Attached files
| file | filename |
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| 8-K - FORM 8-K - AMEDISYS INC | d8k.htm |
| EX-99.2 - RECONCILIATIONS OF NON-GAAP FINANCIAL MEASURES - AMEDISYS INC | dex992.htm |
 Investor Presentation
Leading Home Health Care & Hospice
May 2011
Exhibit 99.1 |
 Leading Home Health & Hospice
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
www.amedisys.com
NASDAQ: AMED
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. |
 Leading Home Health & Hospice
Company
overview
1
3
•
Founded in 1982, publicly listed 1994
•
558 locations in 45 states
•
Leading provider of home health services
-
Services include skilled nursing and therapy
services
•
Growing hospice business
•
94% of Home Health revenue is episodic
based (both Medicare & non-Medicare)
16,100 employees
Home Health Division:
-Total admits. and recerts. in 1Q11 ~ 106,000
-8.5 million visits run rate in 2011
Hospice Division:
-
Average daily census = 3,153
-
Average length of stay = 88 days
2011 revenue
guidance
=
$1.60
-
$1.65
billion
Stats
2
89%
11%
Home Health
Hospice
Revenue Mix
1
For the quarter ended March 31, 2011
2
Provided as of the date of our Form 8-K filed with the Securities and Exchange Commission on April
26, 2011. |
 Leading Home Health & Hospice
Management team
William F. Borne, Chairman and CEO
Founder and CEO since 1982
28 years leading the industry
Michael D. Snow, Chief Operating Officer
30 years leading health care operations
Wellmont, HealthSouth, HCA
Tim Barfield, Chief Development Officer
15 years of corporate development experience
Gov. Bobby Jindal, Vinson & Elkins, The Shaw Group
Dale E. Redman, CPA, Chief Financial Officer
34 years of senior level financial experience
Winward Capital, United Companies Financial
4
Jeffrey D. Jeter, Chief Compliance Officer
14 years of health care law and compliance expertise
Former Medicaid prosecutor, LA AG for DOJ
Michael O. Fleming, Chief Medical Officer
29 years as a family physician
Former President of AAFP, first industry CMO
G. Patrick Thompson, Chief Information Officer
23 years of corporate administration experience
Arthur Andersen, Turner Industries, The Shaw Group
David R. Bucey, General Counsel
24 years of experience in corporate law
Coca-Cola Company, McKenna Long & Aldridge |
 Leading Home Health & Hospice
Agency Locations
5
489 -
Home Health locations
69 -
Hospice locations |
 Leading Home Health & Hospice
Home Health Division
6
•
Industry leader
–
Strong national footprint –
489 locations across 45 states as of March 31, 2011
–
$326 million revenue in 1Q 2011
•
Strong clinical quality
•
Experienced divisional leadership
•
World-class technology platform
•
Well positioned to capitalize
on organic and consolidation
opportunities
$-
$200
$400
$600
$800
$1,000
$1,200
$1,400
$1,600
2008
2009
2010
1Q 2010
1Q 2011
Home Health Revenue
$1,118
$1,409
$1,493
$381
$326 |
 Leading Home Health & Hospice
Hospice Division
7
•
69 locations across 20 states as of March 31, 2011
–
$39 million revenue in 1Q 2011
•
Operational efficiencies drive strong margins
•
Quality care drives referral growth
•
Partnered with the country’s largest and leading Home Health company
–
Offering comprehensive
continuum of at-home care
–
Collective resources to drive
operational and clinical
excellence
–
Cross referral opportunities
to drive growth
$-
$20
$40
$60
$80
$100
$120
$140
$160
2008
2009
2010
1Q 2010
1Q 2011
Hospice Revenue
$69
$104
$141
$33
$39 |
 Leading Home Health & Hospice
Medicare market size
8
Source: Congressional Budget Office baseline reports (Home health figures from 2010
report, Hospice figures from 2009 report) $18
$20
$21
$23
$25
$28
$31
$33
$37
$40
$44
$13
$13
$14
$15
$15
$16
$17
$18
$19
$20
$22
$-
$10
$20
$30
$40
$50
$60
$70
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Medicare Reimbursement
Home Health
Hospice
2009-2019
CAGR
Home Health
9.35%
Hospice
5.40% |
 Leading Home Health & Hospice
Value Proposition
•
Home Health is the lowest total cost, lowest daily cost, and provides care
over the longest period of time
9
*Source: National Association for Home Health & Hospice, Medpac
June 2010 Data Book
Hospital
SNF
Home Health
Average Cost of Stay
$28,191
$14,688
$5,293
Average Length of Stay
4.9 days
27 days
106 days
Per Diem Cost
$5,765
$544
$50 |
 Leading Home Health & Hospice
Our Long Term Operating Tenets
10 |
 Focus
on Clinical Outcomes Amedisys
vs. Footprint –
Outcomes December 2009
•
Exceeded or met 11 out of 12 outcomes vs. footprint
1
Lower % is better Source:
Medicare 11
Leading Home Health & Hospice |
 Leading Home Health & Hospice
12
Internal ACH Rates –
Trailing 12 Months
Note: Data
only
includes
agencies
in
the
2009
Baseline
dataset
.
