Rede D’Or posted another set of positive results, ending the first half of the year with R$4.6 billion in operating cash flow and leverage below one times EBITDA. "We are in a strong position to evaluate other projects for organic expansion and possible inorganic moves," said Rede D’Or CEO Paulo Moll during a conference call with analysts and investors. 

When asked what maximum leverage the company would consider in the event of an acquisition, Mr. Moll said the ratio—considering net debt—could rise from the current 0.99x to between 2.0x and 2.5x EBITDA in a potential deal. 

According to sources consulted by Valor, the hospital group is in talks with Fleury’s shareholders regarding a possible acquisition. Both companies declined to comment on market rumors. 

"We in the company’s history, we have reached leverage of 4x, but given our current size and prevailing interest rates—even with our long-term debt profile—we don’t foresee any move that would push us to very high leverage. It’s unlikely we would exceed 2.0x to 2.5x," said Mr. Moll. 

The company currently holds nearly R$20 billion in cash. Debt maturities this year amount to R$1.6 billion, with R$367 million due in 2026. Total debt maturing through 2030 stands at around R$ 22 billion. 

Rede D’Or also plans to launch new hospitals in partnership with Bradesco Saúde. The two groups announced a joint venture last year to build hospital facilities. Currently, there are three units—located in Guarulhos, Alphaville (São Paulo), and Macaé (Rio de Janeiro)—all performing above expectations. According to Moll, however, no new project announcements are expected in the short term. 

Regarding SulAmérica, the insurer has resumed growth in its premium segment—its historical core—while also investing in markets currently dominated by medical cooperatives and low-cost operators. 

In the second quarter, Rede D’Or posted consolidated net revenue of R$14 billion, up 11.3% from the same period last year. Hospital operations and health insurance each account for roughly 50% of revenue. Hospital revenue grew 13.8%, while SulAmérica’s increased 10.7%. 

A J.P. Morgan analyst team led by Joseph Giordano highlighted in a report that results were "driven by better-than-expected operational trends in both segments, especially hospitals." 

Santander noted revenue came in 5% above its forecasts, thanks to higher volumes and pricing. Occupancy reached 83%, with 136,000 surgeries performed in the quarter—an 8.8% increase year-over-year. The average ticket rose 9.1% to R$ 11,400. 

Consolidated net income rose nearly 13% to R$ 1.1 billion between April and June. EBITDA climbed 18.4% to R$ 2.4 billion, with the EBITDA margin increasing 1.1 percentage points to 17.4%. 

Another positive highlight in the quarterly results was the reduction in average collection period—from 123 days to 116 days year-over-year—due to the termination of contracts with health plan operators facing financial difficulties. Last year, Rede D’Or canceled its contract with Unimed-Ferj, which had been delaying payments and owes more than R$1 billion to the healthcare provider network in Rio de Janeiro.

Rede D’Or considering higher debt level for acquisitions

Rede D’Or, a Brazilian healthcare company, reported strong financial performance in the first half of 2025, with R$4.6 billion in operating cash flow and a leverage ratio below 1x EBITDA. CEO Paulo Moll indicated the company could consider increasing leverage to 2.0x–2.5x EBITDA for acquisitions, though he emphasized caution due to interest rates and long-term debt profiles. The company is in discussions with Fleury’s shareholders about potential deals and plans to expand through partnerships with Bradesco Saúde. Revenue grew 11.3% year-over-year, with hospital operations and health insurance each contributing 50% of revenue. EBITDA rose 18.4% to R$2.4 billion, and the company reduced its average collection period due to contract terminations with underperforming health plan operators.