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Medicover

Quarterly Report Nov 3, 2022

2943_10-q_2022-11-03_cb2f6e4e-a0f9-4326-907f-f107bc6b06d1.pdf

Quarterly Report

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INTERIM REPORT JULY–SEPTEMBER 2022

Third quarter

  • Revenue amounted to €368.6m (€335.0m), an increase of 10.0% with an organic growth of 2.9%.
  • Operating profit (EBIT) was €9.1m (€30.0m), representing an operating margin of 2.5% (9.0%).
  • Net profit/(loss) amounted to €-3.4m (€18.4m), which represents a margin of -0.9% (5.5%).
  • EBITDA was €48.8m (€58.0m), a decrease by 15.8%. EBITDA margin was 13.3% (17.3%).
  • EBITDAaL amounted to €26.9m (€42.8m), corresponding to an EBITDAaL margin of 7.3% (12.8%).
  • Net cash flow from operating activities was €54.5m (€67.0m).
  • Basic/diluted earnings/(loss) per share were €-0.024 (€0.123).

Nine months

  • Revenue amounted to €1,112.5m (€1,001.1m), an increase of 11.1% with an organic growth of 3.6%.
  • Operating profit (EBIT) was €46.8m (€117.8m), representing an operating margin of 4.2% (11.8%).
  • Net profit amounted to €11.8m (€78.2m), which represents a margin of 1.1% (7.8%).
  • EBITDA was €164.4m (€195.3m), a decrease by 15.8%. EBITDA margin was 14.8% (19.5%).
  • EBITDAaL amounted to €101.3m (€153.9m), corresponding to an EBITDAaL margin of 9.1% (15.4%).
  • Net cash flow from operating activities was €128.1m (€162.8m).
  • Basic/diluted earnings per share were €0.069 (€0.501).
€ millions (€m) Q3
2022
Q3
2021
Variance 9M
2022
9M
2021
Variance LTM* FY
2021
Revenue 368.6 335.0 10% 1,112.5 1,001.1 11% 1,488.8 1,377.4
Operating profit (EBIT) 9.1 30.0 -70% 46.8 117.8 -60% 88.4 159.4
Operating profit margin 2.5% 9.0% 4.2% 11.8% 5.9% 11.6%
Net profit/(loss) -3.4 18.4 -118% 11.8 78.2 -85% 40.2 106.6
Net profit/(loss) margin -0.9% 5.5% 1.1% 7.8% 2.7% 7.7%
Basic/diluted earnings/(loss)
per share, € -0.024 0.123 -120% 0.069 0.501 -86% 0.254 0.686
EBITDA 48.8 58.0 -16% 164.4 195.3 -16% 239.5 270.4
EBITDA margin 13.3% 17.3% 14.8% 19.5% 16.1% 19.6%
Adjusted EBITDA 52.8 60.7 -13% 176.5 201.7 -12% 255.3 280.5
Adjusted EBITDA margin 14.4% 18.1% 15.9% 20.1% 17.2% 20.4%
EBITDAaL 26.9 42.8 -37% 101.3 153.9 -34% 158.2 210.8
EBITDAaL margin 7.3% 12.8% 9.1% 15.4% 10.6% 15.3%
Adjusted EBITDAaL 30.9 45.5 -32% 113.4 160.3 -29% 174.0 220.9
Adjusted EBITDAaL margin 8.4% 13.6% 10.2% 16.0% 11.7% 16.0%
EBITA 14.2 32.6 -56% 66.0 125.3 -47% 111.9 171.2
EBITA margin 3.9% 9.7% 5.9% 12.5% 7.5% 12.4%
Definition and reconciliation of alternative performance measures are available at www.medicover.com/financial-information.

REVENUE AND EARNINGS

Definition and reconciliation of alternative performance measures are available at www.medicover.com/financial-information.

* LTM: last twelve months (1 October 2021-30 September 2022)

Medicover is a leading international healthcare and diagnostic services company and was founded in 1995. Medicover operates a large number of ambulatory clinics, hospitals, specialty-care facilities, laboratories and blood-drawing points and the largest markets are Poland and Germany. In 2021, Medicover had revenue of €1,377 million and more than 38,000 employees. For more information, go to www.medicover.com

CEO STATEMENT

Continued strong growth in business as usual despite multiple headwinds, as reported in the second quarter, which have continued into the third quarter. Furthermore, we experienced the highest inflation rates for many years in several of our core markets which impact profitability. Inflation in Poland reached 17% (highest in 26 years), Romania just short of 16% and Germany over 10% in September. Inflation is experienced in all economic sectors and is evident in strong wage growth.

Despite the headwinds we manage to deliver revenue growth of 10.0% and organic revenue growth in business as usual (excl. Covid-19 and Ukraine) was a strong 19.8%. As I expressed in the prior quarterly report, we remain confident in our ability to compensate inflationary cost pressure through price increases in our private pay markets. Price adjustments will be more challenging in Germany where the large majority of revenue is decided by public reimbursement..

Revenue for the quarter grew 10.0% to €368.6m (€335.0m), with an organic growth of 2.9%. Fee-For-Service and other services (FFS) represented 58% of total revenue.

EBITDA was €48.8m (€58.0m), decreased by 15.8%, representing an EBITDA margin of 13.3% (17.3%). Adjusted EBITDA amounted to €52.8m (€60.7m), with a margin of 14.4% (18.1%). Several headwind factors negatively impacted margins during the quarter. As commented on in more detail in the profit development sections, adjusting for the main headwind elements and considering the significant inflation pressure, it is encouraging to see the like for like margin evolution holding steady in Healthcare Services with the bulk of the price adjustment impact for Healthcare Services still to come over the coming quarter.

Healthcare Services revenue reached €230.5m (€176.7m), grew by 30.5%, with an organic growth of 18.3%. Organic growth in business as usual (excluding Covid-19) was an impressive 25.8%, of which price represented 7.7%. The number of members in the Integrated Healthcare Model increased by a healthy 12.6% to 1.6 million (1.5 million) members, with 41,000 new members during the quarter, illustrating the ongoing strong demand. FFS grew 33.3% in the quarter and represented 54% of divisional revenue.

Healthcare Services EBITDA was €32.3m (€26.4m), increased by 22.2%, representing an EBITDA margin of 14.0% (15.0%). New units, pre-opening costs, acquisitions and cost inflation impacted the profit level. Covid-19 services contributed to the margin in the comparative quarter.

Diagnostic Services revenue amounted to €142.7m (€162.9m), decreased by 12.5%, with a negative organic growth of 13.9%. Organic growth in business as usual (excluding Covid-19 and Ukraine) was 9.0%, where price represented 2.6%. The quarter was impacted by Ukraine and a sharp reduction in Covid-19 testing. The number of laboratory tests amounted to 29.0 million (32.4 million), a decrease of 10.6%. The number of blood-drawing points (BDPs) amounted to 919 (809). FFS decreased by 18.9% in the quarter and represented 67% of divisional revenue. We see a challenging market in Germany, as we don't expect price adjustment from the public reimbursement system to fully compensate for cost increases. We will continuously drive operational improvements to compensate for such increases.

Diagnostic Services EBITDA amounted to €22.6m (€35.7m), a decrease of 36.7%, an EBITDA margin of 15.9% (21.9%). Ukraine, a reduction in Covid-19 testing, increased labour costs and other inflationary costs continue to have a negative impact and reduce margins.

We will most likely continue to see high inflation in the coming quarters. We constantly work to increase operational efficiency combined with price adjustments to compensate for increased costs. In the integrated healthcare model a larger proportion of contracts will be price indexed as of October. We have continued to see market acceptance for price compensation in the quarter.

Expansion has continued, for example, one new hospital opened in India during the quarter, and dental services entered the German market with the acquisition of two dental chains in early October, alongside a continued ambitious organic growth expansion.

2 – Interim report July-September 2022

We remain confident that we will be within the financial adjusted EBITDA margin target of 15.5-16.5% for 2022, despite the headwinds from an unusual high number of uncertain factors faced this year. As mentioned, we are relentlessly working on the aspects within our control, as we increase pricing, operational efficiency and drive expansion to maturity, which constitutes a strong base for further growth in 2023.

Last but not least a big thank you to all employees that continue to care for everyone's health and provide the best high-quality and patient centric care for everyone's need.

Fredrik Rågmark CEO

REVENUE THIRD QUARTER 2022

Consolidated revenue amounted to €368.6m (€335.0m), up 10.0% with an organic growth of 2.9%. Revenue from Covid-19 services amounted to €14.2m (€49.8m), 28% of the Q3 2021 levels.

In addition to Covid-19 the business continued to be disrupted by the ongoing war in Ukraine. Taking these two aspects into account, the underlying organic business growth has been strong and further boosted by acquisition growth. To illustrate this, organic growth excluding Ukraine and Covid-19 revenue amounted to a very strong 19.8%.

Inflation is very apparent, with headline inflation measures, reaching 17.2% annualised for Poland in September 2022 and core inflation (net of food and energy prices) at 10.7%. Inflation has been experienced in all sectors of the economy and is evident in strong wage growth. Price indexations in the larger employer paid Polish business are annual and occur either in February or October, with the latter representing a considerably larger proportion of contracts. The trailing indexation is depressing margins with a pick up on the back of indexation expected in Q4 2022.

Acquired revenue amounted to €28.4m. The Group continued to invest in greenfield infrastructure and acquisitions, refer to note 4 for more information about acquisitions. In addition German dental acquisitions have been closed at the beginning of October, refer to note 8.

Foreign exchange fluctuations had a negative impact of 1.4% with weakness for the Polish zloty and the Ukrainian hryvna offsetting the strengthening of the Indian rupee.

€m Q3
2022
Q3
2021
FY
2021
Covid-19 revenue
Healthcare Services 0.3 10.9 66.6
Diagnostic Services 13.9 38.9 179.4
Total 14.2 49.8 246.0

Healthcare Services revenue reached €230.5m (€176.7m), up 30.5% with an impressive organic growth of 18.3%. Revenue from Covid-19 services was negligible at €0.3m (€10.9m). Organic growth excluding Covid-19 revenue was an even more impressive 25.8%, with price representing 7.7pp of this growth.

Employment and economic activity has been strong in European markets, with a significant lack of labour and widespread wage pressure. Some softening of demand is perceived in consumer consumption patterns.

Members increased by a strong 12.6% to 1,648K (1,464K), with 41K new members added in this quarter.

FFS activities have performed well with good demand levels. In Poland, the number of dental chairs increased to 423. Further dental greenfield openings are scheduled in 2022/2023 and additional acquisitions are expected.

The division operated 5,434 commissioned hospital beds, an increase of 1,639 beds since prior year, with the largest addition in India (1,260). In August, a new greenfield hospital opened in Navi Mumbai, adding 150 operational beds with an additional 150 beds to be operational as utilisation increases.

Public reimbursement rates were increased effective July 2022 in Poland for public contracts

compensating for mandated salary increases for healthcare workers.

30 Sep
2022
30 Sep
2021
FY
2021
Clinics 149 128 129
Hospitals 39 31 32
Beds (commissioned) 5,434 3,795 4,028
Fertility clinics 27 25 26
Dental clinics 72 59 64
Dental chairs 423 294 359
Gyms 106 66 77
Other facilities 107 64 65
Members (thousands) 1,648 1,464 1,495

Acquired revenue amounted to €24.2m. The rate of expansion of both organic and acquired revenue is strong, following the high growth in capital investments over the year and previously.

