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Auna S.A. (AUNA)

Q3 2025 Earnings Call· Fri, Nov 21, 2025

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Transcript

Operator

Operator

Good morning, and welcome to Auna's Third Quarter 2025 Earnings Conference Call. My name is Eric and I'll be the operator for today's call. [Operator Instructions] And please note that this call is being recorded. [Operator Instructions] Now I would like to turn the call over to Ana Maria Mora, Head of Investor Relations. Ma'am, please go ahead.

Ana Maria Mora

Analyst

Thank you, operator. Hello, everyone, and welcome to Auna's conference call to review our third quarter results. Please note that there is a webcast presentation to accompany the discussion during this call. If you need a copy of the presentation, please go to our Investor Relations website or contact Auna's Investor Relations team. Please note that when we discuss variances, we will be doing so on a year-over-year basis and in FX-neutral or local currency terms with regard to Mexico and Colombia, unless we note otherwise. Let's move to Slide 2. In addition to reporting unaudited financial results in accordance with International Financial Reporting Standards, we will discuss certain non-IFRS financial measures and operating metrics, including foreign exchange neutral calculations. Investors should carefully read the definitions of these measures and metrics included in our earnings press release of yesterday to ensure that they understand them. Non-IFRS financial measures and operating metrics should not be considered in isolation as a substitute for or superior to IFRS financial measures and are provided as supplemental information only. Before we begin our remarks, please also note that certain statements made during the course of today's discussion may constitute forward-looking statements, which are based on management's current expectations and beliefs and which are subject to a number of risks and uncertainties that could cause actual results to materially differ, including factors that may be beyond the company's control. This includes, but are not limited to, our target leverage ratio, the expected resolution of the issues with physicians, suppliers and information systems in Mexico, the results of the key initiatives we are implementing in Mexico, the expected capacity and market of Torre Trecca once built, the execution of our strategic plan including the recovery of our growth levels and the rollout of the AunaWay in Mexico,…

Gisele Ferrero

Analyst

Thanks, Suso. On Slide 12, we break down the revenue contributed by each geographic component of Auna's diversified regional platform. As you can see in the bar charts, Peru still accounted for well over half of our platform's third quarter and year-to-date revenues. And with its top line increasing 9% in the quarter, Peru continues being a strong and reliable driver of growth and cash flow. Colombia, despite the risk mitigation measures that we put in place to maintain a healthy cap cycle, also contributed to revenue growth, growing 4% in local currency for the quarter. Regarding Mexico, we note, again, that the 12% revenue decline was a product of a still slow recovery of volumes, a slower market and also included nonoperating impacts such as the multisystem migration. Finally, as Suso pointed out, we expect Mexico's revenue to begin growing again next year. Let's now turn to Slide 13. Peru was also a strong contributor of adjusted EBITDA growth at 15% growth. It also had a solid margin of 22.7% in the quarter. And despite us favoring cash preservation over growth, Colombia also supported our profitability while expanding its margin versus last year's quarter, thanks to increased revenues and lower provisions. Mexico accounted for the 5% FX-neutral decrease in our consolidated adjusted EBITDA due to the significant revenue decrease as well as the quarter's mix of payers and services. We expect EBITDA growth in 2026 as we advance the implementation of our business model, as various growth initiatives gradually gain traction and as we bring the learnings from the systems implementation at Doctors Hospital for the next phase of migrations. On Slide 14, we break down the year-over-year change in adjusted net income. The biggest one being Mexico's impact on operating income. This was partially offset by PEN 11…

Operator

Operator

[Operator Instructions] Your first question comes from the line of Mauricio Cepeda with Morgan Stanley.

