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How Auna S.A. Is Heading Toward Its Net Leverage Target
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Key Takeaways
Auna S.A.'s net leverage stood at 3.6X, with a target to reduce it below 3X over the medium term.
AUNA saw a 35% rise in free cash flow and a 42% increase in cash balance, boosting flexibility.
Auna S.A. refinanced $825M debt, cutting interest costs and extending maturities to aid deleveraging.
As of the 2025 fourth-quarter end, Auna S.A.’s (AUNA - Free Report) net leverage held steady at 3.6X Net Debt-to-Adjusted EBITDA. The company is aiming to reduce its leverage below 3X over the medium term, supported by a recovery in EBITDA, margin expansion and sustained free cash flow generation. In the quarter, consolidated adjusted EBITDA declined 14% (FX neutral), reflecting Mexico's underperformance and an unfavorable year-over-year comparison in Colombia related to extraordinary items recorded in the prior-year quarter.
However, Auna grew its free cash flow by 35% over 2024, with year-end cash balance up 42% to Peruvian Soles (“PEN”) 335 million, offering solid flexibility to continue investing in its strategic growth initiatives in Mexico and Peru. Management noted that the year-over-year improvement reflected “operational stabilization, enhanced working capital management, and disciplined capital allocation”.
Free cash flow also benefited from PEN 76 million of cash from a portfolio rebalancing at Auna Seguros. The company paid PEN 454 million in interest, which, net of refinancing fees, would have been PEN 407 million — nearly PEN 90 million less than in 2024. This sharp drop in interest expense, with increased interest coverage, leaves Auna well-positioned to continue deleveraging into 2026.
Auna also strengthened its capital structure through $825 million debt refinancing, which extended its maturity profile, reduced interest expense, lowered short-term debt exposure and increased the proportion of direct local currency funding. Excluding refinancing-related expenses, the company still generated cash after interest and expects further improvement in 2026.
Meanwhile, recent performance in Mexico operations shows stabilization, with signs of a return to steady top-line and EBITDA growth this year. Overall, the company seems to be edging closer to achieving its target leverage ratio.
AUNA’s Peer Updates
Ardent Health (ARDT - Free Report) strengthened its balance sheet throughout 2025. The company increased its cash balance by roughly $150 million, reaching more than $700 million at the end of 2025, while lease-adjusted net leverage fell nearly 0.5 times to 2.5X. Ardent Health’s IMPACT-driven initiatives to further optimize costs and strengthen margins are gaining traction. The company expects to generate $55 million of savings this year from this program, up from $40 million previously.
AdaptHealth Corp. (AHCO - Free Report) generated free cash flow of $219.4 million for full-year 2025, exceeding the top end of its guidance range of $170-$190 million. The company ended the year with $106.1 million in unrestricted cash. AdaptHealth’s net debt stood at $1.69 billion, with a net leverage ratio of 2.75, up from 2.68 at the end of the third quarter. Overall, the company remains focused on its 2.5X net leverage target.
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How Auna S.A. Is Heading Toward Its Net Leverage Target
Key Takeaways
As of the 2025 fourth-quarter end, Auna S.A.’s (AUNA - Free Report) net leverage held steady at 3.6X Net Debt-to-Adjusted EBITDA. The company is aiming to reduce its leverage below 3X over the medium term, supported by a recovery in EBITDA, margin expansion and sustained free cash flow generation. In the quarter, consolidated adjusted EBITDA declined 14% (FX neutral), reflecting Mexico's underperformance and an unfavorable year-over-year comparison in Colombia related to extraordinary items recorded in the prior-year quarter.
However, Auna grew its free cash flow by 35% over 2024, with year-end cash balance up 42% to Peruvian Soles (“PEN”) 335 million, offering solid flexibility to continue investing in its strategic growth initiatives in Mexico and Peru. Management noted that the year-over-year improvement reflected “operational stabilization, enhanced working capital management, and disciplined capital allocation”.
Free cash flow also benefited from PEN 76 million of cash from a portfolio rebalancing at Auna Seguros. The company paid PEN 454 million in interest, which, net of refinancing fees, would have been PEN 407 million — nearly PEN 90 million less than in 2024. This sharp drop in interest expense, with increased interest coverage, leaves Auna well-positioned to continue deleveraging into 2026.
Auna also strengthened its capital structure through $825 million debt refinancing, which extended its maturity profile, reduced interest expense, lowered short-term debt exposure and increased the proportion of direct local currency funding. Excluding refinancing-related expenses, the company still generated cash after interest and expects further improvement in 2026.
Meanwhile, recent performance in Mexico operations shows stabilization, with signs of a return to steady top-line and EBITDA growth this year. Overall, the company seems to be edging closer to achieving its target leverage ratio.
AUNA’s Peer Updates
Ardent Health (ARDT - Free Report) strengthened its balance sheet throughout 2025. The company increased its cash balance by roughly $150 million, reaching more than $700 million at the end of 2025, while lease-adjusted net leverage fell nearly 0.5 times to 2.5X. Ardent Health’s IMPACT-driven initiatives to further optimize costs and strengthen margins are gaining traction. The company expects to generate $55 million of savings this year from this program, up from $40 million previously.
AdaptHealth Corp. (AHCO - Free Report) generated free cash flow of $219.4 million for full-year 2025, exceeding the top end of its guidance range of $170-$190 million. The company ended the year with $106.1 million in unrestricted cash. AdaptHealth’s net debt stood at $1.69 billion, with a net leverage ratio of 2.75, up from 2.68 at the end of the third quarter. Overall, the company remains focused on its 2.5X net leverage target.
AUNA Stock: Price Performance, Valuation & Estimates
In the past three months, Auna shares have risen 26.9% against the industry’s 11.4%% fall.
Image Source: Zacks Investment Research
Auna S.A. is trading at a forward, five-year, price-to-earnings (P/E) of 0.32X, lower than its median and industry average.
Image Source: Zacks Investment Research
Take a look at how estimates for Auna S.A.'s earnings are shaping up.
Image Source: Zacks Investment Research
AUNA stock sports a Zacks Rank #1 (Strong Buy) at present.You can see the complete list of today’s Zacks #1 Rank stocks here.