Good morning, everyone, and welcome to our third quarter 2020 earnings call. This time around, like in the second quarter this year, with these exceptional times that we are living through, I would like to also this time start this call with sending a strong voice of recognition and thank you, first of all, to our dedicated staff and particularly our frontline staff, who all work relentlessly and professionally day round to handle the ongoing COVID-19 pandemic. I really want to start with sending that voice of recognition and thank you. Over to our results. This is our first ever more than EUR 1 billion revenue run rate quarter, so that is quite a milestone, in fact.
For those of you that have had the pleasure of joining us since the IPO three years ago, the third quarter 2017 was the first full quarter that we reported, and we are up 82% since then. In fact, a 22% compound in growth over those three years, which I think well illustrates the built-in power in our business and our business models. Clearly, the rebound that we reported in the second quarter has continued quite strongly also in the third quarter, with robust demand pretty much across the board for our services. Important to point out is that if we call the base business or the underlying business is not yet back fully at pre-COVID-19 levels.
Of course, it varies a little bit between business to business, but in general, that's an important comment, and we will show you some graphs to illustrate that a little bit later on. However, this is certainly more than compensating by surging demand for COVID-19-related services, which again, I think is very well evidencing the resilience of our business. We have strong underlying margin expansion, and again, important to point out that also when we strip out the COVID impact, we still have quite significant underlying margin expansion in our business, evidencing the effect of scale, cost optimization, and ongoing efficiency programs. Always good to remind you what I think I say every time we have this call together, the benefits of our diversification. Our diversification on payer groups, our diversification on service models, and our diversification across our different geographies.
As we talk you through the presentation this time, I think it is as clear this time around as on all other calls, how important and strong benefit that is to our business. We have exceptionally strong operating cash flow, again, evidencing the growth of the business. Joe will speak much more about that later on. Our corporate paid business, which as you know, is very significant in Healthcare Services, as we commented in the second quarter, is now back growing again in the third quarter, albeit at lower rates than historically. I think that's a very important point of principle to show that even in times like we are still living through, that business is back growing. We are all aware, you are all aware of that the virus spread is again increasing across the world and certainly in our markets as well.
Of course, our main operational focus is on protecting and supporting all our staff in this way in order to be able to service and help both COVID-19 and other patients and customers as well as possible. Looking specifically at the quarter, EUR 262.5 million of revenue, just short of 24% top-line growth, of which organic growth 12.3%. Indeed a very strong figure. You see on the graph to the right, the second quarter 2020 there, the prior quarter being the exception to our growth trajectory. It is nice, good, and important to be back with our historic solid growth numbers. EBITA was at record levels, north of EUR 50 million, 54% up versus prior year with a 19.1% margin. Very significant growth in our fee for service segment, plus 37%, now up to 56% of group revenue.
That is, of course, heavily impacted by the inclusion of Medicover Hospitals India from December last year, as you know. In fact, I think this is the first time that fee for service is significantly more than 50% of group revenue. In order for you to be able to understand as much as possible the results and the underlying business, we have carved out the best estimates possible in terms of the specific contribution from COVID-19.
In this quarter, that is estimated on an EBITDA level to be EUR 12.5 million or 2.8% of the margin increase, which leaves, as you see, one percentage points or 100 basis points underlying margin improvement. In the ongoing business, important to point out is, of course, that as you see when you read through the full report, that we are estimating that we have lost out quite significant amounts of revenue, more or less equaling the additional revenue that we estimate came in from COVID-related services. The fact that we can grow the underlying margins despite losing out quite significant amounts of revenue still on the not fully recovered base business, I think one really needs to recognize the importance of that. As we have communicated before, we maintain the three-year financial targets for 2020 through 2022.
