Professional Documents
Culture Documents
Initiating Coverage
HOLD
Stock metrics Promoters holding Market Cap 52-week H/L Sensex Average volume
Valuations
We expect Fortis to face pressure in expanding returns due to the capital intensive nature of the business, while our outlook remains positive for the long-term. We believe the current business is fairly valued and upsides could be expected once the extended bed base is operational in FY10. We arrive at a target price of Rs 112 through a DCF valuation on a base case scenario. We initiate coverage on the stock with a HOLD rating. Price Trend FY07 -98.12 18.07 -5.43 FY08E -55.00 22.67 -2.43 -41.21 2.80 43.86 -6.9% -2.6% FY09E 2.32 22.67 0.10 976.07 2.79 25.35 0.3% 1.7% FY10E 34.47 22.67 1.52 65.75 2.67 17.50 4.1% 4.3%
140 120 100 80 60 40 20 0 Jun-07
Comparative return metrics (%) Stock return 3M 6M Apollo Hospital 7.79 -1.48 Indraprasth M 36.13 69.36 Fortis 15.67 15.80
Exhibit 1: Key Financials Year to March 31 Net Profit Shares in issue (crore) EPS (Rs) P/E (x) Price/Book (x) EV/EBIDTA RoNW (%) RoCE (%)
-25.9% -4.7%
Jun-07
Jul-07
Jul-07
Aug-07
Aug-07
Nov-07
May-07
May-07
Nov-07
Sep-07
Sep-07
Oct-07
Oct-07
Oct-07
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Dec-07
Escorts Acquisition ...12 Company Background ...13 Risks & Concerns ..14 Financials ..15
Consistent topline growth ...15 Margins to improve substantially, better ARPOB in FY10 ..15 Returns to remain capped, asset turnover under strain .16
Revenue Model .17 Valuations .18 Financial Summary ...19 Annexe ..22
Structure of healthcare service industry 22
Exhibits
Exhibit 1: Key Financials 1 Exhibit 2: Indias per capita expenditure on healthcare is among the lowest ...3 Exhibit 3: Private expenditure on healthcare amongst the highest ...3 Exhibit 4: Growth in healthcare contributed by lifestyle-related disease on rise ..4 Exhibit 5: Cardio-vascular diseases, cancer to increase in-patient registration ...5 Exhibit 6: In-patient revenues to be driven by lifestyle diseases ...5 Exhibit 7: Indias comparative cost advantage in medical tourism .......6 Exhibit 8: Infrastructure needs a major fillip .7 Exhibit 9: Major capex plans announced by private players .7 Exhibit 10: Fortis at advantage with a 700 bed extension capacity present 8 Exhibit 11: Fortis capex focus on greater profitability ..9 Exhibit 12: Fortis graph of organic & inorganic growth ...10 Exhibit 13: Management contract to increase reach ..10 Exhibit 14: Escorts history & litigations ..12 Exhibit 15: Subsidiary structure ...13 Exhibit 16: Bottomline to make a mark by FY10 ..11 Exhibit 17: Margins under strain; uo-move in FY10 with improved ARPOB 12 Exhibit 18: Returns to improve with asset turnover improvement ..13 Exhibit 19: Discounted Cash Flow ...14 Exhibit 20: Revenue breakdown ..23
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INDUSTRY OUTLOOK
Expenditure on healthcare set to rise
Currently, the expenditure on healthcare in India is very low. According to the WHO (World Health Organisation), spending on healthcare in 2004 was US$34.9 billion, or 5.2% of GDP. The governments contribution was a meager 1.2% of the GDP. With the economy growing and incomes rising, healthcare spending is expected to rise to 5.5% of GDP (~US$60.9 billion) by 2012. Further, the total healthcare services market in India is expected to grow from Rs 125,300 crore in 2006 to Rs 217,200 crore by 2011, and further to Rs 364,200 crore by 2016. Exhibit 2: Indias per capita expenditure on healthcare is among the lowest
USA UK Japan Brazil Korea Mexico Russia Malaysia Thailand China India 0 1000 2000 3000 4000 5000 6000 7000
Private expenditure on healthcare in India is among the highest in the world. Private healthcare providers stand to gain the most from the expected growth in demand in healthcare services. Exhibit 3: Private expenditure on healthcare amongst the highest (%)
UK Japan Thailand Russia Malaysia Brazil Korea Mexico USA China India 0 10 20 30 40 50 60 70 80 90
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Changing demographic and disease profiles and rising treatment costs are likely to result in increased healthcare spending (more than double) over the next 10 years. The private healthcare sector is likely to contribute the largest component in 2012, rising to Rs 156000 crore from the current level of Rs 69000 crore. With the expected growth in the pharmaceutical market, the total healthcare market in India could rise from Rs 103000 crore currently (5.2% of GDP) to Rs 232000 320000 crore (6.2%-8.5% of GDP) by 2012.
