International Conference Call Grupo Fleury 2 nd Quarter 2011 Earnings Results August 5, 2011

Transcription

1 International Conference Call Grupo Fleury 2 nd Quarter 2011 Earnings Results August 5, 2011 Operator: Good morning everyone, welcome to Fleury Group s nd Quarter conference call. Mr. Omar Hauache, CEO and Mr. Fábio Marchiori, CFO and Head of IR will present the results. This event is being recorded and all participants will be in a listen-only mode during the Company s presentation. After Fleury Group s remarks there will be a question and answer session. At that time further instructions will be given. Should any participant need assistance during this call please press star zero (*0) to reach the operator. This event is also being broadcast live via webcast and may be accessed through the Investor Relation Website at where the presentation is also available. Those following the presentation via webcast may post their questions in advance on our website. They will be answered during the Q&A session as long as we have enough time. Before proceeding let me mention that forward statements are based on the beliefs and assumptions of Fleury Group s Management and on information currently available to the Company. They involve risks and uncertainties because they relate to future events and therefore depend on circumstances that may or may not occur in the future. Investors and analysts should understand that conditions related to macroeconomic conditions, industry and other factors could also cause results to differ materially from those expressed in such forward looking statements. Now I will turn the conference over to Mr. Omar Hauache, CEO of Fleury Group. Please sir you may now begin. Mr. Omar Hauache: Good morning everyone. We will present 2Q results of Fleury Group. We will show a solid organic growth that mainly drives the 13.1% increase in gross revenue. Results were partially impacted by some nonrecurring events that we will describe in details later on and are basically related to efforts for cost recovery, organic expansion plans and costs related to the recent launch of our national brand. I will start describing the operational highlights which on slide 3. On May 24 we launched a new national brand called a+. This brand consolidated 13 brands that were previously acquired. a+ strengthens the offer of diagnostic services across the country and is endorsed by Fleury Group. An intensive media effort was launched on June 18 in order to communicate the innovative services platform of a+. We have very positive with the evolution of a+. The number of new clients since the brand was launched is remarkable. A satisfaction survey was conducted 1

2 during the June/July period analyzing 4600 clients and the satisfaction parameters show very high scores of satisfaction. Media monitoring is worth mentioning as well. Usually clients use social media to complain about services. We monitor different kinds of social media for our competitors and for our brands as well. As for our competitors we identified 38.5% of negative comments; as for a+ 96% of positive and neutral comments have been recorded since the new brand was launched. Less than 4% were negative comments. This is very much compatible with Fleury brand. One other good news is that Fleury was included for the second consecutive year the list of the 50 most valuable brands in Brazil. Fleury Group was awarded the best medical diagnostic company in Brazil by Grupo Padrão and GFK Institute due to its undisputed excellence in customer services. We have received this award 10 times over the last 12 years. We signed the investment agreement authorizing the acquisition of Labs D Or in July 13 and thanks to this deal Fleury Group received the IG-Insper award as 2010 s view of the year. Among the acquired assets that are 57 patient service centers concentrated in Rio de Janeiro State and diagnostic operations in 21 hospitals. These assets will generate 444 million of annualized net revenue and an Ebitda of R$ 111 million corresponding to a 25% margin On net revenues let us move to slide 4. Let us not talk about the financial highlights of 2Q of the year. Gross revenue increased by 13.1% reaching R$ 267 million. A major part of its growth (12.6%) correspondence to organic growth. Our patient service centers grew by 12.4% mainly driven by its organic growth, which corresponded to 11.2%. The remaining 1.2% came from Diagnoson, an imaging company we acquired in Salvador. Its results were included as of June Operations in hospitals continue to show a very solid growth almost reaching 30% boosted by organic growth but also including new agreements. These business line already represents 11.2% of Fleury Group s total revenue. The preventive medicine business line grew 23.7%. Gross profit in 2Q achieved R$ 83.1 million corresponding to 34% of net revenue. General and administrative expenses excluding depreciation represented 11.7% of net revenues. Ebitda reached R$ 51.6 million in its margin on the net revenue was 21.1%. Net income grew 5.7% reaching R$ 33.3 million, or 13.6% margin on net revenue. On the next slide, slide 5, which illustrate the evolution of gross revenue, Ebitda and net income over time from 2007 to 2010 and compare performance between the first semester of 2010 and 2011 and during 2Qs of 2010 and On the next slide we will further detail these figures. Let us move to slide 6, we will now talk about gross revenue. This 13.1% gross revenue growth as I said 2

