Aster DM Quality Care Ltd Management Discussions

Add as a Preferred Source on Google
₹644.75
(-1.52%)
Oct 23, 2026|03:58:38 PM

Aster DM Quality Care Ltd Share Price Management Discussions

Economic Overview

Global Economy1

In CY 2025 the global economy grew by 3.4%, driven by resilient momentum despite elevated trade uncertainty. China grew 5.0%, supported by strong exports while India remained the fastest-growing major economy, expanding 7.6% in CY25 on firm growth momentum, a GST reform, and contained tariff impact. Among advanced economies, the US grew 2.1%, while Europe grew 1.4%, reflecting comparatively weaker demand. Looking ahead, global GDP is projected at 3.1% in CY26 and 3.2% in CY27, down for CY26 driven by the outbreak of war in the Middle East. Global inflation is estimated to be around 4.1% in CY25 and is projected to rise to 4.4% in CY26 before easing to 3.7% in CY27.

Indian Economy

India remained the worlds fastest-growing major economy in FY2025-26, with real GDP growth grew by approximately 7.6%2, up from 7.1% in FY2024-25 supported by resilient domestic demand despite a challenging global environment. The growth was driven by strong government capital expenditure, robust infrastructure development, improving rural demand following a normal monsoon, resilient private consumption, and continued strength in the services sector. Inflationary pressures remained well-contained, with consumer price inflation at 3.4%3, preserving real purchasing power across urban and rural markets.

The Government maintained its focus on infrastructure-led development, with capital expenditure increasing by 9% from INR 11.11 lakh crore in FY24-2025 to INR 12.11 lakh crore4 in the FY25-2026 Union Budget, reaffirming its commitment to infrastructure investment as a key driver of economic growth. The healthcare sector continued to demonstrate strong growth momentum, supported by increased public investment and innovation from the private sector. Despite a challenging global environment, strong macroeconomic fundamentals and resilient domestic demand are expected to underpin Indias medium-term growth trajectory. Looking ahead, India is projected to remain the worlds fastest-growing major economy in FY2026-27, with real GDP growth forecast at 6.6%5 and inflation expected to remain within a range of 4.0% to 4.7%5 underpinned by government capital expenditure, recovering private consumption and ongoing structural reforms.

Industry Overview

Indian Healthcare Sector

Indias healthcare sector remains a fast-growing industry, driven by demographic trends, rising incomes, increasing healthcare needs, and growing health awareness. Supported by investments from both the public and private sectors, along with ongoing improvements in healthcare infrastructure and access, the sector continues to demonstrate strong growth potential.

The Government of India has sustained its focus on building a resilient and inclusive healthcare ecosystem through increased public expenditure and targeted policy interventions. Flagship programmes such as Ayushman Bharat PM-JAY, the National Health Mission, and the Ayushman Bharat Digital Mission have collectively strengthened primary care delivery, expanded health coverage, and accelerated the adoption of digital health infrastructure across the country. Reinforcing these efforts, the Union Budget 2026-27 has allocated INR 1,06,530 crore6 to the healthcare sector, a nearly 10% increase over the Revised Estimates of FY 2026.

Key Segments of Indian Healthcare Sector

Healthcare Delivery9

Indias healthcare delivery market (hospitals and clinics) was valued at INR 7.0 trillion in FY 2025 and is projected to reach INR 11.2-12.2 trillion by FY 2030, growing at a CAGR of 10-12%, supported by rising healthcare awareness, increasing insurance penetration, growing incidence of chronic and lifestyle-related diseases, expanding medical tourism, and continued infrastructure development across Tier II and Tier III cities.

The Indian hospital market remains highly fragmented, with large private hospitals accounting for approximately 20% of the overall market in FY 2025. Private hospitals have gained considerable ground, driven by sustained investments in infrastructure, advanced medical technology, and superior clinical outcomes, resulting in a growing preference among affluent and upper middle-class patients willing to pay a premium for quality care.

Emerging Trends in the Healthcare Industry

Trend

Key Highlights

AI-Driven Healthcare

Artificial intelligence is being increasingly used across healthcare to improve diagnosis, decision- making, patient care, operational efficiency, and administrative processes. Generative AI is also emerging as a tool for documentation, patient engagement and care coordination.

Connected Care & Remote Patient Monitoring

Healthcare delivery is expanding beyond hospitals through telemedicine, remote monitoring, and virtual care, improving access to services and enabling continuous patient care.

Smart Wearables & Preventive Healthcare

Wearable health devices are helping people track their health in real time, detect issues early, and support preventive, personalized care.

Digital Transformation

Healthcare providers are investing in digital health records, cloud platforms, and data analytics to improve data sharing, patient experience, and care coordination.

Cybersecurity & Data

With increasing digitalisation, healthcare providers are investing in robust cybersecurity and data

Privacy

governance to safeguard patient information and maintain compliance.

Robotics & Advanced

These technologies are improving treatment precision, speeding recovery, and delivering better

Surgical Technologies

patient outcomes across a wide range of specialties.

Precision & Personalised Medicine

Advances in genomics, molecular diagnostics and data analytics are supporting more personalised treatment approaches, enabling targeted therapies and improving clinical outcomes for patients.

Ageing Population10 1

India is undergoing a significant demographic transition, with the population aged 60 years and above reaching 156.7 million in 2024, accounting for 11% of the total population. According to the World Health Organization, the share of people aged 60 years and above is projected to increase to 21% by 2050, with the elderly population expected to reach approximately 347 million11. The population aged 80 years and above stood at 15.5 million in 2024, highlighting the growing importance of healthcare services for an ageing population.

Expanding Health Insurance Coverage 2

Indias insurance sector continued its growth momentum in 2024-25, consolidating its position as the 10th largest insurance market globally by nominal premium volumes, with a market share of 1.8%12. Health insurance penetration in India has risen from 35% in FY19 to 41% in FY24, driven by a growing middle class and standard employer-provided coverage13.To strengthen the insurance ecosystem and enhance policyholder protection, the Government undertook a series of reforms during the year, including issuance of 44.14 crore12 Ayushman Cards under AB-PMJAY.

Technology and Digital Transformation 3

Technology is accelerating the transformation of Indias healthcare sector through increasing adoption of artificial intelligence, telemedicine, digital health platforms and data-driven care delivery. AI-enabled diagnostics, predictive analytics and digital healthcare solutions are enhancing operational efficiency, improving patient outcomes and expanding access to quality healthcare services.

Growing Focus on Preventive Healthcare14 4

Indias healthcare ecosystem is increasingly emphasising preventive and primary care through large-scale screening, immunisation and community healthcare programmes. As of June 2026, over 1.86 lakh Ayushman Arogya Mandirs were operational across the country, providing preventive, promotive and primary healthcare services. Additionally, the Universal Immunisation Programme covers 2.67 crore newborns and 2.9 crore pregnant women annually, supporting early disease prevention and improved health outcomes.

Growing Medical Tourism15 5

India is emerging as a leading global destination for Medical Value Travel (MVT), supported by advanced healthcare infrastructure, highly skilled medical professionals, internationally benchmarked quality standards and competitive treatment costs. Rising healthcare costs, long waiting periods and growing demand for preventive care across global markets are driving patients to seek high-quality and affordable healthcare solutions abroad. Indias unique integration of modern medicine with traditional wellness systems such as Ayurveda and Yoga further strengthens its value proposition. The countrys MVT market is valued at USD 8.7 billion in 2025 and is projected to reach USD 16.2 billion by 2030. In 2025, India welcomed over 507K+ international patients for medical treatment, accounting for approximately 5.5% of total foreign tourist arrivals. Supported by initiatives such as Heal in India, AYUSH Visa, digital facilitation platforms and the proposed Regional Medical Hubs, India is well positioned to capture a larger share of the rapidly expanding global medical tourism market

Government Initiatives16,17

Initiative

Key Highlights

Healthcare Budget FY2026-27

Allocation increased to INR 1,06,530 crore, up 10% over FY2025-26, reflecting continued focus on strengthening healthcare infrastructure and service delivery.

National Health Mission (NHM) Ayushman Bharat - PMJAY

Budget allocation increased to INR 39,390 crore, supporting disease control programmes, maternal and child healthcare, immunisation and primary healthcare services. Over 44.14 crore Ayushman Cards issued, covering 12.03 crore hospitalisations and treatment worth INR 1.8 lakh crore.

Ayushman Arogya Mandirs

More than 1.86 lakh centres operational across the country, expanding access to primary healthcare, diagnostics, teleconsultation and preventive care.

PM-ABHIM

Allocation increased to approximately INR 4,200 crore to strengthen critical care blocks, public health laboratories and healthcare infrastructure.

Heal in India Initiative

Government announced establishment of five regional medical hubs integrating healthcare, diagnostics, research, rehabilitation and medical education.