Mauricio Cepeda

Analyst

I have 2 questions, a little bit more about future strategy. So on your plans for Mexico and this MoU that you announced with Sojitz. Could you explain or walk us through the rationale for expanding in Mexico so soon? And how this new agenda align with your goal to deleverage Auna and to ramp up operations in Mexico? And my second question is about Colombia. Do you think that a potential change in the country's leadership there could help ease these pressures on the EPS? Or are there deeper structural issues that might limit any meaningful improvement over the next few years? Jesús Zamora Leon: Thank you, Mauricio. So on Mexico, so as we've always represented, Auna is a growth story and notwithstanding 2025 results, we do have a very interesting opportunity, growth opportunity in Mexico, repeating what we've done elsewhere. As our insurance plans have solidified certain service offerings in the different cities Guadalajara and Tijuana and [indiscernible] and Mexico City as well, some of those create opportunities for investment in the future. Today, I have to be very, very clear. Today, leverage is a key concern, and we want to bring it below 3x. So we don't have a balance sheet to use to allocate capital. Today, the share is really depressed. So we were also limited there in terms of issuing of shares. So we have found with Sojitz a really interesting opportunity . We've been working with Sojitz, a great an admirable company and a set of executives. And we have engaged with Sojitz for the last 5 years looking at different opportunities to collaborate. The MoU we negotiated during the last few months formalizes our relationship and puts up a framework to co-invest together in Mexico. So investors must read the press release that…

Gisele Ferrero

Analyst

Yes, Mauricio, just to complement on the second part of the Colombia question, I would add, as Suso has mentioned that we remain very constructive on Colombia. As you know, it's an integral part of the Auna platform. And we have been able to manage the situation successfully even with the context of the external headwinds. We are constructive that there are some political noises that impact the flow of payments, and we do think that towards the end of next year and going into 2027, there will be certain opportunities for catalysts in the operation. And also kind of to add to Suso's point and clarify, as we've mentioned, we've reduced our exposure materially to [indiscernible] over the past year from 20% to 13% of the Colombian revenues. They have recently -- also, we've seen the announcement, the shared stakeholdership between the government vis-a-vis [indiscernible] and we also see that the government's direct stake in this payer is a positive sign. Jesús Zamora Leon: And Gisele, I also want to complement again the -- my previous response, Mauricio. Again, Auna has a very attractive pipeline in Mexico because of Sojitz and a limited balance sheet today and the share price. We want to make sure we can continue to act in the pipeline within the partnership of Sojitz. That's a critical part of that response, Mauricio.

Mauricio Cepeda

Analyst

Yes. But is it -- just a follow-up, is could be part of this interest of Sojitz to invest in Auna itself and helping the capital structure or it's just for new opportunities? Jesús Zamora Leon: I think that -- I mean I don't want to speak for Sojitz, but the dialogue that we've been having for years is very clear. They like our integrated model. They like Auna. We've been discussing things previously on Peru. They like the insurance business integrated to the health care side. So I don't want to -- it's a wide range opportunity to discuss things in the MoU, but I think it's not limited to new things, it's limited to making sure that we can push the growth opportunity of Auna, particularly in Mexico, but also I think of all Auna.

Operator

Operator

[Operator Instructions] There are no more questions from the phone lines. So I will now turn the call over to Ana Maria Mora from Auna, who'll proceed with questions from the webcast platform.

Ana Maria Mora

Analyst

Thank you, operator. So the questions, we're going to see that repeated, so if we miss anything, please let me know, but internally. But the first question on the webcast comes from Joseph Giordano from JPMorgan. If could you provide more details around the partnership with Sojitz and Trecca project? What are the advancements in Mexico over Q4 '25? And when should we see the operations getting back to 2024 levels in terms of operating leverage? Jesús Zamora Leon: Great. I'll take part of it and Gisele, if I forget anything, please complement. So on Trecca, I think on Sojitz we spoken a lot about -- we make sure that we keep the market updated as we progress with that MoU. So on Trecca, Trecca is a public-private partnership awarded to Auna back in 2010. So these are some of the hidden opportunities we have within Auna. We've been working with Salud, which is a Social Security Peru and PROINVERSIÓN, the investment promoting agency there to amend the concession and to get all the necessary permits to start the project. What we disclosed is that the building permit was authorized, which was a big hurdle in the last couple of years. I want to summarize, this is a very interesting project. As one sees health care in the world. One sees, of course, in limited, but in Latin America, for us, it will be sizable total addressable market of private payers. And then a large segment of indirectly or directly state-owned payer. So this is a contract, it's an 18-year contract with a 2-year building period. So we'll start building mostly at the beginning of next year. It will take us 2 years, and then we have 18 years. During those 18 years, we're talking about 1.9 million ambulatory services, 0.5 million prevention package services and others that sum up to 3.2 million services a year. This is a big endeavor to serve social security beneficiaries in Peru. This contract will deliver certainly sales of over $200 million a year when it scales. It's a very interesting opportunity as we grow our footprint, not only within our total addressable market in the private sector, but also indirectly with the state-served sector. So I'm really excited about Trecca. It's not only about Peru. These are the conversations that we have with government authorities in Mexico as well. So it's really interesting to prove capabilities to deliver services to millions. And I think that's what we are going to show we can do in the next couple of years with respect to Trecca. Gisele...

