Ladies and gentlemen, good day and welcome to the Q4 and FY 2026 earnings conference call of Metropolis Healthcare Limited, hosted by Ambit Capital. 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. There will be an opportunity for you to ask questions after the presentation concludes. Should you need any assistance during this conference call, please signal an operator by pressing star and then zero on your touch-tone telephones. Please note that this conference call is being recorded. I now hand the conference over to Mr. Gaurav Tinani from Ambit Capital. Thank you, and over to you, Mr. Tinani.
Thank you, Farrah. Good morning, everyone. On behalf of Ambit Capital, we welcome you all on the Q4 and FY 2026 earnings conference call for Metropolis Healthcare Limited. Today on the call we are joined by Ms. Ameera Shah, the Promoter, Chairperson, and Whole- Time Director, Mr. Surendran Chemmenkotil, the Managing Director, and Mr. Sameer Patel, the Chief Financial Officer for Metropolis Healthcare Limited. We will begin the call with opening remarks from the management, followed by a question-and-answer session. Thank you, and over to you, ma'am.
Thank you so much, and good morning, everyone, and thanks for joining us today for the Q4 and the FY 2026 earnings conference call of Metropolis Healthcare. As mentioned, I'm joined by Suren, by Sameer, and also by Mohan, the CMO, and the rest of the leadership team and the IR advisors. We've uploaded our investor presentation and related documents on the stock exchanges and the company's website. I hope everyone's had an opportunity to go through the same. Let me begin with a brief perspective on the broader diagnostics landscape before I move into the company's specific updates. The diagnostics industry in India continues to evolve in a very constructive direction. We are seeing a steady shift towards organized, trusted players like Metropolis as doctors and consumers are placing greater emphasis on quality standards, scientific expertise, lab compliance, and an overall superior experience.
This transition reflects a maturing market where trust and reliability are becoming central to decision-making. At the same time, the industry is also gradually moving beyond routine testing-led growth, with stronger contribution now coming from Specialty diagnostics, wellness, and more complex and clinically relevant testing. These areas not only enhance the depth of diagnostic insights but also align more closely with evolving healthcare needs. In parallel, factors such as deeper digital engagement, improved consumer awareness, and a rising focus on longitudinal health monitoring are creating new opportunities for scaled and credible diagnostic platforms. This broad direction has been visible in our earlier quarterly commentary as well, where we've consistently highlighted preventive care, Specialty testing, AI-led enablement, genomics, and customer engagement as key structural drivers shaping the future growth of the sector.
While competition will always be there, we believe the structural runway for us is strong without any unreasonable or disruptive competitive environment. Metropolis remains well-positioned in the industry because our moat is built on capabilities that are difficult to replicate at scale. Consistent lab quality, deep and longstanding doctor engagement, strong scientific and clinical expertise, best-in-class tech platforms, and a highly standardized operating model across the network. Together, these elements create a foundation that goes well beyond surface-level differentiation and supports sustained performance over time. In diagnostics, trust is built not only through brand visibility and geographical reach, but through the accuracy, consistency, and reliability of what happens behind the scenes in the lab. Institutional knowledge built over years of experience further strengthens this backbone by ensuring that complex cases are handled with depth and accuracy.
This remains one of the key reasons why Metropolis continues to earn trust with doctors and patients and sustain its leadership in the premium diagnostic space. On digital and AI, our approach continues to be practical, measured, and focused on high-impact use cases. We do not see AI as a near-term disruptor in pathology, but an important enabler of productivity, service quality, customer engagement, and workflow efficiency. Over the past few quarters, we have strengthened our digital and AI tools across customer and partner platforms, lead management, workflow automation, and contact center quality and selective diagnostic applications. Together, these initiatives are helping us build a stronger operating backbone, improve productivity and efficiency, enhance customer experience, and support more scalable and sustainable growth for years to come. Our genomics journey has continued to advance steadily and remains a key strategic pillar for the future.
With the integration of Core Diagnostics and the ongoing strengthening of our central genomics platform, we are deepening our capabilities across critical areas such as oncology, reproductive health, inherited disorders, and precision diagnostics. This platform is now anchored by two CAP-accredited genomic labs in Gurgaon and Bombay, along with a growing team of genetic counselors across the country, strengthening our ability to deliver high-end genomic testing with quality interpretation and scale.
This integration has also enabled us to expand access to high-end genomic testing across India through both our B2C and B2B channels. Anyone can add machines, but the real difference in results is the personalized interpretation needed for every patient, and that lies in the institutional expertise and knowledge and not in the equipment. As a result, Metropolis is increasingly positioned as a trusted and credible leader in specialty genomics testing, with the ability to deliver advanced solutions at scale.
