Ladies and gentlemen, good day and welcome to the Q3 FY23 earnings conference call of Metropolis Healthcare Limited. This conference call may contain forward-looking statements about the company, which are based on the beliefs, opinions, and expectations of the company as of the date of this call. These statements are not the guarantees of future performance and 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 and zero on your touch-tone phone. Please note that this conference is being recorded. I now hand the conference over to Ms. Cinderella Carvalho from JM Financial. Thank you, and over to you, ma'am.
Thanks, Ruthuja. Good morning, everyone. On behalf of JM Financial, I, Cinderella Carvalho, welcome you all on the Q3 FY23 earnings conference call of Metropolis Healthcare Limited. At the outset, I thank the management for giving us the opportunity to host this call. Today, from the management team, we have with us Ms. Ameera Shah, MD, Mr. Surendran, CEO, Mr. Rakesh Agarwal, CFO, Mr. Sriram Iyer, CRO. With this, now I hand over the call to Ameera for the opening remarks.
Hi, good morning, everyone, and thank you for joining us for the Q3 FY23 earnings call. As Cinderella mentioned, I'm joined by our newly appointed CEO, Mr. Surendran Chemmenkotil, Mr. Rakesh Agarwal, who's our CFO, and Mr. Sriram, who's the Chief Revenue Officer and SGR IR Advisor. We've uploaded our presentations on Q3 and the press release on the stock exchange and the company site, and I hope everyone's had a chance to go through the same. While the diagnostics industry is starting to see normalized growth as we are moving away from the COVID days, due to intense competitive activity, the growth is getting split amongst many players. The large pile of unorganized market continues to lose its market share, and increasingly, customers are preferring organized players for accurate results, faster TAT, and most importantly, outcomes which are accepted by the medical fraternity.
It is the trust of doctors and consumers which is becoming a key factor for selection of labs, much more than just the price point, especially when people are unwell. Convenience, use of technology, and brand premium built by the larger credible players over decades are being preferred over standalone labs, and trust and medical expertise and large test menu of the credible larger players are winning over health tech players and aggregators as well. Metropolis has witnessed consistent low-teens to mid-teens growth of non-COVID revenues for the last four quarters, not only by continuing to be very respected by doctors across the country, but also by introducing technology and consumer connect that makes life easier for our consumers. In Q3, we have seen mid-teens growth in our core diagnostics business, excluding Hitech and government contracts.
So we've seen approximately 13% if we look at our core diagnostics business, like I mentioned, excluding High-tech and excluding government contracts. Of this growth, 10% comes from a healthy volume growth, and 3% comes from an improvement in revenue per patient. What's working for us is growth of our specialized tests, and over the last few quarters, we have started to make inroads in the premium wellness category with wellness plans. Tru Health with revenue contribution from wellness has increased to 13% contribution in Q3 FY23 compared to 10% in Q3 FY22. The wellness segment has grown over 30% in this quarter on a YOY basis. Some of this has happened by introducing our existing customers to a more holistic checkup, which gives them more information about their body, and some of it from new customers coming into the Metropolis ecosystem.
Our wellness does not use price as a USP like many players in the industry, but the brand promise of better content that you can use to improve your health, the trust that the results are accurate, and the ease to engage with Metropolis with the click of a button. Our average realization for these premium wellness packages is approximately INR 2,000 plus, and these tests are margin-accretive wellness packages. In Metropolis 3.0, we continue to focus on growing our wellness business, and our target is to take our contribution from wellness to closer to 20% in the near future. Let me spend some time now on the competitive intensity in the industry. While the barriers to entry are low in our industry, and therefore we see many new players entering, the real challenge is the barrier to scale following good governance and building a profitable, sustainable business.
The competition currently is of two kinds. One is from healthcare players focusing on preventive care as the focus area to acquire new consumers when they are not sick. USP here tends to be mostly price, which gives them some momentum when they burn large amounts of cash, but the business itself doesn't always have strong unit economics. As servicing cost is the largest cost in the P&L in a pathology company, it becomes very difficult to become profitable in this business with high discounted volume growth as the cost of servicing is only increasing. Customers who may use health tech players when they are being pushed a very low-cost wellness package are not always returning to the same health tech platform when they are actually ill as their doctors are not accepting their reports of these health tech entrants.
The health tech entrants also have a hope that customers who are buying e-pharmacy will also buy e-diagnostics. Currently, the cross-sell rate of e-pharmacy to e-diagnostics is less than 5% across the industry. As funding gets harder for these players, we have seen the growth in monthly active users reduce for most of these players, and conversion of e-pharmacy to e-diagnostics is a declining trend. While their growth has been spurred by customers giving more by price for non-critical tests, the players who are getting most hit are the unorganized players who have seen a much larger hit than organized larger players.
Even though these firms, the health tech firms, started off with a D2C focus direct to consumer, since the revenues from D2C digital have not been growing, and they are now not seeing a large opportunity there post-COVID, the majority have changed focus to now focusing on the semi-specialized B2B business across India, via brick-and-mortar franchisees, again using price as the key USP. This is mostly hitting.
Hi, thank you, ma'am.
Yes?
Your voice is sounding a little muffled, ma'am. Can you please check?
Is that better?
Can you speak something again?
Is that better? Yeah?
Yes. Yes. Please go ahead.
All right. Thank you.
Thank you very much.
I'll just repeat the last sentence again. Since the health tech platform was focusing originally on D2C, and they were focusing really on getting consumers to show well, but these revenues are not growing, and because they are not seeing a large opportunity there, most of them have now changed their focus to the semi-specialized B2B business across India, via brick-and-mortar franchisees, using price as the key USP. This is mostly hitting lab companies who had also built their business on low price for semi-specialized tests as their main advantage. The second type of new competition is coming largely from hospitals and pharma companies or pharmacy chains.
Here, the idea is to build a large cluster of labs and a large number of franchise collection centers and focus on D2C and D2B business by getting doctors to recommend patients and business from unorganized lab customers for semi-specialized and specialized test category, which is D2B. Again, price has been used as the main USP for doing this business. While the B2C is showing very low traction for these new entrants. Therefore all are focusing on B2B. At the current price point being sold at, while many may never make money, in the best-case scenario, even with people's volume increasing, unit economics may be a challenge over a 5-10-year period for these new entrants.
