Thank you. The first question comes from the line of Ruchi Mukhija from ICICI Securities Limited. Please go ahead. Ruchi, if you can please unmute your line and ask your question. Since there is no response, we move on to our next question, which is from the line of Sameer Shah from ValueQuest. Please go ahead.

Yes, hi. Congrats, great numbers. First question is if you would like to address the UnitedHealthcare news flow and the impact that it would have on our company. And second, you know these large deals that we have signed, typically when do they, when do they -- what is the kind of ramp up time that they would take?

All right. Thank you for the question and your compliments. Appreciate it. First, UnitedHealthcare. Look guys, it's obviously a difficult time for them. They have been hammered with three macro issues that have hit them sort of back to back, right? One of course is the HCC Version 28 that is compressing their margins on the Medicare Advantage contracts that they have, which is a big part of their business. Second, as you know, the CEO of their insurance business got assassinated just a few months ago. And third, they have this big security issue with Change Healthcare. So I will tell you that there are not many other companies in the world that can withstand three such back to back events that come at them in such dramatic fashion. Having said that, they are still the world's largest commercial health insurer. They I think have something like 60 million American lives insured, just to put that in perspective. And you know, the reality is IKS's relationship with UnitedHealthcare is through OptumHealth, which is about $110 billion subsidiary of UnitedHealthcare, which employs 50,000 plus physicians, the world's largest physician employer. And we obviously are building our care enablement platform for OptumHealth. And remember, our care enablement platform works on the non-discretionary spend, on the opex. And so our platform is all about creating more financial value from the opex that they're already incurring. So if you look at what's happening with us over the last 18 months, where they've been hit by these three dramatic events, I think our business with OptumHealth has grown at least 25%-30% if not more over that duration. So without going into any speculative thinking about what might happen, the CEO has changed. Look, the business isn't going anywhere. It's the world's largest commercial health insurer. It has too many lives where anything's going to go wrong. It's not like they don't make money anymore. They make money, but they make less money than they used to because of industry headwinds that they are facing. And so they're having a big valuation decline. And in a country like America, big valuation decline means CEOs have to take the hit. And so that's really what is happening. Our relationship has only grown over this period. And we have no reason to believe, based on the nature of our relationship, that these headwinds that they are facing create anything but tailwinds for us. Now, again, I don't want to be speculative, but I will tell you that from everything I'm able to see rationally, taking the emotion out, the OptumHealth relationship looks very, very strong for us going forward. The second question you have, Sameer, is as it relates to the ramp-up of the new strategic customer that we assigned. I will say, Sameer, typically what happens is full-platform execution takes somewhere between 4 to 7 months, give or take, depending on the size of the customer. And if it is one feature that we are implementing, typically that can come through in about 3 to 4 months. So that is the way to think about how these ramp-ups happen. And obviously, depending on which feature it is, how much tech intervention there is or not, some of this timeline can be accelerated or not. But generally, those are sort of good benchmarks to keep in mind as it relates to ramp times due to implementations.

Super. Thanks. I'll rejoin the queue.

Thank you. The next question comes from the line of Srivathsan Ramachandran from Avendus Spark. Please go ahead.

Hi. I wanted to get your thoughts on two things. You mentioned about the changes that are happening in the industry with some of the private equity capital and changes, right? This coupled with AI, how do you see it? Because the biggest difference from a business model point of view means the outcome-slash-output-based pricing model you had. Do you see customers or competition kind of changing this, offering other options which were in the benefits of technology and technology improvements within clients? Any big market changes you've seen because of these two changes that's happening in the market.

