EARNINGS RELEASE
2Q2025
Contact ir.rededor.com.br ri@rededor.com.br
ABOUT THIS REPORT
Rede D'Or São Luiz ("Rede D'Or") presents its results for the second quarter of 2025 based on managerial analyses that the administrators believe best interpret the Company's business, reconciled with the international Financial Statement reporting standards.
For further information, we recommend reading the Financial Statements of June 30, 2025,
available on the Rede D'Or's Investor Relations website: https://http://www.rededor.com.br/ir.
In this document, the term SulAmérica is used to address the insurance and pension operations.
DISCLAIMER: SULAMÉRICA ACCOUNTING AND IFRS 17 ADOPTION
Due to the merger of Sul América S.A. ("SulAmérica") being completed on December 23, 2022, the Financial Statements of Rede D'Or São Luiz S.A. ("Rede D'Or") did not include the income statement balances for the 2022 fiscal year of SulAmérica. From the Financial
Statements of Rede D'Or on March 31, 2023, SulAmérica's results are fully included in the Income Statement, as well as the Accounting Cash Flow and Balance Sheet.
In preparing this report, Rede D'Or chose to present selected operational and financial indicators for Rede D'Or and SulAmérica separately, on a voluntary, managerial, and unaudited basis.
The Company also reinforces the disclaimer available on the previous page, in the context of any declarations that may be made related to the combination between Rede D'Or and SulAmérica. For further information regarding the risks that should be considered, please
see section 4, "Risk Factors", of Rede D'Or's Reference Form, available on the Company's IR website, as well as the files directory of Rede D'Or on the CVM website.
The adoption of IFRS 17/CPC 50 for insurance contracts, which impacts SulAmérica's operations, introduced changes to accounting practices and the way the Company's financial statements are released.
For the purposes of managerial analysis and better comparability between periods, the results presented in this document continue to consider IFRS 4/CPC 11, the previous accounting standard. For the reconciliation of the financial information in accordance with the IFRS 17/CPC 50 standard, see the annexes of this report, starting on page 32.
Rede D'Or ("Company"), the largest private healthcare network in the country, in existence for 47 years, is present in 13 states (Rio de Janeiro, São Paulo, Pernambuco, Bahia, Maranhão, Sergipe, Ceará, Paraná, Minas Gerais, Mato Grosso do Sul, Paraíba, Alagoas, and Pará) and the Federal District.
On December 23, 2022, Rede D'Or value proposition was significantly enhanced with the consummation of the merger with SulAmérica - one of Brazil's leading independent insurers.
With operations in the health, dental, life and personal accident insurance segments, in addition to asset management and private pension products, SulAmérica had more than 7 million customers distributed throughout Brazil on June 30, 2025.
On August 16, 2024, after receiving the necessary regulatory approvals, Rede D'Or established a new network of hospitals (Atlântica D'Or) in partnership with Bradesco Seguros, aiming to strengthen its expansion potential and ensuring greater alignment with one of its most important commercial partners. At the end of the second quarter of 2025, the partnership included four hospitals in operation and two additional projects under development.
On June 30, 2025, the Company operated 79 hospitals, of which 76 are owned and 3 are under management, totaling 13,083 beds and the country's largest integrated
cancer treatment network. In addition, Rede D'Or has one of the largest diagnostic networks in Brazil; an extensive blood bank operation; and the largest and most advanced robotic surgery park in Latin America.
HIGHLIGHTS AND P&L 05
ESG AND DIGITAL 09
GROWTH 13
OPERATIONAL 14
REVENUES 17
COSTS 19
EXPENSES 20
EBITDA 22
SULAMÉRICA 23
FINANCIAL RESULT 26
NET INCOME 26
DEBT 28
CASH FLOW 30
PERFORMANCE & APPENDIX 31
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REDE D'OR CONSOLIDATED
› Opening of 265 operational beds in 2Q25, representing an increase of 5.3%, or 522 beds, vs. 2Q24.
› Record patient-day volume of 780 thousand in 2Q25, increase of 3.0% and 11.7% vs. 2Q24 and 1Q25, respectively.
› Gross revenue registers R$9.0 billion in the quarter and expands 13.8% YoY, renewing the historical record for the highest quarterly revenue.
› Oncology increases 17.7% YoY in gross revenue, driven by a 12.2% increase in the average ticket of the segment and a 4.9% expansion in the volume of infusions.
› Consolidated average ticket for the last twelve months ended in Jun-25 advances 9.1% YoY.
› EBITDA totals R$2.1 billion in the quarter, 12,0% YoY growth, with 25.9% margin.
› Gross revenue sums R$15.1 billion in
the 2Q25, 11.5% YoY growth.
› EBITDA totals R$2.5 billion in the quarter, advancing 18.4% vs. 2Q24. Consolidated EBITDA, summed the financial result of insurer's restricted assets, was R$2.8 billion, increase of 20.0% YoY.
› Net income surpasses R$1.1 billion in 2Q25, expansion of 12.9% YoY.
› Adjusted net income totals R$1.2 billion in the quarter, excluding the accounting-only effect of the amortization of the value of the portfolios assumed in business combinations.
› Debt at 1.65x Net Debt/EBITDA in the period, slightly lower in relation to the previous quarter and a drop of 0.4x vs. 2Q24.
› Operational cash flow(1) of R$4.6 billion generated in 6M25, +22.4% YoY.
SULAMÉRICA
› SulAmérica's net revenue reaches R$8.1 billion in 2Q25, increase of 10.7% YoY, reflecting expansion of the membership base and portfolio price adjustments.
› Consolidated loss ratio of 81.3% in the
quarter, improvement of 2.3 pp vs. 2Q24.
› Health and dental portfolio increases 9.3% YoY and totals approximately 5.6 million beneficiaries.
› Level of administrative expenses (disregarding provisions for contingencies) in relation to revenues of 4.7% in 2Q25 (4.9% in 2Q24 and 6.9% in 9M22 pre-incorporation).
› EBITDA amounts R$399.0 million in the period, increase of 68.0% YoY. Adjusted EBITDA by financial results over restricted assets totaled R$729.6 million in 2Q25, expanding 50.0% YoY.
https://www.ri.rededor.com.br
(1) Operational cash flow before interest payments.
Earnings Release 2Q 25 | 5
CONSOLIDATED
Managerial results do not consider IFRS 17 adoption. For reconciliation see report's annexes (pg. 32).