Rs 82,000 crore
17 %
Other Diseases
57 % 41 %
42 % 25 %
2001
2012
Source: CII-McKinsey The rapid growth of the middle and upper urban middle class, a segment that accounts for substantial proportion of healthcare expenditure, will lead to increased per capita expenditure on treating lifestyle-related diseases. By 2012, in-patient spending is expected to rise from the current levels of 39% to 50% of the total expenditure. Currently, in the US, in-patient spending accounts for 62% of total healthcare spending.
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73%
65%
64%
48%
27% 2001
36% 2001
52.50%
2012 Others
Source: CII McKinsey Cardio-vascular diseases and cancer to grow at a faster rate, resulting in a greater share of in-patient registrations
Cardiology, oncology and diabetes that require longer stays and costlier treatments would have a greater share of inpatient revenues
Fortis is expected to benefit the most from the trend with its brand recognised for cardiology and other multi-specialities.
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difference in the cost of high-end surgery and critical care and quicker access to medical care vis--vis some highly developed countries. The cost of such medical care also compares favourably against costs of other more established medical tourism destinations like Thailand.
Exhibit 7: India's comparative cost advantage in medical tourism (in US$) Procedure Angioplasty Gastric bypass Heart bypass Heart-valve replacement (single) Hip replacement Hysterectomy Knee replacement Mastectomy Spinal fusion US insurer's cost 25,704 to 37,128 27,717 to 40,035 54,741 to 79,071 71,401 to 103,136 18,281 to 26,407 9,591 to 13,854 17,627 to 25,462 9,774 to 14,118 25,302 to 36,547 US retail price 57,262 to 82,711 47,988 to 69,316 122,424 to 176,835 159,326 to 230,138 43,780 to 63,238 20,416 to 29,489 40,640 to 58,702 23,709 to 34,246 62,778 to 90,679 India 11,000 11,000 10,000 9,500 9,000 2,900 8,500 7,500 5,500 Thailand Singapore 13,000 15,000 12,000 10,500 12,000 4,500 10,000 9,000 7,000 13,000 15,000 20,000 13,000 12,000 4,500 13,000 12,400 9,000
Sources: Subimo (US rates, including at least one day of hospitalisation); PlanetHospital (international rates)
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INVESTMENT RATIONALE
Demand expected to overshoot announced supply
Currently, India has capacity of around 1.05 million beds. To meet the projected demand and maintain the ratio of bed to population at 1.9:1000, India will need to expand its bed capacity by 632,000 to 1.68 million by 2016, translating to Rs 165,300 crore worth of investment. Exhibit 8: Infrastructure needs a major fillip
Japan (2001) Russia (2005) Korea (2002) UK (2004) USA (2003) Brazil (2002) Thailand (2000) China (2003) Malaysia (2001) Mexico (2004) India (2002) 0 20 40 60 80 100 120 140
Even to maintain the current ratio on an increased base of population, Indian healthcare sector would experience huge supply shortfall
A CII-McKinsey study estimates that 20% of the additional beds will be required for specialty healthcare needs such as cancer and cardiac diseases. In India, privately operated healthcare services accounts for over half of all in-patient hospital visits and 82% of all out-patient visits. Going forward, we expect the investment to come in from the public vs. private for provisioning the demand growth in the same proportion. Exhibit 9: Major capex plans announced by private players No of hospitals 25 20 8 12 7 7 Number of beds 6952 7629 1390 1800 765 1020 Location Pan India Southern India Southern, Western & Eastern Northern India & Chennai NCR Southern India & Nagpur Planned beds ~3200 3025 1850 1337 585 315 Beds by 2011 ~10000 10654 3240 3137 1350 1335 Type of Facility* PT PST T ST PST PST
Source: CRIS-INFAC, ICICIdirect Research * P: Primary Care; S: Secondary Care; T: Tertiary Care
Hospitals with a capacity for a fast ramp-up of bed base and having a geographical spread in metros, where incidence of lifestyle-related diseases is high, would benefit the most from the increased demand for healthcare services. Fortis, with its focus on tertiary care in cardiac
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ailments along with multi-speciality, would stand to benefit from the demand supply mismatch scenario.
