Inventurus Knowledge Solutions Limited (IKS) Q4 2026 Earnings Call Transcript

Ladies and gentlemen, good day, and welcome to the ICES-HELP Q4FI26 Earnings Conference Call hosted by ICSA Securities. As a reminder, all participant lines will be in the listen-only mode, and there will be an opportunity for you to ask questions after the presentation concludes. Should you need assistance during this conference call, please signal an operator by pressing star then zero on your touchstone phone. Please note that this conference is being recorded. I now hand the conference over to Ms. Seema Nayib from ICC Securities. Thank you and over to you, ma'am.

Good morning, ladies and gentlemen. Thank you for joining us today on Q4FI26 Earnings Call of IKS Health. On behalf of ICSA Securities, I would like to thank the management of IKS Health for giving us the opportunity to host this call. Today we have with us Mr. Sachin Gupta, Founder and CEO, Ms. Nitya Balakubramanian, CFO, and Mr. Saransh Mudra, Head of Investor Relations. I turn it over to Mr. Saransh for his brief statement and to take the proceedings forward. Thank you, and over to you, Saranj.

Thank you, Seema. Good morning to everyone on the call. Welcome to our earnings call for the fourth quarter and it ended 31st of March, 2026. I'm Saransh Munda, VP Finance. We hope you've had an opportunity to review the earnings release and the investor's presentation that we issued. Before I hand over to Sachin Nathya, let me begin with the safe harbor statement. As part of our prepared remarks and during Q&A, we may make certain statements which are forward-looking and involve significant uncertainty. IKS doesn't take any responsibility to update such forward-looking statements and your discretion is warranted while making any investment decisions. Over to you, Sachin.

Thank you, Saranj. Good morning and good evening, everyone, depending on where you're joining from. It is my pleasure to join you all today to talk about our performance for Q4 fiscal 26 and the full year ending in December 31st, 2026. I think this is our sixth earnings call since we were in public in December 2024. So excited to be with you all today. We'll start off with a quick recap, obviously, of the overall business. And the business model. Talk about some of the key strategic drivers for success in our business and give you a little update on how those are failing. And then talk a little bit specifically about how we are leveraging AI most effectively to actually make it a differentiated mode in the business as we continue to grow. And then dive into, obviously, our financial performance for Q4, as well as for fiscal 2026. And we then invite Nitya to make some remarks, additional remarks on our financial performance, and we will then turn it over for questions and discussion. So with that, obviously, as you know, I guess it's in the business of delegating chore tasks. Four healthcare providers in the US. It's probably the largest industry in the world at 5 trillion plus. And it creates a very large TAM of north of $260 billion for that U.S. healthcare is spending on all of these tasks that can be delegated or outsourced by our platform. Of that $260 billion TAM, as you might recall, the outsourced TAM today is about $35 billion. And the overall TAM of $260 billion is growing at about 8%. And the outsourced TAM is going faster than the overall TAM at about 12%. And so just to recap, any time IKS grows or a year on your basis for any period faster than 12%, we're gaining market share. Of course, we don't want to be in a situation where we're not growing faster than 12% because that would mean losing market share. But in general, that's sort of a good marker to keep in mind. Today, ITF has a little north of 600 clients, or client organizations, if you will, which are provider organizations. You might recall, same time last year, that number was 700 plus, and maybe a couple of years ago, when we acquired Acuity, that number was closer to 900. As we've always maintained, we have been cutting down the tail of small clients that we had inherited through Acuity because our business in our traditional model works best when we're servicing large clients. And so the number of 600-odd reflects the pairing that has happened over the last year. And as I've always stated, we feel like we'll eventually end up at some number between 500 and 600. So we're more or less close to done on some of that tail-cutting that we had embarked on as we acquired Acuity. Excitingly, 90% of our revenues come from midweek customers, and we have a very healthy vintage of our top 10 and top 5 customers on an average being 5 plus years. Our headcount has a March 21st or 26th. It's 13,331 people, of which 1,981 are clinically trained staff. Just so that people know, that headcount, as of March 21st, 2025 was actually a bit higher. Sorry, a bit lower, but it was about 5.3% lower at 12,661. So our headcount has grown over this period from 12,661 to 13,331, which is about a 5% growth in headcount, which obviously reflects the non-linearity of our business model because our revenue growth is significantly higher in the headcount growth. We should cover in our Q4 financials in a bit more detail. Of our 13,331 people, the fastest growing component of our workforce is actually our technology workforce of now 550 employees that is focused on building all of our proprietary technology that enables our platform. And a large part of that workforce now tends to be the AI

engineering workforce in addition to the data science workforce.

