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8-K - FORM 8-K - Alliance HealthCare Services, Incd8k.htm

Exhibit 99.1

LOGO

NEWS RELEASE

 

Contact:
Alliance HealthCare Services
Howard Aihara
Executive Vice President
Chief Financial Officer
(949) 242-5300

ALLIANCE HEALTHCARE SERVICES REPORTS RESULTS

FOR THE SECOND QUARTER AND SIX MONTHS ENDED JUNE 30, 2011; ANNOUNCES

COST REDUCTION PLAN AND UPDATES FULL YEAR 2011 GUIDANCE

NEWPORT BEACH, CA—August 8, 2011–Alliance HealthCare Services, Inc. (NYSE:AIQ) (the “Company” or “Alliance”), a leading national provider of outpatient diagnostic imaging and radiation therapy services, announced results for the second quarter ended June 30, 2011.

Second Quarter 2011 Financial Results

Revenue for the second quarter of 2011 was $127.8 million compared to $121.4 million in the second quarter of 2010, an increase of 5.2%. On a sequential quarter basis, revenue increased 7.9% to $127.8 million in the second quarter of 2011 compared to $118.4 million in the first quarter of 2011.

Alliance’s Adjusted EBITDA (as defined below) was $38.8 million in the second quarter of 2011 compared to $42.5 million in the second quarter 2010, a decrease of 8.7%. On a sequential quarter basis, Adjusted EBITDA increased 6.1% to $38.8 million in the second quarter of 2011 compared to $36.6 million in the first quarter of 2011.

Alliance’s net (loss) income, computed in accordance with generally accepted accounting principles (“GAAP”), totaled ($4.0) million in the second quarter of 2011 and $0.1 million in the second quarter of 2010.

Net (loss) income per share on a diluted basis, computed in accordance with GAAP, was ($0.08) per share in the second quarter of 2011 and $0.00 per share in the second quarter of 2010. In the second quarter of 2011, net loss per share on a diluted basis was impacted by ($0.03) in the aggregate due to fair value adjustments related to interest rate swaps, severance and related costs, mergers and acquisitions transaction costs, refinancing transaction costs and a lower GAAP income tax rate than our historical income tax rate. Alliance’s historical income tax rate has been approximately 42%, rather than the GAAP income tax benefit rate of 35.8% in the second quarter of 2011.

Cash flows provided by operating activities were $27.2 million in the second quarter of 2011 compared to $21.9 million in the second quarter of 2010. Capital expenditures in the second quarter of 2011 were $11.2 million compared to $8.0 million in the second quarter of 2010. Alliance opened three new fixed-site imaging centers in the second quarter of 2011.

 

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Alliance HealthCare Services

Press Release

August 8, 2011

Page 2

Cash and cash equivalents were $64.2 million at June 30, 2011 and $97.2 million at December 31, 2010.

Alliance’s net debt, defined as total long-term debt (including current maturities) less cash and cash equivalents, increased $52.9 million to $609.0 million at June 30, 2011 from $556.1 million at December 31, 2010. The Company used approximately $42.0 million in cash, net of cash acquired, and assumed $26.0 million in equipment debt in connection with the acquisition of US Radiosurgery in April 2011. The Company used approximately $5.0 million in cash in connection with the acquisition of assets from 24/7 Radiology in April 2011. The Company’s net debt, as defined above, divided by the last twelve months Adjusted EBITDA (pro forma for acquisitions during the last twelve month period ended June 30, 2011), was 4.02x for the twelve month period ended June 30, 2011.

The Company’s total long-term debt (including current maturities) increased to $673.2 million at June 30, 2011 from $653.3 million at December 31, 2010. The Company’s total long-term debt (including current maturities) divided by last twelve months Adjusted EBITDA (pro forma for acquisitions during the last twelve month period ended June 30, 2011) was 4.45x for the twelve month period ended June 30, 2011. In accordance with our Credit Agreement, the Company’s leverage ratio was 4.48x for the twelve month period ended June 30, 2011. The difference between the consolidated leverage ratio and the Credit Agreement leverage ratio is calculated in the table below.

