Fortis Healthcare Limited (NSE:FORTIS)
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Q2 21/22

Nov 15, 2021

Operator

Ladies and gentlemen, good day and welcome to the Q2 FY 2022 post-results conference call of Fortis Healthcare Limited. As a reminder, all participant lines will be in a listen-only mode, and there will be an opportunity for you to ask questions after the presentation concludes. If you need assistance during the conference call, please signal an operator by pressing star then zero on your touchtone phone. I now hand the conference over to Mr. Anurag Kalra, Senior Vice President, Investor Relations at Fortis Healthcare Limited. Thank you, and over to you, sir.

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

Thank you, Aman. A very good afternoon and good evening, ladies and gentlemen, and welcome to Fortis Healthcare's Q2 FY 2022 earnings call. The call is being led by our Managing Director and CEO, Dr. Ashutosh Raghuvanshi. We have Mr. Vivek Goyal, our Chief Financial Officer. From SRL side, Mr. Anand, the CEO of SRL joins us, along with Mangesh, who's the Chief Financial Officer of SRL. We shall begin the call by some opening comments by Dr. Raghuvanshi, for which Anand will take you through certain key highlights of the diagnostics business, and then we would welcome questions and answers from the audience. Over to Dr. Raghuvanshi.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

Thank you, Anurag. Good afternoon, everyone, and welcome to our Q2 FY 2022 earnings call. Thank you for joining us on the call today. I hope you and your families have had a good festival season and are safe and well. I would like to straightaway move to the performance for the quarter. We have had a good quarter, led by strong recovery in non-COVID business and a significant decline in COVID cases. I'm quite pleased with the way we have been able to capitalize on the bounce, which reflects our successful efforts to ensuring continuity and sustainability in business in the challenging past year. Both the hospitals and the diagnostic business continued their upward trajectory, clocking top-line re-growth in excess of 40% over Q2 of FY 2021.

The hospital business revenues have grown 47.2% to INR 1,098.5 crores, while the diagnostic business lab revenues grew 42.6% to INR 402.7 crores. At the consolidated level, revenues were up 47% to INR 1,463 crores and were also better versus Q1 of FY 2022. Important to note that the COVID business has been significantly less with the hospital business revenue contribution from COVID is a mere 3%, while for the diagnostic business, COVID contributes 18% to the revenues.

This compared to Q2 of FY 2021, when COVID revenues contributed 31% and 28% to hospital and diagnostic business revenues respectively. A healthy top-line growth has enabled us to gain higher operating leverage and register robust margins for the quarter.

The hospital business EBITDA margins were at 17.2% versus 10.5% in Q2 of Financial Year 2021 and versus 14.9% in Q1 of Financial Year 2022. The diagnostic business EBITDA margins were at 25.7% for the quarter versus 25% and 30.6% in the corresponding and trailing quarters respectively. At the consolidated level, EBITDA margins were approximately 20% as against 14.6% in Q2 of Financial Year 2021. At the PBT level, before exceptional items, we recorded profits of INR 1,181.7 crores versus 10.4 crores while tax was at INR 130.6 crores versus INR 15.5 crores in the corresponding previous quarter.

We also continue to have a healthy balance sheet with a net debt to EBITDA at 0.74x in Q2 of FY 2022 versus 1.04x for Q4 of FY 2021. This was post the acquisition of the balance 50% stake in the DDRC-SRL joint venture in April 2021. It was funded entirely through internal accruals. Our net debt was at INR 869 crore as on September 30, 2021, reflecting a net debt to equity of 0.13x. With a strong balance sheet, we remain well positioned to evaluate opportunities of growth and consolidation for value enhancement for all our stakeholders. I'll now briefly take you through some aspects in both our hospitals and diagnostic business.

For the hospital business, overall occupancy for the quarter was 64% versus 57% in Q2 of Financial Year 2021. More importantly, our non-COVID occupancy improved to 62% in Q2 of Financial Year 2022 versus 39% in Q1 of Financial Year 2022. Higher complex surgical procedure volumes across key specialties contributed to the highest ever quarterly ARPOB at INR 1.87 crores, a growth of 26% over Q2 Financial Year 2021 and 15% over the Q1 of Financial Year 2022. Surgical revenues contributed 56% to overall hospital business revenue versus 44% in Q2 of Financial Year 2021, and 41% in Q1 of Financial Year 2022. This was as a result of pent-up demand for such complex procedures which were long overdue, along with new demand in the normal course of our business.

Pent-up demand, to my mind, may gradually taper off over the next few months. We are also moving rapidly to expand and further invest in our medical infrastructure and technology. State-of-the-art advanced equipment such as MR Linac, Gamma Knife, Cath Labs, ECG, and bone marrow transplant units are in the process of being commissioned in select facilities such as FMRI, Mohali, Mulund, Shalimar Bagh, Noida, and Jaipur. Commensurate with our plans to expand and upgrade medical infrastructure and programs, we have further augmented our clinically eminent clinicians in specialties of cardiology, medical oncology, surgical oncology and radiation oncology, as well as in the areas of neurosciences, gastroenterology and orthopedic across our key facilities. We continue to review our portfolio of facilities and our effort to turn around underperforming yet high potential facilities such as Fortis Escorts are seeing encouraging results.

