Attached files
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| EX-99.2 - RECONCILIATIONS OF NON-GAAP FINANCIAL MEASURES TO GAAP FINANCIAL MEASURES - AMEDISYS INC | dex992.htm |
| 8-K - FORM 8-K - AMEDISYS INC | d8k.htm |
 March
2010 www.amedisys.com NASDAQ: AMED Exhibit 99.1 |
 Forward-Looking Statements This presentation may include forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. These forward-looking statements are based upon current expectations and assumptions about our business that are subject to a variety of risks and uncertainties that could cause actual results to differ materially from those described in this presentation. You should not rely on forward-looking statements as a prediction of future events. Additional information regarding factors that could cause actual results to differ materially from those discussed in any forward-looking statements are described in reports and registration statements we file with the SEC, including our Annual Report on Form 10-K and subsequent Quarterly Reports on Form 10-Q and Current Reports on Form 8-K, copies of which are available on the Amedisys internet website http://www.amedisys.com or by contacting the Amedisys Investor Relations department at (800) 467-2662. We disclaim any obligation to update any forward-looking statements or any changes in events, conditions or circumstances upon which any forward-looking statement may be based except as required by law. |
 2 Important Website Information We encourage everyone to visit the Investors Section of our website at www.amedisys.com, where we have posted additional important information such as press releases, profiles concerning our business and clinical operations and control processes, and SEC filings. We intend to use our website to expedite public access to time-critical information regarding the Company in advance of or in lieu of distributing a press release or a filing with the SEC disclosing the same information. |
 3 Our Strategy Clinical Excellence Focus on outcomes Develop and deploy specialized programs for chronic diseases and conditions Expand care coordination platform Growth Focus on chronic co-morbid patients Large, growing and highly fragmented market Internal growth/start-ups Acquisitions Efficiency Proven operating model supported by sophisticated technology system Leverage cost-efficient platform Experienced management team |
 4 William F. Borne Chairman and Chief Executive Officer CEO since founding the Company in 1982 Michael D. Snow Chief Operating Officer Joined Amedisys in
February 2010 Tim Barfield Chief Development Officer Joined Amedisys in January 2010 Dale E. Redman, CPA Chief Financial Officer Joined Amedisys in 2007 Management Team Jeffrey Jeter Chief Compliance Officer Joined Amedisys in 2001 Michael O. Fleming, MD Chief Medical Officer Joined Amedisys in 2009 G. Patrick Thompson Chief Information Officer Joined Amedisys in January 2010 |
 5 2 1 Corporate Overview Founded in 1982, publicly listed 1994 586 locations in 40 states Leading provider of home health services Services include skilled nursing and therapy services 95% of Home Health revenue is episodic based (both Medicare & non-Medicare) 1 For the year ended December 31, 2009 2 Provided as of the date of our Form 8-K filed with the Securities and Exchange Commission on
February 23, 2010. . Revenue Mix Stats 16,700 employees Daily visits = 23,800 8.7 million visits completed in 2009 2010 revenue guidance = $1.750 billion |
 6 Patient Overview Average patient is 83 years old Higher acuity patient Patient is taking an average of 13 medications 15 medications for greater than two episodes |
 7 Patient Length of Stay Days Patients Percentage 1-60 140,714 66.74% 61-120 39,788 17.75% 121-180 15,386 7.07% 181-240 7,608 3.97% 241-300 4,271 2.12% 301-360 2,590 1.18% 361-420 1,795 0.64% 421-480 1,275 0.34% 481-540 967 0.15% 541-600 687 0.03% Grand Total 215,081 100.0% - 20,000 40,000 60,000 80,000 100,000 120,000 140,000 160,000 1-60 61-120 121-180 181-240 241-300 301-360 361-420 421-480 481-540 541-600 2009 Patients by Service Days • 84% receive care/ discharged within 2 episodes • 11% received care within 3 and 4 episodes • 5% - Chronic Subset th rd |
 8 Our Locations National home nursing provider located in 40 states, the District of Columbia and Puerto Rico. Largest provider in the Southern and Southeastern United States. 521 home nursing locations* 65 hospice locations* *As of December 31, 2009 |
 9 Medicare Revenue Market Size 2008: Medicare spending for home health reached $16.5 billion 2019: Medicare spending for home health will reach $47.9 billion $ in billions Source: CBO's March 2009 Baseline: MEDICARE $16.5 $17.8 $19.0 $21.1 $23.5 $26.2 $29.0 $32.2 $35.7 $39.7 $43.9 $47.9 $- $10.0 $20.0 $30.0 $40.0 $50.0 $60.0 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Medicare Home Health Revenue |
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6,878 7,223 7,710 8,218 8,868 9,284 9,824 10,581 - 2,000 4,000 6,000 8,000 10,000 12,000 2002 2003 2004 2005 2006 2007 2008 2009 Medicare Certified Home Health Provider Numbers Home Nursing Market Source: National Association for Home Care & Hospice and Medpac reports |