(R$ million) | RDOR | SULA | Eliminations(1) | 2Q25 | 2Q24 | Δ % | 6M25 | ||
Gross revenue | 8,982.0 | 8,232.2 | (2,094.2) | 15,120.0 | 13,563.8 | 11.5% | 29,197.9 | ||
Hospitals, oncology and others | 8,982.0 | - | (2,094.2) | 6,887.8 | 6,135.6 | 12.3% | 12,811.8 | ||
Insurance and pension | - | 8,232.2 | - | 8,232.2 | 7,428.3 | 10.8% | 16,386.1 | ||
Deductions from gross revenue | (1,021.2) | (84.4) | 107.5 | (998.1) | (874.8) | 14.1% | (1,897.6) | ||
Glosses (disallowances) | (492.6) | - | 107.5 | (385.0) | (334.9) | 15.0% | (714.4) | ||
Taxes on revenue and others | (528.7) | (84.4) | - | (613.1) | (539.8) | 13.6% | (1,183.2) | ||
Net Revenue | 7,960.8 | 8,147.7 | (1,986.6) | 14,121.9 | 12,689.1 | 11.3% | 27,300.3 | ||
Hospitals, oncology and others | 7,960.8 | - | (1,986.6) | 5,974.2 | 5,328.7 | 12.1% | 11,105.0 | ||
Insurance and pension | - | 8,147.7 | - | 8,147.7 | 7,360.4 | 10.7% | 16,195.3 | ||
Changes in technical reserves | - | (143.8) | - | (143.8) | (181.5) | -20.8% | (337.7) | ||
Cost with hospitals services | (6,033.5) | - | - | (6,033.5) | (5,215.9) | 15.7% | (11,552.7) | ||
Personnel | (2,123.6) | - | - | (2,123.6) | (1,823.2) | 16.5% | (4,113.2) | ||
Materials and medicines | (1,792.9) | - | - | (1,792.9) | (1,520.1) | 17.9% | (3,336.2) | ||
Third-party services | (1,508.4) | - | - | (1,508.4) | (1,354.0) | 11.4% | (2,909.1) | ||
Utilities and services | (118.8) | - | - | (118.8) | (107.3) | 10.7% | (239.3) | ||
Rents | (26.3) | - | - | (26.3) | (26.8) | -1.8% | (51.3) | ||
Depreciation and amortization | (463.5) | - | - | (463.5) | (384.5) | 20.6% | (903.7) | ||
Operating costs | - | (7,097.4) | 1,986.6 | (5,110.8) | (4,847.2) | 5.4% | (10,035.4) | ||
Insurance | - | (6,945.3) | 1,986.6 | (4,958.7) | (4,716.3) | 5.1% | (9,731.6) | ||
Pension | - | (30.2) | - | (30.2) | (29.5) | 2.2% | (60.8) | ||
Other operating costs | - | (122.0) | - | (122.0) | (101.3) | 20.4% | (243.0) | ||
General and administrative expenses | (326.5) | (510.8) | - | (837.3) | (797.9) | 4.9% | (1,564.9) | ||
Personnel | (210.3) | (225.0) | - | (435.3) | (417.8) | 4.2% | (836.1) | ||
Third-party services | (43.1) | (114.0) | - | (157.1) | (129.5) | 21.2% | (300.7) | ||
Travel and accommodation | (19.9) | (2.5) | - | (22.3) | (21.4) | 4.1% | (43.1) | ||
Depreciation and amortization | (59.0) | (40.1) | - | (99.0) | (89.8) | 10.3% | (195.8) | ||
Provision of contingencies and others | 5.7 | (129.2) | - | (123.5) | (139.4) | -11.4% | (189.2) | ||
Selling expenses | 36.4 | (9.5) | - | 26.9 | (9.7) | -378.0% | 12.5 | ||
Equity pickup | 15.4 | (0.0) | - | 15.4 | 23.9 | -35.6% | 12.5 | ||
Other operating income/expenses | (116.6) | (27.3) | - | (143.9) | (60.3) | 138.7% | (143.9) | ||
Earnings before taxes and financial result | 1,536.0 | 358.9 | - | 1,894.9 | 1,600.6 | 18.4% | 3,690.7 | ||
EBITDA | 2,058.5 | 399.0 | - | 2,457.5 | 2,074.9 | 18.4% | 4,790.2 | ||
EBITDA margin (%) | 25.9% | 4.9% | - | 17.4% | 16.4% | 1.1 p.p. | 17.5% | ||
Adjusted EBITDA | 2,015.3 | 729.6 | - | 2,744.9 | 2,359.9 | 16.3% | 5,386.0 | ||
Adjusted EBITDA margin (%) | 25.3% | 9.0% | - | 19.4% | 18.6% | 0.8 p.p. | 19.7% | ||
(1) Includes eliminations and rebates between Group companies. | |||||||||
(R$ million) | Consolidated | 2Q25 | 2Q24 | Δ % | 6M25 | ||||
Financial results | (549.8) | (368.7) | 49.1% | (1,074.7) | |||||
Financial revenues | 2,887.6 | 2,186.7 | 32.0% | 5,922.4 | |||||
Financial expenses | (3,437.4) | (2,555.4) | 34.5% | (6,997.1) | |||||
Earnings before taxes | 1,345.1 | 1,231.9 | 9.2% | 2,616.0 | |||||
Income Tax and Social Contribution | (215.3) | (231.2) | -6.9% | (468.3) | |||||
Current | (263.3) | (354.3) | -25.7% | (692.9) | |||||
Deferred | 48.0 | 123.1 | -61.0% | 224.6 | |||||
Net income | 1,129.8 | 1,000.8 | 12.9% | 2,147.7 | |||||
Net income attributed to controlling partners | 1,083.6 | 976.9 | 10.9% | 2,075.2 | |||||
Net income attributed to non-controlling partners | 46.2 | 23.9 | 93.2% | 72.5 | |||||
Adjusted net income | 1,182.4 | 1,053.4 | 12.3% | 2,252.9 | |||||
ROIC (LTM) | 31.0% | 20.4% | 10.7 p.p. | ||||||
Adjusted ROIC (LTM) | 15.8% | 17.0% | -1.2 p.p. |
HOSPITALS, ONCOLOGY AND OTHERS
Managerial results do not consider IFRS 17 adoption. For reconciliation see report's annexes (pg. 32).
(R$ million) | 2Q25 | 2Q24 | Δ % | 1Q25 | Δ % | 6M25 | 6M24 | Δ % | ||
Gross revenue | 8,982.0 | 7,894.7 | 13.8% | 7,923.6 | 13.4% | 16,905.5 | 15,311.6 | 10.4% | ||
Hospitals and others | 8,042.3 | 7,096.1 | 13.3% | 7,054.4 | 14.0% | 15,096.6 | 13,767.0 | 9.7% | ||
Oncology (infusions) | 939.7 | 798.6 | 17.7% | 869.2 | 8.1% | 1,808.9 | 1,544.6 | 17.1% | ||
Deductions from gross revenue | (1,021.2) | (897.2) | 13.8% | (888.1) | 15.0% | (1,909.3) | (1,718.8) | 11.1% | ||
Glosses (disallowances) | (492.6) | (425.3) | 15.8% | (424.3) | 16.1% | (916.9) | (820.6) | 11.7% | ||
Taxes on revenue | (528.7) | (471.9) | 12.0% | (463.8) | 14.0% | (992.4) | (898.2) | 10.5% | ||
Net revenue | 7,960.8 | 6,997.6 | 13.8% | 7,035.5 | 13.2% | 14,996.2 | 13,592.8 | 10.3% | ||
Cost of services rendered | (6,033.5) | (5,215.9) | 15.7% | (5,519.3) | 9.3% | (11,552.7) | (10,234.6) | 12.9% | ||
Personnel | (2,123.6) | (1,823.2) | 16.5% | (1,989.6) | 6.7% | (4,113.2) | (3,579.4) | 14.9% | ||
Materials and medicines | (1,792.9) | (1,520.1) | 17.9% | (1,543.3) | 16.2% | (3,336.2) | (2,947.0) | 13.2% | ||
Third-party services | (1,508.4) | (1,354.0) | 11.4% | (1,400.7) | 7.7% | (2,909.1) | (2,656.5) | 9.5% | ||
Utilities and services | (118.8) | (107.3) | 10.7% | (120.5) | -1.5% | (239.3) | (220.9) | 8.3% | ||
Rents | (26.3) | (26.8) | -1.8% | (25.0) | 5.2% | (51.3) | (50.8) | 0.9% | ||
Depreciation and amortization | (463.5) | (384.5) | 20.6% | (440.2) | 5.3% | (903.7) | (780.1) | 15.8% | ||
General and administrative expenses | (326.5) | (298.9) | 9.3% | (327.1) | -0.2% | (653.6) | (550.7) | 18.7% | ||
Personnel | (210.3) | (189.2) | 11.1% | (206.4) | 1.9% | (416.7) | (390.0) | 6.8% | ||
Third-party services | (43.1) | (38.6) | 11.4% | (44.8) | -3.9% | (87.9) | (89.4) | -1.7% | ||
Travel and accommodation | (19.9) | (19.3) | 3.1% | (18.8) | 6.0% | (38.6) | (33.6) | 14.9% | ||
Depreciation and amortization | (59.0) | (51.3) | 15.0% | (57.1) | 3.2% | (116.1) | (101.8) | 14.1% | ||
Provision of contingencies and others | 5.7 | (0.4) | n.a. | 0.1 | n.a. | 5.7 | 64.1 | -91.1% | ||
Selling expenses | 36.4 | 2.1 | n.a. | (3.0) | n.a. | 33.3 | (12.1) | n.a. | ||
Equity pickup | 15.4 | 4.8 | 221.0% | (2.9) | n.a. | 12.5 | (7.2) | n.a. | ||
Other operating income/expenses | (116.6) | (88.0) | 32.4% | (7.9) | n.a. | (124.5) | (174.1) | -28.5% | ||
Earnings before taxes and financial result | 1,536.0 | 1,401.7 | 9.6% | 1,175.3 | 30.7% | 2,711.3 | 2,614.0 | 3.7% | ||
EBITDA | 2,058.5 | 1,837.4 | 12.0% | 1,672.6 | 23.1% | 3,731.1 | 3,495.8 | 6.7% | ||
EBITDA margin (%) | 25.9% | 26.3% | -0,4 p.p. | 23.8% | 2,1 p.p. | 24.9% | 25.7% | -0,8 p.p. | ||
Adjusted EBITDA | 2,015.3 | 1,873.6 | 7.6% | 1,654.8 | 21.8% | 3,670.1 | 3,577.3 | 2.6% | ||
Adjusted EBITDA margin (%) | 25.3% | 26.8% | -1,5 p.p. | 23.5% | 1,8 p.p. | 24.5% | 26.3% | -1,8 p.p. | ||
INSURANCE, PENSION & ASSET MANAGEMENT
Managerial results do not consider IFRS 17 adoption. For reconciliation see report's annexes (pg. 32).
