Rating Rationale
September 27, 2019 | Mumbai
Metropolis Healthcare Limited
Rating Reaffirmed
 
Rating Action
Total Bank Loan Facilities Rated Rs.150 Crore
Long Term Rating CRISIL AA-/Stable (Reaffirmed)
 
Rs.250 Crore Non Convertible Debentures CRISIL AA-/Stable (Reaffirmed)
1 crore = 10 million
Refer to annexure for Details of Instruments & Bank Facilities
Detailed Rationale

CRISIL has reaffirmed its 'CRISIL AA-/Stable' rating to the non-convertible debentures and proposed long-term loan facility of Metropolis Healthcare Limited (MHL; part of the Metropolis group).

The rating continues to reflect MHL's leading position in the Indian diagnostic services market, supported by an established brand and strong reach, and healthy operating efficiency, driven by robust cash flow generation and low working capital requirement. The rating also factors in a strong financial risk profile because of a robust capital structure and comfortable liquidity, and the proven track-record of the promoters. These strengths are partially offset by exposure to risks related to high, albeit reducing, revenue contribution from the business-to-business (B2B) segment, market fragmentation, and moderate entry barriers in the diagnostics industry.

Operating income grew by about 18% and 16% in fiscal 2019 and the first quarter of fiscal 2020, respectively, led by expansion of patient service centres (PSCs) leading to increase in number of patients serviced. In fiscal 2019, number of patients serviced grew 16% to 89 lakh from 77 lakh, a year earlier. The revenue per patient remained high at Rs 854 in fiscal 2019 (Rs 836 in fiscal 2017). The share of B2B has declined to 57% in fiscal 2019 from 64%. Revenue growth is expected to be sustained over the medium term with expansion of PSCs and number of patients serviced. The operating margin was 27% in the first quarter of fiscal 2020 (24% if adjusted for IND-AS (Indian Accounting Standards) lease impact)) and is expected to remain at similar levels. Debt protection metrics are expected to remain healthy, given negligible debt as on March 31, 2019.

Analytical Approach

* For arriving at the ratings, CRISIL has combined the business and financial risk profiles of MHL and its 15 subsidiaries (collectively referred to as Metropolis group) as all these entities are in the same line of business, have strong operational and financial linkages, and are under a common management. The subsidiaries have been acquired over the years as part of MHL's strategic inorganic expansion.
* In its analytical approach, CRISIL has amortised goodwill arising from mergers/on consolidation has been amortised over a period of 10 years, given the strong local brand of the acquired entities and expectation of returns being spread over a longer tenure.

Please refer Annexure - List of entities consolidated, which captures the list of entities considered and their analytical treatment of consolidation.

Key Rating Drivers & Detailed Description
Strengths:
* Established position in the Indian diagnostic services market with a strong brand and reach: The Metropolis group is among the top three diagnostic chains in India with revenue of Rs 760 crore in fiscal 2019 and a large, established pan-India network of about 119 pathology labs and 2,536 service centres.
 
* Healthy operating efficiency driven by low working capital requirement: International and national laboratory accreditations, servicing customers through a hub-and-spoke model, strong quality controls, and continuous process improvement through an in-house research and development set-up, contribute to healthy operating efficiency. Further, working capital requirement is low as reflected in a receivables cycle of under two months and minimal inventory. This has resulted in a strong operating margin and return on capital employed of 27% and 44%, respectively, for fiscal 2019.
 
* Strong financial risk profile: The adjusted networth was moderate at Rs 394 crore as on March 31, 2019, and debt protection metrics healthy, backed by substantial cash accrual and negligible debt. Liquidity is comfortable because of unencumbered cash and equivalents of about Rs 90 crore as on March 31, 2019
 
* Proven track-record of the promoters: The founder, Dr Sushil Shah, is a pathologist and has industry experience of over three decades. His daughter, Ms Ameera Shah, has played a key role in driving growth through a prudent mix of organic and inorganic expansion, while availing minimal debt for funding acquisitions.
 
Weaknesses:
* High, albeit reducing, revenue contribution from the B2B segment: B2B segment has contributed to majority of the revenue over the last three years, resulting in a longer receivables cycle. Debtors greater than six months as on March 31, 2019, were around 10% of revenue for fiscal 2019.
 
* Exposures to risks related to market fragmentation and moderate entry barriers: The diagnostics industry has modest entry barriers on account of average capital intensity, resulting in the emergence of a large number of diagnostic centres. This has led to high fragmentation with large diagnostic chains facing intense competition from hospital-based and standalone centres, which together comprise a dominant share (about 85%) of the industry.
 
Liquidity: Strong
Liquidity is strong. In the absence of repayment obligations, cash accrual, expected at Rs 70 crore annually over the medium term, should cover capital expenditure of Rs 20 crore per annum. Unencumbered cash and cash equivalents were Rs 90 crore as on March 31, 2019. However, any large acquisition will remain a rating sensitivity factor.
Outlook: Stable

CRISIL believes the Metropolis group will, over the medium term, maintain its leading market position in the healthcare services industry, supported by its established brand name and widespread network, and sustain the strong financial risk profile backed by healthy cash accrual.