And then we've also constantly been growing our sales and marketing endeavors and our investments there. And our sales and marketing has come, now stands at 66 FTEs and growing. Good morning, everyone. Just to take a quick recap so that we all understand the competitive landscape, when you have such a large TAM of $260 billion and the outsourced TAM of $25 billion, growing at 1%, you naturally expect a significant amount of competition in the ecosystem. Just to recap and calibrate on our language, there are generally three broad genres of competition that are competing for this TAM. Those three broad genres are first what I call system of record companies, which are nothing but electronic health record vendors that were created back in the early 2000s, as the US government gave money to providers to roll out these electronic health record systems that one, store all of the patient data for the care that is being provided by these caregiving organizations, And two, they have some workflows as it relates to the patient's journey with the caregiving organization. So, call them the core operating system of healthcare providers. Those are the electronic health records. Now, what these electronic health records did when they were ruled out was, in addition to becoming patient data stores, unfortunately, unintended consequence, they made these healthcare providers and the administrators of these healthcare provider organizations almost data entry operators, right? So, they ended up having to start spending a lot of their time. Entering data and maintaining data in the electronic health record versus spending their time managing patients. And that, in addition to that, and a number of regulatory challenges in U.S. healthcare, given how regulated it is, it created a whole bunch of tasks, which we call chore tasks, that the providers are getting distracted with and their administrators are getting distracted with. And so in order to do those chore tasks efficiently, And not get the providers distracted by those chore tasks. That creates the need for what we call systems of action. That would take all these chore tasks and free the providers and their administrators up from those tasks. We call those systems of action that can do that. And in the system of action category, there are two types. There are point solution systems of interaction, which essentially solve for one or two or three of these tasks. Because the individual tab of each of these tasks is so large when the total tab is $260 billion, right? So I call them point solution systems of action. And then there are very few rare organizations that are drinking from the Kool-Aid of the pieces that eventually... Large provider organizations can't be in this point solution hell of buying multiple point solutions, integrating them themselves, and so eventually this market will gravitate more and more towards what I call platform systems of action, which is what really is, where we have a comprehensive platform that takes all of these tasks at once, and when you do that, actually, one, we're able to take accountability for the outcomes for these tasks. You know, the provider organizations have one entity to hold accountable for the cost and quality outcomes for these tasks and revenue outcomes for these tasks. And then second, the value of these tasks done together by one platform compounds because all of these tasks are interconnected in nature. The acquisition of two greats. TrueBridge and our massive opportunity in the rural healthcare market will become another important pillar of execution, which will then have actually some cross-leverage in our core large physician group market as well. But for now, let's focus on these five pillars. The first one is, remember when we started building our platform system of action 18, 19 years ago? It was a human-led? Tech-in-the-loop kind of endeavor, because at that time, technology was not advanced enough, and healthcare was too fragmented, and there were no standardization of workflows for technology to truly be able to eliminate all these tasks. So we started with a human-led tech-in-the-loop model, which over the time frame of, say, 2010 to maybe 2020, became a lot more tech-led and human-in-the-loop, where the humans started to go from doers of tasks to auditors of tasks. And now with the advent of generative AI and really specifically agent AI, back in about 2022-23 maybe, we started moving from a tech-led human-in-the-loop to really an AI-metive. What do we do for these providers? Happy to note that we continue to make some very significant progress. By both Black Book and Glass. So good progress there. I already spoke a little bit about our differentiated... Thank you. or a period of time. Tends to be epic. It is on the back. But the non-linearity between revenue and margin growth Thank you, Sajan.

