Auna Investor Day: Colombia Pressure Prompts 2026 EBITDA Growth Reset

Key Points

• Auna lowered its 2026 adjusted EBITDA outlook to broadly stable year over year, despite maintaining revenue guidance. The reset reflects reimbursement and contracting pressure in Colombia, including a suspended risk-sharing contract, plus one-off billing reconciliation effects in Peru.
• Mexico is emerging as Auna’s key long-term growth market following improved patient volumes and strong oncology growth. The company plans expansion in Mexico City, Guadalajara and Tijuana while prioritizing organic growth, smaller acquisitions and balance-sheet discipline.
• Auna is advancing its integrated, value-based care model across Latin America. In Peru, construction of the self-financed Trecca ambulatory center is expected to begin this month, with operations targeted for late 2028 and projected revenue of about PEN 120 million by 2030.

Auna NYSE: AUNA outlined its strategy for expanding an integrated healthcare platform across Latin America at its 2026 Investor Day, while also lowering expectations for adjusted EBITDA growth this year due to reimbursement and contracting pressures in Colombia.

President and Executive Chairman Suso Zamora said revenue remains within the company’s guidance range, but EBITDA is now expected to finish broadly stable year over year on an underlying basis rather than meeting prior expectations. He said the pressure is concentrated in Colombia and does not reflect weaker demand, clinical performance or a deterioration in Auna’s operating model.

“Our priority is clear: convert that progress into scale and sustainable EBITDA growth,” Zamora said. He added that Mexico has shown more encouraging trends after the company addressed operational bottlenecks and recalibrated its commercial efforts.

Integrated model and growth priorities

Auna described its strategy as a combination of vertical integration, horizontal network integration and a focus on high-complexity care. Management said the company seeks to expand access to healthcare plans and specialized care while using standardized clinical pathways, data and risk-sharing contracts to improve outcomes and control costs.

Zamora said Latin American markets remain underpenetrated in complementary healthcare coverage and have gaps in physician capacity and high-complexity treatment. The company sees Peru as its most mature integrated platform, Colombia as a large risk-sharing market, and Mexico as its largest long-term growth opportunity.

In Mexico, Auna said it has seen improved patient volumes from major payers and high growth in oncology operations. The company plans to pursue expansion into Mexico City, Guadalajara and Tijuana over time, with a focus on high-complexity services. Management also cited the 2025 acquisition of Opción Oncología in Monterrey as an example of a targeted, accretive transaction. Zamora said Auna now represents approximately 30% to 35% of privately insured chemotherapy treatments in Monterrey.

The company said it will prioritize organic growth, small complementary acquisitions and balance-sheet discipline before considering larger transactions. Its capital allocation framework places maintenance capital and high-return organic investment first, followed by deleveraging and smaller accretive acquisitions.

• Management continues to target net debt leverage below 3x EBITDA during 2027.
• Auna said it does not intend to exceed its 3x leverage threshold after reaching that level.
• The company may consider dividends or share repurchases in future years, subject to board approval and operating performance.

Peru platform and Trecca project

Vicente Checa, leader of Auna’s Peruvian operations, said Peru remains a major source of recurring revenue and a blueprint for the company’s broader model. By the second quarter of 2026, Auna had nearly 1.5 million healthcare-plan memberships in Peru and network capacity utilization of nearly 78% across 15 facilities.

Checa said Auna has a 44% share of Peru’s health-plan market and an 83% share of oncology plans, with roughly 1 million memberships. He also cited a five-year cancer survival rate of 75%, compared with figures of 69% in the U.S. and 55% in the U.K., as well as an oncology medical loss ratio of 50%.

The company plans to expand outpatient and inpatient capacity in Lima, add capacity in Arequipa and pursue imaging alliances and bolt-on acquisitions. It is also developing the Trecca Ambulatory Center through a 20-year public-private partnership with Peru’s EsSalud government health agency, with an option to renew for another 20 years.

Construction on Trecca is expected to begin this month, with operations anticipated in late 2028. The facility is expected to include 145 medical offices, more than 300 pieces of medical equipment and approximately 1,500 employees at full capacity. Management said it could serve about 3 million people annually.

Chief Financial Officer Gisele Remy said the project is self-financed and non-recourse to Auna under Peru’s public-private partnership framework. Based on minimum guaranteed demand, Trecca is expected to generate approximately PEN 120 million in revenue by 2030, equal to about 20% of Auna Peru’s current revenue base, according to management.

Value-based care and digital operations

Auna emphasized value-based care as central to its strategy. Zamora said the approach shifts incentives away from traditional fee-for-service arrangements and toward patient outcomes and total cost of care. The model is supported by Auna’s hospitals, physicians, data systems, healthcare plans and risk-sharing contracts.

Chief Operating Officer Rayet Harb said the company manages patient journeys rather than isolated episodes of care, with emphasis on earlier diagnosis, coordinated specialty treatment and standardized clinical pathways. In Colombia, Auna serves 3.2 million people through risk-sharing arrangements and has used that model for about 14 years, according to Harb.

Harb also described Auna’s regional digital strategy, which includes unified data systems, revenue-cycle automation and artificial intelligence applications. One tool, Medbox, has reduced the time physicians spend preparing post-surgical notes by nearly 85%, according to the company. Auna said it is evaluating the tool’s deployment beyond Mexico into Peru and Colombia.

Financial outlook revised

Remy said Auna recorded 9% FX-neutral revenue growth through the second quarter and a 95% adjusted EBITDA-to-operating-cash-flow conversion rate over the last 12 months. The company maintained its 2026 capital expenditure target of about 4% of revenue and reported net debt to EBITDA of 3.6x at the end of the second quarter.

However, Auna updated its EBITDA outlook. Remy said the company faces one-off billing reconciliation effects in Peru and pressure from a specific risk-sharing contract in Colombia. That Colombian contract has been suspended while discussions with the payer continue.

“We now anticipate EBITDA growth in 2026 to be broadly stable year-over-year,” Remy said. The company said it expects to provide more detailed quantification when it reports third-quarter results.

About Auna (NYSE:AUNA)

Auna SA is a Latin American healthcare company that provides integrated medical services through a network of hospitals, clinics, outpatient centers and specialized care facilities. Its operations include hospital care, ambulatory services, diagnostic testing, oncology treatment, preventive care and other medical specialties.

The company also offers healthcare plans and programs designed to provide access to medical services, including specialized oncology coverage. Auna's business model combines healthcare financing and service delivery, allowing it to serve patients across different stages of care, from prevention and diagnosis to treatment and follow-up.

Auna is headquartered in Peru and serves markets in Latin America, including Peru, Colombia and Mexico.

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