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Industry Growth Drivers Trend from inpatient to home-based care: Patient preference Payor incentives Technology advancements Demographics – aging population 8,000 Americans will become Medicare eligible each day beginning in 2011 and by 2030, 57.8 million baby boomers will be eligible for Medicare benefits Increased prevalence of chronic and co-morbid conditions 1 Source: United States Census Bureau 1 |
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Internal Growth Internal revenue growth of 15% for Q4 2009 Internal growth driven by: Overall industry growth Increase in episodic-based admissions • Focus on start-ups Increase in episodic-based recertifications • Higher acuity levels and co-morbidities, requiring more intensive services Increase in episodic-based revenue per episode • Continued deployment of therapy intensive specialty programs |
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Start-Up Strategy Home health start-ups typically generate $1.5 - $2.0 million in run-rate revenue by the end of their second year of operations ~ 18 to 30 months to recoup the $300,000 - $500,000 investment 50 home health and 5 hospice start-ups projected in 2010 155 start-ups in pipeline, 60 incurring expenses * Reported numbers are for home health start-ups Yearly Start-Ups* 0 5 10 15 20 25 30 35 40 45 50 2003 2004 2005 2006 2007 2008 2009 2010 8 13 25 36 32 35 41 50 Projected Completed |
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Acquisition Strategy Reported Purchase Price $17.8M $120.5M $478.1M $63.0M Number of Deals 8 9 10 6 6 0 20 40 60 80 100 120 140 160 2005 2006 2007 2008 2009 83 17 38 131 8 9 0 11 14 12 Hospice Home Health 92 17 49 145 20 |
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Higher Acuity Level Patients Source: OCS BBI Reporter Corporate Comparative Report Date Range: 2008-2009 Case Mix Weight 1.16 1.18 1.20 1.22 1.24 1.26 1.28 1.30 1.32 1.34 1.36 2008 2009 AMED Nation |
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High Quality Outcomes Outcomes – June 2009 Amedisys vs. Nation * Lower % is better Source: www.medicare.gov Exceeded or met 9 out of 12 outcomes vs. nation 0 10 20 30 40 50 60 70 80 90 50 54 62 72 71 49 67 32 23 66 1 87 46 54 47 64 65 43 60 29 22 67 1 80 Amedisys Nation |
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High Quality Health Care Care Management 13 disease management programs 70 clinical tracks Specialty Division Balanced For Life first program in division Serves higher acuity patients Rolled out to 332 locations through December 2009 |
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Marwood Group Report Reviewed Amedisys procedures, corporate compliance processes, controls, clinical infrastructure, technology offerings and future strategies. Compared against three other publicly traded home health companies and 14 large, private non-hospital home health companies. Amedisys ranked highest compared to publicly traded companies Overall score of 84.6% compared to average score of 76.9% |
 Investments in
Technology 19 |
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Comprehensive Compliance Program Local Level • Point of care system enhances clinical documentation accuracy with real-time assessment input • Clinical nurse review of assessments • Physician review/approval • Standardized care plans • Weekly case conferences • Monthly audits • End of episode case review Regional Level Corporate Level • Unannounced compliance & billing audits • Regional directors monitor compliance status and resolve errors • Real-time monitoring capability of local level activity via Point of Care system • Compliance training for all employees • Compliance concerns hotline • Compliance review of metric variances • Compliance manager site visits • Semi-annual clinical/compliance reviews • Annual Sarbanes-Oxley audit • Annual billing competency testing http://www.amedisys.com/pdf/Compliance3/Compliance_Controls.pdf |
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Medicare Reimbursement 2008 CMS issued reimbursement changes Expands HHRG’s from 80 to 153 More integrated reimbursement for therapy Allocation of more dollars to later episodes 2009 Changes Market basket increase of 2.9% Increase offset by 2.75% case mix creep adjustment No rural add-on payment 2010 CMS final ruling Market basket increase of 2.0% Negative 2.75% case mix creep adjustment 10% cap on outlier payments per agency, offset by base
payment increase of 2.5% |
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Strong revenue growth EPS growth of greater than 20% for seven consecutive years Stable margins Low leverage Strong cash flow from operations Financial Highlights |
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Financial Highlights $- $1.00 $2.00 $3.00 $4.00 $5.00 $6.00 $- $200 $400 $600 $800 $1,000 $1,200 $1,400 $1,600 $1,800 $2,000 2004 2005 2006 2007 2008 2009 2010 Revenue and EPS Projected Revenue Actual Revenue EPS |
