Fleury SA

BOVESPA:FLRY3

Earnings Call Transcript 2024-Q3

[Operator]

Good morning, everyone. I'd like to welcome you to Fleury Group Third Quarter 2024 Results Conference Call. Present with us today are Ms. Jeane Tsutsui, the company's CEO; Mr. Jose Filippo, Executive Director of Finance; and Mr. Renato Braun, the IR Director.

I would like to take this opportunity to inform you that this event is being recorded and we have simultaneous translation into English. Initially, we will present the company's results and then we will go on to the question-and-answer session. At the end of this session, Ms. Jeane will offer her closing remarks. All the figures we're going to quote here today are compared to the same period in 2023, except when specified and have been rounded to the nearest thousand.

Before proceeding, I would like to clarify that this presentation may contain information about future events. Information is not just historical facts. It reflects the wishes and expectations of the company's management. The words believes, expects, plans, anticipates, estimates, projects, targets and the like are intended to identify statements that necessarily involve known and unknown risks. Known risks include uncertainties which are not limited to the impact of competitive prices and services. Uncertainties also include market acceptance of services, service transactions of the company and its competitors, regulatory approval, currency fluctuation, changes in the mix of services offered and other risks described in the company report.

I would now like to turn the floor over to Ms. Jeane Tsutsui.

[Jeane Tsutsui, executive]

Good morning, everybody, and I would like to thank you for your participation in this call to present the results for the third quarter '24. In our call today, we will start with a view of the Fleury Group, move on to an in-depth look at the Lab-to-Lab market and then go on to the financial highlights.

Now the Fleury Group has maintained its trajectory of consistent execution and disciplined results delivery. We have several different brands that work with a premium, intermediate and basic segment in 14 states besides the Lab-to-Lab that has partnerships throughout the national territory. Now this means that we have maintained our operations in a challenging macroeconomic environment. We continue to offer services in prevention, primary, secondary and tertiary care. We are concerned with the well-being of people with more complete sustainable experiences. We continue to obtain positive solutions in the outpatient solutions that have the widest breadth nationwide because of our integration with the Pardini Group.

In Slide #6, we show you our 3 avenues for growth. The first, the B2C Medicine has 31 national brands, several patient units and represents 60% of the group's revenues. Now mobile attention represents a great deal of the revenue. We have had a change in the behavior of customers who value the comfort and the excellent quality of our services.

In the Fleury brand, we continue to execute the differentiation strategy, offering specialized services. Recently, we launched the Integrated Neurological Center and the Endometriosis Center. The growing number of patients with cognitive disturbances is what led us to create this neurological unit. In a single physical space, it brings together cutting-edge technology in image diagnosis for the needs of patients and physicians, using equipment and techniques that are state-of-the-art in the world market, with advanced techniques in magnetic resonance, ultrasound and electroneuromyography.

Fleury was also a pioneer in launching the test in Brazil that detects proteins that cause brain alterations that are related to Alzheimer's proteins based on blood samples. The Endometriosis Center is devoted exclusively for advanced disease of the disease that reaches 7 million women in the country. We have a revolutionary way of acting, helping women that have the suspicion of the disease, everything within an environment of safety, working in a customized way, offering support to the physicians and specialists for these women.

The second avenue is B2B representing 4% of the group revenues. It shows a good performance of Lab-to-Lab, that, after the combination of business, had its portfolio of exams broaden, new ways of communicating, and we are now using new technical areas to process exams. I also highlight the new contracts to process exams at hospital. We have a partnership with the Hospital Santa Lucia in the Midwest, with Santa Joana, Pro Matre and Santa Maria hospitals in Sao Paulo.

The third avenue are the New Links that represent 8% of the total revenues. They have 5 specialties, 9 brands. On Health Platforms, the representativity of the revenues was 1%.

Slide #7 shows you, to the left, the growth of the Fleury Group through the years, and to the right, the representation of each business and brand. In 2017, the revenue of the group was BRL 2 million, strongly concentrated on B2C, 84% of the total, and on the Fleury brand, 50%. Since then, the company has expanded its revenues by 3x, BRL 8.2 billion in the last 12 months in September of 2024, driven by organic growth and the combination of business with Pardini in May of 2023, putting us at a new level of revenues. We have a more diversified profile of business. B2C represents 57% of our brand and the Fleury brand 25%. The combination of business with Pardini has strengthened the B2B, and we have the New Links and Platforms. This diversification of payers and brands offers the Fleury Group greater resiliency, the possibility of capturing market share, making us able to become leaders in Brazil.

