Aster DM Healthcare Ltd

Good afternoon. Thank you Inba and Hemish Purushottam for sending me invitation. I appreciate your motto, “We’ll treat you well.” It is better to be honourable then to be honoured. In India healthcare generally is at inflection point so we have lot of opportunities. India remains one of the fastest growing healthcare market globally with 1.4 billion people and India has 10x hospital bed care, a huge growth runway. So what will be the pie of Aster DM? So long- term expect 20%-30% productivity gains, helping lower treatment costs while sustaining doctors' stakeholder income. The 50% revenue now from high- margin specialties like Oncology, Cardiology, Neurology, and Orthopaedics.

Will this change in future? And will we have a pan-India footprint, more than 38 hospitals and 10,000 beds across 27 cities? I think with the capex of Rs.1900 Crores capex expanding from 6,400 beds to 13,600 beds by FY2027. What is

Page 19 of 32 the status? India, top five global destinations, Kerala, Bangalore, Hyderabad, cluster driving growth. How are AI pilots and R&D efforts shaping care and cost? AI pilots and imaging and reporting have reduced turnaround time by 30% to 40%. What is the status today? How is Aster position in medical value travel? India is among the top five global destinations for medical tourism. An IISc joint venture with R&D, what is the result and active in palliative end- stage care, ensuring digital dignity in treatment. In conclusion, healthcare is not just a business, it is a calling that demands compassion, resilience and vision. India has the potential not just to compete, but to surpass global giants.

We will treat you well should be the motto and continue in practice. Aster into future of excellence, inclusive with healing. With this, I wish you all the best. Thank you.

Thank you. We move to our speaker number two, Mr. Samrat Sarkar. Sir, could you please unmute your audio and video and ask your question?

Good morning, everyone. I am Samrat Sarkar from Calcutta. I would like to thank you for this opportunity and I have only five questions. Number one, how do you perceive our revenues to grow annually for the next few years?

Number two, what is our EBITDA per bed and where do you see the ARPOB going forward from the 45,000 odd levels? And thirdly, since I am new to this company, I would love to know what is the difference between your bed capacity and the census or the operational beds. Fourthly, our promoters are having 41% of their shares pledged. So this pledge is against which loan or liability, I would love to know. And lastly, by when do you expect to complete this merger with Quality Care India Limited? That is it from my side. I wish you all the best. Thank you.

Thank you. Our next speaker is speaker number three, Mr. Manjit Singh, who would like to ask a question on audio mode. Mr. Manjit Singh, please go ahead.

Hello. chairman madam. Can you hear my voice?

Page 20 of 32 We can hear you, sir. Please go ahead.

Madam, first of all, good afternoon to you, all the board of directors, all the staff of Aster DM Healthcare Ltd. and my co-fellow shareholder. Madam, first of all, the way you told us about the company in your opening remarks, and madam, the way we have a vision and the way we have given returns to investors on their investment, compliments madam. And behind this, you and your entire team are working day and night to give the best return to the investor with an investor-friendly approach. Madam, we have complete faith that the way you are working hard, we will get even better returns in the coming time. Madam, what is the roadmap for the next 24 months? Tell us a little about it. Our promoter holding around 41% so are we planning a buyback to increase it. Tell us a little about it. Foreign investors have full faith in our company and their investment is also increasing. This means that our future is bright. I pray to God that our company din dugni raat chauguni tarakki kare and each investor gets a good return on their investment. And chairman madam, I want to say little about speaker shareholders, they take their time and they involve depending on the investment in the company and I want to say that you keep rewarding them madam. Apart from that in your leadership the company is getting success and in coming times it will get more success. Thank you so much for giving me chance to speak.

Our next question is from speaker number four, Mr. Vimal Jain, who would like to ask a question on audio mode. Mr. Jain, you may unmute your microphone and ask your question now. Mr. Jain, yes, please go ahead. Yes, you are audible. Please go ahead.

