Narayana Hrudayalaya

“As India also comes off the capex cycle, I think that's when the full effect of the -- all the measures will show on the ROCE.”

“As of now, no bed addition.”

“One good way to look at our numbers is that we haven't added any capacity and our occupancy has also not increased in the past several quarters.”

“We are adding more beds. We are adding more facilities in the hospitals over here. But our ambition is a lot more than that.”

“As and when our facilities are ready to be commissioned, we will share that guidance 1 quarter in advance.”

“The claims ratios themselves, if you look at quarter-to-quarter, that has come down significantly and it is trending -- continues to trend in the right direction.”

“There were a set of strategies we had in mind when we first started out, and some did not work as well as expected. We are adapting and pivoting, and we're keeping the amount of money spent as low as possibly we can.”

“There was an amount of money we had committed towards spending on the clinics, which have proven themselves to be an extremely valuable resource for all our patients and for doctors to run their evening OPDs. That will continue because its value to the larger network is proven.”

“We will spend in moderate amounts to keep our customers very happy to make sure that the claims don't go above and beyond what we had estimated for and to cut the cost in insurance distribution, which is currently a very high priority for the IRDAI Chairman, so that we can break even at a much smaller book than the peer set.”

“Even for Cayman, if you look at the insurance losses, the number is down from $3.7 million to $1.1 million.”

“So on IP volumes, we've seen 4% increase year-on-year. OP footfall, we've seen around 12.5% growth.”

“We expect much stronger footfall growth from the Eastern region in Q3.”

“And with the strong base and good funnel which have been created over the last 2 quarters across all the regions, we foresee good footfall growth both from inpatient side and outpatient side in Q3 and Q4.”

“The growth is purely organic and comes mainly from Bangladesh, because of the brand and loyalty we have built there over the last 2.5 decades, supported by easier visa and travel conditions.”

“We continue to see good growth from non-Cayman sources, that is international patients.”

“And on the margin side, yes, it has gone up to more than 26%, which is now among the best in the industry, even though our ARPOB remains well below peers.”

“Along with better realizations, we've also had the benefit of operating leverage on the costs where our doctors and nursing costs have come down by 1.9% QoQ, which has added to the margin.”

“And our focus will remain on seeing how we can sustain these margins at current levels.”

“So margin expansion isn't the thing that we target. What we're looking for is accessing the largest pool of patients in all the cities that we operate in. Volume growth is what we want to pursue.”

“So there are definite synergies that we've seen with running a very large GCC for all our international operations out of our corporate office in Bangalore.”

“The reason you have seen a slightly lesser cash conversion in H1 is coming from India and Cayman. There has been a slight delay in both India and Cayman in terms of collections.”

“So the cash conversion for U.K. is not a problem. In fact, NHS is a very good payer; it pays on time and partially in advance.”

“Typically, on a full-year basis, this normalizes: in some quarters collections are a little slow, but we catch up over the next few months. So that's what we are expecting.”

“We have close to around 900 postgraduates in training across the entire network.”

“We don't see too much of attrition at the senior level.”

“We have more than 3,000 nursing students in training.”

“But this -- the $1.1 million does have some one-off because it includes the summer school holiday months, when people tend to defer elective care, they'll be on holidays, travel with family, etcetera.”

“There may be some ups and downs as this is implemented, which we will work through as we understand it better.”

“In the Eastern cluster, there was a transition issue in porting certain categories of government scheme patients in Bengal, which should settle in the coming quarter, after which IP footfalls will gradually pick up.”

“There are certain aspects which given it's a new market, a, we are still learning about the nuances and b, a little out of our control with regards to NHS revenue commissioning and external patient acquisition.”

“For example, there was a recent software vulnerability that we were able to patch very quickly. But in the end, this is never ending, and it is something you just have to spend a lot of time and effort towards.”

“We just need to spend more money and build better systems and obviously hope and pray that bad things don't happen that are well beyond our control.”

“ARPOB, as you said, has increased from INR17.5 million to INR19.5 million (annualised) year-on-year, as we focus more on high-end procedures and greater use of robotics.”

“The combined loss of the 2 businesses was around INR33 crores last quarter, and this quarter it is INR22 crores. So the losses have come down actually.”

“For us, our AI use cases are much more measured and more grounded in practical application. AI in radiology predates LLMs.”

“So at a group level, our ROCE is between 15% to 16%. That's because we've come off a huge investment in Cayman as well as the investment we've made in U.K. and India entering the capex phase.”

“We are merging the clinic business into the hospital business, so going forward it will be useful to only look at the insurance number.”