Investment for brownfield expansion should augment our existing operational bed capacity of close to 3,900 beds by another approximately 250-300 beds in this financial year. Of course, our plans for adding a cumulative 1,200-1,300 beds remains well within our visibility. We continue to leverage various digital mediums to increase our patient footfalls. For the quarter, OPD footfalls through digital channels more than doubled as compared to quarter two of financial year 2021, and increased 21% versus the first quarter of this year. OPD footfalls garnered through digital channels contributed 13% of the overall OPD footfalls versus 11% in Q2 of financial year 2022.

In addition, utilizing information technology in the form of myFortis app, ERP system, advanced business intelligence tools, and medical process digitalization will go a long way in ensuring a smooth and seamless experience for all our patients. I'll take you through some highlights of the diagnostic business and leave it to Anand for more detail after I conclude. The diagnostic business continues its upward trajectory. SRL has successfully integrated its acquisition of DDRC SRL joint venture. Post acquisition of the balance 50% stake in the said joint venture in quarter 1 of financial year 2022, the business recorded revenues of INR 83 crores in the quarter, a growth of approximately 20% over Q1 of financial year 2021.

Aided by its collection center expansion and acquisition of DDRC SRL joint venture, SRL's B2C and B2B revenue mix strengthened to 54 versus 46 in the quarter versus a mix of 45-55 in Q2 of financial year 2021. On the network expansion side, the company added 107 new collection centers to its network in Q2, taking the total number of collection centers to 1948. Home collection revenue from preventive health packages and specialized tests are other areas that are seeing good growth potential in the business. My last comment would be on the cost. As you would know, we have always maintained that cost optimization is an inherent part of our efforts to better our performance.

We continue to vigorously look at our drugs and consumables and reagent procurement and aspects related to substitution and consumption optimization. In addition, as a group, we are also looking to building economies of scale with respect to medical equipment procurement. We are constantly pushing ourselves to try and be more efficient in our indirect expense line item such as housekeeping and others. All in all, costs across functions and facilities have and will continue to be monitored closely. Just some concluding thoughts. We have weathered the difficult past few quarters well, and I do believe that as COVID has abated significantly, the probability of an impactful third wave now seems lower. We are investing rapidly in our infrastructure, both physical and in depth, hiring quality talent, driving focused sales and marketing efforts, and effectively leveraging IT enablers both internally and externally for better efficiencies.

I do believe that all these would play a key part in our future growth and progressively strengthen our business performance. I would now like to hand over to Anand to take you through the specifics of diagnostic details. Thank you.

Anand K
Managing Director and CEO, SRL Diagnostics

Thank you, Dr. Raghuvanshi, and a very good afternoon to everyone on the call. Thank you for joining us today. On behalf of SRL Diagnostics, I warmly welcome you all to our Q2 FY 2022 results conference call. It's really good to be able to speak to you again this quarter. I wanted to start off by thanking our employees, customers and partners for their trust and loyalty, which led to our continued strong revenue growth alongside highest ever non-COVID revenue and network expansion. Looking at our Q2 numbers, we can only say that we are coming off a very strong quarter, where our revenues grew by 43% versus the same quarter last year to reach INR 403 crore.

At the same time, we conducted approximately 12 million tests in Q2 FY 2022, which is a growth of 95% versus Q2 FY 2021. We have maintained a healthy EBITDA margin at 25% for the quarter. I am particularly happy to let you know that we recorded our highest ever non-COVID revenues of INR 331 crores in this quarter. This is a growth of 65% versus the corresponding quarter of the previous year. COVID contribution to the overall revenue was 18% versus 28% in Q2 FY 2021. With the pandemic receding, we expect our non-COVID business to grow steadily. The pandemic has no doubt changed the way businesses are running. The digital trends have brought a paradigm shift in the buying journey of our customers.

This has pressurized companies to innovate continuously to converge the online and physical channels so that we can deliver superior customer experience. We understand that the brands of today need to make their online and offline retail strategies work together, and that the buzzword for brick and mortar stores is now experience. That's the reason why even at SRL, we are investing both on our physical presence as well as digital experience of customers. In the second quarter, we continued to expand our customer touch points across India to be more accessible to patients. At the same time, we have also launched our new mobile app with exciting features like live phlebotomist tracking, real-time booking slots availability checking, among others. With this, we want to achieve a close integration between our digital and offline channels.

With our new features like easy sharing of a lab location map link, we want our digital channel to complement the offline experience by making it easy for customers to see the benefits of visiting the physical lab. Our efforts toward improving our customer experience has also resulted in significant growth in home collection. As a result, our home collection revenues grew 40% versus Q2 FY 2021. Currently, we are providing home collection services at one to three plus fees across the country. COVID pandemic also made the world realize the importance of diagnostics, not just in terms of advances in technology, but more in terms of public perception of diagnostics as a critical vertical in healthcare. This has resulted in a growth spurt in preventive packages.

We have seen our highest ever quarterly revenue in the preventive care portfolio with a growth of more than 50% versus Q2 FY 2021. Led by our network expansion and the acquisition of DDRC SRL, our B2C/B2B ratio or the revenue mix significantly strengthened to 54/46 in the quarter versus 45/55 in Q2 FY 2021. To support our government in the national COVID vaccination program, we started vaccinations for general public in 4 of our centers. SRL vaccinated approximately 12,500 people till the end of September. We are also in talks with the government to support the vaccination program as part of our CSR initiative.

