Auna SA (AUNA) 2024 Q3 法說會逐字稿

Good morning, and welcome to Auna's Third Quarter 2024 Earnings Conference Call. My name is Rob, and I will be the operator for today's call. (Operator Instructions) And please note that this call is being recorded. (Operator Instructions).

早上好，歡迎參加 Auna 2024 年第三季財報電話會議。我叫羅布，我將擔任今天電話的接線生。（操作員說明）請注意，此通話正在錄音。（操作員說明）。

Now I'd like to turn the call over to Ana Maria Mora, Head of Investor Relations. Ma'am, please go ahead.

現在我想將電話轉給投資者關係主管安娜·瑪麗亞·莫拉 (Ana Maria Mora)。女士，請繼續。

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 regards to Mexico and Colombia unless we note otherwise.

謝謝你，接線生。大家好，歡迎參加 Auna 的電話會議，回顧我們第三季的表現。請注意，本次電話會議期間有一個網路廣播演示伴隨討論。如果您需要簡報的副本，請造訪我們的投資者關係網站，或聯絡 Auna 的投資者關係團隊。請注意，當我們討論墨西哥和哥倫比亞的差異時，除非我們另有說明，否則我們將按逐年計算，並以外匯中性或當地貨幣計算。

Let's move to slide 2. Before we begin, we would like to remind all participants that our comments today will include forward-looking statements. 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 mutual calculations.

讓我們轉到投影片 2。在開始之前，我們想提醒所有參與者，我們今天的評論將包括前瞻性陳述。除了根據國際財務報告準則報告未經審計的財務表現外，我們還將討論某些非國際財務報告準則的財務指標和營運指標，包括外匯相互計算。

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 or substitute for or superior to IFRS financial measures and are provided as supplemental information only.

投資者應仔細閱讀我們昨天的收益新聞稿中包含的這些措施和指標的定義，以確保他們理解它們。非 IFRS 財務指標和營運指標不應被孤立考慮，也不應替代或優於 IFRS 財務指標，而應僅作為補充資訊提供。

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.

在我們開始發言之前，還請注意，在今天的討論過程中做出的某些陳述可能構成前瞻性陳述，這些陳述基於管理層當前的預期和信念，並受到許多風險和不確定性的影響，這些風險和不確定性可能會導致實際的結果。

These include, but are not limited to, expectations and assumptions related to the integration and performance of the businesses we acquired. For a description of these risks, please refer to our Form F-1 filing with the US Securities and Exchange Commission and our earnings press release.

這些包括但不限於與我們收購的業務的整合和績效相關的預期和假設。有關這些風險的描述，請參閱我們向美國證券交易委員會提交的 F-1 表格以及我們的收益新聞稿。

Slide 3, please. On today's call, we have Suso Zamora, our Executive Chairman and President; Gisele Remy, our Chief Financial Officer, and Executive Vice President; and Lorenzo Massart, our Executive Vice President of Strategy and Equity Capital Markets. They will discuss Auna's consolidated and segment financial and operating results for the third quarter and will provide updates on our various strategic growth initiatives. After that, we will open the call for your questions.

請幻燈片 3。出席今天的電話會議的有我們的執行主席兼總裁蘇索·薩莫拉 (Suso Zamora)； Gisele Remy，我們的財務長兼執行副總裁；以及我們的策略和股權資本市場執行副總裁 Lorenzo Massart。他們將討論 Auna 第三季度的綜合和分部財務和營運業績，並將提供有關我們各種策略成長計劃的最新資訊。之後，我們將打開電話詢問您的問題。

Suso, please go ahead.

蘇索，請繼續。

Thank you, Ana, and thank you all for following Auna and for joining our results call today. The growing strength and earnings potential of Auna's vertically and horizontally integrated regional platform was evident again in this third quarter with our adjusted EBITDA increasing 23% on an FX-neutral basis and our margin expanding 1.4-percentage-points.

謝謝安娜，也謝謝大家關注 Auna 並參加我們今天的結果電話會議。Auna 垂直和水平一體化區域平台不斷增長的實力和盈利潛力在第三季度再次顯現出來，我們的調整後 EBITDA 在匯率中性的基礎上增長了 23%，我們的利潤率擴大了 1.4 個百分點。

In Mexico and Peru, adjusted EBITDA rose to record highs. In Peru, we continue to harvest past investments. The consistent and strong performance of our fully integrated health care and planned business there demonstrates again the robustness and earnings power of our business model when operating at maturity and scale as well, of course, the advantages of our growth strategy.

在墨西哥和秘魯，調整後的 EBITDA 升至歷史新高。在秘魯，我們繼續收穫過去的投資。我們完全整合的醫療保健和計劃業務的持續和強勁表現再次證明了我們的商業模式在成熟和規模化運營時的穩健性和盈利能力，當然也證明了我們增長戰略的優勢。

We are replicating the success in Mexico, a far larger and more underpenetrated private health care market. Our progress implementing the AunaWay there is still encouraging and show stronger results. Productivity among our physicians continues to improve along with a growing mix of more profitable, high complexity services. In Colombia, the regulator interventions have been recent and, in particular, in Nueva EPS as the intervention teams have changed yet in a more stable operating mode. There, we have witnessed a growing relationship that is now keenly focused on collaboration on collections.

我們正在複製墨西哥的成功，墨西哥是一個規模更大、滲透率更低的私人醫療保健市場。我們在那裡實施 AunaWay 的進展仍然令人鼓舞，並顯示出更強勁的成果。隨著更有利可圖、高複雜性服務的不斷增加，我們醫生的生產力不斷提高。在哥倫比亞，監管機構最近才進行幹預，特別是在 Nueva EPS，因為幹預團隊已經發生變化，營運模式更加穩定。在那裡，我們見證了雙方關係的不斷發展，目前正專注於系列合作。

Notwithstanding our strong report with payors and our assessment, there is a clear willingness to pay all outstanding receivables. We increased provisions to reflect the increased risk of timely payments this quarter. This of course impacted profitability. Further, we continue to emphasize cash flow over growth to ensure our cash cycle in Colombia remains positive. Colombia is integral to our scale advantages and excellence in medical practices, and we remain bullish on this health care market in the medium to long term.

儘管我們向付款人提供了強有力的報告和評估，但仍明確願意支付所有未償應收帳款。我們增加了準備金，以反映本季及時付款風險的增加。這當然影響了獲利能力。此外，我們繼續強調現金流而非成長，以確保我們在哥倫比亞的現金週期保持積極。哥倫比亞是我們規模優勢和卓越醫療實踐不可或缺的一部分，我們仍然看好這個醫療保健市場的中長期前景。

Lastly, on this slide, our growing EBITDA drove debt leverage below four times for the first time since our acquisition in Mexico. It is the eighth consecutive quarter that we lowered our leverage since the acquisition in 2022.

最後，在這張幻燈片中，自我們收購墨西哥以來，我們不斷增長的 EBITDA 將債務槓桿率首次降至四倍以下。自 2022 年收購以來，這是我們連續第八個季度降低槓桿率。

Let's move to slide 5 to review our consolidated results. On an FX-neutral basis, our regional platform revenues increased 13% year-over-year to PEN1.1 billion led by Mexico and Peru, which grew 16% and 13%, respectively. That top line growth, combined with increasing operating efficiency and synergies, drove operating profit to PEN229 million for the quarter, an increase of 23% when excluding the benefit of a onetime reversal with a holdback related to our acquisition of OCA.

讓我們轉到投影片 5 來回顧我們的綜合結果。在匯率中立的基礎上，我們的區域平台營收年增 13%，達到 11 億先令，其中墨西哥和秘魯領先，分別成長 16% 和 13%。這項營收成長，加上不斷提高的營運效率和協同效應，使本季的營運利潤達到2.29 億先令，在排除與我們收購OCA 相關的一次性逆轉帶來的好處時，成長了23% 。

During the quarter, average occupancy across our health care services increased 3.8-percentage-points to 67%. Importantly, we also saw capacity utilization arise with regard to high complexity services such as radiology, cardiology, and urology. At OncoSalud Peru, which is our fully integrated health care business, memberships in our health care plans grew just over 4% to nearly 1.3 million, while memberships in our oncology plans increased about 2% to a little more than 979,000 policyholders. Lastly, our oncology MLR decreased 1-percentage-point to 53.7% from the last quarter, remaining at a healthy level.