Ayushman Bharat Digital Mission (ABDM)

Recorded 20.49 crore registrations, with over 27,000 healthcare facilities connected to the national digital health ecosystem.

Biopharma SHAKTI

Launched with an outlay of INR 10,000 crore over five years to strengthen biologics, biosimilars, clinical research and pharmaceutical manufacturing capabilities.

Opportunities

Rising Demand Across Tier II and Tier III Cities

Improving healthcare awareness, expanding insurance coverage and rising disposable incomes are driving demand for quality healthcare services beyond metropolitan regions. The increasing need for organised healthcare infrastructure in Tier II and Tier III cities presents significant opportunities for hospitals, diagnostics and specialty care providers.

Growing Burden of Non-Communicable Diseases (NCDs)18

India continues to witness a rising prevalence of lifestyle-related diseases such as cardiovascular disorders, diabetes, cancer and respiratory ailments. Non-communicable diseases (NCDs) - heart disease, diabetes, cancer, and stroke - now account for 60% of all deaths in India, and this growing incidence of chronic disease burden is driving demand for specialised treatment, diagnostics, long-term care, and disease management services. To address this, NHMs National Programme for Prevention and Control of NCDs (NP-NCD) has been strengthening infrastructure for early detection, diagnosis, and treatment.

Healthcare Infrastructure Expansion

India continues to face a significant healthcare infrastructure gap relative to its growing healthcare needs, creating substantial opportunities for capacity expansion across hospitals, diagnostics and specialty care facilities. Hospital bed availability in India remains relatively low at approximately 1.6 beds per 1,00019 population, underscoring the need for continued investments in healthcare infrastructure, medical colleges, diagnostics facilities and healthcare delivery networks to improve accessibility and meet rising demand for quality healthcare services.

Challenges

Healthcare Workforce Shortages20

Despite ongoing capacity expansion, India continues to face shortages of trained doctors, nurses and allied healthcare professionals, particularly in specialised care and rural regions. As per recent estimates, India has approximately 1.23 doctors per 1,000 population, highlighting the need for continued investments in medical education, workforce development and talent retention to support the growing demand for healthcare services.

Urban-Rural Infrastructure Disparities

Healthcare infrastructure and specialist availability remain concentrated in urban centres, while several rural and underserved regions continue to face accessibility challenges and capacity constraints.

Regulatory and Compliance Complexity

The healthcare sector operates within an evolving regulatory framework encompassing clinical standards, insurance, patient safety, accreditation requirements and data protection regulations.

Cybersecurity and Data Privacy Risks

The growing adoption of digital health records, telemedicine and connected healthcare systems increases exposure to cybersecurity threats and data privacy concerns.

Company Overview

Aster DM Healthcare Limited is among Indias leading integrated healthcare service providers, delivering comprehensive healthcare services across primary, secondary, tertiary and quaternary care. As of March 31, 2026, the Company operates a network of 20 hospitals equipped with 5,449 beds, 304 labs and patient experience centers, 203 pharmacies (Operated by Alfaone Retail Pharmacies Private Limited under brand license from Aster) and 10 clinics located in 16 cities across 5 states in India. Guided by its enduring promise, "Well Treat You Well," the Company continues to focus on delivering high-quality, patient-centric healthcare through clinical excellence, advanced medical technologies and a strong emphasis on specialised care.

During FY 2026, the Company strengthened its healthcare footprint through strategic capacity additions and expansion initiatives, further enhancing accessibility to quality healthcare services. Asters hospitals gained recognition for clinical excellence and patient care, with Aster CMI Hospital and Aster Medcity featuring among Indias top-ranked hospitals in Newsweeks Worlds Best Hospitals Rankings 2026.

Merger of Aster DM and Quality Care

Aster DM Healthcare is entering a transformative phase of growth through its merger with Quality Care India Limited, a strategic combination that is projected to create Indias leading healthcare delivery network. The merger was completed on July 1, 2026, and the combined platform, Aster DM Quality Care Limited, brings together complementary clinical capabilities, strong regional leadership, and a shared commitment to patient-centric care.

Merger Highlights Combined Scale and Reach

The combined entity will operate across 28 cities with a network of 39 hospitals and a capacity of over 10,800 beds, establishing a strong presence in South and Central India, complemented by operations in Western and Eastern India. The combined network will enhance accessibility to advanced healthcare services while strengthening the platforms ability to serve diverse patient populations across multiple geographies. coming years. Supported by a balanced mix of brownfield and greenfield developments, the expansion strategy is designed to address growing healthcare demand while maintaining capital efficiency and operational excellence.

Operational Synergies and Value Creation

Strengthening Clinical Excellence

The combined entity is well positioned to create significant value by leveraging its expanded scale and clinical capabilities to drive revenue growth, while realizing synergies through procurement and supply chain efficiencies, optimized capital investments, and other operational streamlining and cost optimization initiatives.

The merged platform brings together highly regarded healthcare
institutions, experienced medical professionals and a broad

Positioned for the Future

portfolio of specialised clinical services. This integration is expected to accelerate the adoption of advanced medical technologies, improve clinical collaboration and strengthen high- acuity and complex care segments, enhancing patient outcomes.

With a strong clinical foundation, diversified geographic presence and disciplined expansion strategy, the Company post-merger is well positioned to capitalise on Indias growing healthcare demand. The unified platform is expected to create sustainable long-term value for patients, healthcare professionals, communities and shareholders while reinforcing its position among the countrys leading healthcare providers.

Scalable Growth Platform

The combined entity has outlined a robust expansion pipeline of approximately 4,179 additional beds, which is expected to increase overall capacity to more than 15,000 beds over the

About Quality Care India Limited

Quality Care India Limited, operates through 19 hospitals in 14 cities with a combined capacity of over 5,174 beds, making it one of Indias largest hospital networks with a strong focus on emerging healthcare markets. Its facilities carry both NABH and JCI accreditation and span more than 30 medical specialties, backed by a clinical team of 3,790+ doctors. Quality Cares approach to care is anchored in transparency, compassion, excellence, and equity - values that shape its commitment to ethical, patient-first healthcare delivery. For FY26, Quality Care reported total revenue of INR 4,630 Crore, reflecting a 17% year-on-year growth. Operating EBITDA reached INR 1,066 Crore, up 24.1% YoY, with Operating EBITDA margin expanding 136 bps to 23.0%.

As of FY26, the Companys operational network spans 20 hospitals with 5,449 capacity beds across 5 states and 16 cities, strategically distributed across three geographic clusters -2,921 beds in Kerala, 1,481 beds in the Karnataka & Maharashtra cluster, and 1,047 beds in the Andhra & Telangana cluster. Hospitals and clinics remain the primary revenue contributor, accounting for approximately 95% of total revenue generated during FY26. The network of hospitals served 3.62 million outpatient visits and 278,515 inpatient visits during the year, reflecting sustained demand across key markets.

Cluster wise Hospitals-

Hospital

Location

Commencement/ Acquisition Year Bed Capacity Operational Beds (Census)
Aster Medcity Kochi, Kerala 2014 876 702
Aster MIMS Calicut Kozhikode, Kerala 2013 695 465
Aster MIMS Kannur Kannur, Kerala 2019 424 341
Aster MIMS Kottakkal Kottakkal, Kerala 2013 359 282
Aster MIMS Kasargod Kasargod, Kerala 2025 263 100
Aster PMF Hospital Kollam, Kerala 2023 164 117
Aster Mother Hospital Areekode, Kerala 2022 140 101
Aster CMI Bengaluru, Karnataka 2014 502 367
Aster Whitefield Bengaluru, Karnataka 2021 377 245
Aster RV Bengaluru, Karnataka 2019 252 179
Aster Aadhar Hospital Kolhapur, Maharashtra 2008 250 202
Aster G Madegowda Mandya, Karnataka 2023 100 35
Aster Prime Hospital Hyderabad, Telangana 2014 158 98
Aster Narayanadri Tirupati, Andhra Pradesh 2023 150 136
Aster Ramesh Guntur Guntur, Andhra Pradesh 2016 350 225
Aster Ramesh Sanghamitra Ongole, Andhra Pradesh 2018 150 130
Aster Ramesh - Main Centre Vijayawada, Andhra Pradesh 2016 135 125
Aster Ramesh - Labbipet Vijayawada, Andhra Pradesh 2016 54 47
Aster Ramesh Adiran (IB) Vijayawada, Andhra Pradesh 2023 50 42

Aster Pharmacy

Aster Pharmacy complements the Companys healthcare delivery platform through a network of 203 pharmacies, providing access to pharmaceutical and wellness products across key southern states. The Company supports better healthcare access through a broad range of therapeutic, nutrition, infant care, lifestyle, and wellness solutions.

