Auna Q2 Earnings Call Highlights

Auna (NYSE:AUNA) reported second-quarter results marked by continued revenue growth, improving cash generation and a sequential recovery in patient volumes in Mexico, though adjusted EBITDA declined amid margin pressures, talent investments and billing-related penalties in Peru.

Executive Chairman and President Suso Zamora said consolidated revenue increased 9% year over year on an FX-neutral basis, driven by higher volumes and a greater mix of high-complexity services across Mexico, Peru and Colombia. Consolidated adjusted EBITDA declined 9%, reflecting temporary pressure in Mexico and Colombia and accepted penalties tied primarily to the reconciliation of prior-year receivables in Peru.

“Despite encountering margin pressures across each of our markets during the quarter, the underlying performance of the business remains robust,” Zamora said, citing continued demand across the company’s regional healthcare platform.

Mexico volumes recover as oncology expands

Mexico showed an accelerating recovery in patient volumes during the quarter. Surgeries rose 7% sequentially, while oncology chemotherapies and radiotherapies increased 20% from the first quarter. On a year-over-year basis, surgery volumes increased 6% and chemotherapy and radiotherapy volumes grew 86%, according to Chief Financial Officer and Executive Vice President Gisele Remy.

The company attributed the recovery to improved tier classifications with major insurers, expansion of oncology services, physician onboarding and productivity, and favorable pricing in high-complexity care. A new ISSSTE León government contract, surgical and hemodynamics packages, and out-of-pocket revenue also contributed.

Mexico revenue increased 4% year over year and 5% sequentially. Adjusted EBITDA rose 3% sequentially but declined 16% from a year earlier, primarily because of continued investment in medical and leadership talent. Zamora said April’s Easter holidays and Mexico’s new value-added tax on insurance affected the quarter, though volumes and revenue increased noticeably in May and June.

Auna said it expects stronger year-over-year growth in Mexico in the second half as high-productivity physicians are added and high-complexity services continue expanding. The company also plans to inaugurate an Elekta Evo linear accelerator in September.

Peru growth offset by billing penalties and costs

Peru revenue rose 8%, supported by higher average ticket sizes, membership growth and greater penetration of the business-to-business market. Oncosalud revenue increased 11%, helped by annual price adjustments, service mix improvements and a 6% increase in memberships.

Membership expansion included a new B2B plan covering 7,000 Serpal employees. Commercial initiatives also drove a 9% year-over-year increase in emergency treatments, while capacity utilization reached 83%.

Despite the top-line growth, Peru adjusted EBITDA was flat year over year. The company cited accepted penalties related to billing matters, primarily involving prior-year receivables reconciliations, as well as B2B onboarding costs, physician retention incentives, overtime and pharmacy expenses.

Remy said financial pressure among Peruvian payers had led to stricter enforcement of billing deadlines and settlement terms. Auna is shortening its billing cycle and strengthening financial controls, and it expects to finalize open negotiations involving prior-year billing matters during 2026.

After the quarter ended, Auna took possession of a facility that will expand capacity in southern Lima. The project is expected to add 30 beds and expand surgery and chemotherapy capacity, with operations expected between late 2027 and early 2028. The company also acquired a Versius SP4 robotic system for minimally invasive procedures.

Colombia shifts toward private payers and risk-sharing contracts

Colombia revenue increased 13%, supported by private-payer relationships and risk-sharing agreements. Risk-sharing contracts represented 24% of Colombian revenue, up from 14% a year earlier, and covered more than 3 million lives. Revenue from private payers grew 17% and represented 18% of Colombia’s quarterly revenue.

At the same time, revenue from intervening payers fell to 12% from 18% a year earlier. Capacity utilization rose to 79.2%, exceeding levels seen before the Nueva EPS intervention, the company said.

Colombian adjusted EBITDA declined 12% year over year due to higher costs associated with more complex care, statutory wage increases, talent investments and the growing risk-sharing contract mix. However, adjusted EBITDA increased 18% sequentially, and margins expanded by 1.7 percentage points.

Auna expects contractual price increases in the second half to offset much of the cost pressure. Following the quarter, the company expanded capacity at IMAT Oncomédica facilities in Montería by adding 18 adult intensive-care beds and 24 hospitalization beds, which it said required minimal additional capital spending.

Cash flow and leverage improve; guidance reaffirmed

Adjusted net income was PEN 40 million in the second quarter. Remy said the year-over-year change was affected by a PEN 61 million decline in foreign-exchange gains after the company reset the levels of FX hedges related to debt at the end of 2025.

Net cash from operating activities reached PEN 441 million for the first half, up 45% year over year, while free cash flow rose 181%. Auna attributed the improvement to working-capital management, collection recoveries, supply-chain financing initiatives and the use of tax credits. Cash increased 43% from year-end 2025, while leverage declined to 3.6 times from the first quarter.

The company reaffirmed its full-year outlook for approximately 12% FX-neutral revenue growth. It expects adjusted EBITDA growth toward the low end of its 10% to 14% target range, excluding the impact of accepted billing penalties in Peru. Management also expects leverage to continue declining toward its medium-term target of less than three times net debt to adjusted EBITDA.

About Auna (NYSE:AUNA)

Auna, listed on the New York Stock Exchange under the ticker symbol AUNA, is a Peruvian integrated healthcare services company headquartered in Lima. The firm operates a diversified care network that spans hospitals, outpatient medical centers, diagnostic imaging and laboratory facilities, as well as optical and dental clinics. Auna's organizational structure is designed to support a continuum of care model, offering both general and specialized treatments across multiple touchpoints.

The company delivers a broad range of clinical services, including emergency care, inpatient and outpatient surgery, obstetrics, cardiology, oncology, orthopedics, and other specialized disciplines.

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