Auna Q4 2025 Earnings Call - Mexico stabilizes, Peru drives growth as $825m refinancing buys time for 2026 recovery

Operator: Good morning, and welcome to Auna’s fourth quarter 2025 earnings conference call. My name is Ellie, and I will be your operator for today’s call. At this time, all participants are in listen-only mode. Please note that this call is being recorded. There will be an opportunity for you to ask a question at the end of today’s presentation. Now, I would like to turn the call over to Ana Maria Mora, Head of Investor Relations. Ma’am, you may now go ahead, please.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, operator. Hello, everyone, and welcome to Auna’s conference call to review our fourth quarter and full year results. Please note that there is a webcast presentation to accompany the discussion during this call. If you need a copy of the presentation, please go to our investor relations website or contact Auna’s investor relations team. Please note that when we discuss variances, we will be doing so on a year-over-year basis and in FX neutral or local currency terms with regard to Mexico and Colombia, unless we note otherwise. Let’s move to slide 2. In addition to reporting unaudited financial results in accordance with International Financial Reporting Standards, we will discuss certain non-IFRS financial measures and operating metrics, including foreign exchange neutral calculations. Investors should carefully read the definitions of these measures and metrics included in our earnings press release of yesterday to ensure that they understand them.

Non-IFRS financial measures and operating metrics should not be considered in isolation as a substitute for or superior to IFRS financial measures and are provided as supplemental information only. Before we begin our remarks, please also note that certain statements made during the course of today’s discussion may constitute forward-looking statements, which are based on management’s current expectations and beliefs and which are subject to a number of risks and uncertainties that could cause actual results to materially differ, including factors that may be beyond the company’s control.

This includes, but are not limited to, our target leverage ratio, the expected resolution of the issues with physicians, suppliers, and information systems in Mexico, the results of the key initiatives we’re implementing in Mexico, Colombia, and Peru, the expected capacity and market of Torre Trecca once built, the execution of our strategic plan, including the recovery of our growth levels and the rollout of the AunaWay in Mexico, our planned investments in Mexico, expected revenue growth and EBITDA guidance, and the creation of further growth and sustainable value for all stakeholders. For a description of these risks, please refer to our Form 20-F filing with the U.S. Securities and Exchange Commission and our earnings press release. Slide 3, please.

On today’s call, we have Jesús Zamora, our Executive Chairman and President, Gisele Remy, our Chief Financial Officer and Executive Vice President, and Lorenzo Massart, our Executive Vice President of Strategy and Equity Capital Markets. They will discuss Auna’s consolidated and segment financial and operating results for the fourth quarter and full year and will also provide updates on our various strategic growth initiatives. After that, we will open the call for your questions. Jesús, please go ahead.

Jesús Zamora, Executive Chairman and President, Auna: Thanks, Annie. Good morning, everyone, and thank you for joining us to review our 2025 results. During the fourth quarter, we stabilized our Mexico operations, which are now on a clear path to sustained top line and EBITDA growth in 2026. Under the leadership of our new management team in Mexico, we have focused on expanding our reach into the larger segments of privately insured families and furthering our alignment with certain physician groups. These initiatives were implemented late in the year and therefore did not offset the volume losses experienced earlier in 2025, resulting in disappointing results for the year. Evidence of progress in Mexico includes Auna being again included in the policies that serve the larger segment of the privately insured markets.

Additional evidence is the award for the extension of a healthcare plan to cover, on an exclusive basis for most of the services, ISSSTE León, the Social Security institution covering all state employees of the state of Nuevo León. During the quarter, Peru continued to outperform and underpin Auna’s overall performance, driven primarily by a strong pricing mix in healthcare services and a record low medical loss ratio. Peru has operational scale and significant runway for growth. As recently announced, we signed an agreement with EsSalud under a public-private partnership framework to refurbish and operate a 600,000 sq ft high complexity outpatient facility in Lima, expanding access to care for approximately 3 million patients currently served by EsSalud. Colombia’s results came in line with our objectives to grow, yet improve cash flow, with a higher mix of risk-sharing contracts and reduced reliance on intervened payers.

These are promising results. Consolidated adjusted net income reached PEN 136 million in the quarter, compared with PEN 36 million in the same quarter last year. For the full year, adjusted net income more than tripled to PEN 336 million. We also strengthened our net capital structure during the quarter through the $825 million debt refinancing, which improved our maturity profile and lowered our interest expense. Despite the premiums and costs associated with the refinancing, we maintained our leverage ratio at 3.6x, supported by strong free cash flow generation that increased our cash position by 42%. Let’s move to our consolidated results on slide 5. Peru’s strong performance and Colombia’s resilience helped offset last year’s setbacks in Mexico, which is now well-positioned for a strong recovery this year.

Consolidated revenue grew 6% at FX neutral in the quarter, while adjusted EBITDA declined 14% FX neutral, mainly reflecting Mexico’s underperformance as well as an unfavorable year-over-year comparison in Colombia related to extraordinary items recorded in the prior year quarter. For the full year, revenue grew 4%, while EBITDA declined 3%. As shown in the bottom half of the slide, capacity utilization in healthcare services decreased 2.3 percentage points to 64%, reflecting lower utilization, particularly in Colombia, as part of our focus to reduce reliance on intervened payers. At Oncosalud in Peru, plan memberships increased 4.4%, while the oncology MLR continued to improve, reaching a record low of 48.5%. Let’s move to our segment results, beginning with Mexico on slide seven.