Aster Labs

Aster Labs continues to strengthen the Companys integrated healthcare ecosystem through a network of 304 laboratories, clinics and patient experience centres across Southern India. It offers over 2500 diagnostic tests within South India through its network of 1 Reference Lab, 15 Satellite Labs and 288 Patient Experience Centres (PECs) including 59 in Karnataka and 229 in Kerala - supported by 11 Hospital Lab Managements within the hospitals. Strengthened by advanced diagnostic capabilities and specialised expertise, the business plays an important role in preventive healthcare and early disease detection.

Financial Performance

Aster India Financial Performance

Over the past five years, Aster India has delivered consistent growth, driven by capacity expansion, improving occupancy levels, increasing patient volumes and a favourable specialty mix. During FY 2026, the Company reported strong growth across key financial parameters, focussing on tertiary and quaternary healthcare services, operational efficiencies and disciplined execution.

Profit and Loss Statement

Particulars

FY 2026 FY 2025 YoY %

Revenue from Operations

4,643 4,138 12%
Material Cost1 1,049 938
Doctor Cost 1,032 921
Employee Cost 848 760
Other Cost 768 713

Operating EBITDA2

947 806 17%
Employee Stock Option Expenses 8 8
Movement in FV of Contingent Consideration Payable 0 1
Variable Operation & Management Fees 37 32

EBITDA Post IND AS

901 765 18%
Depreciation 264 249
Finance Cost 123 124
Other Income 126 148

Profit Before Tax

639 540 18%
Tax 143 134

Profit After Tax (Before Exceptional Item)

497 406 22%
Exceptional Item (33) (50)

Profit After Tax

464 356 30%
Share of Profit/(Loss) of Associates (37) (19)
NCI (Non-Controlling Interest) 39 30

Profit After Tax (Post Non-Controlling Interest)

388 307 26%

Normalised PAT3

421 357 18%

EBITDA Pre IND AS

788 673 17%

1.Material Cost (% excluding wholesale pharmacy) stood at 21.4% in FY 2026 compared with 20.9% in FY 2025.

2.Operating EBITDA for the period FY26 excludes the ESOP Cost of INR 8.3 Cr [FY25: 8.4 Cr], Movement in fair value of contingent consideration payable of INR Nil [FY25 : 0.8 Cr], Variable O&M fee amounting to INR 37.3 Cr [FY25 : 31.8 Cr]. [Our Operating & Management (O&M) agreements, encompasses both fixed and variable component. While the fixed component of the O&M fee is delineated into depreciation and finance costs as per Ind AS 116, whereas the variable component falls outside the scope of IndAS 116, leading to an incomplete reflection of the standards impact in EBITDA] 3.Normalised PAT for FY 2026 excludes exceptional income of INR 38.4 Cr [FY 2025: Nil] arising from minimum wage reversal, as well as exceptional expenses of INR 71.1 Cr [FY 2025: 50.1 Cr], which includes merger related costs, CSR expenses related to profits from the sale of the GCC business and other provisions.

The consolidated revenue grew by 12% year-on-year to INR 4,643 crore in FY26 from INR 4,138 crore in FY25. The growth in revenue is driven by YoY growth of 9% in total volume and YoY growth of 15% in ARPOB reaching to INR 51,800 in FY26, with an improvement of 4% YoY in ALOS.

EBITDA

Consolidated Operating EBITDA grew strongly by 17% year-on-year reaching to INR 947 crore in FY26 compared to INR 806 crore in FY25. Operating EBITDA margins has also improved to 20.4% in FY26 from 19.5% in FY25. This improvement is driven by operational leverage from strong revenue growth and enhanced EBITDA performance from Lab business.

Costs

Material cost as a percentage of revenue remained stable at 22.6% in FY26 as compared to 22.7% in FY25.

Doctor costs and Employee costs also remained stable at 22.2% and 18.3% respectively in FY26.

Other cost as a percentage has reduced to 16.5% in FY26 from 17.2% in FY25 on account of focused cost optimisation efforts across units.

Finance Costs

Finance cost remained largely stable at INR 123 crore in FY26 compared to INR 124 crore in FY25, reflecting prudent capital management despite continued investments in expansion projects.

Depreciation

Depreciation increased to INR 264 crore in FY26 from INR 249 crore in FY25, primarily due to capacity addition of 290 beds.

Taxation

Tax expense increased to INR 143 crore in FY26 from INR 134 crore in FY25, on account of an increase in profits from the hospital business.

Other Income

Other income reduced to INR 126 crore in FY26 compared to INR 148 crore in FY25, primarily attributable to lower interest income and non-operating gains compared to the previous year.

Net Profit After Tax

The Companys PAT (post non-controlling interest) increased by 26% to INR 388 crore in FY26 compared to INR 307 crore in FY25 reflecting improvements in operational performance and profitability. Normalised PAT (Post NCI) adjusted for minimum wage reversal and transaction cost, increased from INR 357 crore in FY25 to INR 421 crore in FY26 (excluding transaction cost), reflecting a growth of 18%.

Dividend

For FY26, the Board declared an interim dividend of INR 3.0 per equity share (face value of INR 10 each).

Aster India Balance Sheet

Particulars

As at March 31, 2026 As at March 31, 2025

EQUITY AND LIABILITIES

Shareholders Equity 518 500
Minority Interest 258 224
Other Equity 4,058 2,929
Gross Debt 701 642
Lease Liabilities 1,518 1,376
Other Current Liabilities 806 690
Other Non-Current Liabilities 252 246

Total Equity and Liabilities

8,112 6,607

ASSETS

Property, Plant & Equipment (including CWIP) 3,058 2,694
Investments (including Goodwill) 1,429 508
Right-to-Use Assets 1,340 1,255
Inventories 91 93
Cash, Bank Balance & Current Investments 1,327 1,381
Other Non-Current Assets 337 247
Other Current Assets 530 429

Total Assets

8,112 6,607

Fixed Assets

Fixed assets as of March 31, 2026, is INR 3,058 crore as compared to INR 2,694 crore as of March 31, 2025. This growth is primarily attributable to new capacity expansion at Aster Kasargod (greenfield project) along with investments in hospital infrastructure, medical equipment.

Gross Debt

The Company maintained a healthy leverage profile despite continued investments in growth initiatives.

The Companys Balance sheet remained strong with a net cash position of INR 626 Crore as on March 31, 2026.

Total Borrowings stood at INR 701 crore as of March 31, 2026 compared to INR 642 crore as of March 31, 2025.

Total Cash, bank balances and current investments stood at INR 1,327 crore as of March 31, 2026 compared to INR 1,381 crore as of March 31, 2025.

Net Debt (Net Cash) to EBITDA (Pre IND-AS) stood to (0.8) x, reflecting the Companys strong liquidity position and disciplined financial management.

Lease Liabilities

Overall lease liabilities as of March 31, 2026 were at INR 1,518 crore as compared to INR 1,376 crore as of March 31, 2025, primarily due to planned capacity addition at Aster Whitefield (Block D) and revision of lease rentals for the existing capacity at Aster Whitefield.

Change in Financial Ratios (Standalone)

Ratio

FY 2026 FY 2025 Change
Debtor Turnover Ratio (times) 16.5 17.47 -0.97
Inventory Turnover Ratio (times) 14.38 10.72 3.66
Interest Coverage Ratio (times) 4.54 3.83 0.71
Current Ratio 2.39 3.83 -1.44
Net Debt Equity Ratio 0.05 -0.03 0.08
EBITDA Margin (%) 21.04% 19.67% 1.4%
PAT (Post-NCI) Margin (%)* 10% 268% -257.3%
Return on Net Worth (%)* 6% 189% -182.8%

*The ratio has been calculated after considering a one-time dividend income of INR 5,569.96 crore and exceptional income of INR 323.15 crore in FY 2024-25, as well as exceptional expenses of INR 89.92 crore in FY 2025-26.

Aster India Operating Performance

Bed Capacity

The Companys bed capacity increased to 5,449 beds as of March 31, 2026, from 5,159 beds as of March 31,2025. The Company added 290 beds last year including the commissioning of 263 beds at Aster Kasargod and balance of 27 beds across other locations. Aster plans to increase its standalone bed capacity to 8,200 beds over the coming years through a robust expansion pipeline including both greenfield and brownfield projects, reinforcing its healthcare infrastructure and supporting long-term growth.

ARPOB

The Company witnessed healthy growth in Average Revenue Per Occupied Bed (ARPOB), increased by 15% YoY to INR 51,800 in FY26 from INR 45,000 in FY25. The improvement was driven by a favourable specialty mix, improved realisations, focus on high-acuity treatments, growth in international (MVT) revenue and improvement in ALOS.

ARPP IP

The company witnessed healthy growth in Average Revenue Per Patient In-Patient (ARPP IP), increased by 9% YoY to INR 1,21,016 in FY26 from INR 1,10,948 in FY25. The improvement was driven by a favourable specialty mix, improved realisations, focus on high-acuity treatments and growth in international (MVT) revenue.