Foreign exchange fluctuations had a negative impact of 1.5% with weakness for the Polish zloty offsetting the strengthening of the Indian rupee.

Diagnostic Services revenue amounted to €142.7m (€162.9m), a decrease of 12.5%, with an organic reduction of 13.9%. Ukraine and a sharp reduction in Covid-19 services impacted the quarter. Revenue from Covid-19 services amounted to €13.9m (€38.9m) almost a two-third reduction. Currently, there are continued low levels of Covid-19 testing. Revenue in Ukraine amounted to €11.8m (€25.6m), a decrease of 53.9%.

Organic growth excluding Ukraine and Covid-19 revenue amounted to 9.0%, with a mixture of market performances, slower in Germany, good for Romania and with Poland, offsetting the lost outsourced contract in Q1 and reduced Covid-19 revenue with FFS volume. The smaller markets have generally replaced the reduced Covid-19 volume with FFS. The price component represented 2.6pp of this 9.0% growth.

The activity levels in Ukraine are higher than expected. Revenue for September was approximately 65-70% of the normal levels excluding Covid-19 revenue. As at 30 September 2022 the operations in Ukraine include 8 labs of which 2 have suspended operations, a nationwide network of 348 BDPs of which 46 were nonoperational. 8 BDPs have been destroyed. Prices in Ukraine have been increased reflecting inflation.

Indexation has been applied to FFS prices and some commercial contracts over the year, however basic testing was largely shielded to maintain affordability for patients. Public pricing has not been indexed yet despite increasing inflation. Besides a decrease in Covid-19 test prices, German prices have not changed and no change is expected in the near term.

The laboratory test volume decreased by 10.6% to 29.0 million (32.4 million) impacted by the war in Ukraine. Covid-19 tests were 0.5 million (2.2 million), consisting of a larger proportion of higher quality PCR tests which are more expensive. This reflects the demand profile such as hospital admissions screening and commercial contracts. Excluding Ukraine and Covid-19 testing, volume was 24.4 million (23.4 million), a 4.3% increase.

30 Sep
2022
30 Sep
2021
FY
2021
Total labs 108 99 99
BDPs 919 809 852
Clinics 24 24 24
Lab tests (million) 29.0 32.4 133.4

Acquired revenue amounted to €4.2m.

Foreign exchange fluctuations had a negative impact of 1.2% with weakness for the Ukrainian hryvna.

REVENUE NINE MONTHS 2022

Consolidated revenue increased to €1,112.5m (€1,001.1m), up 11.1% with an organic growth of 3.6%. Revenue from Covid-19 services amounted to €107.7m (€184.5m).

The Group continued to invest in greenfield infrastructure and acquisitions, the main acquisitions included NIPD Genetics - a specialised genetics company in Cyprus - and CDT Medicus a leading regional provider of medical services in the south-west of Poland, refer to note 4.

Organic growth excluding Ukraine and Covid-19 revenue amounted to a strong 18.6%.

Acquired revenue amounted to €82.3m.

Foreign exchange fluctuations had a negative impact of 0.7% with weakness mainly for the Polish zloty offsetting the strengthening of the Indian rupee.

€m 9M
2022
9M
2021
FY
2021
Covid-19 revenue
Healthcare Services 12.8 59.0 66.6
Diagnostic Services 94.9 125.5 179.4
Total 107.7 184.5 246.0

Healthcare Services revenue reached €658.1m (€519.7m), up 26.6% with an organic growth of 14.6%. Revenue from Covid-19 services amounted to €12.8m (€59.0m). Organic growth excluding Covid-19 revenue was up a very strong 26.6% boosted 6.4pp by the fast growth in Medicover Hospitals India.

30 Sep
2022
30 Sep
2021
FY
2021
Clinics 149 128 129
Hospitals 39 31 32
Beds (commissioned) 5,434 3,795 4,028
Fertility clinics 27 25 26
Dental clinics 72 59 64
Dental chairs 423 294 359
Gyms 106 66 77
Other facilities 107 64 65
Members (thousands) 1,648 1,464 1,495

Acquired revenue amounted to €67.0m.

Foreign exchange fluctuations had a negative impact of 0.9% with weakness for the Polish zloty offsetting the strengthening of the Indian rupee.

Diagnostic Services revenue amounted to €468.6m (€497.1m), down 5.7% with an organic reduction of 8.3%. Revenue from Covid-19 services amounted to €94.9m (€125.5m). Revenue in Ukraine amounted to €36.8m (€77.1m). Organic growth excluding Ukraine and Covid-19 revenue amounted to 5.0%.

The laboratory test volume was 90.0 million (97.5 million) of which Covid-19 tests were 4.5 million (4.4 million). Excluding Ukraine and Covid-19 testing, volume was 74.5 million (72.0 million), a 3.5% increase.

30 Sep
2022
30 Sep
2021
FY
2021
Total labs 108 99 99
BDPs 919 809 852
Clinics 24 24 24
Lab tests (million) 90.0 97.5 133.4

As at 30 September 2022 the operations in Ukraine include 8 labs of which 2 have suspended operations, a nationwide network of 348 BDPs of which 46 were non-operational. 8 BDPs have been destroyed.

Acquired revenue amounted to €15.3m.

Foreign exchange fluctuations had a negative impact of 0.5% with weakness mainly for the Polish zloty.

Revenue from external customers, recognised over time as services are rendered, by division, by payer and by country is disclosed in the following table.

€m Q3
2022
Q3
2021
Vari
ance
9M
2022
9M
2021
Vari
ance
LTM FY 2021
Healthcare Services
Revenue 230.5 176.7 658.1 519.7 850.0 711.6
Inter-segment revenue -0.2 -0.1 -0.6 -0.6 -1.1 -1.1
Revenue from external
customers 230.3 176.6 30.5% 657.5 519.1 26.7% 848.9 710.5
By payer:
Public 31.9 17.6 81.0% 79.4 53.7 47.8% 100.5 74.8
Private 198.4 159.0 24.9% 578.1 465.4 24.2% 748.4 635.7
Funded 75.0 66.4 13.1% 220.7 193.2 14.2% 289.0 261.5
Fee-For-Service (FFS) 100.2 83.0 20.7% 293.8 251.0 17.1% 379.3 336.5
Other services 23.2 9.6 144.3% 63.6 21.2 199.9% 80.1 37.7
By country:
Poland 148.8 111.6 33.4% 428.1 325.2 31.7% 552.9 450.0
India 46.0 33.0 39.5% 122.0 102.7 18.8% 154.2 134.9
Romania 22.9 20.2 12.8% 69.4 61.7 12.4% 91.5 83.8
Other countries 12.6 11.8 7.7% 38.0 29.5 28.9% 50.3 41.8
Diagnostic Services
Revenue 142.7 162.9 468.6 497.1 658.3 686.8
Inter-segment revenue -4.5 -4.5 -13.8 -15.3 -18.7 -20.2
Revenue from external
customers 138.2 158.4 -12.8% 454.8 481.8 -5.6% 639.6 666.6
By payer:
Public 46.6 44.6 4.6% 160.5 152.4 5.3% 216.0 207.9
Private 91.6 113.8 -19.6% 294.3 329.4 -10.7% 423.6 458.7
Fee-For-Service (FFS) 81.4 97.6 -16.6% 254.2 300.5 -15.4% 369.1 415.4
Other services 10.2 16.2 -37.5% 40.1 28.9 38.7% 54.5 43.3
By country:
Germany 70.8 69.9 1.3% 240.3 230.4 4.3% 326.3 316.4
Ukraine 11.8 25.6 -53.9% 36.8 77.1 -52.2% 69.2 109.5
Romania 20.4 20.8 -1.5% 61.9 64.8 -4.4% 84.9 87.8
Poland 13.1 13.4 -2.6% 39.2 44.6 -12.1% 54.7 60.1
Other countries 22.1 28.7 -23.2% 76.6 64.9 18.0% 104.5 92.8

The following table presents Covid-19 related metrics.

Q3
2022
Q2
2022
Q1
2022
9M
2022
Q4
2021
Q3
2021
Q2
2021
Q1
2021
FY
2021
Revenue (€m)
Healthcare Services 0.3 1.0 11.5 12.8 7.6 10.9 37.9 10.2 66.6
Diagnostic Services 13.9 27.0 54.0 94.9 53.9 38.9 43.9 42.7 179.4
Total 14.2 28.0 65.5 107.7 61.5 49.8 81.8 52.9 246.0
Admissions1)
Healthcare Services 0 6 1,339 1,345 821 1,385 11,767 2,362 16,335
Lab tests2) (million)
Diagnostic Services 0.5 1.6 2.4 4.5 2.6 2.2 1.1 1.1 7.0

1) Include hospitalisations

2) Include PCR, antibody and antigen tests

PROFIT DEVELOPMENT THIRD QUARTER 2022

Operating profit (EBIT) was €9.1m (€30.0m), an operating margin of 2.5% (9.0%), impacted by the war in Ukraine, increased medical costs, lower contribution from Covid-19 services and several projects in maturing stages.

Net profit/(loss) amounted to €-3.4m (€18.4m), which represented a margin of -0.9% (5.5%). Total financial result amounted to €-13.7m (€-6.6m) of which €-8.7m (€-5.5m) was related to interest expense and commitment fees on the Group's debt and other discounted liabilities. Within the interest expense €-5.8m (€-3.6m) was related to lease liabilities. As the Group has expanded its capacity and facilities significantly, including its leased premises, the cost of interest allocated to lease liabilities has increased. Foreign exchange losses were €-5.8m (€-1.3m) of which €-5.2m (€-1.8m) was related to euro denominated lease liabilities mainly in Poland as the zloty weakened.

Basic/diluted earnings/(loss) per share amounted to €-0.024 (€0.123).

Consolidated EBITDA was €48.8m (€58.0m), an EBITDA margin of 13.3% (17.3%). Adjusted EBITDA amounted to €52.8m (€60.7m) a margin of 14.4% (18.1%).

EBITDAaL was €26.9m (€42.8m), a margin of 7.3% (12.8%). Adjusted EBITDAaL was €30.9m (€45.5m), a margin of 8.4% (13.6%).

Items affecting comparability

Acquisition related expenses were €-1.2m (€-0.6m).

Equity settled share-based payments charges relating to long-term performance-based share programmes were €-2.8m (€-2.1m).

The war in Ukraine has impacted the contribution of that market significantly with a reduction of EBITDA to €3.0m (€6.8m), in addition the war had a negative impact on other business units resulting in an estimated EBITDA reduction of €0.3m.

EBITDA for Healthcare Services was €32.3m (€26.4m), an EBITDA margin of 14.0% (15.0%).

The factors having the largest impact on profit for the segment are the swing in Covid-19 activity, the new expansion activities (new unit losses and preopening costs), acquisitions made in the last 12 months and inflation impacts on the cost base. The war in Ukraine has had an impact however relatively minor for the segment.

The medical cost ratio (MCR) to revenue was 78.7% (77.8%), an increase of 0.9pp, the driver for the reduction in margin due to new projects, cost inflation and reduction in Covid-19 services.