3 before was mainly related to organic growth. The 12.6 organic growth was mainly driven by our expansion plan with an increasing offer of imaging services and the optimization and increase in the available area in patient service centers. In addition we continue to innovate in tests, procedures and services such as the recently launched integrated medical centers. One other factor that contributed to this solid organic growth was hospital-based agnostic services. The preventive medicine business lines continue to go consistently as well. Diagnoson is consolidated into group s numbers as of June. The figure below illustrates the contribution of organic growth and the acquisition of Diagnoson in 2Q s growth. Moving to slide 7 let us now talk about the gross revenue breakdown. The pie on the left side tells us that 84% of our revenues come from patient service centers; 11% are related to operations in hospitals and of the remaining 5% come from lab-to-lab and preventive medicine business lines. On the right side we show the relative growth for each of the businesses and skill on this slide we illustrate the gross revenue breakdown by type of test. In fact revenue in imaging and other specialties are much more driven by organic growth in PSCs; but clinical analysis revenues achieved strong growth during 2Q both in PSCs and in hospitals. This explains why the percentage of imaging tests was lower in 2Q11 when compared to Anyway it is important to mention that due to our organic expansion plan that will allow more imaging services for Fleury brand and a+ brand and also due to our recent and future acquisitions imaging participation will significantly increase in the next months. For example thanks to the acquisition of Labs D Or the current 34% participation of imaging in our total revenues will soon jump to 45%. On slide 8 I am going to describe the business lines performance. PSCs showed a 12.4% increase in gross revenue amounting R$ 223 million. This growth is the result of an expansion in both volume of patients and tests when compared to 2Q10. The volume of tests increased 9% as shown in the left figure this slide. The enrichment of mix both in clinical analysis and imaging services and adjusting price strategy also contributed to 2Q s revenue growth stop samestore sales continue to grow double-digit reaching 12% and as shown on the right figure average revenue per PSC grew 16.5% when compared to 2Q10. This is a result of the increase in services portfolio, continuous effort on network optimization and improved capacity utilization. Going to slide 9 on this slide we show that our average revenue per square meter grew at 1.2% reaching R$ 3.8 thousand. PSCs total area achieved 59,000 m², a 2,800 m² increase will during this quarter. The main addition was 3

4 the incorporation of Diagnoson s figures and the expansion projects such as illustrated here with two pictures of new PSC in Rio and in São Paulo. On slide 10 let us talk about diagnostic operations in hospitals. This business line continues to grow at remarkable rates. Revenue achieved R$ 29.8 million, a 29.9% increase. This now represents 11.2% of group s revenue. As shown in this figure the number of tests performed continues to expand by more than 40% considering that 9 hospitals we are reading so far. And with the acquisition of Labs we will be in charge of clinical analysis services of 21 additional hospitals and imaging services in three out of these 21 hospitals (São Luiz hospitals in São Paulo). Considering the additional 21 hospitals this business line will soon represent 17% of the group's revenue. On slide 11 we will talk about lab-to-lab and clinical trials. Lab-to-lab reached R$ 8.1 million, which means R$ 0.6 million less than 2010 and allied with the previous quarter. Even though revenue up this business line has not increased this quarter, the expansion of volume of high complex tests generated better returns. As for clinical trials business the progressive phase-out is in course and it explains the increase in revenues from R$ 1.2 million in 2Q10 to only R$ 0.2 in On slide 12, finally here on slide 12 let us talk about the preventive medicine business lines revenues. It increased 23.7% amounting to R$ 5.7 million and representing 2.1% of group s revenues. These business lines include health assessment, health promotion and chronic disease management. Chronic disease management for each 38,000 lives under contract and its revenues corresponded to R$ 1.5 million. This service has delivered returns on investment in less than one year for the clients such as HMOs, NCOs and companies that hire this kind of service. This return on investment is combined with the improved quality of life of beneficiaries. Health assessment increased by 23% with a 16% growth in the number of assessments. Now I will pass on the word to Fábio Marchiori. Mr. Fábio Marchiori: Thanks Omar, good morning everyone. I will start my presentation with slide number 13, the slide above cost of services and cost of services breakdown. Before we check the numbers I would like to remember the reason why there are two columns in this chart named adjusted criterion and reported. The criterion that has changed (that is from 2011 on) refers to the relocation of expenses which were previously considered general and administrative but in fact are more related to the provision of services to our customers and patient service centers, hospitals and companies in general. 4