Paul S. Viviano, Chairman of the Board and Chief Executive Officer, stated, “Alliance has entered into a challenging phase as our core imaging division continues to operate in a difficult economic environment. We are experiencing both scan volume and pricing pressure in PET/CT and MRI. As a result, Alliance has implemented a significant organizational restructuring, as well as a cost savings and efficiency initiative. Approximately $20 to $25 million in annualized cost of revenues and selling, general and administrative expense savings have been identified and will be realized over an approximate two-year period. Approximately $10 million in annualized savings is expected to be implemented by the end of the third quarter, with an additional $5 million in annualized savings to be implemented by the end of the first quarter of 2012. The Company’s turnaround focus will continue to be augmented with significant growth in Alliance Oncology, operating our 36 centers in a strong manner, continuing treatment volume growth in both our radiation therapy and stereotactic radiosurgery centers, as well as cash flow generation growth in this division. We will also continue to seek out opportunities to increasingly become the hospital outsource provider of choice.”

Included in the restructuring is the departure of two members of Alliance’s executive team, Michael Frisch, President, Alliance Imaging Division, and Eli Glovinsky, Executive Vice President, General Counsel. Replacing Michael Frisch will be Richard Jones, currently Senior Vice President of the Imaging Division, who will be promoted to Executive Vice President of the Imaging Division. Christopher Joyce, Alliance’s current Executive Vice President of M&A and former General Counsel will assume the role of Executive Vice President, General Counsel, Secretary and Corporate Services.

 

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Alliance HealthCare Services

Press Release

August 8, 2011

Page 3

Full Year 2011 Guidance

Alliance is updating its full year 2011 guidance ranges as follows:

 

     Previous    Updated
     Guidance    Guidance
     Ranges    Ranges
     (dollars in millions)    (dollars in millions)

Revenue

   $500 -$530    $475 -$495

Adjusted EBITDA

   $150 -$175    $140 -$150

Cash capital expenditures

   $65 - $75    $35 - $45

Decrease in long-term debt, net of the change in cash and cash equivalents (before investments in acquisitions)

   $25 - $45    $20 - $30

Fixed-site imaging center openings

   20 - 25    12 - 16

Radiation therapy center openings

   3 - 5    2 - 4

Second Quarter 2011 Earnings Conference Call

Investors and all others are invited to listen to a conference call discussing second quarter 2011 results. The conference call is scheduled for Tuesday, August 9, 2011 at 8:30 a.m. Eastern Time. The call will be broadcast live on the Internet and can be accessed by visiting the Company’s website at www.alliancehealthcareservices-us.com. Click on Audio Presentations in the Investors section of the website to access the link.

The conference call can be accessed at (888) 694-4676 (United States) or (973) 582-2737 (International). Interested parties should call at least 5 minutes prior to the call to register. A telephone replay will be available until November 9, 2011. The telephone replay can be accessed by calling (855) 859-2056 (United States) or (404) 537-3406 (International). The conference call identification number is 86327568.

Definition of Adjusted EBITDA

Adjusted EBITDA, as defined by the Company’s management, represents net income (loss) before: interest expense, net of interest income; income taxes; depreciation expense; amortization expense; net income (loss) attributable to noncontrolling interests; non-cash share-based compensation; severance and related costs; loss on extinguishment of debt; fees and expenses related to acquisitions, non-cash impairment charges, and other non-cash charges included in other (income) expense, net, which includes non-cash losses on sales of equipment. The components used to reconcile net income (loss) to Adjusted EBITDA are consistent with our historical presentation of Adjusted EBITDA. Adjusted EBITDA is not a measure of financial performance under generally accepted accounting principles in the United States, or “GAAP.” For a more detailed discussion of Adjusted EBITDA and reconciliation to net income (loss), see the section entitled “Adjusted EBITDA” included in the tables following this release.