(R$ million) | 2Q25 | 2Q24 | Δ % | 1Q25 | Δ % | 6M25 | 6M24 | Δ % | ||
Net Revenue | 8,147.7 | 7,360.4 | 10.7% | 8,047.6 | 1.2% | 16,195.3 | 14,531.4 | 11.5% | ||
Insurance revenues (excl. intercompany eliminations) | 7,891.8 | 7,077.0 | 11.5% | 7,786.1 | 1.4% | 15,677.9 | 14,019.8 | 11.8% | ||
Pension revenues | 188.6 | 204.1 | -7.6% | 198.2 | -4.9% | 386.8 | 395.6 | -2.2% | ||
Other health plans and insurance revenues | 67.3 | 79.3 | -15.1% | 63.2 | 6.5% | 130.6 | 116.1 | 12.5% | ||
Changes in technical reserves | (143.8) | (181.5) | -20.8% | (193.9) | -25.9% | (337.7) | (373.5) | -9.6% | ||
Insurance | 6.3 | (20.6) | -130.8% | (32.2) | -119.7% | (25.9) | (56.8) | -54.4% | ||
Pension | (150.1) | (160.9) | -6.7% | (161.7) | -7.2% | (311.8) | (316.6) | -1.5% | ||
Operating Costs | (7,097.4) | (6,516.0) | 8.9% | (6,829.2) | 3.9% | (13,926.7) (12,834.3) | 8.5% | |||
Insurance | (6,945.3) | (6,385.1) | 8.8% | (6,677.6) | 4.0% | (13,622.9) | (12,562.0) | 8.4% | ||
Claims (excl. intercompany eliminations) | (6,441.9) | (5,933.4) | 8.6% | (6,154.3) | 4.7% | (12,596.2) | (11,662.2) | 8.0% | ||
Acquisition costs | (503.4) | (451.8) | 11.4% | (523.3) | -3.8% | (1,026.7) | (899.8) | 14.1% | ||
Pension | (30.2) | (29.5) | 2.2% | (30.6) | -1.5% | (60.8) | (62.0) | -1.8% | ||
Other operating costs | (122.0) | (101.3) | 20.4% | (121.0) | 0.8% | (243.0) | (210.3) | 15.6% | ||
General and administrative expenses | (510.8) | (499.0) | 2.4% | (400.6) | 27.5% | (911.3) | (919.1) | -0.8% | ||
Personnel | (225.0) | (228.5) | -1.5% | (194.3) | 15.8% | (419.4) | (422.9) | -0.8% | ||
Third-party services | (114.0) | (90.9) | 25.4% | (98.9) | 15.3% | (212.9) | (178.7) | 19.1% | ||
Travel and accommodation | (2.5) | (2.2) | 13.1% | (2.0) | 21.9% | (4.5) | (4.0) | 10.7% | ||
Depreciation and amortization | (40.1) | (38.5) | 4.1% | (39.6) | 1.1% | (79.7) | (77.1) | 3.4% | ||
Provision of contingencies and others | (129.2) | (138.9) | -7.0% | (65.7) | 96.5% | (194.9) | (236.5) | -17.6% | ||
Selling expenses | (9.5) | (11.7) | -19.4% | (11.4) | -17.1% | (20.9) | (17.4) | 20.0% | ||
Equity pickup | (0.0) | 19.1 | -100.0% | 0.0 | n.a. | 0.0 | 21.4 | -100.0% | ||
Other operating income/expenses | (27.3) | 27.7 | n.a. | 7.9 | n.a. | (19.4) | 3.9 | n.d. | ||
Earnings before taxes and financial results | 358.9 | 199.0 | 80.4% | 620.4 | -42.1% | 979.4 | 412.4 | 137.5% | ||
EBITDA | 399.0 | 237.5 | 68.0% | 660.0 | -39.5% | 1,059.1 | 489.5 | 116.4% | ||
(+) Financial results over restricted assets | 330.5 | 248.8 | 32.9% | 326.3 | 1.3% | 656.9 | 474.5 | 38.4% | ||
Adjusted EBITDA | 729.6 | 486.2 | 50.0% | 986.3 | -26.0% | 1,715.9 | 964.1 | 78.0% | ||
Aiming to minimize the impacts of operations and build a positive and transparent relationship with society, Rede D'Or is committed to a series of Environmental, Social and Governance (ESG) initiatives, including those of the principles of the UN Global Compact and the 2030 Agenda.
Of the 17 Sustainable Development Goals (SDGs) that make up the UN program, the Company is committed to contributing to the achievement of eight priority SDGs, namely: good health and well-being (SDG 3); quality education (SDG 4); gender equality (SDG 5); decent work and economic growth (SDG 8); industry, innovation and infrastructure (SDG 9); responsible consumption and production (SDG 12); climate action (SDG 13); e peace, justice and strong institutions (SDG 16).
In this section, you will find the main Rede D'Or Sustainability initiatives, segmented in the ESG topics.
SDG D'OR PROGRAM | GOALS
Good health and well-being: Achieve zone of quality NPS in hospital performance by 2030.
Gender equality: ensure that at least 50% of leadership positions (supervision, coordination, management and senior management) are held by women by December 2025.
Decent work and economic growth: Restructure and launch the Diversity and Inclusion program by December 2024. (goal met)
Industry, innovation and infrastructure: Adopt hydraulic system equipment with low water consumption in at least 90% of specifications in each project completed annually.
Responsible consumption and production: Reach 30% recyclable waste rate by 2030.
Climate action: Reduce by 36% greenhouse gas emissions (GHG) by intensity through 2030.
Peace, justice and strong institutions: Train 90% of active employees in leadership positions on integrity-related procedures by 2025.
To check the prioritized SDGs and the consolidated performance of ESG targets in 2024, consult Rede D'Or's Integrated Sustainability Report.
ENVIRONMENTAL
Emissions. Since 2016, the Company has adopted the methodology of the Brazilian GHG Protocol Program, to measure GHG emissions. In the last cycle, Rede D'Or presented certified inventories for 114 business units. For detailed measurement of GHG emissions, consult Rede D'Or's Integrated Sustainability Report.
HIGHLIGHTS
Rede D'Or plans to reach a total of 74 consumer units operating in the Free Energy Market (MLE) with energy from renewable sources by 2025. (goal met)
In June 2025, the Company had 82 consumer units (allocated in 75 hospitals, oncology clinics, medical centers and SADT clinics) operating in the MLE.
Carbon Disclosure Project (CDP)
Rede D'Or was awarded a score of C in the CDP Climate Change section and score B- in its second report to the water security questionnaire. CDP Climate is a benchmark in the evaluation of sustainable actions that contribute to the battle against climate change, and the analysis is also used as an entry criterion and to evaluate companies by the Corporate Sustainability Index (ISE B3).
Sustainability Indexes
For the third consecutive year, Rede D'Or was part of the ISE B3 portfolio and the Carbon Efficient Index (ICO2), both from B3.
TARGET: Reduce by 36% its greenhouse gas emissions by intensity through 2030 and zero net emissions by 2050, in line with our Race to Zero commitment.
Energy efficiency. Rede D'Or bases construction for new units, adaptations, or renovations of acquired hospitals on sustainable premises. This includes, for example, energy efficiency linked to the building envelope, prioritization for more modern and efficient equipment, use of compact high energy efficiency fluorescent lamps or high-performance tubular lamps, and use of air-cooling technologies that allow the automation of the system in order to enable the appropriate sectorization of the air-conditioned environments. In 2024, the company had 24 Energy Efficiency project contracts at the chilled water center (CAG) in operation, that generated a 17% reduction in energy consumption.
TARGET: Maintain in at least 10% the annual reduction in electricity consumption of all units adhering to the water efficiency project by 2024. (goal met)
Waste management. In 2024, the Company generated 39,958 kilos of waste and a generation intensity of 0.0141 tons/patient-day, representing an increase of approximately 2% compared to the generation intensity of 2023, a relevant challenge due to the increase in the number of beds in the year.
TARGET: Reach 30% recyclable waste rate by 2030.