Sairanj, if you can go on to the next slide. Yes. Just a few additional nuances on the Q4 numbers. Revenue came in at $95 million. We did see some currency support. On the face of the P&L, you're seeing a forex gain of 35 crores, but please note that there was also a hedge loss of 12 crores. So the net currency benefit was for us about 23 crores. Employee benefit expenses Q3, Q4 compared to Q3 was rather flattish in line with the headcount. Other expenses did increase by almost 38 crores between the two quarters. The majority of the delta is actually attributable to one-time due diligence and legal fees that are related to the TrueBridge transaction. The regulatory approvals are still work in progress, so some additional transaction expenses are to be expected in Q1. If you look at finance costs, that has come down sharply compared to Q3. Q3 does have a one-off, write-off of the debt issuance cost when we refinance the loan. So our interest rates have come down, and so has the finance cost. DNA and interest income are broadly in line with Q3. PBT was 258 crores, and PAC was 206 crores. We did report the Western Washington MSO associate loss at about 5 crores. So, Q4 or rather Q1 calendar tends to be seasonally the weakest quarter for U.S. providers. Patient footfalls tend to be very low because of the reset of the insurance and the need to work through the deductible. Plus, it was a fairly intense winter as well. So, patient footfalls are pretty weak. We do expect this to improve in the coming quarters. ETR was about 19% for the quarter and a 20% for the full year. We expect ETR in the range of about 22% for FI27. Saranj, if you can go to the next slide. Our EBITDA per employee stands at 8.8 lakhs in FY26, which is in line with the healthy EBITDA growth that we have seen. Our top 10 customers and top 5 customers tend to grow pretty strongly. Top 10 customers grew at a very healthy 28% and top 5 at 18%. Vintage of our top customers also tends to be very healthy, and it remains at the 5- to 6-year mark. Sartan's already talked about the FC of Yield. In terms of clients with revenue, we have seen a slight decline, and that's simply because some of the equity customers that were at more than 1 million saw a little bit of shrinkage as we offshored those customers and upwards in this country. I'll stop my remarks here and hand it over back to Sajan.

Sorry to interrupt in between. Sachin, sir, if you're speaking, you're on mute.

Oh, I'm sorry, I was on mute. I apologize. Thank you.

So, quickly, I want to just touch upon our proposed acquisition of TrueBridge, which we have spoken extensively about. But just to give everybody a quick recap, we are awaiting the close of that transaction, even after we signed the agreement. And, you know, the idea there is to build the absolute leader, the only integrated system of record and system of action for the rural health care market, which is a $162 billion market with 2,200 plus hospitals. TrueBridge has their EHR in 700 to 800 hospitals, which could be patient data, which includes patient data worth 15 million plus patients. And the reality is for most effective agentic AI orchestration of tasks in the native workflow, the real data, the real moat is not the agentic AI technology, but it is this AI training corpus that can be built if you have the patient data, not just transactional access, asynchronous access, partial access to data, but through ownership of that data, because then you can convert that data into a. Longitudinal. Thank you. That enables truly the most effective agentic orchestration, and then given that we would be in the EHR, and we own the EHR, we can... 325. We were getting close. That's sort of our vision of the true north, and again, a big enabler of that is... you create around it. Neither of my guests. If you would. And so...

Shall we open the floor for question and answer?

Yes, please.

Thank you very much. We will now begin the question and answer session. Anyone who wishes to ask a question may press star and 1 on the touchstone telephone. If you wish to remove process from the question queue, you may press star then 2. Participants, you are requested to use handsets while asking a question. Ladies and gentlemen, we will wait for a moment while the question comes down. A reminder to all, you may press star and 1 to ask a question. We will take the first question from the line of Anil Nahata from Parami Financial. Please go ahead.

Good morning, Sachin and team. First of all, congratulations for a great acquisition of Prubish. The way the deal is, I mean, equals has been completely financed by debt. I guess, which will take around three, four years to pare down the debt, but we can do anything else. I guess we are all in into that. And as they say, when you are all in, you better get it right. So all the best for that. My first question is on the opportunity, which I believe may be coming in the U.S. market, which is Common Spirits Health. I mean, they have terminated their deal with Tenet, and they are one of the largest healthcare providers there and having multiple epic instances. At the same time, I see that we have been very active on the epic marketplace, where we have now sort of seven listings against a couple, which was a couple of photos back. So, how are we getting up for these kind of opportunities? And is that a huge play for us?