On the right-hand side at the bottom, you see the two pie charts that we typically show you. What is different this time around? Well, point made, fee for service has grown quite significantly as a proportion of overall revenue. The funded business, the employer-paid business is back growing. It's 3% year-over-year, much lower than historically. Again, of course, the important thing here, it's a positive number. We brought in 24,000 new members during the quarter, which is not insignificant. On the geographic split, I think the thing to draw your attention to is the German segment, which is now reduced to 23 because of India inclusion. You see the German pie is growing 26%. That's a number that sticks out. There's very minor elements of acquisition growth in that.
The vast majority of that number is underlying organic growth in the largest and most mature healthcare market in Europe. I think that number somehow sticks out. Move on to Healthcare Services. A very strong quarter for Healthcare Services. Revenue up 29.5% to EUR 146.4 million. Organic growth, just short of 7% of that. EBITDA up a very strong 76% to EUR 29.7 million and north of 20% EBITDA margin. This very strong performance is coming certainly from contribution from COVID-19 services, but also a lot of work being done with the cost optimizations. We estimate the additional contribution on EBITDA levels from COVID in this division at EUR 6.4 million or equivalent of 2.4% of that margin expansion. You extract that out and you see the underlying margin growth excluding COVID was 2.9% up.
The point I made on the group just recently here that remember that margin growth, margin expansion is coming despite having then still lost out quite a bit of volume in the still not recovered base business. That's a very strong number. Fee for service, which in this division now for the first time is up to exactly 50% of revenue. Never been on that level before, up 68%. Of course, most of that being the inclusion from Medicover Hospitals India that were not in the numbers last time around. Members now at just north of 1.3 million, up 24,000 for the quarter. That's an important number. We had very high demand in India during the quarter for COVID admissions. We had 5,000 admissions during the quarter, which is significant.
That tapered off somewhat towards the end of the quarter as the virus spread somewhat reduced in India towards the end of the quarter. On the bottom half pie charts, I think the only thing which I want to draw your attention to is, again, India then representing now 20% of revenue in Healthcare Services with the full inclusion and growth of Medicover Hospitals India. Moving on to Diagnostic Services, where revenue was also up a robust 17.5% to EUR 120.1 million. Organic growth was higher, which is an effect of that we've had quite a bit of negative foreign exchange movements against us. Pulling that out for an organic number, that gets even higher at 18.7%, which is very significant indeed.
EBITDA at EUR 23.5 million, up 25% to a margin of just short of 20%, supported by significant amounts of COVID-19 testing, which we estimated at EUR 6.1 million of extra or additional EBITDA contribution or 2.9% margin. You pull out that 2.9% margin and you see, in fact, in this division, margins contracted 1.7% versus the prior year quarter. Again, just as we commented in the second quarter, that's a direct reflection of the fact that in our underlying business, volumes have not fully recovered, and hence our contribution from that part of the business is foregone and margin is slightly lower. I still make the point, same as on Healthcare Services, the fact that we're having these results despite that revenue not yet recovered, I think is a very strong sign.
Fee for service in this division, as you know, has always been higher, and it's two thirds of divisional revenue, was up 16%. Number of tests increased by 3.3%. I already made the point that although demand has certainly recovered sequentially, but non-COVID-19 testing still has some way to go to be fully back. We grew our BDPs as well this quarter by nine of them. Now for the first time, we have more than 700 BDPs across the region. Next slide, we have a nice picture. Just wanted to share with you. We have communicated some weeks back that we have opened at the Munich Airport, terminal 2, a COVID-19 rapid test center. This is up and running since about a month back. It works really well.
This is the way for travelers as well as airline staff to come get their test at the airport, get clearance, get on their plane to whatever destination you're flying. It's easy, it's very reliable, and it works really nicely. If any one of you on the call happens to fly via Munich, this is terminal 2. I really do emphasize, come and see us at this test center. Looking at some specific impacts for the two divisions. The net impact, we comment on this in more detail in the full report. If we take the net impact of the estimated additional COVID-19 related revenues and pull off the lost revenue from fully not recovered business, in Diagnostic Services, we estimate that to be a positive EUR 4 million to EUR 7 million on the revenue line.
