Sample Ier Report Apllo

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Apollo Hospitals Enterprise Ltd

Enhancing investment decisions

Detailed report


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Explanation of CRISIL Fundamental and Valuation (CFV) matrix

The CFV Matrix (CRISIL Fundamental and Valuation Matrix) addresses the two important analysis of an investment making process

Analysis of Fundamentals (addressed through Fundamental Grade) and Analysis of Returns (Valuation Grade) The fundamental

grade is assigned on a five-point scale from grade 5 (indicating Excellent fundamentals) to grade 1 (Poor fundamentals) The

valuation grade is assigned on a five-point scale from grade 5 (indicating strong upside from the current market price (CMP)) to

grade 1 (strong downside from the CMP).

CRISILFundamental Grade

Assessment CRISILValuation Grade

Assessment

5/5 Excellent fundamentals 5/5 Strong upside (>25% from CMP)

4/5 Superior fundamentals 4/5 Upside (10-25% from CMP)

3/5 Good fundamentals 3/5 Align (+-10% from CMP)

2/5 Moderate fundamentals 2/5 Downside (negative 10-25% from CMP)

1/5 Poor fundamentals 1/5 Strong downside (


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CRISIL EQUITIES | 1

January 07, 2011Fair Value Rs 533CMP Rs 454

Fundamental Grade 4/ 5 (Strong fundamentals)

Valuation Grade 5/ 5 (CMP has strong upside)

Industry Information technology

Polaris Software Limited Business momentum remains intact

Fundamental Grade 5/ 5 (Excellent fundamentals)Valuation Grade 4/ 5 (CMP has upside)

Industry Healthcare Providers & Services

Apollo Hospitals Enterprise LtdA healthcare behemoth

Apollo Hospitals Enterprise Ltd (Apollo) is Indias No. 1 healthcare services

provider. Owing to strong brand recognition and superior services, it is poisedto benefit from robust growth in the domestic healthcare industry. We revise

our fundamental grade from 4/5 to 5/5, indicating excellent fundamentals

relative to other listed equity securities in India. The upgrade is bolstered by

consistent strong performance in the hospital business, improving profitability

of the pharmacy business and the managements decision to freeze further

investments in non-core businesses.

Leader in healthcare industry; healthy expans ion plansApollo is a leader in the Indian healthcare industry with ~8,000 beds across 47

hospitals. In the past, it primarily focussed on the southern region and

expanded to other markets only through partnerships/JVs. It is now changing

strategy and is planning to add ~2,700 beds in different regions. Given strong

brand recognition, we believe Apollo is well poised to benefit from robust

growth in the healthcare industry.

Operational parameters show consistent improvementApollos operating parameters have been consistently improving. The

occupancy rate increased from 72% in FY06 to 80% in 1HFY11, while average

length of stay (ALOS) declined from 5.7 days to 4.97 days during the same

period. Average revenue per occupied bed (ARPOB) increased at a CAGR of

11.4% to Rs 11,616 in 1HFY11.

Pharmacy business on its w ay to speedy recoveryShift in management focus from aggressively adding more stores to increasing

the profitability of the existing stores is showing positive results; Apollo

reported positive EBITDA margins in Q2FY11. Given the companys plan to go

slow on adding new stores, margins are expected to improve from -1.9% in

FY10 to 3.9% in FY13 due to increase in contribution from mature stores.

Revenues to grow at a three-year CAGR of 19% , RoCE to increaseWe expect revenues to register a three-year CAGR of 19.1% to Rs 34.3 bn in

FY13 driven by increases in occupancy and ARPOB in the existing hospitals and

addition of new beds. EBITDA margin is expected to improve from 15% in

FY10 to 17.1% in FY13 driven by improving profitability in the pharmacy

business. RoCE is expected to improve to 15% in FY13 from 9.6% in FY10.

Valuations the market price has upside from current levelsWe continue to value Apollo based on the discounted cash flow (DCF) method.

We have rolled forward our DCF valuation to FY13 and also revised our

earnings estimates upwards given higher-than-expected performance of the

pharmacy business. Hence, we revise our fair value to Rs 533 per share (up

from Rs 387, adjusted for stock split from Rs 10 to Rs 5).

KEY FORECAST(Rs mn) FY09 FY10 FY11E FY12E FY13EOperating income 16,142 20,265 24,872 29,232 34,311

EBITDA 2,288 3,032 4,067 4,938 5,878

Adj PAT 1,009 1,346 1,670 2,154 2,438

Adj EPS-Rs 8.4 10.9 13.4 17.1 19.4

EPS growth (%) 49.1 34.8 23.5 27.9 13.2

Dividend yield (%) 0.8 0.9 0.9 1.1 1.2

RoCE (%) 8.2 9.6 12.1 14.2 15.0

RoE (%) 7.1 8.5 9.5 11.3 11.8

PE (x) 54.2 41.7 33.9 26.5 23.4

P/BV (x) 3.7 3.3 3.1 2.9 2.7

EV/EBITDA (x) 25.5 20.5 15.5 13.0 11.5

Source: Company, CRISIL Equ it ies es t imateNM: Not meaningful; CMP: Current Market Price

CFV MATRIX

KEY STOCK STATI STICS

NIFTY / SENSEX 5905/19692

NSE / BSE ticker APOLLOHOSP

Face value (Rs per share) 5

Shares outstanding (mn) 124.7

Market cap (Rs mn)/(US$ mn) 56,619/1253

Enterprise value (Rs mn)/(US$ mn) 62,634/1386

52-week range (Rs) (H/L) 599/274

Beta 0.8

Free float (%) 66.5

Avg daily volumes (30-days) 42,865

Avg daily value (30-days) (Rs mn) 20.3

SHAREHOLDING PATTERN

PERFORMANCE VIS--VIS MARKET

Returns

1-m 3-m 6-m 12-mAPOLLO -8% 3% 24% 42%

NIFTY 3% 0% 18% 18%

ANALY TICAL CONTACTSudhir Nair (Head) [email protected]

Ravi Dodhia [email protected]

Bhaskar Bukrediwala [email protected]

Client servicing desk+91 22 3342 3561 [email protected]

1 2 3 4 5

1

2

3

4

5

Valuation Grade

FundamentalGrade

Poor

Fundamentals

Excellent

Fundamentals

Strong

Downside

Strong

Upside

33.5% 33.5% 33.5% 33.5%

24.8% 23.9% 24.1% 24.0%

3.5% 3.7% 3.7% 3.7%

38.2% 38.9% 38.7% 38.7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Dec-09 Mar-10 Jun-10 Sep-10

Promoter FII DII Others


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CRISIL EQUITIES | 2


Table: 1 Apollo: Business environment

Product / Segment Hospitals Standalone pharmacy

Sales contribution ( FY10) 76.4% 23.6%

Sales contribution ( FY13) 77.9% 22.1%

Product / service offering Healthcare delivery services including consultancy

and hospital-based pharmacies

Provides a wide range of medicines, surgical,

hospital consumables and healthcareproducts

Geographic presence Mainly present in the southern region (63% ofowned beds are in Chennai and Hyderabad).

