Ladies and gentlemen, good day, and welcome to the Q4 and FY 2024 earnings conference call of Metropolis Healthcare Limited, hosted by JM Financial. This conference call may contain forward-looking statements about the company, which are based on the beliefs, opinions, and expectations of the company as on date of this call. These statements do not guarantee the future performance of the company, and it may involve risks and uncertainties that are difficult to predict. As a reminder, all participant lines will be in the listen-only mode, and there will be an opportunity for you to ask questions after the presentation concludes. Should you need assistance during the conference call, please signal an operator by pressing star then zero on your touchtone phone. Please note that this conference is being recorded. I now hand the conference over to Mr. Amey Chalke from JM Financial.
Thank you, and over to you, sir.
Yeah, thank you, and good morning, everyone. On behalf of JM Financial, I am Amey Chalke. Welcome you all for Metropolis for Q4 FY 2024 earnings call. With us today, we have the Metropolis senior management team, represented by Ameera Shah, Managing Director, Mr. Surendran Chemmenkotil, CEO, and Mr. Rakesh Agarwal, CFO. I will now hand over the call to Mr. Am- Ms. Ameera Ma'am, for her opening remarks. Over to you, ma'am.
Good morning, everyone, and thank you for joining us on the Q4 FY 2024 earnings call. Today I'm joined by our CEO, Surendran, Rakesh Agarwal, CFO, and SGA, our IR advisor. We've uploaded our updated result document on the stock exchange and website. I hope everyone has an opportunity to go through the same. Talking about the industry trends, the diagnostic sector is expected to grow at about a 10% CAGR over the next 5 years. The organized segment of the industry is estimated to grow at a faster pace, marked by a transition from unorganized entities to larger, organized players. Between 2020 and 2022, the industry also witnessed an influx of new entrants, attracted by the perceived high margins and return profile.
However, most of them have realized that while entering the market is easy, scaling our profitable revenue poses a significant challenge for new entrants. While aggressive pricing can play a role in creating the wellness market, it has not proven to be a silver bullet in the illness space. Healthcare players had the hope of acquiring customers via wellness and then converting them to illness customers. However, the conversion rates of these have been extremely low single digits, and therefore, these players have also now increased prices of the wellness packages. Even globally, companies like Theranos, which were focused on wellness, and 23andMe, being focused on wellness DNA testing, have been struggling as very few businesses in the pure wellness space build credibility among doctors or make profits. On the contrary, Metropolis and similar established players have benefited from an increase in post-COVID wellness trends.
Having strong brand recognition and developing an omni-channel plan, have been able to increase the share in the wellness segment. We've also seen hospital chains enter diagnostic segments in regional pockets, where they believe their consumer brand is relatively stronger. While the perception is that they already have lab testing infrastructure and doctor connect, and therefore it's an easy pivot into diagnostics, the reality is that in healthcare, each area of expertise is learned, and doctors' perception of expertise doesn't translate easily from hospitals to pathology experts. Also, hospitals face some inherent structural challenges, like the difficulty in attracting prescriptions from specialized doctors outside the hospital due to fear of patients lost to the doctors inside the hospital. Also, another challenge they face is on account of differential pricing inside and outside the hospital.
With these continuing challenges, hospital entrants have largely focused on B2B business for routine and semi-specialized tests by using aggressive pricing strategies, which tends to be focused on the tail end of B2B customers who care more about pricing over other areas. While competition persists in this space, there has been a recent trend towards reduced competition intensity and more rational pricing strategies. Interestingly, the emergence of organized players in the industry has prompted a noticeable shift in customer attitudes towards organized diagnostic players. As a result, standalone labs operating in the unorganized sector have experienced a decline in market share. This shift highlights the growing preference among customers for the reliability, efficiency, and use of technology offered by the organized entities. Building a specialized diagnostics business is all about your expertise behind the scenes.
It's not only about offering the largest test menu, but having the institutional knowledge for testing in each therapeutic area that produces a better quality report compared to others. At Metropolis, we are focused on the fastest growing therapeutic areas such as transplants, neurology, nephrology, gastroenterology, oncology, et cetera. Additionally, to be future ready, we are investing deeply to build world-class testing in areas like genomics and molecular diagnostics, which is the future of the industry. Looking at these trends and opportunities in the industry, the opportunity for Metropolis is to continue to outpace the industry and peers, which will happen via organic and inorganic growth. For accelerated organic growth, we will do the following: We will focus on being the pioneer in new test advancement and amplify our engagement with specialty doctors to grow our specialty volumes.
Number two, we'll also expand our collection center networks in new cities, which will be largely Tier 2 and Tier 3 markets in India. Three, we will heighten our service standards and digital marketing initiatives to improve the productivity of existing centers, and four, we will expand our B2B presence, not only in India, but also to new markets outside India, using our global reference lab in Mumbai as a specialty testing solution. This would be an asset-light model, which would be moving samples from outside India to Mumbai for testing. When we look at inorganic growth, we will assess M&A opportunities through three lenses. Number one, we will acquire firms where we can get cutting-edge capabilities and skills within the technical testing sphere and sell through our large distribution network.
Number two, we will acquire ethical and strong local brand B2C players in markets where we don't have a strong consumer brand, in order to establish a foothold to grow from. Many of these local firms lack prudence in capital allocation and scaling operations to the next level. We intend to evaluate such targets nationwide and do multiple bolt-on acquisitions that will create accelerated growth. This would largely be in the regions of north and east, but also could be in specific cities in south and west, as our industry is hyper local and not regional in nature. And number three, we could look at acquiring good quality brick-and-mortar firms, which are subscale and making inadequate profits, and use our management skills and advanced testing capabilities and strong brand recognition to scale these businesses and turn them around.