EBITDAaL was €16.7m (€16.8m), a margin of 7.3% (9.5%).

Adjusted EBITDAaL was €17.6m (€17.6m), a margin of 7.6% (10.0%). The adjusted EBITDAaL on a like for like basis was stable at 9.4% (9.6%), which given the backdrop of strong inflation and lag in indexation can be considered good for the segment.

Adjusted EBITDAaL €m Margin
Q3 2021 as reported 17.6 10.0%
Covid-19 swing -1.7
Q3 2021 like for like
comparative 15.9 9.6%
Q3 2022 as reported 17.6 7.6%
New unit losses 2.2
Pre-opening costs 0.8
Acquisitions1) -1.5
Q3 2022 like for like
comparative 19.1 9.4%

1)Acquisitions made during the last 12 months, excluding the new hospital in Cluj, Romania included under "New unit losses".

Covid-19 represented approximately 0.9pp in the comparative EBITDAaL margin of which the large majority was relating to India.

The segment has expanded significantly with startups and early stage projects over the twelve months, particularly as investment was restrained in the earlier part of the Covid-19 pandemic in 2020/2021. Among these is the new hospital in Cluj, Romania, a 200-bed general hospital which performed +500 procedures over the quarter with an EBITDAaL of €-1.3m. 3 new units in India were opened over the last 12 months and incurred an EBITDAaL of €-0.9m. Total losses on these new units represent approximately an EBITDAaL of €-2.2m or -1.0pp of EBITDAaL margin for the quarter.

Additionally, pre-opening costs were expensed for a 200-bed hospital under construction in Bucharest and the new hospitals which were commissioned in India (Pune, Navi Mumbai and Begumpet). These incurred an EBITDAaL of €-0.8m, or -0.4pp of margin.

Acquisitions (made in the last 12 months, excluding the hospital in Cluj) have supported profitability over the quarter and have generated an EBITDAaL of €1.5m or 0.7pp of margin, with CDT Medicus being the largest contributor.

Medicover Sports is observing a good increase in demand for sports benefits packages which are sold alongside Medicover healthcare benefits to the same employer base. The ramp up in gyms (3 locations in Q3) is still dilutive to margin overall but has improved compared to the comparative quarter. The further integration of the gyms acquired and gain in market share of the sports/fitness corporate benefit plans is expected to occur over the next coming periods and contribute to margin improvement.

Salary costs, energy and contracted services have been the drivers for increased costs in general and in the corporate paid services, for which there is a lag in passing on cost increases to customers. This has been offset with a reduction in the utilisation level compared to comparative quarter, and price increases on new business. The salary and energy cost increases have however been significant and higher than these positive aspects.

Several other units have performed well, the Polish dental business being notable, with an increase in the number of facilities, consumer demand is currently stable, however some signs of softness in future bookings were appearing at the end of the quarter.

The existing inpatient facilities in Poland and Romania have performed well with indexation of public reimbursement rates in Poland effective July 2022.

Operating profit amounted to €6.5m (€9.9m), a margin of 2.8% (5.6%).

EBITDA for Diagnostic Services was €22.6m (€35.7m), an EBITDA margin of 15.9% (21.9%).

EBITDAaL was €16.3m (€30.1m), a margin of 11.4% (18.5%).

The factors having the largest impact on profit for the segment are the swing in Covid-19 activity, the Ukraine war, acquisitions made in the last 12 months, a lab site move and inflation impacts on the cost base.

Adjusted EBITDAaL was €17.0m (€30.7m), a margin of 11.9% (18.9%).

Adjusted EBITDAaL €m Margin
Q3 2021 as reported 30.7 18.9%
Covid-19 swing -10.5
Ukraine war -1.7
Q3 2021 like for like
comparative
18.5 14.3%
Q3 2022 as reported 17.0 11.9%
Acquisitions -0.5
Lab site move 0.2
Q3 2022 like for like
comparative 16.7 12.0%

The sharp reduction in Covid-19 testing has had a corresponding reduction in margin, representing a swing of approximately 6.1pp of the overall EBITDAaL margin.

The war in Ukraine had a direct negative impact on EBITDAaL of €1.4 m and additionally a negative impact on other business units resulting in an estimated EBITDAaL reduction of €0.3m, a total of €-1.7m and with an estimated impact of -0.9pp swing in margin.

Acquisitions had a positive impact on EBITDAaL of €0.5m, or 0.3pp of margin.

Additional lease costs to move a lab site in Germany amount to €-0.2m of EBITDAaL or -0.1pp of margin.

Margins have been under pressure as a consequence of labour cost increases and other inflationary costs with no price indexation in Germany and in other markets for outsourced contracts and basic testing. The overall negative impact of these items has been offset to a degree with volume increases, however the like for like adjusted EBITDAaL margin reduced to 12.0% (14.3%).

Inflation in most markets has been apparent with increasing staff costs (including legislation increasing staff remuneration) and operational costs such as heat, lighting and other services. Indexation of prices occurred in some markets at the beginning of the year for FFS business, however not on some of the more basic tests to support affordability for patients. Public reimbursement rates have not been changed, adding to margin pressure. A large proportion of testing supplies are under long-term supplier contracts with fixed prices which offsets some pressure on margins.

Operating profit was €9.2m (€24.6m), a margin of 6.4% (15.1%).

PROFIT DEVELOPMENT NINE MONTHS 2022

Operating profit (EBIT) was €46.8m (€117.8m) with an operating margin of 4.2% (11.8%), impacted by the war in Ukraine, a related €-5.1m impairment, increased medical costs, lower contribution from Covid-19 services and several projects in maturing stages.

Net profit amounted to €11.8m (€78.2m), a margin of 1.1% (7.8%). Other income/(costs) of €-2.9m mainly include a gain of €4.4m relating to the revaluation of the NIPD investment offset against a loss on bond funds of €-6.3m. Total financial result amounted to €-27.1m (€-13.2m) of which €-24.1m (€-13.8m) was related to interest expense. Within the interest expense €-16.0m (€-9.6m) was related to lease liabilities. Foreign exchange losses were €-7.3m (€0.1m) of which €-6.9m (€-0.8m) was related to euro denominated lease liabilities mainly in Poland as the zloty weakened. In addition, other financial income/(expense) includes a gain on early repayment of debt obligations of €2.4m (-).

The Group has recognised an income tax charge of €-5.1m (€-28.1m) which corresponds to an effective tax rate for the nine months of 30.0% (26.5%). The effective tax rate has increased due to a larger proportion of development/early stage projects and non-recognition of deferred tax on the related losses.

Basic/diluted earnings per share amounted to €0.069 (€0.501).

Consolidated EBITDA was €164.4m (€195.3m), an EBITDA margin of 14.8% (19.5%). Adjusted EBITDA was €176.5m (€201.7m), a margin of 15.9% (20.1%).

EBITDAaL was €101.3m (€153.9m), a margin of 9.1% (15.4%). Adjusted EBITDAaL amounted to €113.4m (€160.3m), a margin of 10.2% (16.0%).

Items affecting comparability

During the first quarter, the Group recognised an impairment of €-5.1m relating to damaged and destroyed assets as well as assets not under its control in occupied regions of Ukraine, of which €-4.0m is included in medical provision costs and €-1.1m in administrative costs.

Until January 2022 NIPD was accounted for as an associate using the equity method. In January the share of ownership was increased to 87.2% and subsequently consolidated. Upon consolidation, the Group's previously held interest of 18.9%, with a carrying value of €7.9m, was remeasured to its acquisition fair value of €12.3m, resulting in a gain of €4.4m which has been recognised as other income/(costs).

A gain of €2.4m was recognised on the early repayment of €40m nominal of debt obligations at a discount, presented within other financial income/(expense).

Acquisition related expenses were €-5.2m (€-1.7m).

Equity settled share-based payments charges relating to long-term performance-based share programmes were €-6.9m (€-4.7m).

The war in Ukraine has impacted the contribution of that market significantly with an EBITDA of €5.4m (€18.8m), in addition the war had a negative impact on other business units resulting in an estimated EBITDA reduction of €0.9m.

EBITDA for Healthcare Services was €87.7m (€82.3m), an EBITDA margin of 13.3% (15.8%).

EBITDAaL was €44.1m (€57.6m), a margin of 6.7% (11.1%).

Adjusted EBITDAaL was €46.2m (€59.0m), a margin of 7.0% (11.4%).

The strong contribution from Covid-19 services, particularly in India in Q2 2021, has been largely replaced with "normal" business, from organic expansion and acquisitions. The organic growth has weighed on margins as the new units in India and Romania have started up and made negative or dilutive margins over the nine months.

Operating profit amounted to €16.3m (€37.3m), a margin of 2.5% (7.2%).

EBITDA for Diagnostic Services was €95.7m (€126.4m), an EBITDA margin of 20.4% (25.4%).

EBITDAaL was €76.4m (€109.9m), a margin of 16.3% (22.1%). Contribution from Covid-19 has decreased margins by approximately 1.5pp. The war in Ukraine diluted margins as well with a negative swing of approximately 2.0pp. The balance of -2.3pp is the short-term impact in most markets in late February and early March where demand dipped, impacting contribution, and increased cost of inputs (labour, transport, energy) through the period.

Adjusted EBITDAaL was €78.1m (€111.1m), a margin of 16.7% (22.4%).

Operating profit amounted to €50.9m (€95.1m), a margin of 10.9% (19.1%).

Ukraine key data:

Q3 Q3 9M 9M FY
€m 2022 2021 2022 2021 2021
Revenue 13.6 27.6 41.6 82.8 117.4
Healthcare Services 1.8 2.0 4.8 5.7 7.9
Diagnostic Services 11.8 25.6 36.8 77.1 109.5
EBITDA 3.0 6.8 5.4 18.8 28.4
EBITDAaL 1.7 5.5 1.0 14.8 22.8
Net profit/(loss) -0.3 3.2 -9.4 7.1 11.6
Total assets 48.5 63.4 48.5 63.4 61.9
Net assets 31.0 41.9 31.0 41.9 40.7