Rating sensitivity factors
Upward factors
* Higher-than-expected revenue growth of 15% over the medium term, while maintaining healthy operating profitability of 26-27%
* Improvement in revenue mix
* Sustenance of healthy financial risk profile 

Downward factors
* Decline in operating margin to below 22% 
* Large, debt-funded acquisition, capital expenditure, leading to deterioration in key credit metrics
* Higher-than-expected dividend outflow

About the Group

MHL, the flagship company of the Metropolis group, was founded in 1981 by Dr Sushil Shah as a sole proprietorship under the name Dr Sushil Shah's Pathology Laboratory. The firm was reconstituted as a public limited company with the current name in 2001. Ms Ameera Shah is the present managing director. The company provides diagnostic services and operates a chain of centres overseas.

 In April 2019, the company was listed to provide partial exit to CA Lotus Investments (Carlyle), which held 31.54%. As on June 30, 2019, promoters held 57.4%, Carlyle 14.31%, foreign portfolio investors 15.99% and the rest by others.

The company provides diagnostic services and operates a chain of diagnostic centres in India and also has presence eight overseas including Sri Lanka, Ghana, UAE, Kenya, Mauritius (overseas 16% of revenues). The company offers around 3,500 clinical laboratory tests and 530 profiles. As on March 31, 2019, it had a global reference lab in Mumbai, 119 laboratories (13 regional labs) and 2536 service centres. The reference lab is accredited by College of American Pathologists (CAP) and National Accreditation Board for Testing and Calibration Laboratories (NABL).

For the first three months of fiscal 2020, the company registered operating income and profit after tax of Rs 203 crore and Rs 27 crore, respectively as against Rs 176 crore and Rs 27 crore, respectively, for the corresponding period of the previous year.

Key Financial Indicators
Particulars Unit 2019 2018
Revenue Rs crore 760 644
Adjusted Profit after tax* Rs crore 116 104
Adjusted PAT margin* % 15.2 16.1
Adjusted debt/Adjusted networth Times 0.00 0.00
Adjusted interest coverage Times 55.88 76.40
*Adjusted for goodwill amortisation in line with CRISIL's analytical approach

Any other information: Not applicable

Note on complexity levels of the rated instrument:
CRISIL complexity levels are assigned to various types of financial instruments. The CRISIL complexity levels are available on www.crisil.com/complexity-levels. Users are advised to refer to the CRISIL complexity levels for instruments that they consider for investment. Users may also call the Customer Service Helpdesk with queries on specific instruments.
Annexure - Details of Instrument(s)
ISIN Name of Instrument Date of
allotment
Coupon
rate (%)
Maturity
date
Issue size
(Rs crore)
Rating assigned
with outlook
NA Non-Convertible Debentures* NA NA NA 250 CRISIL AA-/Stable
NA Proposed Long Term
Bank Loan Facility
NA NA NA 150 CRISIL AA-/Stable
*Not yet placed
 
Annexure - List of entities consolidated
Sr.No Name of the subsidiary Nature of relationship
1 Sudharma Metropolis Health Services Private Limited Subsidiary
2 Bokil Golwilkar Metropolis Healthcare Private Limited Subsidiary
3 Raj Metropolis Healthcare Private Limited Subsidiary
4 Desai Metropolis Health Services Private Limited Subsidiary
5 R.V. Metropolis Diagnostics & Healthcare Centre Private Limited Subsidiary
6 Micron Metropolis Healthcare Private Limited Subsidiary
7 Dr. Patel Metropolis Healthcare Private Limited Subsidiary
8 Lab One Metropolis Healthcare Services Private Limited Subsidiary
9 Amins Pathology Laboratory Private Limited Subsidiary
10 Ekopath Metropolis Lab Services Private Limited Subsidiary
11 Metropolis Healthcare (Mauritius) Limited Subsidiary
12 Metropolis Star Lab Kenya Limited Subsidiary
13 Metropolis Healthcare Ghana Limited Subsidiary
14 Metropolis Healthcare Lanka Private Limited Subsidiary
15 Metropolis Bramser Lab Services (Mtius) Limited Subsidiary
Annexure - Rating History for last 3 Years
  Current 2019 (History) 2018  2017  2016  Start of 2016
Instrument Type Outstanding Amount Rating Date Rating Date Rating Date Rating Date Rating Rating
Non Convertible Debentures  LT  0.00
27-09-19 
CRISIL AA-/Stable      28-09-18  CRISIL AA-/Stable  26-09-17  CRISIL AA-/Stable    --  -- 
Fund-based Bank Facilities  LT/ST  150.00  CRISIL AA-/Stable      28-09-18  CRISIL AA-/Stable  26-09-17  CRISIL AA-/Stable    --  -- 
All amounts are in Rs.Cr.
Annexure - Details of various bank facilities
Current facilities Previous facilities
Facility Amount (Rs.Crore) Rating Facility Amount (Rs.Crore) Rating
Proposed Long Term Bank Loan Facility 150 CRISIL AA-/Stable Proposed Long Term Bank Loan Facility 150 CRISIL AA-/Stable
Total 150 -- Total 150 --
Links to related criteria
CRISILs Bank Loan Ratings - process, scale and default recognition
Rating criteria for manufaturing and service sector companies
CRISILs Criteria for Consolidation

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