Payor Profile

The overall payor revenue mix witnessed a change with Insurance & Corporate patients contribution increased by 100 bps YoY to 34% in FY26 from 33% in FY25 while Walk-in patients continued to form the largest share of revenues at 55% in FY26. The contribution from government schemes marginally increased to 6.7% in FY26 from 5.3% in FY25 on account of price revision, while contribution from international patients (MVT) remained stable at 4% in FY26.

Specialty Mix

The Company maintained a well-diversified specialty revenue mix during FY26, with no single specialty contributing more than 15% of total revenue. The Companys focus on strengthening high-acuity specialties resulted in an increase in the CONGO mix (Cardiac Sciences, Oncology, Neurosciences, Gastroenterology & Integrated Liver Care and Orthopaedics) to 51% in FY26 from 50% in FY25. The contribution of Oncology increased from 7% in FY22 to 11% in FY26, underscoring the Companys commitment to strengthening access to advanced care across high-demand specialty segments

ALOS (Average Length of Stay)

The average length of stay (ALOS) improved by 4% YoY to 3.1 days in FY26 from 3.2 days in FY25, driven by the adoption of advanced medical technologies in cardiac care and operational improvements such as enhanced discharge planning and streamlined insurance approvals. These initiatives contributed to better bed utilization while maintaining patient care quality and throughput.

Core Business Performance - Hospitals & Clinics

Revenue

The Companys core business hospitals and clinics has achieved a CAGR of 16% in revenue over the last three years till FY26, supported by higher patient volumes, improved case mix, increasing Medical Value Travel (MVT) revenues and expansion across key markets. The segment contributed 95% of the total revenue and grew by 13% to reach to INR 4,500 crore in FY26 from INR 3,990 crore in FY25.

High-End Medical Treatment

The Company strengthened its advanced clinical capabilities across organ transplantation, robotic surgery, oncology, neurosciences and cardiac sciences, reinforcing its position as a leading provider of tertiary and quaternary healthcare services. In FY 2026, the Company performed over 578 transplants and conducted 2,700 robotic surgeries.

Operating EBITDA and Margin

The Operating EBITDA for hospital and clinics has achieved a CAGR of 24% over the last three years till FY26 driven by operating leverage, improved realisations and continued focus on cost optimisation. The Operating EBITDA grew by 18% to INR 1,031 crore in FY26 from INR 875 crore in FY25, while Operating EBITDA margin expanded to 22.9% from 21.9% in FY25.

Return Ratio

The Companys hospitals and clinics business continued to generate healthy returns through sustained profitability improvements and disciplined capital allocation. The Return on Capital Employed (RoCE*) from the Companys core hospital business increased to 27% in FY26 from 25% in FY25, supported by higher earnings and improved operating performance.

Hospitals Operational for Over 7 Years Hospitals Operational Between 3 and 7 Years Hospitals Operational Between 0 and 3 Years

The Companys mature hospital portfolio Hospitals in the 3-7 years maturity Hospitals in this category commenced remained the primary driver of operating category continued to demonstrate operations about two years ago and performance during FY26. Comprising healthy operational performance and are currently in their growth phase. 11 hospitals, this category accounted improving profitability. The segment This category comprised four hospitals for 78% of hospital revenue and 76% of comprised four hospitals and contributed (including Aster Kasargod commenced its operational census beds. The segment 10% of hospital revenue and 12% of operations in Oct 2025) and accounted generated revenue of INR 3,474 crore operational census beds. Revenue stood for 12% of hospital revenue and 13% and Operating EBITDA of INR 882 crore, at INR 442 crore, while Operating EBITDA of operational census beds. Revenue resulting in an EBITDA margin of 25.4%. reached INR 91 crore, translating into an stood at INR 523 crore, while Operating Strong operating efficiencies, established EBITDA margin of 20.6%. The segment EBITDA amounted to INR 55 crore, clinical programmes and higher utilisation reported a ROCE of 23.8%, reflecting resulting in an EBITDA margin of 10.5%. levels contributed to a robust Return on continued ramp-up and improving Excluding Kasargod Hospital, revenue Capital Employed (ROCE) of 36.5%. operating leverage. for the category stood at INR 496 crore, with Operating EBITDA of INR 77 crore, EBITDA margin of 15.5% and positive ROCE of 4.3%.

Cluster wise Performance

Kerala Cluster

Financial Performance

The Kerala cluster performed strongly, contributing 53% of the overall hospital business revenue in FY26. The clusters revenue grew by 14% YoY to INR 2,405 crore in FY26, supported by growth in patient volumes, international (MVT) revenues and contribution from the newly operationalised Kasargod facility. MVT business revenue grew by 39% YoY in FY26 despite macroeconomic headwinds in key source markets. The cluster witnessed temporary disruptions arising from the nurses strike during the last year. Despite these factors, the Operating EBITDA grew by 20% with improvement in operating EBITDA margin to 24.6% in FY26 from 23.4% in FY25, led by cost efficiencies and operating leverage Excluding the newly commissioned Kasargod facility, the revenue grew by 13% YoY in FY26 while operating EBITDA grew by 24% YoY with operating EBITDA margins remained strong at 25.6%.

Operational Metrics

Particulars

FY 2026 FY 2025
ARPP (IP) 104,090 99,003
Occupancy (%) 65% 71%
Inpatient Visits 168,280 159,327
Outpatient Visits (Mn) 2.39 2.15
ALOS 2.9 3.1

Operational Performance

Total patient volumes increased by 11% YoY in FY26, with inpatient volumes growing by 6% and outpatient volumes increasing by 12%. ARPP (IP) improved by 5% YoY to INR 1,04,090 in FY26, supported by a favourable case mix and higher contribution from specialised procedures.

Karnataka & Maharashtra Cluster Financial Performance

The Karnataka and Maharashtra, contributing 35% of hospital business witnessed revenue growth of 10% YoY to INR 1,553 crore in FY26. The growth is supported by higher ARPP (IP) and improved specialty mix. The Operating EBITDA grew by 14.0% YoY to INR 366 crore in

FY26, while EBITDA margin improved to 23.5% from 22.8% in FY25, supported by strong performance with the successful ramp up of Aster Whitefield hospital in Bengaluru. Excluding the Whitefield hospital, the cluster achieved operating EBITDA margin of 25.3% in FY26 as compared to 25.1% in FY25.

Operational Performance

The clusters ARPP (IP) grew by 20% YoY to INR 1,81,792 in
FY26, driven by higher complexity procedures across cardiology,
neurosciences and ortho, particularly robotic surgeries and DBS
procedures and de-empanelment of a low-yielding scheme at Aster
Aadhar. The company has increased its capacity by adding 159 beds
at Block D of Aster Whitefield in April 2026.

Operational Metrics

Particulars

FY 2026 FY 2025
ARPP (IP) 181,792 150,964
Occupancy 58% 62%
Inpatient Visits 67,742 73,907
Outpatient Visits (Mn) 0.80 0.78
ALOS 3.2 3.1

Margin (%)

FY 2025 FY 2026
Margin (%) 22.8% 23.5%

Capacity Expansion

Particulars

Beds
Existing Capacity 1,481
Planned Expansion 1,519
Greenfield Beds 1,010
Brownfield Beds 509

Capacity post expansion

3,000+

Andhra Pradesh & Telangana Cluster Financial Performance

Andhra Pradesh and Telangana cluster performed well with revenue increased by 15% YoY to INR 542 crore in FY26, driven by strong performance from Ramesh hospitals, growth in patient volumes and ARPP (IP). The Revenue from Ramesh Hospitals grew strongly by 10% during the year. The Operating EBITDA grew by 22% to INR 73 crore in FY26, while EBITDA margin improved to 13.5% from 12.7% in FY25.

Operational Performance

Total Patient volumes grew by 12% YoY in FY26 with 7% growth in in-patient volumes and 13.5% growth in outpatient volumes. ARPP (IP) increased by 8% YoY supported by an improvement in case mix. The company has increased its capacity by adding 75 beds at Ramesh Ongole in April 2026.

Operational Metrics

Particulars

FY 2026 FY 2025
ARPP (IP) 91,161 84,393
Occupancy 54% 54%
Inpatient Visits 42,493 39,701
Outpatient Visits (Mn) 0.42 0.37
ALOS 3.7 3.9

Aster Labs

The Labs business continue to demonstrate strong performance during the last year. The overall revenue grew by 16% in INR 153 crore in FY26 while operating EBITDA almost doubled to INR 20 crore with operating margin improved to 12.8% from 7.6% in FY25.

Digital Transformation Aster Digital

The Aster Health app continued to strengthen its position as a key enabler of digital healthcare access, crossing 500,000 downloads during FY26 with the integration of hospital laboratory reports, radiology reports and medical images. This digital platform recorded more than 51,000 unique patients, over 33,000 monthly active users and facilitated more than 64,000 appointments during the year. In parallel, the Company expanded its digital patient engagement initiatives through AsterCare, a clinical reactivation platform designed to re-engage dormant patients based on their healthcare needs. During its pilot phase, the platform achieved an 8% patient reactivation rate, successfully reconnecting with over 6,500 patients. Following a successful proof of concept, the programme is being scaled across additional facilities.

