Detailed narrative
Mexico Operational Enhancements and Growth Drivers
Mexico experienced an accelerated recovery in volumes during the quarter, with surgeries increasing 7% and oncology chemotherapies and radiotherapies rising 20% sequentially. This growth was fueled by improved tier classifications with major insurers, expanded oncology offerings, favorable pricing in high-complexity care, and the new ISSTELEON contract, contributing to a 4% year-over-year revenue increase. Despite a 16% year-over-year adjusted EBITDA decline due to talent investments, sequential adjusted EBITDA increased 3%, with stronger year-over-year growth anticipated in the latter half of the year.
Peru Performance and Billing Reconciliation Challenges
Peru achieved 8% revenue growth, driven by a higher average ticket and sustained membership expansion, particularly from a new B2B plan covering 7,000 employees. High-complexity surgeries and increased penetration of the B2B market also supported growth. However, adjusted EBITDA remained flat year-over-year, primarily due to accepted penalties related to prior year's billing matters and higher B2B onboarding costs. Management is actively shortening internal billing cycles and expects all prior-year reconciliation issues to be finalized during 2026.
Colombia Payer Diversification and Margin Improvement
Colombia made significant progress in diversifying its payer base, with risk-share agreements now constituting 24% of revenue, up from 14% a year ago, and covering over 3 million lives. This diversification contributed to 13% revenue growth and enhanced cash conversion. While adjusted EBITDA declined 12% year-over-year due to higher costs and wage increases, it showed a clear sequential improvement, increasing 18% with margins expanding 1.7 percentage points. Contractual price increases in the second half are expected to offset cost pressures and support strong EBITDA growth.
Strategic Capacity Expansion and Technology Investments
Auna is strategically expanding its capacity and technological capabilities across its markets. In Mexico, an Elekta EVO linear accelerator will be inaugurated in Monterrey in September to enhance oncology treatment. In Peru, a new clinical facility in Lima Sur was acquired, expected to be operational between end-2027 and early-2028, adding 30 beds and expanding surgical/chemotherapy capacity. Additionally, a Versius SP4 Robotic system was acquired to strengthen high-complexity surgical capabilities. In Colombia, operating capacity was expanded at the Monteria facility, adding 18 adult ICU beds and 24 hospitalization beds with minimal CapEx.
Strong Cash Flow Generation and Working Capital Management
The company demonstrated strong cash flow generation, with net cash from operating activities reaching PEN 441 million for the first six months of the year, a 45% increase year-over-year. Free cash flow grew by 181%. This performance was attributed to improved working capital management, higher collections recovery, supply chain financing initiatives, and the utilization of tax credits. The cash position increased 43% since year-end 2025, and the company maintains PEN 125 million in available credit lines.