For mergers and acquisitions, we adhere to predefined internal parameters encompassing IRRs, growth prospects, EBITDA, PBT margins, along with return on capital and return on equity to assess possible acquisitions. Thankfully, there has been a moderation in valuation expectations compared to the COVID period, and we will be open to using options of internal cash accruals, external debt, and our own stock to complete deals. We will be financially conservative when allocating capital or using debt. Currently, we see a fair number of opportunities to buy assets which meet our strategic and financial checklist. To capitalize on this opportunity of consolidation, the company plans to alter its dividend payout from historic 30%-35% of PAT to 15%-20% of PAT for the next couple of years.
Cash will be retained by the company for accelerated growth opportunities in terms of selective M&A, which we believe will fuel growth in the future. Once these growth initiatives are successfully executed, we will restore the dividend payout to historical levels, if not higher. Should there be a case of non-deployment of these funds for M&A, we will prudently return the cash with a suitable option. Over the past two decades, we have successfully completed 23 acquisitions along with strategic partners that have generated high IRRs for the company. While most were done at very reasonable valuations, it was the integration and the ability to drive a high organic growth from them that truly stands out. Since the integration of our most recent acquisition, Hitech, core revenues have shown significant growth, and with synergies and operational efficiencies, we have been able to enhance EBITDA margins also by 4%.
Going forward, we are confident in our ability to do deals at fair valuations and integrate them well and execute plans to generate positive IRRs for Metropolis. Over the past many years, my focus has been on professionalizing the company, and to accomplish this, I've been augmenting our talent pool from within the healthcare domain and from outside. In pursuit of this objective, I brought Suren on board approximately 18 months ago to spearhead our business execution efforts. With his extensive background in running scaled consumer-facing and distribution operations, Surendran has assumed full responsibility for driving the implementation of Metropolis strategy. Over the past 15 months, under his guidance, Metropolis has grown faster than industry and peers, and significantly broadened its geographical presence, setting the base for future growth.
With Surendran and the CXO team now firmly established and demonstrating a strong track record of execution results, we believe it is the opportune moment to delineate and separate governance from operations and run the firm as a promoter-led but professionally managed company. Promoters in India who have successfully done this before have generated large value for shareholders, and I believe it's the right direction to go for Metropolis as well. Accordingly, I will be transitioning into the role of Executive Chairperson and Full-time Director. In this capacity, my responsibilities will encompass driving the strategy of the business and monitoring it, strengthening governance, strategizing capital allocation, including driving harmony activities, acquiring talent, and fostering the culture at Metropolis. Meanwhile, Surendran as CEO will lead the execution of all our operational initiatives while reporting to me.
Surendran and I have worked together in this construct for the past 15 months, and we complement each other well. Together with our strong board, we will prioritize governance, strategy, and sustainability initiatives, aiming for even greater achievements. Let me also take the opportunity to thank our founder and chairman, Dr. Sushil Shah, who will now transition into the role of Chairman Emeritus. Under Dr. Shah's leadership, Metropolis has emerged as a trusted pathology brand, earning recognition from both medical professionals and consumers, solidifying its position as an industry leader. Dr. Shah's visionary leadership, commitment, and dedication have been instrumental in shaping the company's success. In his new capacity as chairman emeritus and director on the board, Dr. Shah will continue to provide invaluable guidance to the board and team, drawing upon his extensive medical experience and expertise to offer mentorship.
We express our heartfelt gratitude to Dr. Shah for his years of service and support in propelling Metropolis to greater heights. With this, I'll hand over the call to Surendran to take you through the quarter and the year gone by and give some flavor of our strategy for FY 2025 and beyond. Thank you, and over to you, Suren.
Thanks, Ameera, and good morning, everyone. Let me take you through the business highlights for this quarter gone by and along with the strategies going forward. For quarter four, quarter four 2024, we are happy to report 11% year-on-year growth on reported revenues and a 15% year-on-year growth in our core revenues, with corresponding volume growth of almost 7% and on 7% on account of product mix change and realization benefits. We have delivered industry-leading volume growth over the last nine quarters and are optimistic about the growth trajectory going forward. Our B2C revenue have grown faster at 20% year-on-year basis in quarter four, with a volume growth of 7% and a 13% increase in RCP, attributable to the recent price increase implemented in January and shifts in product mix.
We are pleased to report that the price hike has been effectively absorbed, and despite this increase, our volumes are maintained at a growth rate of +7%. Alongside our revenues from Mumbai market have grown by 20%, underscoring our increased market share and brand pull in our core geographies. Our specialized and wellness testing grew by 17% and 22%, respectively, on year-on-year basis, in line with our strategy of expanding our specialized and wellness business. Despite some competitive intensity on B2B side, we have been able to grow our B2B revenues by 11% for quarter four, with corresponding volume growth of 7%. The discounting in the B2B segment has reduced as compared to full year 2023, and B2B volumes have grown positive recovery. More and more players are preferring trusted labs with experience on the track of better service and quality of diagnosis.
Let me share some light on the network expansion and outcome of the same. Over the past 2 years, we have dedicated efforts to extend our presence across India. In the last 12 months, we have added 24 new labs, with 7 labs added in the last quarter. Our plan for the current financial year entails the addition of another 25 more labs in strategic locations to target underserved markets, thereby aiming for accelerated revenue growth and market share expansion. In tandem with lab expansion, we are focused on expanding our collection center network and distribution channels. Full year 2024, we have added more than 550 centers, including 150-odd centers in the last quarter alone. Our footprint has expanded from 307 towns in April 2023 to 600 towns by the time we exited last year.