We see genomics evolving into a significant growth driver over time, particularly in disease segments where precision, nuanced interpretation, and strong scientific engagement are essential. The participation and response we received at our recent genomics and scientific symposiums in Mumbai and Chennai have been so strong, clearly depicting there are big gaps in the market for good clinical reports, which we can fill. We believe this is a strong testament to the clinical trust in Metropolis and to the relevance of the scientific platform we are continuing to build in genomics. At the same time, we continue to make steady progress on productivity and platform modernization. Over the last few quarters, we have worked on lab platform upgrades, infrastructure consolidation, vendor consolidation, and more optimal use of technology across the network.
These efforts are helping simplify the operating backbone, improve efficiency, and support structural cost discipline over time. On the inorganic front as well, integration is progressing broadly in line with our expectations. For Core Diagnostics, we had committed that within four quarters of doing the acquisition, we would move from a - 2% EBITDA to a high single-digit EBITDA in Q4. We have completed this mission. We are on our path for our three-year commitment for a 20% + EBITDA at Core. Over the past few quarters, our priority has been on stabilization at Core, driving process alignment, integrating platforms, and realizing synergies across the acquired businesses so that they are seamlessly embedded within the Metropolis umbrella and operating DNA.
We're now beginning to see tangible value emerged, not just from increased scale, but from enhanced capabilities, lab consolidation, better network utilization, procurement efficiencies, and a stronger foundation to support future growth. As we move ahead, our focus will shift from more towards driving volumes and scaling the platform. This, in turn, will unlock efficiencies and leverage, providing a clear pathway for margin expansion over time. Speaking of FY 2026, it's been a strong and well-executed year for Metropolis. We delivered organic revenue growth of 13.7%, better than our stated guidance of 12%-13%. On a normalized basis, organic margins expanded by around 140 basis points to 25.9%, supported by sustained productivity improvements, ongoing lab platform upgrades, and consolidation initiatives.
As you know, we had also done a bonus share issue on March 26th to enhance liquidity of our share for shareholders. I'm pleased to share that the board has also recommended another interim dividend of INR 1 per share. This reflects the strength of our financial position and our continued commitment to creating long-term value for shareholders. Looking at the past three years, we have accomplished the following: An organic CAGR revenue growth of 13% on a like-to-like basis, which is largely driven by test volume and patient volume growth. Restored organic revenue margins to pre-COVID levels of around 26%. Expanded lab capacity by more than 50% and increased our presence to more than 750 towns and cities across India.
Built a strong retail D2C mindset, resulting in self-referrals contributing 40% and B2C business accounting for 60% of revenue, both creating a more sticky, higher-margin business model for the future. We expanded into basic radiology and vital checks in some centers on a pilot basis and are encouraged by the response. We also, in the last three years, established a robust technology architecture from the ground up, enabling digital channels to grow from 0% - 25% of revenue while making the organization significantly more automated. We also strengthened our scientific capabilities and enhanced our reputation amongst doctors and hospitals and added the entire genomics segment. This will lead to better price elasticity and the highest Specialty mix in the industry. We also expanded our North India business, increasing the contribution from mid-single digit contribution to revenue to 17% of revenue.
We added and enhanced and pre-built a stable and better quality management team that can take the business forward. Over the next three years, the vision is the following: To grow at a faster CAGR of 14%-15% in revenue over three years. Organic revenues would come primarily via patient volumes, RPP growth, and price increases. Some additional part of it would also come via adding strategic and value-additive acquisitions. Even though we are building a target for acquisitions, these would only happen if it's at the right deal, at the right price, and not just to add growth.
We're gonna reimagine our processes through automation and technology enablement to drive center productivity and margin expansion with the goal of achieving a sustainable group EBITDA margin of 27%-28% over the next three years, supported by profitability across every regional market and bringing Core Diagnostics to a percent plus margin profile. We would like to continue to be the most respected scientific brand, but not just in the West and South, but also in the North and East of India by building relationships and trust amongst doctors. We're also building a network of 100 mini hubs over the next three years, which would encompass pathology and basic radiology to service retail and corporate clientele. 50 mini hubs would be the existing collection center locations upgraded to mini hubs, and 50 would be new centers to be set up.
We expect these centers to allow us to provide more services to our existing B2C customers and also corporate clients and insurers. We would expand our asset-light collection center network by adding 1,500 more centers. Taking the lab-to-center ratio to 1:35 from the current 1:24, and enhancing center productivity of existing centers by 20% over three years. We would also like to build capability in Metropolis Healthcare to build a tech-enabled D2C vertical, focusing on enhanced chronic business acquired and serviced via digital and physical channels.
Digital revenue in Metropolis Healthcare has a higher customer lifetime value than brick-and-mortar business, and enhancing the digital contribution would enhance the RPP growth. Overall, the direction of the business continues to strengthen with stronger foundations, sharper execution, and better visibility ahead. With that, I'll now ask Suren to take you through the operational performance and key business drivers for the quarter and the full-year.