As we further integrated Opción Oncología, and partly as a result of launching our new onco center at Doctors Hospital, oncology revenues grew again in the fourth quarter, increasing 35% compared with the previous quarter. Notably, out-of-pocket revenues also increased, reaching 12% of total revenues in Mexico in December. This growth reflects the early stages of Mexico’s recovery and helped offset some of the legacy volume and margin pressures related to physician and supplier relationships that we are gradually putting behind us. We expect our oncology growth initiatives to continue gaining traction in 2026 as we further integrate the onco center into our healthcare network in Mexico. Market conditions remain soft in Mexico, affecting the number of surgeries and emergency visits and contributing to a 3% decline in fourth quarter revenues in local currency.

It is important to note, however, that revenues were unchanged from the previous quarter, reflecting the stabilization of our operations. As shown on the right side of the slide, fourth quarter adjusted EBITDA declined 36% and was down 18% for the full year. Lower revenues throughout the year and lower profitability in the last quarter resulted from higher costs and lower margins under our previous healthcare plan with ISSSTE León. On slide 8, we provide an update on the various initiatives underway to get back on track toward achieving these goals. We have strengthened our leadership team in Mexico with the commercial, operational, and clinical experience and skill set required to lead Mexico. With a reinforced team, we have implemented very successful actions that give us confidence we have achieved a turnaround of our operations in Mexico.

The team includes a new chief medical officer who is helping deepen physician engagement, increase productivity, and improve medical outcomes across our facilities. These actions position us well to resume growth in 2026. The fourth quarter results evidence the turnaround of our operations in Mexico. I highlight the inclusion of our hospital network in the preferred provider tiers, policies covering the larger segments of the privately insured population, and the rollout of various packaged services to better penetrate several market segments, particularly the out-of-pocket segment. Through targeted pricing initiatives and pre-negotiated physician rates, this high margin segment reached 12% of revenues in Mexico in December, up from 8% in the third quarter. Corporations and government agencies represent another important opportunity.

The most immediate impact of this strategy was the extension of the healthcare plan to cover on an exclusive basis for most services, ISSSTE León, the social security institution covering all state employees of the state of Nuevo León, which resulted in a double-digit price increase for the year. We are currently in discussions with other governmental agencies. As mentioned earlier, we moved into the preferred tier with two major insurers, which should produce higher patient volumes going forward. We also signed an agreement with a leading insurer to direct policyholders to our own oncology services through targeted deductible structures and financial incentives. This will help further scale our oncology franchise, including the oncology center in Monterrey, where we plan to double the medical staff this year. Physician engagement and productivity continue to grow.

During the quarter, we confirmed volume and margin improvement from approximately 250 physicians who account for about 80% of revenues in the hospital network. These alignment incentives support higher productivity, improved clinical outcomes, and stronger operating performance. Let’s turn to slide 9 to discuss Peru’s performance. Operating at scale, Peru continues to outperform in both revenue and EBITDA. Revenue increased 11% during the quarter, driven by growth in high complexity services that lifted the average ticket, as well as higher volumes supported by investments in new medical equipment, increased bed capacity, and targeted marketing initiatives. On the insurance side, Oncosalud’s revenues grew 10%, supported by a 4% increase in plan memberships and annual price adjustments. Oncology’s MLR also declined 4.4 percentage points to 48.5%, reflecting a sixth consecutive quarterly decrease in the MLR.

This improvement was driven by a combination of higher tickets and continued moderation in pharmaceutical costs. Total adjusted EBITDA increased 14% in the quarter and 14% for the full year. As we further penetrate Peru’s healthcare market and expand relationships, we expect this segment of our regional platform to remain an important driver of growth going forward. Now let’s move to Colombia on slide 10. During the quarter, we constrained our services to government-intervened payers and thus effectively managed the risks posed by them in our accounts receivables, and this resulted in a healthy cash cycle in Colombia. In addition, we expanded risk-sharing models such as PGPs, which grew four percentage points to represent 21% of segment revenue. Higher tickets in surgeries and emergency treatments more than offset lower volumes, supported by growth in chemotherapy and imaging.

In addition, serving the patient population of new payer and the expansion of PGPs contributed to a 6% increase in Colombia’s revenue for the quarter. For the full year, revenue increased 4%, mainly driven by higher tickets. The decreases in adjusted EBITDA and margins shown on the right side of the slide reflect an unfavorable comparison with the fourth quarter of 2024, which benefited from extraordinary price adjustments and a year-end recognition of procurement rebates. That concludes my review of the quarter and the year. I will now turn the call over to Giselle, who will discuss our results in greater detail.

Gisele Remy, Chief Financial Officer and Executive Vice President, Auna: Thank you, Suso. As the graphs show on slide 12, the diversity of our Auna’s regional platform enabled us to deliver 6% revenue growth in the quarter and 4% for the year. Looking at the quarter, the 11% growth in Peru and 6% growth in Colombia offset the 3% decline in Mexico, where we have achieved steadier results in operations. Although demand in the country remains soft, our business there has established a strong foundation for profitable growth this year and beyond, as Suso explained earlier. Now let’s please turn to slide 13. Fourth quarter adjusted EBITDA decreased 14% in FX neutral to PEN 220 million, with the margin contracting 4.5 percentage points to 19.5%.

