Warm welcome to Medicover's Investor Update. My name is Mattias Vadsten . I work as an equity analyst at SEB. I have the privilege to lead this session as a moderator today. I'm part of being responsible of covering Medicover at SEB. Whether you're joining us here in Stockholm, many of you are, or online, we're delighted to have you all here. I will start with giving you a brief introduction to the agenda. We will have two speakers today, John Stubbington, CEO of Medicover, and Anand Patel , CFO. So yeah, John will start with a business overview, a strategy introduction, and then we will have the financial highlights by Anand . So after each presentation, we will open the floor for questions.
Online attendees may raise their hands during designated Q&A segments of this presentation, as I talked about, and wait for a microphone. For online guests, please submit your questions via the chat function at any time, and I will address them. So, lastly, I would mention, I know it as an analyst in the past, you don't need to take photos during the session because it will be readily available online. So I think with those intro words, I'm pleased now to hand over to CEO, John Stubbington.
Good afternoon, everybody. It's my pleasure and duty today to talk to you through a little bit of our history and a lot about our future. Medicover's a great company. You know, when we kind of listed a number of years back, it was an exciting time for us. It was a very unknown time for us, but as you can see that over that period of time, we've grown quite considerably. I mean, this is an incredible sort of growth story that has occurred over that period of time, and we're 3.8 x bigger than we were at the time of listing. Most of that growth has come from organic positions, which is really, really good.
We've managed to be able to develop our markets and be able to move our business forward, and of course, we've complemented it with the odd acquisition along the way, which has been very encouraging and added a lot to our portfolio. If we look at the targets that we set out three years ago, again, when we set those targets out, there were a lot of people saying to us, you know, could we hit them? They're big numbers. You know, there's a long way to go to be able to deliver them. We had COVID at the time, that was distorting a lot of the numbers, so we knew that that was gonna sort of burn away and reduce some of our profitability and revenues over time.
But I'm delighted to be able to say to everybody that we've got tick, tick, tick, tick, tick on all the indicators that we set out. But of course, this is history, so this is now all gone, and we need to move on to more exciting things. If we look at the business, just to give some context so that people can understand who we are, what we do, many people in the room know it and know it very well. Some people might not, so we will give some context. We've got two operating divisions. We've got Healthcare Services, which is 69% of the business. We have Diagnostic Services, which is 31% of the business. We've got some really strong assets in countries that give us the footprint to be able to develop our services.
You know, 187 clinics, 176 gyms, 41 hospitals, you know, 6,000 beds. You know, quite an incredible amount of beds that we have to serve our customers. 14.4 million visits is not a small number. 1.5 million members and a really good payer mix when it comes to Healthcare Services. On the right-hand side, again, really good footprint. 135 labs, lots of blood drawing points, and some clinics to support all of that, and 152 million lab tests, which is quite a number. And a really good payer mix also in Diagnostic Services. If you look on the left-hand side, Healthcare Services is very synergistic towards Diagnostic Services.
Every time, you know, we put on some healthcare assets, we have to do blood testing, we have to do lab testing, so it fuels the right-hand side. And every single time the right-hand side gets creative and starts to put in place new tests, new capabilities, it fuels the left-hand side, so it's highly synergistic. Although we're in many, many countries, 90% of our business is in four main countries: India, Romania, Germany, and Poland. Poland, by far the biggest. Today, I'll talk you through all of those countries in terms of some of the developments that we're doing, so you've got some context and backdrop. Each country has a different business model, so it's not one business model that we're applying across each country. It's a different business model.
We're really in some exciting geographies. You know, we're in countries where in history there's been a lack of investment in the infrastructure. There's been an increase usually in the middle classes and people that can afford healthcare, or afford private healthcare. They want a choice, and we provide that choice. Then if you look at the key indicators in terms of GDP growth and Healthcare spend as a percentage of GDP growth, and the Healthcare growth, and then the private healthcare market growth, each country has big numbers. So, you know, GDP 3.2%-6.8%. You're looking at Healthcare spend all the way up to 12.3% there in terms of Germany, and all the way down at 3.3%. Both are positive, you know?
So if 3.3% is low, that means there's an opportunity for healthcare to be delivered. If the GDP, if there's a lot of healthcare being delivered, then there's an opportunity for us to be part of that delivery system. So no matter how some of these indicators go, we're really well-placed to be able to take advantage of it. And of course, we're in healthcare. These healthcare markets are big, and more importantly, the private sector within those healthcare markets are growing. So if you look at number four, you've got private healthcare market growth, 7.4%, 4.2%, 9%, and 13%, and later on, what you'll see is that actually, we outgrow those particular market dynamics. So we're in a really positive position. And we've also got long-term relationships with our customers.
You know, our customers tend to come and join us, and then they settle with us, and the patterns of what they want and what they need is changing. So people want more convenience and greater access to healthcare. There's an appetite to consume healthcare. There's an appetite to get better. They want a digital experience. They don't just want it to be face-to-face. They want to be able to control things themselves and have access to different information, and be able to manage their journey themselves, and to be able to see what their results have been and their history. And they're also moving into a different side of things when it comes to prevention and longevity. All these trends are really, really positive for us.
And then, when we look at those trends, people want technology, you know, and we've got a really strong set of stack of technology. You know, we've got a lot of different applications that we've built over the years, many of them being things that we've self-built. It's our code. We've put them in place. Really high engagement from consumers in terms of using these digital tools. You know, a 4.6- star out of 5 is a really positive thing. If you get a 4.7 or 4.8, people start to believe that, you know, start to doubt that what you've got is really there. So, you know, we're right in the zone of where we need to be. And these tools engage.
They get customers sort of using you and thinking about your brand. They act as sales platforms. They act as an ability to be able to deliver your services remotely, and they give us, you know, a complete view of what a customer is doing, what a customer needs, what are the trends that are changing. So our technology stack is a really important part of our journey. And sorry, I want backwards, not forwards. And, you know, what are we about? We, as an organization, what we're about is healthcare, and we're about health impact, so we measure that as well. We have an independent organization called Upright that look at the difference that we make to society and the impact that we have in our Healthcare delivery.
For, you know, every EUR 1 of healthcare, every EUR 1 of spend, that's put in place, EUR 2.74 comes back in terms of impact. So that's quite a positive sort of thing, you know, that if somebody puts EUR 1 with us, the health impact that that has on them is EUR 2.74. It's quite a good return. And in terms of overall impact of everything that we've done, they've assessed that, that currently, in 2024, that was EUR 330 million, which is, very, very positive. And out of everything that we do, 92% of what we do is aligned to some of the objectives that are set out by the United Nations in terms of health impact. Again, very, very positive.
Within our delivery system, we've got, you know, a really big capability that's being delivered each and every day. You know, one medical visit is happening every second. That's quite an incredible sort of achievement. There's 11 lab tests happening every second as well. Again, quite an incredible achievement. This is not totally related. They're different customer bases, so you haven't got one person coming in and being tested 11 times. But that's a really, really big impact that we're having on society and for people. And of course, we're delivering that in a very positive way when it comes to the NPS and the how our customers view us with an 83%, 83%, NPS score.
And we're doing this in a very ethical, responsible, and sustainable way, which I believe is what people want in today's society. So a really positive position for Medicover. But we need to move forward, and as we move forward, we need to go to look at the targets that we set for the future. And we set those out yesterday. I'm not gonna deal with these in detail. I'm gonna leave that to Joe to talk about as he comes on to do his session. They're ambitious. You know, they're typical Medicover targets, which is they're ambitious, they're quite aggressive. People question whether we can achieve them or not. We believe we can.
That's why we set them out, and we're really looking forward to the journey of being able to deliver them. Okay, so how will we deliver them? What does that look like? . We've got a few positive drivers that sort of help us. We've got the market growth that we think will happen in our countries. We've got strong market conditions, which we'll talk you through. We've got a good existing network. We've got lots of assets on the ground where we deliver healthcare, and that's very positive for us, but we've also got opportunity to be able to grow more. And as a consequence of growing the network more, we'll improve our financials.
You know, we've got good opportunities for synergies, you know, within our business model, and we think we can increase our productivity, which will, again, really help our financial position. And again, we will continue to develop technology, because when it comes to healthcare, people want more and more technology to be able to have choices on their healthcare solutions. And all of our core markets will help contribute to this. As we said before, 90% of our business is in four key markets, and we will drive growth in each one of them. Our biggest market is Poland, which has 52% of our market share. We've got very good revenue growth there. Again, we'll compare that a little bit later on in terms, versus market conditions.
Most of this delivered through Healthcare Services. We have a very strong business model. So when it comes to our Polish proposition, what do we do? Well, first and foremost, we acquire members. So we tend to go to businesses. Those businesses tend to want cover for their employees. We provide that cover, and as a consequence of providing that cover, we have to have facilities for them to be able to access their care. So we build those facilities.
As we build those facilities, other members of the public say, "Well, I like those facilities, and I wouldn't mind using those as well." And that gives us a bigger footprint because we bring in people that are not only funded members by employers in the main, but they're individuals that are coming off the street that are saying, you know, "Can I have healthcare as well?" Which means we've got to build even more facilities 'cause it's only appropriate that we've got enough healthcare delivery for the employees, but also the excess capacity for the fee-for-service community.
And then what happens is that both of those communities start to say, "Well, you know, my employer covers me for so much, but actually, I'd like some extra services that the employer doesn't cover." And we start to build even more facilities that are related to things that isn't covered by the employer plan, and as a consequence of that, even more people from members of the public decide that they would like to use those facilities as well. All of that kind of delivery system that then gets delivered each and every day to our customers drives synergy within the group. It means that more people go to clinics, it means more people go to hospitals, it means more people go for lab tests and diagnostics.
Of course, as they go for lab tests and diagnostics, our Diagnostics division benefits from that. They get a steady stream of revenues that's gonna come from the Healthcare Services team driving the healthcare delivery. And also, they start to get creative and say to themselves, "Well, actually, we can do more services." And then the hospitals say they can do more services, and then we go around again and offer these services back to existing customers, which gives us a really good revenue mix and a really strong base. When we look at the healthcare market in Poland, the healthcare market in Poland is really attractive for us. You can see the GDP is strong, one of the strongest in Europe.