本季度，我們醫療保健服務的平均入住率增加了 3.8 個百分點，達到 67%。重要的是，我們也看到放射科、心臟科和泌尿科等高複雜性服務的產能利用率上升。在我們全面整合的醫療保健業務OncoSalud Peru，我們的醫療保健計劃會員人數增長了4% 多一點，達到近130 萬，而我們的腫瘤計劃會員人數增加了約2%，達到略多於979,000 名保單持有人。最後，我們的腫瘤MLR較上季下降1個百分點至53.7%，維持在健康水準。

Turning to Mexico in slide 7, please. Revenue at health care services in Mexico accelerated in the third quarter, increasing 16% in local currency, validating the implementation of the AunaWay. Adjusted EBITDA also accelerated, increasing 34%. As you can see in the chart on the right side of the slide, Mexico's adjusted EBITDA margin increased 4.7-percentage-points to just under 36%. We achieved this despite the investments that we continue making to implement the AunaWay at our health care facilities in Monterrey.

請轉到投影片 7 中的墨西哥。墨西哥醫療保健服務收入第三季加速成長，以當地貨幣計算成長了 16%，驗證了 AunaWay 的實施。調整後 EBITDA 也加速成長 34%。正如您在幻燈片右側的圖表中看到的那樣，墨西哥調整後的 EBITDA 利潤率增長了 4.7 個百分點，達到略低於 36%。儘管我們繼續投資在蒙特雷的醫療保健機構實施 AunaWay，但我們還是實現了這一目標。

Top line and adjusted EBITDA growth were driven by a still improving mix of high complexity services and increases in related total and operating capacity, which continues increasing slowly but surely on a quarterly basis since the beginning of the year. Another contributor was productivity, which continues to rise among our existing physicians as well as those we have been recruiting.

營收和調整後 EBITDA 的成長是由仍在改善的高複雜性服務組合以及相關總量和營運能力的增加所推動的，自今年年初以來，這些能力繼續緩慢但穩定地按季度增長。另一個貢獻者是生產力，我們現有的醫生以及我們一直在招募的醫生的生產力持續提高。

All of these significant improvements reflect our progress in implementing the AunaWay, which results in improved operating standards, medical protocols, related skills, physician engagement and, most importantly, patient care. As a reminder, this is an investment that scales nicely and predictably as we've seen with our more mature business in Peru.

所有這些重大改進都反映了我們在實施 AunaWay 方面取得的進展，從而提高了操作標準、醫療方案、相關技能、醫生參與度，以及最重要的是患者護理。提醒一下，正如我們在秘魯更成熟的業務中所看到的那樣，這是一項可以很好地擴展且可預測的投資。

With regard to OncoMexico, we are leveraging our 35 years of experience in delivering integrated oncological services in Peru. As a reminder, this will be Mexico's first oncology insurance, which will be fully integrated into our health care services network. We expect it to be a disruptive product, representing a new era in monoline insurance in the country which has an addressable market multiple times the size of Peru.

至於 OncoMexico，我們正在利用我們在秘魯提供綜合腫瘤服務 35 年的經驗。提醒一下，這將是墨西哥第一個腫瘤保險，它將完全融入我們的醫療保健服務網絡。我們預計它將成為一款顛覆性產品，代表該國單一保險的新時代，該國的潛在市場規模是秘魯的數倍。

OncoMexico remains in a pilot phase in 2024 and early 2025, leading up to its initial launch in Monterrey initially in the B2B segment and subsequently in the B2C segment. We continue testing OncoMexico's commercial, clinical and risk underwriting capabilities in addition to building out a robust sales and marketing function for the product.

OncoMexico 將於 2024 年和 2025 年初仍處於試點階段，隨後在蒙特雷首次推出 B2B 領域，隨後進入 B2C 領域。除了為該產品建立強大的銷售和行銷功能外，我們還將繼續測試 OncoMexico 的商業、臨床和風險承保能力。

Slide 8, please. In Peru, the most mature component of our regional platform, revenue grew 13% while adjusted EBITDA increased nearly 50%, and margin expanded 5.3-percentage-points to 21.6%. The strong growth in profitability was driven by the increases in planned memberships as well as by their higher average ticket, along with the health care networks' continued transition towards higher complexity care and higher occupancy resulting from maturing hospitals and efficiencies across the network.

請幻燈片 8。在我們區域平台最成熟的組成部分秘魯，營收成長了 13%，調整後 EBITDA 成長了近 50%，利潤率成長了 5.3 個百分點，達到 21.6%。獲利能力的強勁增長是由於計劃會員數量的增加以及平均票價的提高，以及醫療保健網絡不斷向更複雜的護理和因醫院的成熟和整個網絡的效率而提高的入住率轉變而推動的。

Adjusted EBITDA also increased as a result of optimizing service flows and strategically reallocating specialties among health care facilities, effectively implementing our pricing strategy in this market and achieving network synergies and efficiencies across operations.

調整後的EBITDA 也有所增加，因為我們優化了服務流程，在醫療保健機構之間策略性地重新分配專業，有效地實施了我們在該市場的定價策略，並實現了跨運營的網絡協同效應和效率。

Let's move to slide 9. Consistent with the cautious approach we have taken toward Colombia with an emphasis on maintaining healthy cash flow, revenue growth there moderated to 11% in local currency terms. The underlying business remains strong, however, with an increase in chemotherapy, surgeries and hospitalization services improving the revenue mix while operating occupancy increased 2.4-percentage- points to 89%. This was mainly driven by a surge in emergency care accompanied with moderate availability of beds due to efficiencies implemented in the facilities to accommodate our offer given the current circumstances with our payors.

讓我們轉到投影片 9。與我們對哥倫比亞的謹慎態度一致，重點是保持健康的現金流，以當地貨幣計算，該國的收入成長放緩至 11%。然而，基礎業務依然強勁，化療、手術和住院服務的增加改善了收入結構，同時營業入住率增加了 2.4 個百分點，達到 89%。這主要是由於緊急護理的激增以及床位供應的適度增加，這是由於考慮到我們的付款人目前的情況，為了適應我們的服務而提高了設施的效率。

Because payments from Nueva EPS have been less predictable, we have increased the provision for impairment losses. This resulted in the 18% decrease in adjusted EBITDA that you see at the right of this slide, while impacting margin again, which decreased 4.5-percentage-points to 12.4%. Excluding the provision, adjusted EBITDA would have increased 11% and margin would have been 17%.

由於 Nueva EPS 的付款不太可預測，我們增加了減損損失準備金。這導致調整後 EBITDA 下降 18%（如本投影片右側所示），同時再次影響利潤率，下降 4.5 個百分點至 12.4%。如果不提撥撥備，調整後的 EBITDA 將增加 11%，利潤率將增加 17%。

Nueva EPS has had changes in the management team as part of the regulators intervention, generating more uncertainty. But we have a productive dialogue with them regularly. While the conversations with them are encouraging, we remain vigilant and continue to monitor the overall situation closely.

作為監管機構幹預的一部分，Nueva EPS 的管理團隊發生了變化，產生了更多的不確定性。但我們定期與他們進行富有成效的對話。雖然與他們的對話令人鼓舞，但我們仍保持警惕，並繼續密切關注整體局勢。

Keep in mind that the bulk of health care in Colombia is provided by private companies like ours. The regulator is mindful of this, and therefore, keen to see payors become compliant, again with the requisite financial ratios. We still believe the situation is transitory and we expect a resolution will be reached. To be clear, Colombia remains a key market for Auna. It is strategic to our business model, and our medium- to long-term outlook has not changed for this segment.

請記住，哥倫比亞的大部分醫療保健服務是由像我們這樣的私人公司提供的。監管機構注意到這一點，因此渴望看到付款人再次遵守必要的財務比率。我們仍然認為情況是暫時的，我們預計將會達成解決方案。需要明確的是，哥倫比亞仍然是 Auna 的一個重要市場。這對我們的業務模式具有戰略意義，我們對該細分市場的中長期前景並沒有改變。

I'll now turn the call over to Gisele, who will provide a more detailed review of our third quarter financials. Please, Gisele.

我現在將把電話轉給吉賽爾，她將對我們第三季的財務狀況進行更詳細的審查。拜託，吉賽兒。

Thank you, Suso. Good morning, everyone. Let's continue with an overview of our consolidated financials for the quarter, beginning with our consolidated revenue on slide 11. On an FX-neutral basis, consolidated revenue grew 13% during the quarter and 12% year-to-date, led by our mature fully integrated business in Peru. Mexico also drove top line growth as the AunaWay gained traction in this key growth market, where we endeavour to replicate our success with this model. As Suso noted in his remarks, we have calibrated growth in Colombia, although it still grew low double digits.