Thank you, madam. Thank you. Good afternoon, Chairman and Deputy MD, and all the management available on this platform and the shareholders attending this meeting at this platform. An excellent speech is given by the madam, wherein she told us about the comprehensive journey about the company and the sustainable growth of the company and about the roadmap for the coming days. And also the CFO told us about the accounts of the company and the growth of the company. In the year under review, we have a good profit of around INR 5,400 Crores as compared to around INR 200 Crores last year and thank you very much for the share dividend you have given a total

Page 21 of 32 of INR 5/- at the face value of INR 10/- to us and thank you to the management also but ye dil maange more madam. We have a very solid profit so we shareholders also to get something, so in this scenario my question is that how would you reward the shareholders in the current financial year where we have a good profit last year? So I should pray we should get a bonus in this current financial year or in the coming days. And the rest of all is all the best. There is no condition or the doubts on the annual reports of the accounts of the company. And in the last but not the least, I would also like to convey my sincere thanks to the company secretary, Mr. Hemish ji, and his entire team for helping me to join this meeting at this portal and also to provide a copy of the annual report to me on just a single request. And thank you and all the best, madam, for the coming days and the year. Thank you, madam.

Thank you. We now invite our speaker number five, Mr. Ankit Agarwal. Sir, could you please unmute your audio and video and ask your question now. Mr.

Agarwal, could you please unmute your microphone? Yes, thank you.

Myself, Ankit Agarwal, the shareholder of your company from Delhi.

Respected Chairman, esteemed Board of Directors, and my dear fellow shareholders. Good morning, ladies and gentlemen. It is a privilege to stand before you at the Annual General Meeting of Aster DM Healthcare for FY2025. I hereby like to comment Chairman, for excellent and wonderful chairman speech and madam for excellent opening remarks. As a shareholder, we have witnessed a remarkable journey for Aster DM from being a regional healthcare provider to emerging as one of the leading integrated healthcare player across India and GCC. It is a matter of pride for me as a shareholder that in FY2025, company’s improvement in EBITDA, revenue growth, and key financial vectors being positive vertical for the company. Also, I studied the full annual report of 441 pages which my heart infers that it is printed with true words and all written in easy understand by any of us from shareholder family.

It is a truly wonderful work of our CFO. Chairman madam, I have few questions which I want to ask from you considering time value. My first question is, you mentioned that in our organization runs various courses. What

Page 22 of 32 percentage of these courses as in our revenue FY2025. And my second question is, with increasing competition from Apollo, Fortis, and Narayana Health, what differentiators are Aster DM's growth strategy in India over the next five years? My last question is, healthcare is not just a profitability, but also affordability. How is Aster ensuring that expansion does not compromise affordable care, especially in under-reserved regions. Before I leave, I would like to thank our CS team and our entire secretarial team for giving me the platform connectivity to connect with KMPs of the Company. Last and foremost, I would like to wish Chairman Sir, for his good health and good wishes for the coming festive season and Onam. And at last, I would like to report that I supported all the resolutions and voted in favour. Thank you. Goodbye.

Thank you. We move to our next speaker member. Mr. Bharat Raj would like to ask a question on audio mode. Mr. Bharat Raj, please go ahead, sir.

Yes, very good morning, Chairman Madam, entire Board of Directors in campus of my hospital. I am Bharat Raj attending from Hyderabad. Madam Chairman, wonderful Chairman speech you have given. A lot of information is given. One, I want to bring to your notice, Madam Chairman, we respect you, the speech, madam, but we want to hear the speech from our chairman, madam. Because this is an AGM. I want to bring to notice, Apollo Hospital chairman he is 85 years also, he will only address the shareholders. In this lifetime, he never miss the address to the shareholders. So I request you, madam, next year, my chairman, I want to see my chairman presence. I will be more happy, madam, because there is no questions to raise. But I want to see my chairman that give more strength and energy.

Mr. Bharat Raj, we cannot hear you. Looks like we have lost the connection for Mr. Bharat Raj. That was the last question from last speaker shareholder. I now hand over the proceedings to Ms. Alisha Moopen. Thank you and over to you, madam.

Page 23 of 32 Thank you shareholders for your questions. While we provide the answers to the questions shortly, I request the moderator to play a video to share the work done by our CSR arm, Aster Volunteers, and the Aster Guardians Nursing Awards. Thank you all for the deep remarks, the kind words, and we will come back to you shortly. (Video played) Welcome our shareholders, I now hand over the proceedings to Mr. Hemish Purushottam. Over to you, sir.