We performed just north of half a million COVID-19 tests in the quarter and a little bit more than three quarters of a million year to date. You can see the ramp up in the third quarter relative to the first half of the year. That test capacity is then further ramped up as we progress. I just made that point that we continue to invest in infrastructure and machinery, upgrading really machinery in terms of capacity. Us, as anyone else in the diagnostic industry, do have supply chain challenges, whether that is obtaining the high throughput machinery or obtaining the required reagents or utensils around to operate. We manage that, but that is for us, as for everyone else, an ongoing challenge. I just commented on the Munich Airport site with the pictures we looked at.
On Healthcare Services, we estimate the net impact, so the additional revenues less the foregone so far from a - 3 to a + 1. The integrated healthcare model has certainly shown a strong resilience, not the least by growth on the member level returning in the third quarter. Our utilization is returned to much more normalized levels. That's important to point out because that reassures us that any potential backlogs of care needed is being looked after and cared for. Our fitness membership business is still impacted, where some of these additional restrictions that has been put in on the back of increased virus spreads do impact the gym's business. That is impacted. Demand for COVID-19 treatments has been significant in India.
I already made that point, and we see that has been slightly weaker towards the end of the quarter, which from a public health perspective is good because that's on the back of the virus surge somehow reducing India. At the end of the quarter, we had 630 dedicated COVID-19 beds in 11 hospitals across India. We have kept investing in bed capacity and also in machinery such as ventilators. I think the jury is certainly out in terms of where the virus spread is going to go from here. We are not predicting. We're staying out of the prediction game, but it may very well be that the virus trends start swinging back up again in India, and then we want to be in a position to be able to put in our effort to support what needs to be done to help out.
Elective services is still lower than normal levels. I think I made that point now a number of times. These are two diagrams. You remember in the spring when the crisis first hit, one way we tried on these update calls then to illustrate for you where we put on three graphs like this, which were showing the German, the Romanian, and at the time, the Polish fee for service diagnostics business to show how demand dropped and then sequentially recovered. Here, we have done the same graph. This is just Germany and Romania to stay on one page. The point we made in the spring, this is very reflective as well, if we were to do the graph of fee for service activities in Healthcare Services. This is just really to show you in terms of the trend lines.
You see two colored graphs, the bottom one, which is slightly paler, that is the revenue levels excluding COVID impact. The more colored red is the total revenue level. The point really to make with these two graphs is if you have the starting point at the very left, and then you see where these two graphs end up, you can see that the Germany point we made many times in the spring recovered pretty quickly and then has hoovered along. The underlying business, you can see in Germany, has still not recovered fully, but it's more than compensated with additional COVID-19 services. In Romania, that's even more pronounced. Shall I go on? Yeah.
Yeah.
Right. We apologize for that little technological interruption. I was just chatting about the right-hand graph showing the Romanian daily revenue line as an illustration. I made a point that while this is Romania diagnostics, on the left is Germany diagnostics. These two lines are very illustrative. Whatever fee for service business in the group we would put on, obviously they wouldn't all be identical, but the trend lines would be very similar. Base business not fully recovered, combined business quite significantly ahead in diagnostics. In services, recovered, but slightly below in base business. With that, handing over to Joe for a bit more detail of the financial comments.
Thank you, Fredrik. On this slide here, we broke out the COVID related revenues as well for a little bit of visibility. Overall, for the quarter, COVID revenues were some 12%. If you look down to the two segments on the Healthcare Services, that was a little bit lower at 11% and a little bit higher in terms of for the Diagnostic Services, 12.7%. Obviously as the diversity of the businesses in the Healthcare Services, there's only certain parts which then access and provide COVID related services, whereas across the diagnostics it's much broader. Towards the end of Q3 we launched finally services also in Ukrainian market and Belarusian market, so that started to pick up a little bit towards the end of the quarter.