So, thank you for your question. I appreciate it. Look, as I was saying, when there is this much capital being put behind point solutions and there is a democratization and acceleration of the development cycles due to something like AI, obviously at a point solution level, the competitive intensity is going to go up, which is why if you remember one of our key pillars of our strategy is that we want to continue to strive to be number one or two or three in each of our features, while we are the only company in the world building the full breadth of the platform. And I think that really is addressing that issue, right? The reality is that Gen AI is commoditizing the rapid advancement of these features is a reality. Our alpha from that perspective is deep customer relationships that give us access to data and context to mature the Gen AI faster than some of these new competitors, even no matter how much capital they have. That continues to be an advantage for us is the deep, like think about it right now, GI Alliance, it's the world's largest installation of GI doctors by a long way. Like this number two player is probably not more than 300 or 350 doctors. These guys are more than 1000 doctors. Now think about our ability to build the care enablement platform for GI better than no matter anybody else that comes in with a large amount of capital, we naturally have an advantage, whether it's at a feature level for GI specialty or at a platform level. So I think, absolutely, we should expect more competitive intensity, we should expect more players at a point solution level. Our strategy to win at the point solution level is the deep customer relationships we already have that allow us to mature the data. And our strategy, obviously larger strategy to win against point solution vendors is this whole graduation towards platform buying behavior. Having said that, I think we live in a very, very disruptive world. And so one of our biggest opportunities is to stay extremely alert from a competitive perspective and track the implications of competition in the marketplace day to day.

Sure, thanks. I just have one quick question. The runoff of revenues on the Aquity revenue, you're more or less done close to the bottom of it. I just wanted to get your thoughts.

No, like I said, when I was articulating the sub vectors of that AQuity strategic pillar, that -- that tail cutting will continue to FY '25 and the larger part of FY '26. And so it is not done yet. And we will see, because remember, I said that we went from 850 total customers to 700. Our end objective is to be ending up somewhere between the 550 to 600 range. And so there's still some work to be done and there's still some customers left to be transformed from a U.S. based headcount operating model to a tech-led offshore headcount enabled model. So those two things will continue to FY26.

Sure, thank you. I will come back later.

Hi, thank you for the opportunity. Great set of numbers. My first question is, I wanted to understand your strategy on your top 10 clients. So if you look at your top 5 clients they do average revenue of around $15 million. You want to understand the potential for those top 5 clients. And what is our strategy to further cross sell or increase our wallet share there? And then on the next top 5 clients, wherein we do around $8 million average revenue. How do we plan to grow these clients?

Okay, great. Thank you for your question, Nilesh. So the reality, Nilesh, if you take our top 5 clients or our top 10 clients, all of our top 10 clients have a wallet possibility of at least $100 million a year ACV with us. So for none of our top 10 clients today, we can say that we are anywhere close to the full wallet potential that they have. Our largest customer, the full wallet potential is North of $300 million. So the simple math, whether you look at top 5 or top 10 is to continue to manifest the land and expand play that we have with them. And the fact that the top 5 and the top 10 are growing is actually demonstrating the fact that that land and expand play is continuing to work out. Now, the other thing that's happening in that mix is we are now starting because we are getting midsize customer and independent medical rooms that are manifesting the full platform, that list of top 5 or top 10 is rapidly changing. And that's why you see some of those vintages in those customers changing in the deck is that there are some new customers coming in with a full platform manifest that day one become a top 10. And so I think this top 5, top 10 is still a little bit immature. The way to think about it is we are nowhere close to full wallet share in any of our top 10 customers. Some we have more headroom, some we have lesser headroom, but there's headroom across all and then the top 5, top 10 list, hopefully, if we execute well on our strategic vectors is actually likely going to change over the next, say, two, three years. Because if we keep landing more and more platform customers, they naturally graduate to the top 10 faster than some of the other customers.

Okay, given it's dynamic, if you acquire, you might like last year you acquired Palomar type deal. So that would change the top 10 clients given the so how should we look at the growth on that side? So your top 10 clients and then obviously, under the rest of the clients, obviously, depending how you cross sell them?