謝謝你，蘇索。大家早安。讓我們繼續概述本季的合併財務狀況，首先是幻燈片 11 上的合併收入。在匯率中立的基礎上，在我們在秘魯成熟的完全整合業務的帶動下，本季度綜合收入增長了 13%，年初至今增長了 12%。隨著 AunaWay 在這個關鍵成長市場的吸引力，墨西哥也推動了營收成長，我們努力透過這種模式複製我們的成功。正如蘇索在演講中指出的那樣，我們已經調整了哥倫比亞的成長，儘管它仍然保持較低的兩位數成長。

Let's turn to slide 12. The quarter's top line growth, coupled with operational efficiencies across Auna's platform, drove a 23% year-over-year increase in consolidated adjusted EBITDA on an FX-neutral basis, while our margin increased 1.4-percentage-points to just over 22%. Mexico's adjusted EBITDA grew 34% versus the third quarter of 2023 as it benefited from an improved revenue mix. Adjusted EBITDA growth is particularly impressive when you consider the investments we have been making to build our capabilities at both local and regional levels in Mexico.

讓我們翻到投影片 12。本季的營收成長，加上 Auna 平台的營運效率，在匯率中立的基礎上推動合併調整後 EBITDA 較去年同期成長 23%，而我們的利潤率則成長 1.4 個百分點，略高於 22%。墨西哥的調整後 EBITDA 較 2023 年第三季成長 34%，受益於收入結構的改善。考慮到我們為在墨西哥當地和區域層面建立能力而進行的投資，調整後的 EBITDA 成長尤其令人印象深刻。

Moving to the right of the bridge, Peru's consolidated adjusted EBITDA margin in this quarter was 21.6%, increasing 5.3-percentage-points from the third quarter of 2023, as shown near the center and top of the EBITDA bridge on this slide. This primarily reflects a more profitable services mix, increased operational efficiencies and synergies as well as growing planned memberships. As explained, while operating performance remained strong in Colombia in the third quarter, we have begun dialling back growth in order to protect cash flow. We also recorded an additional PEN16 millions of provisions for impairment losses in the quarter. Excluding this impairment, consolidated adjusted EBITDA would have been PEN61 million, an 11% FX-neutral growth with a 16.8% margin.

移至橋樑右側，秘魯本季的綜合調整後 EBITDA 利潤率為 21.6%，較 2023 年第三季增加 5.3 個百分點，如本投影片 EBITDA 橋樑中心和頂部附近所示。這主要反映了利潤更高的服務組合、營運效率和協同效應的提高以及計劃會員數量的增加。正如所解釋的，雖然哥倫比亞第三季的營運表現依然強勁，但我們已開始回落成長以保護現金流。本季我們也額外記錄了 16 百萬先令的減損準備。排除此減值，綜合調整後 EBITDA 將為 6,100 萬先令，匯率中性成長 11%，利潤率為 16.8%。

Let's now move on to slide 13, please. For the third consecutive quarter, our adjusted net income was positive. It was PEN 75 million in the third quarter. As shown near the left of the bridge on this slide, our operating profit benefited from an extraordinary income as a result of the reversal of the holdback obligation related to our OCA acquisition in Mexico. When excluding this reversal of PEN44 million, operating profit was still up PEN36 million versus the comparable period of last year.

現在請轉到投影片 13。我們的調整後淨利潤連續第三個季度為正。第三季為 7,500 萬先令。如這張幻燈片橋左側附近所示，我們的營業利潤受益於與我們在墨西哥收購 OCA 相關的保留義務的逆轉所帶來的非凡收入。如果排除 4,400 萬先令的逆轉，營業利潤仍比去年同期增加 3,600 萬先令。

The quarter benefited from a positive foreign exchange gain shown near the middle of the bridge. The gain was primarily due to the appreciation of the Peruvian sol relative to the Mexican peso, which also reduced our net finance costs by PEN23 million. Income taxes in the third quarter were PEN30 million higher versus last year due to increased profits and lower tax credits in Mexico and Peru.

該季度受益於橋中部附近顯示的正外匯收益。這項收益主要是由於秘魯索爾相對於墨西哥比索的升值，這也使我們的淨財務成本減少了 2,300 萬先令。由於墨西哥和秘魯的利潤增加和稅收抵免減少，第三季的所得稅比去年增加了 3,000 萬先令。

Noncash and extraordinary items and adjustments of PEN26 million mostly related to the adjustment of the PEN44 million holdback benefit which impacts our adjustments negatively. Finally, the PEN75 million of adjusted net income was PEN0.98 on a per share basis for the quarter based on a weighted average number of basic and diluted shares.

非現金和非常項目以及 2600 萬先令的調整主要與 4400 萬先令保留福利的調整有關，這對我們的調整產生了負面影響。最後，根據基本股和稀釋股的加權平均數，本季每股調整後淨利為 7,500 萬先令，為 0.98 先令。

Let's now turn to slide 14, please. Our cash position was PEN200 million at the end of the third quarter. On a year-to-date basis, we have generated a solid PEN629 million in pretax operating cash flow. As shown near the left of the bridge on the slide, this is a 20% increase versus the first nine months of last year. Income taxes paid during the same period rose to PEN154 million due to increased profits and lower tax credits, resulting in net cash from operating activities of PEN475 million, up 9% versus the nine-month period in 2023.

現在請轉到投影片 14。截至第三季末，我們的現金部位為 2 億先令。年初至今，我們已產生了 6.29 億先令的穩健稅前營運現金流。如幻燈片橋左側附近所示，與去年前 9 個月相比，成長了 20%。由於利潤增加和稅收抵免減少，同期繳納的所得稅增至 1.54 億先令，導致經營活動產生的淨現金為 4.75 億先令，比 2023 年 9 個月期間增長 9%。

During the nine months of 2024, we invested PEN173 million in investing activities, up 49% year-over-year. The PEN107 million of CapEx that you see in red in the bridge was mainly for maintenance CapEx related to infrastructure, purchases of medical equipment for our hospitals and clinics as well as the implementation of SAP across our regional platform.

2024 年的 9 個月裡，我們在投資活動中投資了 1.73 億先令，年增 49%。您在橋中看到的紅色的 1.07 億先令的資本支出主要用於與基礎設施相關的維護資本支出、為我們的醫院和診所購買醫療設備以及在我們的區域平台上實施 SAP。

Other uses of cash in our investment cash flows were the previously reported PEN47 million of the earn-out obligation related to the IMAT Oncomedica acquisition and an additional PEN18 million in payments that have occurred in the third quarter related to the holdback obligation corresponding to the OCA acquisition in Monterrey.

我們投資現金流中的其他現金用途包括先前報告的與 IMAT Oncomedica 收購相關的 4700 萬先令的盈利義務，以及第三季度發生的與 OCA 對應的扣留義務相關的額外 1800 萬先令的付款蒙特雷收購。

As indicated in the upper part of the cash flow bridge, we generated organic free cash flow of PEN368 million during the first nine months of this year when excluding the impact of the amortizations of the earn-out and the holdback obligations, and total free cash flow of PEN302 million.

如現金流橋上半部所示，今年前 9 個月，我們產生了 3.68 億先令的有機自由現金流，其中不包括盈利攤銷和保留義務以及自由現金總額的影響。

Please move on to slide 15. This quarter, we also crossed a very important milestone, as Suso mentioned in his remarks, with our net debt to adjusted EBITDA ratio falling below 4 times and reaching 3.7 times. This was the eighth consecutive quarter of improving leverage. Getting below that threshold indicates that we are well on our way towards achieving our medium-term target of less than 3 times net debt to adjusted EBITDA given Auna's solid EBITDA growth trajectory.

請繼續看投影片 15。正如蘇索在演講中提到的，本季我們也跨越了一個非常重要的里程碑，我們的淨債務與調整後 EBITDA 比率降至 4 倍以下，達到 3.7 倍。這是槓桿率連續第八個季度改善。鑑於 Auna 穩健的 EBITDA 成長軌跡，低於該門檻表明我們正在順利實現淨債務與調整後 EBITDA 之比不到 3 倍的中期目標。

Regarding Auna's credit facilities, at the end of the third quarter, we had approximately $196 million in revolving credit facilities, which includes a $40 million increase in credit lines from the previous quarter. With respect to the remaining stub of our 2025 bonds, Auna is pursuing a couple of different alternatives to refinance these notes and expect to close the refinancing subject to market conditions in the near term. To summarize this slide, our debt leverage and maturity profile remain healthy, and we are still adequately funded to continue executing our growth strategy.