While this competition is putting a lot of pressure on the entire market, we are seeing that while B2B lab customers value price, they also value strong logistics, sales teams, technology, quality of reports, connect with doctors, and good support and large lab infrastructure from new and old companies. And this is what is actually making it harder for the new lab companies to scale. What attracted most of these competitors to this market is the attractive financial metrics of low capital and high return. But the way the business is being built by most in an urgency to scale is low capital and low return. While the investor worries that this pricing pressure will cause low growth and low revenue growth and margin pressure, and we are seeing B2B businesses facing some pricing pressure and pressure on sales talent.
Since Metropolis business was never built on price as the USP, our customer loss is less because of mostly price and is more linked to our execution of services. With working towards excellence in these services, we are confident that incumbents like Metropolis, who have built a moat using scientific expertise and strong brand connect with B2B and doctors and consumers, will not only be able to withstand the onslaught of competition and the human capital and pricing pressure it brings, but be able to grow the core diagnostics business well and make good returns. As a part of our Metropolis 3.0 strategy, we have been focusing on the consumer as much as we focus on the doctor segment.
We have been taking multiple initiatives like health camps in large societies and catchment areas, educating consumers with health information and tools that will help them make better decisions for themselves and turn to Metropolis for the same. Targeting our existing large pool of chronic customers for regular testing with app-based notifications, test comparison and trends, and suggestive corrective action is definitely helping us. We have been using a lot of digital technology tools to curate the testing requirements based on lifestyle, age, gender to engage with existing customers to have more repeat testing on a regular basis. As we have launched phase two of our app, we are hopeful to offer better technology and engagement for existing and new consumers.
This has helped us to foray into the premium wellness categories with a more sticky consumer base, and as a result, we've been able to increase our wellness proportion from 10%-13% in Q3 FY23. We've also seen increase in web traffic, app download, and increased communication with consumers via digital platforms like WhatsApp. While we are seeing a double-digit growth on the B2C front, if we look deeper, growth is better on the brick-and-mortar side and lesser on the lab at home services. While home services have definitely increased during COVID, this has sustained more on the wellness side post-COVID and less on the illness side. This gives us confidence on our strategy of network expansion as a strong pillar approach for Metropolis 3.0.
We are not only entering the market in tier two and three towns, but we are also going deeper in our existing core markets to increase market share. In terms of network expansion, we added 12 labs and approximately 400 centers in the nine months of this year. Of these 12 labs, five labs have been added in the North and East region, four in the West, two in Central India, and one lab in the international geography. Of the 400 collection centers, 65% have been added in the West region, especially in our focus cities, thus increasing the depth of our penetration in our core geography. This will help us increase our market share in our core markets. We will stick to our target of adding 90 labs and 1,800 centers by 2025.
Moving on to the Hitech acquisition, it has now been a year of Hitech part of the Metropolis family. While the acquisition mostly brought what we expected, we did have some bumps along the way due to unethical behavior by competitors and lack of a proper transition. We, however, stabilized the situation on our own and transitioned the business from being run as an unorganized lab to now a corporate entity with a strong management team, good governance, and proper practices. Hitech revenues have grown by approximately 20% for Q3 FY23. However, it is worth highlighting that the revenues for the last quarter had 22 days less since the acquisition took place on 22nd October 2021. In labs outside Chennai, we have merged the Metropolis and Hitech labs, thus giving us synergies and cost efficiencies in those markets.
In Chennai, we are continuing with the Hitech brand separately from listed Metropolis, which, Hitech, is more of a value-conscious brand, and Metropolis is known more for premium and specialized tests, thus avoiding cannibalization of revenues in the Chennai market. Hitech continues to have a margin profile at EBITDA levels similar to MHL to Metropolis. We have two updates on our PPP business. In Delhi, which is a large and growing market for us, we have recently won a PPP contract, thus making deeper inroads in our non-core geography. We will be partnering with the Delhi government, with the Mohalla Clinics in Delhi, to deliver good quality test reports to unaffording patients. While we normally don't grow via PPP routes, this PPP was based on appropriate quality parameters and we expect it to be margin accretive.
We would also like to inform you that one of the PPP contracts which had a five-year term is coming to an end in Q4. The government has insourced most of this testing and may outsource only some of the volume in the coming year via the new tender. This will have some impact on our revenues from PPP starting in Q4 this year and will continue to grow our core diagnostics business as aggressively as we can to cover up for this. I would now like to introduce Surendran, CEO for Metropolis Healthcare, who has recently joined us on 2nd January 2023. Surendran is a veteran in the consumer-facing industry. He has over 34 years of experience across sectors and has worked with companies like Xerox and Bharti Airtel.
Immediately before joining MHL, Surendran was the MD and CEO for Airtel Networks Nigeria for a year and a half, which is the biggest circle for Airtel in the entire group. The balance of 32 years of experience has been India-focused, and he has worked in most markets across the country. Although Surendran is not from a healthcare background, we see this as a positive, as Metropolis is embarking on the journey of building its B2C business, but it's very important for the CEO to understand the consumer mindset, strengthen the brand equity, and capture the mind share of consumers. Surendran not only has been a veteran in consumer businesses but understands the sales and operating nuances of these businesses well. We believe his rigorous execution skills, keen ability to build strong teams, and consumer focus will be critical in building Metropolis 3.0 as a strong and preferred consumer brand.
The combination of his skills and my 21 years in diagnostics will together help us build a second engine of growth for Metropolis. I now hand over the call to Surendran for some brief comments.
Thank you, Ameera, for your kind words, and good morning, everyone on the call. I'm extremely happy to be associated with Metropolis, a preferred name in the diagnostic industry with high ethical values, capabilities, and leadership positions across geographies. In my last 40 days since I've joined, I've seen a company that has a strong value system and good governance and the right ingredients for further success. I'm hopeful for the strengthening of Metropolis's brand and increasing rigor of execution to make Metropolis grow even faster while continuing to focus on profitable revenue growth. I would be delighted to interact with all stakeholders in the future. I now hand it over to Sriram, who is our Chief Revenue Officer, to brief you on the updates and developments on the B2C and D2C strategy integrated with technology. Thank you.