SOCIAL
Research and Teaching. The high degree of commitment to science that we maintain at IDOR is reflected in the volume of studies published annually in the main national and international scientific journals. The excellence of the research developed at IDOR has resulted in around 170 publications in 2024, which have received more than 240 citations in highly prestigious scientific journals. Since its foundation, the institute established international scientific partnerships in more than 80 countries.
Emotions Management. The Emotion Management Program is an important step towards improving care for employees' mental health, with the objective of promoting a culture of fundamental and preventive health, which interacts with all areas, minimizing biopsychosocial risk factors, providing a healthy and safe environment in your work and social life. The initiative was developed by a multidisciplinary occupational health and safety team, with Health and Well-being Promotion actions in operational units through face-to-face activities, through conversation circles with leadership, and virtual actions, through access to an online health and well-being platform, which is also available on the RH Digital app. In 2024, on-site actions were carried out in all hospitals and corporate offices in Rio de Janeiro and São Paulo, with an average of 15 thousand participations per event.
GOVERNANCE
Quality assistance: Rede D'Or has a structured quality and patient safety program in place, based on the pillars of clinical governance, so that we can offer society a safer environment for patient treatment and the best possible outcomes, according to the profile of the patients seen. Our range of clinical and safety protocols is robust and widespread.
Transparency. Since 2015, Rede D'Or has disclosed a Sustainability Report based on the GRI (Global Reporting Initiative) guidelines. In addition, the report presents elements of the International Structure for Integrated Reporting (IIRC) and meets the disclosure topics and metrics of the Sustainability Accounting Standards Board (SASB) for the Health Care Delivery segment.
Rede D'Or's unswerving aspiration is to be on the frontier of technological and digital developments in the field of patient care and health, in general. The Company has built a digital platform that allows users to schedule in-person or remote medical appointments, complementary exams and second medical opinions, while also allowing them to receive orientation, access their exam results and even coordinate the management of their health needs with extremely qualified health professionals.
As a result of this ongoing effort, the Company's website - https://www.rededorsaoluiz.com.br - continues to receive significant traffic, totaling 37.6 million hits in 6M25, of which 60% was organic traffic. The number of examinations viewed in the platform's "patient area" also registered significant growth recently, rising 65% year-over-year.
Appointments scheduled through the platform accounted for more than 57% of the total scheduled in Rede D'Or in the first six months of 2025; this represented an increase
of 38% when compared to the same period of the previous year, when online appointments were approximately 50% of the total. For its part, online exam appointments grew 68% year-over-year, representing more than 34% of the overall total of solicitations, when adding requests via the new WhatsApp chatbot channel.
The digital environment offers both users and physicians a unique experience by integrating the different areas of a broad ecosystem, ensuring fast and secure navigation along with convenience and availability.
Number of visits (million)
+37.5%
57%
50%
3.8
6M24 6M25
EXPANSION
ORGANIC EXPANSION
The Company has an extensive organic expansion program, with more than 30 projects distributed in new units (greenfield) and expansions of existing units (brownfield).
Projects expected to be delivered between 2025 and 2028 total 3,203 beds, of which 755 are greenfield beds and 2,448 are brownfield beds, as indicated by the timetable in the Company's Reference Form, published in May 2025.
In the second quarter of 2025, Rede D'Or advanced in the final phases of important works, the main one being the new tower of Hospital Assunção, in São Bernardo do Campo.
Additionally, other projects are at different stages of development, with highlight to some greenfields and brownfields that are already with works in progress: the new tower of Hospital São Lucas, in Aracaju; the expansion works, in Hospital Central Tatuapé, and the new hospitals in Ribeirão Preto and Taubaté, all in the state of São Paulo; UDI Hospital, in São Luis, in Maranhão; DF Star, in Brasília; Caxias D'Or and Oeste D'Or, both in the state of Rio Janeiro; Hospital São Carlos, in Fortaleza, in Ceará; and Hospital Aeroporto, in Lauro de Freitas, in Bahia.
More information about the projects under development can be found in section 2.10 of the Company's Reference Form.
OPERATIONAL
NUMBER OF BEDS EVOLUTION
Rede D'Or ended 2Q25 with 13,083 total beds - an increase of 1,178 beds compared to the end of 2Q24 (+9.9% YoY). The main investments responsible for the increase in physical capacity in the period were the new hospitals São Luiz Guarulhos, São Luiz
Alphaville, Macaé D'Or and Aliança Star, in
addition to the new Barra D'Or, inaugurated
in the beginning of 2025.
At the end of 2Q25, 10,413 beds were in operation; 522 more operational beds than at the end of the same period of the previous year and 265 more beds than recorded in 1Q25.
Evolution of beds (end of period)
12,724 13,054 13,054 13,083
11,512 11,512 11,512
11,737 11,737
11,905
10,413
9,462
9,646
9,600
9,598
9,729
9,891
9,830
9,857
10,148
1Q23 2Q23 3Q23 4Q23 1Q24 2Q24 3Q24 4Q24 1Q25 2Q25
OPERATIONAL
BED OCCUPANCY RATE
The occupancy rate of hospital beds in Rede D'Or reached 82.9% in 2Q25, 1.5 pp lower than the occupancy rate recorded in 2Q24. Compared to the previous quarter, the
occupancy rate increased by 5.9 pp, following the historical seasonal trend, even with the operationalization of 265 beds throughout the second quarter.
83.8%
83.8%
Evolution of the quarterly occupancy rate
83.0%
82.6%
83.0%
82.9%
81.6%
80.1%
80.2%
79.3%
79.9%
79.4% 79.5%
79.5%
79.5%
80.1% 79.7%
78.5% 78.6%
77.6%
77.6%
78.4% 78.1%
77.8%
76.4%
77.9%
76.9% 76.8%
77.0%
76.9%
75.0%
76.5%
76.9%
75.6%
76.4%
73.8%
75.8%
73.5%
69.7%
Average quarterly occupancy rate, in the period 2015-2025(1)
1Q - 78.3%
2Q - 82.9%
3Q - 78.5%
4Q - 76.1%
61.2%
1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
84.0%
84.4%
(1) Excluding the pandemic period (1Q20 and 2Q20)
OPERATIONALVOLUME OF PATIENTS
In 2Q25, Rede D'Or recorded 780.4 thousand patient-days in its hospitals, an increase of 3.0% over the same quarter of the previous year and 11.7% higher than 1Q25.
A total of 136.5 thousand surgeries were registered in 2Q25; 9.1% more than the volume recorded in 2Q24 and 4.8% above the amount in the immediately preceding quarter.
Patients-day (thousands)
667.3 724.8 707.1 672.8 698.9 757.6 711.8 688.1 698.9
780.4
1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q
2023 2024 2025
Surgeries (thousands)
121.0 124.8
120.2 121.2 125.0
123.1
1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q
2023 2024 2025
In addition, 64.8 thousand medicinal infusions were performed in its own oncology treatment units, and another 1.0 thousand oncology infusions in the Company's investee clinics (whose results are accounted for by the equity pickup method). In total, considering both owned and invested clinics, the volume of infusions in the quarter represents a 4.9%
132.1
129.3
130.2 136.5
increase compared to the same period of the previous year.
AVERAGE TICKET
The average ticket, calculated by the total gross revenue and the number of patient-days, showed an 10.4% growth vs. 2Q24.
Considering the last twelve months, the indicator registered increase of 9.1% in relation to the same period of the previous year, with a compound annual growth rate of 7.0% since the beginning of the historical series, as shows in the graph on the side.
Considering only the infusions results, the average oncology ticket increased by 12.2% YoY in 2Q25.
Oncological infusions (thousands)
62.7
65.8
59.3
62.4 62.3 62.9
59.1 59.6
59.5
60.6
1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q
2023 2024 2025
LTM average ticket evolution (R$)
+9.1%
11,422.1
10,473.5
9,267.9 9,303.8
9,875.5
8,154.9
CAGR: +7.0%
jun-20 jun-21 jun-22 jun-23 jun-24 jun-25
REVENUESGROSS REVENUE
Rede D'Or's gross revenue is composed of revenues from health services, which includes hospital daily rates, medicines administration, hospital supplies, examinations and medical fees, and is provided mainly to healthcare plan operators.
The Company details its gross revenue in two segments: 'hospitals & other services', and 'oncology (infusions)'.
'Hospitals & other services' represented 89.5% of gross revenue in 2Q25, totaling R$8,042.3 million in the period, 13.3% above the amount recorded in 2Q24 and 14.0% higher than in 1Q25.
