Aster Dm Healthcare Ltd. · NSE:ASTERDM
Aster Dm Healthcare — Investor Presentation (February 2024)
50 slides from Aster Dm Healthcare's investor presentation, Feb 14, 2024
Slide 1: Exchange filing cover letter: Investor Presentation
February 14, 2024 The Secretary The Manager, Listing Department, Listing Department, BSE Limited, The National Stock Exchange of India Ltd 1st Floor, Phiroze Jeejeebhoy Towers Exchange Plaza, C-1, Block G Dalal Street, Mumbai 400001 Bandra Kurla Complex Scrip Code: 540975 Bandra (East), Mumbai 40005
Slide 2: Investor Presentation: Creating two distinct geographically focused entities
Investor Presentation Creating two distinct geographically focused entities February 2024
Slide 3: Disclaimer
Disclaimer This presentation has been prepared by Aster DM Healthcare Limited (the "Company"), content of which was compiled from sources believed to be reliable for informational purposes only and are based on information regarding the Company and the economic, regulatory, market and other conditio
Slide 4: Aster DM Healthcare is being segregated to create two separate entities
Aster DM Healthcare is being segregated to create two separate entities, focused on India and GCC respectively Post-segregation, Aster DM Healthcare Limited will The GCC Business will be separated from Aster DM be a focused listed entity holding India business Healthcare Limited to create Aster GCC1
Slide 5: Transaction Overview
Transaction Overview § GCC Business will be acquired by Alpha GCC Holdings Limited, a company incorporated in Dubai International Financial Centre (“Aster GCC”) at an Enterprise Value of US$1,651.2m (equal to INR13,540cr) § At the closing of the Transaction, Fajr Capital & its consortium members wil
Slide 6: Pre-Segregation Structure
Pre-Segregation Structure Current Structure Promoters Public 41.88% 58.12% Aster DM Healthcare Limited India Business GCC Business Labs & Hospitals Clinics1 Pharmacies1 Hospitals Clinics Pharmacies 2 PECs Andhra KSA Oman Qatar Bahrain Jordan Kerala Karnataka Maharashtra Telangana UAE Pradesh Note: (
Slide 7: Post-Segregation Structure
Post-Segregation Structure INDIA LISTED ENTITY GCC ENTITY Promoters Public Promoters Fajr Consortium 41.88% 58.12% 35% 65% Aster DM Healthcare Aster GCC3 Limited Hospitals Clinics Pharmacies1 Labs & PECs Hospitals Clinics2 Pharmacies2 Andhra Kerala Karnataka Maharashtra Telangana UAE KSA Oman Qatar
Slide 8: Strategic rationale behind segregation
Strategic rationale behind segregation Creating pure-play India Segregation enables better operating entity that allows for understanding of India business 1 independent operations and 2 by investor community.. board / governance structure Clear Capital Allocation Strategy for ..allowing potential v
Slide 9: Creating pure-play India operating entity
Creating pure-play India operating entity that allows for independent operations and board / governance structure Key Highlights of the India Business 1 2,983 453 0% AGR 2 2,384 % 353 ue C R 35 Reven 1,631 1,654 DA C AG 1,314 EBIT 1,178 183 144 121 2 99 FY18 FY19 FY20 FY21 FY22 FY23 FY18 FY19 FY20 F
Slide 10: Segregation enables better understanding of India business by investor community
Segregation enables better understanding of India business by investor community… Public market investors / analyst community should better appreciate the India operations 1 Shareholders get exposure to pure play India business and an opportunity to witness the India growth story 2 The listed entity
Slide 11: …allowing for potential value unlocking
…allowing for potential value unlocking Better performance across key metrics post-segregation Financial Metrics Pre-segregation Post-segregation 1 (FY23) (GCC + India) (India) Revenue YoY Growth 16% 25% ü 2 EBITDA Margins1 13% 17% ü EBITDA YoY Growth 6% 28% ü PAT YoY Growth -19% 146% ü 3 ROCE1 9.2%
Slide 12: Our plan towards utilization of transaction proceeds
Our plan towards utilization of transaction proceeds As internal accruals are sufficient to fund our organic growth plans at Aster India, most of the transaction proceeds will be distributed as dividend to our shareholders - allowing significant returns for them – and the balance will allow us to pu