KEY FINANCIAL DATA

Medicover, €m Jul-Sep
2022
Jul-Sep
2021
Vari
ance
Jan-Sep
2022
Jan-Sep
2021
Vari
ance
LTM FY
2021
Revenue 368.6 335.0 10% 1,112.5 1,001.1 11% 1,488.8 1,377.4
Operating profit (EBIT) 9.1 30.0 -70% 46.8 117.8 -60% 88.4 159.4
Operating profit margin 2.5% 9.0% 4.2% 11.8% 5.9% 11.6%
Net profit/(loss) -3.4 18.4 -118% 11.8 78.2 -85% 40.2 106.6
Net profit/(loss) margin
Basic/diluted earnings/(loss)
-0.9% 5.5% 1.1% 7.8% 2.7% 7.7%
per share, € -0.024 0.123 -120% 0.069 0.501 -86% 0.254 0.686
EBITDA 48.8 58.0 -16% 164.4 195.3 -16% 239.5 270.4
EBITDA margin 13.3% 17.3% 14.8% 19.5% 16.1% 19.6%
Adjusted EBITDA 52.8 60.7 -13% 176.5 201.7 -12% 255.3 280.5
Adjusted EBITDA margin 14.4% 18.1% 15.9% 20.1% 17.2% 20.4%
EBITDAaL 26.9 42.8 -37% 101.3 153.9 -34% 158.2 210.8
EBITDAaL margin 7.3% 12.8% 9.1% 15.4% 10.6% 15.3%
Adjusted EBITDAaL 30.9 45.5 -32% 113.4 160.3 -29% 174.0 220.9
Adjusted EBITDAaL margin 8.4% 13.6% 10.2% 16.0% 11.7% 16.0%
EBITA 14.2 32.6 -56% 66.0 125.3 -47% 111.9 171.2
EBITA margin 3.9% 9.7% 5.9% 12.5% 7.5% 12.4%
Adjusted EBITA 18.2 35.3 -48% 78.1 131.7 -41% 127.7 181.3
Adjusted EBITA margin 5.0% 10.6% 7.0% 13.2% 8.6% 13.2%
EBITAaL 8.4 29.0 -71% 50.0 115.7 -57% 91.5 157.2
EBITAaL margin 2.3% 8.6% 4.5% 11.6% 6.1% 11.4%
Adjusted EBITAaL 12.4 31.7 -61% 62.1 122.1 -49% 107.3 167.3
Adjusted EBITAaL margin 3.4% 9.5% 5.6% 12.2% 7.2% 12.1%
Healthcare Services, €m
Revenue 230.5 176.7 30% 658.1 519.7 27% 850.0 711.6
Operating profit (EBIT) 6.5 9.9 -34% 16.3 37.3 -56% 24.4 45.4
Operating profit margin 2.8% 5.6% 2.5% 7.2% 2.9% 6.4%
EBITDA 32.3 26.4 22% 87.7 82.3 7% 116.1 110.7
EBITDA margin 14.0% 15.0% 13.3% 15.8% 13.7% 15.6%
EBITDAaL 16.7 16.8 -1% 44.1 57.6 -23% 60.5 74.0
EBITDAaL margin 7.3% 9.5% 6.7% 11.1% 7.1% 10.4%
Adjusted EBITDAaL 17.6 17.6 0% 46.2 59.0 -22% 63.2 76.0
Adjusted EBITDAaL margin 7.6% 10.0% 7.0% 11.4% 7.4% 10.7%
EBITA 10.9 11.8 -8% 28.0 43.0 -35% 39.6 54.6
EBITA margin 4.7% 6.7% 4.3% 8.3% 4.7% 7.7%
Members (period end) (000's) 1,648 1,464 13% 1,648 1,464 13% 1,648 1,495
Diagnostic Services, €m
Revenue 142.7 162.9 -12% 468.6 497.1 -6% 658.3 686.8
Operating profit (EBIT) 9.2 24.6 -63% 50.9 95.1 -47% 91.3 135.5
Operating profit margin 6.4% 15.1% 10.9% 19.1% 13.9% 19.7%
EBITDA 22.6 35.7 -37% 95.7 126.4 -24% 149.0 179.7
EBITDA margin 15.9% 21.9% 20.4% 25.4% 22.6% 26.2%
EBITDAaL 16.3 30.1 -46% 76.4 109.9 -31% 123.6 157.1
EBITDAaL margin 11.4% 18.5% 16.3% 22.1% 18.8% 22.9%
Adjusted EBITDAaL 17.0 30.7 -45% 78.1 111.1 -30% 125.9 158.9
Adjusted EBITDAaL margin 11.9% 18.9% 16.7% 22.4% 19.1% 23.1%
EBITA 9.9 25.3 -61% 58.4 96.8 -40% 99.8 138.2
EBITA margin 6.9% 15.5% 12.5% 19.5% 15.1% 20.1%
Lab tests (period volume) (m) 29.0 32.4 -11% 90.0 97.5 -8% 125.9 133.4

CASH FLOW

Third quarter

Cash generated from operations before working capital changes amounted to €51.0m (€55.8m), being 104.2% of EBITDA (95.9%). Net working capital decreased by €3.5m (decreased by €11.2m). Income tax paid was €2.3m (€3.8m). Net cash from operating activities was €54.5m (€67.0m).

Investments in property, plant and equipment and intangible assets continued at a strong pace and amounted to €31.9m (€22.3m) with approximately 87% being growth capital investment and 13% being maintenance investment. €22.9m (€13.0m) was invested in Healthcare Services and €9.0m (€9.3m) in Diagnostic Services. Cash flow from acquisitions of subsidiaries amounted to €27.2m (€56.9m) relating to acquisitions closed in the quarter and payments for earlier closed transactions. Payment for future acquisitions was €15.8m (€3.9m). Proceeds for short-term investments amounted to €57.8m (€25.3m).

Net loans drawn amounted to €3.9m (net loans drawn €20.1m). Lease liabilities repaid were €13.8m (€9.7m). Interest paid amounted to €7.1m (€4.4m), of which €5.8m (€3.6m) related to lease liabilities.

Cash and cash equivalents increased by €14.2m to €77.3m.

Nine months

Cash generated from operations before working capital changes amounted to €158.8m (€186.2m), being 96.6% of EBITDA (95.3%). Net working capital increased by €30.7m (increased by €23.4m). Income tax paid was €14.1m (€12.8m). Net cash from operating activities was €128.1m (€162.8m).

Investments in property, plant and equipment and intangible assets amounted to €99.8m (€65.0m) with approximately 77% being growth capital investment and 23% being maintenance investment. €68.9m (€38.6m) was invested in Healthcare Services and €30.9m (€26.4m) in Diagnostic Services. Cash flow from acquisitions of subsidiaries amounted to €171.9m (€73.0m) relating to acquisitions closed in the nine months and payments for earlier closed transactions. Payment for future acquisitions was €15.8m (€3.9m). Proceeds for short-term investments amounted to €184.4m (€40.3m).

Acquisition of non-controlling interests amounted to €7.7m and mainly related to a hospital in India and a Serbian laboratory business. Net loans drawn amounted to €57.6m (net loans drawn €37.2m). Lease liabilities repaid were €36.7m (€27.1m). Interest paid amounted to €21.9m (€12.2m), of which €16.0m (€9.6m) related to lease liabilities. A dividend of €17.8m (€10.4m) was distributed to shareholders.

Cash and cash equivalents decreased by €1.7m to €77.3m.

FINANCIAL POSITION

Consolidated equity as at 30 September 2022 amounted to €516.6m (€562.1m). The decrease in equity includes a negative movement of €14.1m on translation reserves mainly relating to the weakness of the Polish zloty offset by the strengthening of the Indian rupee. In addition, total equity attributable to owners of the parent includes a negative movement of €15.3m relating to fair value changes of put option liquidity obligations with non-controlling interests and €11.9m relating to acquisition of non-controlling interests mainly in the Indian and Serbian businesses. A dividend of €17.8m (€10.4m) was distributed to shareholders, equivalent to €0.12 (€0.07) per share.

Inventories amounted to €64.0m (€72.0m).

Short-term investments were €5.5m (€192.9m), the investment in the euro-denominated bond funds have been disposed during the year.

Loans payable amounted to €488.5m (€418.2m). The Group has hedged €100m nominal of its floating rate debt in the quarter. €235.5m (€135.5m) is at fixed interest rates and €39.5m (€26.6m) is non-interest bearing (deferred/contingent consideration payable).

In December 2021, the Group carried out its second schuldschein issue (a German private placement debt instrument) under its social financing framework. €277m was issued in eurodenominated tranches with maturities of 5.5, 7.5 and 10 years at fixed and floating rates. €216m

was received in 2021 and €61m in 2022. €69m of the schuldschein loans carried out in the first schuldschein issue in 2020 has been repaid.

In June 2022, the revolving credit facility was renewed and increased from €220m to €300m with a duration of 3 years with the possibility to extend for up to two years. Loans payable net of cash and liquid short-term investments amounted to €405.7m (€143.4m) reflecting the operating cash flows as well as the acquisitions closed in the quarter and continuing pace of organic capital investment. The ratio of loans payable net of cash and liquid shortterm investments to adjusted EBITDAaL for the prior twelve months was 2.3x (0.6x level at yearend 2021).

The Group has utilised €26.9m (€19.5m) under its 2bn SEK commercial paper programme. The Group has an undrawn committed credit facility of €258.9m, liquid short-term investments and cash and cash equivalents of €82.8m, in total €341.7m (€504.8m) at the end of the quarter and is well positioned to support future organic and acquisition growth.

Lease liabilities amounted to €413.2m (€345.9m), an increase by €67.3m of which 60.6% related to acquisitions mainly in Poland, Romania and India. The remaining increase reflected the expansion of facilities leased in Poland, Romania, India and Germany.

The total financial debt was €901.7m (€764.1m).

PARENT COMPANY

There was no significant revenue. The profit/(loss) for the nine months amounted to €0.2m (€-7.7m), impacted by dividends of €9.7m (-). At the end of the quarter €26.9m (€19.5m) has been utilised under the commercial paper programme. The

proceeds of the programme have been lent to the Company's subsidiary on the same maturity as the programme drawings. Equity as at 30 September 2022 was €598.8m (€609.9m).

RISK FACTORS

The Group's business is exposed to risks that could impact its operations, performance or financial position. These comprise operational risks relating to the ability to recruit and retain skilled staff, acquisition execution, anti-corruption, employee protection, environment, insurance risk, IT systems, medical risk, premises, reputational risk, suppliers and technology and innovation risk. External risks consist of risks relating to armed conflict, climate change, legislative and regulatory risk, market risk, pandemic and political risk. In addition, the Group is exposed to financial risks, such as credit risk, currency risk, interest rate risk and liquidity and financing risk. Management of these risks is a key issue for Medicover to execute its strategy and reach financial targets. Medicover sets out to manage those risks that are controllable, through identification, assessment and controls and for those that are not controllable to monitor and mitigate as reasonable possible.

Medicover operates in Ukraine which is experiencing an armed conflict. During armed conflicts there is a risk that facilities and assets are requisitioned, damaged or destroyed and that staff are killed, injured or displaced. Impacts are likely to be negative affecting or potentially affective the ability to continue operations, the economy, funding, currency stability and ultimately impairment of assets and curtailment of operations. Disruptions to operations and to supply chains may also occur as a direct or indirect result due to such issues as cyber-attacks, international embargos, sanctions or other issues arising from conflict. The outlook for the year is uncertain. Ukraine represented 9% of the Group's revenue during 2021 and the diversified business across several countries mitigates the risks to a certain degree. Medicover has taken an approach to protect staff whilst also considering the essential nature of many of its services, hence seeking to maintain services even in difficult circumstances.

Risk factors and uncertainties of relevance to the Group are described in the annual report 2021, section 'Risk and risk management' (pages 61-66).

The board of directors and the CEO declare that the interim report for January-September 2022 gives a fair overview of the parent company´s and Group´s operations, financial position and results of operations and describes significant risks and uncertainties facing the parent company and companies included in the Group.

Stockholm on 3 November 2022

Fredrik Stenmo Chairman of the board

Peder af Jochnick Robert af Jochnick Anne Berner Board member Board member Board member

Board member Board member Board member

Arno Bohn Sonali Chandmal Michael Flemming

Margareta Nordenvall Fredrik Rågmark Azita Shariati Board member CEO and board member Board member

This is information that Medicover AB is obliged to make public pursuant to the EU Market Abuse Regulation. The information was submitted for publication through the agency of the contact person set out below at 7.45 (CET) on 3 November 2022. This interim report and other information about Medicover is available at medicover.com.