5 If we take a look at 2Q10 results statement we will notice that this relocation represents circa 500 bps as a percentage of net revenue. Let us now compare figures looking at the percentages as per the adjusted criterion. As you will notice although the group continues to deliver more efficient operations and to decrease our costs, during this quarter the ratio has increased by 290 bps when we compared to the same period of last year. We can anticipate that most of this increase is related to the nonrecurring and preoperational costs, but let us analyze each line: personnel and medical services costs have decreased by 90 bps to 30.6%. Despite the fact that this can be considered good news this level is slightly above our expectation that inflation of salaries turned out to be higher than our forecasts as a result of an accelerated Brazilian CPI rate. Also it is important to highlight that we have already hired personnel for the new and expanded patient service centers, since it is group's policy to deploy a very comprehensive training program before new employees start to develop their activities. Now moving to general services, rent and utilities as mentioned in previous quarters this cost has increased by 140 bps. There are three reasons for this increase: the first reason reflects in 45 bps and referred to preoperational rental expenses in patient service centers being currently assembled. Some of them will become operational within 2Q11. Second, which represents 60 bps, are the impacts of rental rate negotiations mainly in São Paulo and Rio de Janeiro. In our perception this real estate overheat is a short to medium term effect. Finally the remaining 35 bps or a medium term effect as the new and expanded patient service centers catch up with demand. Just to enforce one of the group's beliefs we will continue to pursue high levels of asset utilization not only due to the overall financial effect also to continue to improve the already high level of customer satisfaction related to the one-stop shop concept. Now moving to materials and outsourcing the group's supply chain continues to improve relationships with our strategic partners. As a result this cost line has further decreased by 20 bps as a percentage of net revenue. Finally talking about general expenses the costs have increased by 260 bps. The vast majority (215 bps) refers to nonrecurring expenses related to the successful launch of a+, our new brand. The reason why we have allocated these expenses as cost of services rather than general and administrative are due to the fact that they refer to efforts such as the devastation of systems; promotional material to explain the brand s platform; training of our call center and patient service centers employees and mortifications. All of these efforts have immediately impacted our patients perception about the brand. 5

6 Just as a reminder during the second semester there will be further expenditure related to the brand consolidation project end of the launch of a+. But as most of this cash outflow will be related to advertising the remaining expenses will be allocated to SG&A. As mentioned earlier we expect inflation on salaries and real estate rates to have an effect on the advance on cost of services over the next few periods; however, we also believe that this pressure will be partially compensated by two factors: further dilution of fixed costs as we grow since the group has some spare capacity in the diagnostics medicine business unit; and second increase of share of imaging and high complexity tests and procedures. Moving to the next slide, slide number 14 about gross margin, this slide brings of course the gross margin reconciliation. After all effects mentioned previously gross margin has achieved 34%. For the following periods if we ignore shorttime, nonrecurring items, we expects this figure to increase about 37%. Moving to the next slide, slide number 15, let us talk about the operating expenses. We will analyze what happened with these expenses during 2Q. As we have previously mentioned we also have to adjust the operational expenses to reflect the location from G&A to the cost of services provided and therefore in order to make the comparison easier we presented this slide 2Q10 and 1Q11 adjusted figures. Overall the figure excluding depreciation has increased by 50 bps when compared to the same quarter last year achieving R$ 32 million or 12.9% of net revenue. However it is important to highlight that in fact this figure has decreased in an underlying basis since during 2Q10 we had recorded a nonrecurring tax benefit related to the REFIS IV program as other operating revenues. For the following quarters our expectation for operational expenses excluding depreciation is to stay below 50% of net revenues. However, there are two sets of nonrecurring events which will adversely affect this figure over the next six months: first as previously mentioned during 3Q we will advertise our new brands a+ in all regions where we are present. We have no doubt that this investment (which will be slightly higher than R$ 9 million) will generate impact on revenues for a long time. But given its nature and accounting principles it will be fully recorded in the second semester of Also we have engaged in a commercial effort to accelerate and maximize cash recovery both from bad doctors and from receivables due for more than 120 days. During this quarter is this decision s net impact on Ebitda and profit was R$ 2.6 million, partially recorded as cancellations and partially recorded as other operating expenses. Of course the benefits of this movement is an improvement in cash from operations. Finally as expected depreciation has increased to R$ 8.7 million in 2Q, which presents R$ 1.5 million above 2Q10 and as previously announced is expected to increase between 40% and 50% in the following quarters as a result of the investments which are necessary to support our organic growth. 6