Medical Imaging and Technology Initiatives

The Company continued to strengthen its digital diagnostics capabilities through its 24/7 teleradiology business model, enabling centralised remote interpretation of MRI, CT and X-ray scans through a hub-and-spoke network. The platform supports both internal operations and external healthcare institutions, improving reporting efficiency, optimising radiologist utilisation and enabling round-the-clock diagnostic coverage.

Aster Pharmacies

The revenue from wholesale Pharmacy business decreased to INR 108 crore in FY26 from INR 134 crore in FY25, primarily due to the planned exit from a loss-making wholesale unit. This strategic decision was undertaken to enhance profitability and has yielded positive results, with the business achieving a positive Operating EBITDA of INR 1 crore in FY26.

Investment Plan

During FY26, the company has added 290 beds, including the commissioning of 263 beds at Aster Kasargod and balance of 27 beds at other locations, reaching total bed capacity to 5,449 beds as of March 31, 2026. Aster has a robust expansion plan to add 2,728 beds in the coming years through a mix of brownfield and greenfield projects. Out of the total 2728 beds, 688 beds will be added in FY27 (Already commissioned 159 beds at Aster Whitefield and 75 beds at Ramesh Ongole in April 2026), 760 beds in FY28, and 1280 beds beyond FY29. With this, the Company is aiming to increase its total bed capacity to 8,177 beds. Following the proposed merger with Quality Care India Limited, the combined platform has a current capacity of 10,898 beds as on 30th June 2026 and planned to add 4,179 beds, taking the total bed capacity to 15,077 beds over the coming years. The expansion plan is focused on a balanced mix of brownfield and greenfield developments, with 53% of the planned additions coming from existing facilities and 47% new facilities, enabling efficient capital deployment while strengthening market presence across high-growth healthcare corridors.

Kerala Cluster

The Company continued to strengthen its leadership position in Kerala through strategic capacity expansion initiatives. Key projects include the development of Aster Capital, Trivandrum with a capacity of 454 beds, along with the addition of 100 beds each at its existing hospitals in Kochi, Kannur and Calicut. These expansions are expected to further enhance the Companys clinical capabilities and extend its patient reach across the region.

Karnataka & Maharashtra Cluster

The Company continued to reinforce its position in Bengaluru through a mix of greenfield and brownfield projects. Key developments include Aster Sarjapur (460 beds), Aster Yeshwanthpur (550 beds), expansion at Aster CMI Hospital (350 beds) and capacity additions at Aster Whitefield by 159 beds (already commissioned in April 2026). These developments are expected to drive long-term growth and strengthen the Companys presence in a key healthcare market.

Andhra & Telangana Cluster

The Company expanded its footprint in Andhra Pradesh and Telangana through capacity additions and new specialty-led facilities. Key projects include Aster Hospital, Hyderabad (300 beds) and capacity addition of 75 beds at Aster Ramesh, Ongole (already commissioned in April 2026).

 

Aster Yeshwanthpur, Bengaluru

Aster Sarjapur, Bengaluru

Aster Capital, Trivandrum

Aster Hyderabad

Multispecialty 550 Beds 30 year long term Lease 5 lakhs sq.ft Built up Area Total Investment: INR 580 Cr

Multispecialty 460 Beds Design Phase 30 year long term Lease 4.2 lakhs sq.ft Built up Area

Multispecialty 454 Beds Construction start date: July 2024 Floors: G+7 Floors 6.5 Acre Land - Owned 6.2 lakh

Mother and Child Care 300 Beds Construction start date: June 2025 Floors: A block G+11 Floors and B block G+5 Floors, 3B common

Expected Timeline: FY30 Architectural and design phase.

Expected Timeline: FY28 Architectural and design phase.

sq.ft Built up Area incl. MLCP area Expected Timeline: H2FY27 Civil works completed. MEP work in progress on site.

2 Acre Land - Leased 3.23 lakhs sq.ft Built up Area Expected Timeline: H1FY28 Construction started. Civil work in progress

Aster Yeshwanthpur - Planned Bed Capacity increased to 550 beds from 500 beds Aster Sarjapur - Planned Bed Capacity increased to 460 beds from 430 beds

Aster CMI

Aster MIMS, Calicut

Aster MIMS, Kannur

Aster Medcity

Bed Expansion: 350 Beds Multispecialty Current: 502 Beds Ownership: Leased (O&M) Expected Timeline: 100 beds in H1FY29 250 beds in H1FY30

Bed Expansion: 150 Beds Multispecialty Current: 695 Beds Ownership: Owned Expected Timeline: FY29

Bed Expansion: 130 Beds Multispecialty Current: 424 Beds Ownership: Owned Expected Timeline: FY29

Bed Expansion:100 Beds Multispecialty Current: 876 Beds Ownership: Owned Expected Timeline: H1FY29

Architectural and design phase.

Architectural and design phase.

Architectural and design phase.

Waiting for statutory approvals. All design and other pre-construction activities completed

Way Forward

Strategic Priorities

Focus Areas

Merger Integration & Synergies

Seamless integration of Aster and Quality Care through network alignment, clinical collaboration and operational harmonisation, followed by the realisation of synergies and enhanced patient access while accelerating long-term growth.

D Capital Investment

Prudent investments in both brownfield expansions and greenfield developments across key clusters, while selectively evaluating inorganic growth opportunities.

Clinical Excellence & Specialty Leadership

Strengthen high-acuity specialties such as cardiology, oncology, neurosciences, organ transplantation, robotic surgery to enhance patient outcomes and improve case mix.

Operational Efficiency & Margin Enhancement

Drive productivity through improved capacity utilisation, procurement efficiencies, cost optimisation initiatives and standardisation of clinical and operational processes across the network.

Integrated Care Ecosystem Digital Healthcare Transformation Medical Talent & Research

Expand the continuum of care through diagnostics, pharmacies, clinics and home healthcare solutions, enabling a seamless and patient-centric healthcare experience. Enhance digital capabilities through integrated patient engagement platforms, teleconsultation services, digital health records, AI-enabled healthcare solutions and data-driven decision-making. Attract, develop and retain high-quality medical professionals while building clinical research, innovation and continuous medical education across the network.

Human Resources

The Company believes that its people are the foundation of its success and remains committed to building a high-performance, patient-centric and inclusive workplace. Through investments in talent development, leadership enhancement and capability building, the Company seeks to nurture a future-ready workforce aligned with its mission of delivering quality healthcare services. Employees are empowered through structured learning programmes, clinical advancement initiatives, leadership development interventions and digital capability enhancement opportunities.

The Companys people strategy focuses on attracting, developing and retaining skilled healthcare professionals while promoting a culture of collaboration, compassion, innovation and excellence. Through progressive HR practices and a supportive work environment, the Company promotes employee wellbeing, engagement and diversity while enabling individuals to contribute meaningfully towards improving patient outcomes and strengthening healthcare delivery.

As part of its commitment to society, the Company encourages active employee participation in community outreach programmes, healthcare awareness initiatives, disaster relief efforts and social responsibility activities. These initiatives reinforce the Companys purpose-driven culture while creating a positive impact across communities.

As of March 31, 2026, the Company had a workforce of over 22,413 professionals, including doctors, nurses, allied healthcare professionals, and outsourced staff. The growth of the workforce reflects the Companys growing healthcare network and ongoing investments in clinical excellence, operational capabilities and patient care.

The Company focuses on building an engaging workplace culture through continuous learning, employee recognition, leadership development and wellbeing initiatives. During the reporting year, it remained committed to creating an environment where employees can grow professionally while contributing to the delivery of quality healthcare services.

The Company continued to be recognised as a Great Place to Work? for its people-centric culture and commitment to employee experience. This recognition reflects the organisations focus on creating a workplace built on trust, collaboration, respect and shared purpose.

Internal Financial Control Systems and their Adequacy

Aster prioritises strong internal financial controls to ensure the orderly and efficient conduct of its business, including adherence to Asters policies, the safeguarding of its assets, the prevention and detection of frauds and errors, the accuracy and completeness of the accounting records, and the timely preparation of reliable financial information, as required under the Companies Act, 2013, as amended from time to time. The internal control framework of Aster is designed to cater to

Asters diverse operations across various locations with varied size and complexity, ensuring consistency and efficiency across its operations, including changes in information technology and business processes, changes in key management, and acquisitions, mergers and divestments, if any. legal and regulatory developments such as changes in industry regulations and new regulatory reporting requirements. changes in the financial reporting framework, such as changes in accounting standards. The Internal Financial Control Framework promotes operational efficiency by optimising business processes and minimising waste and ensures accuracy and reliability of financial reporting, builds trust and transparency with investors and other stakeholders. The Managing Director and Chief Financial Officer (CFO) at Aster annually certifies the existence and maintenance of effective internal controls pertaining to financial reporting, within the Companys Corporate Governance report as per SEBI (LODR) Regulations, adding another layer of accountability and transparency.