Financial calendar

Year-end report January-December 2022 17 February 2023 Capital Markets Day 17 February 2023 Annual report week 13 2023 Interim report January-March 27 April 2023 Annual general meeting 27 April 2023 Interim report April-June 26 July 2023 Interim report July-September 3 November 2023

For further information, please contact:

Hanna Bjellquist, Head of Investor Relations Phone: +46 70 303 32 72 E-mail: [email protected]

Conference call: A conference call for analysts and investors will be held today at 09.30 CET. To listen in please register here. To ask questions please register here.

Address

Org nr: 559073-9487 Medicover AB (publ) P.O. Box 5283, SE-102 46 Stockholm Visiting address: Riddargatan 12A, SE-114 35 Stockholm, Sweden Phone: +46 8 400 17 600

This report may contain certain forward-looking statements and opinions. Forward-looking statements are statements that do not relate to historical facts and events and such statements and opinions pertaining to the future. Forward-looking statements are based on current estimates and assumptions made according to the best of Medicover's knowledge. Such forward-looking statements are subject to risks, uncertainties, and other factors that could cause the actual results, including Medicover's cash flow, financial position and results of operations, to differ materially from the results, or fail to meet expectations expressly or implicitly assumed or described in those statements or to turn out to be less favourable than the results expressly or implicitly assumed or described in those statements.

In light of the risks, uncertainties and assumptions associated with forward-looking statements, it is possible that the future events mentioned in this presentation may not occur. Actual results, performance or events may differ materially from those in such statements due to, without limitation, changes in general economic conditions, in particular economic conditions in the markets on which Medicover operates, changes affecting interest rate levels, changes affecting currency exchange rates, changes in competition levels, changes in laws and regulations, and occurrence of accidents or environmental damages.

The information, opinions and forward-looking statements contained in this announcement speak only as at its date and are subject to change without notice.

REVIEW REPORT

Medicover AB (publ), org no 559073–9487

Introduction

We have reviewed the interim report for Medicover AB (publ) as at 30 September 2022 and for the ninemonth period then ended. The Board of Directors and the Chief Executive Officer are responsible for the preparation and presentation of this interim report in accordance with International Accounting Standard (IAS) 34, Interim Financial Reporting, and the Swedish Annual Accounts Act. Our responsibility is to express a conclusion on this interim financial information based on our review.

Scope of Review

We conducted our review in accordance with the International Standard on Review Engagements, ISRE 2410, Review of Interim Financial Information Performed by the Independent Auditor of the Entity. A review consists of making inquiries, primarily of persons responsible for financial and accounting matters, and applying analytical and other review procedures. A review has a different focus and is substantially less in scope than an audit conducted in accordance with International Standards on Auditing (ISA) and other generally accepted auditing practices. The procedures performed in a review do not enable us to obtain assurance that would make us aware of all significant matters that might be identified in an audit. Therefore, the conclusion based on a review does not give the same level of assurance as a conclusion based on an audit.

Conclusion

Based on our review, nothing has come to our attention that causes us to believe that the interim report is not prepared, in all material respects, in accordance with IAS 34 and the Swedish Annual Accounts Act for the Group, and in accordance with the Swedish Annual Account Acts for the Parent Company.

Sollentuna, 3 November 2022

BDO Sweden AB

Jörgen Lövgren

Authorised Public Accountant

CONDENSED FINANCIAL STATEMENTS

CONSOLIDATED INCOME STATEMENT

€m Jul-Sep
2022
Jul-Sep
2021
Jan-Sep
2022
Jan-Sep
2021
LTM Jan-Dec
2021
Revenue 368.6 335.0 1,112.5 1,001.1 1,488.8 1,377.4
Operating expenses
Medical provision costs -287.0 -249.4 -859.2 -715.3 -1,126.3 -982.4
Gross profit 81.6 85.6 253.3 285.8 362.5 395.0
Distribution, selling and marketing costs -16.8 -12.9 -48.3 -41.8 -64.6 -58.1
Administrative costs -55.7 -42.7 -158.2 -126.2 -209.5 -177.5
Operating profit (EBIT) 9.1 30.0 46.8 117.8 88.4 159.4
Other income/(costs) 0.4 0.7 -2.9 0.8 -3.0 0.7
Interest income 0.8 0.2 1.9 0.5 2.4 1.0
Interest expense -8.7 -5.5 -24.1 -13.8 -30.4 -20.1
Other financial income/(expense) -5.8 -1.3 -4.9 0.1 -3.2 1.8
Total financial result -13.7 -6.6 -27.1 -13.2 -31.2 -17.3
Share of profit of associates 0.0 0.3 0.1 0.9 0.2 1.0
Profit/(loss) before income tax -4.2 24.4 16.9 106.3 54.4 143.8
Income tax 0.8 -6.0 -5.1 -28.1 -14.2 -37.2
Profit/(loss) for the period -3.4 18.4 11.8 78.2 40.2 106.6
Profit/(loss) attributable to:
Owners of the parent -3.6 18.3 10.2 74.3 37.7 101.8
Non-controlling interests 0.2 0.1 1.6 3.9 2.5 4.8
Profit/(loss) for the period -3.4 18.4 11.8 78.2 40.2 106.6
Earnings/(loss) per share
attributable to owners of the parent:
Basic/diluted, € -0.024 0.123 0.069 0.501 0.254 0.686

CONSOLIDATED STATEMENT OF COMPREHENSIVE INCOME

€m Jul-Sep
2022
Jul-Sep
2021
Jan-Sep
2022
Jan-Sep
2021
LTM Jan-Dec
2021
Profit/(loss) for the period -3.4 18.4 11.8 78.2 40.2 106.6
Other comprehensive income/(loss):
Items that may be reclassified
subsequently to income statement:
Exchange differences on translating
foreign operations -12.3 -2.8 -14.1 5.1 -10.1 9.1
Cash flow hedge 0.2 - 0.2 - 0.2 -
Income tax relating to these items -0.1 -0.1 0.0 -0.5 0.0 -0.5
Other comprehensive income/(loss)
for the period, net of tax
-12.2 -2.9 -13.9 4.6 -9.9 8.6
Total comprehensive income/(loss)
for the period
-15.6 15.5 -2.1 82.8 30.3 115.2
Total comprehensive income/(loss)
attributable to:
Owners of the parent -16.9 14.3 -5.5 77.4 24.8 107.7
Non-controlling interests 1.3 1.2 3.4 5.4 5.5 7.5
Total comprehensive income/(loss)
for the period
-15.6 15.5 -2.1 82.8 30.3 115.2

CONSOLIDATED STATEMENT OF FINANCIAL POSITION

€m 30 Sep
2022
30 Sep
2021
31 Dec
2021
ASSETS
Non-current assets
Goodwill 470.9 361.9 371.7
Other intangible assets 119.2 73.1 75.1
Property, plant and equipment 400.3 294.3 319.3
Right-of-use assets 382.4 280.1 327.4
Deferred tax assets 17.0 15.5 11.9
Investments in associates 0.6 8.5 8.5
Other assets 0.1 - -
Other financial assets 16.4 15.7 18.8
Total non-current assets 1,406.9 1,049.1 1,132.7
Current assets
Inventories 64.0 60.1 72.0
Other financial assets 15.8 3.9 3.1
Trade and other receivables 219.0 181.7 201.7
Short-term investments 5.5 - 192.9
Cash and cash equivalents 77.3 92.6 81.9
Total current assets 381.6 338.3 551.6
Total assets 1,788.5 1,387.4 1,684.3
EQUITY
Equity attributable to owners of the parent 473.6 489.9 517.6
Non-controlling interests 43.0 42.7 44.5
Total equity 516.6 532.6 562.1
LIABILITIES
Non–current liabilities
Loans payable 375.7 168.1 375.3
Lease liabilities 329.5 257.3 299.8
Deferred tax liabilities 41.2 35.7 35.3
Provisions 2.7 2.2 2.8
Other financial liabilities 75.5 74.6 78.3
Other liabilities 6.6 4.0 5.7
Total non-current liabilities 831.2 541.9 797.2
Current liabilities
Loans payable 112.8 49.0 42.9
Lease liabilities 83.7 44.2 46.1
Unearned premiums/ deferred revenue 21.1 15.9 20.2
Corporate tax payable 31.5 27.2 28.8
Other financial liabilities 23.0 5.6 4.6
Trade and other payables 168.6 171.0 182.4
Total current liabilities 440.7 312.9 325.0
Total liabilities 1,271.9 854.8 1,122.2
Total equity and liabilities 1,788.5 1,387.4 1,684.3

CONSOLIDATED STATEMENT OF CHANGES IN EQUITY

€m Share
capital
Treasury
shares
Share
premium
Retained
earnings
Non
controlling
interests put
option reserve
Translation
reserve
Hedging
reserve
Other
reserves
Total equity
attributable
to owners of
the parent
Non
controlling
interests
Total
equity
Opening balance as at 1 January 2021 30.1 -0.4 458.7 50.9 -45.1 -55.1 - 8.9 448.0 35.5 483.5
Profit
for
the
period
- - - 74.3 - - - - 74.3 3.9 78.2
Other
comprehensive
income/(loss)
- - - - - 3.1 - - 3.1 1.5 4.6
Total comprehensive income/(loss) for the period
Transactions with owners in their capacity as
owners:
- - - 74.3 - 3.1 - - 77.4 5.4 82.8
Business
combinations
- - - - - - - - - 3.3 3.3
Changes
in
interest
in
subsidiaries
- - - -0.8 - - - - -0.8 -0.6 -1.4
Share
capital
increase
in
non-controlling
interests
Changes
in
put
option
and
liquidity
obligation
with
non
- - - - - - - - - 1.8 1.8
controlling
interests
- - - - -28.7 - - - -28.7 -2.7 -31.4
Dividend - - - -10.4 - - - - -10.4 - -10.4
Share-based
payments
- - - - - - - 4.4 4.4 - 4.4
Total transactions with owners in their capacity as
owners - - - -11.2 -28.7 - - 4.4 -35.5 1.8 -33.7
Closing balance as at 30 September 2021 30.1 -0.4 458.7 114.0 -73.8 -52.0 - 13.3 489.9 42.7 532.6
Opening balance as at 1 January 2022 30.4 -0.7 458.7 141.3 -78.2 -49.2 - 15.3 517.6 44.5 562.1
Profit
for
the
period
- - - 10.2 - - - - 10.2 1.6 11.8
Other
comprehensive
income/(loss)
- - - - - -15.9 0.2 0.0 -15.7 1.8 -13.9
Total comprehensive income/(loss) for the period
Transactions with owners in their capacity as
- - - 10.2 - -15.9 0.2 - -5.5 3.4 -2.1
owners:
Business
combinations
- - - - - - - - - 4.5 4.5
Changes
in
interest
in
subsidiaries
Share
capital
increase/distribution
of
dividend
in
non
- - - -11.9 - - - - -11.9 -5.4 -17.3
controlling
interests
- - - - - - - - - 0.1 0.1
Changes
in
put
option
and
liquidity
obligation
with
non
controlling
interests
- - - - -15.3 - - - -15.3 -4.1 -19.4
Dividend - - - -17.8 - - - - -17.8 - -17.8
Distribution
of
performance
shares
to
employees
- 0.1 -0.1 3.5 - - - -3.5 - - -
Share-based
payments
- - - - - - - 6.5 6.5 - 6.5
Total transactions with owners in their capacity as
owners - 0.1 -0.1 -26.2 -15.3 - - 3.0 -38.5 -4.9 -43.4
Closing balance as at 30 September 2022 30.4 -0.6 458.6 125.3 -93.5 -65.1 0.2 18.3 473.6 43.0 516.6