Thank you, Ameera. Good morning, everyone. Let me take you through our performance for the quarter and the full-year, and then spend some time on the key business drivers across channels, network productivity, margins, and operating outlook. For quarter four, 2026, MHL group revenue stood at INR 425 crore, reflecting a year-on-year growth of 23% with EBITDA margin of 25.4%. For the full-year, revenue stood at INR 1,646 crores, growing 23.6% year-on-year with an EBITDA margin of 24.4%. Just as importantly, the underlying quality of growth remains strong, supported by patient growth, realization improvement, better mix and productivity gains. On an organic basis, revenue grew by 14.7% in quarter four, driven largely by patient volume growth of 9.3% and realization improvement of around 5%.
For the full-year, organic revenue growth stood at 13.7%, as Ameera mentioned. It is also important to note that unlike last year, we did not take a price increase in Q4 due to GST reasons. This indicates that the quarterly performance was driven by healthy underlying demand, mix improvement, and better execution, leaving the price favor as an opportunity for the growth later in the year. Full- year 2026 was not just important for the performance we delivered, but also for the progress we made on several structural changes initiated last year. This includes strengthening the network through lab consolidation and a sharper center-to-lab ratio, driving productivity and margin improvement initiatives across the lab platform changes, building stronger and better quality B2B business, progressing our M&A integration playbook, and advancing our digital agenda.
Importantly, these are not one-time actions. They are structural changes intended to improve the quality and sustainability of growth in revenue and profitability over time. Let me first talk about the channels. In B2C organic revenue, we continue to see strong traction with revenue growth of 14.7% in the quarter and 14% for the full-year. This was supported by the healthy demand across wellness, Specialty, and routine testing, along with better customer engagement through both physical and digital channels. In B2B organic, revenue grew by 14.7% in quarter four and 13.3% for the year. We have been working on improving ease of doing business, enhancing service consistency, deepening institutional and corporate relationships, and building a more sustainable portfolio with better unit economics. From a segment standpoint for the organic revenue, TruHealth and Specialty continue to perform very strongly.
TruHealth and Specialty grew by 20% and 17% respectively in the quarter, and by 21% and 16% respectively for the full-year. These categories continue to improve both customer engagement and overall mix quality of the business. Let me now come to network and productivity, because this is becoming an increasingly important part of our journey. Over the last few years, we have invested significantly in expanding and strengthening our lab and service center backbone. That heavy build-out phase is now largely behind us, and the focus has clearly shifted from expand-led CapEx to throughput-led productivity. In other words, the priority today is not just to add more infrastructure, but to get more output, better efficiency, and stronger leverage from the infrastructure we have already created.
This is a key shift in our operating model and one of the important drivers of margin improvement going forward. During the year, we added 490 centers, taking our total network to over 5,000 collection centers across more than 750 towns and 212 labs. At the same time, the productivity of the existing network improved. With the same lab growth at about 14% and center-to-lab ratio strengthening from 20:1 - 24:1. This is a clear testament to the focused execution over the last year on improving network density and driving higher throughput from the infrastructure we have already built. Over the next 18 months, we expect to strengthen the feeder center network further and move this ratio closer to 30:1 in many markets, depending on cluster maturity.
Over a three-year horizon, we want to take this to 35 : 1 lab-to-center ratio. Another important driver of improvement this year has been our productivity and margin agenda. During the year, we continued to work on lab testing platform upgradation and standardization, equipment vendor consolidation, better inventory discipline through bar coding, and more optimal use of technology in labs across the country. These interventions are improving turnaround time, material productivity, and throughput across the network, and the benefits started coming in through in quarter four. We expect them to strengthen further over the next two quarters as implementation progresses across the network. Organic EBITDA margin for the quarter stood at 27.2% compared to 18.5% in the same period last year, while the full-year EBITDA margin came in at 25.9%.
Although the prior year margin was partly impacted by one-time acquisition related costs then, EBITDA margin expanded by 140 basis points even after adjusting for these costs. This improvement was driven by a combination of better operating leverage, stronger Specialty and wellness mix, productivity gains, integration synergies from acquisitions, and ongoing efficiency initiatives across industry. On acquisitions, the portfolio continued to progress well. Core Diagnostics improved to a high single-digit margin in quarter four 2026, while Dehradun, Agra, Kolhapur acquisition continued to operate at margins above the company average. Over the last few calls, we have been clear that this year one is about integration, cleanup and efficiency followed by revenue acceleration on a stronger platform.
We believe we are now building a repeatable playbook for M&A integration across processes, people, systems, quality standards, and commercial synergies, and that will remain an important capability for us going forward. To summarize, financial year 2026 was a year in which both our business fundamentals and our operating model became meaningfully stronger. As we exit the year, we are seeing strong momentum across multiple areas of the business. Patient volume growth remained healthy in the 7%-8% range, supported by the lab additions made over the last few years, continuous center expansion quarter after quarter, and the acceleration of our digital agenda. We are optimistic of sustaining the same going forward. At the same time, RPP growth is being driven by an improving mix led by enhanced TruHealth offerings, higher Specialty mix, and increasing contribution from genomics.