Diversified to northern and eastern regions through

JV/associate model; it is now looking to foray into

the western region, mainly Mumbai and also to tier

II and III cities through self-owned hospitals

Pan India

Market position Largest private healthcare service provider in thecountry with a network of 3,279 owned beds, 2,197

beds through subsidiaries/JVs/associates and 2,588

managed beds

Largest organised pharmacy chain in India

with ~1,100 stores

Industry growthexpectations

Healthcare delivery industry to grow at a five-year

CAGR of 12% to Rs 3,500 bn by FY15. Lack of

government spending especially in tertiary and

secondary care will lead to higher growth of private

players who are increasingly looking to tap

opportunities in this space

Pharmaceuticals sales are expected to grow

at a four-year CAGR of ~15% to Rs 1,700

bn in FY14

Sales growth(FY07-FY10 3-yr CAGR)

24.0% 54.5%

Sales forecast(FY10-FY13 3-yr CAGR)

19.5% 16.1%

Key competitors Fortis Healthcare, Max India, Manipal Group, Metro Hospitals

Demand drivers Low penetration of beds leads to hugeopportunity for private players. India only has

nine beds per 10,000 people, far below the global

average of 30

Rising lifestyle diseases, increasing healthawareness and growing health insurance

Increasing medical tourism

Growing healthcare industry will have adirect impact on the pharmacy business

Margin drivers Newly commissioned hospitals drag margins inthe initial years. However, as it matures, margins

would improve

Margins to improve as the recentlyopened stores mature. New pharmacy

store takes ~three years to break-even at

EBITDA level

The company is going slow in storeaddition, which will boost margins given

the increase in the number of mature

stores

Source: Company, CRISIL Equit ies


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CRISIL EQUITIES | 3


GRADING RATIONALE

Leader in I ndian healthcare services industry

As many as 8,000 beds across 47 hospitals rank Apollo No. 1 in the Indian

healthcare industry. Manipal Group, the second largest private player, has

~7,000 beds under operations followed by Fortis Healthcare with ~5,500 beds.

Given the leadership position and strong brand recognition, Apollo is well poised

to benefit from the strong growth in the Indian healthcare industry. CRISIL

Research expects the healthcare services industry to grow at a five-year CAGR

of 12% to Rs 3,500 bn in FY15.

Figure 1: Ahead of peers in terms of bed capacity Figure 2: Break-up of beds

S o u r c e : C o m p a n y , C R I S I L E q u i t i e s S o u r c e : C o m p a n y , C R I S I L E q u i t i e s

Operating parameters show consistent improvementApollos operating parameters have improved consistently over the years.

Occupancy rate increased from 72% in FY06 to 80% in 1HFY11, while average

length of stay (ALOS) declined from 5.7 days to 4.97 days during the same

period. Average revenue per occupied bed (ARPOB) increased at a CAGR of

11.4% to Rs 11,616 in 1HFY11.

Figure 3: Improvement in occupancy despite bed additions

S o u r c e : Co m p a n y , C R I S I L E q u i t i e s

8,0647,098

5,463

1,100

0

2,000

4,000

6,000

8,000

10,000

Apollo Manipal Fortis Healthcare Max

No of beds

Owned

beds, 41%

Throughsubsidaries

and JVs, 27%

Managed

beds, 32%

1,

959

2,

135

2,

237

2,

437

2,

717

2,

812

72%

77% 77%

76% 76%

80%

68%

70%

72%

74%

76%

78%

80%

82%

1,500

1,750

2,000

2,250

2,500

2,750

3,000

FY06 FY07 FY08 FY09 FY10 1HFY11*

No of beds Occupancy (RHS)

Self-owned: 3,279 beds

Subsidiaries/JVs/

associates: 2,197 beds

Operations and

management contract:

2,588 beds


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CRISIL EQUITIES | 4


Figure 4: Steady improvement in ARP OB Figure 5: Consistent decline in ALOS

S o u r c e : Co m p a n y , C R I S I L E q u i t i e s S o u r c e : C o m p a n y , C R I S I L E q u i t i e s

* A R P O B o f R s 1 9 , 3 7 6 i n Q 2 F Y 1 1 , i n c l u d i n g r e v e n u e s f r o m h o s p i t a l - b a s e d p h a r m a c i e s

Apollo is predominantly popular in southern India. Chennai and Hyderabad

clusters, which constitute 63% of the operational beds, continued to register

strong operational performance. The Chennai clusters ARPOB (including

hospital-based pharmacies) grew 14.5% y-o-y to Rs 23,525 in 1HFY11, while

the Hyderabad cluster registered 16.9% y-o-y growth to Rs 14,909 during the

same period.

Figure 6: Chennai and Hyderabad account for 64%

of Apollos self-owned beds...