You can see the healthcare market at EUR 6.3, again, is big, and very attractive to us. The private healthcare market is even bigger. And of course, in Poland, we not only do healthcare delivery, we do Sports and Wellness as well, and that market's growing even faster. The population is aging, yeah, and as a consequence of aging, they will require, more healthcare, which again, drives utilization up for us and gives us an opportunity to grow. Then the key insights of the market show that it is very, very attractive. Private healthcare at EUR 11 billion, you know, CAGR at EUR 2.7 billion, a market growth of EUR 3 billion in Healthcare, and EUR 1.5 billion in Sport and Wellness. So really, really big markets.
We've got a very good market share, and we're actually growing at a much faster rate than the overall market. So again, very, very positive, kind of position. And then, then if you look at our footprint, our footprint gives us a real good opportunity to grow. If you look on the left-hand side here, you know, we've added a tremendous amount of capability over a relatively short period of time. In 2022, we have put on nearly 100,000 sq m of extra space. That extra space needs to be, needs to be filled. We've started to fill it.
So if you look at the graph in the middle, you can see that the gray bar starts to show that the space is increasing, and then the revenues per square meter is starting to move up, and our utilization is starting to move up. As we increase utilization, we obviously get more revenues. As we increase utilization, we get operational leverage. All of this is fully invested. We've already put our CapEx spend into these facilities. We've got the extra capacity to fill up. Over the course of the next few years, we will fill this capacity up, customers will come to us, and more importantly, customers will come back.
Then if we look at the opportunity to grow outside of our existing network, in terms of is there space to grow where we're currently not there? If you look on the left-hand side in the pie chart, you can see that you've got the top three providers in the country have got a decent market share. But if you look at the total market, we've hardly penetrated the total market in terms of opportunity for Healthcare. We've got lots of capabilities in each of the voivodeships in Poland, which is what you can see in the middle, but we've got more than enough opportunity to be able to put extra facilities in place. As we put those extra facilities in place, we will grow.
As we grow, we'll get the operational leverage that will help our margins, that will help our growth rates. It's a really positive position for us. We have a very holistic proposition in Poland. Yeah, it's very wide in terms of the capabilities we have available. We have services from pre-birth all the way into hospitalization, and of course, we see a movement not only of people wanting more healthcare, but they also want more health and wellness, and we therefore have an opportunity to develop our product range. And if we look at our product range in history, 2017- 2023, 2025, we've developed different products and services, and if you look at the grey bars, the grey bars do actually represent real growth.
Real growth that has happened in country in relation to some of that product development that we have done. So we have a history of being able to develop new products, new services, new offerings to consumers, to businesses, that attracts them to spend more with us 'cause it's a brand that is trusted in Poland. It's a brand that's known for, you know, high-quality services and is able to deliver. So, you know, in the old days, we just did healthcare. We then moved on to do what we call Healthy Company and Healthy Life, where we're offering much more holistic services and a broader offering, which included our Sport and Wellness. In 2025, we've developed our Healthy Change Program. This is a program which crosses over between Healthcare and Sport and Wellness.
We put a number of people through the program. We looked at it from a scientific perspective, and basically, if you engaged in the program and completed it over the course of a 12-month period, for every year you invested in the program, you and equals an extra year of life. And we've been able to prove that. Now, we're currently, you know, talking to employees about the results of it, you know, - 13% in terms of cardiovascular events, plus 27% greater sense of efficiency in daily life. You live one year longer, 32% reduction in illness. This is a really big program.
It's a really big breakthrough for us, and currently, we're talking to quite a lot of customers in terms of that new development, and it's this kind of thing that we will develop over time. These things, you know, in terms of our history, if you go back years and years ago, most of our relationships were business-to-business relationships, and most of our revenues were funded. But if you look at our revenue mix today, we've tremendously changed, and fee-for-service has become a much more important part of the revenue mix that we have. And that means that we not only need members, but we need relationships to develop and to explore.
And we've got a strong number of relationships in Poland, people that we can talk to each day about healthcare, about their healthcare need. And if you look at that population, on average, that population spends a lot of money in Poland on healthcare and spends a lot of money, which is increasing. So that gives us an even greater opportunity. And when we get these people, when we get customers to actually join us and use us, usually, you know, because we deliver high quality, you know, the average spend that they have with us versus the average spend is much greater. So again, we've got another opportunity to grow, and we look to make sure that, you know, we develop loyalty with those relationships and loyalty with our customers.
We have a brand new loyalty program that we've put in place. It's embryonic in terms of its capabilities, but it is in place, and it is growing very fast. It's another lever that we can pull in terms of ensuring we've got strong, deep relationships for the future. And if they come into our loyalty program, that gives us the opportunity to showcase all of our proposition. In today's society, dealing with a consumer is very difficult. You have to get consent for this, you have to get consent for that, you have to deal with things by legal entities. It's a minefield to be able to navigate, but through our loyalty program, once people decide to engage with us, we've got a greater opportunity to be able to offer them more and more products within our group.
When they do go into our loyalty program, and they do buy things, the revenues that they generate are much higher. They tend to come back more frequently, they tend to buy at a higher price, and they tend to buy more things, which is all very positive for us. We will, in the future, also develop some of our existing outlets and our existing infrastructure. We have a lot of blood drawing points in Poland. Those blood drawing points today just do blood drawing. We intend to change that so that it becomes more health hubs that we can showcase our full proposition, so that gives us 154 new outlets to be able to use as points of sale, and we will expand the number of outlets as well.
And we very much see that the activities that we have in our gyms will not only be about fitness, but also about wellness as well, which means that we've got, you know, nearly 300 sq m of space and thousands and thousands of people coming each and every day into our gyms to be able to showcase our full proposition for healthcare, which will drive even more growth. So from a Polish perspective, we think it's a very attractive market. We think we've got ample space to expand our presence. There's lots of white space to go. We're constantly developing our proposition, and it's highly synergistic, so very, very positive, a good driver for the future. I'll move on to Germany. Germany is a really important part of our Diagnostic Delivery System .
If you look at our history, our lab business developed over a long period of time, with different assets joining us over a period of time, but Germany became central to it. Germany really is a place where we've got a lot of advanced diagnostics, and we take that capability and move it into our core market. So over time, we develop Poland, over time, we develop Romania, and then over time, Romania became a central hub for distribution of some of those advanced diagnostics and some of our Genetics. So, Germany becomes key in terms of being able to not only deal with Germany, but also support the other markets that we operate in. And this becomes a big distribution network across the whole of Europe from a healthcare delivery perspective.
Germany as a market, very stable. GDP 1.3%, healthcare market 4.4%, lab diagnostics 4.2%. The Healthcare spend in Germany is very, very high. There's a couple of points on the Healthcare spend. One is it showcases a bit about how far India, Romania, and Poland have got to go in terms of their Healthcare spend, so it shows how attractive those markets are, but also, at the same time, shows what a solid and big market Germany is for us. You know, EUR 5.1 billion in terms of the diagnostic markets. While the CAGR is relatively, relatively low, it is incredibly, incredibly stable. We've got a little bit of noise going on here, which I think we're due to sort out.
It's incredibly stable, and we've got a good, strong, a good, strong market, and we've got a nice kind of, kind of growth position within the German market per se. But our play in Germany is really three things. It isn't one thing in isolation. Number one, we have a very regionally-based lab business that is very strong and has done very well and has navigated reform incredibly, incredibly well, which again, we'll talk about as we go through. We also have a very national position in terms of some of our other services. We have advanced diagnostics and advanced testing and Genetics, which spreads across the whole country, and we have the opportunity, which we've started to explore and execute, to be able to go international with some of that property.
Some of that proposition, which means that we have, you know, more than one opportunity in Germany to be able to develop our position. If we look at our regional lab business, 95% of its revenues come locally. You know, naturally, people send their lab tests for the routine stuff very locally, but when it comes to the specialized stuff and when it comes to the Genetics, we tend to have a much more national proposition. And not only that, once you've had the national proposition, once people nationally are getting used to using you, they then start to send some of the routine stuff back to the regional labs, the regional labs in the north, in the northeast, and they benefit from that national footprint.
So we've got a strong lab business, we've got a strong advanced diagnostic business, we've got a strong genetic business that leads to high levels of synergy. And you can see here on the left-hand side, that regional lab position, 30% market share, which is, you know, a good market share to have. And we've shown over the last twelve months how resilient our German lab business can be. German reform came in a year ago. It was, at the time, a big worry for people. There was a big amount of fear. How can we navigate this? What can we do? You know, what impact will it have on us?
But if you look at our business over a two-year period, and you sort of say to yourselves, "You know, what size were we in 2023? Where are we now in 2025? What's lab reform done to us?" We've still grown our customer base. Our customer base has gone up 10%. We've still grown our test volumes. Our test volumes have gone up 15%, and we've still grown our revenues. So I think that's great testament to the strength and the depth of our lab team, but also represents Medicover. Medicover, over the years, against many different challenges that comes from reform, against many different challenges that comes from government, we have to be agile. We have to show that agility, refocus our business, adapt, and be able to come through.
We can't necessarily do that every single quarter. You know, it takes a little bit of longer time, but if you look at us over a long period of time, we adapt to some of these challenges. So we're well-placed in Germany to grow. We've managed the reform. That reform has created the beginnings of a transformation for us, which we're currently implementing. We've got good opportunity to drive some specialist lab testing. We've got a broad portfolio where we can get more business, and we can expand our customer base. So we're well-placed. We've also got some good market conditions. So if you look at the market conditions and the trends in Germany, you know, there's a lot of people now interested in new things.
You know, the reform has driven more health awareness. More people are talking about nutrition, more people are talking about anti-aging. So not the traditional healthcare market positions, but more moving towards lifestyle testing. And as that lifestyle testing demand, need develops, our advanced diagnostic portfolio is ideally suited to be able to meet those needs. So we've got some really good, attractive positions for Germany for us to be able to grow our business, whether there is further reform or whether we continue as business as usual. So, you know, if we look at it from a estimated market potential by 2030, from a German perspective on our specialized testing is EUR 1.9 billion.
From our Genetics, it's EUR 0.9 billion, and then, of course, we've got our opportunities to go into our own network, which means across Romania, et cetera, and also to go internationally. So we're well-placed. So from a German perspective, you know, we can expand the customer base, we can broaden the portfolio, and we can drive our specialist lab testing. Okay, Romania. If we look at Romania, in Romania, we've got two very strong divisions. We've got Diagnostic Services, which is our lab position. It's a very balanced business. It's a business that serves doctors, and it's a business that serves consumers. And when it serves consumers, it's the most trusted brand in the country from a lab delivery perspective.