I would now like to speak a bit more about Lab-to-Lab on Slide #9. The Brazilian Lab-to-Lab market, also known as laboratory support, is made up of several national, regional and specialized players. In recent years, the support market has grown faster than the national clinical analysis market due to the acceleration in the trend towards outsourcing tests. Clients, which include small, medium and large laboratories, hospitals, clinics, public bodies, pharmaceutical companies, need laboratory support when they don't have enough expertise, financial resource or scale to justify investing in their operations. Outsourcing brings a number of benefits, from expanding the portfolio to sharing knowledge.

With its brand and reputation, Grupo Fleury is positioned as the largest Lab-to-Lab player in Brazil in terms of turnover through the Pardini brand. This business line is part of the B2B diagnostic medicine growth avenue, which, in the first 9 months of '24, accounted for 24% of revenue and 56% of consolidated test volume.

We provide Lab-to-Lab services to around 7,700 clients and 2,200 municipalities through a logistics network. We cover all the states of the federation, and we use a multimodal model in most of the regions. We have adopted a position of differentiation by offering our clients the most extensive portfolio of clinical analysis, ranging from low complexity analysis to highly specialized areas. There are more than 9,000 different types of tests, which are processed in 13 differentiated areas. We offer the lowest cost of processing, high added value exams, specialized medical care and a full integration of systems with a very agile customer journey.

Before presenting the financial highlights, I would like to point out that besides the accounting results, we offer figures on the same basis for the period. As you can see on Slide #11, the partnership between Grupo Fleury and Pardini in the third quarter of '24 already shows the combined results for both years.

In Slide #12, we see the financial highlights of the third quarter 2024. Gross revenue was BRL 2.1 billion, an increase of 6.1% compared to the same period in 2023. The other brands of Sao Paulo grew 10%. And in Minas Gerais, there was a growth of 10.5% in the quarter. We also had an increase in mobile attention, 5.8% (sic) [ 20.8% ] in the quarter, representing 7.8% of total revenues of the group.

EBITDA reached BRL 347 million (sic) [ BRL 537.4 million], a growth of 6.2% with a margin of 27.4%, an increase of 32 basis points compared to the third quarter '23. This shows the discipline of the company in reducing costs and expenses. We also highlight that our net revenue was BRL 190.7 million with an increase of 9.5% and a net margin of 9.7%, 40 basis points above the third quarter of '23. This performance shows our capacity to generate value, sustainably balancing growth and profitability.

I would now like to turn the floor over to Jose Filippo, Executive Director of Finance, who will comment in more detail on our financial performance.

[Jose de Almeida Filippo, executive]

Thank you, Jeane. We are speaking in detail of the financial highlights for the third quarter and the 9 months of the year. On Slide 13, we see the pro forma results with gross revenue, which was 6.1% in the quarter with a variation compared to the third quarter '23. For the year (sic)[ 9 months ], gross revenues represent BRL 6.3 million (sic) [ billion ] with a growth of 7% vis-a-vis the same period last year.

This result shows the resiliency of our operation in a challenging macroeconomic scenario. We continue to reap positive results driven by the successful integration with the Pardini Group. We had a growth of 20.8% in mobile service, representing 7.8% of the group's total revenue. The B2B business had a positive growth of 8.4%.

On Slide 14, we highlight the growth of 5% in our patient unit, even with a strong base of comparison with the third quarter in '23. This reflects the good performance of other brands in Sao Paulo, which grew 10%, and Minas Gerais brands that grew 10.5%. Additionally, the closing of the acquisition of the Grupo Sao Lucas in Santa Catarina with results captured from September of this year led to the growth of regionals of 5.8%.

On Slide 15, the growth of B2B in the third quarter '24 was 8.4%, reaching BRL 501.3 million in revenue, with 11% increase in the accumulated comparison of the first 9 months of 2024. This result reflects a good performance of Lab-to-Lab with the performance of hospitals and the maturing of clients. In the year, the gross revenue represented BRL 1.5 billion.