Figure 7: ... but contribute 80% to standalone

hospital revenues


Table 2: Improvement in occupancy in Chennai Table 3: Strong ARP OB grow th in Hyderabad

Chennai cluster FY2009 FY2010 HY FY11

No of beds 1,045 1,105 1,083

Occupancy rate 80% 77% 84%

ALOS (days) 5.1 4.8 4.7

ARPOB (Rs/day) 13,265 16,218 23,525

Hyderabad cluster FY2009 FY2010 HY FY11

No of beds 608 608 689

Occupancy rate 72% 77% 76%

ALOS (days) 4.3 4.74 4.77

ARPOB (Rs/day) 8,991 9,638 14,909


7,245

7,563

8,767

9,666

10,749

11,616

7,000

8,000

9,000

10,000

11,000

12,000


Net ARPOB per day

5.70

5.50

5.18 5.13

5.25

4.97

4.60

4.80

5.00

5.20

5.40

5.60

5.80


ALOS (days)

42% 41% 39%

24% 22% 25%

34% 37% 37%

0%

20%

40%

60%

80%

100%

FY2009 FY2010 HY FY11

Chennai Hyderabad Others

61% 62% 59%

22% 20%21%

17% 18% 20%

0%

20%

40%

60%

80%

100%

FY2009 FY2010 HY FY11

Chennai Hyderabad Others


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CRISIL EQUITIES | 5


Pharmacy business on its way towards profitability

Apollo operates the largest organised pharmacy chain with 1,110 stores across

India. The company has consistently and aggressively added stores in the past

four years leading to 55% CAGR in revenues in FY10. However, profitability was

impacted as a new store takes three years to break even. While aggressive store

additions impacted profits, shift in management focus to increase the

profitability of existing stores has started showing positive results. The company

reported positive EBITDA margin of 2% in Q2FY11 compared to -2% reported in

Q2FY10 and Q1FY11 each. While mature stores (the 2007 batch) have posted

positive EBITDA margins (5% in 1HFY11 compared to 2.7% in 1HFY10), losses

in the new stores have declined from -9% in 1HFY10 to -3.4% in 1HFY11.

Figure 8: Revenues grew 55% CAGR in four years Figure 9: Backed by new store additions


Figure 10: Mature stores EBITDA on an uptrend Figure 11: Improvement in overall EBITDA margins


Going forward, Apollo plans to go slow on new store openings and will continue

to focus on increasing profitability. We have assumed an annual addition of 100

stores by FY12 compared to 234 stores added in the past three years. We

expect pharmacy revenues to grow at a three-year CAGR of 16.1% to Rs 7,590

mn in FY13, while EBITDA margins are expected to improve from -1.9% in FY10

to 3.9% in FY13.

1,3132,020

3,345

4,846

-

1,000

2,000

3,000

4,000

5,000

6,000

FY07 FY08 FY09 FY10

(Rs mn)

Pharmacy revenues

263347

612

873

-

100

200

300

400

500

600

700

800

900

1,000

FY07 FY08 FY09 FY10

No of Stores

0.5% 0.6%

0.5%

2.3%

2.9%

3.4%

5.2%4.6%

5.3%

0%

1%

2%

3%

4%

5%

6%

Sep-08

Nov-08

Jan-09

Mar-09

May-09

Jul-09

Sep-09

Nov-09

Jan-10

Mar-10

May-10

Jul-10

Sep-10

EBITDA Margin (%)

-4%

-7%

-6%-5%

-2%

-2%

0%

-2%

2%

-8%

-6%

-4%

-2%

0%

2%

4%

Sep-08

Nov-08

Jan-09

Mar-09

May-09

Jul-09

Sep-09

Nov-09

Jan-10

Mar-10

May-10

Jul-10

Sep-10

EBIDTA Margin (%)

Shift in management

focus to increase the

profitability of existingstores is paying off


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CRISIL EQUITIES | 6


Poten t i a l va lue un lock ing i n ph a rm acy bus iness

Since the pharmacy business is racing towards profitability, Apollo believes it is

time for value unlocking and inducting a strategic partner. We believe this will

release management bandwidth to increase focus on the core business of

hospitals; also, the induction of a strategic partner will be a positive trigger for

the stock.

Expansion plans on track

In order to expand its reach beyond the southern region, Apollo has chalked out

an aggressive expansion plan to mark its presence across different regions. It

plans to add ~2,700 beds over the next three to four years, which includes the

addition of super and multi-speciality hospitals in metros/tier I cites and

introduction of new format (reach hospitals) in tier II cities. Its expansion plans

are on track and we expect ~2,700 beds to be operational by FY14.

About 2,200 self-owned beds to be operational by FY14No Owned projects

Operationalbeds

Total cost(Rs mn)

Company's expecteddate of completion

Our expected date ofcompletion

Expansion in existing projects 130

1 Hyderabad - International Block 100 1,225 Mar-11 Mar-11

2 Chennai - Main 30 100 Sep-12 Mar-13

3 Bilaspur - Oncology 80 Sep-11 Sep-11

Reach hospitals 825

4 Ayanambakkam 200 700 Jun-12 Sep-12

5 Nasik 125 520 Jun-12 Sep-12

6 Karaikudi 100 260 Sep-10 Sep-10

7 Nellore 200 667 Oct-12 Mar-138 Trichy 200 655 Mar-13 Mar-13

Super speciality hospitals 1275

9 Vizag 300 1,150 Jun-13 Sep-13

10 Belapur 350 3,500 Jun-13 Sep-13

11 Mumbai 300 1,400 Jun-13 Sep-13

12 Secundrabad 150 370 Apr-10 Apr-10

13 Hyderguda 175 443 Jun-11 Sep-11

Total 2,230 11,070

JVs and associates

14 Thane (super speciality) 250 2,000 Mar-13 Oct-13

15 Bangalore (expansion) 52 60 Nov-10 Mar-11

16 New Delhi (expansion) 136 400 Nov-10 Mar-11

Total 438 2,460

Source: CRISIL Equities

Expected capex o f Rs 8 .9 bn; f und in g not a concern

Apollo needs to incur Rs 11.7 bn capex for adding ~2,700 beds over the next

three years, of which it has already invested Rs 2.8 bn as of September 2010.

Since capex is spread over three years, we believe the company is in a

comfortable position (debt-to-equity ratio of 0.5x in FY10) to fund its capex

through a mix of internal accruals, debt and QIP/warrants issue. We expect

Apollo to generate operating cash flows worth ~Rs 11 bn over the next three

years.

Plans to induct a

strategic partner inpharmacy business

~2,700 additional beds

are expected to be

operational by FY14


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CRISIL EQUITIES | 7


Figure 12: Comfortable gearing post expansion


RoCE to expand post FY14

Apollos RoCE is currently in the range of 10-11%, which is much lower than 20-

25% that a hospital typically makes in a steady operational state. The lower

RoCE is on account of the capex cycle given the sizeable bed additions. Given

that a standalone hospital takes 18 months to break even at the EBITDA level,

the return on capital is lower in the initial years. Also, low profitability in the

pharmacy business due to the aggressive expansion has impacted the RoCE.

