We stick to that. We're again very prudent in terms of managing those spends. As I mentioned, as a part of the synergy between KIMS, so that I'm very clear, between KIMS and CARE, we've already started to find synergy in the procurement of equipment as well, and this is pretty significant.
The 5% spend earlier, and the 5% spend now is giving us significantly more than what it used to give earlier. I think that's how, I mean, all of this is working out so far.
Sure. This year we have entered at around 16%-70% top-line growth and around 1%-1.5% margin with expansion.
Yeah.
Looking at the improvement we are doing across the clusters ahead.
Yeah.
As well as the around, I think, 900 bed addition we are doing for next two years at least.
Yeah.
You expect this growth momentum and the margin expansion to continue for next 2 years?
Yes, I do. I mean, we've got to a solid start, and I do see that the margin expansion as well as the top-line growth will continue. I think the strategy is firing. Again, strategies are not made for a year. I think the last year has just been a testimony of the fact that what we've started is the right thing to do, and which is where we started to see the numbers roll in. As I mentioned, our team is rock solid, very committed, and we are reasonably sure that we'll continue to add to what we've done last year.
Sure. Thank you so much. I just have last question on Aster. On the Whitefield unit particularly, I think Karnataka cluster has looking like it is coming out of woods quickly after these leadership changes. If you can give some clarity, how is the occupancy now in Whitefield for FY 2026? How it has moved year-on-year? What profitability this unit is working on so that we can get some sense what potential it has in terms of the EBITDA addition for next 2 years. Thank you so much.
See, on the occupancy, currently it's at 60 occupancy. That's only for the block ABC, which is the existing one. Now that the block C is moving to the block B, that's another 159 beds getting added. That's a separate, you know, you know, I would say, road path what we have. In addition to that, the empty 50 beds which is there, that will be integrated to the existing multispecialty hospital. Also, I think I called out even for the CMI, where we are coming to another year or so, we'll have the 100 beds expansion on top of the existing hospital. There already occupancy is still 56, so there is a good, you know, room.
Only thing in Aster RV, because it's just a 250-bed hospital, without having oncology there the runway is little lesser because currently already occupancy is at 66%. Runway, but still you can go up to 75%-80% anyway. That you know, room is already there. From the EBITDA margin point of view, I think only in the Whitefield you asked for, it's already in the high teens, right? High teens is the margin. With the Whitefield coming up, I think then you can look at more than, mid-twenties is the margin what we are expecting to reach.
Sure. Sure. Thank you so much. It is quite helpful. Thank you, sir.
Thanks, Amey. We would like to highlight that we'll be giving preference to attendees who have not asked a question before. In that line, the next question is from Mr. Vivek. Vivek, can you please unmute yourself and ask the question?
Yeah. Am I audible?
Yes, you are audible.
Great. Thank you for the opportunity. I just have a couple of questions. One was with regards to the performance in the Andhra and Telangana unit. The growth has been outstanding in that particular cluster. Just wanted to understand what steps or have you taken any particular steps to, you know, do the course correction and going forward, what can we expect in terms of a sustainable level in terms of both revenue and margins for the cluster?
Vivek, thanks for the question. There are three main hospitals. One is the Ramesh Hospitals Group. We have two hospitals, which is the, in the Hyderabad Aster Prime, which is a smaller 150 beds, and Aster Narayanadri Hospital in Tirupati, which is the 150 odd beds again. In this, I think the two hospitals specifically driving the growth is the Aster Narayanadri Hospitals and also Aster Ramesh Hospitals. Aster Narayanadri Hospital, I think it we opened up almost 3 years back. It's doing really, really well. Even in the current year, we've just seen, we've seen a 46% growth in the revenue and almost 75% plus growth in EBITDA. Because one of the good things why the Aster Narayanadri Hospital growing really well is that we were able to add good clinicians there.
The market is underserved currently. We are able to execute things at the right time. In major of the specialties like cardiac and ortho, and other general specialties, we are able to handle at the 2nd in line also. That is helping us in taking more volumes. We'll be looking at now to convert some of the general wards into single rooms so that we can expect more ARPP growth also. The 2nd big change what we've seen is the Ramesh Hospitals. Ramesh Hospitals were a little stagnant for last 2 years, and they also lost a few doctors in the Q1, Q2. In addition to that, good thing that when the attrition happened, they added the clinicians in 3 core specialties, including the nephrology, pediatric department, ortho, and cardiology.
That's their stronghold there. We have seen after that, I think from the end of December, we have seen a good growth momentum. It's not a one-off growth what we've seen. Last four months, and even the April trends are looking very similarly, so similar. With that, they have achieved more than 32% you know, revenue growth. Why EBITDA has been growing, it's very simple, because you're sitting on low base. Fantastic growth. We ensured that there is a good operating leverage, which is working currently. We are holding onto the cost, not jumping into hiring more manpower. We can leverage on the existing fixed cost, which is anyway there. I think, because it's a one or two month, I would have said it's just a one-off.
We've seen a good runway for last 4 to 5 months. I think we will expect to continue to grow. Not maybe not in the similar manner, but I think the runway what we have created, I think, we expect Ramesh Hospitals to continue to do well.