We go on to Slide 16, where we see the performance of New Health Links and Platforms. Gross revenue for the third quarter '24 grew by 8.4%, reaching BRL 198.4 million, representing 9.3% of the company's revenue. Gross revenue for New Links totaled BRL 183.7 million with a growth of 8% vis-a-vis the same period in '23, reflecting the good performance of orthopedics and ophthalmology.

New Links accounted for 8.6% of the group's gross revenue -- gross revenue of health. Platforms grew by 13.1%, reaching BRL 14.7 million in the quarter. For the year, New Links and Health Platforms reached BRL 587.8 million.

In the next slide, #17, gross profit had a growth of 5.6% in the period, reaching BRL 557 million and a margin of 28.4%. In the 9 months of 2025, gross profit reached BRL 1.7 billion with a margin of 28.9%, showing our cost discipline and our efficiency program.

We go on to Slide #18. In the third quarter of '24, operating expenses totaled BRL 216.9 million with a dilution of 16 basis points compared to the same period last year, representing 11.1% of net revenue. This variation is mainly the result of general and administrative expenses, mainly due to efficiency gain program and a advance in the integration with the Pardini Group.

We go on to Slide 19. The EBITDA for the third quarter grew 6.2%, reaching BRL 537.4 million with a margin of 27.4%, which represents an increase of 32 basis points compared to the third quarter '23. This expansion is mainly a reflection of the increase in gross profit because of a reduction in personnel and medical services and material and exam intermediation.

In the next slide, #20, the net profit for the third quarter '24 grew 9.5%, reaching BRL 190.7 million with a net margin of 9.7%. Excluding the effect of the IHP capital gain, net profit was BRL 202 million with a margin of 10.3%. For the 9 months of 2024, we reached BRL 532 million with a margin of 9.1%.

In Slide #21, we see our CapEx. In the third quarter, they totaled BRL 112 million, an increase of 29.1% compared to the third quarter '23. In the first 9 months of the year, CapEx totaled BRL 277.6 million, 5% above what we observed in '22 -- '23, excuse me.

In Slide 22, you can see the operating cash generation that reached BRL 558.7 million (sic) [ BRL 558.9 million ] in the third quarter with a growth of 16.2% vis-a-vis the previous year as a result of the increase in EBITDA. In the comparison for the first 9 months of 2024, the increase reached BRL 1.4 billion, a cash conversion of 86.7% of EBITDA.

In the next slide, #23, leverage, calculated by the net debt-EBITDA ratio was 1x at the end of the quarter, because of the increase in EBITDA and a greater cash generation, below the 3x limit foreseen in the covenants. At the end of the semester, the net debt represented BRL 1.9 billion compared to BRL 2 billion in the quarter preceding it.

On Slide 24, we show you the debt amortization schedule for the Fleury Group, showing you the robust cash position when it comes to our liabilities. The average term of our debt was 3.4 years. We continue to have a healthy debt profile with no concentration of maturities. It is worth noting that at the beginning of November 2025, the company approved the 10th issue of debentures, which will result in a new average cost of CDI by 0.95% with an average term of 4.2 years as of November 8.

Before we start the Q&A session, I'll hand the floor over to Jeane to conclude the presentation.

[Jeane Tsutsui, executive]

Thank you, Filippo. Once again, we present a quarter with robust results. We work strongly in a disciplined way, working with diagnostic medicine while we move forward in the diversification of payers and sources of revenues. We have been able to maintain our resiliency despite the change of brands. Now the company continues to be very healthy, showing that we have healthy returns and discipline in the application of resources. We are able to capture opportunities that are aligned with our strategy.

Grupo Fleury's excellence was recognized in awards in the third quarter '24. For the third year running, we were voted Brazil's best company in Medical Services in the Valor 1000 award. We also won first place in the Health Services category in Exame's Best and Biggest awards. Fleury was considered the most loved laboratory in Sao Paulo in the survey, the most loved of Sao Paulo 2024 carried out by Veja Sao Paulo Magazine.

We believe that with continued discipline in execution and strategic focus, we are well positioned to face challenges and seize opportunities with growth and value generation for shareholders and partners. Our solid financial structure, strong organizational culture and clear direction allow us to increasingly reinforce Grupo Fleury's position as one of the leaders in the healthcare sector.

Thank you very much. We're now at your disposal for questions and answers.

[Operator]

[Operator Instructions] The first question comes from Mr. Cepeda from Morgan Stanley.