Thank you, Inba. Dear shareholders, we will put our best efforts in responding to all the questions raised in the meeting. However, the shareholders may also write to the company on the designated e-mail addresses given on the website of the company for any further questions or queries you may have. Now the management team will respond to the queries raised by the shareholders. So chairman, shall we go ahead with the questions? Yes, please, Hemish. Please continue.

The first question which was asked by Mr. Arun Kumar Boppana was, how are AI pilots and R&D efforts shaping care and what are the costs associated with it?

So thank you, Mr. Kumar, for your very thoughtful, deep questions. I think it was very broad. I think you have covered a big aspect of what is happening in healthcare, how we think about what is happening in India, what the requirements are in India, what are the shifting specialties. And this is something which we monitor very closely. And of course, looking more progressively forward, what is happening in terms of technology AI as well.

So I would like to also request Mr. Ramesh Kumar to come in because we very closely look at what are our speciality and exactly like you mentioned, we have the CONGO specialities, which is a big part of what Aster is offering right now, where we have the centres of excellence. But we also very closely look at what are the changes, what are the shifts happening in the demographics, in the disease patterns, so that we can also develop teams and be mindful about what needs to be added as services as things are changing. So, Ramesh, if I can

Page 24 of 32 request you to come in on this one as well as the palliative care and the AI interventions that would be very helpful.

Absolutely, Ms. Alisha. As Mr. Arun Kumar Boppana has asked many questions, of course, one is what the speciality mix, what we are talking about, we call it as CONGO-T mix. CONGO-T mix is all about cardiology, oncology, neurology, gastroenterology, and our orthopaedic including transplant. So if you really look at, we are crossing beyond 50% on this CONGO-T mix. And most of the hospitals have been really doing well in this. And we are also looking at how the pattern is changing in some of the major metro cities. So we find it is likely, might be skewed towards the CONGO-T in the metro cities.

So we are watching over this change in the thing and building our infrastructure according to that. Adding to that, you did ask about the AI pilot and R&D efforts, what we are putting in. In fact, AI is playing a major role in our day- to-day life now, especially in hospitals when it comes to clinically, we are trying to enhance diagnostic by enabling faster reporting processes. We see a lot of things changing as far as the patient summary, the OP summary, or the creating of medical records for the patient. So clinically, I think it is quite adaptable, and we are finding a lot of changes happening. Operationally, I would say that AI is optimized to manage inventory, especially patient flow, and planned resources. We have also shortened wait time because we could apply AI very well and on the patient bedside we also find that chatbots, which are quite useful. Overall we find it is the industry expense what we have been spending around 0.5% to 2% would be the expense what we are spending. At Aster we find it very useful of course we have technology partners also aligned with us, like Indian Institute of Science where with neurology, where we have identified carpal tunnel syndrome and AI-assisted carpal tunnel syndrome.

Pulmonology, we have L&T and for cardiac risk assessment we have Lupin company, which is coming in. And of course, Chatbot from THP and others.

And we also see that patient bedside, we have the Dozee as well as the IISc, which is where we are partnering with where we get a real time assessment of the patient. So all these application have been happening at the hospital setups and it is fast evolving as well. On palliative care, of course, we did have palliative medicine in Aster Hospital. It is one of the departments which has been doing exceedingly well, practicing ethical evidence-based medicine, where we find almost mind and body medicine specialists, especially a

Page 25 of 32 multidisciplinary team approach has been happening here. We find palliative nurses, specialists, psychologists, nutritionists and interdisciplinary approaches have been happening so as to give the right care to the patient. We understand that all these individuals are pain experienced patients and they need a total pain relief approach. Our team have complete assessment of the aspect of pain and ensuring an individual plan to treat the patient over and again. The treatment plans are personalized post-evaluation for specific needs and consist of the non-pharmacological and pharmacological approach. So that is about our palliative care.

MVT is also another area you did ask. India is rapidly emerging as the MVT hub. As we all know that India has declared Heal in India as one of those announced in the union budget in 2025. So overall, we have been covering many of the countries including GCC, Africa, Maldives and SAARC countries.