Gisele Ferrero

Analyst

Yes. I would complement there, Suso, with respect to Trecca the way that public-private partnerships are structured in Peru. This can be structured in such a way that it's debt-neutral for Auna. Jesús Zamora Leon: That's very important. Thank you, Gisele. This and the pipeline in Mexico is debt-neutral to debt reduction for Auna, very important. We're going to continue to grow without exposing our balance sheet to any additional debt. This public-private partnerships in Peru have a certain -- have a very defined process as the state finances not only the building but also all the services. So this will have no impact on leverage for Auna. There were some other questions from Joe, I think, Gisele.

Gisele Ferrero

Analyst

Yes, which we covered the subject announcement as well as the progress that we're making in Mexico. Jesús Zamora Leon: Great. I did -- so I think Joe also asked something about whether we're going to get back to 2024 levels in terms of operating leverage. And I know that we're reluctant to give a lot of numbers -- forward-thinking numbers or guidance. 2025 will be a flat year. 2026 will be a growth year. And definitely, it will be a growth year in Mexico.

Ana Maria Mora

Analyst

Thank you, Suso. Let me continue with the questions since we're getting plenty of questions right now. The next question comes from [indiscernible]. So on the turnaround and expected inflection, we understand the turnaround strategy is in motion, but what key KPIs should we track to confirm a tangible recovery in 2026? For instance, occupancy, payer mix, surgical productivity. When do you expect to see meaningful improvements in revenues and EBITDA? There is also another question on recent share price weakness. The share has underperformed despite resilient operations in Peru and Colombia. Do you have visibility on whether specific institutional investor has been exiting? Are you in conversations with such holders to reinforce the investment case? And just 1 more. The third one that I need to read it, but we probably already answered it. On Sojitz potential, could you provide more detail on next steps with Sojitz Mexico? Do you see any opportunities for co-investment in new assets or potential partial assets, asset sales to accelerate returns on capital? Jesús Zamora Leon: Great. So I think I'll take first. The share price question. So first of all, we are convinced the current prices now reflect the company's fundamentals. There has been no significant change from what we've been reporting to the company's fundamentals. We are, of course, always evaluating alternatives to support and enhance shareholder value, and we will be sharing with all of you these as we progress and these are things that we'll be discussing at the Board level very soon. Now we can speculate a little bit because we saw from public filings early this year that one of our competitors in Mexico had made a filing with the Mexican antitrust authority where they request to buy more Auna's shares. From public recent SEC filings, we can see that this leading health care player in Mexico has been selling stock consistently in the past month, which makes us suspect the requests did not move forward. No, we can't be certain of this. There's nothing -- a lot of information that's public, except what has been declared to SEC. And we've seen very high volumes in comparison to what we've seen in the past that coincide with this antitrust findings. So that's our speculation. We, of course -- the recent filings were made public a week ago, and we're making sure that we can approach whoever is selling and see if we can try to propose some block trades that would not impact the share price as it has impacted. Again, I want to insist there is nothing within the company fundamentals has changed in the last 45 days when the stock has dropped, I think, I don't know, I don't know a number, 25% or 30%. Nothing is changed in Auna to produce that.