Yeah, thank you, Surendran, and a very good morning to everyone. This is my first interaction with you, and I would like to briefly talk about our B2C, D2C, and the digital strategies as part of our overall Metropolis 3.0 strategy to strengthen our business and brand equity. On the B2C strategy, we have been focusing on going deeper into our focus cities by identifying micro-markets in each focus city and building depth via adding more collection centers and doing doctor and retail activities. We also found new clusters in our focus cities to go into, which have widened our catchment area under our coverage. More than 50% of our collection centers this year have been built in our focus cities, and this has resulted in more than 15% growth in B2C in quarter three and 21% B2C growth in nine months YTD this year.
On the other hand, we have been targeting key markets in Delhi, Punjab, and West Bengal in our non-core geography to cover the length of the country to build our brand across regions where we are challengers and to keep increasing the market share compared to our core geographies. As mentioned, Ameera, we have started 12 labs this year, out of which five are in North and five are in North and East, four are in West, and two are in Central India, and one is in international geography. On the B2C front, we have been increasing our engagement with the doctors and based on a scientific approach to educate them on the new testing capabilities for accurate diagnostics and for better treatment advice.
We have also been investing in building and training the team at the back in terms of laboratory internal doctors and research teams to recommend better tests, especially on the wellness and bundle testing, hence increasing our consumer connect for sticky business. On the D2C strategy, we have been engaging in micro-catchment areas and have been doing 400-500 health camps a month for increased awareness on the health checkup and maintaining a healthy lifestyle. On the digital strategy, we have revamped our website and search pages based on the search engine optimization activities for the top searches for diagnostic testing, and hence this has rerouted a healthy organic traffic on our website, which has increased by 25% for non-COVID compared to two quarters earlier.
We have also been working on user interface and have optimized the content for better customer understanding and a simplified and seamless booking experience. We have also integrated personalized tests for every health condition, and this has all been done in tandem with a team of doctors with a scientific approach, thus enabling us to target the right set of patients. The data analytics provided by our digital backend infrastructure is also utilized for customer segmentation to target the chronic testing patients with appropriate notification at the right time and providing insight for channelizing customer campaigns of better footfalls. This has definitely helped us build higher stickiness. Initial results of our data mining tools are encouraging as our customer conversions and repeat rate have improved in quarter three by 16% versus quarter two on a contactable base.
We have also launched WhatsApp bot for all our patients with easy access to download reports, book tests, and find centers. We are receiving a very good response from our bot, and our patients are happy to engage on WhatsApp. We are targeting a two-way growth and engagement via WhatsApp and improved self-service levels, which will over time reduce customer service costs. Our app downloads have almost doubled in the last six months, and so have our monthly active users. All these activities help us engage digitally to create an additional funnel of B2C and D2C customers as part of the overall Metropolis 3.0 strategy. With the existing brand equity and more engagement with the doctors and customers over digital forms and with active marketing tools, we are hopeful of increasing our B2C and D2C revenue with the far more sticky consumer base.
We are continuously working on increasing our revenues through digital medium and alongside making our backend systems stronger for better processes and controls for the future-ready technology. This is all for now. I hand over the call to Rakesh Agarwal, CFO for Metropolis Healthcare, for the operational and financial updates.
Yeah, thank you, Sriram, and good morning to everyone. To begin with, let me give you an update on the income tax search, which was conducted in the month of November 2022 at Metropolis. There have been eight searches done in healthcare in the last nine months, including large hospital chains, well-respected pharma companies, and diagnostic firms. In many ways, this was a one-shot audit done on all parts of the business, and we are happy to report that no unaccounted assets were found at any of the Metropolis offices. We have been a highly compliant company and follow the best practices across the organization as per the applicable law. But as a philosophy, we believe it's important to see any event as a learning situation, and any concerns raised by the department have been addressed by us internally.
We have submitted all the necessary documents to the income tax department, and no tax demand has come at this time. The tax assessment will be done in the next 12 to 18 months' time. We envisage no material outcome on account of this search on the financials of the company. I will now take you through a few key highlights for this quarter and nine-month financial year ending 2023. Non-COVID growth for Metropolis, that is, the core growth for our business, excluding the PPP contract, and Hitech is 13% for Q3 financial year 2023 and 15% for nine-month financial year 2023 on a YOY basis. This is a testimony of the strength of our business and brand build over the years for diagnostic testing.
Of the above growth of 13%, 10% is volume-led, and 3% is increase in revenue per patient, showing our ability to sustain the prices in the markets we are present. Henceforth, I will call out the numbers which include the High-tech for easy understanding. Our B2C business has been growing at 15% for Q3 financial year 2023 and 21% for nine-month financial year 2023 on a YOY basis, indicating our strong doctor and consumer connect across markets. Our B2C business for the focus cities has grown by 16% for Q3 financial year 2023 on a YOY basis, with Mumbai and Pune showing strong growth. We have not only seen high growth in our core geographies, but our non-core geographies also have seen a good increase.
Our investment in non-core but very important markets in the northeast combined has shown the business growing by 29% for Q3 financial year 2023 on a YOY basis. Lastly, along with the revenue growth, we have been able to maintain our margins. Our operating EBITDA for labs started before April 2021, stands at 28.3% for Q3 financial year 2023 before CSR and ESOP. The difference of 120 basis points in EBITDA before CSR and ESOP is on account of our investment in our new labs and network expansion strategy to fuel the future growth. This new lab contributed 3% of revenue in Q3 financial year 2023, and the share of revenue should increase going forward as they advance towards maturity stage. Let me talk about the key performance metrics and operational numbers.