Just like we became the official lab diagnostics partner of the Indian Olympic Association for Tokyo 2020 and Paris 2024 games, we also conducted pathology tests of all the players representing India, coaches, media and government officials traveling to Tokyo for the Paralympic Games. Over the last decade, genomics has acquired a prominent position within clinical medicine. As I mentioned in our last call, we have established an advanced center for genomics at our Mumbai reference laboratory that can provide solutions to clinicians through precision diagnostics in the area of oncology, reproductive health, infectious diseases, and inherited disorders. We have also procured advanced machines to improve our TAT on some of these specialized tests. Apart from this, in Q2, we also launched our in-house designed, developed third mutation for Glioma patients on pyrosequencing technology.

To summarize, I would say that the demand environment continues to be strong, and our growth chart over the last few quarters reflect this. It also reflects our improved execution engine. Together with the investments we have made in capabilities and talent over the last few months, I'm confident we'll be able to participate and win at a greater pace. With that, I would like to hand over the call to Mr. Anurag Kalra, our Head of Investor Relations. Thank you for your attention.

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

Thanks, Anand. Ladies and gentlemen, we will now open the floor for questions from the audience. I hope all of you have got a chance to go through our investor presentation that was circulated on Friday evening. Nevertheless, the same has also been uploaded on our website, but we would now like to open the floor for questions, please. Thank you.

Operator

Thank you very much. Ladies and gentlemen, we will now begin the question and answer session. Anyone who wishes to ask a question may press star and one on their touchtone telephone. If you wish to remove yourself from the question queue, you may press star and two. Participants are requested to use handsets while asking a question. Ladies and gentlemen, we will wait for a moment while the question queue assembles. The first question is from the line of Aashita Jain from Edelweiss Securities. Please go ahead.

Aashita Jain
Associate of Institutional Equities, Edelweiss Securities

Hi. Good day, everyone. My first question is for Anand. On the diagnostics side, if I take a look, for example, medium to long term view, let's say three to five years, how should I see this diagnostics business growing in the next three to five years? And what are the growth initiatives that you have in your mind currently, maybe in terms of collection centers or, you know, target patients or your inorganic growth plans? Please, if you could talk briefly on this.

Anand K
Managing Director and CEO, SRL Diagnostics

Thanks, Aashita. So on our brands, we continue to expand both in terms of our network capabilities as well as our lab, you know, lab network across the country. Which is key, we have expanded our collection centers. This customer touchpoint expansion is also going on, and it will be accelerated over the next two to three years as well. While at the same time, we are also looking at the white spaces in the geography in terms of setting up new lab infrastructure. That plan is also going on. Over the next two to three years, we'll be working on these aspects of growth as well.

Aashita Jain
Associate of Institutional Equities, Edelweiss Securities

Any numbers that you could give us in terms of labs or collection centers that you plan in the next two to five years?

Anand K
Managing Director and CEO, SRL Diagnostics

We are currently around approximately 2000 collection points. We are basically planning to double this over the next two to three years.

Aashita Jain
Associate of Institutional Equities, Edelweiss Securities

Okay. Lastly, if I look at the QoQ growth for this quarter, it was near 1%. But if I have to put aside the D-dimer and IL-6 in the last quarter, what is the base business growth for this quarter?

Anand K
Managing Director and CEO, SRL Diagnostics

What is that? I didn't get the last part of the question.

Aashita Jain
Associate of Institutional Equities, Edelweiss Securities

Excluding D-dimer and IL-6 or maybe COVID antibody test, if I remove it from Q1 of FY 2022, what is the like-for-like growth in this quarter sequentially?

Anand K
Managing Director and CEO, SRL Diagnostics

Even though we don't track this separately, but I'm sure that it was a very significant contributor in Q1 of FY 2022, especially the COVID antibody test. We don't track them separately.

Aashita Jain
Associate of Institutional Equities, Edelweiss Securities

Sure, sure. That's helpful. Thank you.

Anand K
Managing Director and CEO, SRL Diagnostics

Thank you.

Operator

The next question is from the line of Ranvir Singh from Sunidhi Securities. Please go ahead.

Ranvir Singh
Senior Equity Research Analyst, Sunidhi Securities

Yeah, thanks for taking my question. I just wanted to understand on OPD side we have digital channel OPD, and then we have on hospital side teleconsulting. I wanted to understand how these activities which is actually contribute to our revenue. For a normal physical OPD and having a OPD through digital channel, how is realization differs in the two modes?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

Ranvir, what we mean by digital channel is when the consultation actually is happening in physical form. There is another component, which is the teleconsultation component. That is not a very significant component. We do charge similar fee, whether it is a physical consult or a virtual consult. As far as the number of patients who come through various digital channels, which means our own app, our website, and through our other, you know, partner apps. That is the traffic which obviously leads to similar revenue profile as it would be from a walk-in patient.

Ranvir Singh
Senior Equity Research Analyst, Sunidhi Securities

Okay. Similar is the case for teleconsult also. Teleconsult just a mode to call patient and finally the patient comes for physical interaction, right?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

There are teleconsultations as well. Those teleconsultations are also charged equal. Those are virtual consultations where patient doesn't physically come. The contribution of that segment is very small at the moment. During the peak of the up, but then as soon as that recovers, those numbers come down.

Ranvir Singh
Senior Equity Research Analyst, Sunidhi Securities

Okay, fine. For our understanding, mode of channel actually doesn't differentiate in revenue contribution, right? Overall.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

Yeah. Yes, correct.

