Aurelia Healthcare Business Plan › Section 10 › Financial Plan

10.1 Financial Modelling Methodology

The Aurelia financial model is constructed on a bottom-up basis from
clinical-volume drivers, applying revenue per case (by service line and
payer), cost per case, fixed-cost-base assumptions, and
capital-deployment schedules to generate fully integrated P&L,
balance sheet, and cash flow statements in monthly granularity for Years
1–3 and quarterly thereafter, consolidated to annual reporting for Years
1–15 (5-year terminal). Modelling currency is USD with ZAR sub-models
for South African operating expenses; FX assumed at ZAR 18.5/USD
(long-run average) with sensitivity at ±15%. All forecasts are presented
before any IFRS 16 lease adjustments unless explicitly noted.

10.2 Revenue Build-up Methodology

Revenue is built bottom-up from the following drivers, applied
separately to each facility and each service line:

• Available bed days = Beds × 365
• Inpatient admissions = Available bed days ×
  Occupancy rate / Average length of stay
• Inpatient revenue = Admissions × Average revenue
  per admission (by service line and payer)
• Theatre revenue = Theatre hours × Procedures per
  hour × Revenue per procedure
• Outpatient revenue = Visit volumes × Revenue per
  visit
• Diagnostic revenue = Modality utilisation ×
  Revenue per study

Revenue per admission and per procedure is benchmarked to current
published Discovery Health Reference Price (DHR), Bonitas reference
rates, and primary research from comparable greenfield operators. Mean
revenue per inpatient admission is modelled at USD 7,800 in Year 1
(range USD 4,200 for general medical to USD 28,400 for cardiac surgery),
escalating at 6.5% p.a. (medical inflation = SA CPI + ~2.0%).

10.3 Operating Cost Structure

The cost structure is benchmarked to the published financial
statements of Netcare and Life Healthcare, with Aurelia’s greenfield
design assumed to deliver structural advantages of approximately 4–5
percentage points of EBITDA margin at stabilization (driven by lower
facility cost per bed, integrated EMR-driven productivity, AI-augmented
diagnostic throughput, and modern energy/water systems).

10.4 Projected Income Statement (USD millions)

The 10-year integrated income statement reflects the phased
commissioning of three operating clusters. Year 1 reflects pre-opening
losses on Phase I (Johannesburg). Year 2 captures partial-year
operations of Phase I post-commissioning. Years 3–5 reflect the rapid
ramp-up of Phase II (Cape Town, Durban, Pretoria) and stabilization of
Phase I. Years 6–10 reflect full platform stabilization with the Phase
III ambulatory ecosystem at scale.

Table 10.1a — Projected Income Statement, Years 1–5 (USD
millions)

Table 10.1b — Projected Income Statement, Years 6–10 (USD
millions)

Figure 10.1

Figure 10.2

Figure 10.3

10.5 Projected Balance Sheet (USD millions)

The balance sheet reflects the heavy capital deployment in Years 1–3
(Phase I construction and equipping) and Years 3–5 (Phase II), with
property, plant & equipment peaking at approximately USD 245M in
Year 5. Senior debt amortises on an 18-year tenor with 3-year grace,
beginning principal repayment in Year 4. The platform achieves positive
retained earnings from Year 6, supporting accelerated debt repayment and
dividend capacity from Year 7 onwards.

Table 10.2a — Projected Balance Sheet, Years 1–5 (USD
millions)

Table 10.2b — Projected Balance Sheet, Years 6–10 (USD
millions)

10.6 Projected Cash Flow Statement (USD millions)

The cash flow statement demonstrates the financing journey of the
platform: heavy net investing outflows in Years 1–4 (USD ~245M
cumulative capex on Phase I and Phase II); transition to positive
operating cash flow from Year 3 covering working capital and finance
costs; and progressively strong free cash flow generation from Year 5
onwards, supporting full debt service, accelerated principal repayment
from Year 4, and dividend distribution from Year 7.

Table 10.3a — Projected Cash Flow Statement, Years 1–5 (USD
millions)

Table 10.3b — Projected Cash Flow Statement, Years 6–10 (USD
millions)

10.7 Senior Debt Schedule & DSCR Analysis

Senior debt is structured as a USD 140M facility (USD 120M AfDB
Senior + USD 20M Commercial Co-financing), with the following terms:
18-year door-to-door tenor; 3-year construction grace period (interest
only); 15-year amortisation thereafter on a sculpted-equal-principal
profile; coupon SOFR + 350bps blended (~7.0% all-in fixed equivalent
post-hedging); customary DFI covenants including minimum DSCR of 1.30x
and Debt/EBITDA <4.0x by Year 6.

10.8 Equity Returns & Valuation

The integrated financial model generates the following returns to
each capital tranche over a 10-year hold horizon, assuming a Year 10
exit at 10.0x EV/EBITDA (vs. peer trading multiple range of 9.5x–12.5x
for African and emerging-market private hospital operators):

Figure 10.4

Figure 10.5

Confidential — this business plan is provided to prospective investors and lenders for evaluation purposes only and may not be reproduced or distributed without the written consent of Aurelia Healthcare Holdings (Pty) Ltd.