The revenue share of the B2C business for focus cities stood at 60% in nine-month financial year 2023, which stick to our target of 65% contribution from B2C focus market in the short term and midterm. Our B2C revenue for Q3 financial year 2023 grew by 15%, and for nine-month financial year 2023, it grew by 21%. Our B2C revenue in focus cities grew by 16% in Q3 financial year 2023 and 25% in nine-month financial year 2023. Our specialized and premium wellness segment are the fastest-growing segment. Revenue contribution for specialized tests, excluding COVID and allied tests, stood at 39% for Q3 financial year 2023, as compared to 36% in Q3 financial year 2022. Contribution of revenue from wellness has increased from 10% in last year 2022 Q3 to 13% in Q3 financial year 2023, with a growth of 30% on a YOY basis.
Number of tests has increased by 13.5% in Q3 financial year 2023 on a YOY basis, and number of patients has increased by 15.7%. Our revenue per test and revenue per patient has increased by 5.6% and 3.6% respectively for Q3 financial year 2023 on a YOY basis. Our revenue contribution among focus cities and other cities stood as follows. Focus cities contributed 61% of the revenue in quarter three financial year 2023, excluding COVID, PCR, and allied, while seeding cities contributed 17% and the rest of the other cities contributed 22%. With respect to geographical distribution, revenue contributed, excluding COVID, PCR, and allied from the west region, was 51%. South contributed 30%, north contributed 8%, while the rest was contributed from east and international location. Revenue from north and east grew by 29% for Q3 financial year on a YOY basis.
Now let us come to Q3 and nine-month financial year 2023 financial highlight. Total revenue for Q3 financial year 2023 stood at INR 285.5 crore, and for nine-month financial year 2023, it stood at INR 866 crore. Most importantly, revenue excluding COVID, PCR, and COVID allied for Q3 2023 increased by 20% YOY to INR 278 crore, and revenue for nine-month financial year 2023, excluding COVID and allied tests, grew by 20% on a YOY basis and stood at INR 827 crore. Revenue from Hitech grew by 20% for Q3 financial year 2023 on a YOY basis to INR 20 crore. However, we must note that Hitech has been consolidated with effect from 22nd October 2021. Contribution from COVID and COVID allied tests has come down only to 3% of revenue now in Q3 financial year 2023 versus 21% of revenue in Q3 financial year last year.
EBITDA before CSR and ESOP is at INR 77.2 crore in Q3 financial year 2023, as compared to INR 80.5 crore in Q3 financial year 2022, which included large COVID revenue. EBITDA before CSR and ESOP for nine-month financial year 2023 stood at INR 31.9 crore. EBITDA margin before CSR and ESOP stood at 27.1% for Q3 financial year 2023 and 26.8% for nine-month financial year 2023. Profit after tax stood at INR 35.9 crore in Q3 financial year 2023. Net margin has been impacted on account of higher interest costs on acquisition of Hitech Diagnostic and higher depreciation on account of investment done to fuel the future growth engine. Coming to our working capital ratios, our debtor days stood at 31 days as on December 2022, at similar level as compared to March 2022.
Overall working capital days stood at 19 days as on December 2022, compared to 14 days as on March 2022 due to paying suppliers faster. Consolidated EBITDA percentage is stronger at 99% for nine-month financial year 2023. Cash and cash equivalent stood at INR 31 crore as on December 2022. Gross borrowing stood at INR 111 crore as on December 2022. We plan to repay the external debt by financial year 2024. Company has also declared interim dividend of INR 8 per share for financial year 2023. This is all from our side. We now leave the floor open for Q&A. Thank you.
Thank you very much. We will now begin the question and answer session. Anyone who wishes to ask a question may press star and one on the touch-tone 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 Rahul Agarwal from InCred Capital. Please go ahead.
Hi, good morning, and thank you for the opportunity. Two questions on the results and one for the new CEO. Firstly, on B2C in focus cities, it looks like the growth has been highest there versus if we compare it in other pockets versus B2B or seeding cities. Just wanted to know your thoughts, Ameera, on this. As in, what does it really signify? Because as per me, my understanding is the competition is actually higher there. And over there, the growth in third quarter has been pretty robust for Metropolis. And even when we compare it to peers, it's better. So any thoughts there? That's the first question.
No, absolutely. And you brought up a very valid question. I think most people believe that when the competition is harder, growth will be tougher. Actually, what we have seen in healthcare is brand premium holds a real big value. And we've always maintained that in our focus cities, we only have between 10%-15% of market share. And we believe we have an opportunity to grow this much more. And that opportunity continues to remain for Metropolis despite any competition coming in. And I think the results very clearly show that if we execute our distribution, our retail activities, our consumer-facing activities, getting the growth that we want and increasing our market share is very doable despite any competition that comes in because they don't have the brand connect and the brand premium in these markets that we enjoy. And we have to leverage that to the maximum.
So this is like a sustainable trend you see? As in, there is no base effect here, right? It's more about sustaining this quarter on quarter, and that's what you experienced during the past three to six months?
That's right. There is no base effect here. This is just about execution. And it is a reflection of the kind of distribution and depth and marketing that we do. And obviously, supported all by strong execution and the right stickiness of business. In our industry, a lot of it is about the kind of business you go after. Business is there everywhere. But if you go after poor quality, high-discounted business, you may get a quick scaling up of non-profitable businesses. But what we have always done is to go after the good quality businesses, doing it slowly and gradually, that gives us high ROCE and sustainability. And we are continuing to do that.
Got it and on second, on Hitech, so essentially, I think last four quarters, revenue has largely been flat. I'm referring to non-COVID business. Could you provide any update, as in how's the progress on regional expansion? What are you seeing in terms of customer behavior, and when do we see higher revenue growth there?
See, Hitech has been, as I mentioned in my speech, it took us a full year to actually put some basics in place because often when we do these acquisitions, these labs have been run as single unorganized sector, where when we bring them into the Metropolis ecosystem, we actually have to first do the integration, not only of technology, but practices, and really change the practices that allow us to feel comfortable with the kind of governance and robustness that we see in Metropolis. So we went through that for the first year. And really now, it's going to be about focusing on how do we get revenue growth going forward. So hopefully, that will be the story for this next year. The good news, like I said, is that we are clear on our strategy.