With all this effort, we have been able to grow our revenues from other cities by 34% for quarter four and 28% in full year 2024, respectively. Growth from the other cities largely on the back of growth and revenues from Tier 2 and Tier 3 cities. Our new labs are also showing robust growth over the last 2, 3 quarters, with revenue contribution of 4% for the full year 2024. In addition to prioritizing network expansion, volume and revenue growth, we have placed equal emphasis on efficiency, productivity, and margin improvement. We are pleased to announce that our reported EBITDA margin stood at 25.5% for quarter four 2024.
Prior to factoring in CSR and ISO, this is 26.5%, and if we add back the dilution cost in the short term by the new labs, our EBITDA stood at 27.4% for the same period. We maintain an optimistic outlook regarding the sustenance of quarter four margins in full year 2025. Upon the completion of our accelerated lab and network expansion by the end of 2025, we are anticipating that the enhanced revenue stemming from both existing and new labs will further enhance our margin profile post full year 2025. Speaking of our organic strategies, we have been focusing on basically four or five big things: infra expansion into new markets to target accelerated growth with lab network and expansion of distribution channels.
We have been focusing on technology transformation, both on the front end, consumer facing, for convenience to customer experience waiting improved, and also to strengthen our back-end digital infrastructure to improve our service levels. With increased focus on technology and digital marketing, we have been able to acquire new customers via the digital route, and revenue contribution led by digital channels has shown robust growth in full year 2024. We have also revamped our Tru Health wellness packages to suit right for consumer needs, with focus on bundled testing packages, curated for specific target audience and also upselling to existing customers. We have also taken multiple initiatives to enhance our service levels for B2B customers. We have set up dedicated relationship managers and special programs for our B2B clients, along with centralized helpdesk, B2B partner portal for strong support system, et cetera.
As a result, we have seen an increase in B2B volumes with rationalization in discounts over the last 2-3 quarters. Lastly, as highlighted by Ameera earlier, we have strengthened our leadership bench, simplified the organization structure, and have fortified our organization's capacity for efficient planning, execution, and leadership continuity. The wealth of experience and diverse backgrounds that these senior professionals bring from various industries enriches our collective knowledge, knowledge base, and enhances our ability to navigate complex challenges and seize the opportunity. Their contributions extend beyond formulation of strategies and play a pivotal role in executing the roadmap ahead of us. Going forward, with the brand strength of Metropolis, talent pool, trusted partners for doctors and consumers, coupled with aggressive expansion plans, foray into adjacencies with opportunities of inorganic growth, we are optimistic of outnumbering in the industry growth in terms of revenue growth and profitability.
With this, I'll hand it over to Rakesh for the financial update.
Thank you, Suren, and good morning, everybody. Let me share some of the key financial performance for the quarter. Reported revenue for quarter four, financial year 2024, stood at INR 313 crore, a growth of 11% YoY. Our core revenue, excluding revenue for COVID and COVID-allied and PPP contract, grew by 15% YoY for Q4 financial year 2024. Our core revenue for financial year 2024 grew by 13.3% YoY, with 9% volume growth and approximately 4% on account of price increase and product mix change. Reported EBITDA for the quarter stood at INR 79.7 crore, as compared to INR 69.2 crore, a growth of 15%. Reported EBITDA margin for Q4 2024 stood at 25.5%.
EBITDA margin adjusted for ESOP, CSR and new lab margin dilution stood at 27.4% for Q4, financial year 2024. EBITDA for the full year stood at INR 284.6 crore, with EBITDA margin of 23.9%. One-off expenses of INR 6.8 crore has been booked on account of whistleblower and Aam Aadmi Mohalla Clinic provision for financial year 2024. PAT for the quarter stood at INR 36.1 crore with margin at 11.6%. PAT for full year stood at INR 128.1 crore with 10.8% margin. Moving on to balance sheet, we are happy to share that we have paid all our debt in the last quarter and have zero debt as on 31st March 2024.
We have a net cash surplus of INR 117 crore as on 31st March 2024. Our working capital days have reduced from 14 days on March 2023 to 7 days on March 2024. Our OCF to EBITDA has improved by 3% and stood at 105%, indicating a higher cash conversion cycle. The company has aligned the accounting year of its fourth overseas subsidiaries with the Indian accounting year, with effect from 1st April 2024. Because of this change, the accounting year for the purpose of consolidation will henceforth be 31st March. For the transition year, that is financial year 2023-2024, the accounting impact of this change is an increase in revenue of INR 18.27 crore and PAT by INR 0.4 crore. That's all from my side.
With this, I open the floor for Q&A. Thank you.
Thank you very much. We will now begin the question and answer session. Anyone who wishes to ask question may press star and one on their touchtone telephone. If you wish to remove yourself from question queue, you may press star and two. Participants are requested to use handsets while asking the question. Ladies and gentlemen, we'll wait for the moment while the question queue assembles. The first question is from the line of Anshul Agrawal from Emkay. Please go ahead.
Hi, am I audible?
Yes, you are.
Great, thanks for the opportunity. My first question is on the quantification of any sums that we would be keeping aside for this M&A activity in the next two years.
So currently, we have, I think, approximately INR 120 crores cash on our books, if I'm not mistaken, Rakesh. And, we'll obviously be using this internal accruals, plus, you know, raising debt or, using stock as equity. It's difficult to obviously quantify an amount as of today, because, you know, there are a bunch of things being evaluated. But, you know, my sense is that if we ever do look at raising debt, we would not look at it beyond 2 to maximum 2.5x EBITDA. And if we were to use obviously stock as currency, then, that could potentially play out well as well, if, if the stock price is, you know, valued well for us.