Margin expansion and EBITDA growth in our Peru business was more than offset by Mexico’s margin decline related to the mix of services and specialties, our previous healthcare plan to cover ISSSTELEON, and our efforts to improve the operation in Mexico through the adjustments to our leadership and new IT systems. Also contributing to our EBITDA decline in the quarter was a higher proportion of risk-sharing contracts in Colombia, as well as the rebates recognized in the fourth quarter of last year in Colombia, which created an unfavorable year-over-year comparison. When excluding extraordinary impacts in both periods, Colombia’s EBITDA would have been relatively flat in the fourth quarter of 2025 versus the fourth quarter of 2024. Slide 14, please.

For the year, adjusted EBITDA remained relatively flat, decreasing 3% in FX neutral to PEN 917 million, with margin decreasing 1.7 percentage points to just under 21%. The trend in EBITDA was largely due to the same reasons that I explained for the fourth quarter. Let’s now move to slide 15. Our adjusted net income increased more than 3 times in the fourth quarter, aided by non-cash FX gains. On this slide, we break down the year-over-year change. Starting at the left of the bridge is operating income. The PEN 46 million decrease was primarily driven by Mexico’s underperformance in the quarter, as well as the extraordinary pricing that Colombia benefited from in last year’s quarter.

The positive PEN 71 million non-cash FX variance is primarily related to the appreciation of the Peruvian sol against the U.S. dollar outside the range of the previous call spreads we had in place. The 154 million soles delta in net interest expenses that you see in the middle of the bridge was mainly due to PEN 170 million of extraordinary expenses related to our refinancing, including not only the tender premiums paid, but also non-cash accounting impacts of derivative unwinds and derivative rollovers in order to effectively hedge the newly issued instruments, as well as the recognition of the unamortized costs of the previous term loan, which was repaid. These impacts are also a part of the PEN 187 million in extraordinary items and adjustments, along with the incentive payments related to the Opción Oncología doctors.

The PEN 41 million in less income taxes are related to negative pre-tax profit in the quarter due to the extraordinary refinancing impacts, which resulted in an income tax credit. Slide 16, please. For the year, adjusted net income grew thanks to greater financial discipline and the steps we took to improve Auna’s debt structure. The PEN 158 million decrease in operating profit was driven primarily by Mexico’s aforementioned stabilization. The PEN 235 million difference in FX reflects a positive non-cash amount of PEN 193 million in 2025 compared to a negative PEN 42 million soles impact in 2024, and is related to the appreciation of the Peruvian sol, as I explained before.

It is important to note that following the refinancing, we have adjusted the range on the Peruvian sol call spread hedges closer to current FX levels, which means we will likely not see these swings in 2026. The PEN 62 million increase in net interest expense was mainly driven by the extraordinary expenses related to the refinancing. Importantly, excluding net finance costs from exchange rate differences as well as extraordinary refinancing costs, net finance costs would have been PEN 459 million in the full year 2025 and PEN 561 million in the full year 2024, representing a decrease of PEN 102 million or 18.2%.

The 205 million in non-cash and extraordinary items mostly reflect the partial repayment of the 2029 notes, but also a PEN 24 million adjustment to business development expenses in the first quarter of 2025 that was related to payments to the Opción Oncología doctors. Lastly, on this slide, the PEN 29 million increase in income tax simply reflects higher pre-tax profit in 2025. The 2025 effective tax rate was unfavorably impacted by the refinancing exercise in the fourth quarter. When excluding the impacts of the refinancing, our effective tax rate would have been largely in line with statutory rates and within our target range of 35%-40%. Let’s now move to the cash flow bridge on slide 17.

Free cash flow grew 35% to PEN 582 million, while our year-end cash position increased 42% to PEN 335 million. This means we have adequate funds to continue investing in our strategic growth initiatives in Mexico and Peru. Pre-tax operating cash flow increased nearly 2% on improved cash conversion. Organic maintenance CapEx was PEN 145 million, or 3.3% of revenues. This mostly included PEN 86 million of infrastructure CapEx, PEN 51 million for the implementation of SAP and hospital information systems in Monterrey, and PEN 15 million of the OCA holdback obligations. Free cash flow also benefited from PEN 76 million of cash resulting from a rebalancing of Auna Seguros’ investment portfolio.

The PEN 454 million in interest paid, which net of refinancing fees would have been PEN 407 million, reflects an almost PEN 90 million decrease versus the PEN 498 million in interest paid in the 12-month period of 2024, also net of extraordinary items. This represents a material reduction in interest expense with increased interest coverage, leaving Auna in a solid position to continue deleveraging into 2026 off the back of growing cash flows and reduced interest expenses. Now a few words about Auna’s new debt structure on slide 18.

Our $825 million equivalent debt refinancing has significantly reinforced Auna’s capital structure by reducing interest expense, extending our maturity profile, increasing short-term liquidity, and as a result, freeing up a material portion of short-term revolving credit facilities. I’d like to point out again that when excluding premiums and expenses resulting from the 2025 refinancing, we have successfully generated cash after interest payments in 2025 and are well-positioned to increase that cash generation in 2026. Finally, all of the aforementioned impacts have moved us closer to achieving our target leverage ratio of 3x net debt to EBITDA in the medium term. That concludes my review. I’ll now turn the call back to Suso, who would like to wrap up our presentation before we open the call for questions.