We actually already have a team in place, and our margin profile is similar to Metropolis. So it is not diluting us in any way. And with the actions that we are taking, we hope that the revenue growth will move from here in a positive direction.
So in terms of daily routine working, the old promoters are involved right now. I mean, how is that working?
The new management team is running the show day to day. And the old management team continues to. We take guidance if needed. But the new management team is the one in running the operation.
Got it. And lastly, just quickly with Mr. Surendran, best wishes for the new role, sir. We have about a month of joint. I know it's pretty early days. But any parallels would you draw from diagnostics and telecom? Because telecom has seen enough price falls in India. Any thoughts from a five-year perspective? What do you think, and how would you go about it? Thank you so much.
All right. Thanks, Rahul. I think the parallels that I could draw are basically two or three things. One is the competitive intensity is not any different, right? I mean, so I think I find it very similar to that of a telecom at some point of time. And I think the distribution network expansion is going to be the common thing that I see in both the places. How far you can reach is going to be one of the important priorities. And also, I believe that consumer experience is key in both the businesses. So that's where I see I can draw some parallels, if you ask me. On your question of what's going to be the longer-term plans, see, from a medium to long-term basis, if you ask me, building Metropolis as a strong consumer brand is going to be my focus.
That's by further strengthening on the digital assets and the digital agenda and simplifying the IT platforms and improving the consumer experience, and also working on improving on the doctor connect, as my colleagues have mentioned earlier, and from a short-term to midterm perspective, scaling up on our execution skills and accelerating speed to market is going to be my focus area. What I mean by that is network expansion, go deeper in our core markets, and also go broader in the rest of the markets. I also believe that there's an opportunity to improve on the productivity of existing assets and labs, collection centers, etc., so that's going to be my focus area, so this is how I put it across from a long-term to midterm and a midterm to long-term perspective. Thank you.
Got it, sir. Thank you so much for answering my questions. Best wishes for the new role, sir. Thank you.
Thank you.
you. As a reminder to the participants to ask a question. You may press star and one. The next question is from the line of Sham Srinivasan from Goldman Sachs. Please go ahead.
Good morning, and thank you for taking my question. Just the first one on slide 13, just trying to understand. I think, Ameera, you mentioned about the competition in semi-specialized in the past. Just want to understand what's the update. So when I look at routine, semi-specialized, specialized, and wellness, I think you touched in your opening remarks. But if you could help us look at the different cohorts of what's happening there.
Sure, Sham. See, I think what happens is in the semi-specialized, which is the part which is more automated and requires less expertise. And that's also the part where TAT is, of course, required on a turnaround time is required quickly, but it's not within two, three, four hours. It's where we are finding a lot of new competitors and focusing their energy. This is the business, actually, that Thyrocare had originally built based on a low-price platform. And this is the business that actually most of these new competitors are going after. Now, again, each of them has got different levels of infrastructure to support it. Some people who have got labs in multiple places will be able to give a faster turnaround. And those who are trying to centralize testing will obviously not be able to compete on turnaround time, which is inversely linked to price.
So what we are also seeing, if you remember, in the last three years, we've always been saying there are strategies to focus on two. One is B2C, which will help us improve tests from all categories, but it will give a disproportionate improvement in routine. And the second is specialized testing because that requires expertise, which is the doctors. Because the doctors are making such critical decisions, they are no more to take any risks when they're outsourcing specialized tests to a lab. And that has been there for our strategy. And we always expected that the semi-specialized will come down as a segment as we continue to build routine and specialized. There is pricing pressure on about 20-30 tests in the semi-specialized segment. And what we are seeing is that there are some customers who are leaving for price.
Often, they don't get the support, the logistics, the technology, all the other things we need besides price to work. Some of them come back to the organized sector. And some of them obviously only value price, and therefore they continue with new lab entrants. But we are seeing overall that while this area is not growing, we are able to balance it out by growing the routine and the specialized quite.
Helpful. My second question is on RPP. It has grown 3% when I look at non-COVID, non-PPP contracts, right? So is it something that we need? Are you now able to take price increases, or is it largely mixed change where we are doing more of the work that's leading to RPP increasing? And what's the outlook on this one? Thank you.
If we look at the past many years, actually, every couple of years, we've done a price increase, which is maybe 2%, 3%, 4% impacting the organization. So unfortunately, we've not been in a situation as an industry to take sort of 10% price increases every year. But Metropolis has had the brand strength every couple of years to increase prices by 3%, 4%. And that's something that we will continue doing. But obviously, the majority of this RPP improvement has come through product mix and some of it through pricing increase.
Got it. Thank you, and all the best.
Thank you. The next question is from the line of Prakash Agarwal from Axis Capital. Please go ahead.
Yeah. Hi, good morning. Thanks for the opportunity. Question is, your focus markets you grew 20% and core Metropolis 13%. So most of the other growth is coming from PPP and Hitech, or how should we think about that?
I think, if I'm not mistaken, the 21% number was including High-tech. If we remove that 21% number and we only look at sort of focus cities without High-tech, I think the number was closer to 15%-16% on B2C. If I'm not mistaken, Rakesh, correct me if I'm wrong. The 13% number that you mentioned for core business of Metropolis is also without High-tech. Rightly, you would say the spread between the two is closer to 2%-3%. What is happening in our business is B2C is growing faster. I'm talking about everything now, excluding PPP and excluding High-tech. The growth in B2C is higher at 15%-16%. The growth in B2B is slower, and obviously, therefore, the average is coming out to be closer to 13%.
Okay. And this is after stripping the PPP?
That's right.
Okay. Okay. And I see that you have one more quarter lump of COVID and LA, which is about INR 50-odd crores. Suppose that it is sub INR 10 crore or something. So post the Q4, you should be confident of a mid-teens kind of growth given the setup of the brand and the geographical expansion and the Hitech integration. Would that be fair?
But currently, it will be nine months. Our growth is 15%, excluding public-private partnership as well as COVID as well as Hitech. So I think looking at that history, I think if we take out COVID, PPP, and Hitech, I think that's the aim for the organization.
