A significant disconnect exists between earnings and cash generation, evidenced by an OCF/NI ratio of 26.71 in 2026Q1, suggesting that reported net income fails to capture underlying cash capacity.
| Cash from Operations | 601.05M | 242.83M | 668.5M | 582.41M | 162.64M | 183.34M | 156.3M | 152.4M | 109.3M | 95.94M |
| Operating CF Margin % | - | 5.54% | 15.24% | 15.03% | 6.63% | 9.53% | 10.83% | 11.02% | 12.69% | 13.27% |
| Operating CF Growth % | 29.37% | -63.67% | 14.78% | 258.1% | -11.29% | 17.3% | 2.56% | 39.43% | 13.92% | - |
| Net Income | 68.14M | 92.01M | 123.96M | -214.34M | -76.83M | -23.02M | -5.38M | 73.87M | 36.64M | 20.65M |
| Depreciation & Amortization | 170.11M | 209.67M | 219.15M | 235.75M | 138.09M | 77.39M | 64.7M | 56.75M | 32.04M | 30M |
| Stock-Based Compensation | 4.66M | 0 | 9.14M | 3.67M | 0 | 0 | 0 | 0 | 0 | 0 |
| Deferred Taxes | 55.23M | 0 | 59.82M | 90.17M | 29.38M | 19.9M | -7.84M | 41.18M | 17.54M | 15.09M |
| Other Non-Cash Items | 345.59M | -9.78M | 429M | 607.61M | 246.07M | 60.05M | 102.48M | 44.36M | 18.76M | 27.9M |
| Working Capital Changes | -52.57M | -49.07M | -172.57M | -140.45M | -174.07M | 49.03M | 2.34M | -63.76M | 4.32M | 2.29M |
| Change in Receivables | -50.57M | -76.95M | -343.15M | -316M | -80.48M | -39.47M | -6.65M | -38.61M | -16.72M | -12.69M |
| Change in Inventory | -31.78M | -16.82M | -25.85M | -30.11M | -22.91M | -10.78M | -14.17M | -6.04M | -527K | -1.01M |
| Change in Payables | 30.65M | 60.9M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Cash from Investing | -44.92M | -78.83M | -236.82M | -173.15M | -3.21B | -291.99M | -125.93M | -125.91M | -580.02M | -12.78M |
| Capital Expenditures | -90.36M | -136.38M | -90.86M | -116.25M | -102.5M | -233.25M | -90.74M | -104.57M | -39.01M | -5.33M |
| CapEx % of Revenue | 2% | 3.11% | 2.07% | 3% | 4.18% | 12.13% | 6.29% | 7.56% | 4.53% | 0.74% |
| Acquisitions | 5.7M | 6.13M | -47.17M | -96.14M | -2.95B | -3.91M | 259K | 0 | -533.68M | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - |
| Other Investing | -42.06M | -19.93M | -98.79M | 61.48M | -153.83M | -54.83M | -35.44M | -21.34M | -7.34M | -7.44M |
| Cash from Financing | -362.44M | -74.31M | -418.12M | -370M | 3.13B | -102.13M | 272.7M | -99.47M | 552.62M | -67.08M |
| Debt Issued (Net) | -730K | 31.38M | 68.27M | 308.02M | 1.91B | 3.08M | 319.5M | -24.33M | 351.54M | -41.92M |
| Equity Issued (Net) | 0 | 0 | 1.27B | 0 | 0 | 0 | 0 | 1K | 242.11M | 0 |
| Dividends Paid | 0 | 0 | -1.15M | -6.84M | -131K | 0 | -10.01M | -10M | -10M | 0 |
| Share Repurchases | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Financing | -361.71M | -105.68M | -1.75B | -671.18M | 1.22B | -105.21M | -36.79M | -65.15M | -31.03M | -25.15M |
| Net Change in Cash | 214.28M | 124.43M | -5.39M | 32.44M | 69.92M | -204.68M | 307.37M | -74.79M | 78.37M | 16.09M |
| Free Cash Flow | 492.83M | 161.76M | 577.64M | 417.25M | 10.67M | -106.03M | 27.38M | 47.83M | 70.29M | 90.61M |
| FCF Margin % | 10.9% | 3.69% | 13.17% | 10.77% | 0.44% | -5.51% | 1.9% | 3.46% | 8.16% | 12.54% |
| FCF Growth % | 4.35% | -72% | 38.44% | 3809.75% | 110.07% | -487.25% | -42.76% | -31.95% | -22.42% | - |
| FCF per Share | 6.77 | 5.37 | 8.54 | 9.50 | 0.24 | -2.21 | 0.61 | 1.11 | 1.88 | 2.44 |
| FCF Conversion (FCF/Net Income) | 7.23x | 2.49x | 6.06x | -2.29x | -1.90x | -6.93x | -22.00x | 2.10x | 3.02x | 4.35x |
| Interest Paid | 0 | 0 | 450.98M | 0 | 0 | 0 | 0 | 37.83M | 21.48M | 24.2M |
| Taxes Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Currency and integration volatility
As reported in recent financial statements, Auna exhibits a significant disconnect between net income and operating cash flow, with the OCF/NI ratio reaching an extreme 26.71 in 2026Q1, suggesting that reported earnings are currently failing to capture the underlying cash-generating capacity of the clinical operations.
The wide variance between net income and operating cash flow indicates that non-cash charges and accounting adjustments are heavily distorting the bottom line. Investors should monitor whether this divergence is a temporary result of acquisition-related accounting or a structural feature of the company's complex payor-provider revenue recognition model.
Based on the provided cash flow data, Auna's free cash flow margin has fluctuated significantly, ranging from a low of 5.5% in 2025Q1 to a peak of 15.2% in 2025Q3, reflecting the inherent instability in cash conversion as the company scales its footprint across Latin American markets.
The inconsistency in free cash flow generation suggests that the company's operational cash flow is highly sensitive to working capital swings and regional economic conditions. This volatility complicates the assessment of the company's ability to self-fund its aggressive growth strategy without relying on external financing.
According to quarterly filings, Auna's capital expenditure as a percentage of revenue has remained relatively contained, averaging approximately 2.2% over the last ten quarters, which may indicate a focus on optimizing existing clinical infrastructure rather than aggressive greenfield expansion in the current high-rate environment.
While the relatively low capital intensity appears favorable, it warrants further investigation into whether this level of spending is sufficient to maintain the high-acuity oncology technology required for the company's competitive moat. If maintenance capex is being deferred, the company may face significant catch-up costs in future periods.
As evidenced by the erratic working capital changes, which swung from a $45.8M inflow in 2025Q4 to a $58.7M outflow in 2025Q3, Auna's cash flow is heavily influenced by the timing of collections and payables within its integrated healthcare plan and hospital service segments.
These fluctuations suggest that the company's cash cycle is susceptible to delays in insurance reimbursements and the management of medical supply inventories. Investors should monitor these trends closely, as persistent working capital outflows could signal deteriorating efficiency in the company's core revenue collection processes.
Quick answers to the most common questions about buying AUNA stock.
Auna S.A. (AUNA) generated $242.8M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Auna S.A. (AUNA) generated $161.8M in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
Auna S.A. (AUNA) spent $136.4M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.