Very creative, very, very innovative in terms of its position. In Healthcare, we have a business that's transforming. You know, originally, a membership business, very much in the mode of the business that we had in Poland, that has moved forward to be more focused on hospitals. Hospital is quite an important part of the delivery system from a Romanian perspective, mainly because it allows you to access two main revenue streams. The Romanian government allow for you to blend people paying out of pocket and for the government fund to pay alongside. So as long as you have got governmental funds, your fee-for-service will naturally grow because people expect to pay extra on top of accessing the public fund.
And we're ideally placed, both from a Diagnostic perspective and a Healthcare perspective, to be able to serve the needs of Romania. Alongside that, we've got some really key enablers. We're very digitally enabled from a lab perspective. We've got our Polish technology stack being developed and deployed into Romania from a Healthcare Services perspective. That will allow us to drive more convenience, that will allow us to give a greater value proposition for doctors. If you look at the market, you know, from a GDP perspective, 2.3%. If you look at the healthcare market, it's a 6.9%, and if you look at the private market, it's even bigger.
Then if you look at the gap in spending from an OECD perspective, it's massive, you know, 2.6x . You see that on the ground. You see that on the ground in terms of the members of the public looking to access healthcare, looking to access private healthcare. Big market, EUR 6 billion, decent CAGR. Medicover share is 5%, so we've got a decent footprint, and the Medicover share in lab diagnostics, 18%, and actually, our growth rate's much greater than the share. Again, same situation as we talked about before in Poland. We have a big increase in our square meters that we've put in place. 17,000 extra sq m have gone in. That means that we've got much more capacity.
You can see in terms of our revenue per square meter, it's starting to grow. You can see in terms of our capacity, there's a big gap in terms of space that we can grow into. All of that space has been fully paid for. You know, the CapEx spend on that space is already done. So as more and more customers come in, you'll see that we'll get operational leverage that will help our financial position. If you look at the market, again, top three have a decent penetration, but a lot of the market is unconsolidated. If we wanted to deploy more CapEx, which we will, we can deploy more CapEx into the white spaces and be in a position to be able to grow our business further.
So we've got multiple areas that we can actually scale our business, both in Healthcare and in Diagnostic Services. We're very positively placed. If you look at the lab side of our business in Romania, again, you know, we've invested. Where we're strong, we're very strong. And you can see there's lots of white spaces there on the left-hand side. We've grown our business very well. Our test volume is up 5%, our revenue is up 10%, and our profits are up 15% in the country over a couple of years period. We're a big fee-for-service player. We're very, very trusted.
You know, members of the public want to ensure that if they spend money with you from a lab perspective, the test is done, and the test is done well, and we have a very wide portfolio of tests available to people based upon our Romanian position, but also our German position of giving advanced diagnostics. And that helps us develop not only Romania, but puts us in a position to be able to develop, to be able to use the capability in Germany to develop Romania and at the same time, expand into new countries, which is the extension that we have with all of the other countries that we serve, which we increased in 2025 when we brought in the SYNLAB portfolio to expand the network.
Again, more volume goes through that network. It's very productive from an operational leverage point of view. So we've got good product development, we've got good digital tools, we've got good procurement, we've got good distribution, we've got an excellent platform to grow. So Romania is an attractive healthcare market with strong fee-for-service segments. Healthcare is coming out of a big phase. Our Healthcare division is coming out of a big phase of investment, which means that we're fully invested. As the customers go into our space, that will be very positive for our business model. And Diagnostics driving a very strong fee-for-service segment balance with not only our developments in SEE countries, but balanced also with the platform we have of distributing via doctors. So a very positive position from a Romanian perspective.
Finally, we have India. And of course, India, in terms of shape, size, and scale, is completely outweighs Europe. If we look at not only the countries we're in Europe, but the whole of Europe. So if we look at the states that we're currently in, the population within those states is the size of Europe. It's a massive country, massive opportunity. If you look at the outlook, all the indicators are extremely positive. GDP, 6.6%; healthcare market, 7.6%; and the private market, 13%. Yeah, if you look at it from an OECD perspective, you've got a massive gap. You know, 19x in terms of India's spend per capita versus the per capita spend of those countries.
You know, when you look at the key insights and say, "What's the size of the market?" You're talking incredible numbers. INR 68 billion, CAGR 13% market, market growth of INR 30 billion. And then you look at our market share, and of course, we look small, but we're a significant player. So, you know, the macro outlook for the country is very, very strong. And it's very strong for us in terms of looking at the potential opportunities to engage with consumers. 'Cause if you look at the disposable income, and you look at the trend of disposable income, you know, people in India are getting richer and richer. You know, people are earning more and more money.
If you look at the gray, the blue, the dark gray, the blue, and the darker blue, you can see they're all growing. More and more people are moving into the middle classes. As more and more people move into the middle classes, they get choices. If they get more choices, one of those choices will be about: where do they get their healthcare? How is their healthcare delivered? We're ideally placed to be able to support that journey. And of course, the population is aging. India is an incredibly young country. Yeah, it's an incredibly young country, but of course, as the population ages, their need for healthcare will increase. As that need for healthcare increases, we will be there to support that, that particular need.
If we look at the investment that we've made in recent times, we've made a tremendous investment in the Healthcare space. You've got 66,000 sq m of extra space that we've put on since 2022, and if we took that further back, it would be even bigger with the extra hospitals that we've put in place. We've changed our mix of hospitals, so you've got a few pluses and a few minuses within the mix, but we've still got a big footprint, and we've got a lot of operating beds. In terms of total beds, it's bigger, but in terms of operating beds, we've got a lot of operating beds.
And you can see, as we've put that capacity online with the middle section, our revenue per square meter has dropped, and our occupancy and our utilization has dropped, which is the pie chart on the right-hand side, which is below 50%. Now, some people will say, "Well, that's bad news 'cause everything's dropped." But actually, it's excellent news for us because as time goes by and this space gets filled, there'll be a tremendous difference in our business model that we have within India. And we've currently reached a phase where, you know, in terms of our major investment, our major investment will have stopped now, and it's time to fill this space with more customers, and it's time to increase the utilization.
There's no shortage of opportunity in terms of further expansion. It's not our focus at this moment in time, but you can see the market is mainly unconsolidated. We operate in four key states. You can see those key states with the graph in the middle, with the blue concentration, and you can see in terms of the number of hospitals we have within three of those states, it's very comprehensive. We are a big player in these states. We're a major part of the Healthcare delivery, and these states are very, very attractive.
It's in a very attractive place to be within India, because the 30% of the GDP of the whole of India is within those four states, and within those four states, as I said earlier, the population is greater than the population of, of Europe. And if you take just Hyderabad itself, Hyderabad itself, which is where our main activities are, you will find over the course of, of coming years, that, that the population of that city alone will increase by 5 million. And as that that increases, it means that we've got an opportunity to fill the beds that we have, but also to put on more beds.
And if you look at the gap of beds across the whole country, and you look at what is the demand today and what is the gap, the gap is somewhere in the region of 2.5 million beds. So in terms of the capabilities on the ground versus the population, the population growth and the middle classes increasing, there's a tremendous opportunity from an Indian perspective. And if we look at that from our own footprint perspective, we've got some really good indicators, a really good trends that will help our business develop and help us move positively towards our financial targets. One is the increase of beds that we've put on recently in Tier 1 cities.
There is a massive difference in Tier 1 cities in terms of the average revenue per occupied bed versus the average revenue per occupied bed in Tier 2 or Tier 3 cities. And a lot of our development in recent times, both over the past three years but before, is to put more capacity into Tier 1 . So we will get a natural increase of our average revenue per occupied bed as we fill our occupancy in terms of the space that we've put on. And with that extra revenue per occupied bed, that will drive business growth.
That business growth will come through in operational leverage, and we'll see that both from a top line and a bottom line. And of course, a lot of our assets are immature. So if you look at the bottom, you've got, you know, what assets have we got? How mature are they? How will that mature over a period of time? We've got a lot of new assets, which means that, you know, they take time for customers to come, it takes time for us to attract the doctors. But over a period of time, what we have seen is it matures, our occupancy increases. As our occupancy increases, our business model improves. And we have another very big advantage in India, which is our digital stack, which is our technology. And in India, we're 100% mobile.
There's no paper. So if you come into our hospitals, you won't find nurses running around with files. You won't find doctors coming in with a, a big paper file, looking at things. He'll come in with his phone. Everything that our doctor needs to be able to treat you as a patient, outside of the operating room, of course, is in that phone. So, he can basically navigate our complete healthcare system with that phone, including if he's unhappy, you know? So if one of our doctors is unhappy, he can simply say it through the application. It will go to a supervisor. That supervisor needs to react within a time period. If they don't react within that time period, it will go to the next level of supervision, et cetera, et cetera, until it's completely resolved.
And that's the same for our customers in India. If our customer goes into the hospital, and there isn't towels or there isn't the bedding isn't right, or there's something they're unhappy with, we're immediately on the spot to be able to solve all of their complaints on the spot. All of our, all of our capability is within our technology, and all of our technology is digital and on the mobile. So, you know, we have a complete, a very efficient way of dealing with all of the patients. That leads to a much greater focus on the way that we care for people. It allows, from our business model perspective, for, you know, our revenues to be tighter.
If a customer comes in and they need a scan, then the person that needs to do the scan knows a customer needs to do the scan immediately, can go and get the person for the scan, take them through, has the scan. Better for the customer 'cause they get their service very quickly. Better for us because they can't walk out of the hospital and say, "I don't wanna have the, you know, I don't have the scan," or, "I'm not gonna have the scan," or, "I'm gonna have the scan somewhere else." So we have a very, very powerful technology stack that we have available in India. A doctor says, "You know, I'm gonna operate on a Monday," that means that the outpatient room that they would use is can't be booked by them.
That we know they're in the operating theater, they can't have the room. That means we get all the efficiency of using all of our space as, as good as we could do. So a very, very positive sort of position. And if we look at India, it's a really, really big market. We're really, really well-placed. We've got a lot of capability there, that we've already invested in. As that fills up, our business model will improve and, and things will get, will get stronger. And then finally, my final kind of point or final kind of section is about technology. Technology is a really important part of the future when it comes to healthcare, both from a customer perspective, both from a doctor perspective.
Some of the things I've just talked about from an Indian perspective will be needed and required in our other markets. People wanna deal with things straight away. People wanna be able to book things straight away. People wanna be able to see their care straight away. They wanna see their results straight away. They want the access to the doctor to ask questions. They want, you know, they want to be able to be empowered and guided through the system. We, as a provider, want to see what our customers are asking for. We, as a provider, want to understand what our customers are not getting. We want to understand where they're frustrated. We want to understand where they're completely satisfied and engaged. The technology stack helps us understand that and develop new services.
