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    Aster DM Health.

    ASTERDM
    Healthcare·1 May 2026
    Management Summary

    Aster DM Healthcare reported a strong Q4 and full-year FY26, both on a standalone and combined proforma basis with Quality Care. The company saw robust revenue and EBITDA growth, driven by increased patient volumes, improved ARPP IP, and a favorable case mix. The merger with Quality Care is progressing well, with NCLT approval pending. Despite some regional challenges like a nurse strike and competition, management expressed confidence in continued growth and margin expansion through disciplined capacity additions and operational efficiencies.

    Highlights

    5
    • Combined proforma Q4 FY26 revenue grew 18% YoY to INR 2,361 crores, driven by 12% increase in patient volumes and 8% improvement in ARPP IP.

    • Combined proforma Q4 FY26 Operating EBITDA grew 25% YoY to INR 517 crores, leading to margin expansion to 21.9% and ROCE improvement of 293 bps to 21.1%.

    • Aster standalone Q4 FY26 revenue (ex-Kasargod) grew 17% YoY to INR 1,166 crores, with Operating EBITDA (ex-Kasargod) growing 31% YoY to INR 253 crores and Normalised PAT growing 32% YoY to INR 153 crores.

    • QCIL achieved FY26 EBITDA of INR 1,066 crores, breaching the INR 1,000 crores mark for the first time, representing a 24.1% YoY growth and margins of 23.0%.

    • Aster Labs demonstrated a significant turnaround, with Operating EBITDA margins expanding from negative 7.6% in FY24 to 12.8% in FY26, driven by 32% YoY growth in external business.

    Concerns

    3
    • The newly launched Kasargod hospital incurred losses of INR 19-20 crores in Q4 FY26, impacting Aster's overall standalone margins.

    • Aster's Karnataka IP volumes grew only 3% in Q4 FY26, attributed to de-empanelment of low-yield schemes and high competition intensity in North Bangalore.

    • Macro headwinds led to a decline in Medical Value Travel (MVT) from the UAE for Aster, though this was offset by growth from Maldives and African markets.

    Key financials

    Single quarter

    06 metrics
    1. 01Combined Proforma Revenue₹2,361 Cr+18%YoY
    2. 02Combined Proforma Operating EBITDA₹517 Cr+25%YoY
    3. 03Combined Proforma EBITDA Margin21.9%
    4. 04Aster Standalone Revenue (ex-Kasargod)₹1,166 Cr+17%YoY
    5. 05Aster Standalone Operating EBITDA (ex-Kasargod)₹253 Cr+31%YoY

    Segment breakdown

    Aster Standalone (ex-Kasargod)
    ₹4,617 Cr FY26 Revenue₹969 Cr FY26 Operating EBITDA21% FY26 Operating EBITDA Margin₹451 Cr FY26 Normalised PAT22.8% FY26 ROCE
    QCIL Standalone
    ₹4,630 Cr FY26 Revenue₹1,066 Cr FY26 EBITDA23% FY26 EBITDA Margin7.0% FY26 IP Volumes Growth10% FY26 OPD Volumes Growth58.7% FY26 CONGO-T Mix
    Aster Labs
    1.8% Q4 FY26 Operating EBITDA Growth14.7% Q4 FY26 Operating EBITDA Margin12.8% FY26 Operating EBITDA Margin
    Kerala Cluster (Aster)
    ₹604 Cr Q4 FY26 Revenue25.6% Q4 FY26 Operating EBITDA Margin (ex-Kasargod)51% Q4 FY26 MVT Growth
    Karnataka & Maharashtra Cluster (Aster)
    ₹394 Cr Q4 FY26 Revenue24.5% Q4 FY26 Operating EBITDA Margin21% Q4 FY26 ARPP IP Growth
    Andhra Pradesh & Telangana Cluster (Aster)
    30% Q4 FY26 Revenue Growth113.0% Q4 FY26 Operating EBITDA Growth18.3% Q4 FY26 Operating EBITDA Margin
    List

    Capital allocation

    4
    high confidence
    CategoryHeadline
    Capex

    ₹2,700 crores

    Debt

    Gross ₹701 crores

    M&A

    Quality Care

    merger · pending regulatory

    Liquidity

    Cash ₹1,327 crores

    Guidance & targets

    9
    CategoryTargetPriority
    Capacity
    Total Bed Capacity (Combined)
    15,000+ beds
    High
    Capacity
    Aster Bed Additions
    ~2,500 beds
    High
    Capacity
    QCIL Bed Additions
    ~1,700 beds
    High
    Capex
    Aster Capex for New Beds
    INR 2,700 crores
    High
    Capex
    QCIL Annual Capex Spend (% of revenue)
    5%
    High
    Profitability
    CONGO Mix Contribution (Aster)
    60-65%
    Medium
    Volume
    IP Volume Growth (Aster K&M Cluster)
    mid to high single digit
    Medium
    Margin
    EBITDA Margin (Aster Whitefield)
    more than mid 20s
    Medium
    Growth
    QCIL Growth Momentum & Margin Expansion
    continue
    Medium

    NCLT Approval for Aster-QCIL Merger

    within this quarter (Q1 FY27)
    CurrentAwaiting final approval
    TargetMerger becomes effective

    Why it matters

    Finalization of the merger is crucial for realizing combined operational and financial benefits, and unlocking synergies.