Thank you for the detailed answer. Secondly, just wanted to understand from Varun about the QCIL expansion, right? Firstly, what you had mentioned about QCIL, two things here. One is with respect to if you could provide the expansion plan by cluster for QCIL. Secondly, what we had mentioned about the QCIL expansion budget, which is around INR 2,000 crore for 1,700 beds, of which 1,500 is approximately brownfield. Just wanted to understand the per bed CapEx that you plan on doing approximately for the brownfield and the greenfield units that QCIL has in its pipeline.
The blend of a cost like CapEx will vary by which hospital, what kind of expansion are we doing. Cost, that generally comes about INR 1 crore-INR 1.1 crore. Right, that's what the number would be for you to take back. In terms of expansion, you know, you know this, but a quick run through. If you look at Bhubaneswar and Raipur, which comes this year, there's capability enhancement happening in Raipur and there's capability as well as bed expansion happening in Bhubaneswar, and that's largely for this year. FY 2028, we expect to add beds in Banjara and capability in Banjara. I probably brought that response to the previous question as well. We will add capacity.
We will add capability in a very significant way in Banjara and Hyderabad. We were waiting to see if we are able to turn the asset around and we start to get favorability both from the consumer patients as well as the clinical fraternity, and that seems to have happened. People are now seeking more from us. That is another investment that we're making. We've been very excited with the Nagercoil launch. We've done extremely well. The assets at about 28%-29% EBITDA and growing month-on-month, month-on-trading month rather. We are now looking at expanding that to by another 100 beds. That's another expansion that's gonna happen. We are adding beds in 28 in Nampally as well.
As I just told you, we're turning that asset around, sprucing it up. With that, we will need more beds to come in. Some of the other projects that we are currently looking at beyond that is gonna be Malappuram, Chittoor, Vizag. It's across the board. You know, when you're looking at brownfield and greenfield, there's one greenfield that we're doing, which is in Goa. 14 assets are on brownfield, which cumulate to the 1,500 beds I spoke about.
Just on the per bed CapEx, you said INR 1 crore- INR 1.1 crore, right? Can you break it down for me in terms of brownfield per bed CapEx and greenfield per bed CapEx?
Yeah. Greenfield will come to about INR 1.5 crore. Brownfield will go down to about, you know, in the range of INR 0.8-INR 1 crore, depending again on complexity. See, I think there's no one number. We'll have to give you number by specialty or by each unit, which is not something that I intend to share at this point in time. The fact is that if you are adding a linear accelerator setup or an onco setup in a particular hospital, then the numbers will go up. It is not just the bed, it is also the complexity and capability that we are sprucing up in the asset.
Vivek, there's no one answer. There'll always be a broad range, and the broad range for brown will be between 0.8 to 1.1. For green it could be about 1.5, 1.6.
Got it. Got it.
Yeah.
Thank you. Thank you for the explanation, Varun, yeah. Just a couple of bookkeeping questions. Just wanted to understand what comprises as a minority share, as a percentage of our total profits, and what should we take that as a percentage going forward?
Vivek, in case of Aster, it's around 8%, and that is with only two units currently, which is the MIMS. We have still a minority of 20% there, and Ramesh Hospital is around 30%. Overall, at a consol, Aster level, it should be at 8%-9%. I think maybe QCIL should be between 15%-20%. Blended should be between 10%-15%.
Overall, it's 10%-15%, right?
Yeah.
Got it. Secondly, just wanted to understand your ROCE number, right? As per what I could understand in terms of ROCE calculation, my ROCE number is coming out to be a bit different to what has been reported in our presentation, right? If you could help me out.
See, in case of Aster, what we exclude is only two things. One is the revaluation reserve, that related to the land revaluation reserve which we taken up when we converged from the old IGAAP to Ind AS. It's just a book entry. There is no actual capital employed. Second is the CWIP because the asset is still not deployed to earn your profits or revenue. These are only two things we exclude. In case of QCIL, I think we exclude the intangibles, right? Because as QCIL, they acquired the entities in Bangladesh and specifically in KIMS, they have some in— you know, intangibles like a brand and goodwill. That is something we're excluding, and that's the only three differences you will have between your calculation and our calculation. We'll be very happy to share it offline also.
Sure. Just one more thing I wanted to ask about QCIL. The QCIL EBITDA margin we report at around 20%-21%. As per the annual report that I could see of QCIL, the EBITDA margin is coming out to be around 17%-18%. If you could make me understand, if I'm missing out on anything in terms of understanding the EBITDA margin, with what's reported in the Aster PPT versus what I can see in the QCIL financials.
Vivek, there is, there's one time that impacts us broadly around, you know, the one time that we are doing a merger, and also some of the work that we are doing with consultants to enhance the productivity. All of that is one time. We can probably provide you a break-up of that if that's desired later.
Sure. Yes, I can—
Fine.
Get back, get back on this later.
Sure.
Yeah. Thank you.
Okay.
Thanks, Vivek. Sure. If anyone, other attendees would like to ask a question, please raise your hand. Okay. There is no more question to the management. Thank you, all. This concludes the earnings call for this quarter for Aster DM Healthcare. I thank the management and all the attendees for joining us today. If you have any further queries and questions, please get in touch with us. Thank you.
Thank you, all.
Thank you.
Thank you, everyone.
Thank you.
Bye-bye.
Bye-bye.