If you look at our preferred measure, EBITDA, the EUR 38.1 million for the quarter, 14.5%. Last time around that was EUR 22.3 million, 71% up. Really fantastic financial performance on the back of that recovery, and on the back end in terms of the services that we've been able to provide to support patients and governments in addressing the pandemic. I'm very happy with it there. If we look at in terms of government grants, we had some EUR 1.2 million government grants recognized in the three months. On the nine months we had EUR 2.4 million of government grants recognized within these figures, that was treated as a reduction of costs. If we look at the IFRS 16 lease adjustments, the landlord agreed reductions and assistance that they gave us in Q2, we recognized a small part of that now in Q3.
Some EUR 200,000, and for the nine months, that was EUR 1.4 million. Again, a reduction of costs. If we look at some of the financial items, interest cost EUR 3.5 million. Although we've reduced our net debt levels, we still have the lease interest, of which EUR 2.5 million of that EUR 3.5 million, and so our underlying debt and actually mostly our unwinding of discounting for various different items in the balance sheet, some EUR 1 million.
FX loss was more volatile, as when IFRS 16 came in, I predicted we would see volatility in that line. We had EUR 2.3 million loss in the quarter, and EUR 1.2 million of that was due to EUR-denominated lease liabilities on our balance sheet getting washed into the FX line. Q3 cash flows very strong, EUR 43.4 million. This is with also increase in working capital of something just over EUR 9 million.
For the year we had positive inflows in terms of working capital. Tax charge. This we start to normalize as we are showing a good profitability level. We're looking to have something like probably the order of a little bit higher than prior year, probably around 28.5% effective tax rate for the full year. Tax paid was lower as we have some ability to defer with some government schemes. That was EUR 7.6 million actual physical cash paid for taxes. Cash and cash equivalents very strong. Just short of EUR 110 million. Up some just short of EUR 35 million since the year-end, obviously with the proceeds from the share issue we did earlier in the year. Then also our debt repayments. All of our commercial paper program has been repaid, so we have no commercial paper outstanding at the end of the quarter.
Loans payable net of cash are down to a very low, just short of EUR 62 million. Our lease liabilities, they've increased EUR 9.5 million. The other side of that FX movement going through the P&L account is the lease liabilities increase. If you look at on the nine months, EUR 9.5 million, I think just over half of that is due to FX movements. Lease liabilities up to EUR 185 million from the year-end level of EUR 176 million. We've been expanding our footprint in India. We're adding new facilities in there as we did press release earlier on in the year. Also in terms of adding new facilities in Poland as we put our expansion plans back into process. Liquidity, very strong. We have pretty much our full revolving credit facility undrawn. In addition, our cash balances on hand. Debt markets are very accessible.
Our credit rating has increased. We're very well positioned in terms of being able to make use of our balance sheet in the future. Capital investment, EUR 10.5 million. We have resumed our capital program. We put that on hold in the Q3 with the uncertainty. We have, for instance, our first LINAC coming online now in Q4 in one of our Indian facilities, and the next one should follow quite quickly early in the new year. COVID-19 helped us to really crystallize some of our thinking and review of some of our development units, and we have an impairment charge, EUR 5.2 million on some goodwill and other assets which have gone through in the nine months. IFRS equity, just short of EUR 500 million. EUR 479 million up from the year end, up on the share issue, up on the strong financial performance.
We also had quite a large translation adjustment movement in terms of our net investment in foreign countries. We broke that out there. You see Poland is the largest of those. Obviously with Poland being our largest footprint, even though the FX movements were large enough with our large exposure there in Poland to have an impact on that. Just to remind you, we look at our cash flow underlying in terms of the countries. In all of those three countries there, we've got fantastic cash flows coming through, and that's really what it's about, is our ability to generate cash out of our investments there. We look at our financial targets, extremely respectable. Q3 organic growth 12.3%.