Yeah. No, why I ask this is because obviously, last year was a low base, so to say, for the non-COVID. And then everything has come to normalcy. And on this base, with the current setup, would it be fair to look at double-digit mid-teens kind of growth?
That's right. That's exactly the aim. See, COVID, obviously, is a base effect. We can't do anything. Hitech will obviously have its own journey. And third, the PPPs are lumpy and out of anybody's control, right? So I think if we look at the core business, I think mid-teens has been consistently at that trajectory even for nine months. And that's the direction we're aiming.
Okay. And any thoughts on looking at some acquisitions since the valuations have corrected? And you are strong now in South also. So is there a plan to look at anything in Central India or East India or maybe not?
So while these valuations have corrected in the public markets, they've not corrected in the private markets yet. And private market players are still sort of very hopeful of very high valuations. So I think large acquisitions, unless they are reasonable, obviously don't make sense for us. So we obviously continue to have a lookout. And if we are able to find acquisitions that are fairly priced as well as of good quality, most important. I mean, even today, there are some 20 deals on the table. Lots of diagnostics firms who want to sell their businesses. But the average asset quality is not high. And therefore, we don't want to go into a place where you land up paying a high value and then you're spending so much time and cleaning up poor practices of the past that actually you lose revenue while doing so.
So I think we would like to continue to be careful, but we obviously continue to be open to the right kind of acquisitions.
Okay. Thank you, and all the best.
Thank you. Participants who wish us to ask a question may press star and one. The next question is from the line of Prakash Kapadia from Anived Portfolio Managers. Please go ahead.
Yeah. Thanks. A couple of questions from my end. If I look at the premium wellness, it's 13% of quarterly revenue. So how different is it from competitor offerings? Is the focus here on corporate wellness, or is it bundling of X-rays and heart and certain high-end things which makes it different? And what percentage would be Mumbai of premium wellness market?
So the reason I was at the premium wellness and what's happening is basically in the preventive care space and in the wellness space with all the new entrants that have come in, we have basically seen a focus on price as the driver to actually expand the wellness market, and it is basically push marketing and the amount of money they spend that makes people sort of say, "Oh, it's so cheap," and I can click with the click of a button, "Let me do it," but that is actually drying up because that high that happened during COVID and after COVID of everybody wanting to do a checkup is obviously not sustaining. The way the acquisition is really about the strength of the Metropolis brand because these are not commodity, these are not commoditized products, right?
I mean, a health checkup that you get from a player where quality is not the focus, the results you get may not be accurate versus the results you get from Metropolis, and you can action something with. Now, we've seen many cases of people doing a health checkup. Everything is fine. Next day, somebody having an incident, and next day, somebody having a heart attack, right? Because in that lab, there's something that missed out because quality was not the main focus. So I think really our premium wellness comes from our brand. And the top focus cities are actually the biggest contributors to the premium wellness business, including Pune.
Okay. And we've added almost 150 service centers in Mumbai this year. Could you talk about that a bit? So is this collection points? Is it patient walk-in centers? Are they set up where footfalls in terms of B2B is also being targeted? What are the costs you spend on this expansion?
So these are. I mean, we talked about adding 150 in the whole year. These are patient service centers, which are franchised, mostly franchised, and some are run by Metropolis on our own. So it's a combination of patient service center, which is PSC, run and operated by Metropolis, and APSC, which is run and operated by the franchisee. They look the same for the consumer, and therefore the consumer doesn't know differently. The practices are the same in the centers. The experience is the same. And the idea is just for us to franchise it is to keep it as applied and that we are not carrying all of that fixed cost on. But we have the same quality assurance and training program extended to our PSCs as well as our APSCs to ensure a standardization of experience for the customer.
The reason we have done this in Bombay is because we believe that the brand strength here, there were many pockets and micro markets of the city that we did not have a strong collection center network where patients could walk in. And that's what we are actually trying to build. And we are really going into Bombay, going into every micro market, establishing our market share in that market, evaluating it. And then if we feel we don't have enough of a presence, expanding that distribution in that particular micro market. And that's how we are building Bombay larger and larger. That obviously has to be supported by the right field, marketing, and operations. Otherwise, just building distribution doesn't give you patients.
Right. And in reference to the previous question, what percentage would be Mumbai of the premium wellness market? Is it fair to say it would be one of the largest markets in India? And is the focus on corporate wellness tie-ups for us also, or that segment we are not looking at to scale the business?
No, at this point, the focus, the generation of revenue has come more from individual wellness and less from corporate wellness. We are doing corporate wellness, but what we find in corporate wellness is the focus is more on low price, high volume. And in individual wellness, because of brand strength, we are able to focus also on a good pricing and a premiumness of the brand. So therefore, individual is driving it. I don't have it off the top of my head what does Mumbai signify as a percentage, but it would be a fair number as a contribution.
And lastly, post-COVID, one would have guessed the awareness for health would have increased. So diagnostics as an industry should have done better. But if I look at sector CAGR for most of the players, it's low single digits. So what is happening in terms of consumer mindset? Is it fatigue which has come post-COVID in terms of constant testing of COVID and COVID-like tests? What will change this? And when do we see growth coming back?
Thank you for asking this question. I think the issue is not on the consumer side. I think the issue is on the expectation side. I think the assumption that we keep aside COVID and post-COVID suddenly health will drive. When you're working in illness, illness is not voluntary. When people fall sick, they go to their doctor, and then they come for testing. It depends on what illness they have at that time. Now, COVID was the illness that all of us suffered from for two years. If we keep aside the main illness and then we look at three-year CAGR, it would be looking for a needle in a haystack, but it's very difficult to find.
So I think the expectation, the right way in my mind to look at this business is to look at all the infections and diseases that happened in that period because in the next three years, there will be other infections and diseases, and we will not be able to separate them out. That's one thing. The second thing is there is often a thought of pent-up demand that people said, "Oh, when COVID gets over, will there be a pent-up demand?" And our industry doesn't work on pent-up demand because you get diagnostics when you're sick, but six months later, you may not need those tests. And therefore, if a month has gone, a year has gone where that testing doesn't happen, that is an opportunity gone and not going to come back sort of in the future.