With a cluster-based approach, we have all our hospitals treating the MVT patients, especially in Kerala as well as in Bangalore. Looking ahead, the way we are establishing the environment continued emphasizes on channel partnership, market diversification, and service differentiation is what we are looking at. In FY2025, we have achieved around INR 150 Crores in MVT revenue. Q1 FY2026 revenue stood at INR 33.2 Crores, reflecting sustained quarter-on-quarter growth momentum in recent months. This momentum has further strengthened with the run rate rising in INR 15 to INR 20 Crores per month. Based on the trajectory, we expect to close in FY2026 at approximately INR 180 to Rs.200 Crores.

And probably the last but not the least, you did ask about the Indian Institute of Science engagement. Yes, that is our major project which has been happening. We have all the IISc professors and many of the team have been coordinating with our clinicians in identifying the right projects. And one of the projects where I did mention about the AI related how carpal tunnel syndrome has been detected quickly. So this is one of the achievements and lot of papers have been published on this as well. So a lot of work has been happening with IISc as well. So with this, I hope I have covered everything.

Thank you, Ramesh. So I just want to close off what Ramesh said. I think one of the most important questions, Mr. Arun, you had asked also was about

Page 26 of 32 balancing affordability in a price sensitive market like India and I just want to say this is a very important question and it is something which is very important for us as Aster because we always talk about quality care and making it affordable. So there are multiple initiatives that we do in terms of trying to optimize the cost. So whether it is procurement, whether it is supply chain efficiencies, whether it is manpower productivity, and also like what Ramesh was talking about, AI, not really building everything ourselves, but to partner with technology partners to ensure that our investments are not becoming too onerous. So there are a lot of measures focused on lowering our operating costs that actually allows us to pass on the benefits to the patients also without compromising on quality. We also always continue to invest in advanced clinical capabilities and also ensure, of course, when it comes to centres of excellence, what are the next things that are happening so that we are able to deliver world-class care, so I think this is something which we make sure that there is a dual approach, making sure there is efficiency on one side and also making sure that quality is also equally the focus area for us. So that is what really helps us enable that there is affordability and accessibility while ensuring there are good returns for us and shareholders as well. So I hope with that we answered most of the questions that you have asked us.

Thank you, Ms. Alisha. The next question was from Mr. Samrat Sarkar. He has asked, how do you perceive our revenues to grow annually in the next few years? He also added, what is our EBITDA per bed ratio and where do you see the ARPOB going forward from INR 45000 level? He also asked, what is the terminology difference between operational beds and census beds? And the other question he had asked was about the promoter's pledge and for which loan. And the final question he had asked was, when do you expect this merger to be completed? Thank you.

Thank you, Samrat, for those questions. I will kindly request the Mr. Sunil Kumar, CFO to just take up the first two or three questions to talk about the roadmap for revenue growth and the clarity on the census, non-census beds.

And I will come back on the promoter's pledge.

Thank you, Alisha. So on the revenue growth, I think if you look at the last five years, Aster has been growing at a rate of 20% revenue, and the EBITDA

Page 27 of 32 has been growing more than 35%. But in the last year, because we have created a higher number of base, wherein we generate now more than INR 4,000 Crores of revenue. Going forward, and also we are adding more than 10% of the capacity beds every year. Keeping that in mind, we see anywhere between to mid-teen revenue growth and around 20% of EBITDA growth is what we expect in a medium term, that is between three to four years. In terms of and also with respect to the mid-teen growth what we are talking about top line, usually the volume contribution should be approximately between 5% to 7% and ARPOB contribution will be approximately 7% to 8%. I think that should answer your first question on what we pursue in the revenue growth in the next few years.

Coming back to the second question, what is our EBITDA per bed? Our EBITDA per bed is approximately INR 10,000 per day per occupied bed. And in terms of ARPOB, we are at FY2025, we close ARPOB at INR 45,000 per bed. And ARPOB has been historically growing at around 10% in the last five years. And last year, we grew at more than 12% and very specifically ARPOB has been a double-digit growth in last two years only because of two three reasons very specifically on the inflation. Inflation has not been growing more than 3% to 3.5% that is a contribution to the ARPOB growth that is basically the price increase what we get from the cash patients and the TPA patients and balance around 4% to 5% is because of the ALOS efficiency which Mr.

Ramesh Kumar also alluded to and balance another 2% to 3% has been coming because of the new hospital like a Whitefield hospital which is in the east of Bangalore growth contributed and from specialty point of view also we got Oncology has been a major driver for our growth, which is one of the major super speciality and that is also actually contributed 2% of our ARPOB growth.