7 Moving on that is see this live that brings the reconciliation between the tax rates, slide number 16. Just to summarize the summary is that we continue to benefit from tax incentives leading to goodwill amortization. As a result the effective tax rate for the quarter was 24.8%. For the next periods we expect that the ETR will remain within the 20% to 25% range. Moving to slide number 17 this slide reinforces bottom-line results: net income has increased by 5.7% reaching R$ 33 million or 13.6% of net revenue. Just to reinforce last year's baseline profit was positively impacted by R$ 15 million as a result of the REFIS IV fiscal benefit. Moving to the next slide, slide number 18, Ebitda has achieved R$ 52 million and margin was 21.1%. Although the first impression is a reduction when compared to 24.5% reported in 2Q10 we would like to move to the next slide in order to highlight the impact of what the company considers nonrecurring items. If we add back the impact of the cash recovery strategy; a+ launching; and preoperational operational expenses these would represent additional 342 bps, which would bring the underlying margin back to 24.5%, the same level recorded in 2Q10 which, again, included the REFIS benefit. Therefore the company continues to believe in its commitment to stay within the 23% to 24% range for this KPI. Let us move to slide number 20. Now we will be able to analyze the performance of each business segment that we disclose. As previously mentioned the diagnostic medicine segment continues to grow at double-digit. Also as already explained the Ebitda margin reduction to 23% from almost 27% in 2Q10 can be explained by nonrecurring events and the cash recovery strategy and therefore we believe that margin levels such as the one recorded in 2Q10 are perfectly achievable as new and expanded units progressively become mature. Now the integrated medicine segment, which grew at an accelerated 27% rate, has decreased its margin by 190 bps to 10.5%. But this is due to two effects: the first one as this segment (integrated medicine segment) because more relevant to the group's performance crossing the 10% share of revenue thresholds we decided to rebalance the allocation of operational support and SG&A expenses between the two segments better reflecting the use of internal resources and as a result the Ebitda margin was adversely affected by 100 bps. The second fact is related, or most of the remaining 90 bps, reflects the nonrecurring events as circa of 5% of the branding expenses were allocated to the integrated medicine segment. We are also very confident about the continuous profitability improvement of this segment (integrated medicine) as a result of increase in hospital activity; better contracts with laboratories and mainly the good results coming from the preventive medicine activities. Let us now move to the next slide, slide 21, and check what happened with the cash flow elements. Cash flow generation remains one of the group s strengths. 7

8 Cash from operating activities achieved R$ 77 million. This was more than enough to finance our investments while reducing debt. Capex has definitely accelerated achieving R$ 36 million this quarter compared to R$ 19 million in 4Q10 and R$ 24 million in 1Q11, which represents circa of 4x depreciation. As you can see in the chart at the right, investment was destined to improve and expand our patient service centers as well as to replace old equipment and improve capacity in the current assets. The group has also revised 2011 s Capex estimate to approximately R$ 135 million, which represents circa of R$ 40 million reduction. This movement can be explained by three main factors: the first one, which represents 20 million, refers to Labs D Or acquisition seems during the negotiation period, which was the first half of 2011, Labs D Or and Fleury s management teams discussed and decided together which maintenance as expansion projects should be implemented by Labs and therefore the cash component of the acquisition price already includes this amount which can be now deducted from the Capex. The second factor which represents R$ 13 million refers to contingency reserves which were included one we prepared the figures back in The main purpose at that time was to protect our investment strategy hedging the budget against currency devaluations as well as increase in construction costs. Now as we come closer to year and we believe that these scenarios are unlikely to happen and therefore we are able to reduce the forecasts. Finally the R$ 7 million that is remain to make the balance of 14 million represents a 25% reduction in the estimated annual maintenance Capex as we have concluded that cash schedule replacements can be postponed to At this point it is paramount to highlight the patient service centers organic expansion area has not been changed as a result of this review and therefore we still expect to deliver additional 10,000 m² during 2Q11 and also to continue to improve the intervention area which adds 18,500 m² and which, of course, increases productivity in existing patient service centers. Let us now move to the next slide just to check, to speak a few words about the balance sheet shape and then we would like to reinforce the following aspects: total debt at R$ 252 million is under control. Less than 25% of this total, which represents R$ 61 million, is due over the next 12 months. Also as previously mentioned the company has engaged a thorough action plan in order to improve cash collection from customers, namely cash recovery, both in terms of total amount as well as aging. This action plan has already affected several activities in the order to cash value chain. Moving on slide number 23 just some brief comments about subsequent events. The first one has already announced some weeks ago the negotiation to acquire Labs Cardiolab has been finalized. The first closing has happened without any incidents and so we are confident that the group will be able to report 100% consolidated results as from August. 8

