Auna increased free cash flow by 181% year over year in Q2 2026 while reducing its leverage ratio to 3.6x, as improved collections and working-capital management strengthened cash generation despite lower adjusted EBITDA margins.
Operating cash flow increased 45% year over year, giving the Latin American healthcare company simultaneous improvement in both major cash-generation measures. Auna attributed the gains to disciplined working-capital management and stronger collections from payors.
The reduction in leverage brings Auna closer to its medium-term target of below 3.0x. Management said the cash-flow performance has exceeded its earlier expectations and now expects full-year free cash flow to finish above its original internal forecast, although the company has not issued formal FCF guidance.
The stronger cash conversion came despite pressure on profitability. Q2 revenue increased 13% on a reported basis and 9% on an FX-neutral basis to S/1.238 billion, while adjusted EBITDA declined 6% reported and 9% FX-neutral to S/227 million. Adjusted EBITDA margin was 18.4%, slightly above the first-quarter level.
Patient volumes continued to expand. Surgeries increased 5.2% to 21,912, days hospitalized rose 5% to 135,107, and chemotherapy and radiotherapy sessions increased 15%. Oncology’s medical-loss ratio remained stable at 50.1%.
Revenue increased across all three of Auna’s geographic segments in local currency. Mexico grew 4%, Peru increased 8% and Colombia rose 13%. Peru benefited from additional B2B Oncosalud memberships and higher-complexity procedures, while Colombia continued expanding risk-sharing PGP arrangements.
Those Colombia risk-sharing contracts reached 24% of segment revenue, while exposure to intervened payors declined to 12%. Auna said the changing payor mix is improving revenue quality and predictability, although the ramp of new PGP contracts, statutory wage increases and SG&A investments have pressured near-term margins.
For 2026, Auna continues to expect FX-neutral revenue growth near the midpoint of its 10% to 14% range, or approximately 12%. Adjusted EBITDA growth is expected toward the low end of that range, reflecting temporary cost pressures as patient volumes and healthcare services scale. Capital expenditures are still expected to equal approximately 4% of revenue.
Auna’s network included 31 healthcare facilities with 2,337 beds and approximately 1.5 million healthcare plans at June 30, giving the company an increasingly large operating base from which stronger collections and working-capital discipline can translate growth into cash flow.
