Welcome to the Medicover Q2 2026 report presentation. For the first part of the conference call, the participants will be in listen-only mode. During the questions and answers session, participants are able to ask questions by dialing pound key five on their telephone keypad. Now I will hand the conference over to the speakers, CEO John Stubbington and CFO Anand Patel. Please go ahead.
Morning, everybody. It's John here. Welcome to our Q2 2026 report. I think we've got a quarter of positive progression, which we're very pleased with. You can see it's another quarter of double-digit organic revenue growth and margin expansion, which is really what we're aiming for. Strong organic growth of 11.8%, and this is our sixth quarter of improved margins, so we're very pleased with that. It's a record that we're proud of and hope to continue as we go forward. Just a reminder for everybody, this particular quarter has a very strong comparable base. Last year we made significant movements upwards, so it's even more pleasing to see the progress that we've actually made. A year or so ago, probably just a year and a quarter, there was a lot of talk about India and what we were going to do in terms of the growth for India.
You can see that over Q1 and Q2, we've had very positive progression and really strong growth percentages. Our diagnostic business has performed very well. There's a level of consistency that's happening within that division, which we're delighted with, and it's all credit to their hard work. We have consistency of increasing our Fee-For-Service revenue streams, which is where our main focus is, and leverage was at 2.9x. Revenue EUR 640.4 million, very respectable in terms of the growth rate. You can see that from an organic perspective it's 11.8%, which is very credible indeed. Adjusted EBITDA EUR 109.2 million. Very pleasing to see that and to see our progress. You can see also with the adjusted EBITDA margin at 17.1%, the increase there is not as big, but as I said, there's a very high comparable.
Just to see that move in the right direction is very positive for us. Operating cash flow is EUR 73.6 million. That's up 28.44%, so really good generation. You know that from our perspective, that's quite important for us because as we do that, it gives us more choices. Leverage, as I said, is at 2.9x. That's down from where we were at year-end of 3.1x, and of course, has improved quite considerably if we look year-on-year from 3.6x last year to 2.9x. Good solid set of numbers that we've produced. We're happy with that. If we move forward and just look at the revenue and the progression of the revenue streams, another good quarter. Revenue produced at expected levels, so we're happy with that.
Revenue by country is very steady, you can see a strong quarter in India, in Euros up 23%, in local currency, much higher. As I said, this time last year, it was a big area of debate for us. It's really pleasing to see the team have continued their progress and got momentum inside that business. Revenue by payer, a little bit of change of mix here happening with different things going on, but very good strength coming through from Fee-For-Service, which is our biggest stream. It's obviously the stream that we want to concentrate on a lot, and it's good to see that growth. Governmental revenue streams in terms of the public pay, lots of micro changes happening there that's affecting it. We know that in terms of our funded business, we want to continue to develop that.
Pleasing to see that we've got growth starting to come through in Poland from some of the initiatives that we've put in place. That's very, very positive. If you look at Healthcare Services, solid performance by Healthcare Services. Again, this is the area where probably the comparable base was the highest. We need to bear that in mind. Revenue growth 6.9%, organic 12.2%. Very good. Price accounted for 5.2% of that. Quite a solid mix that we have there. As I said, with India, 23.1% revenue growth in India in Euros, but 39.6% in local currencies. 34.4% last quarter, towards 40% this quarter. Good momentum in that particular business. Fee-For-Service and other areas perform well. Sports and wellness continues to be strong for us, and we will continue to develop that proposition very strongly. Memberships, relatively unchanged.
As I say, Poland grew. Some membership fall in Romania. Quite a bit of that was contract management. Was managing the profitable and unprofitable accounts, and most importantly really here, related to the Fee-For-Service that quarter-on-quarter, our ability to create the relationships with people that are looking for those kind of solutions is growing quite strongly. Revenue, EUR 442.8 million, up 6.9%, which is good. EBITDA margin 18.4%. A slight change there against the comparable. Memberships are relatively flat, and revenue by country not particularly changing dramatically. When you see the minuses, please bear in mind that we still have Hungary in these comparables. That affects that particular indicator. As we move to Diagnostics, we'll see that it's a strong growth and improved profitability. Congratulations to that team. Good revenue growth, increased by 8.5%.