9 Second the company has already integrated and incorporated Diagnoson and therefore it shall be able to amortize goodwill, which represents circa of R$ 50 million over the next five years. Finally the third item the board has approved the distribution of R$ 18 million as interest on capital. Shares will be traded exinterest as from August 22 and payment will be processed on August 31. Moving on to slide number 25 this slide shows some public information about our shares performance in the red line compared to the Brazilian stock exchange index, the gray line until the end of the first half of Finally slide number 26 shows some upcoming events related to the investor relation schedule. Now we would like to open the question-and-answer session. Q&A Session Operator: Thank you. Ladies and gentlemen we will now begin the Question and Answer session. If you have a question please press the star key followed by the one key (*1) on your touch-tone phone. If at any time you would like to remove yourself from the questioning queue press star two (*2). Our first question comes from Mr. Rafael Frade from her co. Mr. Rafael Frade: Hi good morning everyone. I have three questions, the first one is related to your expansion plan. You are reducing your Capex guidance for the year, Fábio already explained why and I would like to have a better view. In terms of what you expect for this year in terms of square meters you are saying that you are not reducing your expectations for the year, but in 2Q you have an expansion in terms of square meters slightly lower than what was the timeline that you presented in 4Q10 and so I would like to know if there are any if you are really comfortable with this timeline. Another point is related to marketing expenses. From what I understand previously commented that in 2010 you would have marketing expenses very concentrated in 3Q while in this year these marketing expenses would be more concentrated in the first half of the year; but now you are commenting these R$ 9 million in the media expenses for 3Q, so this is a kind of higher marketing expenses then you were previously expecting, so if you could talk a little more about this. And finally I would like to understand a little more about this cash recovery process that is not clear for me. Thank you. Mr. Hauache: Rafael this is Omar. 9

10 The first question, the expansion plan, just to make sure what Fábio mentioned before the original organic expansion plan is a thing, we will not change it. We still expect to deliver new 10,000 m² by the end of the year during the second half of the year. So new 14,000 m² will be delivered this year, this is the same we predicted before and so nothing has changed. As for the slide difference that happened in the second quarter of the year just to mention right in the beginning of July we had already concluded this difference, so nothing is so delayed, we are still very confident that we will deliver these additional 10,000 m² by the end of the year. Everything is the same. As to the two other questions you asked going to pass on to Fábio. Mr. Marchiori: Ok, thanks for the question. About the market expenses we do not see any change in plans to be very honest. What we have done in the second semester is the launch of the brand, the preparation of the patient service centers; the communication with the NCOs, with the companies and with the public in general - so that was the first part of the allocation of the market expenses as you know. Now we have started vehiculation in mid-year and that will permeate 3Q11. In terms of the total amount that is being dedicated to this project nothing has changed and so you can be comfortable that everything is aligned with the original plan: we launched the brand, we make the communication to the patients, we make the communication in the patient service centers and now we are going to advertise in the media and we have already started to do that. So in terms of marketing expenses everything is aligned with the plan. In terms of the cash recovery again I would ask you to be more specific, because what we are doing we are continuously negotiating with the NCOs, with the health plans, with the companies. Of course as you know the sector involves a lot of bureaucracy whenever you are talking about debtors collection and so we organize ourselves, we are putting a plan in place in order to accelerate the cash recovery mainly where the bad debtors and therefore the debts that are due for more than 120 days. Of course this involves the Association with both parties because we understand that in some cases they have cash restrictions and as we were with plenty of cash before we were able to negotiate in a more phased way. Now that we have made this announcement of acquiring Labs, now of course it becomes very important to us not let us call finance these health plans and so what we are doing we are talking to them and trying to find the best solution for both sides in order to make available this cash recovery. Mr. Hauache: About this cash recovery this is a goal for us. We are looking for our cash to come back to Fleury. We understand that this cash belongs to Fleury and so our commercial force is very much aligned with that. We put this as a goal for the commercial force of Fleury. We are negotiating with the health plans. 10