However, going forward, we expect RoCE to improve once the new beds mature

and the pharmacy business turns profitable. Further, improving performance of

the mature beds in Chennai and Hyderabad clusters will boost RoCE. We expect

RoCE to improve from 10% in FY10 to 15% in FY14.

Figure 13: RoCE to improve post add ition of 2,700 beds


5,

310

6,

669

9,1

32

8,7

87

8,

454

11,4

54

0.4

0.4

0.5

0.5

0.4

0.5

0.0

0.1

0.2

0.3

0.4

0.5

0.6

3,000

4,500

6,000

7,500

9,000

10,500

12,000

FY08 FY09 FY10 FY11E FY12E FY13E

Debt (Rs mn) Debt-to-equity (RHS)

2,

244

3,

775

4,

247

2,

293

2,

854

5,

812

2,

709

1,

509

1,

509

9% 8%

10%

12%

14% 15%16%

18%

21%

0%

5%

10%

15%

20%

25%

-

1,000

2,000

3,000

4,000

5,000

6,000

7,000

FY08 FY09 FY10 FY11E FY12E FY13E FY14E FY15E FY16E

Capex (Rs mn) RoCE (RHS)

Increase in RoCE postbed additions

Single digit RoCE dueto high capex

RoCE will improve once

the new beds mature and

the pharmacy businessturns profitable


10/24

CRISIL EQUITIES | 8


BPO and insurance business a drag; no furtherinvestments anticipated

Despite an improvement in the standalone business, poor financial performance

of group companies continues to drag Apollos consolidated performance. The

management has indicated that going forward it will not increase investments in

these businesses. While we continue to remain concerned about the financial

performance of these businesses, we believe given the managements stance of

not infusing further funds, there will not be any drag on Apollos balance sheet

going ahead.

Financial performance of Apollo Mun ich and Apollo Health Street

Rs mn FY07 FY08 FY09 FY10 1H FY11

Apollo Health Street

Revenues 1,428 3,212 5,088 4,635 2,248

PAT 60 (245) 147 83 36

PAT margin 4.2% -7.6% 2.9% 1.8% 1.6%

Apollo Munich Health I nsurance Company

Revenues - 44 290 795 664

PAT - (282) (722) (897) (398)

PAT Margin - -641% -249% -113% -60%

Source: CRISIL Equ ities

Apollo s performance better than Fortis

Apollos 80% occupancy level compares favourably with its peers such as Fortis

whose occupancy level is 74%. Apollos average revenue per bed per day is,

however, lower than that of its peers because it has a mix of secondary and

tertiary care hospitals in its network while the peers have only tertiary care

hospitals. It has outperformed Fortis on major financial parameters.

Figure 14: Apollo has stable EBITDA margins Figure 15: Apollo earns higher RoCE than Fortis


18%

16% 16% 15%14%

15%

-4%

9%10%

2%

14%15%

-10%

-5%

0%

5%

10%

15%

20%

FY05 FY06 FY07 FY08 FY09 FY10

Apollo Fortis

11%

9% 8%10%

-12%

-5%

1%2%

-15%

-10%

-5%

0%

5%

10%

15%

FY07 FY08 FY09 FY10

Apollo Fortis


11/24

CRISIL EQUITIES | 9


Figure 16: Apollo has superior RoE than Fortis Figure 17: Apollo has lower ARPOB than Fortis


22%

10% 9%7% 7% 8%

-39%-35%

-31%

-8%

2%

5%

-50%

-40%

-30%

-20%

-10%

0%

10%

20%

30%

FY05 FY06 FY07 FY08 FY09 FY10

Apollo Fortis

16,1

92

18,00

0

20,548

22

,740

76% 76%

67%

74%

40%

50%

60%

70%

80%

-

5,000

10,000

15,000

20,000

25,000

FY09 FY10 FY09 FY10

Apollo Fortis

ARPOB (Rs/day) Apollo Occupancy rate

Fortis occupancy Rate


12/24

CRISIL EQUITIES | 10


Key Risks

Delay in expansion plans

Apollo plans to add ~2,500 beds at different locations over the next three-four

years. Although we have assumed delays in capacity additon, higher-than-

expected delays or cost overruns may have an adverse impact on financials and

valuations.

Success of reach model is unproven

Apart from capacity additions in metros/tier I cities, Apollo plans to increase its

presence in tier II and III cities through a new initiative the reach model. The

success of this model is unproven, hence replication of Apollos success in super

and multi-speciality model in the reach model remains a key monitorable.

Unavailabili ty of skilled resources might impact

grow th prospectsGiven the aggressive expansion plans, Apollo requires an adequate pool of

doctors and nurses to maintain its quality of services. Unavailability of skilled

resources may hinder Apllos growth plans.

Funding the non-core business

Apollos non-core businesses, such as insurance and BPO, are currently a drag

on its financials. Although the management has indicated that it will not infuse

further funds in these businesses, any shift in stance may strain the balance

sheet.

Replication of success in

super and multi-speciality

hospi tal model in the reach

model remains a key

monitorable


13/24



Financial Outlook

Hospitals + pharmacy business = revenue growth

Figure 18: Revenues to grow at a three-year CAGR of 19%

S o u r c e : C o m p a n y , C R I S I L E q u i t i e s

Figure 19: Segment-wise performance Figure 20: Pharmacy grow th to slow down


Figure 21: EBITDA margin to increase from current

levels

Figure 22: Chennai cluster to earn higher EBITDA

margin


16,1

42.