關於 Auna 的信貸額度，截至第三季末，我們擁有約 1.96 億美元的循環信貸額度，其中信貸額度比上一季增加了 4,000 萬美元。對於 2025 年債券的剩餘存根，Auna 正在尋求幾種不同的替代方案來為這些票據進行再融資，並預計在短期內根據市場情況完成再融資。總結這張投影片，我們的債務槓桿和到期狀況保持健康，我們仍然有足夠的資金來繼續執行我們的成長策略。

That concludes my review of our financial results. I'll now hand the call back to Suso, who has a few closing remarks before we open the call for your questions.

我對我們財務表現的回顧到此結束。現在我將把電話轉回蘇索，在我們開始詢問你們的問題之前，他會做一些總結發言。

Thank you, Gisele. To summarize our performance and outlook, Peru maintained its outperformance, further demonstrating the earnings power of our business model when it's operating at maturity and scale.

謝謝你，吉賽兒。總結我們的業績和前景，秘魯保持了優異的業績，進一步證明了我們的商業模式在成熟和規模化營運時的獲利能力。

Mexico's EBITDA also increased to a record high. We expect to continue driving growth in this massive and highly underpenetrated market. As we continue to implement to the AunaWay in Mexico, we expect our performance to accelerate there as we attract additional physician talent, improve doctor productivity and increase the mix of high complexity services at our current health care facility in Monterrey, which has one of the country's fastest-growing economies.

墨西哥的 EBITDA 也創下歷史新高。我們預計將繼續推動這個龐大且滲透率低的市場的成長。隨著我們繼續在墨西哥實施AunaWay，我們預計我們的業績將會加速，因為我們吸引了更多的醫生人才，提高了醫生的生產力，並增加了我們目前位於蒙特雷的醫療保健機構的高複雜性服務組合，該機構擁有國家成長最快的經濟體。

Colombia remains strategically important with regard to Auna operating with regional scale and to achieve excellent patient outcomes through excellent medical practices. For the foreseeable future, we are focused on maintaining a positive working capital cycle until the situation with payors returns to normal.

對於 Auna 的區域規模運作以及透過卓越的醫療實踐實現卓越的患者治療效果，哥倫比亞仍然具有重要的戰略意義。在可預見的未來，我們的重點是維持積極的營運資金循環，直到付款人的情況恢復正常。

We're very excited about the growth potential of OncoMexico, intending to replicate the long-term success we have had with OncoSalud in Peru. We continue building and testing OncoMexico's capabilities in its current pilot phase, and we're looking forward to a successful launch.

我們對 OncoMexico 的成長潛力感到非常興奮，打算複製 OncoSalud 在秘魯的長期成功。我們在目前的試點階段繼續建構和測試 OncoMexico 的功能，我們期待著成功的發布。

Looking ahead, we also remain excited about the significant progress that we continue to make investing in and scaling Auna vertically and horizontally integrated regional health care platform with our proven business model. And we are only just getting started penetrating private health care in Spanish-speaking Latin America, which is largely fragmented and inefficient and for which demand is substantial. Accordingly, we will continue to innovate, to modernize and to expand access to integrated health care in the region, always with patient centricity and value-based care foremost in our minds.

展望未來，我們仍然對我們透過成熟的商業模式繼續投資和擴展 Auna 垂直和水平整合的區域醫療保健平台所取得的重大進展感到興奮。我們才剛開始滲透拉丁美洲西班牙語地區的私人醫療保健，該地區基本上分散且效率低下，但需求很大。因此，我們將繼續創新、現代化並擴大該地區獲得全面醫療保健的機會，始終將以患者為中心和基於價值的護理放在首位。

That concludes our remarks. Operator, please open the call for questions.

我們的發言到此結束。接線員，請打開電話提問。

(Operator Instructions) Mauricio Cepeda, Morgan Stanley.

（操作員指令）Mauricio Cepeda，摩根士丹利。

We have two questions. First of all, in terms of cash flow, specifically about working capital, I see that there is this impact in accounts receivables. I imagine it's owed to Colombia, but I also see a lot of financing coming from accounts payable. So presumably, I would think you're talking about suppliers.

我們有兩個問題。首先，就現金流而言，特別是營運資金方面，我認為應收帳款有這種影響。我想這是欠哥倫比亞的，但我也看到很多融資來自應付帳款。所以想必，我認為您談論的是供應商。

So my question would be, this kind of expansion in financing from suppliers to compensate for the working capital impacts from Colombia, how long do you think it may continue? Or has it reached the limit so the cash flow may be impacted, because receivables, they end up increasing much more than payables? This is the first question.

所以我的問題是，這種供應商融資擴張以補償哥倫比亞營運資金的影響，您認為這種情況可能會持續多久？或者是否已達到極限，因此現金流可能會受到影響，因為應收帳款最終的成長遠遠超過應付帳款？這是第一個問題。

And the second one, about Colombia. I understand that you, of course, in a good practice are now provisioning doubtful accounts. But the number that we saw in this quarter, it's a catch-up from accounts that you had previously, and now you're just recalculating the probabilities of receiving them? Or should we consider this kind of a run rate? Or -- and how should we think about that for the future?

第二個是關於哥倫比亞的。我知道，當然，您現在正在提供可疑帳戶，這是一種很好的做法。但是我們在本季度看到的數字是您之前擁有的帳戶的赶超，現在您只是重新計算收到它們的機率？或者我們應該考慮這種運行率嗎？或者──我們未來該如何考慮這個問題？

Thank you, Mauricio. Very relevant two questions. Let me frame the response on Colombia, and then I'll ask Gisele to complement. First of all, before I talk about Colombia, in general, there have been no changes in the way we're managing and balancing account receivables to accounts payables. It is a characteristic of the Colombian market and also the Peruvian market in some sense that suppliers of goods and services or financing players like ourselves with significant working capital. So it's not something that has changed dramatically in the last months. I would say that, and Gisele will complement.

謝謝你，毛里西奧。非常相關的兩個問題。讓我就哥倫比亞問題做出回應，然後請吉賽兒補充。首先，在我談論哥倫比亞之前，總的來說，我們管理和平衡應收帳款與應付帳款的方式沒有改變。從某種意義上說，哥倫比亞市場和秘魯市場的一個特點是，像我們這樣的商品和服務供應商或融資參與者擁有大量營運資金。因此，過去幾個月並沒有發生巨大變化。我會這麼說，吉賽兒會補充。

But anyway, I wanted to respond more openly because I just came back from Colombia this week, and I spent a whole week there. Really interesting. It was a very productive, very promising visit. And of course, the takeaways, a lot of these, you guys already know, we are a large player in Colombia. We are a very relevant player in cancer and in high complexity in Colombia.

但無論如何，我想更公開地回應，因為我這週剛從哥倫比亞回來，在那裡待了整整一周。真的很有趣。這是一次非常富有成果、非常有希望的訪問。當然，還有很多要點，你們已經知道了，我們是哥倫比亞的重要參與者。我們是哥倫比亞癌症和高複雜性領域的重要參與者。

I'd like to say we are undeniably a very attractive provider of services to most of the players in Colombia. In the city where we operate, we are -- in cities where we operate, we are needed, not only as a traditional provider of services, of course, but more and more with very intimate products that are risk-sharing service provider product.

我想說，對於哥倫比亞的大多數玩家來說，我們無疑是一個非常有吸引力的服務提供者。在我們營運的城市，我們——當然，在我們營運的城市，我們不僅被需要作為傳統的服務提供者，而且越來越多地需要我們提供非常貼心的產品，即風險分擔服務提供者的產品。

And I see a lot of consideration with three of the biggest five players in Colombia. Now these represent -- these players represent like 50% of the health care system, and we're intimate and needed. And of course, we also need them. This group of players, two of them are intervene, and we operate them with a certain level of normality. These relationships again have a level of mutual dependency.

我看到哥倫比亞最大的五名球員中的三名受到了很多考慮。現在，這些參與者代表了醫療保健系統的 50%，我們很親密，也很需要我們。當然，我們也需要它們。這群球員，有兩個人是介入的，我們對他們的操作也有一定的常態化。這些關係再次具有一定程度的相互依賴。

And this gives me and the team comfort in these stressful times. Now payments from Nueva EPS have been more volatile when seen month to month and compared to past years. So I do not think these are indicative of receivables loss. But a conservative stance, to provision these accounts receivables. I think I'll be back in Colombia in December and expect to see more -- a much more promising scenario there.