Organic growth was up 10.9%, and a good proportion of that is in price. Please remember that from a German perspective, the ability to move price is almost absolutely zero. Very credible performance by the Diagnostics team. Fee-For-Service strong. As we said, that's the area of focus, that's really pleasing to see. Operational leverage coming through. Of course, with the diagnostic tests, mix is quite important in terms of the different types of tests that you do. We've always focused on making sure we've got a reputation for not only covering the basics, but covering the more advanced side of life, that's great. Ukraine continued to deliver really solid performance for us. I mean, Q1 we said was softer. A bit of that was reflected by the weather, a bit of that was reflected by the war conditions.
Considering the things that they have to overcome, we just have such a fantastic team in Ukraine, and we would like to thank them for everything they do because it really is difficult conditions that I do not think any of us would want to trade under. Germany did really, really well. Solid momentum. We are seeing the change in mix continue, where we are getting more Fee-For-Service maybe as a consequence of the environment, but also a consequence of the varied proposition that we have there. Our expansion on the BDPs continues. Really important for us in terms of the future, so that is very good to see. The number of tests are up by 4%, which is good progression. 40.3 million that we produce, which is great. Revenue, very solid, EUR 205.1 million up 8.5%. Very, very good. Continued improvement in the margin.
You can see that that is a significant improvement the team have done there, so very pleasing to see. 40.3 million is a positive sign against our 38.7 million tests of the comparable quarter. If you look through from a country mix, it is again, relatively stable. You can see the strength of Ukraine coming through with that. Again, our payer mix continues to increase on a Fee-For-Service basis. That will give us much more stability and of course, opportunity to move prices as we move forward. A very, very positive sign. Congratulations to everybody in Diagnostic Services. I will hand on to Anand, who will talk you through a little bit more detail of the financials, and then I will come back at the end to summarize. Anand, over to you.
Thank you, John. I will describe the quarter as a solid quarter, and consistency in us delivering double-digit organic growth from a revenue perspective and margin accretion as well. We are pleased with our numbers. I think one number I would put out is EBIT. EBIT of EUR 51.2 million. You can see our margin rate is 8% now, which is up 100 basis points year-on-year. Pleased to see underlying profitability being boosted by, as John said, in some areas, tough comps, but we are still growing our margins year-on-year and our organic growth as well. Other profit measures are up year-on-year as well, as you can see from the page. One I will pull out is the EBITDA, which is obviously our best measure of cash profit at EUR 72.7 million.
That is up just under 13%, with margin accretion of 50 basis points year-on-year at 11.3%. We are pleased with that. As a reminder, in Q2, we paid our dividend of EUR 0.20 per share, so that is kind of reflected in our cash flow. From a healthcare perspective, John has mentioned that we had some tough comps from last year, but still pleased with the growth. I would say a solid performance. Organic growth of 12.2%, and you can see there was kind of growth in both price and volume, which is very pleasing. From the EBITDA perspective, it is up year-on-year at EUR 55.6 million. There is margin rate dilution year-on-year of 30 basis points. That is predominantly due to the tough comps, as I mentioned earlier.
There is also some one-off activity last year, which if you strip out, then we would be up year-on-year. EBITDA relating to the immature Indian hospitals. You can see the loss on those in the quarter was EUR 3.2 million, so it is down a bit on last quarter, but up on last year. Those are predominantly due to the hospital that we opened in Q1, in line with expectations. As John says, we are pleased to see the India overall company performance perform really well at the numbers that he mentioned earlier. I would say a very strong month from Diagnostics . Solid in Healthcare, strong in Diagnostics . Organic growth of 10.9%. Again, pleasing to see volume growth as well as price growth across both. EBITDA of EUR 30.3 million, which is very strong with margin rate up 110 basis points at 14.7%.
I think obviously we kind of concluded on the two acquisitions we did in Q2 last year. It is pleasing to see in both Healthcare as well actually, and in Diagnostics, that the synergies we have realized are helping boost our numbers year-on-year. In other metrics, leverage trends down. It is below 3x, which is good compared to last year as our increasing profitability kind of offsets the fact that we are kind of keeping our invested base safe from a debt capital and equity capital perspective. You will have seen that we increased and strengthened our liquidity in Q2.