1

20,2

65

24,8

72

29,2

32

34,3

11

33%

26%

23%

18% 17%

0%

5%

10%

15%

20%

25%

30%

35%

10,000

15,000

20,000

25,000

30,000

35,000

FY09 FY10 FY11E FY12E FY13E

Revenue (Rs mn) y-o-y growth (RHS)

42% 41% 41% 39% 38%

15% 13% 13% 12% 11%

22%22% 21%

22% 21%

2% 5% 7%

21% 24% 23% 22% 22%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Chenna i Hyderabad Others New Capacities Standa lone Pharmacy

3,3

45

4,8

46

5,6

54

6,5

76

7,

590

66%

45%

17% 16% 15%

0%

10%

20%

30%

40%

50%

60%

70%

-

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000


Pharmacy revenues (Rs mn) y-o-y growth (RHS)

2,2

88

3,0

32

4,0

67

4,9

38

5,8

78

14%15%

16%17% 17%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000


(% )(Rs mn)

EBITDA EBITDA Margin (RHS)

24% 24%25% 25%

25%

19% 19% 19% 20% 20%

17% 18%

16% 15% 15%

-7%

-3%

1%2%

4%

-10%

-5%

0%

5%

10%

15%

20%

25%

30%

FY09 FY10 FY11E FY12E FY13EChennai Hyderabad Others Standalone Pharmacy

Revenue growth in the

hospital segment to be

driven by increasing ARPOB

of existing hospitals as well

as addition of more beds


14/24



Figure 23: EPS and PAT margins to increase Figure 24: RoE and RoCE trend


8.410.9

13.4

17.119.4

6.3%6.6% 6.7%

7.4%7.1%

0%

1%

2%

3%

4%

5%

6%

7%

8%

0

5

10

15

20

25


(% )(Rs)

EPS PAT Margin (RHS)

8%

10%

12%

14%15%

7%

8%

10%

11%12%

0%

2%

4%

6%

8%

10%

12%

14%

16%


RoCE RoE


15/24



Management OverviewCRISIL's fundamental grading methodology includes a broad assessment of

management quality, apart from other key factors such as industry and business

prospects, and financial performance.

Experienced and professional management w ithdomain expertise

Apollo has a strong management with more than three decades of experience in

the healthcare services industry. The management is headed by Dr Prathap

Reddy, who is the founder and executive chairman. Mr Reddy holds a medical

degree from Stanley Medical College, Chennai and has received Fellowship from

the Massachusetts General Hospital, Boston, US. He was awarded the Padma

Vibhushan in FY10 by the Government of India for his exceptional service in the

healthcare industry. He is also the chairman of the CII National Healthcare

Committee since 2007.

Mr Reddy is supported by his four daughters Ms Preetha Reddy (managing

director), Ms Suneeta Reddy (executive director finance), Ms Sangita Reddy

(executive director operations) and Ms Shobana Kamineni (executive director

special initiatives).

Pioneer o f corporate healthcare in India

Apollo is the pioneer of corporate healthcare in India and is the largest private

player in the industry. The company started with a 150-bed hospital in Chennai

in 1983 and currently boasts of ~8,000 beds.

Management gears up to grow aggressively

Apollos management started on a cautious note and did not go for aggressive

expansion. Also, its primary focus was on the southern region and it expanded

to other markets only through partnerships/JVs. However, the company is now

changing its strategy and is planning to add ~2,700 beds in different regions.

Further, the company has also adopted a new format for tier II and III cities

through its reach initiative, which will aid future growth.

Strong second line of managementAlthough family-driven, the company has inducted various professionals from

the industry to its second line. This includes Mr K. Padmanabhan (group

president) and Mr S.K. Venkataraman (CFO and company secretary).

Apollo has a s trong and

experienced

management team


16/24



Corporate GovernanceCRISILs fundamental grading methodology includes a broad assessment of

corporate governance and management quality, apart from other key factors

such as industry and business prospects, and financial performance. In this

context, CRISIL Equities analyses the shareholding structure, board composition,

typical board processes, disclosure standards and related-party transactions.

Any qualifications by regulators or auditors also serve as useful inputs while

assessing a companys corporate governance.

Overall, corporate governance at Apollo reflects good practices supported by a

strong and fairly independent board, good and relevant experience, and board

processes and structures broadly conforming to minimum standards.

Board composition

Apollos board consists 16 members, of whom 11 are independent directors,

exceeding the requirements under Clause 49 of SEBIs listing guidelines. The

fairly large board brings sector expertise relevant to Apollo as well as diversified

technical and business experience.

Boards processes

The board processes appear to be well structured, with all committees - audit,

remuneration and investor grievance - in place, supporting good corporate

governance practices and decision making framework. The audit committee is

chaired by an independent director, Mr Deepak Vaidya. The committee meets at

timely and regular intervals. The board also includes other well-known names

like Mr N Vaghul, who has worked with major organisations like Mahindra and

Mahindra Ltd, Wipro Ltd, and Mr T Balaji, who has worked with Titan Industries.

Commendable disclosure standards

The companys quality of disclosure in reporting can be considered good, judged

by the level of information and details furnished in the annual report, websites

and other publicly available data. For instance, the company discloses business

performance cluster-wise in its quarterly presentations. The disclosure level is

sufficient to analyse varied business aspects.

Apollo has good

disclosure levels


17/24



Valuation Grade: 4/ 5We continue to value Apollo based on the discounted cash flow (DCF) method.

We have rolled forward our DCF valuation to FY13 and also revised our earnings

estimates upwards given higher-than-expected performance of the pharmacy

business. Hence, we revise our fair value for Apollo to Rs 533 per share (up from

Rs 387, adjusted for stock split from Rs 10 to Rs 5). This fair value implies P/E

multiples of 31.1x FY12E and 27.5x FY13E earnings. Consequently, we upgrade

our valuation grade from 3/5 to 4/5, indicating that the market price has

upside from the current levels.

Key DCF assumptions

We have considered the discounted value of the firms estimated free cash flow

from FY13 and have assumed a terminal growth rate of 5%.