這讓我和團隊在這個充滿壓力的時期感到安慰。現在，與過去幾年相比，從每月來看，Nueva EPS 的付款波動更大。所以我認為這些並不表示應收帳款損失。但採取保守立場，撥備這些應收帳款。我想我會在 12 月回到哥倫比亞，並期待在那裡看到更多——一個更有​​希望的場景。

I want to repeat with respect to Colombia and accounts receivables, I think this is a transitory. And I see from this trip encouraging signs, absolutely that we will be paid by all our payors, insurance companies, be they private or public, be they intervene or not intervene. But we are taking a conservative approach by increasing a provision level to our accounts receivables to reflect a higher risk.

我想重複一下關於哥倫比亞和應收帳款的問題，我認為這是暫時的。我從這次旅行中看到了令人鼓舞的跡象，絕對是我們所有的付款人、保險公司將向我們支付費用，無論他們是私人的還是公共的，無論他們是否幹預。但我們採取保守的方法，增加應收帳款的撥備水平，以反映較高的風險。

And we're also moderating our growth to make sure that any growth that comes from Colombia has a working capital cycle that is attractive or more attractive to us. And we, of course, we will continue to monitor the situation and, of course, share with the public markets any update. I don't know, Gisele, if you want to complement on this?

我們也正在放緩我們的成長，以確保來自哥倫比亞的任何成長都具有對我們有吸引力或更有吸引力的營運資金週期。當然，我們將繼續監控局勢，當然，我們也會與公開市場分享任何最新情況。我不知道，吉賽爾，你是否想補充？

Yes. Thank you, Suso. I think you covered most of the points. On my end, I would simply add, first on the point of liquidity, as Suso mentioned, that what we're seeing in accounts receivable and the netting effect of accounts payable in the case of Colombia is very consistent with what we see in the market. We have a very strategic relationship with our suppliers and an open dialogue with them, and this is kind of the way the entire market is moving. And I would also add that obviously, and as we mentioned, we have abundant access to credit facilities and we also utilize these for factoring and confirming products, which also are reflected in those accounts payable days.

是的。謝謝你，蘇索。我認為您涵蓋了大部分要點。就我而言，我只想補充一點，首先是關於流動性的問題，正如蘇索所提到的，我們在哥倫比亞的應收帳款和應付帳款淨額效應中看到的情況與我們在哥倫比亞的情況下看到的情況非常一致。我們與供應商建立了非常策略性的關係，並與他們進行公開對話，這就是整個市場的發展方式。我還想補充一點，正如我們所提到的，我們有充足的信貸便利，我們也利用這些信貸設施來保理和確認產品，這也反映在應付帳款天數中。

And from a provisioning perspective, I think Suso was very clear. Obviously, we're very constructive in the case of Colombia. And it's not that our expectation is that we will not get paid. This is just the mere reflection of our methodology, which is basically based on an expected loss model, which is now leading us to be a little bit more conservative as far as accounts receivable in the case of Colombia. And specifically in the case of the intervened entities, we are reflecting a higher percentage of provision on accounts receivable.

從供應的角度來看，我認為蘇索說得非常清楚。顯然，我們對哥倫比亞的情況非常有建設性。這並不是說我們期望我們不會得到報酬。這只是我們方法的反映，該方法基本上是基於預期損失模型，這導致我們在哥倫比亞的應收帳款方面變得更加保守。特別是就受干預實體而言，我們反映了較高比例的應收帳款撥備。

Caio Moscardini, Santander.

卡約·莫斯卡迪尼，桑坦德銀行。

First question is related with the adjusted EBITDA growth guidance. How confident are you that you will be able to achieve the guidance? And the second question is regarding leverage, right? What are the optionalities that you have in order to deleverage faster? Can you sell like some real estate assets in Monterrey? What could you do in order to deleverage faster? Or are you confident that pure cash generation will take you guys to the level that you want over the next few quarters?

第一個問題與調整後的 EBITDA 成長指引有關。您對能夠實現指導目標的信心有多大？第二個問題是關於槓桿，對吧？為了更快地去槓桿化，您有哪些選擇？你能像蒙特雷的一些房地產資產一樣出售嗎？為了更快去槓桿化，你可以做些什麼？或者您有信心純粹的現金產生將使您在接下來的幾個季度達到您想要的水平？

Thank you, Caio, and good to hear you. So with respect to -- again, Gisele, I'll start to framing the response and help me with anything that I forget or complement, of course. So with respect to our guidance numbers, we are not changing our current guidance, and we expect our EBITDA growth to be at 20% in FX-neutral. Our business and business sales are healthy and they're performing as expected. And of course, we don't control what happens in Colombia with Nueva EPS. But as I indicated previously, our view -- our current view is that it should not prevent us from reaching our numbers.

謝謝你，凱奧，很高興聽到你的聲音。因此，再次，吉賽爾，我將開始製定回應，並幫助我解決任何我忘記或補充的問題。因此，就我們的指導數字而言，我們不會改變目前的指導，我們預計在匯率中立的情況下，我們的 EBITDA 成長率將為 20%。我們的業務和業務銷售都很健康，表現符合預期。當然，我們無法控制 Nueva EPS 在哥倫比亞發生的事情。但正如我之前指出的，我們的觀點——我們目前的觀點是，這不應該阻止我們達到我們的目標。

Colombia remains the smallest portion of our EBITDA contribution. Peru has been overperforming this year. As we have guided, our Mexico growth trended again, the key element of our guidance, and is growing nicely as well. So I would say that's with the guidance. Gisele, do you have any comment, you can also answer on how we're going to continue to deliver as well?

哥倫比亞仍然是我們 EBITDA 貢獻中最小的一部分。秘魯今年表現出色。正如我們所指導的那樣，我們的墨西哥成長再次出現趨勢，這是我們指導的關鍵要素，而且成長也很好。所以我想說這是有指導的。Gisele，您有什麼意見嗎？

Great. Yes. Thanks, Caio, for the question. As far as deleveraging goes, as you guys saw, very solid results, right, this quarter, dropping below 4 times, reaching 3.7 times. And we think this positions us very well on track to reach the 3 times target that we have in the medium term, so towards the end of 2025 beginning of 2026. This year, obviously, as we know, deleveraging has come as a function of EBITDA growth. However, we will see in the second half of this year that organic free cash flow covers interest payments.

偉大的。是的。謝謝凱奧的提問。就去槓桿而言，正如你們所看到的，非常紮實的結果，對吧，這個季度，下降到4倍以下，達到3.7倍。我們認為這使我們能夠很好地實現中期目標，也就是 2025 年底到 2026 年初的 3 倍目標。正如我們所知，今年顯然去槓桿化是 EBITDA 成長的函數。然而，我們將在今年下半年看到有機自由現金流涵蓋利息支付。

And this sets a very positive trend going into next year, where we will begin to see a cash surplus, which will permit us to reduce debt, not only through EBITDA growth but also through debt amortization. So we're very confident there on that side, that both EBITDA growth as well as cash will permit us to continue deleveraging. And obviously very conscious of our cash conversion cycle and any -- on operating assets that we may be able to dispose of, we will also analyse in due time.

這為明年帶來了非常積極的趨勢，我們將開始看到現金盈餘，這將使我們能夠減少債務，不僅透過 EBITDA 成長，還透過債務攤提。因此，我們在這方面非常有信心，EBITDA 成長和現金都將使我們能夠繼續去槓桿化。顯然，我們非常清楚我們的現金轉換週期以及我們可能能夠處置的任何營運資產，我們也會在適當的時候進行分析。

Samuel Alves, BTG Pactual.

塞繆爾·阿爾維斯，BTG Pactual。

Can you hear me?

你聽得到我嗎？

Yes.

是的。

It's Ian from BTG Pactual here. I have two questions here on our side. The first one is about Mexico, a bit more focused on a short to midterm dynamics. I just wanted to understand, if you could give us more color on what do you expect growth to stem from in Mexico in the short term? If it should come from better occupancy rates, mix of procedures, pricing ramp-up or the health care plans ramp up? So I want to understand a bit more of the mix of these results and what do you expect in the short term.