Fortis to benefit from bed extension capacity of 700 in the existing hospitals
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Fortis to focus on tertiary and multi & super speciality facilities creating a brand recognized pan India Announced projects by Fortis
Location Shalimar bagh ,ND Gugaon Medicity No. of beds 258 Phase I 550 Phase II 350 Phase I 850 Phase II Commencement June 2009 Phase I January 2010 Phase I
Capex focused on procedures with high average length of stay, realisation per patient and high margins
On an average, a Fortis hospital takes 20-24 months to breakeven at the operating level. Breaking even at the book, takes around 48 months. Although these expansion plans would pose a burden on the books in the short-term, FY10 would be the year when most of its existing hospitals would turnaround and Fortis should start booking net profits thereon.
Aggressive plans to expand base at a fast pace through acquisitions and management contracts
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26%. On further clarity on business plans we would include these hospitals into our projections. Exhibit 12: Fortis graph of organic & inorganic growth 2007 Acquire 100% stake in Hiranandani Healthcare, Vashi Acquire 46% stake in Malar Hospital, Chennai JV with DLF for setting up 15 Hospitals
2003 Fortis Hospital, Amritsar 2001 Fortis Hospital, Mohali Mgmt C. of Jessa Ram Hospital, ND
2005 Acquire 90% stake in EHIRCL resulting in acquisition of EHCL, EHSSIL, EHSSHL & EHIRCL
2006 Mgmt C. & 5% stake in La Femme ND, Mgmt C. of Khyber Med. Inst. Srinagr. Acquire 99.99% stake in IHL Acquire 100% stake in Oscar Bio-Tech
Source: Company data, ICICIdirect Research For details on corporate structure refer exhibit 15
Management Fee Structure 70% of Net profit or 10% of Revenues till the hospital is loss making 35% of EBIDTA 8% of Revenue 8% of Revenue
Of the current 12 hospitals, Fortis has equal proportion of greenfield projects, acquisitions and management contracts. Going forward, the company plans to increase the number of hospitals to 40 with 7,000 beds. It plans to maintain the ratio between greenfield projects, acquisitions and management contracts.
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Larger market penetration, cost efficiency through Hub & Spoke model
The company follows a hub and spoke model for its hospital network. This strategy helps the company fulfil the dual objective of having a larger market penetration and cost efficiency. The business model helps it serve the medical needs of patients at multi-specialty facilities located close to them. The model also helps deliver sophisticated, advanced procedures and quaternary care at its hub. This helps the company to reach out to patients, who are not even in area of reach of its local multi-specialty hospitals. Through this model, it can efficiently deploy resources across its network and its super-specialty experts to provide their expertise and support at its multi-specialty hospitals. The company plans to have 4 hubs and 12-15 spokes in northern India in the next 2-4 years. This strategy works for tapping patients in the metro through the hub as well as extending reach to tier II cities through spoke.