Deloitte Haskins & Sells, the statutory auditors of Aster DM Healthcare Limited, has audited the financial statements included in this Integrated Annual Report, and as part of their audit, has issued their report on the Companys internal financial controls (as defined in Section 143 of Companies Act, 2013), on the effectiveness of our internal financial controls over Standalone and Consolidated Financial Statements as at 31 March 2026. Aster also has a comprehensive internal audit and internal financial control audit programme in place. This programme is managed by a dedicated internal audit team, supplemented by the expertise of an external risk management firm. The Audit Committee of the Board oversees the internal audit function, ensuring its independence and effectiveness. Internal auditors regularly update the Audit Committee through reports and presentations, keeping them informed about the state of the Companys internal controls. The Audit Committee approves an audit charter that defines the scope and authority of the internal audit function. Based on a thorough risk assessment, the internal audit team develops a plan to evaluate the design and effectiveness of internal controls across the organisation. This approach ensures that Asters internal controls are focused on mitigating the most significant risks facing the Company, providing the Board with greater assurance about the Companys overall financial health and risk management posture.

Cautionary Statement

Certain statements in the Management Discussion and Analysis section pertaining to the Companys objectives, outlook, estimates and expectations may be considered forward looking statements, as defined under applicable laws and regulations. These are based on current assumptions, forecasts and internal and external information available at the time of reporting. However, actual results may differ materially due to various known and unknown risks, uncertainties and other factors beyond the Companys control, including but not limited to changes in the macroeconomic environment, industry dynamics, regulatory developments, legal proceedings and shifts in political or market conditions. These statements are based on current assumptions and available information. Since the factors underlying these assumptions are subject to change over time, the estimates on which they are based are also subject to change accordingly. These statements do not constitute guarantees of future performance and should not be relied upon excessively. The Company assumes no obligation to revise or update any forward-looking statements, whether because of new information, future events, or otherwise.

Strengthening Every

Relationship to Amplify Value

Sustainable growth is built on the strength of the relationships we nurture with those who influence and are influenced by our business.

We engage with our stakeholders to understand their evolving expectations, incorporate their perspectives into decision-making and foster mutual trust. These ongoing interactions provide valuable insights that inform our strategic priorities, strengthen risk management, enhance responsiveness to emerging challenges and enable us to create shared, long-term value for all.

Patients

Purpose of engagement

To understand evolving healthcare needs, deliver safe, high-quality and patient-centric care, and continuously enhance clinical outcomes and service experiences. Engagement also helps us strengthen trust, improve accessibility and uphold the highest standards of patient safety and satisfaction.

Stakeholder expectations

Value we create

Mode of engagement

- Provision for quality healthcare facilities

- Ensuring prompt interventions during emergencies

- Health education sessions - Patient portals

- Affordable healthcare - Enhancing patient satisfaction - Wellness programmes
- Safety, privacy and confidentiality - Offering timely and quality care - Patient surveys

- Emergency care

- Ensuring timely completion and compliance with discharge summaries

- Sharing reporting documents to enable transparency in operations

Frequency of engagement

Material Topics

Capitals SDGs

As and when required - Health and Safety
- Customer Privacy and Data Security

Doctors and Employees

Purpose of engagement

To drive an inclusive, collaborative and high-performing workplace that supports professional growth, well-being and continuous learning. These interactions enable us to strengthen engagement, nurture leadership, align teams with organisational goals and empower our people to deliver excellence in care.

Stakeholder expectations

Value we create

Mode of engagement

- A thriving, rewarding and - Offering career advancement - Internal advancement opportunities
engaging work environment opportunities - Flagship learning and development

- Continuous learning and growth - Fair, transparent and inclusive

- Building their capabilities, developing and enhancing their skills

programmes - Leadership connects to drive

people practices - Recognising employee efforts employee engagement

- Equitable pay structures, performance-based incentives and benefits structures

- Upholding the culture of Aster Cares that promotes, well-being, trust and productivity

- Employee experience and feedback surveys at key touchpoints - Rewards and Recognition

- Providing competitive rewards and incentive schemes

- Well-being initiatives

Frequency of engagement

Material Topics

Capitals SDGs

Regular and need based - Diversity and Equal Opportunity
- Employee Health and Safety
- Non-Discrimination
- Employee Well-Being

Purpose of engagement

To build responsible, transparent and mutually beneficial relationships that ensure reliable supply, consistent quality and operational efficiency. Ongoing engagement also promotes ethical business practices, innovation and resilience across our value chain.

Stakeholder expectations

Value we create

Mode of engagement

- Ethical and transparent business practices

- Ensuring operational readiness and service delivery

- One-on-one interaction - Annual supplier meets and

- Long-term relationships - Fair terms of contract and

- Maintaining transparency in business

conferences - Meetings with Foundry Workers

constant communication to ensure superior service

- Strengthening critical supplier/ client relationships

and Contractors - Supplier/vendor audits

- Optimising costs

Frequency of engagement

Material Topics

Capitals SDGs

As and when required - Non-Discrimination
- Diversity and Equal Opportunity
- Local Communities and
Community Giving

Investors and Shareholders

Purpose of engagement

To maintain transparent and regular communication on our business strategy, financial performance and long-term growth priorities. These interactions also provide clarity on our governance and sustainability commitments, strengthening investor confidence and supporting informed decision-making.

Stakeholder expectations

Value we create

Mode of engagement

- Consistent revenue growth - Maintaining sustainable growth - Investor conferences, meetings
- Transparent practices and returns and calls
- Adherence to ethics, values and - Sustaining high standards of - Annual reports
regulatory guidelines corporate governance and risk - Sustainability reports
management
- Official communication channels
- Understanding their concerns and
expectations

Frequency of engagement

Material Topics

Capitals SDGs

Regular except close period - Economic Performance

Regulatory and Industry Bodies

Purpose of engagement

To ensure compliance with applicable regulations, uphold the highest standards of clinical governance and contribute to the advancement of the healthcare ecosystem. Regular engagement enables us to remain aligned with evolving policies, regulatory expectations and industry best practices.

Stakeholder expectations

Value we create

Mode of engagement

- Compliance with regulations - Building positive relationships - Participation in economic

- Healthcare quality and safety - Cost-effective healthcare

- Ensuring on-time compliance with laws and regulations

publications, journals and seminars - Interaction with District, State and

- Support for public health initiatives

- Adhering to environmental Social and Governance

Central authorities - Meetings with Pollution Control

- Paying taxes on time Boards and tax departments

- Local investments and tax revenues

- Supporting various government schemes

- Submissions through regulatory channels and industry forums

Frequency of engagement

Material Topics

Capitals SDGs

Periodic - Anti-Corruption
- Corporate Governance

- Customer Privacy and Data Security

Communities

Purpose of engagement

To understand local healthcare needs and create meaningful social impact through accessible healthcare, preventive health initiatives and community development programmes. Engagement helps us build lasting relationships, promote health awareness and contribute to the well-being of the communities we serve.

Stakeholder expectations

Value we create

Mode of engagement

- Access to quality healthcare - Engaging in community welfare activities - CSR committee meetings and

- Environmental impact

- Addressing the needs of our community members

implementation reviews - CSR and Society Perception Surveys

- Community engagement

- Adopting sustainable practices

- Ethical business practices - Contribution to communities

- Uplifting the underserved sections of the society

- Informal interaction and CSR programme

Frequency of engagement

Material Topics

Capitals SDGs

Round the year - Access to Preventive healthcare

- Enablement through sustainable livelihood support to the most vulnerable in the society

- Women empowerment through Employment Linked Skill Training Programmes

- Treatment Aid to the economically weaker patients

Prioritising What Matters Most

Understanding stakeholder expectations is fundamental to how we create long-term value.

We engage regularly with our key stakeholder groups to gain diverse perspectives that strengthen our decision-making and help us focus on the issues that matter most. These insights, combined with our strategic priorities, shape our Materiality Assessment and guide our approach to sustainable value creation.

Our assessment extends beyond stakeholder engagement to incorporate emerging environmental, social and governance considerations that are expected to shape the future of our business. This broader perspective enables us to address long-term risks and opportunities proactively while supporting responsible, resilient and sustainable growth.

