Krishna Institute of Medical Science Ltd IPO Information Note

Krishna Institute of Medical Science IPO Details

Issue Opens - June 16, 2021

Issue Closes - June 18, 2021

Price Band - ₹ 815-825

Face Value - ₹10

Issue Size - ~₹2,144 cr (at upper price band)

Bid Lot - 18 Equity Shares

Issue Type - 100% Book building

Company Background

Krishna Institute of Medical Science Ltd. (KIMS) provides multi-disciplinary integrated healthcare services, with a focus on primary, secondary & tertiary care in Tier 2-3 cities and primary, secondary, tertiary and quaternary healthcare in Tier 1 cities. The company operates 9 multi-specialty hospitals under the “KIMS Hospitals” brand, with an aggregate bed capacity of 3,064, including over 2,500 operational beds as of March 31, 2021, which is 2.2 times more beds than the second largest provider in AP and Telangana.

_{For additional information and risk factors please refer to the Red Herring Prospectus. Please note that this document is for information purpose only.}

The company offers a comprehensive range of healthcare services across over 25 specialties and super specialties, including cardiac sciences, oncology, neurosciences, gastric sciences, orthopaedics, organ transplantation, renal sciences and mother & child care.

Object of the Offer

The IPO offer comprises of a fresh issue and an offer for sale. Out of the fresh issue component of Rs.200cr., Rs.150cr. is proposed to be utilized towards repayment/prepayment of certain debt availed by the company and its subsidiaries and the balance amount is attributable to general corporate purposes.

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Financials 

Source: RHP

Competitive Strengths:

Track record of strong operational and financial performance

The company has grown from a single, approximately 200-bed hospital at Nellore (AP) in year 2000 to a leading multi-disciplinary integrated private healthcare service provider with nine multi-specialty hospitals and over 3,000 beds today. The company has consistently delivered strong operational and financial performance through strong patient volumes, cost efficiency and diversified revenue streams across medical specialties. The company has achieved healthy profitability in both Tier 1 and Tier 2-3 markets by identifying markets with significant under-served healthcare demand and delivering quality healthcare services at affordable prices, which in turn drives patient volumes. Their hospitals in Tier 1 markets provide higher margin services such as organ transplants, oncology and neuro-critical care, resulting in higher average revenue per operating bed (ARPOB) and EBITDA. The company’s multispecialty healthcare platform has resulted in diversified revenue streams, with no single specialty accounting for more than 25% of the total income in any of the last three years. As of March 31, 2021, the debt-to-EBITDA ratio was 0.71x and the gearing ratio was 0.31x. The company has achieved strong free cash flow levels, in terms of the cash flows from operations relative to the capital expenditures. The company is one of only three hospitals in India that are rated AA by CRISIL

Well positioned to consolidate in India’s large, unorganized yet rapidly growing and underserved affordable healthcare market

The healthcare industry in India is poised for growth. The Indian healthcare delivery industry is expected to grow at a 17-18% CAGR (2020 - 2024E) and reach ₹7.07 trillion by 2024, according to the CRISIL Report. In Fiscal Year 2020, 68% of hospital treatments, in terms of the treatment value, were carried out in private hospitals, and the number is expected to reach 72% in Fiscal Year 2024, according to the CRISIL Report.

There is a significant and growing need for quality and affordable healthcare services across the country, particularly in AP and Telangana where the company’s hospital network is concentrated. AP and Telangana ranked among the top three in terms of overall health index score, according to the CRISIL Report. AP is also a leading state in terms of doctors per person in 2018 and has been attracting doctors and patients seeking treatments, according to CRISIL report. Health insurance penetration in India stood at only 37% as of March 31, 2018, while AP and Telangana also stand as one of the underpenetrated states in terms of health insurance, with a penetration rate of 4% and 12%, respectively, in Fiscal Year 2020. The government backed schemes in AP and Telangana will also help to set the stage for future growth.

Disciplined approach to acquisitions resulting in successful inorganic growth

The company has a successful history of sourcing, executing and integrating acquisitions. It has a disciplined and low-leverage approach to acquisitions that has enabled them to maintain their affordable pricing model, as they have grown in both tier I and II-III markets. Since Fiscal Year 2017, the company has expanded their hospital network primarily through acquisitions of other hospitals. In Fiscal Year 2017, they have acquired hospital in Ongole (AP), a 350-bed multispecialty hospital founded by local doctors, through a slump sale by Ongole Arogya Hospitals Private Limited. The company further expanded its hospital network to add KIMS Vizag, a 434-bed multispecialty hospital in April 2018 by entering into a service agreement. In addition, it acquired a 250-bed hospital in Anantapur (AP) in October 2018 and a 200-bed hospital in Kurnool (AP) in April 2019, which solidified their presence in southern AP and adjoining areas of Karnataka.

Key Risk Factor:

• The company is highly dependent on their healthcare professionals, including doctors that are engaged on a consultancy basis.
• Their revenues are highly dependent on the hospitals in Hyderabad (Telangana). There is also significant dependence on certain specialties for a majority of the revenues.
• Any adverse impact on the title or ownership rights of the owner or breach of the terms or nonrenewal of the license agreement may lead to disruptions and affect the business operations of the company.

* For complete list of risk factors kindly refer to the Sona Comstar Red Herring Prospectus.

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