Leading Home Health & Hospice |
 Quality Care Initiatives
13
Leading Home Health & Hospice |
 Leading Home Health & Hospice
3%
6%
-2%
15%
12%
17%
-5%
0%
5%
10%
15%
20%
2009
2010
1Q 2011
Same Store Episodic-Based
Admission Growth
1
Home Health
Hospice
Growth -
Organic
14
Tactical growth initiatives
•
Care center action plans
•
Heightened focus on low
performers
•
Leading indicators
•
Measure effectiveness
•
New regional leadership
•
Training & development
•
CRM tool / market intel
•
Incentive alignment
1
Same store episodic-based admission growth is the percent increase in our same store
episodic-based admissions for the period as a percent of the same store episodic-based
admissions of the prior period.
|
 Leading Home Health & Hospice
Growth -
External
15
Industry Consolidation
–
10,500 home health
provider numbers
–
3,400 hospice provider
numbers
–
12-15% public company
market share
Focus
–
CON markets
–
Geographic expansion
–
Market penetration
–
Hospital JV’s
Continuum of
Care
Traditional Investments
Complementary Investments
–
Care management capabilities
–
Revenue diversification
–
Disease Management
15 |
 Leading Home Health & Hospice
Beacon Acquisition
•
Premier hospice in Northeast
–
23 locations
–
$80 million in revenue
–
Quality provider
–
Strong leadership and operations
Beacon Hospice Care Centers
Amedisys Hospice Care Centers
Amedisys Home Health Care Centers
16 |
 Leading Home Health & Hospice
Efficiency –
Systems Infrastructure
17 |
 Leading Home Health & Hospice
Efficiency –
labor
•
Cost per visit improvements
-
Pay per visit focus
-
Reduction in overtime
-
Weekly visit metrics
•
Field Overhead
-
Staffing ratios
-
Streamline leadership
-
Closures/Mergers
•
Hospice
-
Reduced pharma
costs
-
Leverage overhead thru growth
1
*Adjusted for holiday pay and inclement weather
18
$71.00
$71.50
$72.00
$72.50
$73.00
$73.50
$74.00
$74.50
$78.00
$78.50
$79.00
$79.50
$80.00
$80.50
$81.00
$81.50
$82.00
$82.50
$83.00
1Q 10
2Q 10
3Q 10
4Q 10
1Q 11
Home Health Cost per Visit*
Hospice Cost per Day |
 Leading Home Health & Hospice
Industry Challenges/Opportunities
Challenges
Opportunities
•
F2F
•
Therapy reassessment
•
2012 and future
reimbursement /rebasing
•
Regulatory focus
•
Demographics
•
Low cost setting
•
Quality differentiation
•
Value based pricing
•
Consolidation
•
Health care reform
•
Near-term hospice reimbursement
stability
Future state
•
Educating payors, policy
makers and health systems on
the value of a continuum
model
•
Regulatory inefficiencies
•
Risk sharing/capitation
•
Seamless patient care
•
ACO’s / Medical home
•
System savings
19 |
 Investment Rationale
•
Solid industry growth rate
•
IT leader
•
Clinical quality and innovation
•
Low cost setting in high cost healthcare industry
•
Scalable infrastructure
•
Expected industry consolidation
•
Strong liquidity and capital position
20
Tremendous
Opportunities
Leading Home Health & Hospice |
 Leading Home Health & Hospice
Financial Review
21 |
 Leading Home Health & Hospice
Financial highlights
22
$-
$1.00
$2.00
$3.00
$4.00
$5.00
$6.00