    The next hearing is expected in May, and upon receipt of the order, the merger will become effective. Based on current timelines, we expect the process to be completed within this quarter.

    How to verify

    capital_allocation.m_and_a[target='Quality Care'].status

    Risks & concerns

    4
    RiskSeverity

    Initial losses from newly operationalized hospitals

    Kasargod hospital incurred INR 19-20 crores in losses in Q4 FY26, but management expects it to break even quickly.Management acknowledged

    medium

    Impact of nurse strike on Kerala operations

    A temporary and modest impact was observed in Kerala due to a nurse strike, which has since been settled with a small pay increase.Management acknowledged

    low

    Macro headwinds affecting Medical Value Travel (MVT) from specific regions

    Decline in MVT from UAE was offset by increased patient flows from Maldives and African markets.Management acknowledged

    medium

    High competition intensity in certain regions (e.g., North Bangalore)

    Competition led to some attrition of clinical teams, but management successfully brought them back, demonstrating strength of clinical ecosystem.Management acknowledged

    medium

    Q&A highlights

    8

    “I think fundamentally, while a lot of conversations have happened, there are two things that are bothering the industry around it. One is data privacy. Still, I don't think the insurance companies have really figured out a way to ensure data privacy across so many hospitals and the other is transparency as to how this is being done.”

    Analyst raised a potential industry-wide threat, and management indicated it's not currently impacting them due to data privacy and transparency concerns, suggesting it's not a near-term risk for large players.

    asked by Tausif Shaikh

    3 min read6 chapters

    Detailed Narrative

    01

    Strong Combined Proforma Performance and Merger Progress

    The combined proforma performance of Aster DM Healthcare and Quality Care demonstrated robust growth in Q4 FY26, with revenue increasing 18% YoY to INR 2,361 crores and Operating EBITDA growing 25% YoY to INR 517 crores, achieving a margin of 21.9%. For the full year FY26, combined revenue reached INR 9,273 crores (up 14% YoY) and Operating EBITDA was INR 2,013 crores (up 21% YoY), with margins at 21.7%. The merger with Quality Care received overwhelming shareholder and creditor approval and is now awaiting final NCLT approval, expected to be completed within the current quarter.

    02

    Aster Standalone Performance Driven by Volume and Mix

    Aster's standalone operations (excluding Kasargod) reported a 17% YoY revenue growth to INR 1,166 crores in Q4 FY26 and a 12% YoY growth to INR 4,617 crores for FY26. Operating EBITDA (ex-Kasargod) grew 31% YoY to INR 253 crores in Q4 FY26, with margins at 21.7%. This performance was supported by a 15% increase in total patient volumes, a 9% improvement in ARPP IP, and a strategic shift towards higher-acuity care, evidenced by 25% YoY growth in cardiology revenues and 23% YoY growth in oncology revenues.

    03

    QCIL's Operational Excellence and Milestone EBITDA

    Quality Care (QCIL) delivered an 18% YoY revenue growth to INR 1,178 crores in Q4 FY26, with EBITDA growing 23% YoY to INR 272 crores, achieving a 23.1% margin. For FY26, QCIL's EBITDA reached INR 1,066 crores, marking the first time it breached the INR 1,000 crores mark, representing a 24.1% YoY growth. This was driven by a 10% increase in IP volumes, 9% increase in OP footfalls, and a 20% growth in CONGO-T revenue, which now constitutes 58% of total revenue.

    04

    Cluster-wise Performance and Strategic Focus (Aster)

    The Kerala cluster showed resilience with 21% YoY revenue growth and 35% YoY EBITDA growth (ex-Kasargod) to 25.6% margins, despite a nurse strike. The Karnataka & Maharashtra cluster grew revenue by 11% YoY, with ARPP IP increasing 21% and EBITDA growing 25% YoY to 24.5% margins, driven by higher-value procedures. The Andhra Pradesh & Telangana cluster demonstrated significant operating leverage, with revenue growing 30% YoY and Operating EBITDA more than doubling (113% YoY) to 18.3% margins.

    05

    Capacity Expansion and Future Capex Plans

    Aster added 290 beds in FY26, taking its total capacity to 5,449 beds, with a pipeline to add ~2,500 more beds over the coming years at a cost of INR 2,700 crores. QCIL plans to add ~1,700 beds (1,500 brownfield, 200 greenfield) over the next 3-4 years with an estimated investment of INR 2,000 crores. The blended per-bed capex for QCIL is INR 1-1.1 crores, with greenfield at INR 1.5-1.6 crores and brownfield at INR 0.8-1.1 crores, reflecting a disciplined approach to capital allocation.

    06

    Clinical Talent Acquisition and Technology Integration

    Both Aster and QCIL emphasized strategies for attracting and retaining clinical talent, focusing on vision, high-end procedures, and a strong clinical ecosystem. QCIL highlighted its use of AI in patient safety, operations, and clinical care, including AI-enabled CDSS, call center support, EMR pre-population, and an AI-enabled radiotherapy platform. This focus on technology aims to enhance metrics and improve efficiency.

    This is an AI-generated summary of a publicly available earnings call transcript. It is for informational purposes only and does not constitute investment advice, a recommendation, or an endorsement. inve.money is not a SEBI-registered investment advisor. Please consult a qualified financial advisor before making any investment decisions.