Nilesh it is very hard for me to give you a way to model that, the way what I would model is every year 80% plus of our growth will come through expansion of existing customers and under 20% will come to the addition of new customers that I can tell you, but it's very hard for me right now in this relatively immature marketplace, where there are so many dynamics graduation from one solution behavior to platform behavior in certain market segments. Full adoption of features by large health systems that we traditionally not seen, it's very hard for me to give you how to model our top 5, top 10. I will just say 80% of the retail growth, 80% plus from existing customer expansion and under 20% from new customer acquisition.

Okay, my second question is we have seen a good amount of reduction in your employee count by almost 450 employees from the previous quarter. So what is driving this efficiency and how do we see the employee count grow for the next FY26?

So Nilesh the way to think about is Nithya has this statistic, I'll ask her to tell the specifics of it where for FY20 to 24, our revenue grew significantly faster than our headcount. That non-linearity demonstrates the power of our technology led disruption. And there are two vectors in our technology led disruption, where we go human led to tech led, which is incremental reduction of headcount for the same solution. And then there's human led to fully autonomous, where the disruption of headcount is significant. And that is also being manifested predominantly in the AQuity customer base where we've dramatically transformed the AQuity margins from where we acquired them. So that's the way to think about it, we will continue to drive non-linearity. We have remember now I think about 460 odd technologists that are writing a lot of this proprietary technology. We have a GenAI center of excellence that is producing a lot of this technology. And so that trend is going to continue after Nithya if you have that statistic.

So the employee count reduction you're seeing in Nilesh is predominantly driven by the fact that we have been able to deploy both IKS as technology as well as the transition between onshore and offshore. If you look at legacy IKS, what we have been able to demonstrate in the past is non-linearity between revenue and employee count growth. If you go back and look at FY20 through 24, our revenues grew about 25% and in the same time frame, our employee count grew only 10%. So as the tech matures and I think Sachin has mentioned several times before, it remains a very high priority for us and we continue investing there and therefore we hope to do as much or better in terms of our ability to drive faster revenue growth with lower employee count growth in the future as well.

All right. Just a last question or broader question on the industry. Like you mentioned, majority of the private equity players have been acquiring point solution based companies and focusing on the RCM side. So and these companies have not been able to make a profit as you know IKS has been able to generate. So what do you think why these companies have been able to - - have been facing such challenges given you are the leader making top 30% margins and they have been not able to even make double digit. What do you think is the challenge they are facing and what we are not facing?

So Nilesh, I will try to refrain from commenting on what they are not doing right. I can tell you what we are trying to do and what we are trying to do is -- IKS built a business model where our pricing was outcome based. We get paid as a percentage of the customer's revenue and so that's when you combine that with our ability demonstrated ability to constantly drive non-linearity by reducing the headcount required for a particular task at the unit task level that naturally creates a margin accretive business model in which the customer certainly wins because we are actually collecting more and more for them and we win because we are able to collect that at a lower cost and since your question was RCM only I am focusing on that. So it's based on the inherent structure of the business model that we built from the get-go that perhaps we are able to drive margin superiority and that is also one of the other reasons why I said that we will continue to make that outcomes orientation one of the five strategic pillars that we will execute on now not just for RCM, but for the entire platform because I actually fundamentally believe when I talk to buyers across the country. I'm finding that there is a fatigue emerging in buyers of buying the next best AI point solution and then figuring out whether it delivers value or not and if they find models where their outcomes are aligned to the vendor outcomes I think there's a different level of proclivity to that construct. So again I've been refraining from commenting on sort of what they are not doing right because I'm sure they're very smart companies and they'll figure it out, but my best guess is that the fundamental structure of our business model and our execution driven around it is what has driven our margin superiority.

Okay. Thank you so much and all the best. I'll join back in the queue.

Thank you.

Thank you. The next question comes from the line of Seema Nayak from ICICI Securities Limited. Please go ahead.

Thanks for taking my question. My question is more towards the sector. So what percentage of our revenue is from Medicaid and how does the reduction in the Medicaid spending impact the provider ecosystem?