$-
$200
$400
$600
$800
$1,000
$1,200
$1,400
$1,600
$1,800
2004
2005
2006
2007
2008
2009
2010
2011
Revenue
Projected Revenue
EPS
Projected EPS |
 Leading Home Health & Hospice
23
Summary financial results
($ in millions, except per share data)
2009
2010
1Q10
1Q11
Net revenue
$1,513.5
$1,634.3
$413.0
$364.3
Gross margin
789.0
813.9
208.9
173.1
CFFO
247.7
206.3
71.1
52.5
Adjusted
EBITDA
261.8
242.0
70.7
41.2
Adjusted Fully-diluted EPS
$4.89
$4.29
$1.29
$0.62
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 adjustments (i.e Certain items incurred in 2010 and
2011 which are detailed in our Form 8-K filed with the Securities and Exchange
Commission on February 22, 2011 and April 26, 2011, respectively). 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 adjustments (i.e. Certain items incurred in
2010 and 2011 which are detailed in our Form 8-K filed with the
Securities and Exchange Commission on February 22, 2011 and April 26, 2011, respectively).
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 |
 Leading Home Health & Hospice
24
Summary performance results
2009
2010
1Q10
1Q11
Agencies at period end
586
553
600
558
Total visits
8,702,146
9,065,549
2,299,325
2,137,269
Episodic-based admissions
231,782
253,763
65,278
62,480
Episodic-based completed
episodes
411,975
424,988
105,096
99,517
Episodic-based revenue per
episode
$3,166
$3,311
$3,282
$3,029 |
 Leading Home Health & Hospice
25
Summary balance sheet
Dec. 31, 2010
Mar. 31, 2011
Assets
Cash
$ 120.3
$ 148.9
Accounts Receivable, Net
141.5
141.9
Property and Equipment
138.6
144.0
Goodwill
791.4
791.4
Other
108.1
101.4
Total Assets
$ 1,299.9
$ 1,327.6
Liabilities and Equity
Debt
$ 181.9
$ 172.2
All Other Liabilities
238.3
251.3
Equity
879.7
904.1
Total Liabilities and Equity
$ 1,299.9
$ 1,327.6
Leverage Ratio, Net of Cash
0.3x
0.2x |
 Leading Home Health & Hospice
26
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)
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
32.6
32.5
30.8
32.8
34.8
25.0
30.0
35.0
40.0
45.0
50.0
55.0
DSO -
Net
(2) |
 Leading Home Health & Hospice
27
Liquidity
•
Cash balance at 3/31/11 = $149M
•
Available line of credit (LOC): 3/31/11 = $233M
•
2011 Estimated CFFO -
Cap Ex = $110M -
$120M |
 Leading Home Health & Hospice
28
Guidance
1
Calendar Year 2011
2
Net revenue:
$1.60 -
$1.65 billion
EPS:
$3.00 -
$3.30
Diluted shares:
29.3 million |
 Leading Home Health & Hospice
Summary
29
Tremendous
Opportunities
•
Solid industry growth rate
•
IT leader
•
Clinical quality and innovation
•
Low cost setting in high cost healthcare industry
•
Scalable infrastructure
•
Expected industry consolidation
•
Strong liquidity and capital position |
 Leading Home Health & Hospice
Key references
30
Open Letter to Shareholders:
http://www.amedisys.com/pdf/Letter_to_Shareholders.pdf
Wyatt Matas Report: (upon request)
kevin.leblanc@amedisys.com
Avalere Study:
http://www.amedisys.com/pdf/avalere_results_051109.pdf
|
 Leading Home Health & Hospice
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
kevin.leblanc@amedisys.com
31 |