New hospitals take time to mature, leading to higher expenditures taking a toll on margins (Priyanka Parashar/Mint file)
New hospitals take time to mature, leading to higher expenditures taking a toll on margins (Priyanka Parashar/Mint file)

Hospital chain margins likely to improve, but full recovery will take time

  • Barring Apollo Hospitals Enterprises, which gained 40% in the past one year, all other hospital stocks have given negative returns
  • The government’s corporate tax cut to 22% excluding surcharge is expected to boost earnings of hospitals that are paying full taxes

Hospitals looked like a growth area for investors owing to the rising need for good healthcare. But new regulations, which capped prices of procedures and devices, laid speed-breakers on the hospital highway. In fact, most of the hospital sector stocks seem to be in the intensive care. Barring Apollo Hospitals Enterprises Ltd, which gained 40% the past year, all gave negative returns.

Graphic by Satish Kumar/Mint
Graphic by Satish Kumar/Mint

A shift to the new tax regime could be beneficial though. The government’s corporate tax cut to 22% excluding surcharge is expected to boost earnings of hospitals that are paying full taxes such as Narayana Hrudalaya Ltd. Other hospital chains that are availing exemptions are likely to shift to the new tax regime.

“Full tax paying companies are likely to benefit the most from the reduction in effective tax rates while hospital operators such as Apollo Hospitals, which avail of benefits arising out of 35AD, are likely to move to the new tax regime, given no plans of expansion/commissioning of units in the near term where the 35AD benefit applies. Aster DM Healthcare Ltd derived the bulk of its revenues (83%) from its Gulf-countries operations, which will not be impacted by the reforms, while its India operations are PBT negative and are unlikely to see any benefit in the near term," said Kotak Institutional Equities in a note to clients.

While tax cuts will help, a revival in operating margins remains a challenge. Hospital chains aggressively expanded their bed capacity up until FY17, adding about 2,380 beds, the highest in the previous five years. That has slowed considerably as only 622 beds were added in FY19. New hospitals take time to mature, leading to higher expenditures, taking a toll on margins. Overall Ebitda margins contracted to 12.4% in FY19 from 14.9% in FY15.

Analysts note that hospital chains have started to make small price increases on procedures. They are also focusing on cost rationalization and looking at ways to monetize existing assets. Some of the factors likely to aid the hospital sector are incidences of rising lifestyle diseases, increasing life expectancy, deeper health-insurance penetration, and the rise in medical tourism.

“The focus now is to try and stabilize the operational facilities rather than expand aggressively. Regulatory restrictions had impacted the business, but price increase and cost rationalizations have been done now and are helping to improve the operating metrics. Many players have seen a good recovery in the second half of FY19 and Q1FY20", said Kapil Banga, assistant vice president, corporate ratings, Icra Ltd.

That would mean that the slowdown in the capital expenditure of the last two years may look up in the coming years. As for the stocks, recovery is likely to take more time.

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