WACC computation

Explicitperiod

Terminal value

Cost of equity 13.0% 13.0%Cost of debt (post tax) 7.0% 7.0%WACC 11.0% 11.0%Terminal growth rate 5.0%

Sensitivity analysis to terminal WACC and terminal grow th rate

Terminal growth rate

TerminalWACC

4.0% 4.5% 5.0% 5.5% 6.0%

9.0% 701 777 873 997 1,163

10.0% 559 608 667 739 83011.0% 460 494 533 579 635

12.0% 388 412 439 471 508

13.0% 333 351 371 394 420

Source: CRISIL Equit ies Es t imates

Figure 25: One-year forward P/ E band Figure 26: One-year forward EV/ EBITDA band


0

100

200

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700

Apr-06

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(Rs)

Apollo 20x 25x 30x 35x 40x

0

20000

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100000

120000

Apr-06

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(Rs mn)

EV 8x 12x 16x 20x

We revise our fair value

to Rs 533 per share


18/24



Figure 27: P/ E premium / discount to NIFTY Figure 28: P/ E movement


Peer comparison

MarketCap

ROE EPS P/ E P/ BV EV/EBITDACY10 CY11E CY12E CY10 CY11E CY12E CY10 CY11E CY12E CY10 CY11E CY12E CY10 CY11E CY12E

Indian players (Rs mn)

Apollo Hospitals Enterprise * 56,619 8.5 9.5 11.3 10.9 13.4 17.1 41.7 33.9 26.5 3.3 3.1 2.9 20.5 15.5 13.0

Fortis Healthcare *59,910 4.7 6.0 6.4 2.6 3.3 5.4 70.0 44.8 27.5 3.1 1.7 1.6 70.0 40.0 29.8

US players (US$ mn)

Universal Health Services -B 3,810 13.4 13.4 15.3 2.5 2.6 3.4 16.5 16.3 12.2 2.1 2.0 1.8 6.8 6.8 4.6

Health Net Inc 2,575 13.5 13.5 13.0 2.1 2.6 2.8 13.0 10.4 9.5 1.5 1.5 1.2 3.4 2.7 2.5

Community Health Systems Inc 3,322 13.3 13.3 12.6 3.0 3.0 3.2 12.0 12.0 11.1 1.6 1.5 1.3 7.3 6.8 6.5

Lifepoint Health Inc 1,971 8.3 8.3 8.2 3.0 2.9 3.1 12.6 13.1 12.1 1.0 1.0 0.9 6.7 6.6 6.2

Tenet Healthcare Corp 3,229 29.0 29.0 10.4 0.2 0.3 0.3 28.9 24.7 22.7 2.3 2.2 2.0 7.3 6.8 6.5

Health Mgmt Associates Inc-A 2,388 35.7 35.7 28.3 0.6 0.6 0.7 15.6 14.7 13.0 3.6 4.6 3.4 7.4 6.8 6.3

Well Point Inc 22,703 11.2 11.2 10.3 6.5 6.5 6.6 8.8 8.8 8.8 0.9 1.0 0.9 2.4 2.4 2.6

Medco Healthcare Solutions 27,047 32.8 32.8 39.7 3.0 3.4 4.1 21.3 18.6 15.7 6.1 6.4 6.0 11.2 10.3 9.8

Other global players (US$ mn)

Ramsay Healthcare Ltd * 2,404 18.1 15.4 16.2 0.6 0.9 1.0 20.2 17.5 15.2 2.9 2.6 2.4 10.5 8.8 8.1

Sonic Healthcare * 3,430 11.5 12.0 12.8 0.7 0.8 0.9 13.8 14.8 13.2 1.6 1.7 1.7 10.2 8.0 7.2

KPJ Healthcare 400 18.3 19.5 19.5 0.1 0.1 0.1 12.7 15.6 14.0 2.2 1.8 1.7 9.3 7.2 6.7

Raffles Medical 754 16.1 16.4 17.3 0.1 0.1 0.1 19.9 27.8 23.7 3.0 4.4 3.9 22.0 19.4 16.4

Bangkok DUSIT 906 13.0 15.2 16.2 0.0 0.1 0.1 17.5 21.2 17.6 2.1 3.0 2.8 8.5 6.3 5.7

Bangkok Chain Hospitals PCL 284 24.6 21.4 22.1 0.0 0.0 0.0 13.9 16.4 14.2 3.5 3.2 2.9 8.8 9.0 8.1

Fresenius SE 10,802 12.1 13.1 13.3 4.3 5.1 5.8 14.2 16.5 14.8 1.6 2.0 1.8 8.7 7.5 7.1

Note: * for FY10, FY11E, FY12E

Source: CRISIL Equit ies

0%

20%

40%

60%

80%

100%

120%

140%

160%

180%

Apr-06

Jul-06

Oct-06

Jan-07

Apr-07

Jul-07

Oct-07

Jan-08

Apr-08

Jul-08

Oct-08

Jan-09

Apr-09

Jul-09

Oct-09

Jan-10

Apr-10

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Oct-10

Jan-11

Premium/Discount to NIFTY Median

0

5

10

15

20

25

30

35

40

45

Apr-06

Jul-06

Oct-06

Jan-07

Apr-07

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Apr-08

Jul-08

Oct-08

Jan-09

Apr-09

Jul-09

Oct-09

Jan-10

Apr-10

Jul-10

Oct-10

Jan-11

1yr Fwd PE (x) Median PE

-1 std dev

+1 std dev


19/24



EARNINGS REVISION SUMMARYFY11E FY12E

Particulars Unit Old New % change Old New % change

Revenue (Rs mn) 24,835 24,872 0% 28,810 29,232 1%

EBITDA (Rs mn) 3,956 4,067 3% 4,861 4,938 2%

EBITDA margin % 15.9% 16.4% 40bps 16.9% 16.9% -

PAT (Rs mn) 1,645 1,670 1% 2,131 2,154 1%

PAT margin % 6.6% 6.7% 10bps 7.4% 7.4% -

EPS Rs 13.0 13.4 3% 17.0 17.1 1%


20/24



Company OverviewIncorporated in 1979, Apollo is a Chennai-based company promoted by Dr

Prathap Reddy. It commenced operations in 1983 with a 150-bed hospital in

Chennai. Over a period of time, Apollo has emerged as Asias largest and

integrated healthcare group with over 8,000 beds across 47 hospitals in India.

Apollo has also forayed into diagnostic clinics, dispensing pharmacies and

consultancy services.