About Alliance HealthCare Services

Alliance HealthCare Services is a leading national provider of advanced outpatient diagnostic imaging and radiation therapy services based upon annual revenue and number of systems deployed. Alliance focuses on MRI, PET/CT and CT through its Imaging division and radiation therapy through its Oncology division. With more than 2,300 team members committed to providing exceptional patient care and exceeding customer expectations, Alliance provides quality clinical services for over 1,000 hospitals and other healthcare partners in 46 states. Alliance operates 571 diagnostic imaging and radiation therapy

 

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Alliance HealthCare Services

Press Release

August 8, 2011

Page 4

systems. The Company is the nation’s largest provider of advanced diagnostic mobile imaging services and one of the leading operators of fixed-site imaging centers, with 138 locations across the country. Alliance also operates 36 radiation therapy centers, including 15 dedicated sterotactic radiosurgery facilities, many of which are operated in conjunction with local community hospital partners, providing treatment and care for cancer patients. With 15 sterotactic radiosurgery facilities in operation, Alliance is among the leading providers of sterotactic radiosurgery nationwide.

Forward-Looking Statements

This press release contains forward-looking statements relating to future events, including statements related to forecasted annualized revenue from new client contracts in the Company’s revenue gap disclosures, investment, development and acquisition activity, the implementation of strategic initiatives, the integration of acquired businesses into the Company, the implementation and potential savings from the Company’s organizational restructure, the Company’s ability to operate and grow it’s Oncology division, the opening of new imaging and radiation oncology centers, and the Company’s full year 2011 guidance. In this context, forward-looking statements often address the Company’s expected future business and financial results and often contain words such as “expects,” “anticipates,” “intends,” “plans,” “believes,” “seeks” or “will.” Forward-looking statements by their nature address matters that are uncertain and subject to risks. Such uncertainties and risks include: changes in the preliminary financial results and estimates due to the restatement or review of the Company’s financial statements; the nature, timing and amount of any restatement or other adjustments; the Company’s ability to make timely filings of its required periodic reports under the Securities Exchange Act of 1934; issues relating to the Company’s ability to maintain effective internal control over financial reporting and disclosure controls and procedures; the Company’s high degree of leverage and its ability to service its debt; factors affecting the Company’s leverage, including interest rates; the risk that the counterparties to the Company’s interest rate swap agreements fail to satisfy their obligations under these agreements; the Company’s ability to obtain financing; the effect of operating and financial restrictions in the Company’s debt instruments; the accuracy of the Company’s estimates regarding its capital requirements; the effect of intense levels of competition in the Company’s industry; changes in the methods of third party reimbursements for diagnostic imaging and radiation oncology services; fluctuations or unpredictability of the Company’s revenues, including as a result of seasonality; changes in the healthcare regulatory environment; the Company’s ability to keep pace with technological developments within its industry; the growth in the market for MRI and other services; the disruptive effect of hurricanes and other natural disasters; adverse changes in general domestic and worldwide economic conditions and instability and disruption of credit markets; difficulties the Company may face in connection with recent, pending or future acquisitions, including unexpected costs or liabilities resulting from the acquisitions, diversion of management’s attention from the operation of the Company’s business, and risks associated with integration of the acquisitions; and other risks and uncertainties identified in the Risk Factors section of the Company’s Form 10-K for the year ended December 31, 2010, filed with the Securities and Exchange Commission (the “SEC”), as may be modified or supplemented by our subsequent filings with the SEC. These uncertainties may cause actual future results or outcomes to differ materially from those expressed in the Company’s forward-looking statements. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof. The Company does not undertake to update its forward-looking statements except as required under the federal securities laws.

 

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ALLIANCE HEALTHCARE SERVICES, INC.