'Oncology (infusions)' represented 10.5% of gross revenue in the quarter, reaching R$939.7 million in 2Q25; an increase of 17.7% over the same period of the previous year and 8.1% in relation to 1Q25.
In 2Q25, the record for the highest quarterly revenue in Rede D'Or's history was renewed, with gross revenue reaching R$8,982.0 million - an increase of 13.8% compared with 2Q24, and 13.4% considering the previous quarter. Year-to-date, gross revenue totaled R$16,905.5 million, an increase of 10.4% compared to the total amount in 6M24.
Oncology gross revenue also registered a record in the period, reaching R$1,808.9 million, with an expansion of 17.1% compared to the previous year in terms of year-to-date.
It is worth noting that the Company's revenues are historically impacted by, mainly, (i) price adjustments in the contracts signed, principally, with health insurance companies, (ii) patient volume, (iii) variety and complexity of services provided, and (iv) evolution of the number of beds.
(R$ million) | 2Q25 | 2Q24 | Δ % | 1Q25 | Δ % | 6M25 | 6M24 | Δ % | ||
Gross revenues | 8,982.0 | 7,894.7 | 13.8% | 7,923.6 | 13.4% | 16,905.5 | 15,311.6 | 10.4% | ||
Hospitals and other | 8,042.3 | 7,096.1 | 13.3% | 7,054.4 | 14.0% | 15,096.6 | 13,767.0 | 9.7% | ||
Oncology (infusions) | 939.7 | 798.6 | 17.7% | 869.2 | 8.1% | 1,808.9 | 1,544.6 | 17.1% |
Evolution of gross revenues (R$ million)
+13.8%
8,982.0
7,923.6
6,845.4
7,416.9
5,303.7
5,979.8
CAGR: +23.6%
1Q21 1Q22 1Q23 1Q24 1Q25 2Q25
REVENUESDEDUCTIONS FROM GROSS REVENUES
The deductions in the Company's gross revenue are related to two main factors. The first involves cancellations and rebates, which basically consist of the provisioning of medical disallowances that the Company incurs as a result of the review (audit of non-approvals), together with health insurance operators, of materials and services provided. The second corresponds to the taxes levied on gross revenue, mainly PIS and COFINS, which are federal contributions at the rates of 0.65% and 3.0%, respectively; and ISS, which is a municipal tax levied at rates ranging from 2% to 5%, depending on the municipality where the Company actually provides healthcare services.
The combined deductions from gross revenue registered annual growth levels similar to those of revenue itself, as shown in the table below. The disallowances provisioned in 2Q25 represented 5.5% of hospital services revenue.
As a result, Rede D'Or's net revenue in 2Q25 reached R$7,960.8 million, representing growth of 13.88% over the revenue of the same period of the previous year, and 13,2% compared to the amount recorded in 1Q25.
Year-to-date, net revenue totaled R$14,996.2 million; an increase of 10.3% compared to the total in 6M24.
(R$ million) | 2Q25 | 2Q24 | Δ % | 1Q25 | Δ % | 6M25 | 6M24 | Δ % | ||
Gross revenues | 8,982.0 | 7,894.7 | 13.8% | 7,923.6 | 13.4% | 16,905.5 | 15,311.6 | 10.4% | ||
Glosses (disallowances) | (492.6) | (425.3) | 15.8% | (424.3) | 16.1% | (916.9) | (820.6) | 11.7% | ||
Taxes on revenue | (528.7) | (471.9) | 12.0% | (463.8) | 14.0% | (992.4) | (898.2) | 10.5% | ||
Net revenues | 7,960.8 | 6,997.6 | 13.8% | 7,035.5 | 13.2% | 14,996.2 | 13,592.8 | 10.3% |
COSTS AND GROSS PROFIT
COSTS OF HOSPITAL SERVICES
The cost of hospital services are composed of the accounts for personnel, materials and medicines, third-party services, utilities and services, rents, depreciation and amortization.
In the quarter, costs of hospitals services totaled R$6,033.5 million, an increase of 15.7% compared to 2Q24, due to (i) the inauguration of new hospitals over the last twelve months; and (ii) the expansion of the Oncology business, that registered increase in the share of oncology revenue in hospital services revenue (10.5% in 2Q25 vs. 10.1% in 2Q24), whose cost of materials and medicines is more relevant.
Year-to-date, the costs of hospitals services reached R$11,552.7 million, an increase of 12.9% compared to the same period of the previous year.
The cost of materials and medicines as a percentage of gross revenue reached 19.7% in 6M25, an increase of 0.5 pp vs. 6M24, following the increase in the share of oncology revenue in hospital services revenue.
Materials and medicines, and Oncology as a percentage of gross revenue (%)
21.8%
21.1%
20.0%
19.2%
19.5%
11.0%
10.1%
9.8%
8.4%
7.7%
1Q21 1Q22 1Q23⁽¹⁾ 1Q24 1Q25
% Mat-Med/Gross Rev.
GROSS PROFIT
In 2Q25, gross profit reached R$1,927.3 million, an 8.2% rise over 2Q24, due to the growth in revenue over the period. The gross margin reached 24.2% in the quarter, down
1.3 pp on the same comparison, given the increase in hospital services costs (+15.7% YoY), which more than offset the revenue gain.
Year-to-date, gross profit was R$ 3,443.5 million, an increase of 2.5% compared to the same period of the previous year, with a gross margin of 23.0% (-1.7 pp YoY).
(R$ million) | 2Q25 | 2Q24 | Δ % | 1Q25 | Δ % | 6M25 | 6M24 | Δ % | ||
Net revenues | 7,960.8 | 6,997.6 | 13.8% | 7,035.5 | 13.2% | 14,996.2 | 13,592.8 | 10.3% | ||
Cost of services provided | (6,033.5) | (5,215.9) | 15.7% | (5,519.3) | 9.3% | (11,552.7) | (10,234.6) | 12.9% | ||
Personnel | (2,123.6) | (1,823.2) | 16.5% | (1,989.6) | 6.7% | (4,113.2) | (3,579.4) | 14.9% | ||
Materials and medicines | (1,792.9) | (1,520.1) | 17.9% | (1,543.3) | 16.2% | (3,336.2) | (2,947.0) | 13.2% | ||
Third-party services | (1,508.4) | (1,354.0) | 11.4% | (1,400.7) | 7.7% | (2,909.1) | (2,656.5) | 9.5% | ||
Utilities and services | (118.8) | (107.3) | 10.7% | (120.5) | -1.5% | (239.3) | (220.9) | 8.3% | ||
Rents | (26.3) | (26.8) | -1.8% | (25.0) | 5.2% | (51.3) | (50.8) | 0.9% | ||
Depreciation and amortization | (463.5) | (384.5) | 20.6% | (440.2) | 5.3% | (903.7) | (780.1) | 15.8% | ||
Gross profit | 1,927.3 | 1,781.7 | 8.2% | 1,516.2 | 27.1% | 3,443.5 | 3,358.2 | 2.5% | ||
Gross margin (%) | 24.2% | 25.5% | -1,3 p.p. | 21.6% | 2,7 p.p. | 23.0% | 24.7% | -1,7 p.p. |
(1) Does not consider the non-recurring effect from the acceleration of OPSM billing in 1Q23, with a counterpart in the line of materials and medicines.
ADMINISTRATIVE EXPENSESADMINISTRATIVE EXPENSES
General and administrative (G&A) expenses are composed of administrative and executive staff costs, third-party services, travel and lodging, and depreciation and amortization of Rede D'Or's corporate assets.
In the quarter, G&A expenses totaled R$326.5 million, up 9.3% in relation to the same period of the previous year, and 0.2% lower if compared with 1Q25.
As a percentage of gross revenue, G&A expenses represented 3.6% in the quarter, 0.2 pp and 0.5 pp drop vs. 2Q24 and 1Q25, respectively.
Year-to-date, G&A expenses totaled R$653.6 million, a rise of 18.7% compared to the same period of the previous year. As a percentage of gross revenue, G&A expenses increased by 0.3 pp to 3.9% in 6M25.