CONSOLIDATED CASH FLOW STATEMENT

€m Jul-Sep
2022
Jul-Sep
2021
Jan-Sep
2022
Jan-Sep
2021
LTM Jan-Dec
2021
Profit/(loss) before income tax -4.2 24.4 16.9 106.3 54.4 143.8
Adjustments for:
Depreciation, amortisation and impairment 39.7 28.0 117.6 77.5 151.1 111.0
Share-based payments 2.8 2.0 6.9 4.4 9.1 6.4
Net interest expense 7.9 5.2 22.2 13.1 28.0 19.1
Unrealised foreign exchange (gain)/loss 6.2 1.3 8.6 -0.6 6.6 -2.6
Other non-cash transactions 0.9 -1.3 0.7 -1.7 0.8 -1.8
Income tax paid -2.3 -3.8 -14.1 -12.8 -19.6 -18.3
Cash generated from operations before
working capital changes 51.0 55.8 158.8 186.2 230.4 257.6
Changes in operating assets and liabilities:
(Increase)/decrease in inventories -0.9 -4.2 9.3 -5.6 -2.2 -17.1
(Increase)/decrease in trade and other receivables 7.4 -8.9 -1.8 -28.9 -22.4 -49.5
Increase/(decrease) in trade and other payables -3.0 24.3 -38.2 11.1 -23.8 25.7
Net cash from operating activities 54.5 67.0 128.1 162.8 182.0 216.7
Investing activities:
Payment for acquisition of intangible assets and
property, plant and equipment
-31.9 -22.3 -99.8 -65.0 -137.0 -102.2
Proceeds from disposal of intangible assets and
property, plant and equipment
0.8 1.4 2.7 1.8 3.0 2.1
Dividends received from associates 0.1 0.1 0.1 0.1 0.1 0.1
Payment for other financial assets -0.5 - -0.5 - -2.5 -2.0
Payment for acquisition of subsidiaries, net of cash
acquired -27.2 -56.9 -171.9 -73.0 -182.5 -87.5
Payment for future acquisitions -15.8 -3.9 -15.8 -3.9 -15.8 -
Repayment of loans granted 0.2 - 0.2 - 0.2 -
Payment of loans granted - -2.0 - -2.6 -0.2 -2.8
Payment for short-term investments 0.0 - -1.1 - -183.6 -182.5
Proceeds from short-term investments 57.8 25.3 184.4 40.3 184.4 40.3
Interest received 0.6 0.2 1.4 0.5 1.8 0.9
Net cash used in investing activities -15.9 -58.1 -100.3 -101.8 -332.1 -333.6
Financing activities:
Issue of shares, net of transaction cost - - - - 0.3 0.3
Acquisition of treasury shares - - - - -0.3 -0.3
Acquisition of non-controlling interests -3.6 -0.8 -7.7 -1.5 -7.7 -1.5
Repayment of loans -101.2 -25.2 -376.6 -33.7 -397.6 -54.7
Proceeds from loans received 105.1 45.3 434.2 70.9 657.0 293.7
Repayment of leases -13.8 -9.7 -36.7 -27.1 -48.1 -38.5
Interest paid -7.1 -4.4 -21.9 -12.2 -29.4 -19.7
Dividend paid - - -17.8 -10.4 -17.8 -10.4
Distribution to non-controlling interests -3.8 - -3.8 -3.9 -6.6 -6.7
Proceeds from non-controlling interests 0.0 0.1 0.8 1.8 0.9 1.9
Net cash from/(used in) financing activities -24.4 5.3 -29.5 -16.1 150.7 164.1
Total cash flow 14.2 14.2 -1.7 44.9 0.6 47.2
Cash and cash equivalents
Cash balance as at beginning of the period 65.6 77.9 81.9 46.7 92.6 46.7
Net effects of exchange gain/(loss) on cash
balances
-2.5 0.5 -2.9 1.0 -15.9 -12.0
Cash balance as at end of the period 77.3 92.6 77.3 92.6 77.3 81.9
Increase/(decrease) in cash and cash
equivalents 14.2 14.2 -1.7 44.9 0.6 47.2

PARENT COMPANY INCOME STATEMENT

€m Jul-Sep
2022
Jul-Sep
2021
Jan-Sep
2022
Jan-Sep
2021
LTM Jan-Dec
2021
Revenue 0.2 0.1 0.4 0.3 0.8 0.7
Operating expenses -4.2 -3.0 -10.6 -8.0 -14.2 -11.6
Operating loss
Income from participation in group
companies
-4.0
9.7
-2.9
-
-10.2
9.7
-7.7
-
-13.4
22.7
-10.9
13.0
Interest income from group companies 0.9 - 1.0 - 1.0 0.0
Interest expense -0.2 0.0 -0.3 0.0 -0.4 -0.1
Profit/(loss) before income tax 6.4 -2.9 0.2 -7.7 9.9 2.0
Income tax - - - - - -
Profit/(loss) for the period 6.4 -2.9 0.2 -7.7 9.9 2.0

As the profit/(loss) for the period corresponds with the amount in total comprehensive income, no separate statement of comprehensive income is presented.

PARENT COMPANY BALANCE SHEET

€m 30 Sep
2022
30 Sep
2021
31 Dec
2021
Property, plant and equipment 0.0 0.0 0.1
Investments in subsidiaries 584.8 434.8 434.8
Total non-current assets 584.8 434.8 434.9
Current receivables 42.4 189.9 196.5
Cash and bank 0.0 - 0.0
Total current assets 42.4 189.9 196.5
Total assets 627.2 624.7 631.4
Restricted equity 30.4 30.1 30.4
Non-restricted equity 568.4 568.1 579.5
Total equity 598.8 598.2 609.9
Current liabilities 28.4 26.5 21.5
Total liabilities 28.4 26.5 21.5
Total equity and liabilities 627.2 624.7 631.4

NOTES

1. Basis of preparation and accounting policies

Basis of preparation

Medicover AB (publ) ("the Company") together with its subsidiaries are referred to as "the Group". Medicover AB (publ) is a company domiciled in Sweden, with its head office in Stockholm. The reporting and functional currency of the Company is the Euro.

This interim report has been prepared in accordance with IAS 34 Interim Financial Reporting and should be read together with the Group's consolidated financial statements 2021.

The report does not include all disclosures that would otherwise be required in a complete set of financial statements.

Information on pages 1-19 is an integral part of this report.

Accounting policies, use of estimates and judgements

The Group applies the International Financial Reporting Standards (IFRS) as adopted by the European Union. The accounting policies and methods of computation applied in this report are the same as those applied by the Group in its consolidated financial statements 2021 apart from a new accounting principle for hedge accounting as described in section "Hedging of interest rate exposure". Some amendments to existing standards became applicable as from 1 January 2022, however none of these have a material impact on the consolidated financial statements or accounting policies.

Hedging of interest rate exposure – cash flow hedge

Medicover has entered into an interest rate swap to control the exposure to variability in cash flows of

future interest rate fluctuations. The hedging strategy is to fix interest rates on a proportion of the floating rate loan portfolio in issue for a period of its duration, this is achieved by swapping from floating to fixed rates. The objective is to exclude the risk of higher rates than the fixed rate impacting the Group's cash flows over a three year period. In the consolidated statement of financial position, interest swaps are valued at fair value. The interest rate coupon is recognised on an on-going basis in the consolidated income statement as a component of interest expense. Unrealised changes to the fair value of interest swaps are recognised in other comprehensive income and are included as a component of the hedging reserve in equity until the hedged item has an effect on the income statement and as long as the criteria for hedge accounting and effectiveness are met.

The preparation of interim reports requires the use of certain critical accounting estimates. It also requires management to exercise judgement in applying the Group's accounting policies. Refer to the Group's consolidated financial statements 2021 for further information on the use of estimates and judgements.

The parent company applies the Swedish Annual Accounts Act and the Financial Reporting Board's Recommendation RFR 2 Accounting for Legal Entities.

Alternative performance measures (APMs) are presented in this interim report since these are considered as important supplemental measures of the Company's performance. For definition and reconciliation of APMs, refer to www.medicover.com/financial-information.