The only part of healthcare which is dependent on a want and not a need is preventive healthcare, which is still, as an industry, only 5% of the whole industry. 95% of the industry is based on illness, which is not in the control of anybody and just happens to people when it happens. So there is therefore a seasonality factor that comes in with healthcare quarter to quarter, and depending on which location and geography, what illness will happen. So I think if we forget looking at the past, if we look at the future, as asked by one of the other people on the call, I think we focus on our core diagnostics business.
I think we are fairly certain that with the actions we are taking, we should be able to generate a good growth, even keeping aside the PPPs and High-tech and all of that and just focusing on the core.
So what essentially you are saying is that wellness pie, which is 5%, need not grow. The growth will be dependent for the industry and us in terms of more for illness and new kind of infections or diseases which would come in from time to time rather than the wellness, which could become very big. Is that?
That's right. That's right. Because wellness was more of the outcome of COVID. And while the wellness category has got developed during COVID, and not that it will not grow in the future, it will. But the real profit and the real growth continues to be in the illness segment. And even in the wellness segment, unless you know how to sell plans which are unit economic viable, you're not going to get profitable growth. And most of the players who have entered the industry and are focusing on wellness as a core are actually making severe losses. And the revenue growth is actually not so high anymore. As I mentioned, the monthly active users are falling. So this concept of wellness just growing on its own at 20%-25% a year is not actually what we are seeing happening on the ground.
Understood. That's pretty clear. Thank you.
Thank you. The next question is from the line of Monish Shah from Antique Stock Broking. Please go ahead.
Yes, hi. Just a quick question on the pricing strategy. On our website, we are seeing that True Health packages are discounted heavily at 40%-60%. I think for routine and wellness, what kind of footfall increase are you seeing on the basis of these discounts? And what kind of impact it would have on our realization for patients going forward?
So I think first thing, I think healthcare still has not moved online in a significant way for client acquisition. So for example, even when you hear hospital chains talking about digital revenues, etc., those are people who are anyway going to come to a hospital. And now they just found it easy to book an appointment online. It's not that it was a new customer that they have acquired digitally, right? So healthcare still, while there has been an introduction to digital health in the last two, three years, that is still not the core of how customer acquisition is done in the healthcare industry. So while we may have attractive packages online, we are not actually seeing conversions happening online through the significant contribution to our business. The majority of it happens in the brick-and-mortar space.
Even when clients get attracted in some cases by value packages, it all depends on when they actually come into your store or when they come into your call center, what you're able to work with that customer to actually move them to a package that is effective and beneficial for both parties. That's where the training, the skill set, the scientific expertise from our side comes in to be able to veer them towards a package that is actually helpful for them in their own health, as well as something that is profitable for them.
Okay. And just one more question on the pricing. What would be the pricing differential for most of our key tests in a metro and a non-metro market, if you can highlight?
So if you actually look at it, if you compare a metro and a non-metro, the difference in pricing is only on the routine test. So for example, if I take the top 200-300 tests, that's where the pricing difference is there. I think the average would be maybe 20%-25%. But for all the other tests in the menu, the price is actually the same.
Okay. Thank you so much.
Thank you. The next question is from the line of Sayantan Maji from Credit Suisse. Please go ahead.
Yeah. Thanks for the opportunity. So we have done well to scale a wellness package contribution to the overall revenue from 10%-13%. So would you say there are two trends which are happening. One, you talked about an industry-level trend where patients are opting for wellness packages. Second is companies also promoting it through designing more packages. So what factor would you attribute it more towards? So are we in overall industry, are we increasing our share in the wellness packages as well? And how do you see our path to 20% that you had mentioned in your opening remarks?
So as I mentioned in the opening remarks, the current wellness contribution is coming from two types. One is coming from actually existing patients who are walking in for normal illness and are being offered larger packages or other offers, which gives them more insight. And since you're anyway giving blood, would you like to do a larger package that could be scientifically helpful for you? So that's one strategy. The second strategy is to go to a customer who actually has no problem at all, and you're acquiring that new customer to come on board and saying, "I want to do a checkup just to find out what's happening in my body." So on the first one, I think we have been quite successful in execution, and that's something we will continue to drive with momentum.
On the second one, I would say it's still early days for us, where we are doing a lot of retail activities, retail activities to go to customers to bring them in as a first-time user into Metropolis to experiment and to try. And that's where we are using different kinds of packages, different kinds of pricing, and different kinds of services and content to attract that customer base. A lot of piloting, a lot of work going on from our own back side. But at the same time, the market, like I said, for wellness is not growing at the same aggressive pace that it was growing before. The unit economics of that budget wellness are not very positive. So we are trying to position ourselves in such a way that we are still able to attract new consumers, but do it in a sustainable, profitable way.
So I think we've seen some early successes, but this is an area that we're hoping that we can actually expand even more in the time to come.
So that differential 7% from 30% to 20%, you expect a large part of it to come from patients who are otherwise well, but they are subscribing to the wellness packages?
That's right, and also an improvement in our execution of upselling existing patients, combination of the two.
And do you expect this trend to improve the test per patient? So that test per patient metric has been more or less at 2 to 2.1. So do you expect this to improve for the industry going ahead?
Yes.
Whether a patient in a given year is subscribing for more tests?
It all depends on the strategy again. I mean, if the focus is purely wellness and wellness has multiple tests per sample, then that number will go up. But at the same time, we are also building our specialized category where actually labs or doctors only outsource one test to you. So that will bring the average down. So overall, I don't expect to see any drastic change on that number because we are building a balanced portfolio between all different categories.
Sure, and my second question is on the network expansion, so as we're expanding network into, say, some of the smaller towns as well, so while initially dilution to EBITDA margin is understandable as these ramp up, but once they ramp up, do you think that these will be diluted to EBITDA margin given that our realizations are 20%-25% lower, or do you expect it to be at a similar EBITDA margin because the cost of operations is also lower in these smaller towns?