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS

AND COMPREHENSIVE INCOME (LOSS)

(Unaudited)

(in thousands, except per share amounts)

 

     Quarter Ended     Six Months Ended  
     June 30,     June 30,  
     2010     2011     2010     2011  

Revenues

   $ 121,407      $ 127,780      $ 240,068      $ 246,208   

Costs and expenses:

        

Cost of revenues, excluding depreciation and amortization

     65,181        71,394        130,407        138,760   

Selling, general and administrative expenses

     16,514        19,889        32,631        36,947   

Transaction costs

     436        1,810        787        2,182   

Severance and related costs

     81        266        543        730   

Depreciation expense

     23,094        23,197        46,785        45,249   

Amortization expense

     3,087        4,609        5,893        7,935   

Interest expense and other, net

     12,819        12,000        26,123        23,735   

Other (income) and expense, net

     32        193        (328     130   
  

 

 

   

 

 

   

 

 

   

 

 

 

Total costs and expenses

     121,244        133,358        242,841        255,668   
  

 

 

   

 

 

   

 

 

   

 

 

 

Loss before income taxes, earnings from unconsolidated investees, and noncontrolling interest

     163        (5,578     (2,773     (9,460

Income tax benefit

     (73     (2,237     (686     (3,580

Earnings from unconsolidated investees

     (1,071     (1,031     (1,978     (2,020
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

     1,307        (2,310     (109     (3,860

Less: Net income attributable to noncontrolling interest

     (1,227     (1,730     (1,974     (2,583
  

 

 

   

 

 

   

 

 

   

 

 

 

Net loss attributable to Alliance HealthCare Services, Inc.

   $ 80      $ (4,040   $ (2,083   $ (6,443
  

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income (loss), net of taxes

        

Net loss attributable to Alliance HealthCare Services, Inc.

   $ 80      $ (4,040   $ (2,083   $ (6,443

Unrealized gain (loss) on hedging transactions, net of taxes

     133        (248     628        (201
  

 

 

   

 

 

   

 

 

   

 

 

 

Comprehensive income (loss), net of taxes:

   $ 213      $ (4,288   $ (1,455   $ (6,644
  

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) per common share attributable to Alliance HealthCare Services, Inc.:

        

Basic

   $ 0.00      $ (0.08   $ (0.04   $ (0.12
  

 

 

   

 

 

   

 

 

   

 

 

 

Diluted

   $ 0.00      $ (0.08   $ (0.04   $ (0.12
  

 

 

   

 

 

   

 

 

   

 

 

 

Weighted average number of shares of common stock and common stock equivalents:

        

Basic

     52,748        53,222        52,752        53,114   

Diluted

     52,850        53,222        52,752        53,114   

 

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ALLIANCE HEALTHCARE SERVICES, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

(Unaudited)

(in thousands)

 

     December 31,     June 30,  
     2010     2011  

ASSETS

    

Current assets:

    

Cash and cash equivalents

   $ 97,162      $ 64,171   

Accounts receivable, net of allowance for doubtful accounts

     62,956        72,690   

Deferred income taxes

     7,344        7,344   

Prepaid expenses

     9,802        6,734   

Other receivables

     3,594        5,521   
  

 

 

   

 

 

 

Total current assets

     180,858        156,460   

Equipment, at cost

     902,829        943,527   

Less accumulated depreciation

     (591,145     (626,784
  

 

 

   

 

 

 

Equipment, net

     311,684        316,743   

Goodwill

     193,126        202,578   

Other intangible assets, net

     94,622        163,437   

Deferred financing costs, net

     14,883        13,670   

Other assets

     21,028        32,520   
  

 

 

   

 

 

 

Total assets

   $ 816,201      $ 885,408   
  

 

 

   

 

 

 

LIABILITIES AND STOCKHOLDERS’ EQUITY

    

Current liabilities:

    

Accounts payable

   $ 15,541      $ 23,680   

Accrued compensation and related expenses

     17,061        16,902   

Accrued interest payable

     5,812        5,338   

Other accrued liabilities

     37,138        37,137   

Current portion of long-term debt

     9,709        17,148   
  

 