Ana Maria Mora

Analyst

Thank you, Suso. So let's go to the next question. It comes from [indiscernible] from Deutsche Bank. Please comment on return on investment time line on Mexico performance and commentary on the share price performance. Jesús Zamora Leon: So on the share price, I think we've covered. Gisele, do you want to talk about return on investment?

Gisele Ferrero

Analyst

Sure, of course. So I think it's important to note that we evaluate all our investments as well as our operations throughout Auna from a return on invested capital perspective. And that is why we are constantly looking for ways to optimize those returns by making our assets more productive and reducing the amount of invested capital. Specifically in the case of the investment time line on Mexico, as we've mentioned in the call, we have had setbacks this year as a product of the factors that have already been discussed. However, we do expect 2026 to be a growth year for Mexico.

Ana Maria Mora

Analyst

Thank you, Gisele. The next question comes from [indiscernible] from Fundamental Capital. Regarding expansion plans, are you planning to add more beds in Peru? And in Mexico, about the 500 million in expansion plans, how many beds do you expect to add there? Jesús Zamora Leon: So we don't give guidance on projections on capacity growth. But directionally, you will see Auna increase capacity, not only of beds, but of chemotherapy and radiotherapy and surgery rooms, which, of course, fill our beds in Peru, in particular. Some growth there. We see some plans that would be mostly inaugurated in 2027, not 2026. We see ourselves also investing in countries or cities in which we have already large hospital footprint, more in ambulatory care as [indiscernible] particularly oncology, orthopedics and cardiology is moving towards outpatients. And in Mexico, we see ourselves trying to repeat our strategy of urban ecosystems of health care and high complexity that requires beds of -- between 75 to 150 beds minimum landing in each of the cities to produce this urban ecosystem of health care.

Ana Maria Mora

Analyst

Thank you, Suso. The next question comes from [indiscernible]. And the question after that comes from [indiscernible] SG Analytics. I'm just going to bundle them because they're very similar and related to the same topic. And it's about the partnership with Sojitz. Could you clarify whether this collaboration is intended to be part of the previously announced $500 million investment plan for Mexico over the next 3 to 5 years. Or is this a separate initiative? And additionally, how should we think about Sojitz's role in terms of co-investment, capital contributions or participation in the execution of the pipeline. Do you have -- could you provide light on what is the nature of the $500 million investment? And are there any quantifiable impacts on the top line? Thank you. Jesús Zamora Leon: So I think we've -- and I think I made the case that yes, the $500 million is related to our MoU Sojitz. So the opportunity is a 5-year opportunity of $500 million. And what we've signed MoU with Sojitz, it doesn't have a specific number on it, but it's a sizable part of our investment plan in Mexico. Of course, this partnership will produce significant top line growth, and we've seen in the past also in our EBITDA growth. And of course, it is the intention of all these investments is to continue to grow our top line at high-teens and above. Am I forgetting anything, Gisele or Annie?

Ana Maria Mora

Analyst

I think you're good. I'm going to read the next one or unless Gisele wants to chip in.

Gisele Ferrero

Analyst

No, I think we're good. Jesús Zamora Leon: Okay.

Ana Maria Mora

Analyst

Okay. So the next one comes from [indiscernible] from Deutsche Bank. Please comment on the insurance risk management policy of Auna at a group level. Jesús Zamora Leon: Great. That's a great question. It's a complex answer, but we managed risk very much in relation to MLR by policy type, I can talk about oncology, for example. So we manage the underlying oncology risk of our insurance plan with a 50% MLR. That as a goal produces 2 distinct action paths. One is pricing, and the other one is cost containment. Cost containment will be managed by making sure doctors adhere to our protocols, that we purchased the most effective drugs and devices and therapy treatment, that at scale are difficult to replicate by others. And that produces in a consistent fashion that 60%. We're doing the same thing with the very few policies that we have in Peru and general health care with really also attractive MLRs in which we are contain underlying risk. So by this ability to manage all these plans continuously. We reprice continuously, and we contain costs and see things that creep up and how we -- and we contain them on a continuous basis every month in different practices with doctors meeting a lot of the discussion of why not to include that service, why not to include that drug because we're always about scale at the plans and what we deliver for plan members.