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ESCORTS ACQUISITION
In September of 2005, Fortis acquired 90% interest in EHIRCL, a provider of private healthcare services that owned and operates three majorityowned hospitals in north India and operated a fourth hospital in collaboration with the Government of Chhattisgarh, at the time of the acquisition, 10 satellite and heart command centres for total consideration of Rs. 585.01 crore. Post the acquisition Fortis has initiated the process of integrating the Escorts hospitals and their other hospitals, the Escorts hospitals generally continue to exist as a discrete unit with their own resources, employees and management. While the process of integration of EHRC and EHSSI with the Company has been completed to a significant extent, Fortis is still in the process of integrating the operations of EHIRC with the Company. If they are unable to manage the tax payments and land rights, and such litigations, may adversely affect Fortis operations and financial condition and could cause the valuations to decline significantly as EHIRCL consolidated contributes a significant 60% to the revenues of Fortis. Exhibit 14: Escorts history & litigations Oct 21, 1981 Incorporation of Escorts Heart Institute & Research Center (EHIRC) as a Charitable Society, New Delhi, under Society Registration Act (SRA) 1860
DDA, the owner of the land on which the EHIRC hospital is located, has treated both the initial amalgamation of the societies and the subsequent conversion to a company as prohibited transfers of property under the terms of its lease and, accordingly, has terminated the lease deeds and allotment letters in respect of the land on which the EHIRC hospital is located and challenged the same in Delhi High Court. EHIRCL has successfully brought a stay order thereby, restraining DDA from recovering physical possession of property. Due to the cancellation of lease deed by DDA, EHIRCLs nursing licence, which expired on March 31, 2005, also remains suspended for renewal
Source: Company
Nov 11, 1999 EHIRC amalgamated with a Non Charitable Society under the SRA with Registrar of Society Chandigarh
May 30, 2000 Incorporation of EHIRCL post conversion of EHIRC from a NON Charitable Society to a Limited Company under Companies Act
Sep 25, 2005 Fortis acquires 90% share capital of EHIRCL for Rs. 585.01 crore
Delhi High court, on March 22, 2007, ruled that EHIRCL has to provide free medical service to the extent of 25% of Outpatients and 10% of Inpatients as it has received land at concessional rates from DDA. However, EHIRCL is currently planning to file an appeal the in the Supreme Court.
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Company Background
Dr Parvinder Singh, the promoter of Ranbaxy Laboratories, established Fortis Healthcare in 1996. The company is the second largest private healthcare company in India with a network of 12 hospitals in northern India. In addition, it has 15 satellite and heart command centres in India, and one heart command centre in Afghanistan. Most of its hospitals are multi-specialty, which provide secondary and tertiary healthcare services. Some of the multi-specialty hospitals also include super-specialty centres of excellence providing quaternary healthcare services in areas such as cardiac care, orthopedics, neuro-sciences, oncology, renal care, gastroenterology, and mother and child care. Two of its hospitals, Escorts Heart Institute & Research Centre at New Delhi (EHIRC) and Escorts Heart Centre at Raipur (EHCR), focus primarily on cardiac patients, with EHIRC serving as a super-specialty centre of excellence for cardiac care. It also operates Fortis La Femme, a boutique-style hospital that focuses on womens health and maternity care. Exhibit 15: Subsidiary structure
Share holding pattern Shareholder Promoters Institutional investors Other investors General public
0.0 Q3FY07
15.9 Q4FY07
7.4 Q2FY08
Promoter
Fortis Healthcare
Fortis Hospital Mohali Fortis Hospital Amritsar Fortis La Femme New Delhi (O&M) Jessa Ram Hospital New Delhi (O&M) Khyber Medical Institute Srinagar (O&M) 1 satellite center Fortis Hospital Gurgaon
Escorts Heart Institute Research Oscar Biotech Center (90%) (100%) Escorts Heart Institute & Fortis Flt. Lt. Rajan Dhall Research Center New Delhi Hospital Vasant Kunj, New Delhi (O&M) Escorts Heart Center Raipur * Fortis Hospital 15 satellite & Heart command Shalimarbagh New Delhi center (7%)
(39%)
Escorts Hospital & Research Center (100%) Escorts Hospital & Research Center Faridabad
Escorts Heart & Super Speciality Institute (82.61%) Escorts Heart & Super Speciality Institute Amritsar
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Execution risk
While Fortis plans seem robust, timely execution would be a key variable. Any delay in the development of the upcoming hospitals would shift the revenue estimates downwards thereby affect the profitability negatively. We believe that going forward, the growth will be propelled mainly through owned-hospitals (new facility or acquired). Any deviation in the companys strategy of future acquisitions and developments would shift the profitability estimates forward.