Together, these drivers are helping us deliver consistent and broad-based revenue growth. Importantly, this growth is being complemented by a sustainable margin improvement. Our lab platform upgrades, vendor consolidation initiatives, and multiple productivity improvement programs are now translating into stronger operating leverage across the network. We are also seeing an encouraging progress in improving network productivity, strengthening the quality of B2B business, and successfully integrating acquisition through a more structured and scalable playbook.
What is particularly encouraging is that these gains are not driven by one-off factors, but by structural changes we have been implementing across the business over the last year. This gives us the confidence that the business is not only growing, but growing in a more sustainable, efficient, and high quality manner. With this, I hand it over to Sameer, who will take us through the details of the financial highlights. Thank you, and over to you, Sameer.
Thank you, Suren, and good morning, everyone. Let me briefly walk you through the key financial highlights of the group and full-year FY 2026 for both organic business and MHL group. Let's start with organic business. Organic business has delivered a strong and consistent performance during the quarter and the year, driven by healthy growth across both B2B and B2C segment. Quarter four FY 2026 revenue stood at INR 392 crore growing 14.7% year-on-year, supported by 9% growth in both patient and test volume. Full- year FY 2026 revenue stood at INR 1,510 crore, reflecting 13.7% year-on-year growth, with patient volume growth at 7.5% and test volume growth at 8%.
B2C and B2B revenue for the quarter grew at 15% year-on-year, while full-year FY 2026 B2C and B2B revenue grew by 14% and 13.3% respectively. Our focus segment continued to perform well. The TruHealth segment contributed 19% of FY 2026 revenue, grew by 21% year-on-year, and Specialty segment contributed 37% of revenue with 16% year-on-year growth. With respect to margins, quarter four's EBITDA stood at INR 107 crore with a margin of 27.2% grew 69% year-on-year. Full- year FY 2026 EBITDA stood at INR 392 crore with a margin of 25.9% reflecting 29% year-on-year growth. Quarter four PAT stood at INR 55 crore with a margin of 14.1% grew 89% year-on-year.
Full- year FY 2026 PAT stood at INR 194 crore with a margin of 12.8% growth of 33% year-on-year. Now talking about MHL group performance. At MHL group level, performance remained robust across revenue, volume, and profitability. Quarter four FY 2026 revenue stood at INR 425 crore, 23% year-on-year with a patient volume growth of 11% and test volume growth of 14%. Full-year FY 2026 revenue stood at INR 1,646 crore, reflecting 23.6% year-on-year growth with a patient and a test volume growth of 12% and 13% respectively. Across channels, Q4 B2C and B2B revenue grew by 20% and 28% year-on-year respectively. Full-year FY 2026 B2C and B2B revenue grew by 19% and 31% year-on-year respectively.
Segment performance continued to be splendid. The TruHealth segment contributed 18% for FY 2026 revenue grew by 27% year-on-year. The Specialty segment contributed 39% of revenue with a strong 32% year-on-year growth. Profitability remains strong. Quarter four EBITDA stood at INR 108 crore with a margin of 25.4% grew 71% year-on-year. Full-year FY 2026 EBITDA stood at INR 401 crore with a margin of 24.4%, reflecting 32% growth year-on-year.
Quarter four PAT stood at INR 51 crore with margin of 12%, grew by 75% year-over-year. Full-year FY 2026 PAT stood at INR 191 crore with a margin of 11.6%, grew by 31% year-over-year. Talking about the CapEx for the year. We have incurred a CapEx. The CapEx stood at INR 65 crore. As highlighted earlier, our capital allocation strategy is becoming increasingly selective and productivity driven. Investments are now focused on targeted network addition, Specialty test expansion, technology upgrades, and digital capabilities. With most of the lab network already in place, future growth is expected to benefit from improved operating leverage and enhanced productivity as volume continues to scale. With this, I open the floor for Q&A. Thank you.
Thank you very much, sir. Ladies and gentlemen, we will now begin with the question-and-answer session. Anyone who wishes to ask a question may press star one on your touch-tone telephones. If you wish to remove yourself from the queue, you may enter star and two. Participants are requested to please use only handsets while asking a question. We will wait for a moment while the queue assembles. The first question is from the line of Tausif from BNP Paribas. Please go ahead.
Good morning. Thanks for the opportunity. We have talked about our revenue growth guidance of mid-teens for next two to three years. Can you give some more color on this? Can you tell us, in last two quarters, have you seen some structural shift from unorganized player to organized player and any competition threat from online players?
See, there's no third-party data available which tells you sort of the move from unorganized to organized. Our, you know, having feet on the ground, the sense, like I mentioned in the speech, is that there is a movement happening where consumers and doctors are finding more comfort in bigger brands, which have more predictability. Also the Specialty market is increasing. You know, we have to remember that oncology and neurology are the two fastest growing therapeutic segments globally over the next 10 years.
As more of these issues come into India as well, it means more Specialty tests will happen rather than just routine, which naturally will happen with the more organized players and less with the unorganized players. This mid-teens growth, 14%-15% that we've guided for the next three years is obviously a combination of, volume, you know, RPP increase, as well as some price increase. That's the breakup of it.