Jesús Zamora, Executive Chairman and President, Auna: Thank you, Giselle. Let me close with a few key takeaways. We began 2026 well-positioned both operationally and financially. Our new leadership team in Mexico has a clear path to growth. While the risk mitigation measures in Colombia continue to protect our cash cycle. Where Peru continues to underpin Auna’s vertically integrated platform, demonstrating the strength and predictability of our business model at scale. The addition of initiatives such as the Centro Ambulatorio Trecca will further expand our addressable market in Peru and highlight the significant growth opportunities that remain, as do our PGP growth in Colombia, and as do the ISSSTE León healthcare plan award in Monterrey. In Colombia, we will continue to diversify away from intermediary payers and prioritize cash flows through PGP arrangements. We expect Mexico to recover in 2026, regaining volumes and margins.

The team has increased Auna’s accessibility to more policy holders and coverage plans, be it with private insurance companies, employer groups, or ISSSTE León. Finally, we enter the year with stronger liquidity and the financial flexibility needed to execute our growth strategy. Before turning to guidance, as trading volumes strengthen and our commercial and operational initiatives in high complexity gain traction, we expect Auna’s share price to more fully reflect the intrinsic value of our platform. We will continue to strengthen our engagement with the investment community to further the understanding of what Auna is and can be in the future. Finally, let’s turn to guidance on slide 20. Taking into account expected market conditions this year, our stronger position in Mexico, and Auna’s strengthened capital structure, we expect adjusted EBITDA to increase 12% FX neutral, supported by disciplined cost management and ongoing investments in our strategic growth initiatives.

We are also projecting revenue growth of 12%, driven by sustained commercial momentum and operational execution. Finally, we expect CapEx to remain at approximately 4% of revenue as we continue balancing growth investments with cash flow generation. With that, we will open the call for questions. Thank you very much.

Operator: Thank you. At this time, we will open the floor for question and answer session. As a reminder, please, you can also submit your questions online by using the Q&A function of the webcast platform. Your first question comes from the line of Arthur Als of Morgan Stanley. Your line is now open.

Arthur Als, Analyst, Morgan Stanley: Good morning, Suso, Giselle, Lorenzo, and everybody else in the call. Thank you for taking our questions. We wanted to explore a little bit more your guidance, and if you’re able to break down a little bit more by region or by business line, what are your growth and EBITDA expansion in each line? We would assume that a Mexico recovery is what drives most of this improvement year-over-year. If so, shouldn’t we expect a little bit more on the margin side, especially since revenues and adjusted EBITDA guidance imply flat margins? If Mexico is recovering, and this is a fixed business segment of the company, shouldn’t I expect a little bit more in the EBITDA growth versus the revenue growth?

A second question also on the guidance. What are the risks to your 2026 guidance? Where do you think things could potentially go wrong and how are you assessing that? Thank you.

Jesús Zamora, Executive Chairman and President, Auna: Hello, and thank you. Good morning, everybody, and thank you for that call. Let me address it in the following way now. It’s a long question, and it’s a long response. First of all, on Mexico, no? Mexico is off to a solid start for the year, you know, in line with our expectations and the part of everything we’ve done in 2025. I see January and February 2026 versus 2025 metrics you know improved in various different lines. I mean, surgeries are up in single-digit growth. Hemodynamics are up double-digit growth. Of course in oncology, radiotherapy, and chemotherapy, you know, in the double- to triple-digit growth, you know.

Of course, extremely high in comparison to last year because we did not have Opción Oncología, no?

No, we see occupancy, utilization in Mexico, you know, also trending up. I see it in February reaching 41%. Overall results in Mexico, revenues, are up in high single digits versus the same last period. Of course, ISSSTE León is just kicking up its volume. I’m excited about this. Now with respect to margin, and I’ll get the guidance, but with respect to margin, as you did also comment on that. Mexico’s EBITDA margin reflects mix of services and specialties that I’m referring to 2025.

As we see, 2026, with the expansion of ISSSTE Nuevo León, with the preferred provider status now, you know, and with all our cost containment strategies that we’ve mentioned as well in the earnings release, you know, we see higher volumes and margin gains in 2026. You know, of course, as mentioned before, we see interesting and very promising growth in oncology and, of course, those are businesses that we have cost containment. And then with respect to guidance, to finish another question. You know, first of all, in terms of what could prevent or delay our achievement guidance. You know, I think last year we didn’t feel comfortable because there were many externalities, you know.

That’s why we didn’t provide guidance. The political headwinds in Colombia, the issues we had in Mexico as well. You know, today, given all the plans and all the way we’ve fronted these challenges and made them into opportunities, I think we’re very confident in the stability of the business and the outlook, and we feel very comfortable with the guidance. You know, the main variables remain, of course, the pace of volume recovery in Mexico. We see that growing, as I mentioned before. The macroeconomic conditions in operating markets definitely, but we see Mexico pretty stable in that front. You know, and of course certain dynamics affecting payers that I think might even benefit us, you know.