We have got, you know, a long history of being able to develop technology. We've built, you know, all of our capabilities on being as efficient as possible. That, and we've driven a lot of trust with our customers when it comes to our technology. They know that they can use it, they know that it works, they know that it makes an impact, and digital is a big part of our core. There are many things that people talk about today, things like electronic medical records, things about, you know, results online, things about booking stuff. All this type of—we've been doing all of this kind of stuff for a number of years. People talk about virtual care. People talk about virtual care accelerating as a consequence of COVID. virtual care, COVID, didn't affect us.
Didn't affect us at all. We had all of the capabilities to be able to change our services the next day. We didn't have to build anything. We didn't have to do anything. We just executed, and our technology stack and our engagement with customers in our core business is really, really strong. 88% of our members, yeah, have our application, you know, so we are in their pocket. When it comes to healthcare, those people have us walking around with them, and when they have a healthcare need, all they have to do is bring that out of their pocket and start engaging with us in terms of what they need and what they require. You know, 75% of our bookings in our core business is, are done online, you know?
So, people are not going to our receptions, they're not going to call centers, they're not in queues. They're basically sitting there themselves, deciding what they, what they do, what they need, when they need it, looking to access it. And in our, in our primary care, position, and in lots of our, and in lots of our, services that can be done online, 63% of stuff can be, can often be done remotely, which is incredibly high. Having those relationships, having people in our technology, having people engaging with us, allows us to get deeper relationships. If we get deeper relationships, it's harder to move away. If you get deeper relationships, it's also an opportunity for you to be able to say, "Let's do more. Let's do more together. Let us care for you more together.
Let's offer you more together." And of course, it drives a lower cost of servicing because instead of the call center people answering the phone, our customers are doing it themselves. So we're very, very well-placed. We intend to develop that further over the future in terms of different solutions for patients, different solutions for medical professionals, different solutions in terms of our operations people, and of course, we intend to make it much more integrated. We intend to make it much more connected. We intend to make sure that the customer stays within our system, and that we are the people that are looking after them. So in summary, you know, we've, we've got a great opportunity.
We've got some really ambitious targets, which we're really excited about, which we're looking forward to delivering for you over the next three years. We've got 90% of our business in our four key markets. We've got four very attractive markets. We've got four markets where we've got really strong, business models. We've got four markets that are really developing well, and we think, we think that we're well-placed for the future. Thank you very much for your time.
Thank you very much for that thorough run-through, John. We will now go ahead with some Q&A. It will run until 2:15 P.M. Just reminding of the process, those of you that are in the room and want to ask a question, please raise your hand, and we will provide you with a microphone, and you can ask a question. Those of you attending online, continue to submit the questions in the chat. So with that, I think we kick off the Q&A session. Maybe one question from me first. Sorry for being too much of an analyst here, but looking at the chart with the contributors to the 2028 revenue, Germany was a bigger chunk than I maybe thought.
They were the same. We purposely made them the same. Yeah.
That's good.
Yeah.
But when it comes to that, maybe a general sort of zoom-out question to begin with, in terms of the contribution to this revenues, which, h ow do you sort of perceive Germany in that respect?
Germany is a big, stable market, you know. Is Germany gonna be the biggest driver of our, our growth? Probably not, yeah. Is Germany a very important part of our growth? It certainly is. So, you know, whenever you look at our markets, especially our top four, you go, Poland, big opportunity, big growth figures. You go, Romania, the same. You go, India, whoa, even more. And then you go, Germany, oh, that's pretty stable, yeah? And then when you go and look at, we've got increasing middle classes in all the other countries. All the dynamics in the other countries are pretty much the same, and in Germany, it's not. But what Germany provides for us is a very, you know, stable business.
It's got a really good footprint, which is well-established, where, you know, customers appreciate what we do. It's got two very interesting development areas that are national and international. Some of that, we've already deployed internationally within our own network, which is really, really good. So I think it's an important part of our future, and it's an important component, but I appreciate when people look at the dynamics, it looks a little bit different. But it's an important part of what we do.
Definitely. And I guess, a question that's typically being asked in the recent two years, is the maybe a bit challenging environment indeed, with the reform?
Yeah, I mean-
And-
Sorry.
Yeah, just if that opens up, sort of opportunities for you as a large-scale player.
I've said similar things over the course of the last kind of like 12 months, which is, reform is good and bad, you know? Reform is, like, bad for you to begin with because it's like, we've got reform, we need to navigate it. You know, what is it? Understanding what it is, what do we have to do, how do we navigate it becomes the focus of the day. But reform's also good, you know, because it challenges you to change your business, and you've got to do things that maybe you didn't do before, and you've got to do them with a faster sense of urgency. And particularly in Germany, navigating a sense of urgency can be quite hard. You've got all of the work councils that you've got to go through.
You've got to, you know, get a lot of stakeholders lined up to be able to move things forward. I think what we've done successfully, very well, and congratulations to the team, is they've navigated that first year of reform. We've done four quarters and come out of it positively. We've probably got a fifth quarter to go because of the settlement factors that needs to happen, and reform lasts much longer. Sorry, the transformational change that you put in place lasts much longer than the reform itself. So the benefits that we'll get of that will, will go on in further quarters. And then, of course, any reform tends to chop off the tail of supply. So the bigger players tend to be able to navigate reform. Yeah?
The smaller players tend to find that it's harder for them to navigate that reform, and they fall away. And then some of those smaller players, for us, could be an opportunity in terms of picking things up, or they fall away, and the customers that used to go to location A now need to go to location B, and we'll be one of those location B's. So, I think in the first phase, we've done well. In the second phase, we will have to wait and see what happens.
Yeah. Maybe moving, s witching gears to Poland a little bit, I mean, indeed, looking at the past 15 years, it's been strong end market growth and strong execution from Medicover.
Yeah, 'cause I joined.
So I'd say, give or take, you have doubled the growth of the market. So just put it in perspective a little bit, how, you know, challenging is that, and how difficult is that to keep up the pace that you have?
Yeah, I mean, the market's not soft when it comes to competition. I don't think the market will get any softer when it comes to competition, especially in the next cycle. If interest rates drop, there'll be some old competition that disappeared for a while coming back in terms of funds and stuff, which will make it a little bit more interesting. We've got a really, y ou know, we've developed a lot of capabilities in a lot of different parts of Healthcare delivery, you know, from pre-birth all the way to hospitalizations, all the things in between. We've made sure that over that period, that we've tried to offer value to the customer, look after the customer.
You know, when it's come to things like price increases, we haven't shied away from putting the right price increases in, so we can retain the quality as we go along. So we've got a really strong brand. We've got a kind of taxi brand. People come to Poland and say, you know, "Can you take me to so-and-so location? It's right by Medicover." And we've earned that by the delivery that we've done, and we've got lots of opportunities and space to grow, and the team are quite excited, you know, new products, new developments. We've, in recent times, gone into things like Sport and Wellness, which has gone fantastically well. And there's other spaces that we feel we can go into.
While, you know, the environment will change, driven, you know, by government, driven by competition, driven by consumer behavior, we think that we've got a really strong competence in the team, really good leadership, really good opportunity to be able to navigate what comes at us. When it gets difficult, I think that's when we show our true colors. You know, we have to adapt, and we have to adapt fast, and we do that well.
Yeah, and just on what you just said there, there are further spaces to move into, and so on, and you have clearly showed that in the recent couple of decades, that there are more to do in Poland. So just discuss that space of opportunities a little bit, and then I have another question, though. With the success story in Poland, could you move some of the services into, you know, Romania or another country?
Yeah, I mean, in terms of your first question, what spaces and where to go, we're not short of opportunity. Yeah? So usually, what holds us back is more like, you know, management competence, making, y ou know, if we're going to a new space, we've got to be careful, 'cause we need it to work. We want it to work. So we've got to get the right competence in place. But also in our core, you know, we've got so many, you know, different opportunities within the core of what we currently do, that developing that faster probably is our current focus.
As that gets stronger and stronger, then, you know, it gives you a license to explore some of the newer opportunities, but we'll do a balanced, kind of like, move of both. That's really what we'll do. And when it comes to, you know, things like... People ask quite regularly, "What about the Sport and Wellness? Will you take it to places like Romania?" You know, currently, we've got a lot of growth to do in Poland when it comes to Sport and Wellness. We've got 176 gyms. Our major competitor is sort of saying they're gonna go up to 400. We don't have to go up to 400; we just have to stay relevant.
And I know exactly the position so far in the dynamics, and so does the team, about how many do we, how many do we need to stay relevant and continue to take market share. So we'll stay very focused, I think, over the three-year period, to develop Healthcare in Romania, you know, develop our broad proposition in Poland. You know, the core 90% will be where we focus, and most of our activities will be in what we do today, with a little bit of license of going into some new space for the future. Yeah.
Good. Any question in the room right now? We have a question here in the front.
Thank you. Good to see those slides on the capacity utilization. Is it possible to say anything what you target when it comes to improving that in the ambition you have for 2028, sales and earnings?
Yeah, but it's impossible to give you a number, yeah, because you've got many different assets, many different locations, et cetera, et cetera. But, you know, if you take something like India as an example, 'cause that's probably one that you're more interested in. You know, for our India plan to work successfully, you know, we've gotta do double-digit percentage increase in those locations for it to move up. And, you know, in our model in India, from a financial perspective, that once you get past a certain point, 'cause we're very much a fixed cost model, once you get past a certain point, the model becomes very, very sweet.
You know, our focus in the last probably five years, really, has been about taking some really good opportunities to build the scale. And we've built the scale, and now we're entering a slightly different phase, which is that, you know, we're not looking necessarily to put on more hospitals. Although you can never say never if an opportunity came up, but it's much more about, how do we fill up the space. And there's three levers to do it. There's three things that count, which is doctor recruitment, doctor retention, yeah, which has been a real big focus over the last six months, nine months. It's, as a consequence of that, the occupancy going up, and then, within the occupancy, have you got the average revenue per occupied bed right?
As I alluded to on the slides, you know, we'll get a natural increase in our average revenue per occupied bed by the fact that we're going into much more Tier 1 cities. We stated a few, you know, many times that we need to repurpose from being Tier 2, Tier 3 into Tier 1. Even within the Tier 2 and Tier 3, you know, with our kind of... We've got a bit of a price advantage in some locations, and as insurance builds, we may find that, that actually within those locations, we have a good opportunity to not only fill occupancy, but increase average revenue per occupied bed.