Slide 13: Aster India
Aster India 12
Slide 14: India's vast population and increasing healthcare expenditure provides headroom for growth
India’s vast population and increasing healthcare expenditure provides significant headroom for growth …drive consistently fast growth for healthcare One of the lowest hospital bed densities in the …coupled with very little spend on healthcare as % delivery in India, expected to be worth $100bn+ by
Slide 15: A leading healthcare provider in South India
A leading healthcare provider in South India Current Presence 15 cities and 19* 4,857 5 states Hospitals capacity beds Operational metrics (9M FY24) 68% 3.4 days INR 39,250+ Occupancy ALOS ARPOB 9M FY24 Financial metrics Revenue Op. EBITDA Capex INR 2,721 cr Margin: 17% INR 287 cr 20% 35% ~INR 1,000
Slide 16: From Clinic to a Healthcare Powerhouse: A Transformational Journey
From Clinic to a Healthcare Powerhouse: A Transformational Journey to a Thriving Hospital Network... 2024 Kerala Cluster Andhra Pradesh & Telangana Segregation of GCC and India 2023 Aster Whitefield Block A&B, Bengaluru 2022 Aster Medcity Kochi, Kerala | CB: 760 OB: 626 O&M Asset Light Model introdu
Slide 17: …created a dominant positioning in South India region
…created a dominant positioning in South India region Aster predominantly operates in the South; recent 2nd largest network in South India with significant capacity Revenue Growth (5-year CAGR) inroads in Maharashtra beds in southern states 1 Compared with listed peers in India (FY18-23) 2 5255 4857
Slide 18: A de-risked business model across multiple specialties
We have consciously built a de-risked business model with healthy presence across multiple specialties… Geographical Revenue Mix (9M FY24) Specialty-wise Revenue Mix (9M FY24) Andhra & Telangana 12% Cardiac Sciences Multi Speciality 13% 19% Karnataka & Maharashtra Kerala Neuro Sciences 31% 57% 11% O
Slide 19: Sustained improvement in India Business performance
Sustained improvement in our India Business performance over the past few years No. of Capacity Beds ARPOB (in 000s) 4,857 39.3 4,317 36.5 36.1 3,905 4,095 33.5 3,693 3,757 30.1 3,460 27.7 3,007 26.1 23.7 FY18 FY19 FY20 FY21 FY22 FY23 9MFY23 9MFY24 FY18 FY19 FY20 FY21 FY22 FY23 9MFY23 9MFY24 Revenue
Slide 20: Robust performance across key metrics over the last five years
…delivering robust performance across all key metrics over the last five years FY18 FY23 Revenue (5-year CAGR of 20%) INR 1,178 Crores INR 2,983 Crores ü Expanding EBITDA Margin1 (5-year CAGR of 35%) 10% 18% ü Improving ROCE1 1% 20.6%2 ü 19 hospitals, 13 Clinics 10 hospitals Growing Facility Footpri
Slide 21: 9MFY24 performance: core hospital business and new businesses
For 9MFY24, Aster India has delivered strong performance in its core hospital business while rapidly growing the other new businesses % of Revenue Revenue Operating EBITDA INR 2,589 Cr INR 504 Cr Hospitals and Clinics 24% 20% 92% Core established business 19 hospitals(1) 13 clinics 4,857 capacity be
Slide 22: Core hospitals business shows consistent improvement across operational parameters
The core hospitals business has shown strong and consistent improvement across all operational parameters… Track record of consistent facility additions… …and increase in capacity beds… …leading to growing patient volumes… No. of Hospitals No. of Capacity Beds Total Patient Volumes (In Mn) 4,857 4,3
Slide 23: Robust financial performance trajectory
…resulting in a robust financial performance trajectory over these years Hospital Revenue has grown at 20% CAGR over last 5 years… …helping expand Hospital EBITDA margin by 800 bps… Hospital Revenue Hospital EBITDA and Margin EBITDA margin (In INR Cr) (In INR Cr) 19% 20% 17% 18% 2,851 2,589 13% 12%
Slide 24: Maturity Wise Hospital Performance – India 9M FY24
Maturity Wise Hospital Performance – India FY 24 9M 23 Key Performance indicators Revenue Operational Beds Operating EBITDA Maturity Hospitals (INR in Crs.) (Census) ARPOBD Occupancy (INR in Crs.) EBITDA % 7% 15% 0-3 Years 6 ₹172 ₹ ~25,600 52% ₹(14) 530 -8.4% Over 3 93% 85% ₹518 12 ₹2,377 2,984 ₹ ~4
