Auna (NYSE:AUNA) executives said the company finished 2025 with stabilizing trends in Mexico, continued strength in Peru, and a more risk-managed approach in Colombia, while also completing a major debt refinancing intended to improve its maturity profile and reduce interest expense.
Consolidated results and operating metrics
Executive Chairman and President Jesús Zamora said Peru and Colombia helped offset what management described as “disappointing” results in Mexico earlier in the year. On a consolidated basis, the company reported 6% revenue growth in the fourth quarter on an FX-neutral basis, while adjusted EBITDA declined 14% FX-neutral, which management attributed primarily to Mexico’s underperformance and an unfavorable year-over-year comparison in Colombia that included extraordinary items in the prior-year quarter. For the full year, revenue grew 4% FX-neutral and adjusted EBITDA declined 3%.
Mexico: stabilization, oncology growth, and contract reset with ISSSTE León
Management said Mexico stabilized in the fourth quarter, with revenue down 3% in local currency year-over-year but flat versus the prior quarter. Zamora said oncology revenue increased 35% compared with the previous quarter as Auna further integrated Opción Oncología and launched a new oncology center at Doctors Hospital. The company also highlighted growth in out-of-pocket revenue, which reached 12% of Mexico revenue in December, up from 8% in the third quarter, which executives described as a high-margin segment supported by packaged services, targeted pricing, and pre-negotiated physician rates.
Mexico’s fourth-quarter adjusted EBITDA declined 36% year-over-year and fell 18% for the full year. Executives tied profitability pressures to lower revenue throughout the year, higher costs, and lower margins under the prior healthcare plan with ISSSTE León, as well as operational investments including leadership changes and new IT systems.
Looking into early 2026 trends, Zamora said January and February metrics improved year-over-year, including single-digit growth in surgeries, double-digit growth in hemodynamics, and “double- to triple-digit” growth in oncology services such as radiotherapy and chemotherapy, noting the comparison benefited from not having Opción Oncología in the prior period. He added that Mexico occupancy/utilization was trending up, citing February at roughly 41%.
Management highlighted several Mexico initiatives and developments discussed on the call:
- Reinforcement of the Mexico leadership team, including a new chief medical officer to deepen physician engagement and improve productivity and outcomes.
- Inclusion of Auna’s hospital network in preferred provider tiers, which executives said expands access to larger privately insured segments.
- Extension of the ISSSTE León healthcare plan on an exclusive basis for most services, which management said resulted in improved economics for 2026, including a 30% price increase and provisions that allow Auna to control prescriptions, pharmaceuticals, and devices.
- Physician alignment efforts, with management citing volume and margin improvements from approximately 250 physicians representing about 80% of hospital network revenues.
- An agreement with a leading insurer to direct policyholders toward Auna oncology services through deductible structures and financial incentives; management said it plans to double medical staff at its Monterrey oncology center during 2026.
Peru: pricing mix, record-low oncology MLR, and the Trecca ambulatory project
Executives described Peru as operating “at scale” and continuing to outperform. Fourth-quarter revenue increased 11%, driven by growth in high-complexity services that increased the average ticket and by higher volumes supported by new medical equipment, expanded bed capacity, and marketing initiatives. Oncosalud revenue rose 10% on plan membership growth and annual price adjustments, while oncology MLR declined 4.4 percentage points to 48.5%, marking a sixth consecutive quarterly decrease. Adjusted EBITDA increased 14% in the quarter and 14% for the full year.
Management also discussed a recently announced agreement with EsSalud under a public-private partnership framework to refurbish and operate a 600,000 square foot high-complexity outpatient facility in Lima. Zamora said the company now refers to the project as “Centro Ambulatorio Trecca,” emphasizing its focus on outpatient services across six clinical service lines and its role serving EsSalud’s population.
Executives said the facility is expected to commence operations in the second half of 2028. Zamora said the project could represent roughly 25% of Auna’s Peru business at maturity, while CFO Gisele Remy emphasized that construction expenditures are reimbursed through progress certificates paid by EsSalud, which the company said reduces capital risk. Management did not provide detailed margin or revenue contribution assumptions beyond those qualitative comments.
Colombia: risk mitigation, PGP expansion, and year-over-year comparables
In Colombia, management said the company constrained services to government-intervened payers to manage accounts receivable risk and improve the cash cycle. The company also expanded risk-sharing models such as PGPs, which grew four percentage points to represent 21% of segment revenue. Colombia revenue rose 6% in the fourth quarter and 4% for the full year, with higher tickets in surgeries and emergency treatments offsetting lower volumes. Management also cited growth in chemotherapy and imaging.
Adjusted EBITDA and margin declines in Colombia were attributed to an unfavorable comparison with the fourth quarter of 2024, which included extraordinary price adjustments and recognition of procurement rebates. Remy said that excluding extraordinary impacts in both periods, Colombia’s EBITDA would have been relatively flat year-over-year in the fourth quarter.
On provisions, Remy said the company uses an expected loss model across geographies, with a separate methodology for intervened entities in Colombia, and stated Auna does not expect reversals of accounts receivable impairments in the first half of 2026.
Refinancing, net income bridge, and 2026 outlook
Management highlighted a $825 million-equivalent debt refinancing completed during the quarter, which executives said improved the maturity profile and reduced interest expense, while increasing short-term liquidity and freeing up revolving credit capacity. Zamora said leverage remained at 3.6x, supported by free cash flow generation that increased cash by 42% to PEN 335 million at year-end. Free cash flow rose 35% to PEN 582 million.
Adjusted net income was PEN 136 million in the fourth quarter, up from PEN 36 million a year earlier, which management said was aided by non-cash FX gains. For the full year, adjusted net income increased to PEN 336 million. Remy detailed that the fourth quarter included PEN 170 million in extraordinary expenses tied to the refinancing (including tender premiums and non-cash derivative impacts), and said the company adjusted its call spread hedge range closer to current FX levels, which she said should reduce similar swings in 2026. She also said that excluding exchange-rate differences and extraordinary refinancing costs, net finance costs were PEN 459 million in 2025 versus PEN 561 million in 2024, a decrease of PEN 102 million, or 18.2%.
For 2026, management guided to 12% FX-neutral revenue growth and 12% FX-neutral adjusted EBITDA growth, with CapEx expected to remain around 4% of revenue. Executives said risks to guidance include the pace of Mexico’s volume recovery, macroeconomic conditions, and payer dynamics, but they expressed confidence given early 2026 indicators and operational actions taken in 2025.
About Auna (NYSE:AUNA)
Auna, listed on the New York Stock Exchange under the ticker symbol AUNA, is a Peruvian integrated healthcare services company headquartered in Lima. The firm operates a diversified care network that spans hospitals, outpatient medical centers, diagnostic imaging and laboratory facilities, as well as optical and dental clinics. Auna’s organizational structure is designed to support a continuum of care model, offering both general and specialized treatments across multiple touchpoints.
The company delivers a broad range of clinical services, including emergency care, inpatient and outpatient surgery, obstetrics, cardiology, oncology, orthopedics, and other specialized disciplines.