(R$ million) | 2Q25 | 2Q24 | Δ % | 1Q25 | Δ % | 6M25 | 6M24 | Δ % | ||
Gross revenues | 8,982.0 | 7,894.7 | 13.8% | 7,923.6 | 13.4% | 16,905.5 | 15,311.6 | 10.4% | ||
General and administrative expenses | (326.5) | (298.9) | 9.3% | (327.1) | -0.2% | (653.6) | (550.7) | 18.7% | ||
Personnel | (210.3) | (189.2) | 11.1% | (206.4) | 1.9% | (416.7) | (390.0) | 6.8% | ||
Third-party services | (43.1) | (38.6) | 11.4% | (44.8) | -3.9% | (87.9) | (89.4) | -1.7% | ||
Travel and accommodation | (19.9) | (19.3) | 3.1% | (18.8) | 6.0% | (38.6) | (33.6) | 14.9% | ||
Depreciation and amortization | (59.0) | (51.3) | 15.0% | (57.1) | 3.2% | (116.1) | (101.8) | 14.1% | ||
Provision of contingencies and other | 5.7 | (0.4) | n.a. | 0.1 | n.a. | 5.7 | 64.1 | -91.1% | ||
Expenses over gross revenues (%) | 3.6% | 3.8% | -0,2 p.p. | 4.1% | -0,5 p.p. | 3.9% | 3.6% | 0,3 p.p. | ||
Expenses (ex-D&A) over gross revenues (%) | 3.0% | 3.1% | -0,2 p.p. | 3.4% | -0,4 p.p. | 3.2% | 2.9% | 0.2 p.p. |
SELLING EXPENSES, EQUITY PICKUP, AND OTHERS
SELLING EXPENSES
Selling expenses were positive by R$36.4 million in 2Q25, mainly impacted by the partial reversal of provisions for doubtful accounts from certain smaller payers recorded in 3Q23, due to the recovery of amounts owed to the Company.
EQUITY PICKUP
In the quarter, the equity pickup result, referring to the movements of Rede D'Or's main investees, was positive by R$15.4 million; more than three times the result of R$4.8 million in 2Q24, and reversing the negative result of R$2.9 million in 1Q25. In both comparisons, the variation can be attributed to Qualicorp S.A.'s results.
Year-to-date, the balance is negative by R$7.2 million, an increase compared to the negative result of R$12.1 million in 6M23.
OTHER OPERATING EXPENSES/REVENUES
The other operating income/expenses line is mainly composed of: (i) rental of machinery and equipment; (ii) freight expenses with the logistics operation of distribution of materials and medicines; (iii) expenses with notary and legal costs; (iv) taxes, fees, and fines; and (v) other operating incomes and expenses.
The result of the line was negative by R$116.6 million in 2Q25, an increase of 32.4% vs.
2Q24.
As a percentage of the gross revenue, the line represented 1.3% in 2Q25 (vs. 1.1% for 2Q24).
EBITDA
EBITDA reached R$2,058.5 million in the quarter, an increase of 12.0% compared to 2Q24 and of 23.1% compared to the previous quarter. The result in relation to 2Q24 was mainly driven by the growth in net revenue (+13.8% YoY).
Year-to-date, EBITDA totaled R$3,731.1 million, an increase of 6.7% compared to the same period last year, driven by 2Q25's performance
In 2Q25, EBITDA margin reached 25.9%, drop of 0.4 pp vs. 2Q24 and increase of 2.1 pp vs. 1Q25. Year-to-date, EBITDA margin registers 24.9%, 0.8 pp contraction in respect to the same period last year.
(R$ million) | 2Q25 | 2Q24 | Δ % | 1Q25 | Δ % | 6M25 | 6M24 | Δ % | ||
EBITDA | 2,058.5 | 1,837.4 | 12.0% | 1,672.6 | 23.1% | 3,731.1 | 3,495.8 | 6.7% | ||
EBITDA margin (%) | 25.9% | 26.3% | -0,4 p.p. | 23.8% | 2,1 p.p. | 24.9% | 25.7% | -0,8 p.p. |
EBITDA breakdown in 2Q25 vs. 2Q24
(R$ million)
2,058
1,837
(760)
963
35 (18)
EBITDA 2Q24
∆ Revenues ∆ Costs ∆ G&A and
selling expenses
∆ Equity pick-up and other
EBITDA 2Q25
26.3%
25.9%
EBITDA
Margin
EBITDA
Margin
SULAMÉRICA
Note: The following results and analysis do not consider the impacts of the IFRS 17 adoption. For the reconciliation of the results, see the report annexes. Additionally, the analyzes disregard accounting eliminations related to Rede D'Or's hospital services.
HIGHLIGHTS› Net revenue of R$8.1 billion in 2Q25, 10.7%
YoY growth.
› Health and dental membership totaled approximately 5.6 million, increase of 9.3% YoY.
› Consolidated loss ratio of 81.3% in 2Q25, improvement of 2.3 pp vs. 2Q24.
› Administrative expenses accounting for 4.7%(1) of net revenue in 2Q25 vs. 4.9% in
Consolidated Loss Ratio
-2.3 pp
+2.7 pp
(% earned premiums)
78.6%
83.6% 82.1% 80.2%
81.3%
2Q24.
› Adjusted EBITDA by financial results over restricted assets of R$729.6 million in the quarter, increase of 50.0% YoY.
2Q24 3Q24 4Q24 1Q25 2Q25
(R$ million) | 2Q25 | 2Q24 | Δ % | 1Q25 | Δ % | 6M25 | 6M24 | Δ % | ||
Net Revenue | 8,147.7 | 7,360.4 | 10.7% | 8,047.6 | 1.2% | 16,195.3 | 14,531.4 | 11.5% | ||
Insurance revenues (excl. intercompany eliminations) | 7,891.8 | 7,077.0 | 11.5% | 7,786.1 | 1.4% | 15,677.9 | 14,019.8 | 11.8% | ||
Pension revenues | 188.6 | 204.1 | -7.6% | 198.2 | -4.9% | 386.8 | 395.6 | -2.2% | ||
Other health plans and insurance revenues | 67.3 | 79.3 | -15.1% | 63.2 | 6.5% | 130.6 | 116.1 | 12.5% | ||
Changes in technical reserves | (143.8) | (181.5) | -20.8% | (193.9) | -25.9% | (337.7) | (373.5) | -9.6% | ||
Insurance | 6.3 | (20.6) | -130.8% | (32.2) | -119.7% | (25.9) | (56.8) | -54.4% | ||
Pension | (150.1) | (160.9) | -6.7% | (161.7) | -7.2% | (311.8) | (316.6) | -1.5% | ||
Operating Costs | (7,097.4) | (6,516.0) | 8.9% | (6,829.2) | 3.9% | (13,926.7) | (12,834.3) | 8.5% | ||
Insurance | (6,945.3) | (6,385.1) | 8.8% | (6,677.6) | 4.0% | (13,622.9) | (12,562.0) | 8.4% | ||
Claims (excl. intercompany eliminations) | (6,441.9) | (5,933.4) | 8.6% | (6,154.3) | 4.7% | (12,596.2) | (11,662.2) | 8.0% | ||
Acquisition costs | (503.4) | (451.8) | 11.4% | (523.3) | -3.8% | (1,026.7) | (899.8) | 14.1% | ||
Pension | (30.2) | (29.5) | 2.2% | (30.6) | -1.5% | (60.8) | (62.0) | -1.8% | ||
Other operating costs | (122.0) | (101.3) | 20.4% | (121.0) | 0.8% | (243.0) | (210.3) | 15.6% | ||
General and administrative expenses | (510.8) | (499.0) | 2.4% | (400.6) | 27.5% | (911.3) | (919.1) | -0.8% | ||
Personnel | (225.0) | (228.5) | -1.5% | (194.3) | 15.8% | (419.4) | (422.9) | -0.8% | ||
Third-party services | (114.0) | (90.9) | 25.4% | (98.9) | 15.3% | (212.9) | (178.7) | 19.1% | ||
Travel and accommodation | (2.5) | (2.2) | 13.1% | (2.0) | 21.9% | (4.5) | (4.0) | 10.7% | ||
Depreciation and amortization | (40.1) | (38.5) | 4.1% | (39.6) | 1.1% | (79.7) | (77.1) | 3.4% | ||
Provision of contingencies and others | (129.2) | (138.9) | -7.0% | (65.7) | 96.5% | (194.9) | (236.5) | -17.6% | ||
Selling expenses | (9.5) | (11.7) | -19.4% | (11.4) | -17.1% | (20.9) | (17.4) | 20.0% | ||
Equity pickup | (0.0) | 19.1 | -100.0% | 0.0 | n.a. | 0.0 | 21.4 | -100.0% | ||
Other operating income/expenses | (27.3) | 27.7 | n.a. | 7.9 | n.a. | (19.4) | 3.9 | n.d. | ||
Earnings before taxes and financial results | 358.9 | 199.0 | 80.4% | 620.4 | -42.1% | 979.4 | 412.4 | 137.5% | ||
EBITDA | 399.0 | 237.5 | 68.0% | 660.0 | -39.5% | 1,059.1 | 489.5 | 116.4% | ||
(+) Financial results over restricted assets | 330.5 | 248.8 | 32.9% | 326.3 | 1.3% | 656.9 | 474.5 | 38.4% | ||
Adjusted EBITDA | 729.6 | 486.2 | 50.0% | 986.3 | -26.0% | 1,715.9 | 964.1 | 78.0% |
(1) Administrative expenses not considering provisions for contingencies.