2. Segment information

Jul-Sep 2022 Jul-Sep 2021
€m Healthcare
Services
Diagnostic
Services
Central/
other
Group
total
Healthcare
Services
Diagnostic
Services
Central/
other
Group
total
Revenue 230.5 142.7 0.1 176.7 162.9 0.2
Inter-segment
revenue
-0.2 -4.5 0.0 -0.1 -4.5 -0.2
Revenue
from
external
customers
230.3 138.2 0.1 368.6 176.6 158.4 0.0 335.0
By
payer:
Private 198.4 91.6 0.1 290.1 159.0 113.8 0.0 272.8
Public 31.9 46.6 - 78.5 17.6 44.6 - 62.2
By
country:
Poland 148.8 13.1 0.0 161.9 111.6 13.4 0.0 125.0
Germany - 70.8 - 70.8 - 69.9 - 69.9
Romania 22.9 20.4 - 43.3 20.2 20.8 0.0 41.0
India 46.0 - - 46.0 33.0 - - 33.0
Ukraine 1.8 11.8 - 13.6 2.0 25.6 - 27.6
Other
countries
10.8 22.1 0.1 33.0 9.8 28.7 0.0 38.5
Operating
profit
6.5 9.2 -6.6 9.1 9.9 24.6 -4.5 30.0
Margin 2.8% 6.4% 2.5% 5.6% 15.1% 9.0%
Depreciation,
amortisation
and
impairment
25.8 13.4 0.5 39.7 16.5 11.1 0.4 28.0
EBITDA 32.3 22.6 -6.1 48.8 26.4 35.7 -4.1 58.0
Margin 14.0% 15.9% 13.3% 15.0% 21.9% 17.3%
Right-of-use
depreciation/impairment
-10.7 -5.4 0.0 -16.1 -6.8 -4.8 0.0 -11.6
Interest
on
lease
liabilities
-4.9 -0.9 0.0 -5.8 -2.8 -0.8 0.0 -3.6
Segment
result:
EBITDAaL
16.7 16.3 -6.1 26.9 16.8 30.1 -4.1 42.8
Margin 7.3% 11.4% 7.3% 9.5% 18.5% 12.8%
Other
income/(costs)
0.4 0.7
Net
interest
expense
-7.9 -5.3
Other
financial
income/(expense)
-5.8 -1.3
Share
of
profit
of
associates
0.0 0.3
Income
tax
0.8 -6.0
Profit/(loss)
for
the
period
-3.4 18.4
Jan-Sep 2022 Jan-Sep
2021
€m Healthcare
Services
Diagnostic
Services
Central/
other
Group
total
Healthcare
Services
Diagnostic
Services
Central/
other
Group
total
Revenue 658.1 468.6 0.3 519.7 497.1 0.3
Inter-segment
revenue
-0.6 -13.8 -0.1 -0.6 -15.3 -0.1
Revenue
from
external
customers
657.5 454.8 0.2 1,112.5 519.1 481.8 0.2 1,001.1
By
payer:
Private 578.1 294.3 0.2 872.6 465.4 329.4 0.2 795.0
Public 79.4 160.5 - 239.9 53.7 152.4 - 206.1
By
country:
Poland 428.1 39.2 0.0 467.3 325.2 44.6 0.0 369.8
Germany - 240.3 - 240.3 - 230.4 - 230.4
Romania 69.4 61.9 - 131.3 61.7 64.8 0.0 126.5
India 122.0 - - 122.0 102.7 - - 102.7
Ukraine 4.8 36.8 - 41.6 5.7 77.1 - 82.8
Other
countries
33.2 76.6 0.2 110.0 23.8 64.9 0.2 88.9
Operating
profit
16.3 50.9 -20.4 46.8 37.3 95.1 -14.6 117.8
Margin 2.5% 10.9% 4.2% 7.2% 19.1% 11.8%
Depreciation,
amortisation
and
impairment
71.4 44.8 1.4 117.6 45.0 31.3 1.2 77.5
EBITDA 87.7 95.7 -19.0 164.4 82.3 126.4 -13.4 195.3
Margin 13.3% 20.4% 14.8% 15.8% 25.4% 19.5%
Right-of-use
depreciation/impairment
-30.4 -16.5 -0.2 -47.1 -17.5 -14.1 -0.2 -31.8
Interest
on
lease
liabilities
-13.2 -2.8 0.0 -16.0 -7.2 -2.4 0.0 -9.6
Segment
result:
EBITDAaL
44.1 76.4 -19.2 101.3 57.6 109.9 -13.6 153.9
Margin 6.7% 16.3% 9.1% 11.1% 22.1% 15.4%
Other
income/(costs)
-2.9 0.8
Net
interest
expense
-22.2 -13.3
Other
financial
income/(expense)
-4.9 0.1
Share
of
profit
of
associates
0.1 0.9
Income
tax
-5.1 -28.1
Profit
for
the
period
11.8 78.2
LTM Jan-Dec
2021
€m Healthcare
Services
Diagnostic
Services
Central/
other
Group
total
Healthcare
Services
Diagnostic
Services
Central/
other
Group
total
Revenue 850.0 658.3 0.3 711.6 686.8 0.3
Inter-segment
revenue
-1.1 -18.7 0.0 -1.1 -20.2 0.0
Revenue
from
external
customers
848.9 639.6 0.3 1,488.8 710.5 666.6 0.3 1,377.4
By
payer:
Private 748.4 423.6 0.3 1,172.3 635.7 458.7 0.3 1,094.7
Public 100.5 216.0 - 316.5 74.8 207.9 - 282.7
By
country:
Poland 552.9 54.7 0.0 607.6 450.0 60.1 0.0 510.1
Germany - 326.3 - 326.3 - 316.4 - 316.4
Romania 91.5 84.9 0.0 176.4 83.8 87.8 0.0 171.6
India 154.2 - - 154.2 134.9 - - 134.9
Ukraine 7.0 69.2 - 76.2 7.9 109.5 - 117.4
Other
countries
43.3 104.5 0.3 148.1 33.9 92.8 0.3 127.0
Operating
profit
24.4 91.3 -27.3 88.4 45.4 135.5 -21.5 159.4
Margin 2.9% 13.9% 5.9% 6.4% 19.7% 11.6%
Depreciation,
amortisation
and
impairment
91.7 57.7 1.7 151.1 65.3 44.2 1.5 111.0
EBITDA 116.1 149.0 -25.6 239.5 110.7 179.7 -20.0 270.4
Margin 13.7% 22.6% 16.1% 15.6% 26.2% 19.6%
Right-of-use
depreciation/impairment
-38.8 -21.8 -0.3 -60.9 -25.9 -19.4 -0.3 -45.6
Interest
on
lease
liabilities
-16.8 -3.6 0.0 -20.4 -10.8 -3.2 0.0 -14.0
Segment
result:
EBITDAaL
60.5 123.6 -25.9 158.2 74.0 157.1 -20.3 210.8
Margin 7.1% 18.8% 10.6% 10.4% 22.9% 15.3%
Other
income/(costs)
-3.0 0.7
Net
interest
expense
-28.0 -19.1
Other
financial
income/(expense)
-3.2 1.8
Share
of
profit
of
associates
0.2 1.0
Income
tax
-14.2 -37.2
Profit
for
the
period
40.2 106.6

3. Share capital

Share capital as at 30 September 2022 was €30.4m (€30.4m) and corresponded to the following shares:

Class A
shares
Class B
shares
Class C*
shares
Total
1 January 2021 78,551,881 69,798,670 2,384,644 150,735,195
Conversion of class A to class B shares -610 610
30 September 2021 78,551,271 69,799,280 2,384,644 150,735,195
1 January 2022 77,569,276 70,781,275 3,584,644 151,935,195
Conversion of class A to class B shares -170,000 170,000
Conversion of class C to class B shares 603,016 -603,016
30 September 2022 77,399,276 71,554,291 2,981,628 151,935,195

* held by the Company as treasury shares.

Celox Holding AB owned 47,157,365 shares and 55.6% of the voting rights (47,157,365 shares and 55.5% of the voting rights at year-end 2021).

The number of shares used to calculate the basic earnings per share was 148,953,567 (148,350,551) for the quarter and 148,697,340 (148,350,551) for the nine months.

The quota value was €0.2 (€0.2) per share.

Equity settled share-based programme

The five-year vesting period for Plan 2017 was completed on 27 April 2022. The performance conditions were achieved in full, corresponding to eight performance shares for each share right. The annual EBITDA (pre IFRS 16) growth rate (CAGR) calculated on the basis of the Group's financial statements for 2016 and 2021 (restated consolidated financial accounts prepared on a pre IFRS 16 basis), was 37.1%. Refer to note 33 in the annual report 2021 for more information.

Medicover compensated the participants for the dividends paid during the duration of the programme by increasing the number of shares. The issuance date of Plan 2017 was 24 May 2022. 603,016 class C shares were converted to class B shares and distributed to the participants.

4. Business combinations

Acquisition Description Voting
Note date Name Country of business Segment* rights, %
NIPD Genetics Public
a) 10 Jan Company Ltd ("NIPD") Cyprus Laboratory DS 68.3
c) 20 Jan Polaris Medical S.A. Romania Hospital HS 90
Centrum Diagnostyczno Hospital/
Terapeutyczne "Medicus" Medical/
b) 28 Jan sp. z o.o. ("CDT") Poland Laboratory HS 100
Premium Fitness & Gym sp.
c) 31 Jan z o.o. Poland Gym HS 100
Sahrudaya Health Care
(Vizianagaram) Private
c) 11 Feb Limited India Hospital HS 60
c) 28 Feb Bellevue Polska sp. z o.o. Poland Vision care HS 100
c) 11 Mar "Medicover Diagnostics"
d.o.o. Banja Luka) (former
"Konzilijum" d.o.o. Banja
Luka)
Bosnia
Herzegovina
Laboratory DS 80
c) 1 Apr Czar-Dent Poland Dental HS -
Clinical trial business of
c) 4 Apr Nasz Lekarz Poland Laboratory DS -
c) 8 Apr Dialab Poland Laboratory DS -
Ostoya Holding sp. z o.o.,
Propsyche Allenort sp. z
o.o., Psychiatria Allenort
Bialystok sp. z o.o., Mental
Psychomedica Allenort sp. z health/
c) 25 Apr o.o. Poland hospital HS 100
c) 5 May McFit Polska sp. z o.o. Poland Gym HS 100
Intergenetics Private
Polyclinic Single Member
c) 14 Jul SA Greece Laboratory DS 100
c) 1 Aug Ambasada Uśmiechu Poland Dental HS -
Nasz Lekarz Przychodnie
c) 13 Sep Medyczne sp. z o.o. Poland Medical HS 100
c) 14 Sep Laurus Medical S.R.L. Romania Medical HS 100

* DS: Diagnostic Services, HS: Healthcare Services

Preliminary purchase price allocations are as follows.

€m NIPD CDT Other Total
Other intangible assets: 25.8 13.3 13.1 52.2
Brand - 12.9 7.0 19.9
Customer relations - - 6.0 6.0
Development costs 9.4 - - 9.4
Patents 16.3 - - 16.3
Other 0.1 0.4 0.1 0.6
Property, plant and equipment 1.6 23.8 27.1 52.5
Right-of-use assets 1.3 0.4 40.5 42.2
Accounts receivable and inventories 6.8 3.0 16.8 26.6
Corporate tax receivable 0.1 - 0.1 0.2
Cash and cash equivalents 7.8 3.6 4.7 16.1
Loans payable - -3.4 -0.4 -3.8
Lease liabilities -1.3 -0.4 -39.1 -40.8
Deferred tax (net) -2.0 -4.1 -0.4 -6.5
Corporate tax payable - 0.0 -0.2 -0.2
Accounts payable -6.2 -3.2 -19.5 -28.9
Other payable - - -1.4 -1.4
Net identifiable assets 33.9 33.0 41.3 108.2
Non-controlling interests -4.3 -0.2 -0.2 -4.7
Goodwill 27.2 23.3 56.2 106.7
Total consideration 56.8 56.1 97.3 210.2
Cash and cash equivalents acquired -7.8 -3.6 -4.7 -16.1
Contingent consideration payable - - -8.4 -8.4
Deferred consideration payable - - -3.3 -3.3
Previous held interest in NIPD -12.3 - - -12.3
Non-cash movements - - -3.3 -3.3
Net cash flow outflow, acquisitions in current year 36.7 52.5 77.6 166.8
Payment related to acquisitions in prior years - - - 5.1
Net cash flow outflow 36.7 52.5 77.6 171.9

Included in the consolidated income statement 2022 was revenue of €55.6m and a net loss of €-5.7m related to business combinations in the nine months. If these acquisitions had occurred on 1 January 2022, revenue would have been €22.2m higher and net profit would have been €1.2m higher.

Acquisition related expenses (included in administrative expenses) amounted to €-5.2m for the nine months.

a) NIPD is a specialised genetics company based in Cyprus with 170 employees, active in the field of designing, developing, producing, and providing in vitro genetic testing solutions. NIPD offers

advanced genetic testing services in over 30 countries in Europe, Asia and Africa. NIPD's technology and expertise in prenatal testing complements and expands Medicover's genetic offering in its markets while NIPD's geographic reach allows Medicover to penetrate new markets quicker with a combined product offering. Revenue for 2021 was €20.3m.

In January the Group increased its ownership in NIPD from 18.9% to 87.2%. Total consideration for the 68.3% acquired shares in NIPD was €56.8m, settled in cash €44.5m. Goodwill of €27.2m was recognised and represented expected synergies with existing operations. Goodwill is not expected to be deductible for tax purposes. Patents amounted to €16.3m with an estimated useful life of 18 years, valued by using the relief from royalty method. Capitalised development costs mainly related to staff costs for scientists that are developing the tests. Non-controlling interests have been measured at the proportionate share of the acquiree's net assets.