Ma'am, do you plan to take a price hike in this fiscal?
Well, at this point of time, we are not looking at a price increase, but as the things progress during the year, if there is a need for us to do it, no, we would not hesitate to do it.
Okay, just a follow-up question on your guidance. We have guided a better margin of 27%-28% next two to three years, but how would you see the next fiscal? Would be in the range of 26%? That's quite achievable.
We are definitely looking at about 125 - 150 basis points improvement in the coming year.
Okay, that's helpful. I'll get back in the queue.
Thank you. The next question is from the line of Raman KV from Sequent Investments. Please go ahead. Raman sir, your line is unmuted.
Yes, hello. Can you hear me?
Yeah, we can.
Yeah, just a follow-up on the guidance part. You mentioned that you will be growing at 14%-15% CAGR over the next three years. How much will be this from the volume growth in terms of like the patient volume growth and how much will be it in terms of, you know, better price realization coming from Specialty and Core Diagnostics?
About 8%-9% of the patient volume growth is what we are estimating for the coming fiscal for sure. The remaining 5% will be coming from the realization.
Understood, sir. Sir, my next question is with respect to the Specialty division. For the past two years, the contribution the revenue makes from Specialty has been around, hovering around 35%-37%. Are you planning to increase your volume share in the Specialty division, like contributions from your Specialty going forward? Do you think this is a healthy mix?
Yeah, definitely. I think there are two big levers that we have over and above the already existing Specialty testing capabilities that we have. One, of course, we talked about the genomics journey that we have already started off and accelerating. Second one is the Core Diagnostics product capability that we have, which we'll use it across our network. I mean, these two things added to our otherwise the Specialty portfolio that we have should be able to take the Specialty contribution further higher.
Are you expecting that, this year it will be around 40%?
I think so.
Right.
Yeah.
Okay. Thank you, sir.
Thank you. The next question is from the line of Sudarshan Agarwal from Axis Capital. Please go ahead.
Hi, thank you for taking my question. In the initial comments you said you are adding some 100 mini hubs. Can you tell me the nature this is how this is different versus your collection centers, and how many do you have in your existing network? What is the differentiation in terms of CapEx requirement for, let's say, mini hub versus your normal collection centers?
A normal collection center just, you know, obviously we collect blood samples there and then transport it to lab for testing. One of the things that we have done over the past two years is we have added some ECG, X-ray, and in some limited locations, sonography as well, to sort of see whether we are able to increase the RPP per patient by doing that. We have found that that has helped us. Therefore we wanted to now go out and do this in a bigger way. It will not be about just adding X-ray, ECG, but maybe some more basic radiology modalities. Not like a CT, MRI, but more basic modalities.
Like it could include, in some cases, a bone densitometry, in some cases a mammogram, mammography machine, or in some cases a bigger X-ray machine. The idea is basically that you're creating enough services at the local level. It is not just blood, but blood plus radiology, plus in some cases it require a consultation possibility. Making these into slightly bigger, more serviced infrastructure centers, which can be then utilized not only for retail customers but for corporate customers as well.
Okay, got it. The CapEx would be higher for these centers?
Of course.
By how much?
It will be higher than a collection center, but it will probably be similar to sort of a lab, a satellite lab. You know, about INR 30 lakh, INR 40 lakh is approximately what we are estimating at this point of time.
Yeah. Got it, t hanks. Last, one more on the bookkeeping side. I was looking at your, you know, bridge through organic to growth. When you mentioned that Core Diagnostics is at high single digit, but if I subtract your MHL group revenues and EBITDA to your MHL organic numbers, the M&A portion margin comes to around 4%-5%. Is there some inter-segment elimination that is happening? I cannot reconcile the numbers to high single digit otherwise.
Yeah.
Absolutely.
Tell you, what happens when the business is generated from MHL and the processing happening on the Specialty in the Core. At the consolidation level, there is an elimination of revenue and the margin which will be there. Therefore you see that.
Okay. That benefit may be then sitting on the organic margin that you have.
Yeah. Yes.
Got it. Last one, last bookkeeping. Your depreciation increased quite sharply on a QoQ basis. I assume this is due to the genomic machinery that was expected, or there was some one-off or impairment that happened during this quarter?
It's a mix of few things. Certainly genomic machine has come also. The CapEx investment has been in the later part of the year, hence the quarter four sees the full depreciation impact. Also, the network expansion was also more aggressive in the second half. That's where those elements are reflecting in depreciation.
Got it. Thank you, that is it from my side.
Thank you. The next question is from the line of Surya Patra from PhillipCapital. Please go ahead.
Yeah. Thanks for this opportunity, congrats on the great set of numbers. My first question is on the growth side. What I am seeing that, okay, the Tier 1, Tier 2, Tier 3, in the regions the growth looks similar because the revenue mix also similar on a YoY basis. The general understanding is that the Tier 2, Tier 3 should be growing faster than the cities because cities would be having the all possible format of competition.