I don't have an exact number for you at this point, because there are many things in the pipeline, but we'll obviously look at each deal from an IRR and a ROE perspective.
Got it. And while you have outlined the strategy behind selecting these M&A targets, would there be any specific region that we would be planning to target?
So, as I mentioned in, you know, we have three strategies for the M&A, and one of them is our geographical expansion strategy, right? Which would be primarily in, we would look at obviously North and East, which are the markets where we would like to expand through a sort of a B2C route. That's one of the opportunities that we're sort of looking at, one of the lens of M&A. But these, as I said, could also be in South and West of India, because, you know, there are still markets in South and West, certain cities in which we may not have a strong B2C brand, and entering those markets may also be useful. So, I would say primarily North and East, but also South and West, for the geographical expansion strategy.
The other two strategies, which are about technical capabilities, which obviously could be anywhere in the location of the country. The third one, which could be, you know, regional player or any other kind of player, could be in any part of the country. Because we are looking at taking businesses which may not be necessarily providing the kind of profit on their own, either because they're subscale or need better management, and picking those up and actually sort of being able to turn them around under our management skills and scaling prospects.
Got it, thanks. My second question is on any indicative broad margin guidance for FY 2026 post our network expansion plans?
So I think we are comfortable with our Q4 margin. You know, we believe that we will, you know, be able to sustain that into the next year, and hopefully try to expand it as the volumes grow and we're able to execute some synergies. You know, so I think, 25.5%-26% margin, give or take, you know, I think is sustainable.
This, this would be reported margins, right?
Actual.
Thank you so much. All the very best.
Thank you. A reminder to all participants, you may press star and one to ask questions. The next question is from the line of Amey Chalke from JM Financial Limited. Please go ahead.
Yeah. Thank you for taking my question. Ma'am, there was a period when nationalized diagnostic chains were being impacted with the politicization of e-commerce players who were cutting into the prices. Now we are seeing the trend reverse, so where most of the nationalized chains or larger chains who are having good physical presence are outgrowing the market. Is this only linked to pricing in your assessment or anything else which is also driving this shift?
Yeah, I think when the health tech firms came in, it was during COVID, or some of them which had started just before COVID, and it was a black swan event that really gave rise to digital usage, which obviously helped people in many industries there. We saw it in med tech, we saw it in food tech, we saw it in many industries, actually . And we saw it in health tech as well. Now, mostly because a lot of the unorganized centers were closed, because they could not operate due to lack of employees, et cetera. And it gave rise to more of this home testing, home collection, especially for COVID. Now, in some industries, obviously, that that trend con- you know, consistently sustained.
But in our industry, once COVID sort of came down, people actually prefer to go into brick-and-mortar labs and actually give the sample. While the home testing, home collection has grown compared to pre-COVID, it has, there is still a minority share compared to more people walking into brick-and-mortar. So pricing was never really the key. Even the, at that time, the health tech firms used convenience as a way to really drive their business. What they used pricing for was for wellness expanding of the wellness market. Because in the wellness market, there's no need, and you're actually doing a push product to create a need of preventive healthcare.
And when they used pricing to create that kind of awareness, as I mentioned, it helped the incumbents a lot because it actually created a new market that didn't exist before, which was of preventive care, which was earlier a very small market. So it has actually been beneficial to the incumbents as well. But that preventive care market, while it's growing fast, is not growing at the pace it was growing in COVID anymore. So I think, you know, for a lot, for the health tech firms, really now the question is about, you know, where should they really play? What is going to be really their unique, you know, what they bring to the table? And I think many of them are figuring out what that means for them.
From our perspective, pricing is never been the most important thing in illness and healthcare. Because at the end of the day, you fall sick once or twice a year. And the more sick you are, the more critical your illness, you're really not looking at who's giving you something INR 50 or INR 100 cheaper. You're looking at who's best in class to get the best diagnosis, usually recommended by your doctor, so you can get treated quickly. I hope I answered your question.
Sure, ma'am. The second question I have is on the expansion side. You have been saying that we are adding around 20, 30 labs over one year. Why not 40 or 50, or why not 10? What, what is it that decides this number? Generally, for businesses, there is a capital limitation to expand or management bandwidth, or maybe a lack of opportunity, or some of them are not ready to take the financial hit. What is it in our case that decides this factor, organically, how much labs we will be adding going ahead? How do we decide?
I'll give you my input, and Suren can come in as well. Look, in my opinion, the only reason there's no... The science behind this number, 20, is that earlier we were till about FY 2019-2020, we were only adding about four to five labs a year. You have to remember, the lab is only a factory which does the testing. The demand generation really happens when you go to the customers, you build collection centers, and you are able to build the demand in those collection centers. The hard part is not in building a lab. Could we set up 100 labs in a year? The answer is yes. The question is: Can you generate demand in all those locations?
Because for an average lab, you need at least 20-30 centers and B2B customers to be able to fill that lab. So really it's about getting the right quality of talent on the front end, training them, and to be able to go and scientifically sell to doctors and generate that demand, you know, and set up those collection centers. Unlike other industries which have ready distribution, whether it's pharma or modern trade, in our industry, we have to set up each distribution point. So it's not like a product that you just push through an existing distribution. So really that's where the time goes, in getting the right talent, training, and setting up the distribution and generating demand. Suren, anything you want to add to that?