Ana Maria Mora

Analyst

Thank you, Suso. And this is the last question we have on the website. It comes from [indiscernible] from HSBC. If I recall correctly, the preferred payer network and bundled package for corporates in Mexico were discussed last year. Have they been launched or are these initiatives different? How do you plan to increase out-of-pocket sales mix in Mexico? Jesús Zamora Leon: Great. So the preferred payer network has been launched, but it's a continued dialogue with payers now. We are very excited and very enthusiastic and we believe that in this -- these things are negotiated, we negotiate every year, so we are in the midst of that. And I think we're going to have really positive results these coming weeks to be in the most preferred networks of the largest insurance companies in Mexico for our operations in Monterrey. So this continues. It's not something that's done in -- it's about cost containment again and how we dialogue with payers now. The out-of-pocket sales mix is something that we, I think, have been doing in Monterrey with less ambition. And we're definitely moving that. I think as I mentioned in the press release. We are trying to double the penetration of sales -- more than double the penetration of sales by out-of-pocket patients. And we do that by 2 things principally. A lot of packages from attorney for certain preventive procedure colonoscopies and even surgeries, orthopedic surgeries as well. We package services in an integrated way from diagnosis all the way to the post surgery aggressively with good margin, but aggressively with respect to what the patient sees in other hospitals. And secondly, we've launched, I think, midyear, we've launched a very -- is a very fast-paced response to out-of-pocket patients that come in to ask for a quote of certain services. And our ambition is to capture anything that comes into the hospital quote and not lose it. So we're being very aggressive in pricing for our out-of-pocket patients. I must insist the out-of-pocket category has very high margins. So there's a lot of cushion to be very aggressive in those. So we've launched an internal process that is very agile, has urgency to respond and to capture the out-of-pocket patient that comes in.

Gisele Ferrero

Analyst

Perhaps I would add there, Suso, to further clarify to [indiscernible] question what Suso presented today were 6 very important and concrete initiatives that we're working on in the Mexican operation. Some of them are new, others have already been rolled out, but are continuing to evolve in their level of maturity and these are the actions that are concrete and taking us to resume growth in 2026.

Ana Maria Mora

Analyst

Thank you, Gisele, and thank you, Suso for your answers. I don't see any other questions on the call. So at this point, I'd like to turn the call back to Suso for his closing remarks. Jesús Zamora Leon: Thank you very much, Annie, and thank you very much the Auna team as well as all the shareholders and investors that follow us and as well as the research community that also follows us. It's been a difficult year, yes. We've done a lot of things. Some of them we can share with the public investors, some of the things that are in process of being implemented. Mexico. There's no doubt, Mexico will be a huge and growth market for Auna. We're really excited what we can bring to the table. We can see evidence of the engagement with a lot of counterparties with respect to that. Sojitz and their interest in Mexico is a testament to what we're doing and what the opportunity is. So a difficult year, yes. Very promising future for Auna in Mexico and the rest of the region, no doubt. I want to also highlight, sometimes we represent Peru as a mature market. We are the dominant player there and it's not a mature market. Trecca demonstrates how Auna can have a significant increase. It's not even mapped anywhere of how we grab more and more market share from -- not from the established traditional players, but from the state and from the out-of-pocket. Colombia growing, not withstanding the difficulties in Columbia. I don't want to minimize the difficulties of Colombia. We're growing. We're growing profitably, even more profitably, we're collecting well in a very stressed market. This is what Auna can do. And Sojitz, Trecca all these things are hidden gems that we have that will produce significant growth results in the future. We will definitely do something about the share price. We're not going to stay without acting on it, and we'll be discussing that at the Board level at the right time as well. Thank you very much for your support. Thank you very much for your coverage. And with that, I would like to end the earnings release call and the Q&A section of it. Thank you very much.

Operator

Operator

This concludes today's conference call. You may now disconnect.