What's the question?
Question is that, are we not anticipating better growth or faster growth in the beyond Tier 1 market, and hence a progressively better growth with the mix improving towards that side?
Well, let me help you to decode the Tier wise growth. Tier 1, Tier 2 growth. See Tier 1 we have added the Core. You know, Core Diagnostics is coming on largely on Tier 1 setup, and you see a much higher growth in Tier 1 for the last year. Similarly on the Tier 2, you have cities like Dehradun, Agra, etc, got added, and you will find a higher growth in Tier 2. Tier 3 we are growing at about 26%-30% in the last few quarters. So definitely the Tier 3 and above is showing a much higher growth, you know, than the Tier 1, Tier 2 on a like- to- like basis. It will be continue to be so.
Okay. This digital initiatives what we are talking about, should we consider that as a kind of a lever for margin expansion or it drives even volume?
It drives volume first. Of course, you know, the cost of servicing is relatively, you know, lesser than that of a non-inorganic channel. Definitely the margins get better as our digital revenue scales up.
Okay.
Just to add, it depends on the way you acquire a customer, right? I mean, there are many health tech companies which are looking at deep discounting to acquire customers, which is not the Metropolis way. If you do deep discounting to acquire, then obviously that business may not have strong unit economics and may not be positive profitably. The kind of business that Metropolis is acquiring digitally is more on the back of already a strong brand that we have in physical channels on the ground, which allows us to therefore have a lower cost of acquisition, a lower cost of servicing, and a higher customer lifetime value, which could therefore result in a better margin for Metropolis. Doesn't mean it's the standard for the whole industry.
Sure, ma'am. Another point was about inorganic growth, ma'am. Is there any scope for that? Because it looks like that, okay, having done the Core Diagnostics, now we are focusing more on the organic part. We also do understand that t he targets in the diagnostic space within India, if we see it is more or less singular labs largely. Hence M&A possibility looks limited or less. What is your view on that from the scope of the inorganic growth?
Actually there are, like you said rightly, there are some INR 3 lakh labs in India, and 90%-odd of them are single labs. There are some chain labs which have been created regionally, and there are many, many assets available for acquisition. We generally find that the quality of many of the assets available for acquisition may not be up to our sort of standards of what we would like to buy. We will continue to be selective, but we continue to see opportunities at play. We continue to explore them, obviously when something looks like the right candidate, which is adding something strategic to us at the right price, then obviously is when we go ahead to try to close a deal. In broad, I think we can continue to see inorganic action for the next few years.
Okay. Just one clarification from my side. What portion of our, let's say, test volume would be led by insurance companies?
You know, that's very insignificant at this point of time. We don't have high volumes on insurance segment as of now. We're just building a portfolio at this point of time.
Sure, sir. Yeah, thank you. Wish you all the best.
Thank you.
Thank you. The next question is from the line of Shyam Srinivasan from Goldman Sachs. Please go ahead.
Good morning. Thank you for taking my question. Just one on the opening remarks of trying to increase our branch productivity or our network productivity by 20% for mature stores. Can you just double-click on that, please?
We have set up, all these, let's say last year, 500 centers and the year before that, 500 centers. In the initial days, you know, once the centers are set up, you know, we just drive for improving the walk-ins into the centers by engaging with the doctors nearby, and we're engaging with the hospitals, clinics, etc, nearby. Also, you know, doing many other, you know, activities to engage with the customers in the neighborhood. That helps us to improve the productivity of each of the centers that we have set up. I mean, on a year-on-year basis, you know, about 8%-10% improvement on the productivity of the same center. On a three years period, we are definitely able to get a 20% improvement from the same center that we have set up in the last couple of years.
Yeah. Is there any absolute number that we are starting with? Like this is the right numbers per center, if there is any metric like that.
For us, you know, our own centers, for example, the average productivity is around, you know, INR 3.5 lakhs - INR 4 lakhs per center. When we set up in year one, you know, this comes to by the end of year one, you know, we do about INR 1.5 lakhs, and we bring this into about INR 3 lakhs at the end of the third year. That's the number for our own centers, and these numbers differ for the franchisee centers and the rural centers.
Got it, very helpful. Thank you.
Yeah.
Just my second question on the other comment on digital channels, right? That they now contribute. Did I get it right when you said it's contributing 25% of revenue? If you could explain that, please. What are some of the measures? I know we've been investing in technology, but just want to understand the nature of this channel. Is it like D2C, or am I missing something here?
No, these are largely D2C. Let me talk about three distinct channels here. One, of course, you know, our Metropolis app. We drive customers through the Metropolis and engage with them. Secondly, I mean, we, you know, acquire customer through our website, you know, where we will, you know, encourage the customer to come and, you know, place his request for a test. Third one is our, you know, the customer data platform, which is a CLM engine that we talk about. Every existing customer, we reach out to them through the digital modes and give them what the next best action or on the basis of their past, you know, testing trends, you know, what is the right thing for them to do in the coming days, you know. These are three big, you know, initiatives that we do to drive the digital, you know, customer acquisition.