11 We understand their side; but we are open to negotiate and have already been successful by adding some cash back to Fleury in 2Q and this generated the write-off of R$ 2.6 million during this quarter. This may happen again in the next quarter. But we understand this is very important: to pursue cash is a very important task we have and we are going for that. Mr. Frade: Great. Just in the case of cash recovery maybe I do not understand well: my doubt is that you are pointing as a kind of nonrecurring item these 2.6 million that you would add back; but if I understand right it was related with other operation expenses that are 1.6 million. From what I understand this line should be something it is very volatile this line; but the more recurring level of this line maybe is around 1% of revenues or a little less than that. My doubt is what you are putting, adding back as a kind of nonrecurring item, this is my doubt here. Mr. Marchiori: It is simple Rafael: it is just because as you know we have a policy to make the provision for bad debtors and for specific customers we have a discretionary policy because we, of course, have different payment terms with some customers. So what we are doing now, right now we have we have a special negotiation, a set of special negotiations with some customers and this was not accrued because they were discretionary and so this was on top of what we normally do with bad debtors. We are normalizing this policy now and as we might have this successful, this negotiation, we must disclose that because this is a nonrecurring item because this just affects From now on we have to be very open with you, transparent, what we have done is within this negotiation to recover the cash we have normalized the payment terms, we have explained how it will work from now on and so we believe that this cash deployment delay will only happen once and that is why we are putting it as nonrecurring. We do not expect this level of write-offs in the future for sure. The commercial area has been very effective, very successful, mainly considering the track record past and so I believe that now as the market becomes more mature as we go everyone starts to understand how the cash flow must how the cash must flow between the companies. Mr. Frade: Ok thank you for the answer. Operator: Excuse me. Our next question comes from Mr. João Carlos dos Santos from BTG Pactual. Mr. João Carlos dos Santos: Hi good morning everybody, thank you very much for taking the question. The first one regards to the integrated medicine portion of the business. You have explained quite precisely the margin 11

12 contraction you had year over year due to the rebalance of operational support and costs and so on and so forth. However I just wonder if you could talk a little bit further on that matter given that hospitals continue to grow with the percentage of revenue that comes from integrated medicine and we would expect that the hospitals would have a relatively better margin than, for example, in the lab-to-lab business, so I just wonder if you could talk a little bit on how do you see the evolution of the margin of integrated medicine going forward especially considering that with Labs D Or deal you are going to add a significant amount of the hospitals as you said getting to 70% of revenues. So if you could just give a little bit of clarity on that, how would that margin perform over time and how would that compare to the regular business, day by day business. The second question would be also regarding working capital. We have seen that accounts receivables came up these quarters; so in line with the discussion of the efforts that you are doing if you could just give a view on what would you see as a healthy level for accounts receivable and working capital as a whole, maybe as a percentage of revenue for the company going forward. Thank you very much. Mr. Hauache: Hi João this is Omar, thanks for your question. First I am going to talk about margins for the integrated medicine business line. We are very positive about the evolution of these margins. We have plenty of reasons to believe that these margins are going to improve over time. When you talk about hospitals, diagnostic operations in hospitals, what happened this year and I think you understood very well we allocated differently some of these costs because until last year these costs were in a way they were positioned, they were not reflecting actually the costs of the business and so now with the change of the allocation of these costs they are in a way weighting more for the business of hospitals. But we believe that with the growth of this business line - and remember we are going to add 21 new hospitals soon - the margins will always remain very healthy and they tend to grow, we believe that they tend to grow for the hospital segment. As for chronic disease management it is growing, more labs have been added for this last quarter and now we have 38,000 lives under contract. We still expect to reach breakeven by the end of the year or the beginning of 1Q12 and again it will contribute with the margins of integrated medicine. Our assessment seems very profitable. It is growing, you saw the numbers, the figures. It is growing consistently over time. It is already adding margins to the integrated medicine business and one challenge we have is lab-to-lab. As I said the addition of more complex, esoteric tests to the mix of lab-to-lab has been increasing margins for this segment. Even though the revenues did not grow when compared to the corresponding quarter of 2010 the margins grew for this 12