SULAMÉRICA
HEALTH AND DENTAL
Health and dental revenues totaled R$7,762.6 million in 2Q25 (+11.6% YoY), with the evolution of the average ticket and of the number of beneficiaries.
In 2Q25, health and dental loss ratio reached 81.9%, an improvement of 2.4 pp vs. 2Q24, maintaining the consistent trajectory of gradual normalization of the indicator. In relation to 1Q25, the indicator worsened by 2.6 pp, following the seasonality of the period.
The Company continues to apply price adjustments to achieve economic balance in the contracts, after a period of high frequency and severity of claims. At the same time, it has been intensifying its claims management efforts, including initiatives aimed at mitigating fraud, reimbursements, along with better health coordination.
MEMBERSHIP EVOLUTION
SulAmérica ended 2Q25 with approximately
5.6 million health and dental beneficiaries, an
Net Revenue
(R$ million)
+11.6%
6,954.9
2Q24 2Q25
Loss Ratio
(% earned premiums)
-2.4 pp
+2.6 pp
84.3% 82.8% 80.7% 79.3% 81.9%
2Q24 3Q24 4Q24 1Q25 2Q25
Health and Dental Beneficiaries (thousand)
increase of 9.3% YoY.
In health, total membership surpassed the 3.0 million mark, an increase of 7.7% YoY and representing a net addition of 65 thousand lives, reinforcing the growth trajectory and the attractiveness of the product portfolio.
In dental, SulAmérica reached 2.5 million beneficiaries in the year, increase of 11.3% YoY, maintaining a solid growth trend.
2,263
106
557
2,335 | 2,394 | 2,435 | 2,519 | |||
104 | 102 | 102 | 101 | |||
561 | 576 | 624 | 632 |
5,082
5,174
5,302
+9.3%
+2.8%
5,402
5,555
653 | 658 | 654 | 640 | 657 | ||||
1,504 | 1,517 | 1,576 | 1,604 | 1,647 | ||||
2Q24 | 3Q24 | 4Q24 | 1Q25 | 2Q25 |
SULAMÉRICA
ADMINISTRATIVE, SELLING AND OTHER EXPENSES
SulAmérica's administrative expenses, disregarding the provisions for contingencies and others line, totaled R$381.6 million in 2Q25, increase of 6.0% YoY, representing 4.7% of its net revenues (vs. 6.9% in 9M22, before the merger with Rede D'Or, and 4.9% in 2Q24).
Considering SulAmérica's administrative,
selling and other expenses, under Rede D'Or accounting standards for expense allocation, the sum of the values reached 6.7% of net revenues in the quarter, a 0.1 pp increase compared to the same period of the previous year, mainly due to the impact stemming from the sale of the minority share in Órama DTVM S.A. last year.
EBITDA
In 2Q25, EBITDA related to SulAmérica's operations reached R$399.0 million, showing significant growth of 68.0% when compared to the same period in the previous year, and 39.5% lower than 1Q25, mainly due to the trajectory of loss ratio observed in each of the comparison bases.
Adjusted EBITDA, influenced by the financial result of restricted assets, totaled R$729.6 million in 2Q25, an increase of 50.0% in relation to 2Q24.
FINANCIAL RESULT AND NET INCOME
FINANCIAL RESULT
The financial result was negative by R$549.8 million in the quarter, a drop of 49.1% when compared to 2Q24, due to higher financial expenses mainly related to the increase in CDI, which ended 2Q25 at 3.33% (vs. 2.49% in 2Q24).
NET INCOME
Consolidated earnings before financial results and taxes (income tax and social contribution) reached R$1,894.9 million in 2Q25, of which R$1,536.0 million stemmed from the hospital service operation and R$358.9 million from the insurance operation.
Income tax and social contribution expenses were R$215.3 million in 2Q25. As a result, the Company's net income without IFRS 17 adoption ended the quarter at R$1,129.8 million.
Excluding the accounting-only effect of the amortization of the portfolios assumed of SulAmérica in business combinations, the net income would have reached R$1,182.4 million in 2Q25.
The Company's accounting net income, considering the IFRS 17 effect, totaled R$1,047.8 million in 2Q25.
(R$ million) | 2Q25 | 2Q24 | Δ % | 1Q25 | Δ % | 6M25 | 6M24 | Δ % | ||
Financial result (a+b+c) | (549.8) | (368.7) | 49.1% | (524.9) | 4.8% | (1,074.7) | (772.2) | 39.2% | ||
Financial revenues (1)(a) | 877.3 | 607.9 | 44.3% | 789.9 | 11.1% | 1,667.2 | 1,196.6 | 39.3% | ||
Financial expenses (b) | (1,215.1) | (910.1) | 33.5% | (1,241.8) | -2.1% | (2,456.9) | (1,858.5) | 32.2% | ||
Interest and monetary adjustments | (1,070.0) | (841.5) | 27.2% | (1,116.1) | -4.1% | (2,186.1) | (1,743.7) | 25.4% | ||
Taxes and charges | (30.0) | (19.8) | 51.7% | (28.0) | 7.2% | (58.1) | (42.5) | 36.5% | ||
Leasing (2) | (124.2) | (116.1) | 7.0% | (128.1) | -3.0% | (252.3) | (229.3) | 10.0% | ||
Other financial expenses/revenues | 9.2 | 67.3 | -86.4% | 30.5 | -69.9% | 39.6 | 157.1 | -74.8% | ||
Net exchange variation and other (3)(c) | (212.1) | (66.5) | 219.0% | (73.0) | 190.4% | (285.1) | (110.2) | 158.6% |
Considers the short- term investment yield, devaluation of investment, monetary adjustments and interest on reserves.
Referring mainly to the effects of IFRS- 16. For more information, see note 15 of the ITR.
Considers the effects of net exc hange variation, fair value of debt and the fair value and settlement of derivatives (swap). For more information, see note 24 of the ITR.
(R$ million)
2Q25
2Q24
Δ %
1Q25
Δ %
6M25
6M24
Δ %
Net Income (Ex-IFRS17)
1,129.8
1,000.8
12.9%
1,017.9
11.0%
2,147.7
1,841.1
16.7%
IFRS17 Adjustement (4)
(82.0)
(5.2)
n.a.
48.9
n.a.
(33.2)
(10.0)
230.6%
Net Income
1,047.8
995.5
5.2%
1,066.8
-1.8%
2,114.5
1,831.0
15.5%
The corporate result is impacted by the adoption of IFRS 17/CPC 50, introduced changes to accounting practices, which impacts insuranc e contracts from SulAmérica's operations. For the reconciliation of the financial information, see the annexes of this report, starting on page 32.
IFRS 16: Leasing expenses posted by the Company as interest and depreciation reached R$219.7 million in 2Q25, totaling R$434.6 million year-to-date. Considering the cash effect, the Company's lease expenses were R$200.0 million in the quarter and R$387.4 million in 6M25.
INVESTMENTS (managerial)
Company's investments (ex-M&A) were R$676.2 million in the quarter, totaling R$1,267.9 million in the year-to-date and registering a reduction of 8.8% in relation to 6M24, mainly due to disbursements related to expansion projects - including the development of greenfield and brownfield projects: Hospital Assunção, Vila Nova Star, São Lucas, Macaé D'Or, the new Barra D'Or, and the new São Luiz units in Alphaville and Guarulhos.