Helpful, yeah. Thank you and all the best.
Thank you.
Thank you. The next question is from the line of Alankar Garude from Kotak Institutional Equities. Please go ahead.
Hi, good morning, everyone. Sameer, can you elaborate further on the inter-segment eliminations and how long will these eliminations continue?
It will be there always because when we core the business is going to process genomics business and oncology businesses, and while the revenue is generated across the network, that is the synergy benefit that we'll. Where we are expanding this test menu to across the country, all of our client and clinicians. That is from where the revenue will generate it and then the processing will happen. That's why the intercompany transfers will happen and the elimination will be there.
In fact, if I can just add on to what Sameer said, you know, one of our objective is to drive high-end oncology revenue of the core products through the MHL distribution network. We will keep on stepping up this particular engine and start selling more and more core products through the MHL distribution engine. As the revenue grows and of course, there will be more and more intercompany adjustments. When you look at the group level, you know, this anyways gets neutralized and, you know, we'll report the net number at the group level, as you know.
Got it, sir. Just thinking whether ideally we should split the inter-segment eliminations between the organic and the inorganic EBITDA when you report it in your presentation. Would that be a better approach or you think organic EBITDA is what the true EBITDA is as you report in the presentation?
See, honestly, we can go and split the hairs, the reality is now the acquisition is a year old, everything is going to be organic anyway from April 1st. It really doesn't matter. It will all get consolidated into the group anyway.
Okay.
From quarter one results onwards, you will be seeing only one number in all our, you know, presentation, which is the organic or a company level number. Last year we provided this because, you know, the acquisitions were just happening and integrations were happening.
Fair enough. The second question is, you have been seeing a pretty good increase in revenue per patient as well as revenue per test, despite not taking any price hikes over the last few quarters. Premiumization and TruHealth have been important drivers. Specifically on TruHealth, based on the visibility you have today from 19% currently, till what level can the mix increase to over the longer term?
Well, I mean, this can definitely go beyond 25% as well, I mean, in the next two to three years period. I mean, every year I think we are moving this up by about couple of percentage. Maybe in the coming years we will further step up our efforts to, you know, make it faster. Because we are now in the TruHealth packages, we are including vital checkup consults, basic radiology, you know, and also going forward, maybe some of the other adjacent services we'll keep adding. You know, the overall RPP will keep getting better on the TruHealth packages. We would like to see this going, moving faster, the contribution of TruHealth moving faster in the coming years.
Understood, sir. That's it from my side, thank you.
Thank you. The next question is from the line of Kunal Thanvi from Banyan Tree Advisors. Please go ahead.
Hi, thank you for the opportunity. I had two questions. One was on, you know, the gross margin expansion that we have seen, you know, for Metropolis and for Abhopay as well. If you can, you know, double-click on this and explain us what is that is driving this gross margin improvement. Is it only the scale advantage that we are seeing from our suppliers or it is also to do with the on ground competitive intensity kind of softening in last one year? The trend has been true for almost all the, you know, listed players. That was first question. The second question is on our core markets in something like Mumbai, like what kind of volume growth are we witnessing there?
You know, in few concalls you said that you've been gaining market share in core markets like Mumbai as well. Is the trend still, you know, continuing? The last one was, you've talked about, you know, the lab expansion is largely behind us, and from here on we'll see operating leverage. If you can, you know, again, double-click on the current utilization level on a console basis and how that is, you know, expected to move around in FY 2027 and then in going ahead. These are three questions. Thanks.
Okay. Let me address the first question, which is the, you know, gross margin improvement. There are two things which is really helping us to improve the gross margin. One is, like we mentioned in our speech, you know, we have undertaken a lab platform consolidation and upgrades. You know, we are just consolidating some of the vendors and moving to better, higher efficient, more productive technology-enabled and scalable platforms, you know. In this process, you know, we will get, you know, scale advantage. In this case get some advantages coming out of the technology and overall our material consumption hence, you know, improves. Also during this year we have introduced, you know, bar coding in all our 220 labs, which has also further helped us improve our, you know, material consumption percentages.
Second thing that we mentioned, you know, last year we have not significantly added any more new labs. You know, our lab addition phase is over, I mean, a year back. You know, in the coming year also we are not planning to add, you know, high number of labs in the network. These two things will definitely is helping us to improve the gross margins, you know. The second question was about, you know, what you said that?
Volume.
The Mumbai city volume side. I think it's largely in line with the overall volume of the company volume growth. I mean, give or take 1 percentage here and there, that's the numbers that we see across the geographies. Of course, we see a much higher patient volume growth on the northern part of the market for us, I mean, for this year because of the new acquisitions that we have done on that side. Otherwise, largely across the country we are getting stable and good patient volume growth across.
Sure. On the utilization of overall lab capacity?