[Mauricio Cepeda, analyst]

I would like to further explore what you have in the release that, of course, is built year after year. I would like to explore the trends throughout the quarters. I say this because I understand that your economics depends on the volume expansion through time. What I observe is that there has been a slowdown in the Fleury brand. And despite the growth of B2B, it seems that this growth rate is also in a slowdown.

Perhaps you could remark on what has led to this? If it is due to the fact that there are downgrades of plans of the Fleury Group plans, if there is a saturation in the plans that are addressable by the company.

On the other hand, I would like to understand in terms of costs, which is a very important part of your thesis. If you still foresee the possibility of gaining in terms of costs. I see that the number of employees you have as the proxy of the cost throughout the quarters, it has had less movement. So if you could speak about volume trends and cost trends and how saturated you may be at this point and how this will impact you going forward?

[Jeane Tsutsui, executive]

Cepeda, you were very clear. Throughout the quarters, we do carry out this follow up. And I'm going to use the Fleury brand as an example, but extend this to other brands and B2B. There's a sequence between the second quarter '24 and third quarter '24, where we have a reduction in the number of operating days. In the second quarter '24, we had 77.8 days of operation and lower figures in the third quarter, 74. This, of course, has an impact on growth. The Fleury brand is a premium Brazilian brand with a very high market share, but it is a reality that we don't have a growth in the number of beneficiaries in the premium group.

The brand grew 3.2%, at similar levels that we had before the pandemic. After the pandemic, we had steep growth -- first a reduction and then growth. And last year, more specifically, we had a very strong base. In the 9 months of 2023, the Fleury brand grew 11.6%. It's natural, therefore, that the quarter-on-quarter growth this year will be lower because the group of beneficiaries is not growing. It is a very resilient brand. We continue with actions to differentiate the brand. I refer to the new integrated centers, which is a way to ever more capture more complex conditions, for example, endometriosis or neurological conditions.

And the Fleury Group is becoming a set of brands and services. When we look at B2B as an example, in the quarter and despite having less working days, we had a higher growth than B2C. And we continue to increase our market share. So very generally, we believe that the Fleury brand will continue on with this resiliency despite the challenging macroeconomic market, especially in the premium segment.

In Sao Paulo, we had a growth of 10% in other brands. In Minas Gerais, we had a growth of 10.5%. It is important, therefore, that the Fleury Group capture growth opportunities and market share growth in areas where this is more possible to expand our market share. And the diversification offers us greater resiliency in general.

So besides that division of working days, it is important to mention that we grow more in volume versus price, but in a healthy way, continuing to expand EBITDA margin despite a less favorable mix of brands.

And we do have the issue of costs that you mentioned, on the possibility of continuing to have gains in terms of cost. The Fleury Group has stringent discipline in terms of cost and expenses. This year with the Pardini Group, it was important to capture synergies. But to have a good integration, we had to devote ourselves to this, this year.

Looking forward, for the mid and long term, we will have other potential levers that will help us in productivity gains. One of them is digital evolution. An example at present is that part of our services, our digital services, in the Sao Paulo brand, in the labs and in the Fleury brand. This began this year. And it means we have a productivity gain, maintaining the quality and the customer satisfaction. These new levers to gain efficiency are being put in place in the group in a very general way.

[Operator]

The next question is from Leonardo from UBS.

[Leonardo Olmos, analyst]

Two questions at our end, the first referring to working capital. If you could discuss the variation, the change in receivable days. And a follow up on Cepeda's question. Jeane, you remarked that the macroeconomic environment is challenging, especially in the premium segment. I don't know if I understood this clearly. Is it more challenging in the premium segment or is it a general challenge? These are our 2 questions.

[Jose de Almeida Filippo, executive]

Leonardo, regarding the working capital, obviously, we are extremely devoted to it. It's a management that we follow up closely because it makes up our cash generation, and we have to maintain this at satisfactory levels. In terms of days, working days, as you mentioned, when we look at the comparison quarter-on-quarter, year-on-year, there was an increase in the day of receivables, but this is associated to the change in mix.

Last year, we saw this evolution in Lab-to-Lab that has a certain profile of days, the composition of B2C. So it's the mix that is reflected throughout the year. If you look at the previous half of the year, we have been maintaining our level in terms of the makeup of our revenue. So this level of days of receivables at present is stable. It has not grown.

