Global Health Limited analyst Q&A

Thank you very much. We will now begin the question-and-answer session. The first question is from the line of Tushar Manudhane from Motilal Oswal Financial Services. Please go ahead.

Thanks for the opportunity. Congratulations on good set of numbers and happy Diwali to the entire team. Sir, my question refers to more on the Patna. If you could share some ballpark profitability for Patna Hospital now?

Sorry, could you just repeat that question, Tushar, if you could share what about Patna?

The profitability of the margin side Patna for first half FY ‘24 or 2Q FY ’24?

So, Tushar, as you are aware, we reported the numbers on the quarterly basis for the mature and developing hospitals separately. You will get a chance to see the GHPPL, which is our Patna facility at the end of the year. What I can share with you is that overall we've seen very strong and robust growth in Patna. If you recall, our financial year FY ‘23 , we had ended with approximately 10% EBITDA margin, and that has grown significantly during this quarter. You know, getting to a very healthy profitability margin and almost doubling the kind of profitability. If you look at our growth across Patna, it has come in from good amount of addition of clinical talent, ability of the teams that were already existing to expand their scope of services because of the additional operating rooms that we've been able to add. Of course, a normal growth happening because of the increased awareness of our facilities, and we see now patients coming in from vario us parts of the region as well. Overall the Patna growth story continues very strongly. We believe that just in the seco nd year to deliver these kind of EBITDA and profitability metrics is not a small feat. However, I would like to add that we have still quite a long way to go in Patna. We've got a lot of growth still to come. We've got clinical talent still being on boarded. One point, I think which may be important to note with respect to Patna, as you may be aware, it is a public-private partnership with the government of Bihar. And this quarter, we have seen the government patients start to now flow in. While this activity has taken some amount of time to get started because of various logistical challenges, I'm pleased to report that we are now able to service the patient community, which is being referred to us through this partnership with the government of Bihar. So, on an overall basis, I think strong performance in Patna, and we're very happy with the way that is growing up.

Understood, sir. That's helpful. At the same time, ARPO B for developing hospitals is pretty stable now for almost three quarte rs, four quarters, while we have been adding clinical talent. So, any thoughts over there?

So, when you look at the ARPOB across the developing hospitals, one, of course, we don't really look at this on a quarter -to-quarter basis. There is so me amount of fluctuation and seasonality depending on what is the disease profile. But if you look at this across the year, what you will find is that Lucknow Hospital, which has been now in operations for just about four years, we haven't really taken any tariff increases in that at all. So, a lot of the growth that you see coming in, not only in terms of ARPOB, but also in terms of the average revenue per patient, is largely driven by the volume growth and as that expands. Some amount of this is a little bit dilutive in this quarter, because the patients who come in for dengue and some of the other medical management patients typically have a little bit of a lower realization. But more than a lower realization, you will notice that the average length of st ay also has increased a little bit. So, of course, that has a dilutive effect on ARPOB. Patna, of course is a newer facility there we haven't taken any tariff increases as well. So I think that as we look at the years coming forward or the months coming forward, we will evaluate what is the right time to look at tariff increases in both these facilities. But we do also expect that as the sales mix stabilizes beyond the seasonal fluctuations, you will see a better picture of how this ARPOB moves on an annualized basis.

Okay. And sir just lastly, for this 100 beds addition at Gurgaon, so how much is the approximate investment and when would they be operational?

Sorry, for Gurgaon, how much is the what? Sorry?

100 beds, the presentation indicates 100 beds will be added at Gurgaon. So just would like to understand how much is the investment and when will that be operational?

As we have mentioned before, the bed additions in Gurgaon are largely link ed to some amount of interior work which is happening. So the capex on that is fairly limited. We'll be adding one complete floor of our mother and child services. We added in this clinical team towards the end of last financial year. And their working space or their area is being outfitted. We expect this to be on-board by the start of the next calendar year. So that work is underway. As far as the capex goes, since it is really just an interior fit out, it is almost negligible amount of capex that is involved because there is no incremental build, which is happening in terms of civil infrastructure in Gurgaon. The second area is our medical oncology floor, which we are renovating, as we may have mentioned as well earlier, converting additional chemotherap y beds, scaling that up. And that also is more of a renovation and an increase in capacity in our existing infrastructure. So also fairly negligible capex. As far as the capex goes for Gurgaon bed additions, I would say, it would be negligible. However, as we look forward, we do anticipate some amount of capex, maybe somewhere in the range of maybe INR70 crores to INR100 crores over the course of the next year -plus, which would be largely medical equipment refresh and upgradation of technology in our Gurgao n facility. To answer your question, the bulk of the capex, which we anticipate coming in in Gurgaon, will be more around technology than around infrastructure.