We talked about, you know, the lab, you know, what do you call, productivity has gone up by 14% during this year, right? That's why we do not add any more labs and add more centers to feed them. The lab utilization, you know, goes up. You know, see, the, all these labs are of a different category. You know, some of them are big regional reference labs, some of them are global labs, some of them are satellite labs, and some of them are greenfield labs.
You know, it's very difficult for us to give a one unit as to lab utilization for per se in this business. I mean, we can talk more about when we set up a lab, you know, we are just starting fresh. Every year if the growth goes up by 14%-15%, you know, that's utilization growth that you can, you know, relate to.
Yeah, got it. If I can squeeze one more question, that was to do with, when we are talking about, you know, this productivity improvement, you know, the efficiency improvement, the use of technology, etc . You know, from a longer-term perspective, like say five years, 10 years out, what kind of, you know, steady-state margins this business should have? Because with the kind of gross margin expansion that we have seen, like, you know, what is at some stage when, you know, the expansion, when most of the labs that they're adding today will get kind of, you know, utilized, you know, to an optimal level. Like this 27%-28% EBITDA margin is the aspired to make or over longer period margins can even go further if we don't, you know, choose to invest aggressively the way we've done in last few years.
Margins can keep expanding till the time you have operating leverage, right? I mean, as long as you're able to keep growing the business and your cost growth is lower, you can keep having operating leverage. Finally, I think when we are building a business, you look at it not only from a short-term basis, but a medium and long-term basis, and keep reinventing yourself and keep investing in strategic initiatives that allow you to build second and third growth engines for the future.
Maximizing the EBITDA and may not, in our mind, be the smartest strategy. We believe a sustainable EBITDA at this point over the next three years, of 27%-28% makes sense for us. If we are able to generate more operating leverage, we would like to invest it back in the business, either in terms of adding services or building the brand further or building for the distribution. That's the direction we would like to go.
Yeah, makes sense. All the very best, thank you.
Thank you.
Thank you.
Thank you. The next question is from the line of Kaustav Bubna from BMSPL. Please go ahead.
Yeah, hi. Thanks for taking my question. You know, previously you mentioned that your growth in Tier 1 areas is less than it's in single digits. I wanted to understand really because let's take Mumbai for example, right? In Mumbai, even a Tier 1 city is broken down into different areas where consumption patterns would be different because of the type of people with different income levels staying in those areas. If you take Bombay, for example, right, and you say what would your growth rate, expected growth rate be in a place like Mumbai?
If you had to actually break that down between the areas of Mumbai, like, you know, north, south, like a eastern, more eastern area, like the Kalyan side, etc, what would you say Metropolis', how you call it, presence is in these areas, and how would the growth rates differ in these different areas in Mumbai?
See, Mumbai is our biggest market, as you know. You know, we have about 500 service centers across Mumbai, not only in the metropolitan area, but also spread into, you know, across, even the, you know, outskirts of Mumbai. We are present, you know, whichever, whether it's Kalyan or Borivali or, I mean, Virar, Vasai. I mean, all areas we are spread off, and we keep increasing the, you know, network print footprint in this area. This is a continuous process.
In Mumbai also we are growing at 13%-14% kind of a revenue growth on a year-on-year basis. It will be difficult for me to share, you know, further micro market segmentation of Mumbai and tell you how much is the Kalyan growth, how much is the Thane growth. That will be very difficult for me to share with you. At an overall level, most parts of Mumbai are growing at 13%, 14% kind of a growth.
Just to clarify, I think the Tier 1 growth is not single digit, but it's closer to 11%.
Okay, thank you.
Thank you. Ladies and gentlemen, due to time constraints, that was the last question. I now hand the floor over to the management for closing comments.
Thank you to all for joining us today for the Q4 and the FY 2026 earnings call. We appreciate all the engagement and all the questions. We've had quite a tremendous year, not only a year with a strong organic growth, but a year of fundamental building, which has also helped us expand our margins quite significantly. Also a year where we did four acquisitions and have not only absorbed them, but seamlessly integrated them into the business. You know, realizing obviously a very fast growth rate of about 23.6% for the whole year. We are very, very excited and positive about the next three years, we believe that we are three or four channels, or we are three or two sort of pillars.
We'll continue to build the business very strongly. We are doubling down on technology. We are doubling down on building engagement with our consumers and building the brand through experience, and doubling down on science, and really building the scientific foundation even stronger. Obviously all of this is going to be enabled by the right people, the right talent, and finally to result in a commercially and a stronger business and a bigger business, in the next few years to come.
We continue to remain excited, and we look forward to meeting all of you soon. And we are looking forward to actually planning a sort of a day in our lab, sometime in June or July. We'll come back to a lot of you, where we would be very happy to host you, show you around, and engage even deeply, more deeply. Thank you so much.
Thank you very much. On behalf of Ambit Capital, that concludes this conference call. Thank you all for joining us, and you may now disconnect your lines. Thank you.