13 segment - but very slightly. It is time for us to grow in revenues and keep the margins healthy. So is a wholly believe that integrated medicine business line will show over time increasing margins due to all these factors. Fábio, can you speak on the working capital? Mr. Marchiori: João, thanks for your question. Your question was on healthy working capital level. This I would not be able to answer, what is healthy, because as you know the sector is very complex and of course the HMOs are in different levels of maturity and they have different sizes; of course some of them need more payment terms and in some this reflects a price, some of them did debt and this reflects on price. What I can tell you is that what I am trying to achieve here together with the commercial area is that we keep our working capital level in this first step between 15% and 20% of net revenue. That is what we want to achieve. But again, 15% to 20% can be very unhealthy are very healthy depending on the aging of what we are doing and depending on the price. I have no problems to keep a high level of working capital if the mix of services that are provided to a specific HMO, a specific company, is good for us in terms of Ebitda margin. But of course if Ebitda is a little bit narrower then I would have to reduce that. So what we are agreeing, we are discussing here HMO by HMO, company by company, situation by situation with the commercial area what is appropriate for that specific customer. But again, just to help you modeling what I am trying to achieve here is a stable level between 15% and 20% (more to the 15 side then of course the 20% side). In the future maybe we can decrease this a little bit more. Mr. dos Santos: That is excellent Fábio, thank you very much. Mr. Marchiori: Thank you. Operator: Excuse me. Our next question comes from Mr. Josh Milberg from Deutsche Bank. Mr. Josh Milberg: Good morning everyone. My first question is another one on your square meter extension. You mentioned that you are maintaining your 10,000 m² projected for the second half and I presume around 15,000 still for 2012 and I wanted to know how much of that extension you are already fully committed to? In other words have you already signed contracts to carry out that growth? And if you could just remind us to what degree your current utilization rate at your existing PCSs is behind your decision to grow at such a strong case and what other factors are driving that? 13

14 And then I have one other question. Mr. Marchiori: Ok Josh, thanks for the question. Just trying to highlight the points that you asked yes, we confirm that there is no problem with the expansion plan for this year and so we still believe that we will deliver 10,000 m² and remember there is also 18,500 m² intervention and that is linked to your second question. Your second question is about how much of the capacity to utilize. The capacity utilization in the current PSCs is very high, it is not fully... that is why we are doing these adaptations to increase productivity. But what we believe is that with these 18,500 of intervention that could increase productivity. The 10,000 m² are fine and so we have ensured already the space to make the construction or to make the expansion so there is no doubt that we have already conditions to these 10,000 and as far as we can see for 2012 we have no adjustments to make to the 14,000 m² that we plan to deliver in So let me be very clear: nothing, absolutely nothing has changed in terms of area and in terms of the intervention area, because as everyone remembers the expansion and never remember the intervention; the intervention is even is an area that is equal in space and we trust that this can deliver much higher, much better returns because they already exist in some patient service centers where the patient is used to go. So we are very confident about this strategy. Mr. Milberg: Ok that is great and then if you could just comment quickly on how customers have reacted to a+ in the first months following the rollout, what you have seen in terms of revenue performance, if you could just give us an idea that that would be great. Mr. Hauache: Ok Josh this is Omar. The reaction was very positive. As I mentioned before just during the beginning of my speech the satisfaction indexes are really very, very positive. It shows that we are on the right track. As I said 4600 clients were surveyed and these satisfaction parameters were really, really positive. Almost 200,000 new clients came into a+ since the brand was launched on May 24 and this is really a very good parameter for us. This obviously will translate into revenues, we are not going to open the revenues; but we know that this is bringing new clients for the new brand and this is nationwide; this is not only in São Paulo, not only in Rio. I am talking about Salvador, I am talking about Recife, Curitiba and Porto Alegre as well. And one other thing that I would like to reinforce, that is a very indirect way of translating the satisfaction of the customers: the number of good comments that we are receiving from the clients and even from the physicians when talking about a+ is really remarkable, is worth mentioning. So we believe we are on the right track. 14