Thank you, sir. Thanks for the elaborate answer and all the best.

Thank you.

Thank you. The next question is from the line of Jainil Shah from JM Financial. Please go ahead.

Yes. Hi. Thank you for the opportunity. My question is on the capex. So like which other regions are we targeting now? We have announced Indore, we have announced DLF JV. So, which other regions are we planning to expand?

I think with respect to capex, as I said, I let Sanjeev handle that. But a little bit respect to what the capex that we have already visible. I think really your question is not just capex, but around, where do we see additional facilities coming up? When we look at Medanta's approach to care, we have always maintained that our approach is to make sure that we are able to deliver a very high-standard of care at the right complexity and care level. We are more in the business of bigger, definitive steps, high -end, high-complexity kind of institutions. We have also articulated that we believe that in the immediate future , our strategy will remain focused around central India and north as a region. We are currently evaluating opportunities in several cities in these regions, both in territories where we already have existing hospitals as well as in newer cities. A lot of our thought process around this is to make sure that we are able to get the right asset or the right location at the right scale. Therefore, as we think about this growth, which you will, of course, come to hear about as and when we conclude on that, it has to be the growth which links up to our strategic footprint. Last quarter, we articulated that the strategy around our facility in Delhi was not only to look at Delhi as a stand-alone facility, but actually to look at the entire NCR region now linking up to start with our Gurgaon facility, our Noida facility and then our Delhi facility, which very nicely links up along a major arterial road connecting these three facilities. So we do have thoughts on how we can serve the people of the NCR region, but also other areas in Uttar Pradesh. We already have a big facility doing very well in Lucknow. And obviously, with the success of that, there is a demand from the communities to see if we can provide additional services there. But also, as I mentioned, other cities beyond our existing regions continue to be in focus. As and when these become slightly more definitive, we will definitely share them with you and the larger community.

So, sir, can you specifically call out which cities are these and what would be the asset size that we would be looking at? And what kind of business model or rather how would we be financing it? So will it be a pure green field? Will it be in a partnership? What is the thought process there?

Jainil, you would obviously appreciate that there is only so much that we can call out, both with respect to where we are on what is definitive as well as in context of, too much crystal ball gazing into the future, which may or may not be allowed. So I'm not at this point in a position to give you specifics on which city we're looking at beyond what I've said. As far as the partnership model, you're aware we just signed the deal with DLF. So obviously that is a partnership that we feel is a very strong and well-respected partner. You are also aware that the O&M model where a partner would build out the warm shell and hand over to us is something that we already are looking at doing. And then, when you look at our balance sheet, I think Sanjeev mentioned we are already sitting on approximately INR600 crores of net cash. So we do have a fairly healthy balance sheet to be able to look at opportunities directly, both in terms of greenfield or brownfield or acquisitions as they come up. So I think we are not constrained on any one particular model. However, the model has to make sense for that location and has to make sense from a quality and our brand point of view, as well as from a financial point of view. The one thing that I can say for you is that we will unlikely make very small bets. So you a re unlikely to see, 70, 100 bed big footprint facilities from Medanta, especially if they're in the greenfield arena. They will typically be larger in size. Now, again, a city like Lucknow, a 1,000 beds may also be too small. But we believe that certain other cities, like, for example, Indore, 300, 400 beds is an optimal size. So the size of the facility will be linked to the territory, but it will be a substantial facility for the most part. So I think the sweet spot we typically believe is 300 beds and up wards is a good size for the kind of care that we deliver.

So that's helpful. I have a few questions, but I'll get back to you. Thank you.

Thank you. The next question is from the line of Bansi Desai from JP Morgan. Please go ahead.

Yes. Hi. Congratulations on a good set of numbers. My question is on occupancy. So we've seen very strong outcomes in this particular quarter, both in mature and in developing clusters. And for mature specifically, the increase is not just quarterly, but even on a year-over-year basis, we are seeing a 500 basis points of expansion. So I understand international patients has grown significantly for us. But should we consider this as a new base and barring quarterly fluctuations? You know, can we expect your overall mature cluster to trend at 65% and then, above?