In May, we managed to increase our RCF from EUR 300 million to EUR 400 million. That gives us more scope and more optionality and headroom to take further investment decisions in the future should we choose to. I have mentioned the dividend we have paid of EUR 30 million in Q2.
Taxes in line with expectations at 28%. An improved performance in cash versus Q1, with net operating cash flow at 28% at EUR 73.6 million, and free cash flow at 4.1% of revenues versus 3% last year. Finally, on ROIC, kind of an improvement there as well. 13.6% versus 9.3% last year. I would say a good performance on those measures. In terms of CapEx, if you look on the left, you can see there is clear blue water between our free cash flow and our growth CapEx, which is good. Our CapEx overall was EUR 29.7 million in the quarter, about 4.6% of revenues. I have mentioned previously that we will be around 6% of revenues for the full year, and we will stick to that. In terms of where the money was spent in the quarter, 2/3 was in Healthcare Services and 1/3 in Diagnostic Services.
The maintenance growth split is 44%/56% in this quarter. However, looking forward for the full year, we expect to revert back to more two-thirds on growth and a third on maintenance. Finally, medical space of just over 1 million sq m. A little movement in the quarter, but up year-on-year. Finally, with regards to our midterm targets to 2028, we still expect to achieve them. Organic revenue of EUR 3.25 billion, adjusted organic EBITDA of EUR 600 million, leverage under 3, and all the other measures highlighted in the bottom right corner, including EBIT, we expect to achieve that for now. With that, I would like to say thank you, and I will hand back to John to wrap up.
Yeah. We say here solid performance, and that's probably our Englishness that's coming through there. It's really good to see the consistency that we've got with the double-digit organic growth. Six consecutive quarters with margin improvement, which is the zone that we want to be in. Strong Fee-For-Service growth. That's one of our most important revenue drivers, and really good to see that the synergies from the two acquisitions, which were our largest in our history, have come through, and the acquisitions have been embedded well into the organization and are very much part of Medicover now. India, as I said before, a lot of conversation, a lot of talk about India.
If we go back 12 months, we said that we would start to see the momentum of that coming through, and it is coming through, strong double-digit revenue growth, even in Euro with the exchange rate. Congratulations to all. We will do what we've said that we were gonna do. We'll focus on our execution, we'll focus on making sure we get efficiency, improving our capacity utilization, and making sure that when it comes to our price and cost management, that we take the appropriate steps that means that the customer gets what they need and that we have a good, strong, sustainable business.
Finally, just a thank you to all of the people in Medicover. These results have been created due to your hard work, thank you very much for all you do. Now we'll go to the Q&A and hand over to the moderator to help us with that.
If you wish to ask a question, please dial pound key five on your telephone keypad to enter the queue. If you wish to withdraw your question, please dial pound key six on your telephone keypad. The next question comes from Kristofer Liljeberg from DNB Carnegie. Please go ahead.
Yeah. Hi. I have some questions here regarding Poland and then India as well. Poland first. Would you be able to comment what growth would have been adjusted for the strength in the sport and wellness segment? I'm thinking about both funded and the Fee-For-Service adjusted for sport and wellness, which seems to do very well.
No, we don't disclose that information, Kristofer, unfortunately, I can't answer that question. We don't do it for competitive reasons.
Okay. You said funded were growing again in Poland. Is that also true for members quarter-over-quarter?
Yes. Yeah. Our funded position started to move again in Poland. As we commented on previous quarters, we've put some different solutions out there in the market, and more are gonna come. We fully expect the employment market to sort of help us along as well. Even whilst that's been adjusting a little bit, that's probably the best way to describe it, we still know that we can penetrate more. We expect to do more on that line as we move forward.
Given that the number of members were down here sequentially seems a pretty large drop than in Romania, if you could maybe explain that a bit.
We did some looking at our profitability on the portfolio and made some sort of harsher decisions in terms of the membership that we have in the portfolio in Romania. It did drop. What we have to remember about Romania, currently there's quite a lot of fiscal things that are happening and there's some other companies that decided that healthcare is not right for them at this moment in time. Membership isn't the biggest part of our business down in Romania. It's a much, much smaller percentage of our mix of revenues. I think that will stabilize as we move forward. We've got a watch and brief on it. We're taking counter actions. Your question about Poland is, we expect Poland to be as history, relatively strong for us.