Investments to maintain the Company's operations totaled R$111.0 million in 2Q25, equivalent to 1.4% of the net revenue of hospitals, oncology and others registered in the period (versus 1.1% in 2Q24). Year-to-date, maintenance investments totaled R$231.1 million (1.5% of net revenue from hospitals, oncology and others)
(R$ million) | 2Q25 | 2Q24 | Δ % | 1Q25 | Δ % | 6M25 | 6M24 | Δ % | ||
Investments (ex-M&A) | 676.2 | 653.9 | 3.4% | 591.7 | 14.3% | 1,267.9 | 1,390.9 | -8.8% | ||
Maintenance | 111.0 | 74.9 | 48.2% | 120.7 | -8.0% | 231.7 | 163.7 | 41.6% | ||
Expansion | 565.2 | 579.0 | -2.4% | 471.0 | 20.0% | 1,036.1 | 1,227.2 | -15.6% | ||
Merger and acquisitions (M&A)(1) | (70.8) | 30.0 | n.a. | (383.4) | -81.5% | (454.2) | 31.1 | n.a. | ||
Total investments | 605.4 | 683.9 | -11.5% | 208.3 | 190.7% | 813.7 | 1,422.0 | -42.8% |
In 1Q25, the M&A line registered amounts related to the the reimbursement of the proportional amount spent on investment in the Hospital São Luiz Campinas, as provided for under the agreement with Atlântica D'Or.
DEBT
At the end of 2Q25, the Company's consolidated gross debt balance(1) was R$37,101.3 million, an increase of 5.0% compared to Jun-24. When compared to Mar-25, gross debt increased by 0.9%.
Regarding the gross debt profile at the end of Jun-25, the average debt term reduced to 5.4 years vs. 5.5 years in Mar-25. The average cost(2) of gross debt at the end of the quarter was equivalent to CDI +1.0% pa (vs. CDI
+0.9% in Mar-25).
At the end of the period, 81.5% of the consolidated gross debt was denominated in Reais (vs. 80.9% in 1Q25), while the remainder was denominated in foreign currencies, with hedging for currency exposure fully contracted.
In Jun-25, the consolidated position of cash and equivalents was R$42,409.4 million.
Excluding the balance of technical reserves recorded in subsidiaries regulated by SUSEP and ANS in the amount of R$22,605.8 million, the Company's consolidated net cash was R$19,803.6 million.
Considering the consolidated position of cash net of technical reserves of private pension, the Company's net debt was R$9,187.8 million in Jun-25, a decrease of 20.6% vs. Jun-24 and of 3.3% vs Mar-255. The leverage ratio reached 0.99x in the period (vs. 1.07x in Mar-25).
In the same period, considering the consolidated position of cash net of technical reserves of private pension and insurance, the Company's net debt was R$17,297.6 million.
(R$ million) | jun-25 | jun-24 | Δ % | mar-25 | Δ % | |
Cash and cash equivalents (a) | (42,409.4) | (35,489.2) | 19.5% | (41,839.1) | 1.4% | |
Cash and cash equivalents | (5,078.1) | (3,634.8) | 39.7% | (7,675.5) | -33.8% | |
Securities (3) | (37,331.3) | (31,854.4) | 17.2% | (34,163.5) | 9.3% | |
Technical reserves (b) | 22,605.8 | 17,921.6 | 26.1% | 22,393.5 | 0.9% | |
Insurance | 8,109.8 | 6,207.9 | 30.6% | 7,843.3 | 3.4% | |
Private pension | 14,496.0 | 11,713.6 | 23.8% | 14,550.2 | -0.4% | |
Net cash from technical reserves (a+b) | (19,803.6) | (17,567.6) | 12.7% | (19,445.6) | 1.8% | |
Gross debt(1) | 37,101.3 | 35,351.0 | 5.0% | 36,787.4 | 0.9% | |
Loans, financing and bonds | 37,985.7 | 36,268.8 | 4.7% | 37,845.2 | 0.4% | |
Derivative financial instruments | (1,044.6) | (1,183.9) | -11.8% | (1,287.2) | -18.9% | |
Cash flow hedge | 160.1 | 266.1 | -39.8% | 229.4 | -30.2% | |
Net debt | 17,297.6 | 17,783.4 | -2.7% | 17,341.8 | -0.3% | |
Net debt / LTM EBITDA(4) | 1,7x | 2,1x | - | 1,7x | - | |
Net debt (ex. insurance reserves) | 9,187.8 | 11,575.4 | -20.6% | 9,498.5 | -3.3% | |
Net debt (ex. insurance reserves)/LTM EBITDA(5) | 1,0x | 1,6x | - | 1,1x | - |
Corresponds to the sum of the balances of loans, financing and debentures net of all debt derivative financial instruments (current and noncurrent). Does not consider leasing liabilities and accounts payable for acquisitions.
Considering the future market yield curve, until the maturity of all obligations.
Includes the hedge of R$4.3 million related to the investment in ICO with a Notional of R$100 million and maturity on 02/03/2028, as detailed in note 24.2 of the ITR.
LTM EBITDA considers SulAmérica's adjusted EBITDA as of 1Q23.
LTM EBITDA considers SulAmérica's numbers as of 1Q23.
DEBT
The consolidated leverage ratio, considering the net cash from technical reserves, measured by the Net Debt/EBITDA ratio reached 1.65x at the end of the period, slightly lower in relation to the previous quarter and a drop of 0.4x vs. 2Q24.
Regarding the debt profile at the end of Jun-25, considering the contracting of derivatives and other financial instruments (as described in Note 24.2 of the Consolidated Financial Statements), and the Company's available cash, 7.4% of the net debt was pegged to fixed rates, while 92.6% was pegged to floating rates.
Rede D'Or has no financial restrictive clauses (covenants) to indebtedness levels or based on EBITDA and financial expenses.
For legacy debt incurred by the merger with SulAmérica (6th, 8th and 9th issuances of debentures), the Company approved at a general meeting of debenture holders held on August 18, 2022, the temporary waiver of the observance of such restrictions until the first date of early redemption. For more information see Note 13 in the Consolidated Financial Statements.
The graphs below illustrate (i) the debt evolution, measured by the net debt/EBITDA ratio of the last 12 months; (ii) the amortization schedule related to updated balances of loans, financing, and debentures; and (iii) the evolution of the average cost of debt and its average term.
Net debt(1) / EBITDA 12M
2.59x 2.77x
Debt amortization schedule
(principal) (R$ million)
2.22x
2.30x
1.88x
1.65x
Dec-20 Dec-21 Dec-22 Dec-23 Dec-24 Jun-25
Evolution of the average cost of debt
(in CDI+; end of period)
5.3
5.4
Average term (years)
CDI+ 1.1% CDI+ 1.0% CDI+ 1.0%
CDI+ 0.7% CDI+ 0.7%
CDI+ 1.8%
Cash⁽²⁾ 2025
2026
2027
2028
2029
2030
2031
2032
2033
2034-39
19,804
1,617
367
3,910
4,835
4,277
7,195
4,413
1,967
743
7,634
Dec-20 Dec-21 Dec-22 Dec-23 Dec-24 Jun-25
Considers amounts referring to cash flow hedge, as of 2020. Last 12 months EBITDA.
Cash, cash equivalents, and securities, net of technical reserves.
MANAGERIAL CASH FLOW
CAPITAL ALLOCATION
The Company approved, in 2Q25, a total of R$450.0 million in interest on equity (gross) to its shareholders, totaling R$850.0 million in the year-to-date.
Furthermore, the Company disbursed around R$390.5 million in its share buyback programs in the first half of the year.
OPERATIONAL CASH FLOW
The managerial operating cash flow (before taxes, financial activities and investments) calculated in 6M25 was R$4,616.6 million, registering an expansion of 22.4% in relation to the same period of the previous year.
Managerial Cash Flow Reconciliation
(R$ million)
4,790.2
(813.7)
1,924.1
(1,878.8)
1,100.7
(387.4)
(220.2)
(666.7)
Reported | ∆ Working ∆ Other | ∆ Leasing | ∆ Taxes | ∆ Financial | ∆ Invest- | ∆ Cash |
EBITDA | capital⁽¹⁾ balance | activities | ments | 6M25 | ||
6M25 | sheet items |
WORKING CAPITAL CYCLE
48
48
51
47
47
54
45
53
44
50
The average receivables term(2) -considering only accounts receivable from hospital services - was 116 days at the end of 2Q25, reducing six days when compared to the previous quarter. The average inventory outstanding days (50 days) decreased three days in the same comparison, as did the average
Hospital services: average days receivables (ADR), days inventory outstanding (DIO)
and days payable outstanding (DPO)
(in days)
116
121
123
129
124
123 123 122 122
116
payable outstanding days (41 days).
45 45 45
46 44 43
43 43 44 41
1Q23 2Q23 3Q23 4Q23 1Q24 2Q24 3Q24 4Q24 1Q25 2Q25
Change in working capital includes annual variation of private pension technical reserves (R$1.0 billion).
Since 4Q22, ADR calculation adjusted by the integration of SulAmérica in the Company's balance sheet, therefore excluding
provision eliminations between companies of the group.