Ranvir Singh
Senior Equity Research Analyst, Sunidhi Securities

Okay. Secondly, on our expansion plans, earlier we indicated that 1,300 beds we are likely to add. If you could give some timeline when what number of bed will be added year-wise, if possible.

Vivek Goyal
CFO, Fortis Healthcare

Yeah, this is Vivek. I can take this question. This 1,300 bed we are planning to operationalize in next 24 years time. Out of the 1,300, almost 300 we will be commissioning during this financial year.

Ranvir Singh
Senior Equity Research Analyst, Sunidhi Securities

Okay. Rest will be roughly equally distributed in next three years?

Vivek Goyal
CFO, Fortis Healthcare

Yeah, almost equally. Yeah. Almost 300-400 beds every year we are planning to increase.

Ranvir Singh
Senior Equity Research Analyst, Sunidhi Securities

Okay, thanks a lot. I'm in a queue in case I have more question, I will come again. Thanks a lot.

Operator

Thank you. The next question is from the line of Shyam Srinivasan from Goldman Sachs. Please go ahead.

Shyam Srinivasan
Research Analyst, Goldman Sachs

Good afternoon, and thank you for taking the questions. First one is on the ARPOB, INR 1.87 crore annualized number. How should we look at this, doctor? I suppose you mentioned a little bit about pent-up may go away, but you know, this is the highest level. So should it ideally now go to a more normalized level and or will it be between the INR 1.6 crore versus INR 1.9 crore, let's assume. How should we look at it going forward? So what are some of the drivers of this sustaining at higher levels versus pre-COVID?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

Yeah, sure. As I mentioned that, you know, 56% of the business came from surgical cases this quarter. That is one of the drivers of the higher ARPOB. As you're aware, we haven't taken any pricing correction in last one and half to two years. We do have some possibility of doing that as well. Though we are not planning it immediately, but we would do that. My estimate is that this might get slightly moderated over the next quarters as the medical business picks up, but the numbers should definitely be higher than what the previous baseline was. It would get moderated to some extent, but more or less, this could be the trend going onwards.

Shyam Srinivasan
Research Analyst, Goldman Sachs

1.75, 1.8 number you think is sustainable on a go-forward basis once all this normalization and pent-up demand and all goes away. Think so?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

That's correct. Yes.

Shyam Srinivasan
Research Analyst, Goldman Sachs

Got it. Okay. That's very useful. What are the levers for it to go further up from here? Is it the international patients today? I think you discussed 58%. Would they be also accretive to ARPOB or you think, no, they come at the same similar levels, that wouldn't be a driver.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

They do come at a slightly higher ARPOB level, but overall, from profitability point of view, it works out the same. You're right that those patients we are likely to see coming back to normal volumes over the next one or two quarters, depending on travel restrictions. Yes, that definitely will contribute to maintaining the ARPOB at a higher level.

Shyam Srinivasan
Research Analyst, Goldman Sachs

Got it, sir. Very helpful. Second question is on hospital.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

There's one more point which we deliver here that the GIPSA rates have been revised in quite a few of our units from this month. We would see some impact of that coming over the next two to three months.

Shyam Srinivasan
Research Analyst, Goldman Sachs

Revised upwards, downwards in the percentage, sir?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

Revised upwards to the tune of about 10%-15%.

Shyam Srinivasan
Research Analyst, Goldman Sachs

That's useful. In terms of the margins now, about 17% if I remove the startup cost at Chennai, INR 8 crore-INR 9 crore for the quarter, it's at 18% like this presentation says. This is something that we were aspiring to. Is there an element of one-off in these margins, or you think we can build on these margins from here?

Vivek Goyal
CFO, Fortis Healthcare

Yeah. There is no one-off, Shyam, on these margins. These are more sustainable margins. As Dr. Ashutosh Raghuvanshi mentioned, with the international business coming up and GIPSA rate revision and continuous focus on cost optimization, I think margins would go up only.

Shyam Srinivasan
Research Analyst, Goldman Sachs

Vivek, sir, we had a goal of reaching 18%. Now we have reached 18%. What do we do now? Do we go to 20%? Is there, you know, just looking at your peers, you know, and if you can outline what are some of the cost structures we are still different or inferior versus, say some of the peers where we think the levers are still existing. Maybe that's the other way to ask the question.

Vivek Goyal
CFO, Fortis Healthcare

Yeah. As I said, the margins should only go up. Last call, we mentioned about 18% target, and we were lucky enough to, in this quarter itself, achieve 18%. I think 20% is the immediate target for us. In terms of levers, there are certain cost items which are on our radar. Certain costs which we have, which in our system, which we are bringing back into system, which will result into reduction in the cost. Like, captive pharmacy and things like that. We are working on that and the results we will be seeing in the coming quarters.

Shyam Srinivasan
Research Analyst, Goldman Sachs

Got it. Helpful. Last question is on SRL. Just like an industry question, Anand, we have seen two of your largest competitors announce acquisitions. I know we have done a DDRC JV, but that was a JV which we have now resumed. Just how should we look at M&A for you as we look forward, just looking at your geographical mix, east seems to be the one where we have the least exposure to or lower exposure, relative exposure. How should we look at, you know, M&A? Do you think there is appetite for us? Do you think that is the way forward or do you think organically we still can grow, you know, higher than the industry?