We focus strongly on this -- evidently on this composition. We attempt to do the same with average terms of payment. It's not offsetting everything, but it does help us in this type of item, along with our inventories in this business composition, where we have an increase in share of New Links and infusion. This brings about a level of inventory that is higher.

And so we're focusing on inventory management as the -- as an element in working capital. So we are at a stable position. We continue to optimize this. And there has been no change in profile quarter-on-quarter, although we have had an evolution in terms of our business mix, which does generate minor variations and not dramatic changes.

[Jeane Tsutsui, executive]

When we speak about the premium segment of the Fleury brand, we're speaking specifically of a brand that is present in Sao Paulo. There are other cities. And we have mobile services. We're speaking of a limited number of beneficiaries. This number is not growing. And we have a very steep market share in the premium segment.

When we look at the intermediate segment, where we have several brands throughout Brazil -- but I'll bring this back to the Sao Paulo context. Our market share is lower and the number of beneficiaries is higher than in the premium segment, which means we have a greater opportunity for growth. And we have been executing our brands in Sao Paulo, like [ Mai ] Sao Paulo. It has the endorsement of the Fleury Group. Physicians maintain that relationship, that recognition of quality that we have built through the Fleury brand. Because we have lower market shares and a higher number of beneficiaries in the intermediate segment, we are able to maintain growth every quarter more than in the premium segment.

Despite the change in mix -- and I recall that in 2017, the Fleury brand was responsible for 50% of the group's total revenues. But with BRL 2.6 billion -- and we have increased this threefold. The total revenues is BRL 8.2 billion in the last 12 months. The Fleury brand continues to be very relevant, differentiated, but represents only 25% of the company's revenue. Other brands have become more representative. This is an important point. We have different brands, different services. We're more relevant. And by having additional volume, we can reduce our cost and maintain an appropriate level of profitability.

Now the positive point to remind you, Leonardo, is that we see that operators went through a period with a high number of claims. The last data of the ANS in the last quarter shows that they're on an average level reaching a claim level similar to the pre-pandemic period. It's a more promising scenario when it comes to the health system as a whole.

[Operator]

The next question is from Estela from JPMorgan.

[Estela Strano, analyst]

It's a more direct question. With more than 1 year of the integration with the Pardini Group, do you see any opportunity in terms of your guidance and SG&A, COGS? And another point I would like to touch upon in the integration, which is the focus of the company in -- when integrating the Fleury operations with Pardini.

[Jeane Tsutsui, executive]

In the second quarter, we concluded 1 year of our business partnership. We are in the first quarter of the second year of integration. It has been a very intense year, Estela. We worked on the pillar of cultural integration. We brought in 5,000 physicians, 1,000 employees, working with that focus that we are a sole company. All teams were working in an integrated way since the beginning, and we had discipline to capture synergies besides integrating processes.

Now we continue working in the same way in terms of synergies, and we have obtained synergies aligned with what had been planned very generally. Now in the second year, we still have some synergies to capture. We had a curve where the capture of synergies was greater in the first year. It would get to 60% in the light of the first year and then increase sequentially. And we're going to be following that curve.

The focus of the company in the second year, we still have some integrations in the technical platform. And we had mentioned that some contracts would be captured for further negotiations with suppliers in the first year. Some contracts went beyond the first year. So we had to focus on the term of the contracts and issues related to systems, technical platforms, which will be dealt with in the second year. We are confident that the integration of the first year was highly successful and we will continue to work with discipline.

[Jose de Almeida Filippo, executive]

Estela, regarding the allocation of those synergies, we had evolution in terms of expenses, as was mentioned, and we're going to continue on with what was indicated by the synergy curve. And in some items, we still have space in the evolution to continue on. But we're looking at the efficiencies of this partnership and the impact on expenses. In COGS, we will begin to focus on this, but it's a balance of both things. Neither of these line items will predominate. And it is our understanding that the guidance that is still in effect at present is the most appropriate to understand the impacts of this business combination.

[Operator]

The next question is from Flavio Yoshida from Bank of America.

[Flavio Yoshida, analyst]

I have 2 at our end, the first referring to the product mix. When we think about clinical analysis and imaging, I would better like to understand what we should expect in terms of the growth, if clinical analysis will have a greater growth than imaging? We understand that exams have a lower ticket, imaging has a higher medical cost. How should we think about this dynamic going forward?