No, I think you covered it all, Ameera. I think if at all, I can add one more thing. Look, see, setting up the lab doesn't... I mean, you know, start from the day you start working on the infrastructure of the lab, but it actually starts out more than a year before. You know, we have to enter into a city. We need to familiarize with the Metropolis reports, and we need to get the channels appointed, and then we do start getting some level of customers and revenue from that market. And once the revenue reaches a particular level, that's the time when we start looking at putting up a lab there. So I think the whole process takes a slightly time-consuming, and it's based on analytics.
It's based on a lot of hard efforts, and hence, it may be prudent for us to do it more judiciously and at the right places, you know, and at the right pace.... So like Ameera said, you know, the previous two years, you know, put together, we have set up 30 labs. And last year alone, we set up 24, 25 labs. So we did definitely speeded up the process, and this year again, we are going to put up another 25 labs. So the required speed has almost has been brought in, and once we get this as our norms and, you know, and even if there's an opportunity to get into any other market in the coming years, we will look at it.
But otherwise, we are pretty happy with the current pace and, you know, and also our ability to turn around the new labs into profitable ones in about two years' time.
Sure. Thank you so much. I will join back.
Thank you.
Thank you. A reminder to all participants, you may press star and one to ask question. The next question is from the line of Kunal Randeria from Axis Capital. Please go ahead.
Hi, good morning. So, Ameera, just one of the points you made, you know, that a sick patient definitely looks at quality and not really the price. So, you know, while I completely, I'm with you on that. But on the wellness front, you know, do you think the pricing is a lot more important factor than it is in sickness, and perhaps it's where some of the online guys would have an advantage over traditional players?
Sure. See, on the, on the wellness side, you should remember there is no one kind of customer. There are different kinds of customers, right? If you look at a customer segmentation, you have a more health-conscious customer or a more brand-conscious customer who is more educated and aware. Usually, they will prefer if they're doing a health checkup once a year, you know, and they're gonna spend INR 2,000, they are not thinking, "Oh, let me go and spend only INR 1,200 with somebody new who have not experienced, and take a chance on my health check." Because you have to understand, why are you doing a health check? It's to find something early that you are able to then treat so that it doesn't become a much bigger issue.
So there is a large amount of trust that is required, whether it is in illness or whether it is in wellness. But in wellness, because the doctor is not involved, consumers can be a varied variety. So the health-conscious, educated customer will still choose a brand which they are trusting. A slightly less aware customer may say that, "Look, let me go on price." That might be their perception. And those people, those customers who have a wrong perception that all results are the same, may go for a lower price, and choose somebody who's sort of giving a more discounted price, right? But finally, the question is that if it's being done at a discounted price, is there a structural cost advantage that health tech players have? And the answer is no.
Actually, there is nothing differently being done that makes it cheaper. Only probably the levels of quality control and quality will be different between you know, the top incumbents and maybe some of the health tech players. Now, there's no structural cost advantage in actually doing it the way they are doing it, and therefore, it is about burning cash in the short term to acquire customers and then hoping that those customers will come to you again and again, or hoping that those customers will convert to illness, and that's how you'll recover your money. So I think it's more of a difference in business model than I think it is really a structural cost advantage that they have.
Sure. Just taking forward from there, does your B2B business include some business from the online players?
I'm sorry, I couldn't hear you.
So sorry. I meant, you know, does your B2B business include the business from online players? And they, they may, you know, generated on the website, but you would be maybe, you know, your lab would be analyzing the sample.
Yeah. So the B2B business includes some of the online players and aggregators, but that contribution is very, very low for us, you know. It's largely through the B2B labs and hospitals, you know, that we generate revenue on B2B segment.
Sure, sure. And just one more question, if I can. So just taking forward the discussion on lab expansion. So I think in the previous quarter, you had shared that, you know, you've added somewhere, I think, 50 labs in the last 3 years, and these too act as a dilution to your EBITDA margins. It's around 100-120 basis points, right? So the fact that you are going to, you know, add more labs in future, you know, does your sort of guidance take these expansion plans for the next 2-3 years?
Yeah. So, like I mentioned in the last year, you know, the 24 labs that we added at a EBITDA dilution of roughly 1%, right? And the next one year also, we will add another 25 labs, and we will have an equal amount of dilution of the EBITDA of 1%. But the guidance that we have said, 24- 25.5- 26%, is already considering that, you know, lab addition related dilution. So that's how it's going to be. Maybe after full year 2025 and beyond that, and I think our lab addition may not be at this pace, you know, and hence, you know, we will be able to see little more expansion of the margins, you know, beyond the full year 2025.
Sure. But any maybe indicative number you can give at beyond 2025, how many you plan to add, and what part of the country you're targeting?
We will be adding around, you know, maybe 6, 7, 8 labs beyond 2025, you know, and we will go to specific markets that we want to penetrate further. And, you know, this number could be definitely well under 10. So that's our current estimate.
Got it. Got it. And sorry, just one more, if I can. Ameera, Mumbai is the biggest market, yet your revenue has been growing in double digits. Just want to understand what has been driving it. Are you adding more centers or is it, you know, more package stats? How is it and what should we expect going forward?
Let me, let me answer this, you know, for you. Basically three things, you know. One is our distribution expansion in Mumbai continues, right? And we are expanding enough number of, you know, the service centers and collection centers in Mumbai, and we still see there's a good opportunity going forward, and we'll also get into the peripheries of Mumbai, Mumbai. And we believe that, you know, we could rather set up a collection center for every 2.5-3 km in Mumbai. So we really clearly see an opportunity to further expand in Mumbai, and that will continue. And the second one is, of course, you know, we are—our specialty business.