I don't expect the EBITDA margin to be any very different in tier two, tier three towns. And the reason for that is, again, it depends on the product mix. So often in these markets, while we are offering routine tests, which are 20% lower, but the product mix that we actually get is more tilted on the specialized and the semi-specialized side where the realizations are no different than metro cities. So again, it depends on your product mix and your execution in those markets. And like you rightly said, if you also get operating leverage with volume. So as these mature and their volumes grow, I don't expect the EBITDAs to be very different.
Sure. That's helpful. And just a couple of clarifications. So would you have a number of, say, B2C revenue within focus cities on a three-year table basis?
Rakesh?
Yeah. So we internally look at it, but that's not the number which we are really giving out to the market. But obviously, we can look at it and see how can we publish that number as well.
Sure. And my second clarification is on this interest cost in the presentation. It's a bit higher than what you reported in the P&L. So where is the difference coming from?
So there is some bit of Ind AS impact also comes in. So there's combination of both of it. So there is a bit of because we keep on taking a lot of rental machines and we keep on adding a lot of franchise in the center. So that also has a bit of an impact on the Ind AS accounting. So that also has a bit of an impact on interest cost.
Got it. So basically, the one that is mentioned in the presentation is post-Ind AS, and in the P&L, in the results that you gave, it is on a pre-Ind AS basis. Is that right?
Yes. Yes, yes. Absolutely.
Okay. And also, do you give the B2C, B2B mix for the company as a whole?
As a whole, we have not published, but yeah, we can tell you that the total mix is 50% is B2C, 35% comes from B2B, and the rest 15% is basically the institutional, corporate, PPP, all this comes into that. So that is how this market is bifurcated.
So B2C is 50% of total now?
Yes.
Okay. Sure. Okay. Thank you so much for taking the questions.
Thank you.
Thank you. The next question is from the line of Main Wholesale from Axis Capital. Please go ahead.
Yes, sir. Thank you for the opportunity. Same online patient test per patient kind of a volume, which is more of like marginally come down. But this is despite that there is an increase in the wellness share. So, is there any disconnect or anything else like your wellness is now contributing around 13% against 10%, but your test per patient is like somewhere in range of 2.14 versus 2.16. So, is there any kind of can you explain something on this?
No, there's really no connection between that. Wellness, like you said, offers many more tests than a patient thinks. Actually, that should increase the number of tests per patient or per sample. And overall, like you said, wellness is accretive to us at an EBITDA level as well as at a revenue per patient level. So no negative consequence of that that we have seen on any of these KPI metrics.
One more one, we are like gross margin has come down to 77%, I think 77.8%. So, is there any impact because of price or is it largely because of business mix or test mix?
No, there is some impact because of the dollar. So as the dollar is appreciating against the rupee, obviously, most of our reagents are imported. Almost 70%-80% of them come from international locations. And therefore, the dollar appreciation does have some impact on pricing charged by vendors to lab companies in the industry. So as those prices come in, increase in prices come in, we try to balance it with operational efficiency on the back end and cut down the impact on the people.
Lastly, on this cost part, continuing like stock quantities at 3%, but on other expenses side, it's down 6%. What could be the reason for that? Why the other expenses are coming down despite your expansion?
Rakesh, you want to take that?
Yeah. So basically, other expenses has an element of one is provision for doubtful debt. So as we have improved upon a lot in last two, three years, we have seen a bit of control over the debtor. So that was 0.5% of the total cost coming in that. So we have seen this year, actually, there is a bit of a reverse in that cost because we have recovered some old debts, and we are not required to create a lot of provision this year. So 0.6%-0.7% of the total revenue benefit has come in that. So I think INR 2-3 crore has been the impact for that. And obviously, there are other expenses like there are a lot of financial expenses which happened last year because of the Hitech acquisition, etc. So that cost is again not part of these other expenses.
So overall, the other expenses basically coming down mainly because of these two reasons. And this number to continue for the next few quarters, is this a base we can take it for?
Yeah, yeah.
For the next few.
I don't think that there will be much changes, but obviously, as I said, that there is one-time some benefit coming in the PDD because of the recovery of old debts. So maybe that may not continue. So there may be a bit of a 2.2%-2.3% here and there, but not much.
Lastly, just on your margin of 24.7%, so can you break it between your Metropolis business and the Hitech business? What could be the margins, EBITDA margins?
Yeah. So one clarification is 24.7 basically coming because in other expenses, there is a 2 crore rupees of Forex unrealized loss which has been taken because the Kenya currency has depreciated a lot in last quarter. So we basically, from a management reporting point of view, we don't take the Forex P&L loss in the EBITDA piece. So therefore, there is a bit of a gap between what we have reported of 25.5 versus 24.7, which we are looking at from a financials. So just a clarification. Second, from a high-tech and MHL point of view, already Ameera mentioned that the high-tech is operating at the similar level of margin than what MHL is doing. In fact, a bit higher, maybe 100 basis points higher than what MHL is doing. So that is how the margins of buy can be taken.
Okay. Thank you.
Thank you. Ladies and gentlemen, due to time constraints, that was the last question for today. I would now like to hand the conference over to Ms. Ameera Shah for closing comments.
Thank you. And thank you to all of you for logging in and hearing us this morning. This past year has been quite a tumultuous year for all of us. And I'm very happy and proud that while there have been a lot of external threats for Metropolis, we have not only survived through this period, but we have tried. And with the team that we have in place, with the rigor of execution, the processes, and systems, we genuinely believe that we are sitting at the right fork to continue to grow well in this industry and to continue to grow in a right, profitable, high ROCE way. And that will be our focus as we go into this next year as well.
Obviously, at the end of this fourth quarter, we will come back with some more detailing on our blueprint forward with our strategy, our key pillars, and we'll be happy to share with investors, and I think just focusing on our core revenue growth, which is B2C and B2B, and really how we can continue to expand that and grow at a fair level and generate good EBITDA will be the focus for us going forward. Thank you to all of you for your support, and we look forward to chatting with all of you.
Thank you. On behalf of JM Financial, that concludes this conference. Thank you for joining us, and you may now disconnect your lines.
Thank you.