Anand K
Managing Director and CEO, SRL Diagnostics

Shyam, we continue to explore both options. We have organic as well as inorganic expansion plans, and we are evaluating opportunities for M&A. You know the geographies where you know we have a lighter presence. At this point of time, as you know, SRL has a much more equitable distribution across geographies in India.

We are looking at options in terms of white spaces as well as to consolidate our you know our leadership, especially if you see East, we are the top player in the East. We would like to look for how we can consolidate our position there as well as you know strengthen our presence in other locations where you know in most cases we are the contenders and we have a strong presence. We are exploring all options.

Shyam Srinivasan
Research Analyst, Goldman Sachs

Correct. Last two data points on the SRL. What is the home collection revenue percentage to total revenue? Preventive, you said grew 50%. Can you also give us the relative contribution? In the old disclosure, I think it was some 2%-3%. So just some color. Yeah.

Anand K
Managing Director and CEO, SRL Diagnostics

Home collection revenue is about 7%-8% of the overall revenue. That is, that's what we should say.

Shyam Srinivasan
Research Analyst, Goldman Sachs

Preventive, sir?

Anand K
Managing Director and CEO, SRL Diagnostics

Preventive, we don't have a separate number that we can share.

Okay. Maybe we'll circle back with Anurag.

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

Thank you. Thank you so much. All the best.

Anand K
Managing Director and CEO, SRL Diagnostics

We'll get back to you.

Operator

Thank you. The next question is on the line of Shantanu Basu from SMIFS Limited . Please go ahead.

Shantanu Basu
Senior Research Analyst, SMIFS Limited

Hi, good afternoon, and thanks for giving me the opportunity. I have two questions. The first question would be on, basically on why there has been a drop in EBITDA margin, I mean, in SRL from 30% to 25% in Q2 FY 2022. On the call you stated that 30% EBITDA margin is sustainable. This 25%, is this, an aberration on what should be, I mean, how should we look at it, going forward? Would it again revert back to 30% going forward? That's one.

With regard to your hospitals, I mean, why has the revenue contribution increased to 30% of total revenue for hospitals in the below 10% and 10%-15% EBITDA margin markets from 16% of total revenue in the same quarter in Q4 FY 2021? Although the number of hospitals have remained the same, but the operational beds have gone up and the revenue contribution has also gone up by 30%. Why this 14% jump in revenues in the lower EBITDA hospitals? I would want two data points. What would be your non-COVID and COVID ARPOBs for the quarter? And DDRC revenue during the quarter.

Anand K
Managing Director and CEO, SRL Diagnostics

Right. On the difference between the two quarters, what I can say is that, our expectation on this would be normally in the range of 23%-25%. The 20% of the previous quarter was driven mainly by, you know, the high volumes as well as, you know, you know, we had a higher pricing on COVID in many of the places. As you know, even during July and August also, many states have reduced their pricing. Overall, we have seen a drop in average revenue per test, both for COVID as well as non-COVID. What we feel is that, what we are seeing in this quarter is more sustainable than what we see as an aberration in the previous quarter.

Shantanu Basu
Senior Research Analyst, SMIFS Limited

25% is a sustainable number going forward?

Anand K
Managing Director and CEO, SRL Diagnostics

23%-25%.

Shantanu Basu
Senior Research Analyst, SMIFS Limited

Okay. Okay.

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

To your next question, I think you also asked the breakup of DDRC revenue for the quarter. Q2 FY 2022 DDRC revenue was about INR 83 crores versus 69 crores in Q1 of FY 2022.

Shantanu Basu
Senior Research Analyst, SMIFS Limited

Okay.

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

Right? To your third question.

Shantanu Basu
Senior Research Analyst, SMIFS Limited

Right.

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

Before coming to the last one, you had also requested for the ARPOB of COVID versus non-COVID. COVID ARPOB in quarter two has been about INR 1.26 crores, whereas non-COVID has been about INR 1.29 crores.

Shantanu Basu
Senior Research Analyst, SMIFS Limited

Sorry, COVID ARPOB has been 1.36?

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

29. 29 . 29 .

Shantanu Basu
Senior Research Analyst, SMIFS Limited

INR 1.29 crores. Non-COVID?

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

INR 1.89 crores.

Shantanu Basu
Senior Research Analyst, SMIFS Limited

1.89. Okay. Lastly,

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

COVID has been a very small portion of the overall hospital business. Out of the total revenue, only 3% revenue contribution is from COVID.

Shantanu Basu
Senior Research Analyst, SMIFS Limited

Right. Right. Yes, you have disclosed that. What about the question with respect to the buckets of revenue in the lower EBITDA margin?

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

Yes. Yes.

Shantanu Basu
Senior Research Analyst, SMIFS Limited

Why this happening compared to Q4?

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

Sure. That question we will have to see what is the movement in terms of facilities that have moved either up or down in the range of the EBITDA margin that you mentioned. If you look at the last range, if you look at comparative with quarter four, there are a couple of hospitals that have moved up the ladder while, one or two hospitals have come down. I think the intention of showing this this margin matrix is to just give a flavor of how our various facilities are doing and what is the potential, you know, of these facilities to go to their peak, which is, you know, margins between 20%-25%.

I think there's a whole lot of detail behind this, so I don't know how to explain that. If you look at the contribution, there are certain facilities that have moved up. For example, as Dr. Ashutosh Raghuvanshi was also mentioning, just as a way of an example, Lotus Red Cross was one of the facilities that was in the below 10% range in quarter two of FY 2021.

