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Aster DM Healthcare (ASTDM) Aster DM Healthcare (ASTDM) CMP: | 141 Target: | 170 (21%) Target Period: 12 months BUY November 11, 2020 Strong sequential recovery, GCC back to near normal After a pandemic impacted Q1, Aster’s Q2FY21 results showed a strong sequential recovery. Q2FY21 revenues grew 28.8% QoQ to | 2268 crore. GCC revenues grew 26.8% QoQ to | 1932 crore. India revenues also grew 38.8% QoQ (albeit down 3.7% YoY) to | 415 crore. EBITDA margins expanded 385 bps QoQ to 12.0% due to better operational leverage. Subsequent EBITDA grew 89.9% QoQ to | 271 crore. PAT came in at | 32.9 Particulars crore vs. a loss of | 83 crore in Q1FY20. Particular Amount Market Capitalisation | 7036 crore Result Update Result Strong RoCE in GCC despite aggressive expansion Debt (FY20) | 5605 crore Cash (FY20) | 34 crore Aster derives ~81% of revenues from GCC countries. In the last six years, it EV | 12606 crore expanded its hospitals, clinics, pharmacy count by ~2x. However, despite 52 week H/L (|) 182/78 aggressive expansion, RoCE has stayed healthy (hospitals- 12% (established Equity capital | 499.5 crore hospitals- 25%), clinics- 21% and pharmacies- 44%) due to 1) assets light Face value | 10 model, 2) integrated business model, 3) faster occupancy owing to strong Key Highlights brand equity, 4) healthy ARPOB and 5) targeted strategy. We believe RoCE would improve further due to continuing improvement in occupancy and Q2 results show strong sequential operational leverage at new assets. The GCC region has shown recovery tracking normalisation of commendable resilience in the ongoing Covid-19 pandemic crisis, which GCC business augurs well for healthcare players like Aster to return to normalcy earlier. We expect gradual margins, ROCE improvement on the back of higher Expanding presence in India occupancy, capacity optimisation in new assets from FY21E onwards Notwithstanding being a late entrant, Aster has a network of ~13 hospitals and nine clinics, mainly in Tier-II and Tier-III cities in India. The company is Maintain BUY Price performance now looking to expand its network in metros and Tier-I cities, which is likely to improve its overall ARPOB. However, due to continuous expansion and 250 12000 few specific unforeseen issues, the RoCE in India is just 3%, which is 200 10000 dragging its overall RoCE. To improve the return ratios, the company is 8000 150 focusing on an assets light model for future expansion. 6000 100 Valuation & Outlook 4000 Retail Equity Research Equity Retail 50 2000 – Despite the ongoing Covid-19 crisis having created unforeseen hurdles, the 0 0 company reported a strong quarterly performance tracking normalisation of Feb-18 Feb-19 Feb-20 Nov-18 Nov-19 Aug-19 Aug-20 GCC business despite India operations being still impacted. Aster has a Aug-18 May-18 May-19 May-20 unique business model among Indian healthcare services providers with a Aster DM(L.H.S) NSE500(R.H.S) strong established presence in GCC and India. While the India expansion remains on investment curve, firm footing and FCF generation from the GCC Research Analyst set-up is keeping the entire scheme of things under control, especially when Siddhant Khandekar the company is pursuing aggressive expansion mode in both GCC and India [email protected] Securities ICICI albeit via