我是來自 BTG Pactual 的 Ian。我這邊有兩個問題。第一個是關於墨西哥的，更關注短期到中期的動態。我只是想了解一下，您能否給我們更多關於您預計墨西哥短期內增長的原因是什麼？是否應該來自於更好的入住率、程序組合、價格上漲或醫療保健計劃的增加？因此，我想更多地了解這些結果的組合以及您對短期內的期望。

And the second question is regarding results in Peru. We see that MLRs are running at improved levels and also OpEx in the units. And I wanted to understand if we should expect Q3's higher profitability in this business unit as recurring, or if you see more space to improve current profitability levels. So just want to ask these two questions.

第二個問題是關於秘魯的結果。我們看到 MLR 的運作水準以及設備的營運支出都在提高。我想了解我們是否應該預期該業務部門第三季的獲利能力會重複出現，或者您是否認為有更多空間可以提高當前的獲利水準。所以只想問這兩個問題。

Thank you. I think it's [Samuel], right, because I can hear you at the beginning. So with respect to Mexico. Let me, first of all, repeat something that I've done in the past. What are our countries' strategies? I mean, very quickly, I don't want to -- Peru is proof of concept. Peru has been the winning formula of the vertical and horizontal integration. Colombia has scale and excellence in medical practice at scale. Colombia is moving towards horizontal integration, and with the growth of private insurance in the future, vertical integration as well.

謝謝。我認為是[塞繆爾]，對，因為我一開始就能聽到你的聲音。墨西哥也是如此。首先，讓我重複一下我過去做過的事情。我們各國的戰略是什麼？我的意思是，很快，我不想──秘魯是概念的證明。秘魯一直是縱向和橫向一體化的致勝法寶。哥倫比亞在醫療實踐方面具有規模和卓越。哥倫比亞正在走向橫向一體化，隨著未來私人保險的成長，縱向整合也是如此。

And Mexico, the question, Mexico is a large field that needs to be planted and harvested. We are currently planting it. We have the physician groups. We have the hospitals. We have the insurance arm and we have the commercial capabilities. We're rolling out all of this in a deliberate yet gradual way. This is how we have built our formidable businesses of patient care gradually and deliberately.

還有墨西哥，問題是，墨西哥是一塊需要播種、收穫的大田。我們目前正在種植它。我們有醫生小組。我們有醫院。我們有保險部門，也有商業能力。我們正在以一種深思熟慮但漸進的方式推出所有這些。這就是我們逐步、謹慎地建立強大的病患照護業務的方式。

Now in Mexico, in particular. Let me go on the two major themes in Mexico. So with respect to recruitment of physicians in Mexico, our results reflect the success of our strategy in physician recruiting. We continue with programs to incentivize doctors in the high complexity procedures. We'd like to increase their productivity with us.

現在尤其是在墨西哥。讓我談談墨西哥的兩大主題。因此，就墨西哥的醫生招聘而言，我們的結果反映了我們在醫生招聘方面的策略的成功。我們繼續實施計劃，激勵醫生參與高複雜性的手術。我們希望與我們一起提高他們的生產力。

That's something we're already harvesting and it's going -- I'll give you some numbers in a bit. Simultaneously, our model is starting to resonate in the market which has led to very interesting discussions of physicians wanting to join us, in addition to our recruiting efforts. That is high complexity physicians coming to us and, hey, how can I work here in your oncology practice. That's also something that is growing in the trend.

這是我們已經在收穫的東西，而且它正在發生——我稍後會給你一些數字。同時，我們的模式開始在市場上引起共鳴，除了我們的招募工作之外，這也引起了想要加入我們的醫生的非常有趣的討論。這是高度複雜的醫生來到我們這裡，嘿，我怎麼能在你們的腫瘤學實踐中工作？這也是一種正在成長的趨勢。

And with respect to third quarter performance drivers, where we see in, for example, in surgical procedures, average surgery reached almost 2,000 surgeries, 1,900 almost. That's 6% quarter-to-quarter. That's boosted revenue, as you saw. Growth was primarily driven by two strategies, of course, physician management and then what we call the private sales strategy. I'll explain this very quickly.

就第三季的業績驅動因素而言，我們看到，例如在外科手術中，平均手術量達到近 2,000 例，接近 1,900 例。即季度環比增長 6%。正如您所看到的，這增加了收入。成長主要由兩種策略推動，當然，醫生管理和我們所謂的私人銷售策略。我會很快解釋這一點。

The physician management, we have also the loyalty program we launched in May 2024. I think I discussed it in the previous quarterly results. This has resulted in significant and very promising results. In the second quarter of 2022, we had something like 68 enrolled physicians in this program -- the loyalty program. And they produced in that first month around MXN20 million in production. Now in the third quarter, we have MXN106 million. We've almost doubled that. Physicians generated -- of those physicians that generate more than double, almost MXN50 million additional in revenue.

醫師管理方面，我們還有 2024 年 5 月推出的忠誠度計畫。我想我在之前的季度業績中討論過這個問題。這已經取得了重大且非常有希望的結果。2022 年第二季度，我們有大約 68 位醫生加入了這個計畫——忠誠度計畫。他們在第一個月的產量約為 2000 萬墨西哥比索。現在第三季度，我們有 1.06 億墨西哥比索。我們已經幾乎翻倍了。醫生創造的收入——在那些創造兩倍以上的醫生中，增加了近 5,000 萬墨西哥比索的收入。

So very clear, again, seeding and harvesting what we've done in the past. Currently, we have enrolled physicians in Monterrey. So that's a big number. And you can see how it impacts the new enrolment. There is a significant part of the new enrolment. And then we have the private sales development, we call it [La Libertad], which is offering new products, bundles to the doctors and doctor-like groups. This has -- this shifts away from the volume and reliance from third parties second shares.

非常清楚，我們過去所做的一切都是播種和收穫的。目前，我們已在蒙特雷招募了醫生。所以這是一個很大的數字。您可以看到它如何影響新的入學人數。新入學人數中有很大一部分。然後我們進行私人銷售開發，我們稱之為[La Libertad]，它向醫生和類似醫生的團體提供新產品、捆綁產品。這已經擺脫了對第三方第二股的數量和依賴。

And that has grown also in the third quarter something like MXN30 million since the end of the previous quarter. It went from MXN30 million in the previous quarter to MXN35 million in this quarter -- this last quarter. That's a 17% increase just on selling bundles of products related to doctors that can deliver those services now. That's a different and additional source of what I described before.

自上一季末以來，第三季這一數字也增加了約 3,000 萬墨西哥比索。從上一季的 3,000 萬墨西哥比索增至本季（即最後一季）的 3,500 萬墨西哥比索。僅銷售與現在可以提供這些服務的醫生相關的產品捆綁包就增加了 17%。這是我之前描述的不同的額外來源。

Of course, what are the contributing factors there? Well, we've already launched some digital tools and we've improved pricing and costing for these bundled packages. We've increased acquisitions of new patients, higher conversion rates. I mean, from consultations to surgery, from surgeries to the horizontal integration of all the services related to that pathology. We're very focused on that, and that's also resulting very interesting -- in very interesting increased volume. Physicians in oncology are reaching out to us. giving our position in oncology. So that's -- that's in general what we see in Mexico and where we'll see in volume increases in Mexico.

當然，這其中的影響因素有哪些呢？嗯，我們已經推出了一些數位工具，並且改進了這些捆綁包的定價和成本核算。我們增加了新患者的獲取量，並提高了轉換率。我的意思是，從諮詢到手術，從手術到與該病理學相關的所有服務的橫向整合。我們非常關注這一點，這也帶來了非常有趣的結果——數量的增加。腫瘤科的醫生正在與我們聯繫。顯示我們在腫瘤學領域的地位。這就是我們在墨西哥看到的整體情況以及墨西哥銷量的成長。

And the second question was on Peru. Gisele, could you take that one, on the MLR?

第二個問題是關於秘魯的。吉賽爾，你能拿走 MLR 上的那個嗎？

Yes, of course. I think it was around MLR in Peru as well as profitability levels. As we've seen in -- over the last few quarters, we've surpassed the 20% EBITDA margin in Peru when we consolidate the health care network as well as the integrated portion of the business. And we are comfortable with these profitability levels, which this quarter are above 21%.

是的當然。我認為這與秘魯國土資源部以及獲利水準有關。正如我們在過去幾季所看到的，當我們整合醫療保健網路以及業務的綜合部分時，我們在秘魯的 EBITDA 利潤率已經超過了 20%。我們對這些獲利水準感到滿意，本季的獲利水準超過 21%。

As we've also seen, MLR obviously is a function of our business model, right? And as we know, even though between one quarter and another, there may be some movements, which over the past few quarters have been more attributable to intercompany impacts than real organic MLR impact, and that is why we continue to expect our EBITDA margin in Peru to remain at these levels.