Okay, great. Then India, if you could comment on margins there. I don't know if EBITDA versus the rest of the group, if it's improving year-over-year.
I think broadly speaking, they're slightly up year-on-year. As I said, we're more pleased about the revenue growth. As always, with building margin in, let's say Indian hospitals that I've seen, you kind of recruit the doctors first and then the kind of revenues tend to follow. We've got a strong base of having recruited a good doctor set, and now the revenues are starting to follow, as you can see. We expect a bit of margin accretion further. Yes, no, we're pleased.
Is it true then that India margins are still dilutive for the business?
Yes.
Okay. Just when it comes to the impact on EBITDA margin from leases, is that the similar effect that you have in Europe if we look at it as a percentage of sales or something like that?
Similar, yes. I would say yes, because obviously the Rupee has depreciated year-over-year as well. Yes.
Okay, great. Thank you very much.
Thank you.
The next question comes from Mattias Vadsten from SEB. Please go ahead.
Yes, hi. I have a couple of questions. Starting with Romania, I think the macro backdrop quite well explained. What would be helpful, I think is some more flavor on the political situation and perhaps more what tangible initiatives that are taken there to impact the ability to grow for you and maybe, yeah, if it will be sort of soft on a year-on-year basis also for H2 2026. That's the first one.
Yeah. The political situation down there creates a degree of instability, and that translated into some micro changes in the payment system in healthcare from the governmental funds, where they've capped things which in history weren't capped before, and they've cut some of the tariffs. They're basically repurposing their framework to be able to balance budgets and coming into line with things. What happens there is that these changes happen, and then for us, we feel it, because in that location we do. Over time, what we would expect to happen, and usually does happen, is that the people that are not getting their care through that means will switch to getting their care through an alternative means. We have to repurpose our operations as these things happen.
We're taking those kind of countermeasures in terms of the offerings that we do for Fee-For-Service and the way that we look at the lines that have been affected from a governmental perspective. Usually what happens is our Fee-For-Service line starts to attract more people as a consequence, and we start to move through. Ultimately, government of Romania have a responsibility to provide care to the people of Romania through the governmental funds, and they will continue to do that. There's just that there's micro changes happening that we have to adapt to. It will take a bit of time for us to adapt, but we should be able to come through that.
Thank you very much.
Sorry, one more thing. Usually that creates opportunity for us. Let's see how it plays out.
Yeah. Thanks. A good example of that, I guess is Germany and what we've seen, you had better growth year-on-year in Q2 compared to the first quarter. Would you say this is just more patients moving to the Fee-For-Service line that is helping you there, or is it anything else?
I think it's a combination of a number of factors as it always is in our business. It's not really down to one particular answer due to the nature of what we do. Yes, the nature of the reforms that happened a year ago, would have changed consumer behavior to be more prepared to pay out of pocket because of delays. We don't expect that to be like a tap, which didn't have a lot coming out of it, and suddenly there's loads coming out of it. We expect that to move over a period of time.
I think the strength of our broad portfolio of testing and the fact that we've got lots of tests that are very much focused on to the medical side of life and supporting the medical profession, also within our portfolio, we have more lifestyle-related things which are becoming more and more popular. I think we're well-placed to be able to take advantage of those positions and see Fee-For-Service progress. Don't expect it to be a dramatic thing. It should be steady as we go. As we see the trends and understand where to focus on, we'll very much seize on that.
Thanks. I'll squeeze in one last question. In terms of the price contribution in diagnostics, it has been averaging around 3.1% since the onset of 2025. Now, I think it was five. Just what is driving that? I think in Germany, no changes, I presume.
Yeah.
Could it be an impact of raising prices in Fee-For-Service for Germany, maybe?
No. I don't think so. I don't think that any price change that we do in Germany, there's frameworks that control things. No, it's much more mix, yeah. The strength, as I said, of the broad nature of our portfolio.
Thank you so much.
Thank you.
The next question comes from Kane Slutzkin from Deutsche Bank. Please go ahead.
