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Narayana Hrudayalaya Ltd>
  • CMP : 1,249.6 Chg : -9.15 (-0.73%)
  • Target : 870.0 (21.34%)
  • Target Period : 12-18 Month

11 Feb 2023

Steady quarter amid seasonality; focus on new capex

About The Stock

Narayana Hrudayalaya operates a chain of multispecialty, tertiary & primary healthcare facilities that initially focused on cardiac & renal but expanded to cancer, neurology, neurosurgery, orthopaedics and gastroenterology facilities.

  • NHL’s network comprises 21 hospitals (including two managed hospitals), four heart centres, 18 primary care facilities (including clinics and information centres) and a multi-speciality hospital in Cayman Islands)
  • Revenue mix Q3FY23 – India: ₹ 928.3 crore; (Bengaluru:35%, Southern Peripheral: 6%, Kolkata:26%, Eastern Peripheral: 10%, Western: 5%, Northern: 18%); Cayman Islands: US$ 28.2 million
Q3FY23 Results

Steady performance across segments with margins beat.

  • Revenues de-grew 1.2% QoQ to ₹ 1128.2 crore as hospitals in India de-grew 2.4% QoQ followed by Cayman Islands, which de-grew 2.2% QoQ
  • EBITDA grew 4.4% QoQ to ₹ 254.4 crore. EBITDA margins grew 121 bps QoQ to 22.6%
  • Adjusted PAT declined 8.9% QoQ to ₹ 153.8 crore
What should Investors do?

NHL’s share price has grown at 27.36% CAGR over the past three years.

We maintain BUY rating due to 1) pick-up in occupancy levels and ramp-up in new hospitals, 2) consistent performance at Cayman Islands and 3) judicious plan to expand at existing hospitals nearing full utilisation

Target Price and Valuation

We value Narayana at an SOTP of ₹ 870 by valuing matured India & Cayman hospitals at 14x & 13x FY25E EV/EBITDA, respectively, heart centres at 10x FY25E EV/EBITDA and other business at 1x FY25E EV/sales.

Key Triggers for future price performance
  • With Covid almost completely waning, increase in footfalls is expected to lead flagship hospitals on a steady growth path amid better returns
  • New hospitals (Gurugram, Dharamshila) are likely to see an improvement in profits while SRCC has broken even
  • Improvement in ARPOB on the back of judicious case mix and payer mix
  • Expansion at Cayman Islands in oncology while being margin dilutive in the near term is likely to provide significant additional operating leverage
Alternate Stock Idea

Apart from NHL, in our healthcare coverage we like Apollo.

  • Apollo Hospitals is an integrated healthcare provider undergoing an optical transformation towards creating an omni-channel healthcare platform while turning the new hospitals profitable on the back of a judicious case mix
  • BUY with a target price of ₹ 5230

Key Financial Summary

Particulars FY20 FY21 FY22 5 Year CAGR(FY17-FY22) FY23E FY24E FY25E 2 Year CAGR (FY23E-FY25E)
Revenues 3,127.8 2,582.3 3,700.4 14.5 4,539.8 5,164.9 5,620.0 11.3
EBITDA 422.9 182.1 652.6 23.3 954.9 1,122.5 1,119.4 8.3
EBITDA Margins (%) 13.5 7.1 17.6 - 21.0 21.7 19.9 -
Adjusted PAT 129.8 -14.3 341.9 32.3 587.9 591.6 556.5 -2.7
EPS (|) 6.4 -0.7 16.7 - 28.8 28.9 27.2 -
PE (x) 112.9
EV to EBITDA (x) 36.5 83.7 23.1 - 16.1 13.8 13.5 -
Price to book (x) 12.9 13.1 9.8 - 7.1 5.6 4.6 -
RoE (%) 11.4 -1.3 23.0 - 28.6 22.5 17.6 -
RoCE (%) 11.0 1.2 20.5 - 24.2 21.0 17.0 -
Source: Company, ICICI Direct Research

Key takeaways of recent quarter & conference call highlights

Q3FY23 Results: Steady performance across segments 

  • Revenues de-grew 1.2% QoQ to | 1128.2 crore. Business from hospitals in India declined 2.4% QoQ followed by a decline in Cayman Island revenues, down 2.2% QoQ. Therapy wise cardiac, oncology and gastro remained the major contributor during the quarter. EBITDA grew 4.4% QoQ to | 254.4 crore. EBITDA margins grew 121 bps QoQ to 22.6%. Lower input costs supported margins. Adjusted PAT was impacted by 8.9% QoQ to | 153.8 crore. ARPOB for Indian hospitals came in at | 35,068, improving 4.1% QoQ whereas Cayman Islands ARPOB was at | 1807, up 6% sequentially
  • NHL’s numbers were in line with our estimates on the revenue front but beat our estimates on the margin front due to better ARPOB. Newer hospitals and a better payer mix were driving forces behind this performance. Throughout the quarter, the contribution from foreign patient footfall was unaffected. Despite the holiday season, its Cayman operation was still able to contribute to the total performance. On the basis of an asset-rights approach, a commitment to affordability and confidence in the NHLs longterm growth potential, we continue to remain optimistic

Q3FY23 Earnings Conference Call highlights: 

  • The improvement in payer mix, newer hospitals and business growth across its flagship segments contributed to the overall success
  • Owned and operated hospital remained the larger contributor, which accounted for (96%) of the business mix followed by heart centres (4%)
  • Cluster wise breakup includes: Bengaluru: 35%, Kolkata: 26%, Northern: 18%, Eastern peripheral: 10%, Western peripheral: 5%, Southern peripheral: 6% of the total revenue mix
  • Payee profile was mainly driven by domestic walk in patients, which contributed (45%), insured patients (27%), schemes (20%) and international patients (8%) The management has guided that current gross margins are sustainable in the long run
  • Revenue for three new hospitals was at | 110 crore, up 17% YoY. On the operational front, EBITDA margins came in at 9.3% for the quarter. Dharamshila and Gurugram have started contributing to profits whereas SRCC Mumbai has touched breakeven levels
  • The pilot subscription programme in Bengaluru was successful. It is witnessing continuous success and enrolment for the same
  • Cayman Islands business looks promising to the management and is looking for opportunities as a plan to expand further. Focus remains on exploring other Caribbean islands for providing radiology and oncology treatment
  • Capex will be funded with a mix of debt and internal accrual
  • Capex for FY23 at | 1000 crore remains intact. Going ahead, incremental capex would be funded from a mix of internal accrual and debt in the ratio of 50:50

Disclaimer

ANALYST CERTIFICATION

I/We, Siddhant Khandekar-Inter CA, Kushal Shah-CFA L1, CFP, Utkarsh Jain -MBA, authors and the names subscribed to this report, hereby certify that all of the views expressed in this research report accurately reflect our views about the subject issuer(s) or securities. We also certify that no part of our compensation was, is, or will be directly or indirectly related to the specific recommendation(s) or view(s) in this report. It is also confirmed that above mentioned Analysts of this report have not received any compensation from the companies mentioned in the report in the preceding twelve months and do not serve as an officer, director or employee of the companies mentioned in the report.

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RATING RATIONALE

ICICI Direct endeavours to provide objective opinions and recommendations. ICICI Direct assigns ratings to its stocks according -to their notional target price vs. current market price and then categorizes them as Buy, Hold, Reduce and Sell. The performance horizon is two years unless specified and the notional target price is defined as the analysts valuation for a stock

Buy: >15%

Hold: -5%to 15%;

Reduce: -15% to -5%;

Sell: <-15% 

Pankaj Pandey

Head – Research

pankaj.pandey@icicisecurities.com

 

 

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