You know, Mumbai has got all the top hospitals in the country, and hence, you know, our engagement with the doctors in the top hospitals is getting amplified. And, you know, we are trying to, you know, expand our business on the B2B segment also here. So, and also the third thing is our existing centers. You know, we are not allowing the productivity of the existing centers to drop any, despite the increase in, you know, the number of centers that we are adding. So we have a very, very clear and dedicated focus on expanding the productivity of the existing centers. So a combination of these three things is what is actually driving our volumes in Mumbai. Hello?
Sorry. Yeah, sorry, I was on mute. So, can you remind us how many centers you have in Mumbai, and how many you plan to add in the next 2-3 years?
Mumbai, we have about 400- 30- 430 centers we have in Mumbai, and we want to take this number to 500+, in the coming year or so.
Perfect. Thank you very much, and all the best.
Thank you.
Thank you. A reminder to all participants, you may press star and one to ask questions. The next question is from the line of Shyam Srinivasan from Goldman Sachs. Please go ahead.
Yeah, good morning, and thank you for taking my question. Just the first one is, Ameera, on the opening remarks, you talked about the two kinds of competition. I'm just more interested in the hospital-based competition, right? So if you could elaborate, I think you made two points, but just elaborate. One was on B2B, and the other one was the dissonance between pricing of hospital labs versus outside, inside and outside. So if you could just clarify on those two points or elaborate on that, please. Thank you.
Sure. So if you see today as a customer, if you walk into a top sort of 20, 30 hospital, you'll find the prices of pathology tests inside these hospitals is significantly higher. You can say 50%-100% higher, compared to, let's say, Metropolis or other incumbent prices outside. So there is a much higher pricing when you actually go to the hospital and do these tests. So when hospitals go outside to consumers, some cases they are choosing to have a lower pricing when they go to consumers outside. But that, as you can understand, creates a dissonance for customers and for consumers, right? Because there's no logic why or there's limited logic why the pricing is so different inside and outside the hospital.
And that actually limits the hospital's ability to actually control the pricing outside, because they already have a very high pricing inside the hospital. So that becomes one structural problem and one fundamental issue for hospitals. The second issue for hospitals that I mentioned was that you have to remember that hospitals' business is about bringing patients to the hospital and then doing everything under the aegis of the hospital, right? But so there are doctors which are sitting outside of this. If a gynecologist sitting outside the hospital and that gynecologist refers that patient to the hospital, the worry will always be that, listen, will the patient then go to a gynecologist inside the hospital?
And therefore, you know, there is sometimes there tends to be a, a concern for doctors outside the hospital to refer those patients to the hospital or to the hospital collection center. So these are the two structural issues that hospitals may face, and in the B2C side of the business. And therefore, I was saying that, you know, many of them have focused much more on the B2B side of the business. And either they are going to small hospitals, nursing homes, where they're doing INR 5 lakh business, INR 10 lakh business of pathology per month and trying to do management contracts for these small hospitals, which we find in our experience tends to be a very, very poor margin and poor receivables.
Therefore, we don't do that business much at all, or it tends to be on the B2B side, you know, where you're going to the customers, which are on the tail end. Because if hospitals go to the other top hospitals and say: "You give me your business," there's a competition there, so that doesn't happen. So they have to go to the labs, which are the unorganized sector, to say that, "Look, why don't you outsource a thyroid or a vitamin D, like a more common test to me?" And that tends to be more price sensitive. So these are some of the sort of challenges that come up in the B2C and the B2B side for any player.
Yeah, Ameera, just harping on this again. So when Apollo Diagnostics, which is the chain outside the hospital, puts up, like, an INR 500 crore revenue number for, say, fiscal in a 12-month basis, you would imagine this is also probably cannibalizing their own in-patients? I'm just trying to understand, or it's largely led on B2B. That's the color I'm unable to understand.
So I, I would not like to comment on any individual player, but what I can share with you is that a lot of the players, some of the business comes from their own hospitals. Some of their business comes from other ventures that they have in healthcare. Potentially, there are people who are doing multiple things in healthcare. So it comes from you know, their own, sort of service facilities. Some of it may come from an online digital, and a large amount of it will come from B2B and HLM contracts. So when you set up these collection centers, for example, Metropolis reports separate B2C revenues and B2B. But most players, what they do is they report generalized revenue.
Therefore, whether a patient is walking into a center, a collection center, or whether that collection center is picking up a sample from B2B, is not necessarily, fully, clear. Therefore, there is no data that you may get, but from the ground, we are aware that a lot of this tends to be, B2B.
Got it. Helpful. Just the second question is on the outlook for fiscal 2025. While we talked about margin guidance, you know, trying to sustain at fourth quarter levels, what's our outlook on revenue for fiscal 2025? And how we could likely split this between volume and price or ASP? Thanks.
So, Suren, you want to take that?
Yeah. See, we have delivered, you know, 13.3% year-on-year growth during the last year. We're really looking forward to taking this further beyond this number, and definitely looking forward for mid-teen kind of a growth in the year, you know, full year 2025. The volumes, I mean, the split could be maybe the, again, the volume is 8%-9%, and, you know, 5%-6% may be coming from the, you know, the realization. That could be the split.
This includes the 3% increase we took in January, and there is also a mix change towards... I'm just trying to see where the 5% comes from, 5% or 6%.
Yeah, it's a, it's a combination of both the mix change as well as the price increase that we have taken.
That's helpful. My last question, just bookkeeping one. When I look at slide 17, last column, we have the 15-month data. We also have fiscal 2024, few columns before, which is the one which doesn't include 15-month. So when we talk about flat margins, I'm unable to understand. It should be actually 25.5, right? When we look at guidance for fiscal 2025.