Going forward, because ALOS is a one-time thing, we are already efficient.

We have been at ALOS of 3.8, 3.9 few years back and now our ALOS has come down to almost to 3.1 and the 3.1 is the best in the class ALOS and I think going forward, the idea is to maintain this ALOS between 3.1 to 3.2 and keeping that in mind, the future growth of in ARPOB between three to four years, we expect somewhere between 78% should be the ARPOB growth in the future years. Lastly, answering your question on the difference in terminology between the bed capacity and operational beds. Bed capacity

Page 28 of 32 means the actual, the beds which were installed in the infrastructure. So when we say a 500-bed hospital, 500 is the number of beds which is there in the particular hospital. And out of 5,000 beds, usually we demark into what we call as the census and non-census beds. So usually in a 500-bed hospital, 80% of the capacity will be census beds, and 20% of the capacity will be non-census beds. So in a 500-bed hospital, usually 400 beds will be census beds, and 100 beds will be non-census beds.

What is the meaning of census beds? Census beds is usually beds where you admit the patient overnight, like an example of a general ward, twin sharing room, single room and an ICU bed. A non-census bed is a bed wherein you do not admit patients overnight, usually used during the daytime. For example, emergency care beds, day care beds, dialysis bed. These are the beds which are not used to admit the patient. That is the difference between the census beds and non-census beds.

Now, coming to last terminology called as operational beds. Operational beds mainly means to say that among the census and non-census beds, how many beds we are operationalised wherein we have the manpower to deal with.

Whenever you open up a new hospital with a 500 bed capacity, we usually start with operationalising 100 beds. So when you say 100 beds are operationalised, to that extent we brought the manpower. So that will ensure that we are not overmanning the hospital and increasing fixed costs. To ensure that we are profitable and also taking operating leverage, we only operationalise when and when the occupancy percentage increases. I hope I am able to address the nomenclatures of capacity beds, census beds, non-census beds, and operational beds. Thank you very much.

Thank you, Sunil. Samrat, just coming back to your question on the promoter's pledge. So actually in FY2025, we as the promoters, we have significantly reduced our share pledge. It was 99%. We have brought it down to 41% right now. We have completed a full debt refinancing and done it with a top tier global financing institutions. The pledge shares, they are linked to this refinancing arrangement. It does not have any operational liabilities at all for the company. I think the reduction is a very positive sign because it shows actually all of our commitment and confidence in the business. This is

Page 29 of 32 completely linked to promoter-level financing, does not have any effect on the company's balance sheet and day-to-day operations. It was largely linked to the GCC transaction when we did the segregation. So I hope that clarifies as well. Hemish?

Thank you, Ms. Alisha. There is also another question by Mr. Samrat on the timelines expected to complete the merger with QCIL.

So for the merger, we are hoping that we have got most of the key milestones have been achieved so far with the shareholder support for the merger resolutions. We have had the CCI approval. We have had the initial share swap transaction has already been completed. And we submitted all the application for the no objection certificate with SEBI as well. So the next stage is getting the approval from the NCLT. Our expectation and hope is that it should be completed by the Q4 FY2026.

Thank you. Moving on, the next set of questions were from Mr. Manjit Singh.

He had two questions. The first question was, what is the roadmap for the next 24 months for Aster? And are there any plans for buyback of shares?

Namaste Manjit ji. You praised your Company Aster, thank you so much for that. For the next 24 months, our entire effort in the next 24 months will be focused on the integration of Aster and QCIL. This is our full focus. When we go from 10,000 beds to 14,000 beds, this is a big transformation for the company. 50,000 people in the company will be working on this. Mr. Sunil Kumar, you want to come a little bit more on the roadmap?

Out of 2,600 beds, which is there in Aster, at least next year, this FY2026, we should be operationalising around 500 beds. And FY2027 is a major expansion with Aster Capital and other big operational happening around 1,000 beds should be the expansion which we are expecting in FY2027. Thank you.

Moving on, the next set of questions, were from Mr. Vimal Jain. He had asked how Aster DM would reward the shareholders in the current year, given our strong performance. So maybe Mr. Sunil Kumar. Sure. Sunil, you want to?

Page 30 of 32 Alisha if you want to start on that?