I think with Peru continuing to perform strongly, Mexico way on its way to recovery, you know, I’m very confident that guidance is achievable. I don’t know, Gisse, would you want to comment anything on this more open-ended question?

Gisele Remy, Chief Financial Officer and Executive Vice President, Auna: Sure, Suso. Thank you. Thank you for the question. Perhaps what I would complement there is, you know, kind of what’s that mix behind the guidance, from a country perspective and what are we expecting from margins is that, I think, you know, normally when we set out our growth targets, it’s very well-balanced across the three geographies. We are expecting solid growth from all three geographies off the back of all of the strategic initiatives that we mentioned in the call. In the case of margins, specifically when we talk about Mexico, as we noted in the call, the fourth quarter impacts had an impact on the fourth quarter margin.

We will see that margin recovering in the case of Mexico going into the first quarter of 2026 and the rest of the year, you know, from that fourth quarter level, right? We will see both a mix of EBITDA growth across the three geographies, as well as all the strategic initiatives that we’re taking in the case of Mexico also to contain costs and to finally increase volumes, which obviously will have a favorable impact on margins as well.

Jesús Zamora, Executive Chairman and President, Auna: I think just to finalize, we’re not giving guidance by country. You know, at a certain moment we might consider that definitely. But right now, just directionally, as I project the company five years out, I think Mexico and Peru will be the motors of the company. You know, Colombia will be diminished because of the growth of Mexico and Peru. Now it’s a critical part of our strategy, Colombia, but because of the scale, the cost efficiencies it has that we take to the other two countries. But the growth opportunities in Mexico and in Peru as well, you know, continue to be the most important sources for growth in the next five years. Thank you.

Arthur Als, Analyst, Morgan Stanley: That’s very clear. Thank you.

Operator: Hello, everyone. If you’d like to ask a question, please press star followed by one on your telephone keypad. That’s star followed by one on your telephone keypad. We will pause for a brief moment to wait for the questions to come in. Your next question comes from the line of Giovanni Vescovi of JP Morgan. Your line is now open.

Giovanni Vescovi, Analyst, JP Morgan: Hello, team. Can you hear me?

Jesús Zamora, Executive Chairman and President, Auna: Yes, perfectly.

Giovanni Vescovi, Analyst, JP Morgan: Okay, perfect. Thank you for taking my question. Suso, Giselle, and Lorenzo. My question regards to Torre Trecca, which I have seen some updates recently, but I wanted to know, more color and more details in terms of margins, revenue contribution, and if the company already has, like, a set date for the opening of the project, maybe third quarter, fourth quarter of 2028, if I’m not mistaken. And, just for a recap on the ISSSTE León, price increase, you guys are expecting the double-digit price increase for 2026. Is this correct? That’s it. Thank you.

Jesús Zamora, Executive Chairman and President, Auna: Thank you very much. Thank you very much, Giovanni. Going with the last question first, yes, it is for all of 2026. It’s a much better award than we’ve had in the past. It allows us to control also prescription and devices. I think qualitatively and quantitatively, it’s a much improved contract. I think, we’re gonna deliver great service to them, and we’re gonna also have attractive margins from a large contract, the largest contract you can get, with respect to a counterparty like the state in the state of Nuevo León. Yes, it is for all of 2026. And then with respect to Torre Trecca.

This has to be viewed as a very attractive opportunity for Auna, you know. I wanna step back and make sure the investor community understands, you know. Auna is a healthcare play that has been very successful in B2B relationships with the insurance company, of course, large collective employers or groups, you know. In Peru, particularly with B2C. The biggest market, you know, when you project out the next 10 years, is the B2G segment. State being the large payer for certain services. You have that everywhere in the world, and you have it as a very attractive segment in Peru and particularly in Mexico as well.

This contract is also foundational for our development for the B2G segment. Torre Trecca, we don’t wanna call it Torre Trecca anymore. We wanna call it Ambulatory Center Trecca, you know. It is an ambulatory center that will deliver 3 million services, you know, for the EsSalud population. EsSalud is Peru’s social security system, you know. It is an ambulatory center that’s very focused on few services, those that EsSalud has limitations to provide, you know. With a very well-known and very stable system of payments through EsSalud, you know, which are the issuance of some certificates, you know, for the operation every month and for the construction, you know.

As we make progress, EsSalud will issue the certificates. They’re easily discountable in the market. There’s an implicit risk of the public approval. So there’s no risk of payment. It’s a system of public-private, private-public partnerships that works in Peru and has been proven for the last, I think, over 10 years. So there’s no risk in payment. The contract is very solid and very focused, as I said, in very few services, six services, six clinical services, scaled, you know. This will commence operation in the second semester of 2028, you know. I can’t give numbers.

I think right now what we see is that Centro Médico Torre Trecca will represent, you know, something like 25% of our business in Peru, you know, at maturity. You know, it is a significant business. More importantly, qualitatively, it is a segment in which we have not been there. People sometimes talk to me about, you know, the private sector in healthcare in Peru and the size of it, and it is growing, but it is not growing as fast as the other segments, you know. This is a substantial new opportunity for Auna on a major scale, you know, serving the principal payer in Peru. It is a very important opportunity for Auna, no doubt.

I don’t know, Gise, if you wanna add anything, if I forgot any parts of the question.