正如我們所看到的，MLR 顯然是我們商業模式的功能，對吧？如我們所知，即使在一個季度與另一個季度之間，也可能會出現一些變動，在過去的幾個季度中，這些變動更多地歸因於公司間的影響，而不是實際的MLR 有機影響，這就是為什麼我們繼續預計我們的EBITDA 利潤率秘魯將保持在這些水平。

We continue to see opportunities to continue growing both our member base as well as the utilization and the mix and the high complexity impact of our hospitals. And that's also why we are very, very optimistic about growth potential in Peru for next year at these margin levels. And obviously, this is a testament to how well the integrated model works at maturity and at scale.

我們繼續看到繼續擴大我們的會員基礎以及我們醫院的使用率、組合和高複雜性影響的機會。這也是為什麼我們對秘魯明年在這些利潤水準上的成長潛力非常非常樂觀。顯然，這證明了整合模型在成熟度和規模化方面的運作。

And there are no more questions from the phone lines. So I will now turn the call over to Ana Maria Mora from Ana -- who will proceed with questions from the webcast platform.

電話線上也沒有再問任何問題。因此，我現在將把電話轉給 Ana 的 Ana Maria Mora，她將繼續回答來自網路廣播平台的問題。

Thanks, operator. The first question we have is from (technical difficulty) I have a few questions regarding Colombia. What percentage of your doctors and nurses are on temporary contracts? With the Colombian requirement, would you need to hire these personnel full time? What are your expectations regarding the proposed price cap for high complexity procedures in Colombia? What's your current occupancy rate for Clinical del sur and when are you expecting to finish its ramp-up?

謝謝，接線生。我們的第一個問題來自（技術難度）我有一些關於哥倫比亞的問題。您的醫生和護士中有多少比例是臨時合約？根據哥倫比亞的要求，您需要全職僱用這些人員嗎？您對哥倫比亞高複雜程序的擬議價格上限有何期望？Clinical del sur 目前的入住率是多少？

Great. And this is a series of very relevant questions. So today, in Colombia, the last number I saw, a little shy over 50% of our doctors have some contractual relationship with us, be them they're in the payroll or they have an independent contract or they have a group contract depending on the practices. So we have more than 50% of our doctors already have an established relationship with us, especially again in the high complexity practice that we focus so much on.

偉大的。這是一系列非常相關的問題。所以今天，在哥倫比亞，我看到的最後一個數字有點害羞，超過 50% 的醫生與我們有合同關係，無論他們是在工資單上，還是有獨立合同，或者有集體合同，具體取決於的做法。因此，我們超過 50% 的醫生已經與我們建立了良好的關係，尤其是在我們非常關注的高複雜性實踐中。

In addition to that, we have been doing a high complexity, particularly on oncology, for decades now. And we've done it with risk sharing products and services that actually are very attractive to the insurance companies.

除此之外，幾十年來我們一直在進行高度複雜的研究，特別是在腫瘤學方面。我們已經透過風險分擔產品和服務做到了這一點，這對保險公司實際上來說非常有吸引力。

Our scale in these products has always allowed us known to be the most efficient provider in cancer. So I'm reluctant to give a very clear answer on what's -- how it's going to impact on some price gaps. I don't see a lot of those price caps affecting immediately in Colombia. I see some drug around price cuts. More than anything, that is going to be the focus on the state unlike.

我們在這些產品上的規模始終使我們成為癌症領域最高效的提供者。因此，我不願意就它將如何影響某些價格差距給出非常明確的答案。我認為這些價格上限不會立即影響哥倫比亞。我看到一些藥品在降價。最重要的是，這將成為對國家的關注。

I hear the Colombians wanting to replicate the Spanish system in which the country itself is procuring and making sure it has the lowest price for some of the expensive drugs in the world. I see that happening more than a control of private hospitals. Remember, in Colombia, 82% of the hospitals in Colombia are private. And that is -- that has a high variation with small, big, and very large hospital.

我聽說哥倫比亞人希望複製西班牙的製度，該國自己進行採購，並確保其某些昂貴藥品的價格是世界上最低的。我認為這種情況的發生不僅僅是對私立醫院的控制。請記住，在哥倫比亞，哥倫比亞 82% 的醫院是私立的。也就是說，小型、大型和超大型醫院之間存在很大差異。

So I would say that with respect to our expectation. And then on Clisur; Clisur is our second hospital in Medellin -- in the city of Medellin, and we inaugurated a couple of years ago. It's been ramping up nicely. With respect to our current capacity to the hospital, we're running at a 80%. But remember, Auna is not a holding company or countries, and it is not a holding company of hospitals.

所以我會根據我們的期望這麼說。然後是 Clisur； Clisur 是我們在麥德林的第二家醫院，位於麥德林市，幾年前開業。它一直在很好地增長。就我們目前醫院的容量而言，我們的運作率為 80%。但請記住，Auna 不是控股公司或國家，也不是一家醫院的控股公司。

What we do at Auna is we build ecosystems of health care, urban ecosystem of health care. So Clisur actually operates within the Medellin ecosystem of health care. So we push certain procedures to that hospital, and we leave(technical difficulty) with them other focus and other procedures in which it is more efficient, in which NPS and medical resolution is the best.

我們在 Auna 所做的是建立醫療保健生態系統、城市醫療保健生態系統。因此，Clisur 實際上是在麥德林醫療保健生態系統內運作的。因此，我們將某些程序推給該醫院，然後將（技術難度）留給他們其他焦點和其他更有效的程序，其中 NPS 和醫療解決方案是最好的。

Now very interestingly, from my visit last week to Colombia, two large payors have approached us to see if we could do something special at Clisur on high complexity. That's a very attractive proposition. It's a very interesting proposition of higher volume, higher complexity with one payor, maybe co-branding the facility for what's a growing trend in Colombia, which is these private insurance policies that are being rolled out -- that most probably will double the size of the private policies in what we call prepaid policies and complementary policies in Colombia.

現在非常有趣的是，從我上週訪問哥倫比亞開始，兩家大型付款人已經與我們接洽，看看我們是否可以在 Clisur 的高複雜性方面做一些特別的事情。這是一個非常有吸引力的提議。這是一個非常有趣的提議，與一個付款人一起提供更高的容量、更高的複雜性，也許可以根據哥倫比亞日益增長的趨勢對該設施進行聯合品牌，這些私人保險政策正在推出——這很可能會使保險的規模增加一倍。

So those new policies that have a high growth rate require from insurance companies to make sure that they can deliver the services with cost containment. And I think we're very lucky to always have counterparties that find us quite competent in cost containment, especially in high complexity. So we see that as a growing opportunity in Colombia with respect to Clisur.

因此，那些高成長率的新保單要求保險公司確保他們能夠在控製成本的情況下提供服務。我認為我們非常幸運，總是有交易對手發現我們在成本控制方面非常有能力，尤其是在高複雜性方面。因此，我們認為哥倫比亞對於 Clisur 來說是一個不斷增長的機會。

Gisele, did I forget anything? Is there anything else you want to complement?

吉賽兒，我忘了什麼嗎？還有什麼想要補充的嗎？

No, I think that was very complete.

不，我認為這已經非常完整了。

(Operator Instructions) Alejandro Zamacona, HSBC.

（操作員指示）Alejandro Zamacona，匯豐銀行。

Two questions from our side. The first one is I know it's kind of early, but do you have any high level thoughts or early expectations for 2025? And then our second question is on the oncology plans rollout in Mexico. So far, how is it performing against your initial expectations? And can you share thoughts on what's coming for that.

我們這邊有兩個問題。第一個是我知道現在有點早，但是您對 2025 年有什麼高層次的想法或早期期望嗎？我們的第二個問題是關於在墨西哥推出的腫瘤學計劃。到目前為止，它的表現與您最初的預期相比如何？能否分享一下對此的看法？

Great. Thank you very much, Alejandro. So I'm reluctant to give guidance on 2025 because we're in the middle of the budget process. I don't think it's going to be very different from what we currently have. We need to make sure that we recognize the opportunities and also the risks in Colombia in terms of growth. But besides that, I think we'll have a very clear idea and we're committed to delivering guidance in our next quarterly call at the beginning of the year for 2025.