What do you say is somewhere 60%-70%?
Yeah. I mean, you know, once you get over the 60 mark in India, it's that you feel it. Yeah.
And-
And then in Europe, it's a lot higher.
Your comment here about maybe slowing down on investments in India, still you want to keep total investment or total CapEx as a percent of sales. So what markets will you prioritize here in the next coming years?
Most of our capital will go into our top four markets. Yeah, and of course, you know, we've developed India very well in recent times. We've had a focus on it. We've developed our Sport and Wellness very well in recent times in Poland. You know, I think we can easily deploy more capital into it, back into our medical business in Poland to fuel much more growth and strong profitability. So, you know, we intend to make sure all of our key markets move forward.
Just maybe a follow-up to that. Is the competition more intense in the Tier One cities in India?
Yeah, it can... I mean, it's different dynamics, really. It's not one of those things where you should sit there and say, "Tier One, Tier Two, this is the way it works." It's city by city, location by location, you know? So, you know, your population in India is so big in the immediate catchment around where you are, that a lot of the competition is about who's close to you, which hospitals are close.
You know, don't underplay the retention and recruitment of doctors. It's a really important part. You know, we've had times when that's hurt us a little bit, and in recent times, we've really, really focused hard on it. You'd have seen a bit of momentum that's come through in recent times. You know, Q4, 14.7 growth, local currency. We expect that to continue from the work that we've done. We're at the business end when it comes to the IPO process. And everybody in the room knows that we've got to increase our revenue growth to be able to, you know, be in the right zone at the right time, and that's where our focus is. So it's gonna be interesting few quarters.
Good. I think we have another question from the audience.
Yes, or it was, actually on competition in India, so maybe just rephrasing it and a little bit broader. So, as it is a huge market potential, how should we look at competition in relation to markets in Europe, so to say?
In what respect?
Is it much tougher than, for instance in Poland or?
Oh, okay, okay. India can be cutthroat. You know, it, there can be times when it's really, really cutthroat. So what's really important for us and any player is that you recognize what's going on really, really fast, and as a consequence of that, you take action really, really fast. And that you're agile, you know, that you don't have a position where this is our fixed model, let's keep with our fixed model. We've got a really good operating team in India, you know. The capabilities they've put in place is really smart because what they've done with that technology stack is that, you know, if they are to build a really big business, they can't be the people dealing with the doctors all the time, and they need to make sure that their doctors still get really well served and looked after.
And looked after from, you know, a complaint perspective, you know, what technology do they need? Do they want? What what environment do they wanna work in? What support they require? All this type of thing. So our doctors can all the time say what's required, and we respond very, very quickly. So, you know, the retention, the recruitment, the retention, the facilities that we give, the kit that we give, the fact that we will pay them on time, it sounds stupid, but, you know, that people are getting paid will drive a higher degree of doctor retention, and from that, that will really help us grow. But it's cutthroat. It really is cutthroat, but we've got a great team.
Don't mind it if it's cutthroat, if you've got a great team, because they can, they can move, and they can take advantage of the spaces that, you know, what's the environment they're in. They never stand still. They never stand still. They're very challenging and demanding on me, and long may it last.
Okay, just short follow-up there. Would you say the competition has increased a lot over the last years or-
Okay, so India's become a hotter subject in healthcare in recent years. So, you know, more people being interested, more people wanting to play. If you actually look at our hospitals and go through the history of where are they, how did we get them, what was the history of who owned them before, all this type of thing, it's an absolute graveyard of people that thought coming into healthcare was really easy in India. Look at the dynamics, loads of beds needed. Let's just put the beds out there. We'll get the customers. Everything's gonna be great, and the reason that we've been able to build such a great network with low capital is because we've come along afterwards and swept it all up, and then we've sorted it all out.
You know, the local team has sorted it all out. So, you know, more people are interested, but we've managed to navigate. I'm sure we'll navigate as we go forward in the future. Interesting time for India.
Good. I'll get along with the question. One wording I caught from the presentation was that the segments are highly synergistic. So maybe a discussion around that. I would say maybe Romania is where you have a big presence of both, maybe in the country.
Yeah.
So, just how investors should perceive that?
You know, Poland is probably a good example, really. You know, we've historically the model we had in Poland, we had very focused, kinda like, verticals, with people looking at a different space. We did that because we didn't have necessarily the competence in each of those verticals. We needed to attract the right competence. We wanted to build that competence. We had opportunities to buy lots of things, so we needed the management teams to be able to be there to buy lots of things. I think now we're reaching a different phase, which is, you know, we've built the competence, we've bought lots of things, now we need to bring things together, and as you bring things together, you do become highly synergistic.
We've already got natural synergies from the fact that when you've got Healthcare delivery, you've got, you know, testing that's done, and, you know, our Polish business and our Romanian business does a lot of testing. That all goes back into, to our, our own facilities, and probably we haven't used our property footprint as well as we could have done in, in history. Which is the... You know, we've got a property there that does X, and all it does is X. And we really think that when we look at our property portfolio, which is big, we've got a lot of, a lot of points of sale and a lot of points of service, that we can do points of service there, but we can do much more points of sale there and much more showcasing of our full, our full capability.
So, you know, synergies is a word that we would like to hear more of internally in the business, and how we do things together, and how we create new things together. And, you know, that may not actually be all executed in this three-year cycle, but we've got some great things like Genetics, you know, that could take a little bit longer to get full execution, to bring it together, but is a really big opportunity for us.
Good. We have a question in the front.
Two more, if that's okay. Interesting, what you say about this upsell potential at the Romanian hospital. Is it possible to qualify that in a way, or quantify it in a way, and is it so that, you know, most patients showing up at the hospitals there are having some public reimbursement to start with, and then they add to that, or how does it work?
Yeah, it tends to work in that way. So, the model tends to be that there are certain services that a consumer will pay totally out of pocket for. There are some. But most of the services, they want to access the national fund, but it's recognized both by the fund and the consumer that the fund's average pay for the service will be too low, and that there will need to be a contribution from the consumer on top of that payment for their care. So the more national fund development that you can do, then it naturally drives a higher fee-for-service volume in the country.
What's the typical split between-
Depends on procedure.
Okay.
Probably the easiest way to kinda like mentally think about it is, let's say that the fund is paying for the hospital services, and then the consumer is paying for the doctor. Yeah, that, that, that's kinda like a mental way that they deal with it.
One more question. Germany and the diagnostic business, you showed how the sales number of tests has increased in the last two years, despite the reform there. What could you say about profitability?
Yeah. Yeah, it's, it's okay.
Are earnings up or down, or what case? Loss of-
It's okay.
It's okay.
I refer to my previous answer.
Okay.
Yeah.
Okay. Thank you so much. With that, we will do a 15-minute break, I think. There is coffee and water, and you, those of you joining online, make sure you have a stretch, and be back in 15 minutes for our next session.
Thank you.
Thank you. Yes, welcome back, everyone. It's 2:30 P.M. now. It's time to continue with the session here. We have the great pleasure to introduce Anand Patel , CFO of Medicover, who will walk us through the financial highlights, and after that, we will have plenty of time for additional Q&A. With that, Anand, welcome.
Hello, everyone. Thank you for those attending in the room, and thanks to our people listening in online as well as participants. We appreciate, John and I, do the time spent with you today to explain through our exciting business and our exciting plans. I guess in terms of my slides, just a couple of things. So, one, I'll talk about the history of the last three years. Two, I'll touch on the recurring themes that we take forward into outer years, and finally, I'll end on the 2028 plan. So in terms of what we've done in 2025, and even before that, actually, if you think from the IPO launch, Medicover has set targets, external targets, three times, aside from the ones we're gonna be doing later. And all three times they've exceeded those targets.
So this is a company that has a track record of delivery. So if you look at 2025 in particular, for example, yeah, John and I reported them yesterday. You can see that we've grown our revenue, organic revenue by 15.5% CAGR to over EUR 2.2 billion. Material growth, I'd say, an accelerating growth in EBITDA to EUR 369 million. We operated within our leverage and dividend targets. And finally, for the incremental measures that we added on later, because they were asked for to kind of explain our valuations a bit better, we beat those as well. So, you know, if you look, I'm particularly proud this year, I think, of the EBIT number of EUR 156 million, a material step up, and also our EBIT margins were very strong as well.
So again, three times the company in the past has said we're gonna do something. Three times we've delivered. We do what we say we're going to do. Talking and looking at adjusted EBITDA in particular, so you can see that actually the rate of our growth is increasing as well. Maybe that'll be a similar theme for when we look up to the 2028 numbers. So there's been growth and we've accelerated our margins as well. So we've always historically, John and I have said, that we invested a lot of space in the past. That led to muted margins for a while. But in FY 2025 particularly, you saw the flow-through in the margin rate, in particular, of those investments. So they were worthwhile investments, considered, disciplined, but actually they're paying through.
So in terms of the CAGR growth of adjusted EBITDA, 16.4%, faster than our revenue CAGR, clearly which implies that we had increased margins. We are scaling capacity and also creating further headroom. This is a slide on margins, and I think the other thing I'd touch on this slide is about the medical space. So if you look at the organic medical space, organic version, which is the light blue boxes, you can see that actually we've increased by about 13% to 924,000 sq m by the end of 2025. So we've invested but still grown our margins at the same time. We haven't grown our margins by cutting costs. We have invested in the right things, and our margins flow through regardless.
So irrespective of whether through price or volume growth or investment in business units that we acquire, organic or external, we've just seen a steady flow of improvement in our EBITDA margins. So that's pleasing to see, and we'll see more of that in the future, given the numbers that we've got. It's a VUCA world, right? As we say, there's a lot of headwinds against us and our competitors on a variety of issues. You've heard us talk about a lot of these in terms of, you know, workforce, getting the right people whilst you grow. Inflation's been there. Can you price inflation and still grow the business? And obviously, we've spoken a lot about Germany in terms of public lab reform in the past.
But what we do have is a tremendous team with a lot of experience that really pulls on the right, either revenue levers, the productivity levers, or the cost levers, to really kinda see off those headwinds and provide efficiencies and opportunity. So I'll touch on a few of the comments on the right. So from a revenue payer mix perspective, you've seen that in the past, and John said earlier, that we've got opportunities in the future to kinda move to more fee-for-service funding or revenue payer mix in certain countries. So we'll continue to do that where appropriate. From an optimization and a workforce optimization perspective, what we have done, so I'll give you a very simple example.