My second question is about expansion. Jeane said that the Fleury brand has a very good penetration, a high market share, but growth is more difficult. What should we expect in terms of the expansion of units of other brands or other segments? New Links and Campana will have an expansion. But is there something else in the radar that will help you with your growth?

[Jeane Tsutsui, executive]

Regarding the product mix, Flavio, when we look at the growth of the volume of analysis in the patient units and in B2B and the revenues per exam in the 2 main growth avenues, we do have a growth that favors clinical analysis. We're growing more in clinical analysis than in imaging. Because of this, we look at both line items.

We have a higher volume in terms of exams, but we had a slight reduction in the average ticket per exam precisely because we have more clinical analysis exams. It's important, because in imaging exams, we have the associated cost of physicians. And I underscore that although the ticket for clinical analysis is lower, the margin is extremely healthy, and it helps us in that change of mix.

Looking forward, we have the opportunity of growing with Lab-to-Lab. And in Lab-to-Lab, specifically, we're going to take advantage of technical areas. With the combination of business with the Pardini Group, we have 24 technical areas. Processing, Lab-to-Lab exams, we have 13. We have the opportunity of enhancing the production capacity devoted to Lab-to-Lab and grow in terms of supporting simpler exams that have a lower ticket, but have a very healthy margin. All of this has already been scheduled. We have a new production capacity for Lab-to-Lab in Sao Paulo and Rio Grande do Sul. And through time, we do have the opportunity to have greater growth in clinical analysis.

Now the mobile services growth is important. If we look at the growth this year, there was a growth of 23% in the first quarter, 19% in the second quarter and 20.8% growth in the third quarter. Mobile services are predominantly clinical exams. And through time, we have added the types of services and products in mobile services, vaccines, infusion of medication and other services. But predominantly, it focuses on clinical analysis. That is why we have so many mobile units in B2B.

Regarding the expansion of units, Flavio, the lever of mobile services will be important and will allow us to grow in the different brands without necessarily having to add more patient units. Mobile services corresponds to 7.8% of the group's total revenues. When we look at the revenues of mobile services and the average revenue of patient units, mobile services corresponds to 60 patient units. We were able to expand without necessarily adding more patient units and without having to allocate our capital in these units. Of course, in patient units, we have had expansion. We do have investments. Most of them are in the digital part. But we also renew equipment and expand services.

Retrofits are opportunities that we have to increase the availability of new services and include revenues per square meter. We are going to expand patient units whenever this is pertinent. In the business combination with Pardini, we have an additional 185 patient units in our portfolio, and we're making the most of these units to have a higher revenue per square meter.

[Operator]

The next question is from Samuel Alves from BTG.

[Samuel Alves, analyst]

We have 2 questions at our end. Let's go back to the Fleury brand. And if you could give us more color in terms of the figures of October for the year-on-year growth compared to the growth quarter-on-quarter?

The second question, more specific on your results. We observed that there was a BRL 16 million return on insurance. If you could explain the nature of this and if you think this will repeat itself in the fourth quarter?

[Jeane Tsutsui, executive]

Well, you know that we don't offer guidance. It is aligned with our expectations. And it is very important to take into account the point that I mentioned at the beginning, the number of operating days. If we consider this parameter, we have a good number of operating days for October. But we don't give any guidance in terms of the growth of the fourth quarter. Without a doubt, we will discuss this at the beginning of 2025 with the fourth quarter '24 results.

With the Fleury Group, we're creating ever more differentiation, innovation, applying artificial intelligence, using other parameters as integrated centers that we launched this quarter. And obviously, we're beginning to capture synergies. We have the aging of the population. And the data of the World Health Organization shows the increase of cognitive diseases. And that is why we're differentiating Fleury with the integrated center.

We have women with growth in endometriosis, one of the main causes of infertility in women. We have more than 7 million women with endometriosis. We have specialists and the best physicians to carry out a diagnosis with cutting-edge technologies. So these are important differentials and we continue ever more with this strategy of share of wallet in the Fleury brand.

In mobile services, we have expanded the portfolio. We have several other services for the premium Fleury brand. When we look at New Links, it's a way of offering an integrated offer to the customer journey for other services for an audience that truly is a Fleury audience.

I will turn the floor to Filippo.