Thank you for your kind words, first of all. Appreciate it. Lots of good work ahead of us. You know, it's hard to comment on individual opportunities, as you can imagine, based on the confidential nature of some of these pursuits. But I'm happy to note that CommonSpirit is very much on our radar, and they are in the process of figuring out the specifics of their own strategy, as they have bolted out of the tenant arrangements. And, you know, in fact, we have some past history of working with several ministries within common spirit. And so as their own strategy becomes clearer, it'll be interesting to see how that plays out for us. But I think your observation is very appropriate and timely that it could present a pretty large opportunity.

Thank you for listening. My second question is, if I go back to your last quarter's phone call, you did mention that you are creating a parallel system, just like we have the platform in the ambulatory space for the IQ space. And then came the announcement for 2Bitch, which is basically in the IQ space. This sort of development you were mentioning, it will take us two years to complete to where we are in the ambulatory space. So how will the product development, the tech stack, now happen once QBitch and IKS is integrated? Would IKS stack be taken there, or how is it going to happen? Just if you can do a slight feedback into that. Thank you so much.

Sure, I'm happy to do that, obviously. So, the way to think about it is, remember I was saying that 60 to 70% of the care delivered in rural hospitals is outpatient care. And what IKS has done in its traditional large physician group market is predominantly outpatient care. So, a lot of the technology that we have built in our platform system of action for all of these tasks. Actually becomes naturally applicable to that rural healthcare market because of the service mix that they have, because they don't have secondary, tertiary, ordinary capabilities that sophisticated hospitals. So yes, I think our platform system of action from our physician group market will be very relevant in the rural healthcare market, even though there is zero actual customer overlap. Now, of course, the holy grail here will be In our traditional market, the platform system of action had to asynchronously interact with the system of records like Epic, eClinicals, Cerner, etc. And they would access the data and the electronic health records based on API calls. We would get partial access to the data to orchestrate that transaction. In the world that we are going to, if we are able to close the true rich transaction successfully, and as we modernize their EHR from a legacy co-voil to a co-stress, what we'll be able to do is now integrate our system of action deeply. to the electronic count record, with the access to data, convert that data into the AI training corpus, and using that AI training corpus, which is necessary for this agentic orchestration, to be able to do that agentic orchestration synchronously. In the native workflows of the EHR. So think of it as a good, still a good two-year type product journey. Now some of the features of our platform system action will be able to integrate faster into the Trubridge data. Others might take longer depending on the specifics of that feature, but I think you're exactly right that the Trubridge acquisition puts us in a position where we are able to orchestrate Several features of our traditional platform system of action in the human healthcare market, such that we are the only integrated platform system of action in the system of action.

Thank you. We will take the next question from the line of Nitin Jai from Fair Value Equity Advisory. Please go ahead.

Yeah, thank you for the opportunity. And what I would like to know from the management is what type of risks do you envisage you might face two, three years down the line when AI becomes more prevalent and coding becomes even more cheaper? And how are we preparing for that?

It's been, obviously, the better part of the presentation, and the dialogues were actually carried around that, obviously. Thank you for your question. But, um... I'm surprised to say that, obviously, we are building our own AI. So, the fact that AI makes coding easier or cheaper is awesome for us because we don't get paid to write code for others. We write our own code and our own technology orchestrates these actions. So, as AI makes code generation cheaper and more reliable, that's a huge statement for us. That's not a hedge fund. And then as it relates to how are we leveraging the AI that we're building, that is what I was talking about, where... Because now with the TrueBridge acquisition, we will have access to this data mode and the AI training corpus that we will build from it, all the AI that we are building will actually become a lot more relevant and usable much faster in the native workflows of the electronic helmet.

Hello. Hello. Thank you for the clarification. My next question is, the management mentioned that we have been growing very well for the last almost five to six quarters now, and given that we have a high base going into the next year, at what point of time do we think this base will catch up and our growth might taper down a bit?