You know, for some kind of general or kind of minor doctor practices, we enable under certain legal requirements for nurses to do them. That affects us in terms of optimizing doctor time to focus on high revenue-generating items, whilst kind of really optimizing the cost of the nurses. So we've got a terrific team that does things like that. From a cost and productivity perspective, as Poland has grown, in particular, we scale Poland, you naturally get the economies of scale in terms of your purchasing. So that kind of flows through into the numbers, and we see further growth, as John said, exciting in terms of Poland in the future as well, which should hopefully further leverage even further cost opportunities. And finally, John gave a lot of praise to the Germany team today. Absolutely great. Hats off to them.
They've dealt with the reform over the last two years. We've carried on growing volumes, although clearly there's been a price cut, as we've seen. We showed there's been increase in revenues, and we have improved our EBITDA margins as well. So this is a team that faces adversity, let's say, in terms of headwinds, and comes out with a superior result on the back of it. Although we've invested, I'd say we've been quite disciplined in terms of our investments, and what that has meant is actually our cash flow has materially improved as well.
So, I, if you looked at, I mentioned this yesterday, in terms of real key note for me, Q4 was very good, but actually, if you look at the full year for Medicover, you know, our free cash flow as a percentage of revenues was up to 7.1%. We are generating more of our earnings into cash. That's a good news story. You know, from EUR 48 million and 3.2%, you know, three years ago, which wasn't that long ago. And what that space does actually, clearly, is even after you deduct the organic investments we make in CapEx, there's clear white space opportunity, which naturally provides more cash in the future and gives us options, which is very pleasing. You'll have seen our invested capital worked harder as well.
So we reported yesterday that our ROIC's gone up to 13%, on the back of investing, actually, not cutting costs, right, or stopping investing on certain things. So there's been a big jump, particularly in 2025, as you'll know, because at the end of 2024, it was 6.7%. Big jump up this year. We expect ROIC to improve in the future, given some of the initiatives that John spoke about earlier. And from a shareholder perspective, I think we strengthen returns to our shareholders, so EPS, another number I'm proud of that we reported yesterday, up to over EUR 0.51, up from EUR 0.11 last year. And over time, in a controlled way, we've increased our dividend per share. So you'll have also seen yesterday that we announced we're going to.
The Board approved for the AGM approval of a EUR 0.20 dividend, which, hopefully, will be done, at the AGM in April. So again, stronger returns for our shareholders while we grow our business. In terms of financial discipline, I think, you know, you'll, you'll have known, you'll have heard, we've bought quite a few businesses over the years. There's lots of investment phases, et cetera. But actually, we said we'd operate under 3.5 x, and, and we have. And, you know, that's despite the fact, if you think not that long ago in Q2, we bought two of our biggest acquisitions in history, right? You know, net totaling nearly EUR 200 million. Yet after that, from 3.6x to 3.1x in half a year, just shows the strength of cash flow that we're driving.
So remarkable. It's really pleasing for me to be part of a business that does things like this. Makes my job very easy to talk about, when I sign up and talk to you guys. So in terms of the common themes, I'll just touch on them. Again, I've said it before, we do what we say we're going to do, and that's one. We accelerated our cash. We enhanced shareholder value. We kept CapEx at around 6% over the last three years. We'll probably keep about that percent going forward. But I think, you know, equally, there are headwinds, and there have been headwinds, and there'll be headwinds in the future. But we've got a team and processes. That means we face those headwinds and come out stronger.
So if you look forward, and some of these kind of repeat what John said earlier, so I'm not gonna kind of keep going on about them. We'll drive more cash. We will continue to invest in capacity. Yeah, so I mentioned that, you know, we'll spend around 6% of our CapEx. Historically, in the last year or so, you could argue India's got a disproportionate amount of CapEx versus the revenue it drives. That will normalize now, as we wait for the benefits to come through in terms of capacity utilization in India. And that CapEx will be rebalanced to other areas where we see further growth, and there are opportunities. We do believe there still is scale in terms of cross-country synergies, so there is a bit on that and also intra-country as well.
So from my perspective, we've bought quite a lot of businesses over the last two, three years. We haven't fully integrated them yet, right? You buy a business, you buy their finance team, their systems, their whatever. There's value to be generated by integrating it within the Medicover model as well. So there's opportunities there. John spoke earlier about improving utilization in India and Romania. We can see that happening, and we're focused on that. You know, it's stepping up a little bit quarter-over-quarter. And finally, you know, ROIC, as a consequence for all those things, will go up and margins go up. And despite all that, we're still targeting double-digit revenue growth. So after a long period of double-digit revenue growth and growing margins, we're gonna be doing much of the same in the future, so very pleasing for us.
I guess now, onto the new targets. So, I'll pause for a minute, 'cause I know you'd have seen them already yesterday. But we believe they're ambitious, we believe they're challenging, but we believe in the strength of our business, that we can deliver them. So organic revenue in excess of EUR 3.25 billion, that's double-digit growth. Organic EBITDA in excess of EUR 600 million, again, very strong. Dividend, broadly the same policy as last time. Leverage, we've reduced from 3.5x to 3x. That doesn't demonstrate that we've got any lack of ambition in our business. It just demonstrates we're driving a lot of cash that gives us options. If we need to exceed three, 'cause there's good opportunities, then we reserve the right to go over that for a short period of time.
You can see the bottom two illustrative measures that I've touched on in the past, with regards to adjusted EBITDA up , in excess of EUR 430, and EBIT in excess of EUR 290. So we talked about the EBITDA CAGR of roughly 16%, 16.5%. If you look at the EBIT CAGR, and I'm sure some of you already calculated that, that's 23%. So we are driving, if you believe these numbers, and we've done them in the past in terms of achieving our targets, we're driving a significant about EBIT, which drives a significant amount of net profit into our business. So not just focusing on the EBITDA, but across all the profit lines, the numbers look better. So that's it from me. I think, very proud for me to stand here and talk through these numbers.
I'll be very proud in three years' time to stand here and say that we've delivered the numbers. But in the meantime, I think it's over to us for some Q&A. Thank you.
Thank you for that, Anand.
Thank you.
It's now time for the final Q&A session. It'll be longer. I'll just remind everyone once again, that if you do want to ask a question, please raise your hand and ask for a mic in the room. And online, keep on, adding the questions to the chat. I can see we have quite a few already, which is, which is good. With that, I think to kick off this Q&A session, M&A has been a core part of Medicover's journey, as long as I've been looking at it, at least. You've added some 5% to revenue growth, I think, via M&A in the longer perspective. So yeah, how is the pipeline?
It's good. We've got a good team that are constantly developing it and looking for the right opportunities. You know, Anand and I would rather look for some bigger opportunities, similar to what we did in 2025, 'cause the big deals, you know, big deals for us, 'cause they're the two biggest we've done, make the most sense. But of course, they don't come up every quarter. And of course, we have spots in our network, which we can cover much more efficiently by buying than building. So you'll see us being active. You know, it's a constant kind of process. People will say: "Well, you know, what are you looking for?" You know, we very much want to expand our hospital network.
We very much want to expand our clinic network. Our Sports and Wellness, we want to expand. You know, our lab capabilities are important to us, so we need to look at that as well. But we think we've got some good opportunities, and over time, you should see that we're announcing we've done this, and we've done that, so we're very active.
Good. Would you highlight any particular areas that are of maybe more interest than others?
Yeah, you know, Sport and Wellness, we have to stay relevant. You know, when we made a decision in Poland to go into that sector, we were taking on a very dominant player, and to take on a dominant player, you've got to be relevant to their dominance, yeah? So we've still got to remain relevant there. We'll do some of that organically, some of that inorganically. You know, clinics and hospitals, it's the same as I said before, really. I mean, they're really the important things for us at this stage of our cycle. But we're, you know, as an organization, we're entrepreneurial. If something came along that made sense for us, you know, never say never.
Our focus at the moment is on the core, but let's see what happens.
Yeah. Maybe a question for you, Anand . You talked about the ROIC in the presentation. It's gone up quite a lot, so, you know, you talked about the general trajectory going forward, but could you say anything about, you know, internal demand on what you should do on ROIC terms or where you aim for?
Yeah. So I've, I think, w ell, I'm pleased, I guess, in my first year, that it's gone up a lot, that it wasn't in the first few years. So there you go, a little bit from an ego perspective. But look, I think we are clearly healthcare. Providing quality healthcare is our priority, but fundamentally, we have to be a profitable business in order to do that. So we have a very strict, let's say, regime, in terms of assessing the opportunities that come to us, because if we generate any returns on the back of that, then we can put down more healthcare square meterage, which serves people. So I'd say we've got a robust process. In terms of future outlooks for ROIC, I'm not gonna guess it.
I mean, you can imply the margin rates on EBIT and EBITDA from the numbers that we've given to them. I'm not saying they'd be great, but they'd obviously be ballpark enough. Look at what we've got at the moment, and you can kind of extrapolate where ROIC roughly would end up, right? Particularly given the fact that we've said that leverage will be where it will be as well. So it'll be north of now. But, you know, as you say, I think what will happen, but that's on a like-for-like basis, if you let our current existing units mature, we will buy things which may kind of dampen it in the short term, but as an ongoing piece. But we will only do that if we believe there's value in it from a monetary perspective.
That's a good answer. I think, as I'm asking the online audience to ask questions all the time, I might as well take a few questions from there.
Sure, please.
Here we have one. "With respect to the 2028 targets, is there a back or front-end loaded nature to it, or should we assume a more steady and linear progression?
Over to you, Anand.
Yeah, look, I think, if you look at the last three years, it's kind of a bit hockey stick, so I'd kind of model something accordingly. Otherwise, we'll have constant calls in the next year about why you're not demonstrating that trajectory. That's not to say that it won't be, because actually we're doing actions now, but yeah, I would kind of back in some of the benefits.
Good. And we have, I'll get ahead with another one. "Please update on the IPO of the Indian subsidiary. What's the status? When do you plan to go ahead, or do a go, no-go decision?
Sure. So, you know, we just to put it into context, December the 12th, 2024, we announced that we would explore doing a listing in India, and we put a long time scale in it because we knew we had to do a lot of prep preparation work. We've done all that preparation work over the course of 2025. We're now into what I call the business end of the IPO process. So now we're, you know, we're currently sort of finalizing our advisors that are required. We know exactly the process that we have to follow.