Slide 25: Significant capital investments in brownfield and greenfield expansions
We have made significant capital investments in brownfield and greenfield expansions for enabling future growth performance… Significant capex incurred in last few years Capex (INR Cr) Investment Mix (9M FY24) Greenfield 23% 282 287 O&M Projects Brownfield 8% 190 69% 117 FY22 FY23 9MFY23 9MFY24 7 Ho
Slide 26: Clear Capital Allocation Strategy for India Business going forward
Clear Capital Allocation Strategy for India Business going forward Internal accruals to enable investment (under our capex plan) to increase Aster India bed capacity to 6,616 beds by FY27 6,616 4,857 4,317 3,693 3,757 3,905 3,460 3,007 FY18 FY19 FY20 FY21 FY22 FY23 9M FY24 By FY27 Expected Completio
Slide 27: Asset Light O&M investments through Low Capex Models
…and Asset Light O&M investments through Low Capex Models to further improve our return profile 2022 Adding more beds through the O&M asset light model allows us to take Aster Mother Hospital healthcare to suburban areas at minimal cost Areekode, Kerala 140 capacity beds Year of Commencement of O&M
Slide 28: Building the healthcare ecosystem with labs and pharmacies
In addition, we are gradually building the healthcare ecosystem in India by establishing labs, pharmacies etc. to create network effects No. of Facilities Revenue Leveraging the ecosystem of our pharmacies (In INR Crs) and labs to benefit the hospital business Pharmacies* Labs 462 447 217 213 205 15
Slide 29: Innovative approach to medical procedures delivering medical achievements
Our innovative approach towards medical procedures has delivered remarkable medical achievements… 1st ever Patent Foramen Ovale (PFO) closure in South Asia using Life Tech Cera Flex PFO device 2nd European Collaboration Center for 1st ever Minimally invasive Laser Enucleation Infectious Diseases in
Slide 30: High patient satisfaction across our facilities
…resulting in high patient satisfaction across our facilities… Karnataka and Maharashtra Cluster Kerala Cluster Andhra and Telangana Cluster 29
Slide 31: Recognized for unmatched excellence
…recognized for unmatched excellence… SRV Accredited Endometriosis Medcare Women and Children Hospital DNV Accredited Orthopaedics Centre of Excellence | Medcare JCI Orthopaedics and Spine Hospital Accredited European Aster Ramesh Society of Guntur Medical Aster Medcity NABL Oncology Accredited reco
Slide 32: Aster Hospitals named among best in India's medical landscape
…and Aster Hospitals named among best in India’s medical landscape Outlook 2023 Best Hospital Ranking Times All India Critical Care Hospital Ranking Survey Best Multispecialty Hospital Emerging 3 3 Aster Medcity Aster CMI Aster Medcity Aster Medcity: Best Multispeciality Hospital: All India Neurosci
Slide 33: Strategic priorities driving future growth and profitability
Our strategic priorities towards driving future growth and improvement in profitability Capital Investment Substantial brownfield and greenfield investments in pipeline to drive occupancy rates across clusters Cost Improvement Initiatives To help improve EBITDA Margins Improving Specialty Mix Focusi
Slide 34: Key Financials
Key Financials
Slide 35: India Financial Summary- Profitability Statement FY23
India Financial Summary- Profitability Statement FY23 Particulars (In INR Cr) FY21 FY22 FY23 Y-O-Y Revenue from Operations 1,654 2,384 2,983 25% Material Consumption 443 666 779 Doctors’ Cost 376 499 647 Employee cost (excl. doctors) 357 443 581 Other expenses 319 421 523 EBITDA (excl. other income)
Slide 36: Balance Sheet- Key Numbers
Balance Sheet- Key Numbers Key Financial Numbers As on March 2021 As on March 2022 As on March 2023 As on Dec 2023 Gross Debt 399 431 597 714 Cash and Cash Equivalents (Less) 93 112 87 81 Net Debt (Gross Debt less Cash and Cash Eq.) 306 319 510 632 Lease Liabilities - INDAS116 346 444 533 657 Fixed
Slide 37: India Financial Summary- Profitability Statement 9M FY24
36 India Financial Summary- Profitability Statement 9M FY24 Particulars (In INR Cr) 9M FY24 9M FY23 Y-o-Y Revenue from Operations 2,721 2,179 25% Material Consumption 684 573 Doctors’ Cost 596 466 Employee cost (excl. doctors) 550 428 Other expenses 439 371 Operating EBITDA 453 342 32% Employee Stoc