Bansi, let me answer that on two, three dimensions. First of all, as far as the mature hospitals goes, we have seen strong growth coming in from all specialties, not just t he specialties, which are a little bit more seasonal in nature for this particular quarter. And as you very rightly pointed out, this growth is not just a quarterly growth. This is actually growth, which we are seeing on an annualized basis. I would also l ike to just refer you back to the strategy that we had articulated, several quarters ago where we really talked about investing in and focusing on our core capabilities. So if you recall, I think it was in our last quarterly presentation or maybe even both the last earnings calls, we have mentioned that we have made very significant clinical additions in our mature facilities. Almost 80 doctors added in during the course of 12 months in our mature facilities, which is for the most part, in case of Gurgaon, over 10-year old facility. So what we are really doing is delivering and executing well on what we had said. And some of that is now playing out over the months, which you are seeing. So what you are actually seeing is the playing out of the new talent coming in, the new equipment getting utilized, and all of the strategies around hardcore execution and focus on our operations and our quality. And that gets reflected, whether it comes in this quarter or the previous quarter. Yes, there is some amount of sea sonality with respect to internal medicine, dengue, etc. But frankly speaking, we've seen a little bit more of that in our Lucknow facility than our Gurgaon facility. This is how we see ourselves playing out. Like I said earlier, we don't necessarily just look at this on a quarterly basis. We are committed to putting in place all the tools that allow us to grow consistently and in a stable manner over the period. And by the way, we are still adding in clinical talent into our mature facilities and, of course, also into our developing facilities. So from our point of view, the growth in clinical talent, technology and patient servicing in terms of volumes continues. And we do hope that that will play out as the quarters go forward. There will be some seasonality that changes based on festivals, typically the Diwali time is a little bit more conservative in terms of elective procedures. But these things, even out over the course of the year, which is really how we look at it. So that's our approach. Just to touch on quickly on the developing facilities, Lucknow, pretty big now in terms of 600 beds. But like I said, adding in about 100, 150 beds there. So we do anticipate growth coming in Lucknow in terms of bed addition as well. We are also adding in clinical talent into Lucknow. In fact, both going deeper in the existing specialties as well as filling out other specialties that may not be as mature as some of the others. So Lucknow growth will continue both on beds as well as in talent. Finally, Patna. Patna is, as you are aware, is little bit further behind. So that talent will continue with addition and that bed growth will continue. And frankly, in Patna, we've already seen very high demand, especially for services like critical care, emergency care, etc. S o we are trying to ramp that up as fast as possible. And our immediate focus actually in Patna is to add in approximately 40, 50 ICU beds because there's a big demand for it. And then lastly, as we move, it's not a quarterly play, but as you think about the next 12 months to 18 months, we do already have our sights set on the talent that will be required to get Noida off the ground. I may have mentioned earlier as well that we have already started to look at some of this talent coming in in advance so that we can get everybody geared up to the Medanta way of functioning and also get as advanced a team as possible ready so that we can hit the ground running in Noida. So that's how we look at it across all the three pools of developed assets, mature assets, developing assets, and then the upcoming Noida facility.

Understood. Thanks for that. And therefore, just thinking from a profitability standpoint, if we continue to see, improvement in our occupancies at both these clusters and given the bed addition, barring Noida is not going to be significant at Lucknow and probably is also measured in case of Patna as well. We can continue to see improvement over the current levels as well, right? Because the drag from the newer units are not going to be as much. Is that correct understanding?

So just to clarify, we do have, on a base of 600 beds in Lucknow, we will be adding approximately 130 to 150 beds. So from a percentage capacity increase, that is not a trivial amount. So there will be som e addition. However, as you rightly pointed out, a lot of that addition is going to be in, because of the way in which we build out within the existing structure. As far as the profitability and the drag goes, look, I mean, you all are better experts to k ind of project some of these things out. The way I think about it is that when you look at the company as a whole and you look at the portfolio of assets that we have, we feel fairly confident about how well balanced portfolio of assets we have . So you've got a strong and so to speak, well - sweated asset in terms of our mature facilities, of course, led by Gurgaon and very big in scale. That's delivering well. And as that volume scales up, obviously, you get the benefits of profitability coming in there. Lucknow is now hitting a little bit of a more mature state, even though we're still growing there. And there we see as we add in volumes, as we add in capability there, you will obviously see some amount of operating leverage benefit. And we still don't have any subsidized patients as such in Lucknow.So that's all at a fairly healthy realization. And then, of course, Patna, Patna as it scales up, you will see the EBITDA profile increase there as well. So the drag that, may come in maybe next 12, 18 months as we start to put some expenses into the pre-operationalization of Noida, kind of gets well balanced out as the operating leverage kicks in in some of the developing hospitals and as we continue to grow in our Gurgaon facilities. Overall, we're not very concerned about, how this moves. But like I said, we don't view this on a quarterly basis, but a little bit more longer term. But I think if you look at this across the year, we feel fairly good that we have got this portfolio well balanced to be able to mana ge both the profitability ups and downs, as well as the investment that will be required to build out into the future.