[Jose de Almeida Filippo, executive]

Regarding Note 30 of other revenues and expenses, you drew attention to this reimbursement of insurance associated to the events of Rio Grande do Sul. We had several coverages. They were instrumentalized. And we had this cash receipt. We should not have any other action in insurance looking forward. This is a process that has been concluded and has been formalized by instrumentalizing the policy. And the resources should be coming in very soon.

[Operator]

Our next question is from Gustavo Miele from Goldman Sachs.

[Gustavo Miele, analyst]

I also have 2 questions. First of all, we spoke about an issue in the first quarter. In the third quarter, we see an increase of -- if you have a one-off effect, if this increase is due to a closer scrutiny of payer sources and if we can use these for our modeling in the midterm. They're referring to closings in Lab-to-Lab.

In the release, you do mention some new contracts that you obtained this quarter, Santa Joana, Pro Matre and Santa Maria Hospitals. Help us to understand the size and the goal of these contracts when we compare this with other existing groups in B2B for the Fleury Group, simply to understand the dynamics of a vertical that is very relevant for the group.

[Jose de Almeida Filippo, executive]

Regarding the losses, it's a dynamic which is natural in a commercial relationship. It has always existed. We have been working on this. And we work with operators in a partnership and -- in that search for efficiency to reduce fraud and the inefficiencies associated to enhance the operation. We see an enhancement in the operating results of the operators, which is, of course, positive for the system as a whole. So it is very difficult to know which will be the evolution of these cancellations.

There will be nothing exponential. We're managing this. Some time ago, we carried out a management adjustment. The receivables management has a group dedicated carrying out an in-depth analysis of those aspects that are questioned by operators, but also failures or internal causes when reviewing the information for invoicing.

It's natural for this to happen. All the parties are seeking greater efficiency. We're reducing to 0 some of these internal failures. They're natural. So we're looking very closely at all of this and with a great deal of discipline. We cannot indicate which will be the trend, of course. But historically, we have had the lowest levels of cancellations in the market. And we're working on this and we're focused on this. This is the trend that we observed for this item.

[Jeane Tsutsui, executive]

I'd like to refer to your question referring to B2B. We had a growth of 8.4% in the quarter with double-digit growth for the year. We have Lab-to-Lab, the diagnostic support to laboratories in more than 1,200 municipalities and this diagnostic support in hospitals. For clinical analysis -- and depending on the hospital, we also have imaging services, what predominates our clinical analysis.

This is a dynamic cycle. We're always prospecting for new hospitals. We do have the interruption of some contracts. It has to make sense for the hospital and for ourselves. We want to maintain growth, but have healthy profitability in our different business lines.

Regarding what you mentioned, we entered some hospitals in the third quarter. In the Santa Joana Group -- we're in the Santa Joana Hospital and Pro Matre and Santa Maria, and in Brasilia, in the Santa Lucia Hospital. Last year -- at the end of last year, we entered the HCor in Sao Paulo. It's a dynamic process. We have operations that carry out basic exams, but we also have specialized exams in the hospitals. This is an important business line for us. We maintain a relationship with the clinical corp.

These are differentiated services. It has challenges. We have to work 24/7 in hospitals with emergency areas. So we have to have local technical areas. It's different from the support where we have efficient logistics and process the exam in our technical centers disseminated throughout Brazil. In hospitals, we have an intra-hospital operation. We're always seeking for new opportunities, Miele. And this is a dynamic that differs from one hospital to the other. It depends on the hospital's strategic vision.

[Operator]

The next question is from Leandro Bastos from Citi.

[Leandro Bastos, analyst]

We have 2 questions here on the Fleury brand. The first, if you could remark on the growth level of mobile services in the Fleury brand? It has been accelerating the pace and supporting growth that we see for the company as a whole.

Second question. Last year, you shared several initiatives, a retrofit, an increase of the square meter for exams, which was important for the Fleury brand and its productivity. Are you thinking of similar levers recently to enhance the performance of the brand? Or are you simply going to continue working with the premium market? If you could remark on this.

[Jeane Tsutsui, executive]

Regarding the mobile services, we have a different penetration level for different brands. As the Fleury brand is 98 years old, and we began mobile services with the Fleury brand, it is a higher level of maturity. Despite this, we do see a growth of mobile services in the Fleury brand because of some characteristics. In mobile services, we are using some tools, artificial intelligence tools, a platform to create routes, to manage routes. This allows for a better distribution. We were able to have a 15% increase in the offer of agendas. We have also broadened the offer of differentiated services in the Fleury brand, because you have to have a return.