Medicover has an obligation, at a future date, to acquire the non-controlling interests. This put option liquidity obligation was measured at €6.3m at 30 September 2022.

Until January 2022 NIPD was accounted for as an associate using the equity method. Upon consolidation, the Group's previously held interest of 18.9%, with a carrying value of €7.9m, was remeasured to its acquisition fair value of €12.3m, resulting in a gain of €4.4m recognised as other income/(costs) in the first quarter 2022.

b) CDT, which was acquired in January, is a leading regional provider of medical services in southwestern Poland consisting of a network of hospitals, clinics and laboratories and has approximately 1,000 employees. Revenue for 2021 was €28.9m. The consideration was €56.1m, settled in cash. Goodwill of €23.3m was recognised and represented expected synergies with existing operations. Goodwill is not expected to be deductible for tax purposes. Brand of €12.9m has been recognised with an estimated useful life of 10 years, valued by using the relief from royalty method.

c) Goodwill within other acquisitions amounted to €56.2m, including €14.2m (laboratory), €14.0m (gyms), €11.1m (dental), €9.9m (medical) and €6.6m (vision care). Lease liabilities amounted to €39.1m, including €14.6m (hospital) and €13.8m (gyms). None of these acquisitions were individually significant.

5. Related party transactions

The Group has transactions with non-controlling interests in MHI. The purchase of material and services amounted to €-10.8m (€-6.1m) for the

quarter and to €-26.8m (€-19.4m) for the nine months. Trade payables were €6.1m (€7.7m) as at 30 September 2022.

6. Financial assets and liabilities

30 Sep
2022
30
Sep
2021
31
Dec
2021
Non Non Non
Note €m current Current Total current Current Total current Current Total
Financial
assets
at
fair
value
through
profit
or
loss
Short-term
investments
- 5.5 5.5 - - - - 192.9 192.9
Foreign
currency
swaps
- - - - 0.0 0.0 - 0.5 0.5
a) Other
financial
assets
2.9 - 2.9 3.7 - 3.7 5.8 - 5.8
Total 2.9 5.5 8.4 3.7 0.0 3.7 5.8 193.4 199.2
Interest
rate
swaps
used
for
hedging
- 0.2 0.2 - - - - - -
Total
financial
assets
at
fair
value
2.9 5.7 8.6 3.7 0.0 3.7 5.8 193.4 199.2
Financial
assets
at
amortised
cost
Other
financial
assets
13.5 15.8 29.3 12.0 3.9 15.9 13.0 3.1 16.1
receivables1)
Trade
and
other
- 176.8 176.8 - 152.9 152.9 - 171.2 171.2
Total 13.5 192.6 206.1 12.0 156.8 168.8 13.0 174.3 187.3
Cash
and
cash
equivalents
- 77.3 77.3 - 92.6 92.6 - 81.9 81.9
Total
financial
assets
16.4 275.6 292.0 15.7 249.4 265.1 18.8 449.6 468.4
Financial
liabilities
at
fair
value
through
profit
or
loss
Foreign
currency
swaps
- 0.6 0.6 - - - - - -
b) payable2)
Contingent
consideration
20.6 6.8 27.4 19.0 6.0 25.0 17.2 7.5 24.7
Total 20.6 7.4 28.0 19.0 6.0 25.0 17.2 7.5 24.7
c) Put
option
liquidity
obligations
with
non-controlling
equity)3)
interests
(with
movement
through
74.9 18.8 93.7 74.6 - 74.6 78.3 0.7 79.0
Total
financial
liabilities
at
fair
value
95.5 26.2 121.7 93.6 6.0 99.6 95.5 8.2 103.7
Financial
liabilities
at
amortised
cost
Borrowings2) 347.6 101.4 449.0 147.7 42.2 189.9 356.7 34.9 391.6
Lease
liabilities
329.5 83.7 413.2 257.3 44.2 301.5 299.8 46.1 345.9
Other
financial
liabilities
0.6 4.2 4.8 - 5.6 5.6 - 3.9 3.9
payables1)
Trade
and
other
- 56.5 56.5 - 53.4 53.4 - 65.1 65.1
payable2)
Deferred
consideration
7.5 4.6 12.1 1.4 0.8 2.2 1.4 0.5 1.9
Total 685.2 250.4 935.6 406.4 146.2 552.6 657.9 150.5 808.4
Total
financial
liabilities
780.7 276.6 1,057.3 500.0 152.2 652.2 753.4 158.7 912.1

1) Amount does not reconcile with amount in the statement of financial position due to non-financial items.

2) Presented as loans payable in the statement of financial position.

3) Presented with other current and non-current financial liabilities in the statement of financial position.

Financial assets and liabilities carried at amortised cost are considered to have carrying amounts that materially correspond to their fair values, for longterm borrowings this is due to interest rates approximating current market rates.

Recognised fair value measurements - valuation technique and principal inputs

A breakdown of how fair value is determined is indicated in the following three levels:

Level 1: Short-term investments of €5.5m include government bonds. At year-end 2021, short-term investments of €192.9m mainly included eurodenominated bond funds which have been sold during 2022. Fair value hierarchy level 1 is used when the valuation is based on quoted prices in active markets.

Level 2: The Group has foreign currency- and interest rate swaps where the valuation is based on level 2. Fair value hierarchy level 2 is used when inputs, other than the quoted prices included in level 1, are observable.

Level 3: The Group has the following financial assets and liabilities measured using level 3, where fair value is not based on observable market data:

a) Other financial assets mainly include €2.5m (€3.6m) relating to 14% (14%) of the voting rights in a dialysis clinic in Germany.

b) The contingent consideration payable resulting from current year and past business combinations is based on the estimated outcome of future performance targets.

c) The put option liquidity obligations with noncontrolling interests consist of:

  • The Group is contractually obliged, at a future date, to acquire a non-controlling interest in

one of the Group's German subsidiaries at market price determined at that future date. Fair value amounted to €25.7m (€22.6m). Due to contracted terms disadvantaging the holder, it is estimated that the put option will be exercised in November 2023 at the earliest.

  • A put option liquidity obligation with noncontrolling interests in Medicover Hospitals India ("MHI") of €49.3m (€43.1m). Half of the put options can be exercised in June 2023 at the earliest and the remaining half (which corresponds to €30.5m) from June 2027.
  • Put option liquidity obligations with noncontroling interests in subsidiaries in Norway, Cyprus and Bosnia-Herzegovina of €18.7m (€13.3m), estimated to be excercised in 2026 and 2027. During Q2, the Group acquired the non-contolling interest in the Danish subsidiary and the put option liquidity obligation of €0.8m (€0.7m) was settled.

In determining the fair value of the obligations, estimations of key variables were made, of which the most significant are the growth rate of the business to determine its profitability at the future date of exercise and the discount rate applied to the nominal value.

The following table summarises the quantitative information about the significant unobservable inputs used in level 3 fair value measurements:

Fair Value (€m) Inputs Sensitivity
Description 30 Sep
2022
31 Dec
2021
30 Sep
2022
31 Dec
2021
Relationship of
unobservable inputs
to fair value (FV)
Put option
(liquidity obligation
with non-controlling
25.7 22.6 Earnings growth
factor
5.5% 5.5% Increase of 1% point in
profit growth = increase in
FV liability of €0.2m
interests in a
German
subsidiary)
Risk adjusted
discount rate
1.5% 0.9% Decrease of 1% point in
discount rate = increase
in FV liability of €0.3m
Put option
(liability obligation
with non-controlling
49.3 43.1 6-year projected
CAGR EBITDA
34.8% 34.8% Increase of 10% in CAGR
EBITDA = increase in FV
liability of €5.5m
interests in MHI) Risk adjusted
discount rate
12.1% 11.8% Decrease of 1% point in
discount rate = increase
in FV liability of €1.4m
Put option
(liability obligation
with non-controlling
12.0 12.6 4-year projected
CAGR EBITDA
28.8% 28.8% Increase of 10% in CAGR
EBITDA = increase in FV
liability of €1.2m
interests in a
Norwegian
subsidiary)
Risk adjusted
discount rate
7.4% 6.3% Decrease of 1% point in
discount rate = increase
in FV liability of €0.4m
Put option
(liability obligation
with non-controlling
6.3 - 5-year projected
revenue
29.5% - Increase of 10% in
revenue = increase in FV
liability of €0.6m
interests in a
Cypriot subsidiary)
Risk adjusted
discount rate
11.2% - Decrease of 1% point in
discount rate = increase
in FV liability of €0.3m
Put option
(liability obligation
with non-controlling
interests in a
Bosnia
Herzegovina
subsidiary)
0.4 0.7 Risk adjusted
discount rate
16.9% - Decrease of 1% point in
discount rate = increase
in FV liability of €0.0m
Contingent
consideration
payable
27.4 24.7 Risk adjusted
discount rate
5.5%-11.8% 5.5%-8.7% Decrease of 1% point in
discount rate = increase
in FV liability of €0.5m

No additional significant changes have been made to valuation techniques, inputs or assumptions in 2022.

No financial assets or liabilities have been reclassified between the different levels in the fair value hierarchy.

7. Net financial debt and other financial liabilities

€m 30 Sep
2022
30 Sep
2021
31 Dec
2021
Non-current loans payable 375.7 168.1 375.3
Current loans payable 112.8 49.0 42.9
Total loans payable 488.5 217.1 418.2
Less: short-term investments -5.5 - -192.9
Less: cash and cash equivalents -77.3 -92.6 -81.9
Loans payable net of cash and liquid short-term investments 405.7 124.5 143.4
Non-current lease liabilities 329.5 257.3 299.8
Current lease liabilities 83.7 44.2 46.1
Total lease liabilities 413.2 301.5 345.9
Financial debt 901.7 518.6 764.1
Less: short-term investments -5.5 - -192.9
Less: cash and cash equivalents -77.3 -92.6 -81.9
Net financial debt 818.9 426.0 489.3
€m 30 Sep
2022
30 Sep
2021
31 Dec
2021
Other financial liabilities
Non-current 75.5 74.6 78.3
Current 23.0 5.6 4.6
Total 98.5 80.2 82.9

8. Subsequent events

In October, Medicover acquired 100% of the voting rights in MeinDentist Zentrum GmbH, MeinDentist Berlin GmbH and MeinDentist Brandenburg GmbH ("MeinDentist"), as well as 80% of voting rights in DDent MVZ GmbH ("DDent").

MeinDentist is a leading dental provider in the Berlin area, in Germany. Revenue for 2021 was approximately €31.4m. The purchase price was €15.8m, settled in cash, with no debt assumed.

DDent is a dental provider in northern Germany. Revenue for 2021 was approximately €11.6m. The purchase price was €18.0m, including €13.8m of debt assumed/settled.

The purchase price allocations have not yet been finalised. The businesses will be consolidated from the fourth quarter 2022.

The Group has signed an agreement to sell its business in Belarus. The transaction price for Medicover's holdings in Synevo LLC and Nedvizhimost Vostok LLC amounts to €14.5m net of transaction costs. The transaction is subject to customary regulatory approval and is expected to close during the fourth quarter 2022. The Group's revenue in Belarus was €21.7m in 2021 and €15.3m for the nine months 2022. The net assets of €-0.6m in Synevo LLC and Nedvizhimost Vostok LLC have not been recognised as assets classified as held for sale as of 30 September 2022 based on materiality.

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