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FINANCIALS
Consistent top line growth
Fortis has shown a consistent growth in top line since its inception. During FY05-07, when the private healthcare sector gained substantial weight in the overall healthcare industry, Fortiss top line increased at a phenomenal 172% CAGR to Rs 546 crore in FY07 from Rs 73 crore in FY05, with the company breaking even at the operating level in FY06. This growth was achieved through expansion of rooms in Fortis (Mohali and Noida) and Escorts (Delhi and Amritsar). Going forward, the increased demand in the tertiary acre segment is expected to remain in the favour of Fortis. We believe Fortis would be able to improve its bottom line despite the strain due to the ongoing capex and low asset turnover. During FY07-10, Fortis is expected to witness a 29.3% CAGR growth in net sales (Rs 530 crore in FY08, Rs 789 crore in FY09, and Rs 1108 crore in FY10). It is expected to book marginal profits of Rs 2.32 crore at the net level for the first time in FY09, which should improve substantially to Rs 34.47 crore in FY10E. Exhibit 16: Bottomline to make a mark by FY10 (Rs crore)
1200 1000 800 600 400 200 0 200 FY07 FY08E Net Sales
Source: Company, ICICIdirect Research
FY10E
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margin to improve to 3.1% in FY10E when Fortiss planned expansions become operational. Exhibit 17: Margins under strain; up-move in FY10 with improved ARPOB
20 15 10 5 % 0 5 10 15 20 25 ARPOB (RHS) Operating Profit Margin Net Profit Margin FY07 FY08E FY09E FY10E
0.8 0.7 0.6 Rs Crore 0.5 0.4 0.3 0.2 0.1 0.0
Average revenue per occupied bed to increase post FY08 along with booking profits at net level from FY09
Source: Company, ICICIdirect Research ; ARPOB: Average Revenue per Occupied Bed
0.9 0.8 0.7 FY07 FY08E FY09E FY10E 0.6 0.4 0.3 0.2 0.1 0.0 ROCE (LHS) Asset Turnover (RHS) Days 0.5
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Revenue Model
Owned Beds (in Nos.) Fortis Hospital Mohali EHIRC, Delhi Fortis Hospital Noida EHRC Faridabad EHSSI Amritsar Fortis Hospital Amritsar Fortis Hospital Shalimar Bagh Mallar Hospital Hiranandani Fortis Vashi Escorts Jaipur EHCR Raipur Management Contract Fortis Flt Lt Rajan Dhall Hospital Vasant Kunj Jessa Ram Hospital Delhi Fortis La Femme Khyber Medical Institute, Srinagar Total Beds Occupancy Fortis Hospital Mohali EHIRC, Delhi Fortis Hospital Noida EHRC Faridabad EHSSI Amritsar Fortis Hospital Amritsar Fortis Hospital Shalimar Bagh Mallar Hospital Hiranandani Fortis Vashi Escorts Jaipur EHCR Raipur Fortis Flt Lt Rajan Dhall Hospital Vasant Kunj Jessa Ram Hospital Delhi Fortis La Femme Khyber Medical Institute, Srinagar ARPOB (in Rs. Crore) Fortis Hospital Mohali EHIRC, Delhi Fortis Hospital Noida EHRC Faridabad EHSSI Amritsar Fortis Hospital Amritsar Fortis Hospital Shalimar Bagh Mallar Hospital Hiranandani Fortis Vashi Escorts Jaipur EHCR Raipur Fortis Flt Lt Rajan Dhall Hospital Vasant Kunj Jessa Ram Hospital Delhi Fortis La Femme Khyber Medical Institute, Srinagar
Source: Company, ICICIdirect Research
FY08E 225 331 150 220 128 45 180 150 163 45 120 100 36 30 1923 FY08E 80% 60% 83% 92% 60% 58% 30% 30% 30% 40% 60% 65% 60% 60% FY08E 0.82 0.9 0.75 0.29 0.54 0.23 0.40 0.50 0.40 0.74 0.80 0.16 0.55 0.27
FY09E 250 331 178 240 128 45 180 150 163 45 145 100 36 30 2021 FY09E 80% 72% 84% 92% 65% 65% 40% 50% 50% 50% 65% 75% 70% 70% FY09E 0.90 1.00 0.85 0.45 0.59 0.25 0.50 0.60 0.50 0.75 0.90 0.25 0.61 0.35
45 120 100 36 10 1346 FY07 76% 83% 81% 92% 47% 50%
FY10E 275 331 200 250 150 50 258 400 150 163 50 165 150 50 50 2692 FY10E 85% 77% 85% 92% 75% 70% 40% 50% 70% 70% 60% 75% 80% 80% 80% FY10E 0.95 1.05 0.90 0.60 0.65 0.27 0.60 0.60 0.70 0.70 0.75 0.95 0.30 0.67 0.40
30% 40% 55% 50% 50% FY07 0.75 0.90 0.68 0.26 0.49 0.23
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VALUATIONS