Gisele Remy, Chief Financial Officer and Executive Vice President, Auna: No, Suso, I think it’s very clear. I would just reinforce the point for the audience’s benefit that the construction expenditures are reimbursed through progress certificates.

Yeah.

paid by EsSalud, which significantly reduces any capital risk that Auna is exposed to. It’s fully funded.

Jesús Zamora, Executive Chairman and President, Auna: We’re not the first public-private partnership in Peru that has this system. This is something we’re taking on that works and has been working, as I indicated before, for years in Peru. Thank you.

Giovanni Vescovi, Analyst, JP Morgan: Perfect. Thank you very much.

Operator: Thank you. There are no more questions from the phone lines, so I will now turn the call over to Ana Maria Mora from Auna, who will proceed with questions from the webcast platform.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, operator. Good morning, everyone. Let me begin with the questions from the webcast. Some of them have already been answered. I would still like to acknowledge them. In case Giselle and Suso would like to mention something else regarding the questions, the answers, please go ahead. Otherwise, I can move on. The first one is from Joaquin Riesgo, and his question is: Can you guys please detail more into the Torre Trecca project, financing, operating? What is your view there? The second one is related to Trecca as well. Comes from Julio Lam. He is a graduate from Universidad de Piura. Thanks for the presentation. I have a question related if you have expected CapEx that you will invest in Torre Trecca this year and the next one.

If it exists, is it possible to watch it?

Jesús Zamora, Executive Chairman and President, Auna: Maybe just quickly to reiterate, given that there are two questions. Now, again, Centro Ambulatorio Trecca, it’s structured under a concession framework. Predictable revenues. You know, supported by minimum guaranteed payments from EsSalud. You know, as Giselle said, the construction expenditures, they’re all reimbursed by these progress certificates she mentioned. You know, this reduces capital risk, you know. This is very much related to the large unmet demand for outpatient services in Lima. We’re taking a huge chunk of these unmet demand for outpatient services in Lima, you know. In a very de-risked way, you know. Of course, as we make progress, we’d be happy to share milestones that we’re reaching. With respect to. If it exists, is it possible to watch it?

I mean, of course, it’s a tower that exists already. It hasn’t been finished, and we will be refurbishing and finishing it. Yes, of course. We’ll make sure that we post some photographs and some images of the inside and outside of what as we progress, and maybe some virtual tours as well. Let’s jot that one down, Annie, please. Thank you.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, Suso. The next question would come from Christian Tessy. What is the expected CapEx for 2026 and for 2027 and 2028? I recall you have mentioned an expansion of the business. What would be the expected CapEx there?

Gisele Remy, Chief Financial Officer and Executive Vice President, Auna: Thank you, Annie. To give you a little bit more color on CapEx, as Suso already mentioned, our guidance for the year is approximately 4% of revenue, very much in line with what we’ve seen in previous years. That CapEx will be allocated to maintenance investments, both across medical equipment as well as infrastructure. It also includes our technology investments as we continue with systems implementations across Mexico as well as Colombia, and the rest of our recurring CapEx investments. We’re not giving any specific guidance further on into 2027 or 2028, but as was mentioned in the question, we should expect investment for the expansion of our Lima network to begin in 2027.

We will give the market more information into that as the year progresses.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, Giselle.

Jesús Zamora, Executive Chairman and President, Auna: Maybe, Annie, important point with respect to Giselle’s last comment. So Lima is reaching high levels of occupancy, you know. As we continue with that, we see ourselves considering certain options to expand urban ecosystem healthcare in Lima in 2027 and 2028. Thank you.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, Suso. The next question comes from Christian Tessy. When do you expect to happen that Mexico total occupancy rate reach 40%?

Jesús Zamora, Executive Chairman and President, Auna: Yeah. Thank you very much for that question. As I mentioned, in a previous answer, I believe we’re already at 41%. I’ve seen certain days, especially in Doctors Hospital, our main higher complexity facility in Monterrey, at much higher rates of that. Again, I’m optimistic. We are already above 40%. We’re at 41%, and we continue to see some potential for growing that, of course, during the whole year.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, Suso. The next question comes from Gerard Ford. Hi. Regarding Colombia, what conditions are required for provisions to be reversed? Could this materialize beginning in first half of 2026?

Gisele Remy, Chief Financial Officer and Executive Vice President, Auna: Thank you, Gerard, for the question. As we’ve previously mentioned to the market, our provisions are based on an expected loss model, and that is the case for all three of the geographies. Specifically in the case of Colombia, within that expected loss model, there is a separate methodology for the intervened entities. We continue to provision according to the expected loss model. We think that even though this does not reflect a view that we will not be able to collect on those accounts, it does permit us to de-risk the balance sheet and de-risk future results. We do not expect to have any reversions in impairments of accounts receivable in the first half of 2026.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, Gise. The next question comes from Alexandre Loiseau. Also I’m gonna bundle that with the question from Demo Tarrago. This relates to the Sojitz MOU. Can you provide any update on the Sojitz MOU?

Jesús Zamora, Executive Chairman and President, Auna: Great. Well, we actually had a meeting in the last few weeks in Mexico and elsewhere with Sojitz on various alternatives. I think we’re not ready to inform anything to the market, but I think we’re getting traction there. I do think that we need to focus in the future, as we have in the past, to grow inorganically. Sojitz is offering an attractive, you know, potential, you know, capital increase that will sustain our growth in Mexico in particular. We’ll bring that back, but it is related to Mexico and how to allocate more dollars to Mexico and grow Mexico.