So, as you know, I've said this all through the time we went public. We are not giving guidance, and we won't give guidance. You know, this is not a linear journey. Not only do we have a track record of six quarters, but if Saranj, you can put that slide out there, we have a track record of 10 years that we can demonstrate in our financial performance, but that is nothing to say that history is not always a predictor of the future. All I can tell you is there's a very large TAM, a very small outsourced TAM relative to that large TAM that is growing at 12%. And I think we've built a business that has the right to win in this market. And yet, I'm not in a position within to predict that exactly what our growth rate is going to be quarter on quarter. Having said that, we've given a true north target to ourselves of tripling our EBITDA from trading 12 months, calendar 2025, about 1,000 crores to about 3,000 crores in FY30. I wish I had a better ability to predict exactly what's going to happen every quarter, quarter after quarter, and when the growth will accelerate or slow down. I don't, unfortunately, but I think at the context of our fast flow track record and the defensibility of the model that we've built, hopefully, you know, we're putting ourselves in a position that over a medium to long-term time frame, we can emerge as a leader in this space.

Thank you. We will take the next question from the line of Rohit Thorat from Axis Capital. Please go ahead.

Yes, thank you for the opportunity. So, in your opening comments, you highlighted that your revenue growth is growing faster than your headcount growth. So, aren't you seeing any pricing pressures from clients to actually pass some of the productivity back to them? Because a lot of IT services companies and BPO people have also highlighted the fact that they are seeing AI-led productivity deflation of around 2% to 3% in FYI 27. So, are you witnessing any similar pressures or you haven't encountered any such pressures yet?

So, thank you for the question, and, you know, as I've been always saying, our model is slightly different from, or maybe fundamentally different from traditional auto services and BPO services, where they are getting often paid based on the number of people they deploy or the number of transactions they process. Our pricing model has always been outcome-based. And a percentage of the customer's revenue is how we get paid. And so obviously in that model, sir, you'll appreciate that it gives us a very differentiated ability to be able to capture some of the efficiencies in our margins. Having said that, over a period of time, naturally, even on a percentage of revenue basis, can we expect a minor deflation in the percentage of revenue pricing that we get? Yes. Have we seen that depletion already in some of our features that large health system-owned groups buy individually? Absolutely, yes. For example, like I was mentioning our ambient AI describing product, we have seen depletion in pricing. And I would say that we will see more depletion in pricing of features that are more easily automatizable and less depletion of pricing in features that are not easily automatizable, right? And at the confluence of that, that is also one of the reasons that... The winner over a period of time is going to be a platform system of action versus what we call the point solution system of action. Because when you have a point solution system of action, the proclivity of that pricing getting commoditized is much higher than when you have a consolidated platform pricing for the customer, which is why that platform approach is very, very important to our future. You know, because one, the platform makes life a lot easier for the customer, and second, it has enhanced benefits for the entity that's providing the platform as well. So, I think fundamentally different paradigms, but of course, I mean, the history of any product, sir, as you know, is that as products keep getting better, costs come down or prices come down, and the winners in the market are able to mitigate best pricing through both intelligent pricing mechanisms and managing their own business. And so far, we've been able to, and we feel like we're continuing to build a model where we will have a significant advantage over traditional equity services in building models.

Thank you. Thank you for answering that. Just a couple of more bookkeeping questions from my side. First is on the ESOP cost, which has seen sharp increase in the last couple of quarters. So what should be the steady quarterly run rate which we should see going forward? And the second question is regarding ETR. So Nithya mentioned that ETR should be 22% in FY27. Is that just for the core ITS business or would it be on a consolidated basis for ITS and true business businesses combined whenever the transaction completes?

So, I'll let you respond to the second one. Maybe you can answer both.

Yeah, sure.

So on ETR, the guidance is only for IKS. It's not for the Profoma, IKS, and True Bridge Entity. We'll talk to you about it when we do the consolidation. And on ESOP cause, our ESOP cause will trend in line with our aspiration to continue to expand our technology team as well as our leadership team. And ESOP is a tool that we continue to use to be able to align our employees' incentives with shareholder value creation. Sachin, if you want to add on the ESOP question?

Yeah, just our only thing I'll add is that just like any other financial parameters, we don't give guidance on any one parameter. But like Nitya said, it is a very important tool. It is a competitive market. As a leader in the market, we need to make sure that the most important...

Thank you. Thank you for answering my questions.

Thank you. We will take the next question from the line of Dev Thakkar from ITORPMS. Please go ahead.