Do bear in mind that when we look at the COVID related revenues for the Healthcare Services side of the business, a large part of that actually is in the acquired part of the growth. Very respectable. Even if we look at the nine months, still a very good growth organically, even taking in the big shortfalls that we had in Q2. Adjusted EBITDA margin 19.8%, so again, very respectable. Even for the full year, 15.5%, which then is already at the target levels for 2022. Obviously helped by the COVID related business. Our capital structure, very respectable again. 0.7 times in terms of our loans payable net of cash, looking to our EBITDA figure.
I think that just reemphasizes in terms of the liquidity point that I made earlier on, that we have a very good position in terms of being able to leverage the balance sheet further with both organic and inorganic growth. Fredrik, maybe I'll hand back to you.
Sure. Thank you, Joe. Before handing over to questions you may have, just a quick wrap up. We clearly have a very strong quarter behind us. In fact, I think it's the strongest quarter we have ever had. We see continued strong and growing demand for all COVID-19 related diagnostics as we go forward. We see some signs of early change in consumer behaviors for elective services due to the increased virus spread in our markets, but so far, really only marginally. We do expect our strong growth trajectory to continue as historically, and I think we are very well positioned considering where we are, and certainly our balance sheet, and the demand situation certainly for the remainder of 2020 and also into 2021. With that, we wrap up, and very happy to see if there's any questions.
Thank you. Ladies and gentlemen, we will now begin the question and answer session. As a reminder, if you wish to ask a question, please press star one and wait for your name to be announced. If you wish to cancel your request, please press the hash key. Once again, it's star one if you wish to ask a question. Thank you. Your first question comes from the line of Christopher Neeley Barr from Carnegie. Please ask your question. Your line is now open
Yeah. Hi, good morning. I wonder about the COVID positive effect on sales in the Healthcare Services. Is this mostly related to India, or have you had inpatients in other countries as well?
Yes, Christopher, it's mainly related to India. We do have it elsewhere as well, but it's mainly India.
Okay. Your comment about the continued strong demand for COVID-19, I don't know if you phrased it services or whatever.
No.
Is that-
I said related diagnostics.
Okay, where you see it now is in the Diagnostic side, not in the Healthcare side?
Well, I said that we are certain to see continued strong demand in the Diagnostic side, and the demand on the Healthcare Services side is very much related to how the trajectory of the virus spread will go, and particularly in India.
Okay.
I don't want to get into speculating. That was the point I made. We've invested to be able to be in a position, if it start to goes north again. Time will tell how the virus spread in India evolves.
Okay. Right now in India at your hospitals, do you have fewer COVID-19 patients than the average for the third quarter?
Yes.
Okay. Yeah. If the COVID volumes are going down in India, how quickly do you think you could compensate that by the normal business, or is it likely to see India declining year-over-year now in the next few quarters?
No, I wouldn't say so. It's not one to one, week to week, but I think it's fairly compensatory, so to speak. Yeah. Over a quarter or two.
Okay
It sort of equals out.
Also, Christopher, I think you need to make sure you don't underestimate what we've been doing in India as well. We've added quite a number of facilities, and we still are adding new facilities as well. Year-on-year, you're going to have that driving growth as well.
Okay. Just last one. The strong growth in Germany, you mentioned, how much of that is COVID testing?
Well, we stripped out the amount of COVID-19 testing for you. A large chunk of that is Germany, that very over significant growth, so to speak, is largely COVID-19 related testing.
That graph that we put on there, just to illustrate the COVID versus non-COVID, we have Germany there as well. You can actually see day by day what the split is, if you like.
Okay. That's perfect. Thank you very much.
Thank you. Your next question comes from the line of James Vane-Tempest from Jefferies. Please ask your question. Your line is open.