Once we have it a little more built and defined with Sojitz, we’ll definitely bring it back to the investor community. That would be Demo Tarrago’s question on Sojitz. I don’t know, Gise. I think that’s the situation there. Anything else?

Gisele Remy, Chief Financial Officer and Executive Vice President, Auna: Correct. No, nothing to add on my end.

Jesús Zamora, Executive Chairman and President, Auna: Okay.

Ana Maria Mora, Head of Investor Relations, Auna: Okay. Thank you.

Jesús Zamora, Executive Chairman and President, Auna: Thank you, Demo.

Ana Maria Mora, Head of Investor Relations, Auna: Moving along. The next question comes from Antonio Cardoso, and it relates to our debt. What’s the all-in cost debt after the refinancing?

Gisele Remy, Chief Financial Officer and Executive Vice President, Auna: Thank you for that question. First of all, it’s important to note that, we, you know, after the refinancing exercise, which we executed in last year, we increased the proportion of direct local currency funding, which now leaves us, as was mentioned during the call, with 56% of our total debt in direct local currency funding. The remaining 44% of the debt is in U.S. dollar denominated debt. However, that U.S. dollar denominated debt is 85% hedged to the Peruvian sol via derivatives. As you will recall, our all-in rate, which again, obviously reflects, a mix of currencies and where those rates are in each one of the three geographies. Our blended rate in 2025 was closer to approximately 12.5% with the old debt structure.

As a product of the refinancing, and now also including the new derivatives, which have been put in place to hedge the new debt structure, that rate has dropped over 100 basis points. That’s from a blended perspective, including all of our debt, both short and long term.

Jesús Zamora, Executive Chairman and President, Auna: Thank you, Gise.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, Gise. The next question comes from Facundo Turconi, and it’s also related to cash flow. Facundo Turconi says, "Congratulations on the strong 2025 finish. Now that the company has officially reached a positive free cash flow inflection point and is guiding for $45 million in free cash flow for 2026, how is the board prioritizing capital allocation? Specifically, given that the stock is trading significantly below its book value, is there any internal discussion regarding a share buyback program once the leverage ratio hits the 3x target?

Jesús Zamora, Executive Chairman and President, Auna: That’s a good question, Facundo, and thank you for that. I don’t have a precise answer, but at the board, we’ve been discussing, you know, the best use of our capital in the different alternative allocations that we have. I think it’s important to note that I think we mentioned in the earnings release, we’ve had the stock has underperformed dramatically, we believe, because of the selling pressure from a very large shareholder that now is officially no longer a shareholder, has sold all their position.

You know, we believe that the share, given that there’s no, you know, significant selling pressure from anybody, I think the stock will trade much better and closer to its book value, certainly, you know. To be clear, the board has discussed, has analyzed, you know, share buyback programs. We think that given that this selling pressure has been solved, I’m not certain it would be a high priority. I think a higher priority would be to use the balance sheet once it’s below three to continue to grow at, you know, the rates that we’ve grown in the past, particularly in Mexico. In Mexico, we have a very rich pipeline of growth opportunities, high complexity, higher margin opportunities.

That’s where we need to put the money to produce, I believe, more appreciation in the stock price. Would you like to, Gise, complement my response?

Gisele Remy, Chief Financial Officer and Executive Vice President, Auna: Yeah. Just to complement Suso on the first part of the question with reference to free cash flow and what our expectations are. While we have not specifically given any guidance related to free cash flow, as Suso already mentioned, we’ve given strong guidance with reference to revenues and EBITDA growth, which will obviously have a direct impact in free cash flow generation in 2026. Additional to this, as we continue our disciplined working capital management, as well as I already mentioned, around the CapEx numbers, which in 2026 will continue to be close to historical levels and limited to maintenance and IT investments. We expect to see growth in free cash flow also in line with what we’re guiding for revenues and EBITDA.

Given that, as I already mentioned, we’ve materially reduced interest expense, this does generate a virtuous cycle as far as deleveraging. I do wanna emphasize the point that the company already showed in 2025 that we were able to generate cash flow after interest payments, and this will only grow going into 2026, permitting us to continue to delever and get closer to that 3x net debt to EBITDA target.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, Gise.

Jesús Zamora, Executive Chairman and President, Auna: Thank you, Gisele.

Ana Maria Mora, Head of Investor Relations, Auna: Okay. The next question comes from Joaquin Berro. Hello. Thank you for this question. How are you planning the ramp-up in occupancy in Mexico and the margins to come back up to 30%? What is the normalized level of occupancy you’re looking for in 2026? Thank you.

Jesús Zamora, Executive Chairman and President, Auna: Okay. Thank you, Joaquin. These two levers of occupancy and margins, we manage particularly through mix, higher complexity mix. You know? Of course, one can fill a hospital much faster, but with much lower margins. We’re very careful with that. To fill a hospital and to maintain higher margins means to have a higher mix or higher complexity, and that’s how we plan to manage the ramp-up of occupancy in Mexico and, of course, the recovery of the margins. I think very importantly, I do wanna say, volume and volume growth is a foundation in which everything else comes, even higher complexity and margins, of course. You know?