Environment

Social Governance Economic

GRI 302:

GRI 403: GRI 205: GRI 201:
Energy Management Health and Safety Anti-Corruption Economic performance

GRI 303:

GRI 406: GRI 2:
Water Management Non-Discrimination Corporate Governance

GRI 305:

GRI 401: GRI 418:
Emission Employee Experience and Customer privacy and data
Well-being security

GRI 306:

Waste Management GRI 405:
Diversity and Equal
Opportunity
GRI 413:
Local Communities &
Community giving

Risk Management

Navigating Uncertainty to protect Long-Term Value

Risk is an inherent part of every business environment, but resilience lies in the ability to anticipate change before it becomes disruption. As markets evolve, technologies advance, regulations change and stakeholder expectations rise, organisations must continually reassess the risks and opportunities that shape long-term performance.

At Aster DM Healthcare, risk management is an integral part of the way we govern our business and make decisions. Rather than viewing risk solely as a potential challenge, we recognise it as an opportunity to strengthen our capabilities, enhance preparedness, and build a more agile organisation. By embedding risk awareness across our operations, we are better positioned to respond to change, safeguard stakeholder interests and pursue sustainable growth.

Enterprise Risk Management (ERM)

Our Enterprise Risk Management (ERM) framework provides a holistic and enterprise-wide approach to identifying, assessing, monitoring, and mitigating risks that could impact the achievement of our strategic objectives. Integrated into our business processes and governance framework, ERM enables proactive risk identification, timely de-risking and informed decision-making across the organisation. This holistic approach enhances organisational resilience, supports business continuity and reinforces our ability to create sustainable long-term value for all stakeholders by managing exposure down to an acceptable residual level.

Risk Management Organization / Structure

Our risk governance framework is supported by clearly defined roles, responsibilities and accountability across the organisation. A structured governance mechanism, combined with robust oversight and cross-functional collaboration, ensures that risks are identified, evaluated, managed and monitored effectively, ensuring a strong culture of risk awareness and enabling consistent execution of our strategic priorities.

Risk Management Process

Process

How we do

Risk Identification

We identify the risks that could impact our strategic objectives, operations, compliance, financial performance, or stakeholder confidence. Through regular monitoring of a range of key risk indicators, SME workshops, cross-functional assessments, market intelligence, regulatory monitoring and updates / inputs from external environment,

Risk Analysis and Assessment

we evaluate emerging and evolving risks, group them into thematic categories and align them with strategic priorities to enable focused mitigation and accountability. Risks are analysed and assessed based on their likelihood of the occurrence of the risk event, magnitude of the impact if the event occurs and the effectiveness of existing controls. The combination of likelihood of occurrence and the magnitude of impact provides the inherent risk level, while the residual risk is measured on the basis of effectiveness of de-risking strategies

Risk Action or Treatment

Using a structured risk-rating methodology that combines qualitative insights with quantitative analysis, we prioritise enterprise risks and continuously review them through cross-functional governance to ensure timely action. Risk evaluation helps ensure appropriate resource allocation for the purpose of risk treatment and channelling of Management attention towards risks of significant concern. We implement appropriate actions such as risk mitigation, avoidance, transfer, or acceptance strategies based on the nature of each risk. Risk management is embedded into everyday business decisions, enabling timely interventions, operational resilience, and business continuity across the organisation. Risks are monitored continuously through defined governance mechanisms, with periodic reviews by management, the Risk Management Committee, and the Board.

Risk Monitoring, Communication and Reporting

Regular reporting, supported by KRIs, digital monitoring tools, and enterprise-wide reviews, ensures effective oversight, timely escalation, and continuous refinement of mitigation strategies.

Risk Register and Robust Risk Culture

A risk register is a living, comprehensive document used to identify, assess, and prioritize potential risks in the risk management process. It provides a structured overview of risks, including their likelihood of occurrence, potential impact, risk owner details and de-risking strategies.

We maintain a strong risk-aware culture by promoting accountability, strengthening risk management capabilities, encouraging informed decision-making, and embedding risk ownership across all levels of the organisation.

Key Risks and Mitigation Measures

Business Performance Risk

Market Risk

Risk overview

Persistent geopolitical instability, elevated inflation, high interest rates, rising insurance costs, and evolving healthcare and government policies are creating a volatile global macroeconomic environment. These conditions raise our input, financing and operating costs while simultaneously reducing patients disposable income and willingness to spend on private healthcare. This dual pressure on our cost base and on patient demand is what makes the environment a direct risk to our revenue growth, margins and cost of capital across the geographies we operate in.

 

Risk impact

Mitigation measures

Opportunity for value creation

Slower economic growth and rising unemployment reduce patients ability to afford private healthcare,

- Provide comprehensive care across the continuum to meet diverse patient needs and reduce risk exposure

By navigating market challenges, we unlock growth, improve returns and diversify our healthcare offerings.

leading to lower patient volumes, deferred elective procedures and reduced average revenue per patient, particularly in price-

- Continuously track strategies and outcomes to improve affordability and service delivery

Stakeholders impacted

sensitive markets. Elevated interest rates and inflation also raise our cost of borrowing and operating

- Engage proactively with regulators and government bodies to align with policy developments

expenses, compressing margins and constraining the capital available for expansion.

- Drive operational and cost efficiency initiatives to support sustainable growth

- Diversify speciality offerings across geographies to reduce dependency risk and expand resilience

Changing Business Environment Risk

Risk overview

The rapid rise of telehealth, remote care and digital patient monitoring with the help of AI, is transforming how healthcare is delivered and consumed. This shift lowers the barrier for health-tech and digital-first entrants to compete for patient volumes traditionally served by hospitals, creating a risk that we lose market share and patient loyalty if we do not adapt our service delivery model and technology capabilities at the pace the market demands.

Risk impact

Mitigation measures

Opportunity for value creation

Growing patient preference for accessible, tech-enabled care and intensifying competition from

- Build leadership and management capability to navigate digital transformation

Stronger digital engagement with patients builds trust and supports high- quality, patient-centric service delivery.

health-tech players can erode our market share, reduce footfall at physical facilities and pressure pricing. Failure to remain digitally

- Encourage innovation through exploration, experimentation and adoption of digital solutions

Stakeholders impacted

agile could weaken our competitive positioning, patient retention and long-term revenue growth.

- Adopt a patient-centric approach to strengthen trust and long-term loyalty

- Continuously refine our strategy to stay relevant and future-ready

Credit Risk

Risk overview

We are exposed to the risk of financial loss from delayed or non-payment by patients, insurance providers, government bodies and corporate clients. As a significant share of our revenue is billed and collected post delivering our care service, any deterioration in the creditworthiness or payment discipline of these counterparties directly exposes us to working capital strain and potential bad debt.

Risk impact

Mitigation measures

Opportunity for value creation
Overdue insurer payments, patient defaults and outstanding institutional receivables increase our days sales outstanding and strain working capital and cash flow. Where amounts remain unrecovered, they result in bad debt write-offs that directly reduce profitability and limit the funds available for reinvestment and growth. - Enforce robust internal financial controls aligned with our Credit Risk Policy Stable financial management boosts investor confidence and
- Closely monitor receivables to reduce bad debts / delayed remittances and improve cash flow efficiency supports sustainable growth. Stakeholders impacted
- Promote Medical Value Travel to grow our medical tourism presence
- Strengthen claim rejection controls to minimise denials and revenue leakage
- Enhance financial resilience through digitalisation, consolidation and cost- containment
- Timely renewal of the contracts with the customers as applicable, to avoid any disallowances

Supply Continuity Risk

Risk overview

Our operations depend on seamless supply chains for critical medical equipment, pharmaceuticals, utilities and essential services. Any disruption to these supply chains, whether from geopolitical events, sustainability events (e.g. climate risk) vendor concentration or logistics failures, creates a risk of treatment delays, higher procurement costs and compromised quality of patient care.

Risk impact

Mitigation measures

Opportunity for value creation

External disruptions, geopolitical events and dependency on single or limited-source suppliers can delay procurement, increase input costs and, in severe cases, interrupt the availability of critical medical supplies, affecting our ability to deliver uninterrupted, high- quality care across our network and potentially harming patient outcomes and our reputation. - Diversify supply channels and vendor base with a strong focus on quality Reliable, uninterrupted supply strengthens our reputation and ensures uninterrupted patient care.
- Use an integrated ERP system for improved inventory control and procurement transparency Stakeholders impacted
- Stronger inventory levels defined to avoid any disruption of operations due to non-availability of materials

Brand Equity Risk

Risk overview

Our reputation rests on trust, clinical excellence and patient-centric care. As healthcare decisions are highly trust-dependent, an unforeseen incident arising from human error, operational lapses or adverse publicity can disproportionately damage stakeholder confidence, creating a risk that extends well beyond the immediate incident to our broader brand and patient relationships.