Morning, guys. Just a quick one. I'm not sure if you can comment, but can you talk to the situation around the Indian business? Originally, you were looking to list this business, but I guess in June, we learned of talks with KKR regarding a potential sale. Where are we on these bits? Thanks.
Yeah. As you can expect, I can't say too much on this from a legal perspective. I can just reiterate the facts for everybody, which is, as everyone knows, some time back we said we'd explore the IPO in India. That still very much is an option for us, and we're continuing to do the work on our IPO. At the same time, our business in India is very attractive and it's no surprise and shock to us that people have knocked on our door. Our responsibility if somebody does that is for us to evaluate things and see what's the best course of action for us. Of course, one person knocking on the door doesn't mean to say that there could be other people that would want to knock on this door as well. It's a good position that we find ourselves in.
We've got a very attractive business and different options that we could deploy. No decisions have been made on options, and as I say, we've got a responsibility to evaluate, and we're in that process. That's really all we can say at this moment in time.
Cool. Thank you.
The next question comes from Darius Saftoiu from Jefferies. Please go ahead.
Hi. Thank you for taking my questions. I hope this time the line is better. First on India, I would like to ask, given the strong local currency growth in Q1 and Q2, and of course, the new hospital opening in Q1, if you could provide some color on when do you expect these startup losses to peak and when we should see a meaningful reduction in the drag from newer hospitals? As well, if you could provide some color, excluding this new hospital in Q1, how was the progression there?
Great news is the line's very clear this quarter, that's very positive. The trend of opening new hospitals and the period before the drag disappears is different hospital by hospital, because a lot depends upon the size of it, scale of it, the mix of the specialisms, and your ability to get various licenses approved and your recruitment. What doctors have you recruited? Are they big hitters? Are they people that are going to take a little bit longer to be able to build up your revenue stream? Very difficult to say the model is exactly this. We've made really good progress in terms of when we've done openings. If you look back in history, you'll see that there's always been a drag. Quarter on quarter, as we've reported that drag, that drag has tended to reduce if we haven't opened any new hospitals.
Of course, in this period, we have opened a couple of new hospitals in India, which in our IPO program were the final two that we were looking to do. What you would expect to see is as we go by each quarter, seasonally adjusted, of course, you'd expect to see that that drag just reduces over time and over a period of 18 months, two years or so, that that starts to be less significant.
Yep. Thank you. My second question on the Fee-For-Service momentum in Q2 accelerating. If you could discuss about the momentum in Germany versus Poland and Romania, also some color on how do you see the differences between volumes and pricing going forward, given inflation has been more stabilized in Germany and Poland versus higher inflation in Romania?
Yeah. We have a stance that we've repeated a number of times when it comes to pricing, which is that our position is that we want to provide high-quality healthcare to the people that entrust their money with us, and that as they come to us, that we give them the care that they need to get the effective outcome. If that means that we have to adjust price to be able to pay our resources appropriately, then we will do that. We've got a history of making sure, whether it's funded or whether it's Fee-For-Service, of adjusting price to the market conditions. In history, if you go back a little bit, we've been a little bit more price adjustment in our revenue growth. This will balance out because the inflationary period that we had in history was much, much higher.
That inflationary period now is starting to wash through. Although there'll still always be inflation in healthcare, always higher than the average inflation, it's not as high as history. You kind of expect the pricing and volume kind of mix to balance out a little bit dependent upon the line.
Yeah. Thank you. If I may have one last short question. In regards to the recent heatwaves across Europe, have you observed any postponements in surgeries or appointments or testing? If you could provide some color on the, let's say, end of 2Q or.
No. In our first six months of the year, we've been affected by weather more than anything else. No, we haven't seen any dramatic change in trends created by events. No.
Yep. Thank you.
Thanks a lot.
The next question comes from Kristofer Liljeberg from DNB Carnegie. Please go ahead.
Hi. Just a quick one on the tax rate. Have you commented what tax rate you expect for the full year?
Yeah. I think the kind of counsel I gave was between 26%-30%. Yeah.
Okay.
We're following.
Great. Thank you.
The next question comes from Mattias Vadsten from SEB. Please go ahead.