Being in these much larger healthcare plans throughout Monterrey gives us a huge improvement in the total addressable market, you know, with respect to the private policies. You know? That will produce volume growth. You know? Then the mix will produce the margin recovery. We have a very clear plan for 2026 to recover at least a couple of points of the margin contraction that we’ve implemented to make sure that we have a growing volume of all our services and treatments in our hospital network. I don’t think we’re giving guidance on the occupancy level, Gise. I definitely think that 40%-41% that we have today is a really good base.

We’re gonna be growing that. We’re definitely gonna be growing that. I don’t know. Gisele, should we comment on the occupancy in Mexico?

Gisele Remy, Chief Financial Officer and Executive Vice President, Auna: I would simply add, Suso, both from an occupancy as well as a margin perspective, I would like to remind the market, as Suso already said, that we have successfully been awarded the extension for the ISSSTELEON Healthcare Plan with very improved economics.

Unknown Speaker, Unknown: It’s 6:00.

Gisele Remy, Chief Financial Officer and Executive Vice President, Auna: We are starting the year with preferred provider status with two major insurers. Cost containment strategies have been an integral part of the discussion with payers to secure the preferred provider status, and this will have a direct impact on the increase of volumes in 2026, as well as margin gains. Finally, as Suso already mentioned, in the first two months of 2026, we have continued to see growth across several services. Utilization normalizing as well as the cost base stabilizing, so therefore, we expect to gradually recover during 2026.

Jesús Zamora, Executive Chairman and President, Auna: Great.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, Jesús. The next question comes from Constanza Urmeneta. Could you please detail how ISSSTE hurt your performance in Mexico in the Q4, and how this planned expansion will be an improvement for 2026?

Jesús Zamora, Executive Chairman and President, Auna: Great. Thank you, Constanza. Basically the improvement on the award of the ISSSTE contract for 2026 is related to, first of all, we increased prices 30%. We included the agreement that we control the pharma and the device and prescription. That’s critical for cost containment and of course, for the increases in prices for margin, for better margins, no? The end of the quarter on this award, on the previous award of 2025, was mainly affected by higher complexity, you know, volume in that award, you know, that of course reduced the margins, but at a set price that was set in 2025. Of course, it reduced the margins.

I think the 30% more than covers, you know, a very healthy margin for us with a large indirect insurer, you know. We’re very excited about what has occurred and our relationship with ISSSTE Noroeste is every day much more intimate and much more and the NPS we’re getting from the beneficiaries of ISSSTE Noroeste is very positive. I think that’s gonna be a growing contract in the future, a growing award in the future.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, Suso. We only have time for one or two more questions. I realize the time is up. The next question comes from Joaquin Berro. I’ve noticed high impairment losses on trade receivables, not only in Colombia but in Peru. Can you give us more color on this? Thank you.

Gisele Remy, Chief Financial Officer and Executive Vice President, Auna: Yes. Thank you for the question, Joaquin. I think we talked a little bit about the impairment losses in Colombia in the previous question. I’ll address the ones in Peru. The first thing I’d like to highlight is that it’s very important to note that accounts receivable days in Peru have improved in the third and fourth quarter of 2025, and we expect to continue on that trend during 2026 as a product of several process and systems initiatives which we are rolling out specifically in the accounts receivable cycle. The higher impairment in the case of Peru in 2025 is more related to specific conciliations with some payers from previous years, right?

Related to services, around, you know, 2024, where we have, you know, had some specific negotiations related to those specific services, especially as a product of, you know, technology changes that have occurred in the insurance companies as well as on our end, which led to a lag in recovering those accounts. That’s what impacted the impairment impact in Peru, specifically in 2025. It’s a much more isolated effect, and we will be basically working on those reconciliation impacts during the quarters of 2026. We should not expect to see impairment increase versus the 2020-2025 levels.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, Jesús. I do think we have time for one more question. This question comes from Cesar Piedra. Peru continues to be the main growth driver for the group. How much of that performance do you see as a structural versus temporary, whether for pricing mix, ramp-up effects or unusually favorable conditions?

Jesús Zamora, Executive Chairman and President, Auna: I feel very comfortable in representing that Peru is a very solid and consistent part of Auna, you know? And very predictable for us. It’s difficult for me to put Peru’s performance as temporary or any unusual considerations. I think Peru works pretty much like clockwork, you know. With the models very mature, with brands and the medical staff is very well known, you know. Our integrated insurance business we manage for an MLR, you know. And again, that produces a lot of predictability. No, besides some upside from Trecca and some other things in the future, I think it’s a very stable operation with very few risk for surprises of any sort.

Ana Maria Mora, Head of Investor Relations, Auna: Thank you, Suso. This was our time for the questions, and now I will leave it to you for your closing remarks.

Jesús Zamora, Executive Chairman and President, Auna: Well, thank you very much, everybody. We know it’s been a difficult year in 2021, 2025 for Auna. We’ve done the work. It’s been a year of introspection. It’s been a year of a lot of internal work. We have built the foundations for continued and recovered growth for 2026 and onwards. I wanna thank the investing community for supporting us and our mandate to transform healthcare in Latin America. Thank you again.

Operator: This concludes today’s conference call. You may now disconnect. Goodbye.