Risk impact

Mitigation measures

Opportunity for value creation

Adverse incidents, negative publicity or misinformation, even where outside our direct control, can erode patient trust, reduce patient footfall and referrals, invite regulatory scrutiny and weaken investor sentiment, with consequences for both near-term revenue and long- term brand equity. - Enforce standardised clinical guidelines with regular audits and infection-control assessments Upholding integrity strengthens stakeholder confidence and our brand image.
- Maintain a clear Code of Conduct that ensures integrity, accountability and ethical conduct Stakeholders impacted
- Implement robust data protection protocols to safeguard patient information

- Set clear guidelines for social media use and external communication

- Monitoring of the social media channels for any adverse communications

Clinical and Patients Safety Risk

Risk overview

Delivering consistent, high-quality care and ensuring patient safety are at the core of our purpose. Given the inherently high-stakes nature of clinical care, any lapse in clinical protocols, infection control or quality standards creates a direct risk to patient outcomes, regulatory standing and the trust that underpins our business.

Risk impact

Mitigation measures

Opportunity for value creation

Any lapse in clinical excellence or safety standards can result in adverse patient outcomes, litigation and regulatory action, and can undermine patient and physician trust, affecting patient volumes, accreditation status and our long- term sustainability and reputation. - Follow evidence-based clinical practice guidelines aligned with the latest research Continuous improvement strengthens clinical excellence, patient trust and business growth.
- Deploy advanced technologies such as robotic surgery to improve safety and recovery outcomes Stakeholders impacted
- Invest in continuous training and education for healthcare professionals

- Conduct regular internal audits and pursue accreditations such as NABH and JCI

- Maintain a Medical Advisory Board overseeing clinical governance practices

- Analyse patient feedback /
complaints by severity to drive timely
improvement

Statutory Compliance Risk

Compliance Risk

Risk overview

Regulatory scrutiny of healthcare providers is intensifying, and we operate across multiple jurisdictions, each with its own statutory and regulatory requirements. This regulatory complexity creates a risk of inadvertent non-compliance, particularly as clinical, operational and financial norms continue to evolve.

Risk impact

Mitigation measures

Opportunity for value creation

Failure to comply with evolving clinical, operational or financial norms can result in fines, licence suspensions, litigation and

- Systematically monitor compliance requirements with our Legal and Compliance team and business leaders

Continuous compliance protects our reputation, avoids penalties and fines and ensures uninterrupted operations.

reputational damage, and can disrupt operations increasing compliance costs and diverting management attention from core

- Track and analyse regulatory changes proactively with subject- matter experts

Stakeholders impacted

business priorities.

- Conduct regular training and awareness programmes on compliance obligations

- Carry out regular audits and surprise checks

Legal Risk

Risk overview

We face risk from delays in responding to legal notices, contractual disputes or evolving healthcare laws across jurisdictions. Without timely, coordinated legal oversight, such matters can escalate into costly disputes or expose us to regulatory penalties.

Risk impact

Mitigation measures

Opportunity for value creation

Delayed or inadequate responses to legal and regulatory matters can expose us to financial penalties,

- Maintain a robust legal oversight mechanism to monitor all legal communications

Strong governance reduces liabilities and builds stakeholder trust. A proactive legal framework supports

adverse judgments, reputational damage and operational disruption, and can increase legal costs and the amount of management time spent

- Consult subject-matter experts and ensure timely responses to litigation and regulatory matters

informed decisions and faster dispute resolution, driving sustainable growth.
on dispute resolution. Stakeholders impacted

Business Continuity and Catastrophic Risk

Risk overview

We operate in a highly regulated environment and events such as natural disasters, pandemics or man-made incidents pose a serious threat to healthcare infrastructure. As our facilities provide critical, life-saving services, any disruption to operations creates a risk not only to business continuity but to patient safety and community trust.

Risk impact

Mitigation measures Opportunity for value creation
Catastrophic events can overwhelm - Maintain a comprehensive disaster A robust disaster recovery plan
systems, disrupt essential services, management plan across all facilities, ensures business continuity and
damage infrastructure and endanger including a dedicated DR team uninterrupted patient care.
lives, while regulatory lapses in - Establish data backup, retention
disaster preparedness can trigger and restoration protocols for critical
reputational, financial and legal systems Stakeholders impacted
consequences, potentially resulting
- Conduct Crisis Simulation Workshops
in extended service outages and loss
for leadership decision-making
of patient confidence.
- Run mock drills to prepare teams for
unforeseen events

Human Capital Risk

Risk overview

Delivering world-class healthcare depends on attracting, developing and retaining a diverse, skilled workforce amid rising competition for specialised talent. Given the acute shortage of specialised clinical professionals in the market, any gap in our ability to attract or retain talent creates a risk to our service quality, capacity and growth plans.

Risk impact

Mitigation measures

Opportunity for value creation

Talent shortages, gaps in succession planning and rising manpower costs can reduce operational capacity

- Maintain a supportive, engaging workplace aligned with being an employer of choice

A motivated workforce drives innovation, engagement and long- term organisational growth.

and increase staffing costs, while shifting workplace expectations and organisational change can affect employee morale and retention, ultimately affecting the quality and consistency of patient care

- Uphold our Code of Conduct for a safe, respectful and inclusive workplace

Stakeholders impacted

- Run well-being initiatives and retention schemes for medical and non-medical staff

- Maintain a succession planning framework for leadership continuity

- Credential clinicians during onboarding alongside effective retention planning

- Use HR engagement models to identify challenges and enable timely intervention

Information, Data Privacy and Cyber Security Risk

Risk overview

Secure, seamless information flow is essential to patient-centric care. As we accelerate digital transformation across electronic medical records and telehealth, our growing digital footprint increases our exposure to cyber-attacks, data breaches and unauthorised access, creating risk to patient confidentiality, system availability and regulatory compliance.

Risk impact

Mitigation measures

Opportunity for value creation

A compromise of sensitive healthcare data could result in

- Deploy advanced firewalls and data- loss prevention systems

Secure digital infrastructure improves service quality, efficiency

regulatory penalties, litigation, reputational damage and loss of patient trust, while any disruption to critical IT systems could impair

- Monitor cyber threats continuously with rapid investigation and remediation

and innovation while protecting our reputation. Stakeholders impacted

clinical operations and patient care delivery. Non-compliance with the Digital Personal Data Protection

- Operate a Security Operations Centre (SOC) for real-time threat detection and response

(DPDP) Act could also lead to financial penalties.

- Align policies and data governance with the DPDP Act

- Run regular IT awareness and training programmes for personnel

- Conduct regular VAPT assessments and security reviews to close gaps

Sustainability Risk

Risk overview

Our operations use limited natural resources and generate environmental impacts such as emissions, biomedical waste and water usage. If these impacts are not responsibly managed, they create a risk of regulatory non-compliance, resource scarcity and contamination that could affect both our licence to operate and our standing with stakeholders.

Risk impact

Mitigation measures

Opportunity for value creation

Rising regulatory and stakeholder pressure for sustainable, low- carbon practices means that falling

- Use energy-efficient equipment to reduce consumption and environmental impact

Environmental responsibility improves operational efficiency and supports our corporate citizenship

short of expectations could result in penalties, restricted operating approvals, higher compliance costs

- Adopt renewable energy, including in-house solar power generation

goals. Stakeholders impacted

and damage to our reputation among regulators, investors and

- Recycle treated wastewater to conserve resources

communities.

- Minimise biomedical waste and ensure its safe, compliant disposal

- Comply with hazardous and non- hazardous waste management requirements

- Maintain our ESG framework with robust SOPs and updated disaster recovery plans

Knowledge Center
Logo

Logo IIFL Customer Care Number
(Gold/NCD/NBFC/Insurance/NPS)
1860-267-3000 / 7039-050-000

Logo IIFL Capital Services Support WhatsApp Number
+91 9892691696

Download The App Now

appapp
Loading...

Follow us on

facebooktwitterrssyoutubeinstagramlinkedintelegram

2026, IIFL Capital Services Ltd. All Rights Reserved

ATTENTION INVESTORS

RISK DISCLOSURE ON DERIVATIVES

Copyright © IIFL Capital Services Limited (Formerly known as IIFL Securities Ltd). All rights Reserved.

IIFL Capital Services Limited - Stock Broker SEBI Regn. No: INZ000164132 (Member ID - NSE: 10975 BSE: 179 MCX: 55995 NCDEX: 01249), DP SEBI Reg. No. IN-DP-185-2016, IA SEBI Regn. No: INA000000623, Merchant Banker SEBI Regn. No. INM000010940, RA SEBI Regn. No: INH000000248, BSE Enlistment Number (RA): 5016, AMFI-Registered Mutual Fund Distributor & SIF Distributor
ARN NO : 47791 (Date of initial registration – 17/02/2007; Current validity of ARN – 08/02/2027), PFRDA Reg. No. PoP 20092018, IRDAI Corporate Agent (Composite) : CA1099

ISO certification icon
We are ISO/IEC 27001:2022 Certified.

This Certificate Demonstrates That IIFL As An Organization Has Defined And Put In Place Best-Practice Information Security Processes.