India is under-serviced as far as healthcare services. With the huge expected demand in the tertiary care segment, along with the changes in demography, we expect Fortis would benefit in the long-term from its metro-focused multispeciality facilities with expertise in cardiac care. We expect the company to maintain its average occupancy at 70% on an extended room base. We expect Fortis to face pressure in expanding returns due to the nature of the business while our long-term outlook remains positive. We believe that the current business seems fairly valued while the up tick can be expected once the extended bed base is operational in FY10. We arrive at the target price through DCF valuation of Rs 112 on a base case scenario. We initiate coverage with a HOLD rating. On an EV/EBIDTA valuation, Fortis is valued at 43.8x in FY08E. Going forward an EV/EBIDTA of 25.3x in FY09E seems on the higher side while 17.5x in FY10E look fairly priced in at current levels. Fortis acquired Escorts at the deal valued 15.9x EV/EBIDTA. Apollo, the segment leader, trades at an EV/EBIDTA multiple of 18.6. By discounting FY10 earnings by 18x EV/EBIDTA we arrive at Rs 103 per share valuation. On EV/Sales basis, Fortis looks rich at current levels trading at 4.8x and 3.4x FY08 and FY09 net sales. While a multiple of 2.38 of FY10 sales looks reasonable considering Escorts valuation at the time of acquisition been done at 2.45x and Apollo trading 2.97x EV/Sales at current levels. By discounting Fortis by an EV/Sales multiple of 2.6, we arrive at per share value of Rs 110. Our Discounted Cash Flow (DCF) valuation gives a value of Rs 111.86 to the stock. We have assumed terminal growth rate at 2.5%. Risk free rate of return is 7.8% while market rate of return is taken as 15%. WACC works out to be 10.81%. Exhibit 19: Discounted Cash Flow Year ending March FY08E Number of beds 1637 Occupancy (%) 60% ARPOB (Rs. crore) 0.54 Revenue 529.98 EBIDTA 58.01 Interest 33.32 Depreciation 42.14 Goodwill Amortised 42.41 PBT -47.11 Tax 8.48 PAT -55.00 FCF 135.96 NPV 2738.63 Equity Value Per Share 111.86
Source: ICICIdirect Research
FY09E 1710 69% 0.66 789.08 105.66 38.66 42.32 42.41 -1.24 -0.34 2.32 1.03
FY10E 2277 70% 0.69 1108.61 150.94 36.69 54.78 42.41 39.51 10.67 34.47 98.50
FY11E 2352 65% 0.79 1219.44 160.35 34.27 80.08 42.41 42.34 13.97 34.88 -12.31
FY12E 2702 65% 0.80 1412.54 268.38 28.87 54.97 42.41 196.02 64.69 138.48 57.12
FY13E 3052 64% 0.80 1571.12 329.94 22.16 59.59 42.41 271.48 89.59 189.03 116.09
FY14E 3402 64% 0.82 1795.37 412.94 21.31 63.99 42.41 358.00 118.14 247.18 171.42
FY15E 3752 63% 0.82 1948.78 471.61 20.46 68.20 42.41 422.15 139.31 290.16 226.40
FY16E 4102 63% 0.84 2182.28 576.12 18.46 72.22 20.18 557.85 184.09 381.26 290.47
FY17E 4452 62% 0.84 2331.10 615.41 14.46 72.57 0.00 627.76 207.16 428.09 404.29
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FINANCIAL SUMMARY
Profit & Loss
Y/e March Net Sales YoY Growth(%) Other Income Income from Mgmt Contract Expenses Employee Cost % of NS Material Consumed % of NS Power & Fuel % of NS Other Operating % of NS Admin & Others % of NS Total Expenses EBIDTA YoY Growth(%) % of NS Goodwill Amortisation Depriciation Interest PBT Tax Share in profit/( loss) of associates PAT % of NS
Source: Company, ICICIdirect Research
Rs Crore
FY07 512.35 75.1% 13.05 FY08E 529.98 3.4% 5.00 7.75 FY09E 789.08 48.9% 5.00 11.48 FY10E 1108.61 40.5% 5.00 17.45 Top line to grow at 29% CAGR over FY07-10
175.53 34.3% 177.27 34.6% 18.42 3.6% 45.90 9.0% 46.77 9.1% 463.88 48.47 72.2% 9.5% 45.53 38.28 66.00 (88.29) 7.28 (2.55) (98.12) -19.2%
184.72 34.9% 180.19 34.0% 16.96 3.2% 45.05 8.5% 45.05 8.5% 471.97 58.01 1.7% 10.9% 42.41 42.14 33.32 (47.11) 8.48 0.59 (55.00) -10.4%
255.74 32.4% 268.29 34.0% 25.25 3.2% 67.07 8.5% 67.07 8.5% 683.42 105.66 44.8% 13.4% 42.41 42.32 38.66 (1.24) -0.34 3.23 2.32 0.3%
372.32 33.6% 376.93 34.0% 33.26 3.0% 88.69 8.0% 86.47 7.8% 957.66 150.94 40.1% 13.6% 42.41 54.78 36.69 39.51 10.67 5.63 34.47 3.1% Profits at net level in FY09 with substantial bottom line growth in FY10
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Balance Sheet