Hello, thank you for the opportunity and congratulations for the great set of numbers. So my question was regarding the TrueBridge acquisition, where COBOL to SQL is listed as the most important item. So could you please expand on that? Like what challenges are we seeing? And of the 700 clients, any rough number, how many of them are on the COBOL and how important it is for the RCM expansion?

Great. Thank you for the question. So, first of all, obviously, you know, the transaction isn't closed now. So, until the transaction closes, we can't really affect anything. But the strategy, which, by the way, they have already started, is the migration from COBOL to Postgres. And that is critical to move them from the legacy system to eventually a cloud native AI first system. And so in a traditional world, the COBOL to Postgres migration would have been a real challenge because as you know, in the COBOL world, a lot of the business logic is embedded in the database layer. A lot of it is embedded in the UI layer as well. And reverse engineering that business logic out of those layers becomes a huge challenge. But in this case, as AI has become much more prevalent, AI does a lot of that, the new AI does a lot of that reverse engineering of the business logic, which makes the migration... Remarkably easier than it used to be in a traditional world. Having said that, it is still a significant migration, and it will take us a while to get our arms around it and do that completely. The good news is we're doing it in a modular way. So there's several modules of the EHR that might be in a Postgres world before the others are, and that will accelerate our progress. Having said all that, I guess there are some business across the 700 plus hospitals. On a gross level, it's growing at 15-16%. At a net level, it's only growing at 10% because they're not able to execute efficiently, leveraging technology, leveraging the India model, and that's where ITS's core expertise will come in, transform that RCMPs. So in this parallel, the COBOL to Postgres migration will happen and the creation of the data finding will start to happen, which will then allow us to get agentic in that, in several of the tasks within the RCM system of action. So this is a good 18 to 24 month process before we can be in a fully integrated system of action and system of record that allows for agentic orchestration in native workflows, but that doesn't impede us for continuing to do what needs to be done. To improve performance in RCM, as well as proliferating that RCM into, you know, beyond the 250, 300 of their customers that are already on RCM, the HR customers, proliferating the RCM model to the other customers.

Got it. Thank you so much for the detailed clarification. Next question could be, it was a bit elementary, but when we look at the contribution of revenues from top 10 clients on a quarterly basis, the percentage contribution is much higher as opposed to fee on an annual basis. So, like, how should we see this? Because what I want to understand was the overall growth trajectory. Like you mentioned, equity cross-selling strategy has been revamped. So, like, going forward, should we see the overall growth among all set of clients?

I think it's best if you look at it more on a year-on-year basis. That gives a more truer reflection of the underlying business growth. There will always be quarterly variances, and there is some seasonality to some parts of a business as well. So please look at it on a year-on-year basis.

We will take the next question from the line of Madhu Chanda Deh from MC Pro. Please go ahead. Hi, I have three questions.

The first question is, you have grown at a rate of 15% in your fee terms. So is it possible to break up that growth between volume and value?

Hello. Yes, here you have. Your question is about to break up growth between volume and value. We tend not to do that. Obviously, that changes on a very, very frequent basis, and so it's very hard to do that, ma'am.

Okay. I mean, we just wanted to understand what kind of value growth happens annually, I mean, in an existing context of yours.

Like I said, that doesn't, it's not a natural linear number, man, because the volume growth is a function of many factors. Like, let's say you take a large physician group that you're working with, there will be years in which they will have the same number of physicians year on year, and the volume growth is just driven by the patient group form. There will be other years where the number of physicians itself has grown. And hence the volume growth is driven by that. There are customers in which there might be a thousand positions, but only 500 of their positions are using our product. And so now in a year, the 500 could grow to 750, and that drives a different type of volume growth. Thank you. It's increased in the number of features that the physicians are using of our platform, the same number of physicians, and that could lead to a different type of volume growth. So that's why, ma'am, it's very hard to isolate the specifics of perhaps what you're asking, if I understand it correctly.

Okay, I got it. I have another housekeeping question before I move to my first question. Which is, you know, in your latest presentation, the contribution from top 10 customers is 37% for support.

So, if I look at the quarterly numbers, The gentleman before this had the same question, and I would recommend investors to look at these numbers on an annual basis. They always tend to be quarterly variances in terms of our customers. As I mentioned before, there also tends to be seasonality in particularly the revenue optimization of the RCM business. So that tends to contribute to the quarterly variances. So, I think the best right number to look at would be on an annual basis, whereas you can appreciate both our top 10 and top 5 have grown strongly.