Which has now moved up to the 10%-15% range. That's an improvement. There will be at various points in time various facilities that will kind of move up. Our overall intention will be to ensure that you know facilities that are towards the latter of one-third half below then eventually move up. That today we want to show this.

Shantanu Basu
Senior Research Analyst, SMIFS Limited

I see. The operational beds, you know, that is also in the 10%-15% and 50 below 10%. The number of operational beds have also gone up. While the number of facilities has remained the same, the number of operational beds have also gone up. I mean, can you talk on that or?

Anand K
Managing Director and CEO, SRL Diagnostics

Yeah. That would depend on facility to facility, right? Because if you have a certain facility that is 200-250 beds, that for some reason in the quarter come down to the -10% mark. Because it's a larger number of beds, the number of beds could go up. Unfortunately, if you have a smaller facility that margins are doing very well, that will then go to the next level. Each facility will be looked at in terms of the number of beds and our facilities range from as low as 50 beds to as high as about 300 beds.

Shantanu Basu
Senior Research Analyst, SMIFS Limited

Okay, fine. Okay. Thank you very much.

Operator

Thank you. The next question is from the line of Amit Khetan from Laburnum Capital. Please go ahead.

Amit Khetan
VP, Laburnum Capital

Hi, good afternoon, and thank you for the opportunity. You have a brownfield expansion plan. Just wanted to understand, like is the Supreme Court judgment in any way impeding your growth aspiration in terms of inorganic growth or greenfield expansion?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

As far as all the organic growth and brownfield expansion is concerned, that has no constraints from the legal issues. Those are totally unrelated. All the plans which we have highlighted in terms of number of beds of 1,300 over a period of next three years or so are not contingent on what happens on the legal side. We have a very comfortable operational position to be able to deliver on this growth, what we have stated.

Amit Khetan
VP, Laburnum Capital

Sure. What about acquisitions? You're not looking at them right now?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

As I mentioned earlier that we are looking for all kinds of growth. If there is a larger acquisition which is available, we would definitely consider it. At the moment we are exploring few smaller options which may be available. We would stick to our stated strategy of expanding in the given clusters where we have a good presence. Then it has to be attractive valuation at which the asset comes. There are no constraints as far as the growth is concerned, be it organic or inorganic.

Amit Khetan
VP, Laburnum Capital

Understood. How have occupancies trended in the quarter? If you could give figures for July, August, September and October.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

Just a moment.

Vivek Goyal
CFO, Fortis Healthcare

It was July. July for non-COVID bed is 58%, 62%, and 65%. The COVID was 3.3%, 2.8%, 2%.

Amit Khetan
VP, Laburnum Capital

What would be the figure for October overall?

Vivek Goyal
CFO, Fortis Healthcare

It is almost at similar levels, around 65-odd% in October for non-COVID bed.

Amit Khetan
VP, Laburnum Capital

Got it. This is a sustainable number or does this have some element of pent-up demand, October number?

Vivek Goyal
CFO, Fortis Healthcare

Very little pent-up demand in ortho and all. As you know, the system is getting settled, the occupancy is going to go up only from here. We expect it to settle around 70%-72%.

Amit Khetan
VP, Laburnum Capital

Understood. Thank you and all the best.

Operator

Thank you. The next question is from the line of Sanjay Shah from KSA Securities. Please go ahead.

Sanjay Shah
Director, KSA Securities

Yeah. Good afternoon, gentlemen. Thanks for the opportunity. Just my question was regarding our focus on medical tourism. After things getting normalized and the border gets opened up, what are our targets on medical tourism, and what are we doing to increase that business?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

Okay. Medical tourism, as you know, is contingent upon Sanjay, the travel restrictions. A lot of that is not in our hands. Our focus continuously remain. We have remained engaged with all these geographies where we are present. Some of our teams have also visited even during this period. We would aim to bring it back to our normal level within next two quarters or so. Then, you know, we take it further from there.

Sanjay Shah
Director, KSA Securities

Okay. Now, going through our growth trajectory and increasing our foothold, are we planning to enter any Tier 2 cities, or do we have any plans or any major plans to ramp up our business?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

As I was speaking in the earlier question that, you know, our strategy very clear that we will remain focused on the geographies where we are present and have a meaningful cluster. The only exception to that would be another geography where we could create a meaningful cluster either through some acquisition or some other possibilities. Some large cities where we may not have presence today are attractive markets, then we would definitely consider those.

Sanjay Shah
Director, KSA Securities

Okay. Continuing to my same question was regarding our growth. How do you see our business coming? Do we see any patient coming to from unorganized single hospital to institutions or business is coming because of incremental growth on our new surgical and other therapies and other businesses? Sorry. How do you see that change happening? Do you see that visible change on the patients' preferences?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

There are certain segments which are moving more towards larger hospital, and there are certain segments which are moving towards boutique facilities. Like for example, obstetric work is moving in the opposite direction, whereas all other major surgical specialties and critical care areas are moving more towards organized hospitals. That is the trend across the industry we are hearing, and that's the same thing what we are seeing as well. It is not that there is some gross consolidation towards the organized players. Smaller hospitals still continue to serve a large population, especially in tier 2 , tier 3 cities. They're developing more formal relationships with the larger hospitals for sending their complex work.

Sanjay Shah
Director, KSA Securities

My last question was regarding Supreme Court verdict. Any update on that side?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

We don't have anything new to add except that, you know, we are waiting anxiously just like you.