Sure Vimal ji. Thank you so much for the question. We have made a lot of effort to have a very positive year and I think with the interim dividends from the segregation of the GCC, we have given INR 118/- dividends at the sale of the GCC. And then there was INR 4/- interim dividend also that had come so special dividend plus interim dividend of INR 122/- in the last one year. So in total, actually, we have given more than INR 6,100 Crores back to the shareholders. I know you said, dil maange more, but we want to grow. We want to make your company bigger and bigger, make the organization bigger.

We have gone from 20 hospitals to 38 hospitals in the last one year with the merger. But there are so many more in the pipeline like what Sunil was talking about. So with that, we are taking a very balanced approach, but we still wanted to do a little bit extra, which is why we have proposed this final dividend as part of the festivities and as part of final closure and looking at the overall books and taken a very prudent approach. So hopefully, you will be very happy that we are putting more and more money back in the company to also grow, which will make your company and also the shareholders very happy.

Thank you. Moving on, the next set of questions were from Mr. Ankit Agarwal.

He had two questions. One was, Aster runs various courses. What percentage of these courses are percentage of our revenue? The second question was, with increased competition from Fortis, Apollo, and Narayana, What differentiators define Aster DM's growth strategy in India over the next five years?

Ramesh, may I please request you to come in here?

On the first one, I will answer Alisha on the revenue and other things. So on the, just, thanks for the question from Ankit Agarwal. On the courses, we run courses in both in our own vertical called as Aster Health Academy, and also we run courses in our hospitals. Specifically, we run PG courses, basically developed by National Board of Examination in Medical Sciences. Also, we run courses related to IMT from the Royal College of Physicians UK. And also we run certain emergency medicine courses from the George Washington University. In addition to that, our health academy, Aster Health Academy, also runs fellowship courses, very mainly in clinical courses like Critical Care Medicine, Clinical Neurosonology, and Non-Invasive Cardiology. And these

Page 31 of 32 actually contribute to approximately INR 33 Crores of revenue per annum. And we have a total revenue of INR 4,138 Crores. So this contributes to around 0.8% of our total revenue. Thank you.

Thank you. So Ankit ji, you are also asked about the increasing competition, whether it is with Fortis, Narayana, and what is the differentiating factor with Aster? So I think for us, the reality in India is also that there is such a huge requirement for additional beds to come, quality beds to come. Our focus has always been on what more we can do. How do we build on our strengths? And in healthcare, we always say it is about the people. So how do we attract the best talent? How do we bring the best doctors? How do we support them with the right infrastructure and the right technology so that we are able to kind of keep differentiating ourselves, because healthcare is changing so rapidly, it becomes very important for us to be on top of it on point and have the best teams that are always progressive and aggressive in terms of what is happening next so maintaining ethical, moral standards and delivering good quality, affordable care. That is always our guiding principle. And we make sure that we on board teams that are aligned to that same vision for us.

Thank you. The final request was from Mr. Bharat Raj. He had requested for chairman's presence at the AGM. So I request Alisha.

Yes. Thank you, Bharat ji. Absolutely he was very hopeful of being participating in the AGM this time. There was a very unmissable stakeholder engagement commitment that he had, because of which he could not attend this time's AGM. But we will pass on all your sentiments, your love, your wishes.

We know that having him here will always add a huge boost of energy for all of us, but we will make sure that we pass it on so that he can join us next time.

But thank you. Thank you for the warmth. Thank you for the love. And wishing you happy Diwali and all the festivities forward.

Thank you. So that is it in terms of the Q&A questions. I hope we have answered all your queries. Now I request Ms. Alisha to give her closing remarks.

So thank you all, dear shareholders. I think that concludes us and brings to the end of the formalities for today.

Page 32 of 32 Shareholders who have not yet voted, the voting window will be available for the next 30 minutes. And Mr. Rajiv Balakrishnan, Director of Beyond Compliance Corporate Services, has been appointed as a scrutinizer, who will be giving a scrutinizer's report soon. And the results of these resolutions will be uploaded on the website. And that is it. So on behalf of the management and all the Board Members, I thank all the shareholders for their active participation. With this, Ms. Alisha, you can conclude the meeting.

Thank you all. So we will keep the voting open for the next 30 minutes. Thank you all for attending. I am wishing you all a wonderful season ahead. I now declare the meeting as concluded.