Thank you. We will take the next question from the line of Chris Jain from Nafa Asset Managers. Please go ahead.

I hope I'm audible. So, first of all, congratulations on a great year, and I hope this growth continues. So, my question is more about the industry as a whole. So, just like a few days back, Carlisle Group, one of their, bought two companies, which are in the RCM space. And this is not the first time I've heard a PE deal happening. Two or three other big PE firms have bought Indian RCM peers, you know, one, one and a half years back. So, to understand this, my understanding of, you know, consolidation happening in the industry and more and more PE firms getting interested in this space is correct. And what is your comment about, you know, the competitive landscape in the medium and future, medium and long term because of these acquisitions?

Hi, Chris. Thank you for the question. And you and me both hope that the growth continues, even as we work on it. But real quick, on competitive, like I was saying, you know, Chris, when you have such a large TAM and the outsource TAM is so small relative to the TAM and growing so significantly, obviously, you have to expect the competitive intensity to increase. And you have to expect that there will be more and more capital that will enter the space chasing the opportunity. So, none of that is a surprise. There is a lot of private equity capital. In fact, the statistic is... In order of magnitude, there has been about 50 billion dollars invested in healthcare IT alone, which is all of this space over the last four years. So there is a lot of capital across the globe chasing this opportunity. And this 50 billion dollar compound is predominantly just for the US healthcare market. Having said that, the way you think about competition, like I said at the beginning of the conversation, is there's three genres of competitors. There's a finite set of system of record companies that DHR enters, there is... A massively growing set of point solution systems of action, which is the easiest way to enter the market is build one feature or one action. And then there is this, call them rare, beachfront properties, perhaps, although that sounds a bit self-serving, like ours, where, you know, we are building a platform, comprehensive system of action that takes all the features that the provider should not be struggled with, right? And so I think the fastest growing category of competitors is in that point solution systems of action. Because again, the entry barriers in that genre of competition is the smallest, the entry barriers. And that's where you see that, you know, the Dean you referenced with Carlyle, it's a point solution company with pure focus on RCM. That doesn't make them a good or a bad company. I'm not commenting on the quality of the competition. I'm just saying that is the genre that will see the maximum competitive intensity. Now, we could be right or we could be wrong, but our contention is... I call that word point solution health because imagine if a large health system has to hire 15, 20 different vendors or even 10 different vendors across these 15, 16 tasks to do them well. In a scenario like that, how can they possibly hold any one vendor accountable? And they are left with the baggage of integrating everything, right? And so for me, Very early in our journey, we are determined that we don't want to be a point solution vendor. We want to be a full platform system of action. And that's what we're betting on. But that is not to take away from the fact that there will be a constant increase in competitive intensity in that point solution system of action space. And yes, there will also be continued consolidation in that space, because as that space gets more and more commoditized, which is inevitable, then your only way to fight that commoditization is to scale and consolidate. And that's why one is continuing to see that.

Hope this helps. Yes, thank you for the detailed answer. That clearly helps a lot. And forgive me, but I'm usually late to the call, so maybe this question has been answered. But what is going to be a strategy in the future for acquisitions? Are we going to see more rubric as acquisitions, which is basically doubling revenue? Or are you looking at, you know, very focused AI players that you want to buy, small focus players like the recent acquisitions?

So, good question. Thank you again. No, I mean, I don't think we are looking for additional two bridges. As you know, if they're able to consummate the through-rich transaction, we will end up with about 3x leverage of EBITDA at the time of close. And so, obviously, our focus will be to deleverage the balance sheet through the internal accruals and the strong cash flows that we anticipate generating through the combination. Having said that, I think there will be some continued opportunities for tuck-in type deals, some much smaller in nature like the deal we announced today with AI that fundamentally accelerate our capability from an AI perspective, or there might also be some tuck-in type opportunities as it relates to certain point solution vendors like I was discussing earlier that will end up having found sort of a space where they have hit their ceiling because of the commoditization of the point solutions, and those might create service opportunities. But a transformative acquisition like Thrubridge, first of all, Comes very rarely. And second, you know, obviously, we want to continue to stay disciplined about not over leveraging the balance sheet and or not unnecessarily diluting shareholder equity through raising equity. So generally, I don't anticipate more transformative acquisitions anytime soon. Small tuck-ins that are highly accretive certainly will be open to those.