Sanjay Shah
Director, KSA Securities

Okay, sir. Good luck to you, sir. Thank you.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

Thank you.

Operator

Thank you. Next question is from the line of Ryan Suraj from Rare Enterprises. Please go ahead. Ryan Suraj, your line is unmuted. Please unmute yourself and proceed with the question. It seems there is no line response from the current participant. We will move to our next question, which is from the line of Negeendra Kumar from Growthx Capital. Please go ahead.

Negeendra Kumar
Equity Research Analyst, Growthx Capital

Hi sir. Thank you for the opportunity. Sir, just wanted to on the expansion side, you mentioned the bed is 3,900. Is it a current bed or it would be after 2022 ends?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

This is the current number. As we said earlier that about 200 beds will get added to this within this financial year.

Negeendra Kumar
Equity Research Analyst, Growthx Capital

Okay. Post March 2022 end, that would be roughly 4,100.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

That's right.

Negeendra Kumar
Equity Research Analyst, Growthx Capital

Just wanted to know, just on the new bed addition. What is the expected occupancy level on this, these new bed additions in this financial year or any time when you add new beds within the year? What is the expected occupancy level for the next financial year?

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

We do add beds when we see that there is occupancy level in the existing hospital is high. We expect the occupancy level to remain at the similar levels at which they are there. Some of these hospitals where expansion is happening are generally having a occupancy of about 70% +. We expect it to remain within that range. You would appreciate that when new capacity is just added at that time there may be a little lag before it comes to a normal occupancy level, which is about 70%.

Negeendra Kumar
Equity Research Analyst, Growthx Capital

Okay. I just wanted to refer a news. There was a news in September 5 from The Economic Times, that is, SRL is going to allocate INR 300 crore-INR 500 crore for expansion by April 2023 end. The news stated that, company is going to add 25-50 labs during this period. Can you give some color on this?

Anand K
Managing Director and CEO, SRL Diagnostics

As I was telling earlier, also, we are looking at opportunities for expansion both in organic way as well as inorganic way to add more labs. We are exploring options. We have some opportunities in hand and some we are considering. We are focusing on that. We'll let you know once something happens there.

Negeendra Kumar
Equity Research Analyst, Growthx Capital

There is no current plans analyzed, right?

Anand K
Managing Director and CEO, SRL Diagnostics

Well, plans are on, but, you know, there is nothing that we can officially declare now.

Negeendra Kumar
Equity Research Analyst, Growthx Capital

Okay. Just one data point question, sir. Can you give the number on the side of what is the COVID mix during the quarter? Number of COVID cases.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

COVID case number 1.2 million.

Vivek Goyal
CFO, Fortis Healthcare

I think it is nine.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

Number of COVID value.

Anand K
Managing Director and CEO, SRL Diagnostics

1.1 million.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

1.2 million.

Vivek Goyal
CFO, Fortis Healthcare

That's about 1.3 million test.

Anand K
Managing Director and CEO, SRL Diagnostics

1.3 million. Last quarter it was roughly 1.65 million.

Negeendra Kumar
Equity Research Analyst, Growthx Capital

Okay, thank you. That's all from me.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

Thank you.

Operator

Thank you. The next question is from the line of Nitin Agarwal from DAM Capital. Please go ahead.

Nitin Agarwal
Senior Research Analyst, DAM Capital

Hi, thanks for taking my question. On the diagnostics business, there are again post-COVID reemergence of a lot of small niche franchises in various parts of the country. Have you seen a transaction increase competitive pressure, especially in the pricing front, across in certain parts of the country?

Anand K
Managing Director and CEO, SRL Diagnostics

We don't see any pressure on pricing or competition like that. The only thing is we are seeing more and more people, you know, coming out for doing preventive health packages as well as approaching, you know, diagnostics through various trends, including digital channels. I don't see any specific competition that is probably pushing the prices down.

Nitin Agarwal
Senior Research Analyst, DAM Capital

Ever since you mentioned the digital channels, are the digital channel-based sales which are happening, are there, you know, I mean, is there, is it accelerating the pricing competition in the market or you don't think there is a pressure on pricing because of the increased aggression of the digital channels?

Anand K
Managing Director and CEO, SRL Diagnostics

We focus more on acute and chronic patients. You know, our company mainly the pure play digital players focus on wellness segments where there is a price competition. In our case, we focus more on acute and chronic illnesses. That is why, you know, we don't see that difference in pricing.

Nitin Agarwal
Senior Research Analyst, DAM Capital

Okay. Thank you.

Anand K
Managing Director and CEO, SRL Diagnostics

Thank you.

Operator

Thank you. Anyone who wish to ask a question at this time, then you please press star and one. The next question is from the line of Bhagwan Chaudhary from Sunidhi Securities. Please go ahead.

Bhagwan Chaudhary
VP of Investment for Family Office, Sunidhi Securities

Yeah. Hi. Thanks for the opportunity. Can you share what was the vaccines revenue in this quarter?

Vivek Goyal
CFO, Fortis Healthcare

Very small number. INR 20 crore.

Bhagwan Chaudhary
VP of Investment for Family Office, Sunidhi Securities

INR 20 crore. Okay. Secondly, on your diagnostic business, now I think there was some contribution from the COVID in the current quarter as well. If we look in the longer term, how should one look at the margin side? Because pre-COVID it was around 20%-22%. Now still holding at 25%, given the fact that there is an integration of DDRC as well. Just a longer term view where the margin would be and what kind of trajectory in the revenue maybe.