In mobile services, productivity is lower. You have the time of displacement. So in the Fleury brand, we have a broader portfolio. We carry out polysomnography exams with graphic methods. We have other innovations in terms of carrying out the Holter exams. We work with the infusion of immunobiologics. So mobile services in the Fleury brand continue to grow.

But we remind you that the penetration in the Fleury brand is greater than in other brands. We have other brands that come from Pardini. For example, in some of them, we have a lower penetration of mobile services. Through time, we will be increasing this penetration. And that is why mobile services are a leverage for growth, thinking of the 14 states where we act with patient units.

Regarding the other point you mentioned, it is a fact we had a period where we had a significant expansion with retrofits in the Fleury brand. In the JK unit, we increased square meters by 17%. We had an additional floor, magnetic resonance. And of course, there was resulting growth from this. We still have some units that are undergoing the same process. The exam is the unit in Jundiai with the Fleury brand. We have expanded services. We have a broader offer. And this is a unit where we also see a better customer service in general. Very generally, we would like to remind you that the Fleury brand is already more mature and has higher market share. So we seek out all opportunities, Leandro.

[Operator]

The next question is from Vinicius from Itau BBA.

[Vinicius Figueiredo, analyst]

Some of the topics have already been approached. To work with a follow-up, in B2B, something that benefited the company at the beginning of the year was that you observed greater rationality in the main competitors with transfer of prices more aligned with inflation to preserve margins. Now what is happening with that rationality at present? Has there been any change? Are you able to observe that competitors have become more aggressive in terms of prices, in terms of cancellations or clauses?

As you have had control for many years in this specific topic, you ended up not being affected as the rest have been affected because of the nature of diagnosis that has less room for this. I would like to understand if you have observed that one of the payer sources -- or if there is some type of cancellation that has appeared more frequently? These are my questions.

[Jeane Tsutsui, executive]

Vinicius, regarding the competitiveness scenario of Lab-to-Lab, of course, we're one of the largest players, but there are other players in the market. I draw your attention, we have the production capacity at present that is broader if we consider our technical areas, and a greater opportunity of making strides in other exams where we were not so strong, total support, for example. Very generally, we see that this rationality of competitors remains. I do not observe any significant change. What we do observe are opportunities to have what we call the outsourcing of exams through the laboratories that exist throughout Brazil.

When we look at the diagnostic medical market, it's very broad, highly fragmented in small laboratories throughout Brazil. Once these laboratories detect an opportunity to outsource further as we offer quality services, a very good turnaround time, the capacity of carrying out collections and support to laboratories, they may begin to outsource more. And this is an opportunity to expand the market, generally expand the Lab-to-Lab market in Brazil. So we still see opportunities for market growth. And this will be beneficial not only for our company, for all of those that are active in the market.

Now regarding those cancellations, there is no specific payer. What we have observed was an increase this quarter compared to last year, but at lower levels, as you mentioned, not only -- because of the fact that this is for outpatient services. We have exams with higher complexity, where we have a pre-authorization. But not for all exams. They're only for the more complex exams.

As Filippo explained, a situation is that the operators are avoiding fraud. We're aligned with that. We do want sustainability in the system. And we're going through a process of greater complexity. That is why internally we have further reinforced the training of the teams so that we can avoid having this scale up.

What is positive is that based on the data of ANS, we see that the number of claims of operators has dropped vis-a-vis other quarters. We're close to the levels we had before the pandemic. And we're going to work jointly so that we can surpass this challenge as well.

[Operator]

Ladies and gentlemen, as we have no further questions, we would like to end the question-and-answer session. I will return the floor to Ms. Jeane Tsutsui for the closing remarks.

[Jeane Tsutsui, executive]

I'd like to thank all of you for your attendance in our third quarter '24 call. We continue to be confident that we will execute with discipline, delivering quality services and new services that fulfill the journey of care of customers. We do maintain our goal of generating value for all the stakeholders. Thank you very much. Have a good weekend. And hope to see you soon.

[Operator]

With this, we conclude the conference call for the Grupo Fleury. You can now disconnect. Have a very good day.