Hi, good morning. Thanks for taking this. Two, if I can, please. On the Diagnostic Services business, it's very helpful to see the revenue progression with and without COVID-19. I'm just kind of curious, when you consider sort of seasonality and things from where we are, is the Q3 number sort of representative of what we can expect to see in Q4? My second question is on the Healthcare Services margins, clearly very strong in Q3 compared to history. I know you've given some qualitative statements in terms of what's driven that, it'd be helpful to try and go into that in a little bit more detail to think how that can impact, or benefit Q4 as we go into next year, if that's representative of the business mix. Thank you.
Hi, James. I think Fredrik was quite emphatic about on the Diagnostic Services side that we're going to continue to see large levels of demand in terms of COVID-19 related services. I think that that's not controversial if you look around what's going on in our markets, I think that you can fairly clearly see that that's going to be the case. In terms of Healthcare Services, the margin underlying has been very good. We took Q2 to clear out, as you see in terms of the impairment charges and things which we had less confidence in a more difficult economic environment were going to get to the points where we needed for them to be to justify themselves. We went through and looked at that. We obviously went through on our cost structure as well, looked at that.
Also in terms of the whole digital shift in terms of that's been helpful as well for us in terms of being able to provide services in a more cost-effective way. How much of that will stick, we'll see over time. You see we came back to growth in terms of the Q3. I think that is a very strong indication about the level of demand, the employment situation that you're seeing, particularly in Poland. I think those are the things that are driving it, really. On top of which you then have the COVID-related business, which we broke out for you.
Sure. I guess the margins were north of 20%, which is new phase of evolution. It is such a big uptick, I understand what you're saying qualitatively, but are there any one-off cost reduction measures which are expected to come back or mix shifts expected as we get into next year? It is a standout number, it would just be helpful to understand perhaps how much those measures you mentioned benefited the profitability.
Yeah, I think we broke out also the government grants, that helped at some sort of marginal level. In the course of the support from landlords was negligible. It's a good situation. We've got a lot of people pulled together and those are the main drivers. We also, as I mentioned, we trenched a little bit in the Indian fertility business as well. We took a view there in terms of some of the new development locations that we were going to cut those. We came back to a core there that also had an impact as well, particularly year-on-year. That was very supportive in terms of the numbers.
Last follow-up for me, if I can. How supportive then were, you mentioned the landlord, so if you hadn't had that support from the?
No, that was on the full 12 months. I gave you that number there earlier on in the call. That was EUR 1.4 million.
Oh, okay. All right.
For the nine months, EUR 200 ,000 for the quarter.
Okay.
EUR 1.2 million for the government grants for the quarter, EUR 2.4 million for the nine months. EUR 12.5 million was the contribution overall from the COVID-related business, which is the same at an EBITDA level because we haven't really allocated any lease costs into that, so there's not much difference.
That's great. Thank you.
Thank you. Your last question comes from the line of Paul Noring from Danske Bank. Please ask your question. Your line is now open.
Good morning, guys. I have a couple of questions. If we look at the current trading in October and early November in Healthcare Services, could you say anything about how the kind of COVID-19 development we are seeing in Poland right now, how that is impacting elective surgeries and services? That will be very helpful if you could comment on that.
Yeah. That's the point I made in my little shorter wrap-up here. I think I said we are seeing some signs of change in consumer behavior for elective services due to the increased virus spread, but so far only marginally. You can see some of it. It's a very big difference. Perhaps I just slightly expand on that answer because we've had other questions that hasn't been asked on this call. In terms of the increased restrictions of movement, et cetera, how does that impact versus how it very significantly impacted us in the spring? It's a very big difference if I talk specifically now about Poland and in terms of what the authorities do. Clearly the virus spread is significantly many times higher now than it was in the spring.
In the spring everything closed down and movements were significantly restricted as we talked about quite a bit in the spring and very much impact everything we did. The restrictions on movements are much less, almost really none. You have quite a lot of restrictions on group gatherings, putting larger groups of people together, restaurants, all those kind of things that would be similar pretty much in every country across Europe, perhaps slightly different here in Sweden. That doesn't really impact yet people's ability to come and be serviced. Consumer behavior still changes a little bit because of I'm sure people are a little bit reluctant perhaps to do some things that they can wait with.