Got it. This is very helpful. Thank you. And I wish you a happy Diwali.

Thank you. And to you.

Thank you. The next question is from the line of Rishabh Tiwari from Allegro Capital Advisors. Please go ahead.

Hi, thanks for the opportunity and congratulations for the amazing set of numbers. Just wanted to understand the capex cycle reg arding the INR100 crores mentioned for the medical equipment's and technology upgradation of Gurugram facility. So how what is the capex cycle of such kind of cost increase that we incurred, say, four years or five years? Because it was also mentioned that Lucknow facilities are on four years old now. So maybe in a year or two, that would be would be incurring such kind of expenses at other facilities?

Let me hand over to Sanjeev to give you a slightly more holistic perspective on capex beyond just the medical equipment. But looking at how we're thinking about this over the next couple of years. So, Sanjeev, you want to give a quick overview on the capex?

If we actually look at the capex, we need to incur capex on three things. O ne is the increase in actually capacity in case of Lucknow, which is expected to go from 601 beds to almost 950 beds. So I think that's that one area of capex that we really need to incur. The second area of capex is that when we actually have to increase the capacity in case of Patna, which also has to go up to almost 650 beds. The third place where we will be incurring capex would be would be in Noida. And in case of Noida, this is going to be a 550 bed facility, which we have already said that we will ha ve 300 beds, you know, in the initial phase. So these are three places as far as the capex is to be incurred in terms of the existing projects. And apart from that, there would be a maintenance capex. So as to say for the purpose of technology upgradation or, you know, maybe some of the assets which are getting worn out and need to be replaced. So primarily when we look at these four segments, we actually find that we are likely to spend almost in the region of INR1000 crores to INR1100 crores over the nex t three years or so. Out of which the maintenance capex, which you look at in case of Gurgaon, we have been seeing that it would be somewhere in the region of, almost INR60 to INR75 crores on an average in some years it could be lower and actually some years could be higher.

Also, just to clarify on the question around the Lucknow four years, much of the medical equipment is in the nature of bigger assets, CT -MRI, cath labs, etc. And their life cycle is not four years. It's actually closer to 10 years. So, some of our assets in Gurgaon are now running for 13 years and running very well. So just to give a clarity that the medical equipment, especially the bigger, more expensive medical equipment does have a longer life than the four years you articulated. It's probably closer to, you know, eight to 10 and in some cases maybe even longer.

Thanks for the clarification. And what would be the maintenance capex at a consol level?

What is a maintenance capex at a consol level?

At a consol level, as I explained that probably in case of Gurgaon, it would be a capex. But in case of MHPL, which is Lucknow and at Patna facility, at present, they may not be major maintenance capex. So it would be largely only in ca se of their matured units, which could be in the region of approximately INR60 to INR75 crores per annum. In a particular year, it may be lower or higher, but it would be within this range.

Thank you.

Thank you. The next question is from the line of Sourabh Kapadia from Sundaram Mutual Fund. Please go ahead.

Yes, thank you for the opportunity. So first question on the, how we should look at the ramp up of the new beds, both at Patna and Lucknow? And will that change the payor mix in the overall company?