Key milestones

1979 Incorporated by Dr. Prathap C Reddy1983 Started the first hospital in Chennai with 150 beds

1992 Introduced artery stenting for the first time in India1994 State-of-the-art cancer hospital in Chennai1995 Did first bone marrow transplantation and first multi-organ transplant in the

country

2000 Extended operations to Sri Lanka, Dubai, Saudi Arabia and Ghana2007 Partnered with Munich Health to enter into the health insurance business

2008 Chennai and Hyderabad hospitals received healthcare award2009 Launched the Cyberknife robotic radio surgery system2010 JV with British American investment company - Mitus Ltd - to set up multi-

speciality hospital in Moka, Mauritius

2010 Launched 50th hospital with 150 beds in Secunderabad2010 Set up Indias first comprehensive cancer care hospital at eastern India

Source: Company,CRISIL Equities

List of self-owned and operated hospitalsNo Name Location Beds Type

Beds owned directly by Apollo1 Apollo Hospitals, Greams Lane Chennai 619 SS

2 Apollo Specialty Hospitals, Nandanam Chennai 251 SS

3 Apollo Hospitals, Thondiarpet Chennai 60 MS

4 First Med Hospital Chennai 120 MS

5 Apollo Hospitals, Sowcarpet Chennai 17 MS

6 Apollo Childrens Hospital Chennai 81 MS

7 Apollo Hospitals, Jubilee Hills Hyderabad 345 SS

8 Apollo Emergency, Hyderguda Hyderabad 38 MS

9 Apollo Emergency Medical Centre Hyderabad 18 DC

10 Apollo Centre, Vikrampuri Hyderabad 75 MS

11 Apollo DRDO Hyderabad 150 MS

12 Apollo Hospital Secunderabad 150 MS

13 Apollo Hospitals Madurai 185 SS

14 Apollo Loga Reach Hospital Karur 70 MS

15 Apollo Heart & Kidney Hospital Vizag 65 SS

16 Apollo Hospitals Aragonda 54 MS17 Apollo Reach Hospital Karimnagar 120 MS

18 Apollo Hospitals Bilaspur 250 SS

19 Apollo BGS Hospitals and Medical Centre Mysore 176 SS

20 Apollo Hospitals Bhubaneswar 290 SS

Beds own ed through subsidiaries,JVs and associates

21 Samudra Healthcare Kakinada 150 MS

22 Imperial Hospital Bangalore 250 SS

23 Indraprastha Medical Delhi 632 SS

24 Indraprastha Medical Noida 100 MS

25 Apollo Gleneagles Kolkata 470 SS

26 Apollo Hospitals International Ahmedabad 300 SS

27 Apollo Hospitals International Ahmedabad 20 SS

28 Lavasa Pune 67 MS

Managed beds 2588SS - super speciality ; MS multi-speciality


21/24



Annexure: Financials

Source: CRISIL Equit ies

Income statement Balance Sheet

(Rs mn) FY09 FY10 FY11E FY12E FY13E (Rs mn) FY09 FY10 FY11E FY12E FY13E

Operating income 16,142 20,265 24,872 29,232 34,311 Liabili ties

EBITDA 2,288 3,032 4,067 4,938 5,878 Equity share capital 602 618 624 629 629

EBITDA margin 14.2% 15.0% 16.4% 16.9% 17.1% Reserves 14,351 16,158 17,583 19,310 20,895

Depreciation 632 750 864 1,015 1,282 Minorities - - - - -

EBIT 1,656 2,282 3,203 3,924 4,596 Net worth 14,954 16,776 18,206 19,939 21,524

Interest 459 602 941 905 1,045 Convertible debt - - - - -

Operating PBT 1,197 1,680 2,262 3,019 3,550 Other debt 6,669 9,132 8,787 8,454 11,454

Other income 302 341 249 221 117 Total debt 6,669 9,132 8,787 8,454 11,454

Exceptional inc/(exp) (40) (6) - - - Deferred tax liability (net) 446 536 536 536 536

PBT 1,459 2,015 2,511 3,240 3,668 Total liabil ities 22,069 26,444 27,529 28,929 33,514

Tax provision 490 675 842 1,086 1,229 Assets

Minority interest - - - - - Net fixed assets 10,118 12,690 14,118 15,958 20,488

PAT (Reported) 969 1,339 1,670 2,154 2,438 Capital WIP 2,524 3,240 3,240 3,240 3,240

Less: Exceptionals (40) (6) - - - Total fixed assets 12,642 15,930 17,358 19,198 23,728

Adjusted PAT 1,009 1,346 1,670 2,154 2,438 Investments 3,760 4,165 4,165 4,165 4,165

Current assets

Ratios Inventory 1,162 1,412 1,704 2,002 2,350

FY09 FY10 FY11E FY12E FY13E Sundry debtors 1,744 2,228 2,726 3,203 3,760

Growth Loans and advances 2,103 2,968 3,233 3,800 4,460

Operating income (%) 32.9 25.5 22.7 17.5 17.4 Cash & bank balance 876 3,117 2,457 1,463 1,003

EBITDA (%) 24.2 32.5 34.1 21.4 19.0 Marketable securities 2,154 1 1 1 1

Adj PAT (%) 34.3 33.3 24.1 29.0 13.2 Total current assets 8,039 9,726 10,121 10,470 11,574

Adj EPS (%) 30.8 30.0 22.9 27.9 13.2 Total current l iabil ities 2,693 3,906 4,645 5,434 6,483

Net current assets 5,346 5,819 5,476 5,036 5,091

Profitability Intangibles/ Misc. expenditure 320 530 530 530 530

EBITDA margin (%) 14.2 15.0 16.4 16.9 17.1 Total assets 22,069 26,444 27,529 28,929 33,514

Adj PAT Margin (%) 6.3 6.6 6.7 7.4 7.1

RoE (%) 7.1 8.5 9.5 11.3 11.8 Cash flow

RoCE (%) 8.2 9.6 12.1 14.2 15.0 (Rs mn) FY09 FY10 FY11E FY12E FY13E

RoIC (%) 11.3 12.9 14.7 15.2 14.2 Pre-tax profit 1,499 2,021 2,511 3,240 3,668

Total tax paid (514) (586) (842) (1,086) (1,229)

Valuations Depreciation 632 750 864 1,015 1,282

Price-earnings (x) 54.2 41.7 33.9 26.5 23.4 Working capital changes (552) (385) (316) (554) (515)

Price-book (x) 3.7 3.3 3.1 2.9 2.7 Net cash from operations 1,066 1,799 2,218 2,614 3,205