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Summary Financial Results ($ in millions, except per share data) 2008 2009 4Q08 4Q09 Net revenue $1,187.4 $1,513.5 $340.1 $405.5 Period-over-period growth 70.1% 27.5% 75.3% 19.2% Gross margin 624.8 789.0 178.1 208.1 Percent of revenue 52.6% 52.1% 52.4% 51.3% CFFO 150.7 247.7 63.9 28.7 Adjusted EBITDA 181.4 261.8 51.7 71.3 Percent of revenue 15.3% 17.3% 15.2% 17.6% Adjusted Fully-diluted EPS $3.31 $4.89 $0.98 $1.35 1 Adjusted EBITDA is defined as net income attributable to Amedisys, Inc. before provision for income taxes, net interest (income) expense, and depreciation and amortization plus certain TLC integration costs. Adjusted EBITDA should not be considered as an alternative to, or
more meaningful than, income before income taxes, cash flow from operating activities, or other traditional indicators of operating performance. This calculation of
adjusted EBITDA may not be comparable to a similarly titled measure reported by other companies, since not all companies calculate this non-GAAP financial measure in the same
manner. 2 Adjusted diluted earnings per share is defined as diluted earnings per share plus the earnings
per share effect of certain TLC acquisition costs. Adjusted diluted earnings per share should not be considered as an alternative to, or more meaningful than, income before income
taxes, cash flow from operating activities, or other traditional indicators of operating performance. This calculation of adjusted diluted earnings per share may not be comparable to a
similarly titled measure reported by other companies, since not all companies calculate this non-GAAP financial measure in the same manner. 1 2 |
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2008 2009 4Q08 4Q09 Agencies at period end 528 586 528 586 Period-over-period growth 49.2% 11.0% 49.2% 11.0% Total visits 7,004,200 8,702,146 1,991,407 2,261,121 Period-over-period growth 62.8% 24.2% 68.9% 13.5% Episodic-based admissions 199,371 231,782 53,748 59,694 Period-over-period growth 53.8% 16.3% 58.1% 11.1% Episodic-based completed episodes 353,076 411,975 98,592 108,360 Period-over-period growth 60.6% 16.7% 61.8% 9.9% Episodic-based revenue per episode $2,854 $3,166 $2,972 $3,260 Period-over-period growth 7.3% 10.9% 11.6% 9.7% Summary Performance Results |
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Dec. 31, 2008 Dec. 31, 2009 Assets Cash $ 2.8 $ 34.5 Accounts Receivable, Net 175.7 150.3 Property and Equipment 79.3 91.9 Goodwill 733.9 786.9 Other 78.5 108.8 Total Assets $ 1,070.2 $ 1,172.4 Liabilities and Equity Debt $ 328.5 $ 215.2 All Other Liabilities 179.6 220.9 Equity 562.1 736.3 Total Liabilities and Equity $ 1,070.2 $ 1,172.4 Leverage Ratio 1.6x 0.8x Summary Balance Sheet ($ in millions) |
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47.7 43.7 53.3 46.8 39.1 39.6 43.3 45.2 45.0 46.8 51.0 47.2 40.4 36.9 33.2 33.9 25.0 30.0 35.0 40.0 45.0 50.0 55.0 3/31/06 6/30/06 9/30/06 12/31/06 3/31/07 6/30/07 9/30/07 12/31/07 3/31/08 6/30/08 9/30/08 12/31/08 3/31/09 6/30/09 9/30/09 12/31/09 DSO - Net (2) Days Revenue Outstanding (DSO) (1) Our calculation of days revenue outstanding, net at March 31, 2008 is derived by dividing our
ending net patient accounts receivable (i.e. net of estimated revenue adjustments, allowance for doubtful accounts and excluding the patient accounts receivable assumed in the TLC Health Care Services,
Inc. (“TLC”) and Family Home Health Care, Inc. & Comprehensive Home Healthcare Services, Inc. (“HMA”) acquisitions) by our average daily net patient revenue, excluding the results of
TLC and HMA for the three-month period ended March 31, 2008. (2) Our calculation of days revenue outstanding, net is derived by dividing our ending net patient
accounts receivable (i.e. net of estimated revenue adjustments and allowance for doubtful accounts) by our average daily net patient revenue for the three-month period. (1) |
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Liquidity Available line of credit (LOC): 12/31/09 = $239m 2010 Estimated CFFO - Cap Ex - Required Debt Pay = $160m |
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Summary Strong revenue growth EPS growth of greater than 20% for seven consecutive years Stable margins Low leverage Strong cash flow from operations |
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Guidance 1 Guidance excludes the effects of future acquisitions, if they are made. 2 Provided as of the date of our Form 8-K filed with the Securities and Exchange Commission on
February 23, 2010. Calendar Year 2010 Net revenue: $1.700 - $1.750 billion EPS: $5.40 - $5.60 Diluted shares: 28.8 million 1 2 |
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Contact Information Kevin B. LeBlanc Director of Investor Relations Amedisys, Inc. 5959 S. Sherwood Forest Boulevard Baton Rouge, LA 70816 Office – 225.292.2031 Fax – 225.295.9653 kleblanc@amedisys.com We encourage everyone to visit the Investors section on our website at www.amedisys.com, where we
have posted additional important information such as press releases, profiles
concerning our business and clinical operations and control processes, and SEC
filings. We intend to use our website to expedite public access to time-critical
information regarding the Company in advance of or in lieu of distributing a press
release or a filing with the SEC disclosing the same information. |