So far what we have seen has very marginal impacts on us and I'm not going to try and speculate how that will be a month or two down the road. We certainly in no way would expect a scenario like what we saw in the spring.
Thank you. That's great. Can you say anything about how the sequential maybe development in let's say Healthcare Services has been during the quarter? In July, August and September, how has things changed over the quarter versus being flattish or how has the development been if you could say?
I think not to pad our own backs, but I think it has been very much like we sort of predicted in the spring actually. I think we called it back then an ongoing gradual recovery in the third quarter and approaching normalization in the fourth quarter. I think that is very much what we have seen. We have seen an ongoing improvement sequentially during the quarter. I think that very much supports that view really.
Yeah. That's great. Lastly, if you could comment anything about the supply chain constraints that you're seeing in COVID-19 testing. That's what everyone is seeing as there are so large volumes. Can you say that will that impact you negatively in Q4? Will you still be seeing? You're still stating that you're predicting to see a strong development. Can you say anything? You expect that to increase sequentially, the COVID-19 testing from Q3? Will the supply chain constraints impact negatively?
No, it will not. I think the point we're making, we could not comment on this without commenting on supply chain issues because everyone has it. I don't want to compare to other people, but we were quite fast to seek to increase capacity, invest in higher throughput machinery. As we speak, we have put in place significantly higher capacity. I don't think it's going to negatively impact our ability for sequential growth in the fourth quarter. I think you should more read that comment that if we had had, which we don't, but if we had had another one or two or three pieces of machinery, we probably would have filled that as well. We don't have that because no one else has it either. You're going to run at full capacity. I think that's the sort of prediction we're making.
Yeah, I think that anyone in this industry you ask that question to, they're going to be running everything that they can. If they could get more capacity, they would put it in place.
Yeah. Thank you. If I may, just one last one. If we look at the investment levels, that has been a bit lower maybe in Q3, and you're saying that you're starting to invest again now more in Q3. Can you say anything, will lower investment activity maybe impact organic growth going into 2021? Do you see that maybe pent-up demand in maybe Healthcare Services will, what do you say, mitigate the lower investments, or how should we see this?
No. We maintain our guidance in terms of the three-year outlook, and part of that then is making sure that we put in the investment that's required to actually drive that growth. We halted things in Q2, but it was just a temporary hiatus and we've put that all back in place. As you can see in terms of the recent expansion in India, we even accelerated that a bit.
Yeah. Thank you guys. That's all from me.
Thank you. We have no further question at this time. Please go ahead.
We have two questions in the chat room from AL Bank. Regarding slide nine, what is the index on the chart? It's in EUR and RON.
Yeah. Index is in Euro for Germany, and it's local currency for Romania, Romanian lei.
The second question is the recent acquisition of Dental Sense in Poland a new business area for Medicover? If so, what is the overall plan?
No, not at all. This is the private pay dental business that we have focused on since now, I guess it's three, four years back, or perhaps five even. In terms of the Polish dental business, we sort of do two things. Historically, we have provided dental service internally to our insured members pretty much since we started, and we certainly continue to do that. In addition to that, since, let's say five years, as a proxy, we have also started to develop greenfield organic, our dental business, to cater to external fee-for-service patients. In addition to that, we have also consumed a number of acquisitions to build a nationwide dental network. That is very strategic for us. It's very well executed by our Polish dental team.
In fact, that is probably the area where we do most absolute number of acquisitions, although all of them individually are fairly limited in size due to the nature of the dental business. Dental Sense, in fact, was probably one of the larger ones historically. We expect and we will do many more of those as we proceed.
Any more questions?
We have no further question on the phone. Please go ahead.
All right. We thank you all for participating and look forward to meeting you all, hopefully, at the fourth quarter announcement in the beginning of next year.