Thank you. We will take the next question from the line of Dev Thakkar from iTalk BMS.

Please go ahead.

Dave, you may proceed with the question.

Hello. Thank you for the opportunity again, sir. Sir, I had just one request. Sir, the metrics and the presentations are very detailed, but if possible, could you also provide breakup of revenue in terms of single solutions and multi-solutions because that would be very helpful.

Yeah, we've never done that. Remember the basic thesis of our business is that the winners are the platform constructs, right? And so, over a period of time, we anticipate. The bulk of our revenue migrating to platform constructs, even in cases of large health systems, where we might start and land with point solutions and expand to the platform. So, we ourselves are resisting the temptation of getting too caught up in revenue contributions for individual solutions because that is at odds with the identity of the organization in and of itself. So, I apologize, my friend.

Got it, sir. Thank you.

Thank you. We will take the next question from the line of Chira Kachadiya from Motila Loswar Financial Services. Please go ahead.

Hello. Am I audible?

Yes, you're audible. Please proceed.

Such a new mention about the electronic health record that all these systems in the US started in August 2000, and they remain, you know, just a database collector of reputation. Chirag, I'm sorry, you're very faint here. Can you speak a bit louder?

Sorry, Chirag.

Yeah. So, my question is on the electronic health reports. As you mentioned, most of the players in the US started in early 2000 or before that, and they remain, you know, just a collector of their patient database and all. So, the entity which we are acquiring, they also have an ASR practice, right? And if you look at their past historical performance, this is largely stagnant. So how are we going to, you know, increase the growth trajectory of that vertical and in our existing IKS offering, what percentage is coming from EHR and is there any overlap in...

I really struggled to catch the question. Did you catch it, Tim?

Bits and pieces. I think his question is around TrueBridges, EHR that we're acquiring, and the fact that that business has been stagnant. And I think what do we intend to do about it once it's in our hands?

Ah, okay. So, thank you for the question. Yes, so, you know, like we've said, the EHR market is a mature market, Where in most of the EHR sub-segments, You know, they've already reached the maturity, whether it's a two or three vendor market, and there is not much fluctuation. So for example, in the rural EHR space, there are 2,200 hospitals, there are 2,200 hospitals, and two pages EHR is already in 700 of those hospitals, right? So maybe 35% market share already exists. So what one should not anticipate is some dramatic growth coming from the EHR segment in of itself. Having said that, in the case of rural healthcare, The two vendors that are most prevalent are Thrubridge and a vendor called Meditech. There is also a third vendor called Meadows, but Thrubridge and Meditech are the most prevalent. And so the EHR that is able to modernize itself most rapidly. And is able to build an integrated system of action, eventually might have some market share opportunity as well. Our focus will not be to capture greater EHR market share in the next two to three years. Our focus will be to modernize the EHR. Integrate our system of action in it, and the real growth will be to cross-sell the system of action into the EHR customer base. Remember I said only 250-odd of the EHR customers actually have, only 250-odd have the RCM offerings. First is you have a 450-plus customer market just for the RCM system of action. Then there are other components of our system of action because we have 16-odd features. Our team is just six or seven of them, right? So we'll also cross-sell all of those features into the two-bridge EHR install base. So think of the growth vectors really as the cross-sell of the system of action in the EHR install base. And then as we modernize the EHR and we've integrated the system of action, Would we, uh... Ignite another vector of growth where we actually capture additional EHR market share, perhaps, but I wouldn't be banking on that as a thesis here.

Okay, thank you.

Thank you. A reminder to all, you may press star and 1 to ask a question. Thank you very much. As there are no further questions from the participants, I now hand the conference over to Mr. Saraj Mundra for closing comments. Thank you and over to you, sir.

Thank you. Thank you, everyone. Please reach out if you have any further questions. Thank you so much for attending.

Thank you, everyone.

Thank you.

Thank you, members of the management. On behalf of ICSA Securities, that concludes this conference. Thank you all for joining with us today, and you may now disconnect your lines. Thank you.