Great question. Thank you. So please understand that our customers tend to have a fairly healthy payer mix depending on specialty. Some of them have no Medicaid at all and depending on specialty they do have Medicaid and so I don't know that I can give you the Medicaid percentage of our revenue across our entire customer base. If I were to hazard a guess it's probably less than 10% across our entire customer base. Having said that again I keep reiterating this look we are in the non-discretionary opex business, so when reimbursement per unit of care is cut which could be first of all to understand the Medicaid policy they are not cutting the let's say that today the government reimburses $100 per unit of care for Medicaid. That $100 grows every year based on a certain rate of inflation. What the government is saying is if it was growing at 4% a year, they're going to reduce that growth from 4% to 2%. So first of all on an absolute basis the reimbursement per unit of care is still going to grow. The growth will contract and second when the reimbursement per unit of care is not growing as fast and their costs are still growing dramatically it actually puts more pressure on the customers to adopt our model further. So from my perspective I don't look at the Medicaid growth contraction not Medicaid contraction. But the Medicaid growth contraction, I don't look at it as a headwind for us and of course it's a small percentage of our overall payer mix but nevertheless, tomorrow the same phenomena is being faced in Medicare physician fee schedules as well, and in my opinion that's an imminent tailwind.

Yes, thanks and one more question recently there is a news that Aetna is leaving the US healthcare space so does that affect us in any way?

I'm sorry, I couldn't catch that question ma'am. Can you can you repeat that slowly sorry?

So, Aetna is going to leave the US healthcare insurance space so does that affect us?

No not really.

Okay, thanks. I'll get back in the queue.

Thank you. The next question comes from the line of Chetan Shah from Jeet Capital. Please go ahead.

Hi, thank you Sachin and team and congratulations for a great set of performance over the years. Just two quick questions in your opening remark you mentioned about intensifying competitive scenario, and also in one of the questions, you said that it is still a still a premature stage, because the competition is in a in an investment mode and they are not exactly providing the full-fledged service the way what we are doing the business. So my question is how do you see this, this thing evolving over a period of time and in terms of business model and margin, how will this impact us? That is the first part of question. And second part of question is the kind of cash flow what we generate do we have any plan apart from reducing our debt from the books and in terms of any kind of inorganic small or large opportunities something what we did in last 6 to 8 quarters? These are the two broad questions. Thank you so much and once again congratulations.

Thank you for your kind remarks and thank you for the question. See look in terms of what the future might hold in terms of growth of revenue and margins, like I was saying earlier because of the relative immaturity of this market remember only $35-odd billion of now over the $270 billion TAM is outsourced so far so it's highly immature it's very fragmented competitive intensity is increasing. So, it's very hard for me to hazard a guess by which you can model, but I understand you guys have to model so which is why I've always maintained look if the outsource TAM is growing at 12% my point is if I'm growing faster than 12% I'm gaining market share, if I'm growing slower than 12% I'm losing market share all I'm able to say is if the outsource TAM is growing at 12% I think we will grow faster than that outsource that outsource TAM, now that growth accelerates to 15% and we gain market share it will be faster than 15%. If that growth de-accelerates which I don't see de-accelerating it might be lower and then the other thing I'm able to tell you is based on everything I am seeing, I have confidence that for the next several years our margin growth will be faster than that revenue growth that I'm talking about. So our focus is on gaining market share versus trying to predict the exact trajectory of growth and our focus is on continuing to prove the superiority of our model by having industry leading margins that continue to grow faster than the revenue growth, so we're trying to tell you that its very hard to tell you what the revenue growth and profit growth will exactly look like. That's number one. On cash flows a great question look I think, if you see our 18 years of history we are not a natural acquirer type of company we are very organic growth based company we did a very significant acquisition in Aquity we have taken a good 18 months to digest integrate that's we've laid out the four key vectors within acuity that we are executing on, we have perhaps complete execution on two of the four vectors, two are still ongoing. I think our stated strategy is not to acquire our stated strategy is to grow organically. We might have some uses of capital periodically in these type of unique outcome orientation deals where we might be able to participate in the outcomes that we create for our customers thereby demonstrating skills again and driving that type of platform behavior. So those might be smaller uses of cash than a typically large acquisition. Also just genetically our leadership team is not very comfortable with debt even today our debt is I don't know 0.6x something like that EBITDA and we would like to operate conservatively in a manner where eventually there is little to no leverage in the business. So stated strategy not acquisition oriented never say never but there might be some uses of capital in outcome oriented deals with customers.