assets light model. Despite the capex cycle getting pushed further Mitesh Shah due to the pandemic, we are positive on the company’s integrated business [email protected] model and expect gradual margins and RoCE improvement on the back of higher occupancy and capacity optimisation in new assets from FY21E Sudarshan Agarwal onwards. At current levels, we envisage favourable risk-reward matrix and [email protected] maintain BUY rating with a target price of | 170 (SOTP basis). Key Financial Summary | Crore FY20 FY21E FY22E FY23E CAGR FY20-23E (%) Revenues 8738.1 9031.9 9963.2 10927.8 7.7 EBITDA 1257.2 1090.9 1428.2 1625.5 8.9 EBITDA margins (%) 14.4 12.1 14.3 14.9 Net Profit 276.6 155.2 496.5 671.4 34.4 EPS (|) 5.5 3.1 9.9 13.4 PE (x) 25.4 45.3 14.2 10.5 EV to EBITDA (x) 9.9 10.6 7.7 6.2 RoCE (%) 7.1 5.2 9.1 10.9 ROE 8.5 4.5 12.7 14.6 Source: ICICI Direct Research; Company Result Update | Aster DM Healthcare ICICI Direct Research Exhibit 1: Variance Analysis Q2FY21 Q2FY20 Q1FY21 YoY (%) QoQ (%) Comments YoY growth amid 12.7% growth in GCC segment mainly due to pent-up Revenue 2,267.7 2,086.7 1,760.6 8.7 28.8 demand post Covid-19 and increase in expatriate patients volume amid travel restriction Raw Material Expenses 686.6 615.8 584.2 11.5 17.5 Employee Expenses 714.1 728.8 624.5 -2.0 14.4 YoY decline mainly due to cost rationalisation Improved due to higher lab expenses and increase in normal course of Other Expenditure 595.9 497.5 409.2 19.8 45.6 business Operating Profit (EBITDA) 271.1 244.7 142.7 10.8 89.9 EBITDA (%) 12.0 11.7 8.1 23 bps 385 bps Improvement in margins mainly due to decline in employee cost Interest 74.6 88.4 80.3 -15.7 -7.1 Depreciation 152.9 149.0 154.7 2.6 -1.2 Other Income 7.9 4.1 6.5 92.3 21.8 PBT before EO & Forex 51.5 11.4 -85.7 351.2 LP Forex & EO 0.0 0.0 0.0 0.0 0.0 PBT after Exceptional Items 51.5 11.4 -85.7 351.2 LP Tax 10.3 5.0 3.9 108.1 166.7 PAT before MI 41.2 6.5 -89.6 537.7 LP MI 9.4 3.8 -5.7 150.4 LP Delta vis-à-vis EBITDA mainly due to lower interest cost, depreciation Net Profit 32.9 3.0 -82.9 1,001.2 LP and higher other income Key Metrics YoY growth impacted amid Covid-19, improved QoQ growth amid India 415.0 431.0 299.0 -3.7 38.8 increased patients footfall partially amid pent-up demand and increase in Covid patients YoY growth amid pent-up demand post Covid-19 and increased local GCC 1,932.0 1,715.0 1,524.0 12.7 26.8 patients volume amid travel restriction Source: ICICI Direct Research Exhibit 2: Change in Estimates FY21E FY22E (| Crore) Old New % Change Old New % Change Revenue 9,412.6 9,031.9 -4.0 10,506.1 9,963.2 -5.2 EBITDA 811.1 1,090.9 34.5 1,473.3 1,428.2 -3.1 EBITDA Margin (%) 8.6 12.1 346 bps 14.0 14.3 31 bps PAT -71.9 155.2 LP 480.9 496.5 3.2 EPS (|) -1.4 3.1 LP 9.6 9.9 3.2 Source: ICICI Direct Research ICICI Securities | Retail Research 2 Result Update | Aster DM Healthcare ICICI Direct Research Conference Call Highlights Capex in advanced phase: Sharjah, Whitefield (Bangalore), Kolhapur Net debt: | 2476 crore = Net debt (India): | 353 crore + net debt (GCC): US$ 288 million Cost optimisation measures in H1FY21 for manpower, material costs and other direct expenses showing benefits GCC – Some countries seeing second Covid wave but with less intensity and no lockdowns GCC revival seen from June onwards (including Q2FY21) after a Covid-impacted April-May 