You know, there's two key elements to it really, which is, one is the process, and making sure that, you know, our prep work was good enough and that we have got the right things in place, and the second is getting business performance to maximize value. You know, if we look at 2025, we started slowly, and then we bumped a little bit and then moved forward. These next few quarters are key for us, in terms of the growth. So it's quite an exciting time for us with our Indian colleagues and our performance. If that goes into the right kind of zone, we're on plan, plan A. Currently today, inside the organization, nobody, we're not talking about a plan B.
If somebody says a plan B, they kind of get a stern look 'cause we're totally on plan A. If it turned out that we needed a little bit of extra time, for whatever reason, 'cause it made more sense from a value creation, that 24-month period that we gave wasn't a backstop. It wasn't like we have to do it by this time because, because, because. But we're totally on plan A. Yeah.
Good. Do we have any questions in the room right now, where you want to ask questions? Otherwise, I will go ahead with another one from the audience online. So this relates to competitive environment, basically. "So what do you think is your major disadvantage versus LUX MED in Poland? In which area do you see room for improvement? Do you consider LUX MED entering diagnostic services as a threat?
You know, LUX MED are a very respected competitor of ours. You know, we've been together competing with each other for a long period of time. People love to say LUX MED versus Medicover. You know, it's a natural, easy thing to do. But if you analyze the two businesses and do your analysis in terms of the space that we're in, we're in lots of different spaces that they're not in, and they're in lots of different space that we're not in. And there are a couple of things that we go head-to-head on. Membership business is one. Quite often, they pick up slightly different membership type business than we do, a slightly different profile. So we kind of coexist. They do good things, we do good things.
We do different things. Some customers go left, some customers go right. I think that that will continue. I think their move into Diagnostics is a sensible one. Yeah, you can understand it. It looks like, though we're not privy to the information, it looks like they had a historic agreement with Diagnostyka when they were owned by the same people, and then that agreement has ended, and that means they should move into that space. If you look at what Diagnostyka's done, they've taken a lot of good space in the Polish market, and if you look at our position, maybe we could have done better. And I think now, them moving into that space, us getting a bit more aggressive in that space, will be interesting for the market in terms of the diagnostic space in Poland.
So I think it's gonna be a really interesting time. You know, they've got good capabilities, we've got good capabilities. That's always been the case. We're gonna develop new things, they're gonna develop new things. Sometimes we'll go head-to-head, sometimes we won't. We're comfortable currently with the environment that we find ourselves in. Yeah.
I think that's a good answer to that question. I have another question from the chat here. Do you plan to enter new markets in Central Eastern Europe with your Healthcare service offering after you have entered those markets with Diagnostics now?
You know, for Healthcare to work, you need scale. Yeah, and the more scale you get, the better it is. Yeah, because then you can tailor your services, then you can get more specialized in what you do. As a consequence of getting more specialized, you get more expertise, you know, and it tends to work. A lot of the markets that we're in from a diagnostic perspective are smaller in terms of population. But never say never, but currently today, we're comfortable with the model that we've got. You know, at some stage, I'm sure that we will strategically want to look for new markets, but at the moment, you know, over the course of the three-year period, we're very comfortable with the footprint that we've got.
We wouldn't rule out doing something different, but, you know, we'd have to make sure that we've got the right competence, the right people, the right expertise, the right timing. A lot of things to go right for you. You can, you can expand into a lot of new space and lose a lot of energy, lose a lot of cash flow, you know, lose momentum, and we've got momentum at the moment. We wanna keep that momentum going.
Good. And maybe my next question ties into that a little bit, relating to the SYNLAB acquisition. So just what are the key learnings from that? Have there been, you know, challenges along the way or?
Yeah, I mean, none of these things ever go. When I write the book, it will be brilliant. Yeah, but none of these things ever go to plan. There's always a deviation in some way, shape, or form. Out of the two acquisitions that we did in 2025, you know, the CityFit one, one was a little bit easier for us to get the synergies right from day one, and they were executed well. SYNLAB had a few challenges in terms of some of the things we thought we'd get value faster. Some of the agreements that we thought we had prior to completion that some people delayed on us, and then some detail that just wasn't available.
You know, at times there's like, you can do this deal, you can do this deal at, with these parameters, but it has to be done within a certain timeframe, and there's only so much data to make the decision. And then when we went in and found more information, it caused a few more complications. However, what I will say is that the team that were working on it, whilst they went through that journey of ups and downs, they've come out of that journey well, and we now find ourselves in a position when we look at the plan, that we're kind of close to the plan, and most things are ticked off. And one of the key synergies is the difficult one, which is you've got duplication. Can you remove duplication?
And sometimes some management teams kind of avoid that 'cause it's hard, but they executed that. So credit to that team. You know, they were behind, they caught up, they've ticked a lot of boxes. Some stuff that we thought we'd get, we didn't get. Some stuff that we did get is going better than we thought. So it's the normal swings and roundabouts, but if I was to, you know, be the headteacher and mark the class, they've done well.
Good. And if you would share a few words on earnings per share accretion from those acquisitions, how do they look?
Yeah. So, I think, look, we're not kind of splitting out by business unit now. You'll have seen our Q4 report. So we'll talk a little bit more in terms of splitting the, let's say, the net profit impact of those two entities individually in our annual report. So we've said we'll do that at the end of March, and we'll carry on doing that. But if you look at the numbers we reported yesterday, look, I think versus the underlying Medicover delta, you know, the margins accretive. Yeah. So we're pleased. I think John says a little bit of a slower start on SYNLAB versus CityFit, but actually both businesses are doing well. Both businesses have been revenue accretive and margin accretive to our business, so we're pleased with how it's going.
Well, that's good. Any question in the room right now? I see no hands at the moment. Maybe switching gears to Genetics. So if you could, I mean, you gave an update, of course, in the presentation, but if you could give us a feel for how fast it is growing for, for Medicover, and sort of what makes you excited around that business for the coming years?
A few things there. I mean, you know, Genetics actually in 2025 did well, but they had quite a challenging year with some of their, you know, international customers who faced challenges. A good example was the NHS. You know, the NHS, we've got some agreements with, and they, you know, were going through quite a bit of change, and as a consequence, some bits slowed down. But the footprint that we've got is very, very good. I think that, you know, this is one of these longer term things for us. And, you know, in my change of role, one of the things that I've definitely identified is that I think our Genetics business is something that could add value, more value.
I'm not saying it 'cause it does add value today. More value both for our healthcare division and for our international, you know, aspirations. So they had a good year, and they're growing quite nicely, but it's the long term. And I'm not, you know, I've alluded to it a bit for our the three-year period, but we have to have some things which are, "I know I can pull that lever, and I'll get it in three years." And we also have to have some things which is, "I can pull that lever, but if I get it in three years, I'll be very happy." John Stubbington being very happy is an unusual word.
But if I get it in the 6-9, I'll be even, you know. So this is a really interesting area for us 'cause we're in healthcare, and if you look at Genetics, you know, people will be saying for a long period of time, "Genetics is gonna change the face of healthcare." Somebody's got to crack how they deliver that. Somebody's got to crack how the system works. So this is a short and long-term, this is a medium to long-term play for us. And we've, you know, the great thing about us as an organization is we've got this capability in the business. We've got these experts that are in this space, that have got a decent business today, and a decent European business when you look at Genetics European.
Where the big growth is coming from, from a Genetics perspective, is in America. Yeah, and of course, to do that, you've got to be one of the preferred providers in the you know, embedded into the system, yeah? So there's lots of interesting things with Genetics, so it's definitely part of our strategic thinking. There's some short term, there's some medium term, there's definitely some long term in this.
Yeah, but it's fair to sort of assume that it will grow faster than the 11%?
Yeah, the team will do well. Yeah, I think the team will do well.
Good. And how many countries, by the way, are you collecting revenues within Genetics?
I don't know off the top of my head so I couldn't answer that.
We'll talk about it.
Sorry. Yeah, yeah.
Good. I think I'll continue with a few more questions from the audience here online. So your strategy clearly assumes EBITDA margin expansion. In which sector you see more opportunities for this margin expansion, is it sort of Healthcare or Diagnostic?
I think both, you know, we've got two really good divisions. We've got some really strong positions which are growing well, which are driving the cash, which are driving the margin increase that you've seen over the course of recent times. But also within our mix, you know, we've got some things that we need to drive faster. We've got some things that can grow faster. We've got, you know, as Anand alluded to in his presentation, we've got part of our support service area where we can integrate it much more than we have in history. That doesn't sound big, but of course, that creates efficiency, and that means that as you layer on more volume through that efficiency, it starts to count.
So you know, we've got quite a number of levers that we can pull to be able to make the midterm targets start to move. You know, what we're concentrating on at the moment is, I took over in May. It takes a period of time to get everybody organized, everybody focused, everybody on message. We're quite happy with the development that we've done, but we think we can do a better job of engaging the leadership team to deliver more for us, and I think they will.
I think, so just to add to that as well. So I think, you know, the, I think John's slides were super in terms of showing things by country, in terms of, you know, the opportunities we've got, either in terms of non-CapEx spend, by just kind of, you know, maximizing utilization versus spend as well. So I think if you kind of, you know, replay back some of those slides, we should grow EBITDA in all of those countries based on what we've said. Now, clearly, there'll be some material step-ups in some countries versus others, but they'll be a small part of the business. So India is a good example. We should see a step-up in EBITDAs in India, but it's only 10% of our revenue.
Right? So it won't shift the dial for the whole business materially. But there's enough in there for us to believe that there's growth everywhere.
Yeah. Maybe I can follow up with my own follow-up question there. Looking at the LTM adjusted EBITDA margin, it's just short of 11% now. Pre-pandemic, then I'm talking 2014- 2019, it was 9.6%. So maybe just for the broad audience, sort of, is that increase versus this period, a better capacity utilization, or is that mainly a movement in sort of mix that you're operating in more margin-accretive segments? Or just to understand.
It's gonna be both. Yeah, it's gonna be both.
It's gonna be.
It's gonna be the answer that you don't want, which is both, which is good, you know? And I think both sides of both of those levers still can be pulled. Yeah. So I don't think that we, we sit here today saying, "We've got a perfect model." We've got a really good model, yeah? We're obviously very confident. We're putting out there some ambitious targets in the Medicover way, which is that, you know, will they get them? It's ambitious. What's it gonna look like? And of course, we're gonna have to grow to them. But we feel we've got enough levers, and a, a couple that you've talked about there are, are, are things that we can, we can improve, yeah? So we're a really, really good business, but we, we've also got areas we can do better. Yeah.