Hi. One follow-up. A bit larger tie-up in working capital year-to-date this year versus six months 2025. Is it anything in particular that is driving that, or is it expected to normalize going forward? Thank you.
Sorry, Mattias. I didn't hear. Did you say working capital? Is that what you said?
Yeah. The tie-up in working capital year-to-date figure this year is a bit higher than last year.
Yeah.
I just wanted to see if there's anything in particular or if it.
Yeah, no. Nothing particularly in terms of one-offs or anything like that. I think it's just to do a little bit with the mix of our business, right? As we do more, let's say governmental-led business either in India or in Poland, then they naturally have kind of longer terms in terms of securing our payables. Yeah. I mean, that's it. Aside from that, there's nothing specific to pull out in terms of working capital.
Thank you so much.
All right.
The next question comes from Dawid Górzyński from PKO BP Securities. Please go ahead.
Hi. Thanks for taking my question. Actually, I have three questions. The first one, again, on EBITDA loss from India from new hospitals. You said that the majority of this quarter loss, which was EUR 3.2 million, if I'm right, was related to the new hospital opened in the first quarter. When we compare to three, just is also about EUR 3 million in the fourth quarter, where there was no impact of this new hospital. Does it mean, or is my conclusion correct that the loss from other hospitals opened in last two years was close to zero this second quarter?
Yeah. Look, I can't answer the question exactly, look, I think over about 2/3 or so, at least of the EUR 3.2 million is driven by the new hospital. It's a very big hospital, 14 floors, is it? I think it's the tallest hospital in Hyderabad. Yes. The others are performing broadly in line with where we expect on their recovery curves versus the new one we just opened, which is a big one.
Okay. Thank you so much. [audio distortion].
Remember there was another hospital opening as well that happened in that fourth quarter. There's two.
Yep. Okay. Two questions on Polish market. First on Diagnostic Services business. There are several government programs right now, including Myself program. Last year there was Like Prevention 40 Plus program. I wonder what is the net impact of these programs on your revenue dynamic in Poland in the aggregate business?
Yeah. We don't really comment on that, but everybody knows in the market that last year's program was more generous than this year's program.
Sorry. Just to confirm, last year program.
Sorry. Sorry, I went too fast. We don't really comment on the specifics, but as a general, everybody in the market knows that last year's program was more generous than this year's program, in general terms.
Okay, thank you. The last issue on the quite recent plans from Polish government to cut wages for the best-paid doctors. Do you think it will have any impact on your wages in Poland? I also wonder if you may see some shift from the reduction from all the number of procedures performed by public healthcare and maybe shift to private healthcare. What do you think about that?
Yeah. There was quite a number of concepts that were talked about in recent weeks in relation to Poland. We have to put this into context of the way that we've ran our business for the last 30 odd years, which is constantly over that period, different governments and different people within those governments have wanted to make changes in the healthcare system to be able to manage it more effectively for that particular country. One of our strengths as an organization is over the 31 years that we've been trading is as these things have happened, we've been close enough to understand what's happening, what's the implication to us, and how do we repurpose. Yeah. How do we move our operations around to be able to make sure that whatever changes are put in place, we can adapt.
That means that we're here for the long term, and then we have a sustainable business. This is business as usual to us. There are some specifics in that particular set of changes that people talk about, and we will work through those specifics. Currently, from our perspective, it is business as usual. Some of these changes will come in. We'll adjust, and we'll move forward. We're confident that we'll be able to navigate. Often, when these changes have happened, there's very positive things that can happen to our business if we repurpose in the right way, and that's what we expect to do.
Okay. Thanks so much.
Thank you.
There are no more phone questions at this time. I hand the conference back to the speakers for any written questions and closing comments.
There's a few questions that have come through online. We'll just try and answer those before we close out. People have asking for a bit of flavor in terms of the drivers in India, which is moving the growth up. As before, it's a lot of recruitment of new doctors. Those new doctors now are becoming established with us. That's driving the revenue. That's the main question that's come through. I'd like to thank everybody for their time this morning. We're very pleased with the results that we've generated for Q2. We think we have a solid base to be able to move forward. Yes, there's some changes in our markets which could be quite exciting for us. We're looking forward very much to talking to you in a quarter's time to see how we're progressing. Thank you very much.