2020 Exception to normal summer seasonality in GCC (exodus of expats) due to pandemic restrictions helped Q2 performance Not much contribution from Covid in GCC Elective surgeries also saw a sequential uptick in GCC regions GCC Pharmacy – Some retail footfall drop seen, but management expects near normal footfall from Q3 Aster Labs has done ~26,500 Covid tests India – 15% of India revenues (| 415 crore) Covid based 56% revenue contribution from Kerala cluster Kannur + RV (Bangalore) – very high occupancies Recovery trend to continue in Q3 Home care India: Presence in eight locations, good year for homecare, strong growth in North Kerala Wahat: Additional contribution of | 34 crore over last year; has good margins GCC – Expanding but some lack of nurses seen (amid Philippine’s travel restrictions) Constant currency hospital revenue, EBITDA growth of 3%, 2% respectively in H1FY21 Other expenditure higher: Lab related/ sanitisation expenses; could continue but to drop gradually Nothing in inorganic expansion currently ICICI Securities | Retail Research 3 Result Update | Aster DM Healthcare ICICI Direct Research Exhibit 3: Quarterly Financials (| crore) Q 1F Y 19 Q 2F Y 19 Q 3F Y 19 Q 4F Y 19 Q 1F Y 20 Q 2F Y 20 Q 3F Y 20 Q 4F Y 20 Q 1F Y 21 Q 2F Y 21 Y oY (% ) Q oQ (% ) Total Operating Income 1774.7 1836.9 2150.1 2201.0 2028.4 2086.7 2321.6 2301.3 1760.6 2267.7 8.7 28.8 Raw Material E xpenses 552.0 549.9 654.8 663.1 627.3 615.8 695.1 697.3 584.2 686.6 11.5 17.5 % of Revenue 31.1 29.9 30.5 30.1 30.9 29.5 29.9 30.3 33.2 30.3 77 bps -290 bps Gross Profit 1222.6 1287.1 1495.3 1537.9 1401.2 1470.9 1626.5 1604.0 1176.4 1581.1 7.5 34.4 Gross Profit Margin (% ) 68.9 70.1 69.5 69.9 69.1 70.5 70.1 69.7 66.8 69.7 -77 bps 290 bps Employee Expenses 633.1 657.2 708.4 689.5 707.1 728.8 730.1 737.9 624.5 714.1 -2.0 14.4 % of Revenue 35.7 35.8 32.9 31.3 34.9 34.9 31.4 32.1 35.5 31.5 -343 bps -398 bps Other E xpenditure 465.7 504.5 523.6 498.1 470.5 497.5 511.4 462.2 409.2 595.9 19.8 45.6 % of Revenue 26.2 27.5 24.4 22.6 23.2 23.8 22.0 20.1 23.2 26.3 244 bps 304 bps Total E xpenditure 1650.8 1711.5 1886.9 1850.7 1804.9 1842.0 1936.6 1897.4 1617.9 1996.7 8.4 23.4 % of Revenue 93.0 93.2 87.8 84.1 89.0 88.3 83.4 82.4 91.9 88.0 -23 bps -385 bps E B ITDA 123.8 125.4 263.2 350.3 223.6 244.7 385.0 403.9 142.7 271.1 10.8 89.9 EBITDA Margin (% ) 7.0 6.8 12.2 15.9 11.0 11.7 16.6 17.6 8.1 12.0 23 bps 385 bps Other Income 17.3 16.2 5.8 7.5 3.3 4.1 3.9 26.6 6.5 7.9 92.3 21.8 Interest 40.1 39.5 56.4 55.4 87.7 88.4 71.5 112.1 80.3 74.6 -15.7 -7.1 Depreciation 73.8 75.8 78.9 78.0 126.0 149.0 139.8 171.1 154.7 152.9 2.6 -1.2 P B T 27.3 26.3 133.7 224.5 13.0 11.4 177.7 147.3 -85.7 51.5 351.2 -160.1 Total Tax 11.7 10.2 16.7 4.4 2.2 5.0 8.2 -0.1 3.9 10.3 108.1 166.7 Tax rate (% ) 42.7 38.6 12.5 2.0 17.1 43.4 4.6 0.0 -4.5 20.0 NA NA PAT 12.3 11.0 100.3 209.2 3.1 3.0 139.0 131.1 -82.9 32.9 1001.2 PAT Margin (% ) 0.7 0.6 4.7 9.5 0.2 0.1 6.0 5.7 -4.7 1.4 913.4 LP E P S (|) 0.2 0.2 2.0 4.2 0.1 0.1 2.8 2.6 -1.7 0.7 Source: ICICI Direct Research, Company ICICI Securities | Retail Research 4 Result Update | Aster DM Healthcare ICICI Direct Research Company Background Aster DM Healthcare (Aster) commenced its operations in 1987 as a single doctor clinic in Dubai established by Dr Azad Moopen.
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