Yeah. So we are saying 25.5 is the actual margin, and when we add up just these four entities for quarter four, for additional three months, the margin will be, the reported EBITDA goes up from 25.5 to 25.6, because this, this entity has just reported a bit higher margin in January to March. So, the guidance is on 25.5% only.
Got it. Yeah, helpful. Thank you, and all the best.
Thank you.
Thank you. A reminder to all participants, you may press star and one to ask questions. The next question is from the line of Prakash Kapadia from Spark PMS. Please go ahead.
Yeah, thanks for the opportunity. I have two questions. You know, if I look at the debtor days, they are still at around 30 days, so how much can they reduce in the coming year? And secondly, if I look at, you know, the premium wellness segment, it's steadily growing for us and is now almost 15% of sales. So what is driving this? Is it self-awareness? Is it doctor advocacy? And if you could, you know, comment on the ARPU in this segment, is it top five, 10 cities, or is it beyond that? And, you know, some color will be helpful.
Yeah. So I will take the debtors thing and then hand over to Suren for the next question. So, debtors, we have been maintaining and reducing substantially in last three, four years. If you see, we were at around 46, 47 days, and now it is coming down to 30 days. Definitely, it's also a combination of, you know, your cash and credit business. So now, going forward this year, we are planning to reduce it at least by 20%. So we will be, you know, aiming to come down to 24-25 days of debtors, if you, you know, as per the target we internally taken, and then keep improving it, you know, year-on-year basis.
So that is definitely there is a lot of focus is there, and 31 days last year has come down to 30 days, and we should move around 25 days next year. I'm just handing over Suren to answer the next question.
See, on the wellness expansion, you know, basically there are the two ways of looking at it. One is definitely the external reasons, which is one, the consumer awareness, the increasing consumer awareness, wanting to get his health checkups done on time, et cetera. And also, a lot of awareness being created by the health tech players in the past, by huge advertisements and, you know, the price, et cetera. And hence, now more and more people are coming to the banner of, you know, getting the wellness check done on a regular basis, you know, then we are getting the advantage of that both. And internally, if you ask me, there are two or three things that we definitely do. One is the upsell at our centers.
You know, when a patient walks into a center, even with an illness, our ability to, you know, upsell a full panel or maybe a wellness package, you know, at every center that we operate, you know, it's getting increasingly better. You know, so that's one place where we definitely are able to increase the wellness volumes. And second is our digital initiatives, you know, our website, our app, et cetera, where we... And the way we reach out in the social media. So that's definitely able to get some traction on the wellness. Third thing is our own customer base. You know, we have now a good, you know, marketing CRM available with us.
Our ability to reach back to the customers on a lifecycle management, reminding them on time about their next wellness check, checkup, and on the base of certain illness patterns, advising them about the best packages and the best panels. So all this is helping us. There's a combination of all- both these external, internal activities, actions that we take put together, is taking the wellness revenues, which has grown 22% last quarter and the last year. And we see that, you know, this can be further expanded in the days to come.
And, you know, is it top city-centric? If you could give some insights into, you know, what has been the realization or the ARPU per patient in this segment for us, and what are we looking at?
Yeah. So definitely the big city, the top four, five cities, you know, the wellness growth is much better. If you ask me, Mumbai, Chennai, Bangalore, et cetera, you know, Pune, et cetera, the wellness growth is relatively higher. But definitely the next set of cities also picking up. As we said, for the reasons I mentioned it to you, the wellness growth is picking up in the - the base is relatively smaller in some of these cities, but the growth rates are much better, right? So the wellness - overall, the wellness awareness is definitely picking up, tier one, tier two cities, and we are able to see the traction. And the average revenue on the wellness package is about INR 2,400.
2,400, we are able to see INR 200-INR 300 rupees of growth over the last two quarters before versus now, because of the realignment and the restructuring of the packages that we have done in the month of November, December.
Fine. Fine. Understood. That was helpful. Thank you.
Thank you.
Thank you. The next question is from the line of Aashita Jain, from Nuvama Institutional Equities. Please go ahead.
Hi, good morning. Congratulations on the good set of numbers. My f- my... I have one question on the volume growth. I think this quarter we reported 7% patient growth, versus high single digits that we usually report in last four, three, four quarters. Just wanted to understand, could there be an impact of pricing fees taken in B2C? Are you seeing any impact, in those markets? Or this is just a seasonal phenomenon, and this should phase out as we expand, going forward?
Yeah, that's right. You know, we have seen in our non-core markets, you know, we have seen slight softness on the volumes after the, you know, the price increases. Immediately after the price increases have been done, maybe the first quarter. And then we are also now seeing that is getting stabilized, and, you know, we are trying to see, we are seeing this is coming back to the normalcy. And also, we have done some few corrections in some of the markets. We found that, you know, the impact was relatively higher. So but overall, there is some softness in some of the non-core markets as a result of the pricing.
Like any industry, if you have seen that whenever there's a price increase happen, there's a little bit of hit on the volumes, but then it stabilizes maybe in one quarter or two quarter. And we, we have clearly seen that maybe by the end of quarter two, the volumes will come back to our earlier levels for sure.
Okay, this is helpful. Thank you so much.
Thank you.
Thank you. The next question is from the line of Tushar Manudhane from Motilal Oswal Financial Services. Please go ahead.
Yeah, thanks for the opportunity. Just on this core business slide, as I see, the number of patients visit and the number of tests has increased at a similar rate in FY 2024, and effectively, let's say, test per patient is largely stable at two. But at the same time, there has been good increase in B2C or let's say the preventive healthcare space, where typically the number of tests taken by patient is higher. Some disconnect here, or am I missing in terms of understanding this?