EV/EBITDA (x) 25.5 20.5 15.5 13.0 11.5 Cash from investments

EV/Sales (x) 3.6 3.1 2.5 2.2 2.0 Capital expenditure (3,775) (4,247) (2,293) (2,854) (5,812)

D iv idend payout ratio (%) 48.5 37.7 29.8 29.8 29.8 Investments and others 328 1,749 - - -

Dividend yield (%) 0.9 0.9 0.9 1.1 1.3 Net cash from investments (3,447) (2,498) (2,293) (2,854) (5,812)

Cash from financing

B/S rat ios Equity raised/(repaid) 796 1,050 345 333 -

Inventory days 31 30 30 31 31 Debt raised/(repaid) 1,359 2,463 (345) (333) 3,000

Creditors days 56 70 66 67 68 Dividend (incl. tax) (470) (504) (584) (754) (853)

Debtor days 39 40 40 40 40 Others (incl extraordinaries) 290 (70) (0) (0) -

Working capital days 46 45 42 41 41 Net cash from financing 1,975 2,939 (584) (754) 2,147

Gross asset turnover (x) 1.3 1.3 1.4 1.4 1.4 Change in cash position (407) 2,241 (659) (994) (460)

Net asset turnover (x) 1.7 1.8 1.9 1.9 1.9 Closing cash 876 3,117 2,457 1,463 1,003

Sales/operating assets (x) 1.5 1.4 1.5 1.6 1.6

Current ratio (x) 3.0 2.5 2.2 1.9 1.8 Quarterly financials

Debt-equity (x) 0.4 0.5 0.5 0.4 0.5 (Rs mn) Q2FY10 Q3FY10 Q4FY10 Q1FY11 Q2FY11

Net debt/equity (x) 0.2 0.4 0.3 0.4 0.5 Net Sales 4,561 4,809 4,829 5,233 5,864

Interest coverage 3.6 3.8 3.4 4.3 4.4 Change (q-o-q) -36% 5% 0% 8% 12%

EBITDA 731 777 629 883 996

Per share Change (q-o-q) -48% 6% -19% 40% 13%

FY09 FY10 FY11E FY12E FY13E EBITDA margin 16.0% 16.2% 13.0% 16.9% 17.0%

Adj EPS (Rs) 8.4 10.9 13.4 17.1 19.4 PAT 341 439 292 393 496

CEPS 13.6 17.0 20.3 25.2 29.6 Adj PAT 341 439 292 393 496

Book value 124.1 135.8 146.0 158.5 171.1 Change (q-o-q) -35% 29% -34% 34% 26%

Dividend (Rs) 3.9 4.1 4.0 5.1 5.8 Adj PAT margin 7.5% 9.1% 6.0% 7.5% 8.5%

Actual o/s shares (mn) 120.5 123.6 124.7 125.8 125.8 Adj EPS 5.5 7.1 4.7 3.2 4.0


22/24



Focus Charts

Apol lo ahead of peers in terms of bed capacity EBITDA margins of pharmacy stores have

improved


Improvement in occupancy despite bed additions Steady improvement in ARP OB


RoCE to improve post capacity additions Shareholding pattern over the quarters


8,0647,098

5,463

1,100

0

2,000

4,000

6,000

8,000

10,000

Apollo Manipal Fortis Healthcare Max

No of beds

-4%

-7%

-6%-5%

-2%

-2%

0%

-2%

2%

-8%

-6%

-4%

-2%

0%

2%

4%

Sep-08

Nov-08

Jan-09

Mar-09

May-09

Jul-09

Sep-09

Nov-09

Jan-10

Mar-10

May-10

Jul-10

Sep-10

EBIDTA Margin (%)

1,9

59

2

,135

2,

237

2,4

37 2

,717

2,

812

72%

77% 77%76% 76%

80%

68%

70%

72%

74%

76%

78%

80%

82%

1,500

1,750

2,000

2,250

2,500

2,750

3,000


No of beds Occupancy (RHS)

7,245

7,563

8,767

9,666

10,749

11,616

7,000

8,000

9,000

10,000

11,000

12,000


Net ARPOB per day

2,

244

3,

775

4,

247

2,

293

2,

854

5,

812

2,

709

1,5

09

1,5

09

9% 8%

10%

12%

14% 15% 16%

18%

21%

0%

5%

10%

15%

20%

25%

-

1,000

2,000

3,000

4,000

5,000

6,000

7,000

FY08 FY09 FY10 FY11E FY12E FY13E FY14E FY15E FY16E

Capex (Rs mn) RoCE (RHS)

Increase in RoCE

post bed additions

Single digit RoCEdue to high capex

33.5% 33.5% 33.5% 33.5%

24.8% 23.9% 24.1% 24.0%

3.5% 3.7% 3.7% 3.7%

38.2% 38.9% 38.7% 38.7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Dec-09 Mar-10 Jun-10 Sep-10

Promoter FII DII Others


23/24

CRISIL I ndependent Equity Research Team

Mukesh Agarwal Director +91 (22) 3342 3035 [email protected]

Tarun Bhatia Director, Capital Markets +91 (22) 3342 3226 [email protected]

Chetan Majithia Head, Equities +91 (22) 3342 4148 [email protected]

Sudhir Nair Head, Equities +91 (22) 3342 3526 [email protected]

Nagarajan Narasimhan Director, Research +91 (22) 3342 3536 [email protected]

Ajay D'Souza Head, Research +91 (22) 3342 3567 [email protected]

Manoj Mohta Head, Research +91 (22) 3342 3554 [email protected]

Sachin Mathur Head, Research +91 (22) 3342 3541 [email protected]

Sridhar C Head, Research +91 (22) 3342 3546 [email protected]

CRISILs Equity Offerings

The Equity Group at CRISIL Research provides a w ide range of services including:

Independent Equity Research IPO Grading White Labelled Research Valuation on companies for use of Institutional Investors, Asset Managers, CorporateOther Services by the Research group include

CRISINFAC Industry research on over 60 industries and Economic Analysis

Customised Research on Market sizing, Demand modelling and Entry strategies Customised research content for Information Memorandum and Offer documents


24/24

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CRISIL is India's leading Ratings, Research, Risk and Policy Advisory Company.

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Ahmedabad I Mumbai I Pune

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Bengaluru I Chennai

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Documents

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