偉大的。非常感謝你，亞歷杭德羅。因此，我不願意給予 2025 年的指導，因為我們正處於預算過程中。我認為這與我們目前的情況不會有太大不同。我們需要確保認識到哥倫比亞在成長方面的機會和風險。但除此之外，我認為我們會有一個非常清晰的想法，並且我們致力於在 2025 年年初的下一個季度電話會議中提供指導。

On OncoMexico, a couple of things that are really interesting. I want to again highlight, so OncoMexico is being deployed, I think I said it in the conference call at a pilot level in 2024 and in early 2025. So we are testing the product, the price, the selling channels and other variables and levers that allow us to launch the product initially in the B2B segment and subsequently in the B2C segment.

在 OncoMexico 上，有幾件事非常有趣。我想再次強調，OncoMexico 正在部署，我想我在 2024 年和 2025 年初的試點級電話會議上說過。因此，我們正在測試產品、價格、銷售管道以及其他變數和槓桿，使我們能夠首先在 B2B 領域推出產品，然後在 B2C 領域推出產品。

So we are deploying OncoMexico in the same way we have done so in the past in Peru. First, positioning ourselves in oncology, grabbing market share of oncology practices and building B2B relationships that grants us a larger pool of patients with a payor behind sooner. This impacts our revenues, of course, positively and margin positively today and tomorrow.

因此，我們正在以與過去在秘魯相同的方式部署 OncoMexico。首先，將自己定位在腫瘤學領域，搶佔腫瘤學實踐的市場份額並建立 B2B 關係，使我們能夠更快地獲得更多的患者和付款人。當然，這會對我們今天和明天的收入和利潤率產生正面影響。

The rollout of the B2C to cover populations directly, this impacts our revenues and margins in the future. So I want to make sure that all our followers understand that. We're very excited with what we have today in Peru, but it takes some time, especially to build the B2C component of our offering. This is what we've done well in the past and we're confirming it works in Mexico.

B2C的推出直接涵蓋人群，這會影響我們未來的收入和利潤。所以我想確保我們所有的追隨者都明白這一點。我們對秘魯今天所擁有的一切感到非常興奮，但這需要一些時間，特別是建立我們產品的 B2C 組件。這是我們過去做得很好的事情，我們正在確認它在墨西哥行之有效。

What are the general confirmation that we see in Mexico in 2024? What are the lessons learned? First of all, our products of services in oncology in Mexico are very well received. They're unique and they are liked. This confirms the market need and the potential.

2024 年我們在墨西哥看到的整體確認是什麼？吸取了哪些教訓？首先，我們在墨西哥的腫瘤學服務產品非常受歡迎。他們是獨一無二的並且受到人們的喜愛。這證實了市場的需求和潛力。

The product is highly appealing to the Mexican population without what's called in Mexico a major medical expense insurance which is almost 90% of those that are insured in Mexico have that type of insurance, which means that it only cover -- or insurance only covers a major event and covers no prevention or early detection, none of that we naturally cover in our policy. So it really fits in what is the main traditional product of insurance in Mexico today.

該產品對沒有墨西哥所謂的主要醫療費用保險的墨西哥人口非常有吸引力，在墨西哥投保的人中幾乎 90% 都有這種類型的保險，這意味著它只承保——或者保險只承保重大事件，不涵蓋任何預防或早期發現，我們的政策自然不會涵蓋這些內容。因此它非常適合當今墨西哥主要的傳統保險產品。

Our evaluation indicates that at least 20% of the Mexico population in the middle class has significant interest in this type of the product, but we believe that not more than 50 million people can afford it at today's prices at today's demographics. In terms of the collective sales potential, it is the B2B program. We see the product gaining traction in B2B. Again, due to a large coverage gap among employers, for example, in Monterrey 55% to 60% of active workers have the major medical expense insurance.

我們的評估表明，至少 20% 的墨西哥中產階級人口對此類產品表現出濃厚的興趣，但我們相信，以目前的價格和人口結構來看，能夠負擔得起的人不會超過 5000 萬人。就集體銷售潛力而言，是B2B計劃。我們看到該產品在 B2B 領域越來越受歡迎。同樣，由於雇主之間的保險覆蓋範圍存在很大差距，例如在蒙特雷，55%至60%的在職工人擁有主要醫療費用保險。

We are clearly playing in the field not only as a product of a commercial efforts but also with some requests from brokers and employers to quote coverage plans, oncology coverage plans for employers and insurance companies and another group represented by brokers. We have active discussions today on the B2B side with retailers, with corporates and brokers with respect to the B2B strategy.

顯然，我們在這一領域的參與不僅是商業努力的產物，而且還應經紀人和雇主的一些要求，為雇主和保險公司以及經紀人代表的另一個團體提供保險計劃、腫瘤保險計劃的報價。今天，我們在 B2B 方面與零售商、企業和經紀人就 B2B 策略進行了積極的討論。

On the B2C insight, again, this is a pilot scale. First, we increased patients from B2B. Slowly, we increased the population that we cover on the B2C. But today, we could also conclude, there's a big market segmentation in Mexico on the B2C opportunity. 65% of policies will be sold through our own channels for individuals without any coverage from what I said before, the major medical expense insurance. Because this is a population that has no insurance and has -- and might only have social security payable.

從 B2C 角度來看，這也是一個試點規模。首先，我們從B2B增加了患者。慢慢地，我們增加了 B2C 覆蓋的人群。但今天，我們還可以得出結論，墨西哥的 B2C 機會存在很大的市場區隔。 65%的保單是透過我們自己的管道銷售給個人，沒有我之前說的大醫療費用險的承保範圍。因為這是一群沒有保險的人群，而且可能只會繳納社會安全保障。

What have we seen today, high interest from working women. We see a lot of engagement in the nurses, reception to secretaries, whose jobs do not provide medical insurance, as I described before, and who insure themselves and their children, a lot of nice dialogue there. And on employees that are covered -- are covering their employees with the Mexico's social security IMSS, but IMSS has a very poor offering characterized by waiting lines and list of appointments in surgeries.

今天我們看到的是職業婦女的高度興趣。我們看到護士們有很多參與，接待秘書，他們的工作不提供醫療保險，正如我之前所描述的，他們為自己和孩子投保，那裡有很多很好的對話。對於受保的員工來說，正在為他們的員工提供墨西哥社會安全保障 IMSS，但 IMSS 的服務非常差，其特點是排隊等候和手術預約清單。

So those are also nice growing dialogue with that segment of that population. A lot of interest from the independent workers, doctors, dentists, nutritionists. Remember, we're selling a lot of this as well in our reception, in our hospitals. And so it does have a certain bias to those professionals.

因此，與這部分人群的對話也是很好的。獨立工作者、醫生、牙醫、營養師對此非常感興趣。請記住，我們在接待處和醫院也出售許多此類產品。所以它確實對那些專業人士有一定的偏見。

And they -- since they are independent, they also need to secure individual insurance coverage. And that's where they find our product interesting. I think that sort of gives some insight into where we are and how we see the product landing. I'd like to conclude, it's landing well. We're very deliberate but gradual as we grow these businesses, as we take care of these populations.

他們——因為他們是獨立的，所以他們也需要獲得個人保險。這就是他們對我們的產品感興趣的地方。我認為這可以讓我們了解我們所處的位置以及我們如何看待產品落地。我想得出結論，它落地順利。當我們發展這些業務、照顧這些人群時，我們非常謹慎但循序漸進。

At this time, I'm showing no further questions. So I'd like to turn the call back over to Suso, who has a few closing remarks.

目前，我沒有再提出任何問題。所以我想把電話轉回蘇索，他有幾句結束語。

Well, thank you very much, everybody. It's been a good quarter, as you might have asked. We will continue to update you all on this progress and our various growth initiatives on our next earnings call. In the meantime, we remain keen to continue meeting with the shareholders as well as investors that are new to the company.

嗯，非常感謝大家。正如您可能會問的那樣，這是一個不錯的季度。我們將在下一次財報電話會議上繼續向大家通報這項進展以及我們的各種成長舉措。同時，我們仍然熱衷於繼續與公司的股東和新投資者會面。

With that in mind, please reach out to our Investor Relations group and Ana in particular, if you like to arrange a call or meeting with Gisele, Lorenzo, and myself, happy to do that. Have a great day, everybody, and enjoy the rest of the week. Thank you.

考慮到這一點，如果您想安排與吉賽爾、洛倫佐和我本人的電話或會面，請聯繫我們的投資者關係團隊，特別是安娜，我們很樂意這樣做。祝大家有美好的一天，並享受本週剩下的時間。謝謝。

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

今天的電話會議到此結束。您現在可以斷開連線。