15 Mr. Milberg: Ok I am sorry I had joined the call somewhat late and so I missed your initial comments on that. But thanks very much for going over. Mr. Hauache: You are very welcome. Operator: Excuse me. Our next question comes from Mr. Guilherme Assis from Raymond James. Mr. Guilherme Assis: Good morning everyone. My question is regarding the average price mentioned at the PSC level. I noticed that there was a price increase. On a quarterly basis it increased 5.3% and I wanted to understand what drove this price increase, if it was mix or an active pricing policy by the company. Thank you. Mr. Hauache: Guilherme could you please repeat your question? It was really hard to understand please. Mr. Assis: My question was regarding the price at the patient service center, the average price per examination. I noticed that there was a 5% increase on a sequential basis and my question is what drove that price, if it was change in the mix that you are seeing at the PSC level or if it was something related to the company's new policy with the negotiation with the NCOs, so I wanted to have a look on that. Mr. Hauache: Ok now I understood, thank you Guilherme. Actually it was both things: mix contributed, that is for sure; the enrichment of mix for both clinical analysis and imaging services really contributed for the pricing. But not only that. The frequent negotiations we undertake with the HMOs is always a factor. This still corresponds to the negotiations we undertook last year. In about some days or some weeks we are going to start a new process of negotiation with HMOs. It is year over year, it usually begins in August, July or September and so we are going forth, further increases in prices. But basically it is a combination of mix and the adjustments in prices that we negotiate on a year basis with the health plans. Mr. Assis: Ok. I recall that when you announced the a+ brand and the rollout you guys said that actually the way it was done was that you do cultivated the average per HMO and you negotiated the same price and so it would not affect the average price. Did that actually happened or did you guys see any additional price increase due to the rollout of the a+ brand? Mr. Hauache: You are right, it actually happened. The net effect was zero for the a+ brand. Remember it has been launched two months ago and so yes, when we negotiated with the health plans it was really one thing that we made very clear for them: the net effect would be zero. So we mixed all the brands we have to reach this net effect and we are looking for, for the case of a+, for the mix the effect; for the enrichment of the portfolio of exams for both clinical analysis and imaging services and we believe that with better services that is 15

16 already happening we believe that there is still room for further increases in prices as well. But the mix at first will contribute a lot. Mr. Assis: Ok just a final question: the goal from now on - in terms of the pricing, not of the mix - is to adjust with inflation or you expect to get something different from that? Mr. Hauache: We always look for inflation, to cover inflation; but we know that the track record we have made us clear that we have space for good negotiations for the a+ brand in the near future; for the CAMPANA brand still this year and when we talk about Fleury brand and Weinmann there is room for negotiating something similar to inflation, a little bit lower. We cannot depend - this is the point - we cannot depend solely on price negotiations with HMOs. We have been a very able and capable of not depending solely on price negotiations. It is an important component of our strategy, of our increase in revenues; but as I always say it is not a single one. We depend on mix, we depend on organic expansion, we depend on the services, new businesses as well to increase our revenues. Price increase is important, but not a single one component of increase in revenues we have ahead of us. Mr. Assis: Ok thank you. Operator: Ladies and gentlemen as a reminder, if you would like to pose a question please press star one. This concludes today s question and answer session. I would like to invite Mr. Omar Hauache to proceed with his closing statements. Please sir go ahead. Mr. Hauache: Ok thank you very much for your attention, for your interest. Just to remind you of an important detail: on August 29 we are going to have to Fleury Day, our first Fleury Day here in São Paulo. I would like to invite you all to be present. Soon we will announce more details about this event. We hope you can come, we will be very pleased to see you here with us at Fleury Day on August 29. Thank you are much, have a good day. Operator: Thank you. That does conclude the Fleury Group audio conference call for today. Thank you very much for your participation and have a good day. 16