Anand K
Managing Director and CEO, SRL Diagnostics

On the longer term, margins will be in the range of 23%-25%. You know, we with the COVID contribution coming down as we see it's 18% of our overall revenue. With that, you know, we will continue to be in this kind of margins in future.

Bhagwan Chaudhary
VP of Investment for Family Office, Sunidhi Securities

Do you think that this 25% is the base in the current quarter?

Anand K
Managing Director and CEO, SRL Diagnostics

Yes, that's more on the sustainable basis, yes.

Bhagwan Chaudhary
VP of Investment for Family Office, Sunidhi Securities

Okay. Secondly, if I'll, I may ask you in this way that, what has led to improvement in the margin from the earlier 20% to the current 25% scenario?

Anand K
Managing Director and CEO, SRL Diagnostics

Overall, most of our capabilities that we have set up over the last two years, we have started having better utilization on the capacity. As well as we have taken some cost optimization measures, over various factors, including revenue linked costs as well as, you know, direct costs like materials. We have been constantly tracking this, and this has led to some improvements in the margin.

Bhagwan Chaudhary
VP of Investment for Family Office, Sunidhi Securities

Got it. Just final, on the same, in the current scenario, the COVID business margins are same the non-COVID or it's a bit higher or lower?

Anand K
Managing Director and CEO, SRL Diagnostics

COVID margins are lower.

Bhagwan Chaudhary
VP of Investment for Family Office, Sunidhi Securities

Okay. Thank you.

Anand K
Managing Director and CEO, SRL Diagnostics

Yes. Thank you.

Operator

Thank you. Next question is from the line of Sumit Choudhary from Zaaba. Please go ahead.

Sumit Choudhary
Principal of India and Asean Long Short Specialist, Zaaba Capital

Yes. Hi, Dr. Ashutosh Raghuvanshi, GM team, and congrats on great execution. Couple of questions from my side. Just on the hospital side, to be clear, between now and the year-end, we are expecting to add another 200 beds, yet the occupancies should remain in the mid-60s%. In fact, I thought I heard we should expect it to stabilize at closer to 70%. Just want to be clear that's the right understanding.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

That's correct.

Sumit Choudhary
Principal of India and Asean Long Short Specialist, Zaaba Capital

Understood. In terms of the ARPOB, you know, of course there was the change in mix from COVID away from the COVID patients leading to the numbers which you reported. When I listen to some of the other hospital players out there, it seems mostly as expected to be sustainable considering the uptick from the international patient side. You know, the case mix is expected to remain strong. Is there anything which benefited Fortis disproportionately in the quarter gone by for that not being the case for us? Or is it that

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

No, not really. You know, it is just a marginal difference in the number of surgical versus medical cases. The trend is sustainable. The same number I think may not be there. It might get moderated a little bit as the medical number of cases increases. That is our estimation at the moment. Of course, it needs to be seen. Earlier on, as I was mentioning, that there are certain pricing interventions which are happening parallelly, which would also have an independent impact. Net-net eventually we may end up sustaining at our corporate levels which we have achieved.

Sumit Choudhary
Principal of India and Asean Long Short Specialist, Zaaba Capital

Understood. Thanks for that. You mentioned some of the cost out measures that you are undertaking, including pharmacy, pharmaceutical procurement, et cetera. You know, I guess even on the investment side, you did mention how you're like looking to add more complex surgical machinery along with hiring more experienced clinical technicians at all of your hospitals. I imagine the RCoS should benefit from the latter as well. Coming to the point of the cost outs, if you could help us quantify how much exactly the cost outs, either in margin percentage points or rupees that you're looking to take out?

Vivek Goyal
CFO, Fortis Healthcare

Yeah, I can take this question. You know, the cost side, there are various company initiatives which we have initiated, and I have enumerated that. It is very difficult to quantify the number on that. We'll not be able to quantify the number. Having said that, this is a continuous effort and you can witness from the last half year, with the same fixed cost we're able to achieve higher revenue, which it can give a better margin.

Sumit Choudhary
Principal of India and Asean Long Short Specialist, Zaaba Capital

Yes. Understood. I guess putting it another way, you've mentioned, I think earlier on the call about 20% margins are achievable. Over what timeframe would you kind of expect to get there, for the hospital business?

Vivek Goyal
CFO, Fortis Healthcare

We strive to go to 50% in the shortest time.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

sooner the better, Sumit.

Sumit Choudhary
Principal of India and Asean Long Short Specialist, Zaaba Capital

Yes. For all of us. Yes. Thank you and good luck.

Ashutosh Raghuvanshi
Managing Director and CEO, Fortis Healthcare Limited

Yes.

Operator

Ladies and gentlemen, that would be our last question for today. I now hand the conference over to management for the closing comments. Thank you and over to you.

Anurag Kalra
SVP of Investor Relations, Fortis Healthcare Limited

Ladies and gentlemen, thank you very much for taking the time to be with us on the call today. In case there are any further queries, clarification requests, Gaurav and Madhvi are there to address those. Thank you for your time again, and have a good day. Thank you.

Operator

Thank you very much. Ladies and gentlemen, on behalf of Fortis Healthcare, that concludes this conference. Thank you all for joining us. You may now disconnect your lines.

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