Y/e March Sources of Funds Equity Capital Pref. Share Capital Reserves & Surplus Networth Total Debt Minority Interest Deferred Tax Total Liabilities Application of Funds Gross Block Less: Acc. Depreciation Net Block Capital WIP Investments & Goodwill * Current Assets Less: Current Liabilities & Provisions Net Working Capital Misc. Exp not w/o Total Assets FY07 180.67 27.00 161.19 368.86 592.20 19.35 4.99 985.40 FY08E 226.67 27.00 556.95 810.62 338.96 19.35 4.99 1173.92 FY09E 226.67 27.00 559.27 812.94 508.24 19.35 4.99 1345.52
Rs Crore
FY10E 226.67 27.00 593.75 847.42 468.24 19.35 4.99 1340.00
660.68 254.79 405.89 102.59 401.59 233.71 158.47 75.24 0.09 985.40
702.40 296.93 405.47 312.59 359.18 275.33 178.70 96.63 0.04 1173.92
705.26 339.25 366.01 562.59 316.77 335.68 235.55 100.13 0.02 1345.52
912.94 394.02 518.92 522.59 274.36 352.20 328.08 24.11 0.01 1340.00
Source: Company, ICICIdirect Research * Goodwill amounting Rs 381.71 crore in FY07 is to be amortised till first half of 2016 by approximately Rs 42.41 crore per annum. Escorts and IHL were acquired at a gross goodwill of Rs 419.56 crores and Rs 14.85 crore in FY05 and FY06 respectively.
Cash Flow
Y/e March Opening Cash Profit After Tax Depreciation & Goodwill Provisions & Others Cash Profit Changes in WC Net Increase in CL Net increase in CA Cash Flow after change in working capital Capex & Other Investing Activities Cash Flow after investing activity Proceeds from financing actvity Cash Flow after financing activity Net Cash inflow Closing Cash
Source: Company, ICICIdirect Research
Rs Crore
FY07 16.74 -88.29 83.80 1.22 -3.27 FY08E 30.68 -55.00 84.56 0.04 29.60 FY09E 61.22 2.32 84.73 0.02 87.07 FY10E 96.89 34.47 97.19 0.01 131.67
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Ratio Analysis
Y/e March Margins (%) EBIDTA PAT Asset based ratios (%) RONW / ROE ROCE / ROI Gearing Debt / Equity Per Share (Rs) Earnings Book Value Cash EPS Turnover (Days) Asset Inventory Debtor Creditor Valuations (x) P/E P / BV M.Cap / Sales EV / EBIDTA EV / Sales Market Cap. (Rs Crore) EV (Rs Crore)
Source: Company, ICICIdirect Research
FY10E 13.6% 3.1% Consistent growth in operating margin with positive EPS from FY09
-25.9% -4.7%
-6.9% -2.6%
0.3% 1.7%
4.1% 4.3%
1.61
0.42
0.63
0.55
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Annexe
Structure of healthcare service industry Types of Facilities
Healthcare facilities in India vary by the level and complexity of treatment offered, quality of infrastructure facilities and availability of qualified doctors and support staff. They can be divided into:
Secondary care facilities offer both inpatient and outpatient medical services, including simple surgical procedures. Such facilities offer basic medical specialties including internal medicine, pediatrics, obstetrics and gynecology, and limited coverage of other specialties including gastroenterology, urology, dermatology, and cardiology. CII-McKinsey estimates that the total spending in this market in India was approximately Rs 25000 crore in 2001. Tertiary care facilities offer highly specialised and sophisticated medical
care and surgical procedures in a primarily inpatient setting. Such facilities offer treatment in specialty and super-specialty areas of cardiology, neurology, oncology, and orthopedics, among others. CRISINFAC estimates that expenditure on tertiary care hospitals comprised approximately 15-20% of the total Rs 125300 crore spending for healthcare delivery in India in 2006. According to CRIS-INFAC, this segment is expected to grow faster than the primary or secondary care segments because of an expected rise in complex lifestyle