You know, I'm not sure whether I really got the question right, but, you know, revenue per patients on the B2C has gone up higher because-
No, no, not revenue per patient. I meant tests per patient.
Tests per patient. You know, I think it's 7% only, right?
Right.
7... 7.8%- 7.8% is the test per patient volume growth.
Tests per patient is almost two for FY 2024 as well as FY 2023. Both number of tests as well as number of patient visits have increased at a similar rate of 8.8% for core business.
Yeah, let me comment on this. See, one of the things is that when we declare our test volumes, and for example, we declare a wellness profile as one test, not as if even if it has 10 tests inside it, we declare it as one test.
So as there is a movement of some patients upselling and bundling the packages, even though the number of tests are increasing, you are not necessarily seeing that reflecting in the test per patient right. Now, going forward into FY 2025, we are planning to change the way we are presenting that, and we are trying to recalibrate the numbers, where we are able to give the real test volume, including the breakup within the wellness packages. So just bear with us, and hopefully in a quarter or so, we should be able to align that for you.
That, that's really helpful. And just secondly, maybe in FY 2024, some amount of price increase was actually with respect to reduction in the discount per se. So is there any further scope to reduce the discount? And if you could elaborate on in terms of pricing separately on routine tests, on premium wellness and specialized tests, that would be helpful.
See, I don't think discount is going to change much. It didn't change much from last two years. There was a slight decrease in the discount. And I think what we were referring to is that basically we have seen a marginal decrease, which means that the competitive intensity has sort of stabilized, right? Because the discount is not going up, but it's actually stable and marginally sort of coming down. So there's not too much of a difference that really is going to attribute any benefit in it. As far as the price increase on the different segments, you know, the way the price increases are done, you know, is obviously done across the, across the spectrum. But we look at sort of, you know, competition prices, local and national.
We also look at our cost base, and that's how we do it. I don't think we have a breakup of the price increase across the segments, but largely it would be pretty similar, you know, across the segments. I don't think you'll find too much of a difference. But probably you will find a higher price increase for routine, because you get B2C through that, and some increase on specialized. You'll probably find a lesser price increase on semi-specialized as a segment, because that area tends to come a little bit more from B2B, which tends to be a little bit more price-sensitive.
Understood. And just to connect this, on the final aspect in the sense, so effectively, the cost per test also then, does it remain more or less stable, irrespective of whether it is routine, specialized or premium wellness, and so effectively that converts to better profitability?
No, I mean, your cost per test is different for every test, right? So, for example, your gross margins on routine tend to be higher, but your gross margins on specialized tend to be lower, even though, you may find a different result on a net margin basis. Because your material cost is only, obviously, only one cost. Your servicing cost, your production cost is also additional. So generally we find that, the specialty segment tends to be, a fairly profitable net margin segment, and that's one of the reasons why Metropolis' strategy is focused on B2C, because that channel tends to give you better profitability. Doesn't matter which test comes through that channel.
Specialty as a segment, again, doesn't matter which channel it comes through, but specialty as a segment, we find tends to give us a better profitability. Obviously there is a stronger moat for the business because very few people are able to actually compete in this segment and provide the kind of quality of results that we do.
Understood. That's helpful. That's it from my side. Thank you.
Thank you. The next question is from the line of Bino from Elara Capital. Please go ahead.
Hi, good morning. Just a clarification on an earlier question regarding guidance. So, when you say mid-teen growth, last year on the base, we had some non-core businesses because of which the reported growth was lower, but the core growth, like you said, was 13, 13.3%. So when we look at FY 2025, are all the non-core businesses out of the base on, in FY 2024? So will the reported growth be in the mid-teen range, or will there be some adjustment still to be made?
Yes, you are right. In fact, from this quarter onwards, the reported revenue is equal to core revenue is equal to the group revenue. So there's only, you know, everything is same for this year. The guidance we have provided is, for the reported revenues.
What Suren mentioned, what Suren mentioned is that the growth, which was 13.3% from a core basis last year, can go up to mid-teen, so the re-guidance could be 13%-15%, would be sort of the guidance that we would provide for FY 2025.
Perfect. Thank you. Thank you very much for the clarification.
Thank you. As that was the last question for the day, I now hand the conference over to the management for closing comments. Over to you.
Thank you, everybody, for joining us today and being part of us with, you know, in this quarter and in this journey. It's been a very, you know, interesting and exciting year for Metropolis. We've done lots of changes, from the technology side, lots of rollouts, including obviously a price change, including some leadership and management changes. I think despite all these changes, which obviously sometimes cause some flux within the business, we've managed to really demonstrate a great set of results, a strong volume growth, ability to be able to take price increases, and ability to be able to really navigate our expansion, despite all of the changes. I think we are very excited about FY 2025 as well.
We feel confident of our team, we feel confident of our aggression on the ground, and we've really put in a lot of the ingredients this last year on the revenue side as well as on the cost side, to be able to really demonstrate a good set of results next year. Our focus is also going to move to not only the financials, but also really focusing on the sustainability of the business, the governance of the business, and really ensuring our processes and systems only get tighter as we move along.
So very excited about next year, and we believe that the industry has, like we said, settled down, and it gives us the right platform to continue to be able to execute really well, and be able to, you know, create more value for all the shareholders. Thank you so much. Suren, is there anything you would like to add?
No, that's good enough, Ameera, and thank you, everyone.
Thank you. On behalf of JM Financial Limited, that concludes this conference. Thank you for joining us, and you may now disconnect your lines. Thank you.