Good. I'll just go ahead with some other questions from the chat. Yeah, this one relates to the amount of new members that you touched upon a little bit yesterday. The question is, what is behind the sort of slowdown there, and how are you addressing that?
Yeah, you know, if you look at our membership growth in history, a bit came from Hungary. Hungary were doing well. Hungary's not there anymore. If you look at Romania, we're remodeling Romania more to be, you know, in towards the hospital clinic, integrated, model, less dependent on membership, so it's a smaller part of what we do. So most of our members that we talk about is Poland, yeah? And if we look at Poland, go back a couple of years, we had really severe inflation, yeah, where it just took off. And like, you know, it took off on day one, and we couldn't get to our price increase till about day 270.
You know, so there was a long period of time before we could start to represent that extra cost in our business model. So we had a decision to make as a leadership team, which was, you know, what do we do? Do we price appropriately, or do we, you know, do we use this opportunity to chase more market share, pick up membership? You know, what matters to us now, if you look at our business mix, especially in Poland, is relationships as much as membership. Membership is one type of relationship that we have. It's an important type, but over the last two-year period, we haven't really chased volume of membership.
We've chased making sure we've got the right price point to deliver the right care at the right time, in the right place, to the right person, for the right outcome to make the customer happy. And sometimes that, that's meant some of our customers have walked away, 'cause some of these price increases were really, really big. And those customers that, you know, wanted what we, what we stand for, have stayed with us. We're now gonna enter a slightly different cycle, yeah? And we should start to see, you know, relationships and members develop a little bit more in Poland because it's just a different cycle.
Yeah. Maybe on that, with the price component then going forward, how do you, w hat's the outlook there, really?
It will still be healthy. I mean, what we had was super inflation. You know, it really went—it was really sharp. It was really quite scary at the time it happened. It's one of those kind of like Medicover moments, which is what I always describe as fact or fear. Which is the fear hits you, and everybody panics, but let's deal with fact, guys, yeah? Let's, let's move forward and just deal with it. And then later on, we'll see how much the fear equals the fact, and it's always lower, it's always lower. But as we, as you look forward, medical inflation, yeah, is, is not something that goes to zero, yeah? There's always medical inflation in the system. Doctors, nurses, people that are delivering care, scarce resources, people want them.
That drives a certain, wage increase that comes with it. Governments have been playing around with it now as well, forcing, forcing things on us. So we'll have a decent price position. And of course, where we've got pockets where we feel that we can take a slightly different value price position, we'll do it. So it's not gonna be as rich as it has been in the last couple of years, but it was, y ou know, we're still, price will be a component of what we talk about. It'll be, it'll be an interesting couple of years. Yeah.
Yeah, and for those in the audience that wonder about Germany in that respect, because I assume everything you said now is basically ex-Germany, so.
Yeah, I mean, from a Germany's slightly different. It's highly regulated, you know, so price is not really part of it if the fund is paying. And then outside of that, you know, there are some things which are not fund-related. And, you know, therefore, what we've got to do is if your price is regulated, you've got to be really, really efficient, yeah? And part of the German reform has made us question a lot of things to do with how could we become more efficient. We obviously took actions because that's why we've come out of the reform okay, but we can do more. And like, as I alluded to earlier, our change process will last longer than the actual reform. And that should help manage some of our price mix positions. So again, I'm looking forward to seeing what they do.
Yeah. So just touch a little bit more on Germany. So, you're right, and I think although price is down in the public sector, what we have seen, and I will push for clearly, is a move for fee-for-service wherever possible. But we are growing volumes as well, and the mix of tests into, let's say, higher value tests, which kind of clearly generate more revenues than EBITDA does for us. You know, we're seeing, you know, pleasing early signs, I guess.
We, we, we-
From the team.
You saw on one of my slides, I talked about lifestyle testing was on there, and it's quite a big growth that's happening in terms of the lifestyle testing. You know, there is a trend, not just in Germany, but across Europe, in terms of you hear longevity much more. You hear people wanting to do anti-aging, all this type of thing. We're quite well placed with our test portfolios for this kind of space. And that doesn't have a price regulation to it in Germany, and outside of Germany, it's another opportunity. So, you know, I think one of the really big positives about Medicover is, you're asking me questions about different challenges that are coming along, and they're there. They're absolutely there, and they are a challenge when you're in a leadership position, you know?
This is going to happen: what's it gonna do to you? But then, as a Medicover leader, with the capabilities we've got, if you take a step back and go, "Okay, so that door now, that, that opportunity now is a little bit harder to get at, but I've still got that one, and I've still got that one, and I've still got that one," yeah? So we're in a, you know, our leaders have got really good opportunities to grow their businesses, and they've got a track record of going problem, solution to solution. Sometimes we need to help them to move into that process, but they've done it, you know.
All credit to them. You can't say a better example, and we haven't mentioned them today, and I'd like to, than Ukraine. Because, you know, that team had such a big challenge from what was happening to them, and their performance in 2025 has just been amazing. So all credit to them.
Good. I can see now we have a question in the back. Just make sure you have a microphone.
Hi, John and Anand. Thank you for a very great presentation. I was wondering, you've talked about the growth potential, but when you lose clients, and what is the main reason why clients walk away from you and choose to go to a competitor?
If you, you know, it depends what market, you know, 'cause we're and what line. But if we go to the core Polish market, yeah, because Poland's our biggest country, most of the time it's a price component. You know, there are some of our companies in the market where all that matters to them is price, yeah? And there are some of our customers that at times, you know, they find themselves in a business position where they have to save money, and they just need to find a way to save money, and that hits us.
You know, sometimes there's a bit of capability catch-up, because, like, we might be developing something really great here, but then somebody might do something here, and we, we're like, "Oh, we've got a bridge to go." And some people, you know, feel, "Okay, let's have a look at that." But then we play capability catch-up, which is we build it into our, into our stack, and we, we try and move it forward. But, but price, it, it, it becomes important to some customers at some time. Yeah.
So it's not product range and things like that?
We've got. You know, if we look at, c ertainly if you look at our business-to-business sector, we tailor our products are built from scratch. So, you know, the customer basically says what they want, and we design what they want. And if we look at our portfolio of different product solutions that we have, we've got the broadest portfolio of product solutions, certainly in Poland from a different businesses and different areas of focus that we've got. So no, but, you know, if you, if you're gonna tell me something in the, in the end that I should know about, I'm quite happy to listen. Yeah, I don't want to sit here and say we've got all the answers, 'cause we haven't, and we're quite prepared to be challenged, listen, learn, and solve.
Helpful. Thank you.
No problem.
Any more question in the room right now? One question in the front here.
A follow-up question on Ukraine, and I understand that it's difficult to assess, but what would a peace scenario mean? Is that instant ramp-up or sales, or lifting the margin, or what would you say on that?
I think it'd be very difficult to say what would happen. You know, I think if the war ended in Ukraine tomorrow, you've probably got some population shifting that would happen. So some population from Poland going back, some population from Ukraine that couldn't get out, would want to get out, so there'd be a change in the market dynamics. But also then there'd be a massive building program that starts to happen in the country, you know. One of the challenges that might happen for us is actually the cost of building and resources for people to build because it'll be sucked into Ukraine, and that's one of the scenarios that we need to think about. But there'll be definitely opportunity for a player like us, where, you know, we're very respected in the country.
Everybody knows that if they come to us, 'cause consumers come to us mainly directly, to have their test done, and they know if they come to us, the test is done. And that, you know, there, there's an opportunity for us to move deeper into healthcare in that particular country 'cause there is a population scale. So, you know, we've got I think I've answered it before, that we've got a business as usual, and our team are doing fantastically and, you know, really all credit to them. And then we've got, you know, at a relatively detailed level, that if war ended, what are the things we would consider?
But, you know, we're not gonna say, "Let's press the button," because there's gonna be an environment shift that happens, and we need to assess what that environment shift looks like. So quite a difficult question to answer, but, you know, if you take a complete step back, think about it logically, and let everything settle, we're a significant player in Ukraine that's trusted. That surely puts us in a better place than most people who would want to explore Ukraine.
Okay, and a short follow-up there. Should we assume that the margin there is below?
You should never assume anything in life.
No.
Or, I guess that is not at the same level where it was around 2019 and Covid levels.
We do not give out margins by individual business lines or—
Yeah.
So I couldn't, I want to answer your question as a human being, but we just don't do it. But, you know, I'll go back to what I have said, which is that business has done incredibly well in 2025, yeah? And you should read into that what you'd like to read into it.
Okay, thank you.
Good. A couple of more online here. Any important regulatory changes anticipated in the next one to two years that could, you know, create opportunities or challenges?
You know, there's always regulatory changes that are being talked about, you know. So when we map those out and we have the sessions with our people that's responsible to look at it, they love a gossip, and they love to scare you. And there's so many of them, and you look at it and go: "Well, which one should we focus on?" And we have a kind of process for what we think is real and what we think is isn't so real. And, you know, what, there's nothing in it at the moment where we're going, "Oh, my God, oh, my God!" But you never know what's gonna change.
and I'll answer it the same way that I have a little bit earlier, which is there's two choices: You can either go with fact or fear. Yeah, we'll go with fact. So we've got a track record in history, which no matter what changes occurred, we've been agile enough, you know, both as a, as a leadership community and mentally, to be able to shift quite quickly into a different way of being, to enable us to develop our business going forward. And it's one of those scenarios which is that door's closed, which door's open?
Good. I think we are running short of time here. So I'm sure that those questions that were not asked online, they can be addressed to Medicover afterwards, and you will get the answers. And as we approach the end of the event here, I think I'll hand the word over to you, John.
Sure.
For some closing remarks.
Sure. Sure. Okay, so I'm not gonna take too much time for everybody because we've spent a lot of time in the room. We've covered a lot of ground. I think you've heard quite a lot of exciting things from us. What's the key takeaway messages? Well, first and foremost, Medicover is in a really good place. We've got, you know, really good capability. We've got really good teams. We've got passionate teams that really wanna do a good job for the customer. We've got a track record of delivery. We've got some exciting plans that are happening or that we've set some exciting targets. They're ambitious.
Yeah, they're challenging, but they're the type of things that we like to do, and we're looking forward to, you know, developing them, developing our business over the next three years. There's lots of levers that we can pull for growth. There's lots of levers that we can pull to improve our operating position, and, you know, we're looking forward to sharing the journey with you in the coming quarters and the coming years. Thank you very much for your attendance, and thank you very much for your support, and thank you. This is the end. Thank you.