Okay, so let me go aspect by aspect, since you asked about Patna and Lucknow. First, Patna, we are currently at about 358 beds in Patna. And as I mentioned, we are building out about 50 beds more. Those 50 beds actually for the most part are ICU beds, although we are also adding chemotherapy, dialysis, etc. beds in those facilities. So some of the demand for the beds in Patna are actually linked to, potentially higher realization patients because of the fact that it may be critical care. We are already operating with about 84 ICU beds in Patna, but we will be building out. So that asset will go from somewhere around 350 beds today to maybe, a little bit over 400 beds, maybe 410, 420 beds by this end of this financial year. As I mentioned already, that is part of the existing build out. So the bulk of that capex is pertaining to interior fit out, etc. Largely, again, for the ICUs that we're building. One important point also is that our radiation onco logy services in Patna, as we speak, not in quarter two, but post end September have actually begun. We have started our radiation oncology services in Patna as well and in the coming weeks, we hope to have an inauguration there of that facility. And so that should help ramp up our cancer services in Patna as well. So that's how we see the bed build out happening in Patna. As far as the supporting clinical teams, etc. there, I would say for the most part in place, we would have some additional doctors being hired in to manage our ICU, etc. And of course, the supporting staff for that as well. When it comes to Lucknow, we have already got 600 beds operational in Lucknow. And out of those 600 beds, about 200 beds are ICU beds. So there is a strong demand for adding in some of the ward beds in Patna. So not only will we be adding ward beds across specialties, but there's also some talk about increasing our mother and child capacity there, because we have seen a very, very strong response of our mother and child services in Lucknow. As I mentioned, somewhere around 100, 150 beds getting added in to Lucknow, mostly ward beds, and that will scale out. Now, in Patna, to answer your question on a payor mix, Patna may see some slight shift in payor mix because of th e fact that the PPP work has really only started towards the latter part of the second quarter of this year. As that scales up, you will see that not only the regular cash and insurance business, but you may see some of the PPP mix come in as well. As far as Lucknow goes, currently no real change or no real plans on any changes in the payor mix. But we do believe that that should be able to sustain us towards the end of this financial year as well. So no changes in Lucknow payor mix anticipated.

Okay. And my second question on the long -term margins for these developing hospitals. Right now, it's much higher than the mature hospital, but if you look at two, three years down the line, how would you look at the margin profile for these developing hospitals?

Again, you're asking for a little crystal ball gazing. I would definitely say that the margin profile on the developing hospitals has been very strong. Obviously, a lot of that is currently our Lucknow facility, which, as I mentioned just earlier, is currently 100% cash and TPA business. So, you know, as Patna becomes a little bit more part of this, you will see Patna contributing a certain percentage to that profitability or a greater percentage to that profitability. And so Patna does have a lower margin profile than Lucknow. As well as when you look at this out by the end of this year, we will probably be somewhere around 700, 750 beds in Lucknow, around 400 beds in Patna. And we don't see very significant shifts that will happen there. But as you move forward, there is possibilities that you may have different payor mixes kicking in. But then also, as I mentioned earlier, you we have not taken tariff increases in these two facilities. So you will have the positive impacts of tariff coming in. Hence, I think the way to think about the margin profile is on levers. Right. So there are some levers which may be slightly dilutive, lower tariff patients in terms of PPP, lower pricing maybe as compared to both the developing hospitals, which is Patna versus Lucknow. Patna tariffs are slightly lower, but then there are positive levers as well. One of those positive levers was on the margin profile is, of course, tariff increases that may get taken. And then very importantly, you have operating leverage. So just don't forget that we have a fairly robust teams in place in both the institutions. And many of those teams are in place to cater to the full facility, not just the 600 or the 300 beds that are there right now. So as the facility scales, the costs should not scale linearly. And therefore, you should get the benefit of operating leverage kicking in as we move out on this. So I think overall, we feel fairly confident about the margin profile in the in the developing units. But there will be some up downs as we move along the quarters over the next few years.

Okay, thank you. And all the best.

Thank you.

Thank you. The next question is from the line of Alankar Garude from Kotak Institutional Equities. Please go ahead.

Hi, thank you for the opportunity. Sir, my first question is more of a continuation of the previous discussion. If you look at our margin profile between mature and developing, there is a big difference, as you said, almost 10 percentage points. Without giving any numbers, is it possible to broadly rank all the five facilities in the order of their profitability?

Alankar, today, when you look at our Gurgaon facility, all the so-called corporate overhead costs are fully accounted for in our GHL, which is our mature facility. So logically, if we were to look at a costing or a profitability by assets, it would make sense for some of that cost to be apportioned across all of the units, on some basis, maybe re venue or whatever. So you will definitely see some dilution of the EBITDA profile in the developing hospitals and some increase in the mature hospitals to the extent that that margin profile gets spread out across. I think it's no secret, even if you look at the full year financial results, which declare out the three entities, which we have, which is MHPL, GHPPL and GHL, that currently on a percentage basis, the Lucknow facility has got the highest margin profile. And then, I would say, that the Gurgaon facility would be, next in line. And, of course, Patna is little bit unfair to compare financially on FY ‘23 margin profile or even now, because it's still very new compared to the other two. And it's a question of about a year and a half of full operations in Patna versus about four years in Lucknow and maybe, about 10 years, 12 years in Gurgaon. I would say that, since you asked for a ranking, that's how I would rank it. But I don't think that it is necessarily a fair ranking, because in some ways, they're all running in slightly different races or at slightly different periods of time. And that, as I said, from a portfolio level is actually quite beneficial.