Thank you so much Sachin for this, I'll come back in the queue. Thank you so much.

Thank you. The next question is from the line on Nilesh Jain from Astute Investment Management. Please go ahead.

So, like last year we did Palomar type of deal wherein we paid an upfront amount. Are we looking for any such more type of deals for FY '26 or in FY '27 as well?

It was a great question, thank you for the question. See if you think about the Palomar deal shortly after the Palomar deal we did another deal that I just announced called Sky Lakes which is in that mid-size health system segment, and that Palomar deal by upfronting the incentive we created a precedent of a large mid-size health system embracing the full platform which has already paid dividends not only in Palomar but now paying dividends in the construct of Sky Lakes, as well because they got the confidence that another peer health system was able to you know embrace the full platform successfully. And of course in Sky Lakes we did not have to incentivize them with any sort of outcome orientation. So, Nilesh, I think the short answer is in each of these market segments smartly and strategically we might do one or two example deals that might play out over FY '26 and FY '27. But it is not the way we are going to continue to operate. So, yes it's possible that there might be two three more deals for different market segments that might emerge over the next 12 to 18 months, but we feel very confident about our strategy and the other thing I want to lay out is we are very disciplined about tracking our return on capital in scenarios like that and so not only will those deals obviously create traditional margins by the full manifest of our platform. But we are very clear that to the extent there has been capital deployed there to incentivised those deals, or the creation of those deals, we will be religiously tracking our return on capital on that as well. So in the end our simple thesis is either we produce superior return on capital for our shareholders or we give them the capital back. Nilesh Jain All right. Just a bookkeeping question for Nithya, in the balance sheet the other financial asset has gone up from INR21 crores to almost INR111 crores what exactly would be that?

Other financial assets the Palomar upfront guarantee that we had paid out that is booked in other financial assets.

Okay, sure. Thank you.

Thank you. We have the next question from the line of Siddharth Misra from Fidelity International. Please go ahead.

Yes. Hi I had just one question. Could you talk about your pipeline and the details around the pipeline?

Can you hear us Siddharth?

Yes I can hear you. Can you hear me?

Yes. thank you for the question. Traditionally we haven't published our pipeline or the details but I can say confidently that when we look at all of these three market segments that we are focused on the mid-size health systems, the large health systems and the independent medical groups that might be single specialty or multi-specialty might be publicly traded or private equity owned. We are obviously tracking pipeline by each of those market segments and the pipeline seems to suggest that we are at an all-time high in terms of where the pipeline stands. Now I will say that the buying cycles are still a little immature, so I'm not in a position to predict the conversion rate. The reason I'm not publishing the pipeline. Siddharth, is because I see so much immaturity still in the buying behaviour in the conversion cycles and so as we start to get data that I think starts to make a little bit more sense that can allow you to model conversion timelines and dates, we'll be able to talk a little bit more about it. But I will say that activity for us right now is at an absolute all time high.

Okay thank you.

Thank you. Ladies and gentlemen with that we conclude the question and answer session. I now hand the conference over to Saransh Mundra AVP Investor Relations. Please go ahead.

Thank you everyone. Thank you for joining the call. In case of any further questions please feel free to reach out to us. My email id and the Investor Relations email id are there in the press release and the link for the call. Thank you.