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4. Facilities and institutions owned by charitable trusts, the government, local bodies or for-profit institutions, but operated by separate for-profit institutions; and 5. Collaborations between government bodies and for-profit corporations (i.e., joint ventures and public-private partnerships). Certain for-profit hospital operators have become integrated healthcare services providers by expanding into a wide variety of healthcare services including pharmacy, health insurance and telemedicine. Other for-profit hospital operators have chosen to focus primarily on healthcare delivery, adding tertiary and quaternary care facilities that serve as hubs for, and admit patients from, smaller primary and secondary care facilities in local communities. Exhibit 20: Revenue breakdown (FY07: Rs 546 Crore)
Revenue Mix
In-patient (90.3%)
Out-patient (7.6%)
Rental
Consultancy
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RATING RATIONALE ICICIDirect endeavours to provide objective opinions and recommendations. ICICIdirect assigns ratings to its stocks according to their notional target price vs current market price and then categorises them as Outperformer, Performer, Hold, and Underperformer. The performance horizon is 2 years unless specified and the notional target price is defined as the analysts' valuation for a stock.
Outperformer: 20% or more; Performer: Between 10% and 20%; Hold: +10% return; Underperformer: -10% or more.
Harendra Kumar
Head - Research & Advisory ICICIdirect Research Desk, ICICI Securities Limited, Gr. Floor, Mafatlal House, 163, H.T.Parekh Marg, Backbay Reclamation Churchgate, Mumbai 400 020 research@icicidirect.com
harendra.kumar@icicidirect.com
Disclaimer
The report and information contained herein is strictly confidential and meant solely for the selected recipient and may not be altered in any way, transmitted to, copied or distributed, in part or in whole, to any other person or to the media or reproduced in any form, without prior written consent of ICICI Securities Ltd (I-Sec). The author of the report does not hold any investment in any of the companies mentioned in this report. I-Sec may be holding a small number of shares/position in the above-referred companies as on date of release of this report. This report is based on information obtained from public sources and sources believed to be reliable, but no independent verification has been made nor is its accuracy or completeness guaranteed. This report and information herein is solely for informational purpose and may not be used or considered as an offer document or solicitation of offer to buy or sell or subscribe for securities or other financial instruments. Nothing in this report constitutes investment, legal, accounting and tax advice or a representation that any investment or strategy is suitable or appropriate to your specific circumstances. The securities discussed and opinions expressed in this report may not be suitable for all investors, who must make their own investment decisions, based on their own investment objectives, financial positions and needs of specific recipient. This report may not be taken in substitution for the exercise of independent judgement by any recipient. The recipient should independently evaluate the investment risks. I-Sec and affiliates accept no liabilities for any loss or damage of any kind arising out of the use of this report. Past performance is not necessarily a guide to future performance. Actual results may differ materially from those set forth in projections. I-Sec may have issued other reports that are inconsistent with and reach different conclusion from the information presented in this report. This report is not directed or intended for distribution to, or use by, any person or entity who is a citizen or resident of or located in any locality, state, country or other jurisdiction, where such distribution, publication, availability or use would be contrary to law, regulation or which would subject I-Sec and affiliates to any registration or licensing requirement within such jurisdiction. The securities described herein may or may not be eligible for sale in all jurisdictions or to certain category of investors. Persons in whose possession this document may come are required to inform themselves of and to observe such restriction.
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