Fair enough, Pankaj. That's helpful. The second question is, if you look at, I mean , Patna and compare it to Lucknow, if I exclude the difference, which will potentially come up in the future because of the PPP partnership, is there any other fundamental reason which can lead to our margins in Patna being different than Lucknow?

I think we should be very clear. The market in Patna is not at a tariff level or a patient realization level as high as Lucknow. There is definitely a gap of around 10% to 15% from a realization point of view between Lucknow and Patna or UP and Bihar, you may say. So there is absolutely a difference in that vis-a-vis the two units, not just linked to PPP or payor profile. The second thing is that, because of the historical nature of the clinical talent in Lucknow and because, frankly speaking, of the exceptionally fast ramp-up that we saw when Lucknow opened. You may recall Lucknow opened right around COVID time and while everybody else was struggling, Lucknow just took off like a rocket. So, we did get a very, very fast ramp -up and therefore a fast re covery of costs, although we have been able to breakeven in almost all our facilities within one operating year. But Lucknow had an exceptionally fast ramp-up, even better than what we had anticipated. So I don't think that payor mix is the only reason. I do think that Lucknow benefited from that fast ramp-up. Patna is moving along very well, but a little bit more slow and steady. And maybe everybody has got a little bit spoiled with the speed with which Lucknow achieved whatever it achieved. But I think if you compare Patna on an overall basis at the size it is, I think and you compare that across industry, I think also doing exceptionally well in terms of how it ramps-up. But I do believe that the EBITDA profile between these two facilities will be slightly different in the long run as well, just because of the nature of the market and the payor ability in these markets.

Sure, that's helpful. And one final question. How has been the offtake of this PPP partnership over the past few months? I mean, broadly in terms of patients, how many patients are being admitted on a daily basis? Are there more efforts by the government to kind of spread awareness about this partnership? Any color on this?

Just give you the quick context. You may be aware that there had been some logistical challenges with respect to how we can actually operationalize this partnership in terms of things like building out the website and how the various government authorities can send in and refer the patients to our facility in Patna. That, for the most part, has been fixed. The websites are up. Access has been given to all the government medical colleges and other appropriate officers by the government authorities. And they have been very, very supportive in this. I must say that across the board, the partnership is fairly strong. The support from the government authorities has been very, very good. And we have also been helping them to build out this. We have right now a majority of the patient population still coming in from the Patna area. And we are actively working on our side as well as the government is working to actually spread this information to all the districts where the patients can be referred from. So today you see, I would say almost 80%, 90% of t he patient population still coming in from Patna . As far as PPP is concerned, we do believe that in the coming months that will spread out to all the government medical institutions around all the districts of Bihar. And we will see patient flows coming in from those regions as well.

I'm sorry, broadly out of the 25%, what would be the occupancy right now negligible?

It's right now negligible. If you look at the Q2 numbers, because this really started in maybe last couple of we eks of September. So as far as the occupancy percentages come in, it's almost negligible. And we haven't really captured exactly the occupancy for PPP versus cash separately. As we scale that up and as we see the volumes grow, we'll assess whether that's something that we can capture and report.

Just to add to that, Alankar, I think the good thing which has happened is that the process has started. You know, all the processes of escrow mechanism, etc, that is now settled. So we have received the actual payment of the very first set of such PPP patients. So I think those systems have been now established and then in the subsequent quarters, we will see much better inflows on account of PPP.

Understood, sir. Thank you and wish all of you a very happy Diwali.

Happy Diwali to you as well.

Thank you. We have no further questions. I would now like to hand the conference over to the management for closing comments. Over to you, sir.

Thank you very much. And on behalf of Dr. Trehan, our entire clinical leadership, as well as our entire management team, I would like to thank you all for participating. Just to close by saying that, over the course of the last couple of interactions we've had with y ou, we have remained committed to executing on the strategies we've talked out. We believe that focusing on the right quality, the right ethics and value system is the right way forward. We hope that is translating into the appropriate results as well. And we do intend to continue this focus on quality values and a slightly longer term approach towards how we move forward. With that, I would like to take the opportunity to wish all of you a very Happy Diwali and Healthy Diwali. And thank you all for joining this call.

Thank you. On behalf of JM Financial, that concludes this conference. Thank you all for joining us. You may now disconnect your lines.

Notes

1. This transcript has been edited for readability and does not purport to be a verbatim record of the proceedings 2. No part of this publication may be reproduced or transmitted in any form or by any means without the prior written consent of Global Health Limited