Slide 38: Business Snapshot- India 9M FY24
Business Snapshot- India 9M FY24 Revenue Operating EBITDA PAT Post NCI (In INR Cr) (In INR Cr) 453 (In INR Cr) 2,721 32% 25% 342 153 2,179 % 54 99 15.7% 16.6% 5.5% 6.5% FY23 9M FY24 9M FY23 9M FY24 9M FY23 9M FY24 9M Operational Performance [FY24 9M | (FY23 9M)] Total Capacity Beds ALOS (Days) ARPOB
Slide 39: Region-wise Business Snapshot- Kerala
Region-wise Business Snapshot- Kerala Revenue (In INR Crs) Aster Mother 1,691 Hospital 1,489 Aster MIMS Kannur 1,318 1,237 Aster MIMS Calicut 875 935 Aster MIMS Kottakal 701 Aster Medcity FY19 FY20 FY21 FY22 FY23 FY23 9M FY24 9M Aster PMF EBITDA (In INR Crs) 356 FY24 9M 317 255 257 124 124 78 FY19 F
Slide 40: Region-wise Business Snapshot- Karnataka & Maharashtra
Region-wise Business Snapshot- Karnataka & Maharashtra Revenue 817 793 (In INR Crs) 655 598 442 433 Aster Aadhar Hospital 310 Aster CMI Aster RV Hospital FY19 FY20 FY21 FY22 FY23 FY23 9M FY24 9M Aster Whitefield Aster G Madegowda EBITDA 154 (In INR Crs) FY24 9M 128 109 83 42 28 33 FY19 FY20 FY21 FY2
Slide 41: Region-wise Business Snapshot- Andhra & Telangana
Region-wise Business Snapshot- Andhra & Telangana Revenue (In INR Crs) Aster Prime Hospitals 370 344 303 314 307 279 250 Ramesh Main Centre Ramesh Labbipet Ramesh (IB) Vijaywada Ramesh Guntur Ramesh Sanghamitra FY19 FY20 FY21 FY22 FY23 FY23 9M FY24 9M Aster Narayanadri EBITDA (In INR Crs) FY24 9M 69
Slide 42: Aster Board of Directors
Aster Board of Directors Dr. Azad Moopen Alisha Moopen T. J. Wilson Chairman and Managing Non-Executive Director Deputy Managing Director Director Shamsudheen Bin Daniel Robert Emmanuel David Mohideen Mammu Haji Mintz Gootam Non-Executive Director Non-Executive Director Independent Director Purana H
Slide 43: India | Aster Leadership Team
India | Aster Leadership Team Dr. Azad Moopen Founder Chairman and Managing Director - Aster DM Healthcare Dr. Nitish Shetty Dr. Somashekhar S P Sunil Kumar M R T. J. Wilson Chairman of Medical Group Head - Governance & CEO – Aster DM Healthcare Joint Chief Financial Officer Advisory Council and Glo
Slide 44: GCC | Aster Leadership Team
GCC | Aster Leadership Team Dr. Azad Moopen Founder Chairman, Aster DM Healthcare Alisha Moopen T. J. Wilson Managing Director and Group Head - Governance & Group CEO Corporate Affairs Dr. Sherbaz Bichu Dr. Shanila Laiju Bala NS Brandon Rowberry Chief Executive Officer, Chief Executive Officer, Chie
Slide 45: Appendix
Appendix
Slide 46: True growth rate is even higher as non-covid business ramped up
Infact, true growth rate is even higher as the non-covid business has significantly ramped up to offset the covid business Non-covid revenue has grown at 41% CAGR over FY21-23 41% 273 40% 152 2,983 2,111 1,503 FY21 FY22 FY23 Covid revenue Non covid revenue Non-COVID revenues grew at 41% CAGR over FY
Slide 47: Geography – wise Business – Snapshot – FY24 9M
Geography – wise Business – Snapshot – FY24 9M 46 KARNATAKA & ANDHRA & KERALA TOTAL MAHARASHTRA TELANGANA FY23 9M FY24 9M FY23 9M FY24 9M FY23 9M FY24 9M FY23 9M FY24 9M Total Capacity Beds 2,208 2,386 1,016 1,424 871 1,047 4,095 4,857 Operational Beds (Census) 1,720 1,834 761 890 652 790 3,133 3,51
Slide 48: India Hospital & Clinics Cluster-Wise Trends
India Hospital & Clinics Cluster-Wise Trends 47 Kerala Cluster Karnataka & Maharashtra Cluster Andhra & Telangana Cluster Revenue (INR Cr) Revenue (INR Cr) Revenue (INR Cr) 817 793 1,691 370 344 655 303 314 307 1,489 598 279 1,318 1,237 250 442 433 875 935 701 310 FY19 FY20 FY21 FY22 FY23 FY23 FY24
Slide 49: Segmental Performance FY24 9M – India
48 Segmental Performance FY24 9M – India Growth rates Hospitals & Hospitals & Hospitals - Labs & Unallocated Hospitals - Labs & Unallocated Clinics Clinics 9M FY24 O&M Asset Wholesale & Total Gw % O&M Asset Wholesale & Total (Ex. O&M Asset (Ex. O&M Asset Light Pharmacy Eliminations Light Pharmacy El
Slide 50: Thank You
Thank You Investor Relations: investors@asterdmhealthcare.com
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