 

   

 

 

 

Total current liabilities

     85,261        100,205   

Long-term debt, net of current portion

     455,747        468,052   

Senior notes

     187,809        187,956   

Other liabilities

     1,229        1,302   

Deferred income taxes

     72,496        74,858   
  

 

 

   

 

 

 

Total liabilities

     802,542        832,373   

Stockholders’ equity:

    

Common stock

     525        527   

Treasury stock

     (2,551     (2,551

Additional paid-in capital

     16,062        18,680   

Accumulated comprehensive loss

     (669     (870

Accumulated deficit

     (11,176     (17,619
  

 

 

   

 

 

 

Total stockholders’ equity attributable to Alliance HealthCare Services, Inc.

     2,191        (1,833

Noncontrolling interest

     11,468        54,868   
  

 

 

   

 

 

 

Total stockholders’ equity

     13,659        53,035   
  

 

 

   

 

 

 

Total liabilities and stockholders’ equity

   $ 816,201      $ 885,408   
  

 

 

   

 

 

 

 

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ALLIANCE HEALTHCARE SERVICES, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(Unaudited)

(in thousands)

 

     Six Months Ended
June 30,
 
     2010     2011  

Operating activities:

    

Net loss

   $ (109   $ (3,860

Adjustments to reconcile net loss to net cash provided by operating activities:

    

Provision for doubtful accounts

     294        1,658   

Share-based payment

     2,844        2,642   

Depreciation and amortization

     52,678        53,184   

Amortization of deferred financing costs

     1,340        1,426   

Accretion of discount on long term debt

     756        792   

Adjustment of derivatives to fair value

     (196     (1

Distributions greater than (less than) undistributed earnings from investees

     842        (625

Deferred income taxes

     (1,355     (3,974

Gain on sale of assets

     (328     (71

Changes in operating assets and liabilities, net of acquisitions:

    

Accounts receivable

     (2,915     (6,105

Prepaid expenses

     617        3,435   

Other receivables

     1,007        (1,906

Other assets

     (667     (351

Accounts payable

     (4,842     5,442   

Accrued compensation and related expenses

     (891     (657

Accrued interest payable

     1,992        (548

Income taxes payable

     105        61   

Other accrued liabilities

     1,336        (3,861
  

 

 

   

 

 

 

Net cash provided by operating activities

     52,508        46,681   
  

 

 

   

 

 

 

Investing activities:

    

Equipment purchases

     (28,232     (21,079

Increase in deposits on equipment

     (5,356     (2,312

Acquisitions, net of cash received

     (22,732     (46,650

Decrease in cash in escrow

     485        300   

Proceeds from sale of assets

     1,876        271   
  

 

 

   

 

 

 

Net cash used in investing activities

     (53,959     (69,470
  

 

 

   

 

 

 

 

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ALLIANCE HEALTHCARE SERVICES, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (continued)

(Unaudited)

(in thousands)

 

     Six Months Ended
June 30,
 
     2010     2011  

Financing activities:

    

Principal payments on equipment debt

     (3,621     (4,574

Proceeds from equipment debt

     358        —     

Principal payments on term loan facility

     (2,300     (2,300

Principal payments on senior subordinated notes

     (5,582     —     

Payments of debt issuance costs

     (348     (213

Payments of contingent consideration

     —          (1,626

Noncontrolling interest in subsidiaries

     (2,152     (1,543

Proceeds from shared-based payment arrangements

     75        54   
  

 

 

   

 

 

 

Net cash used in financing activities

     (13,570     (10,202
  

 

 

   

 

 

 

Net increase in cash and cash equivalents

     (15,021     (32,991

Cash and cash equivalents, beginning of period

     111,884        97,162   
  

 

 

   

 

 

 

Cash and cash equivalents, end of period

   $ 96,863      $ 64,171   
  

 

 

   

 

 

 

Supplemental disclosure of cash flow information:

    

Interest paid

   $ 20,811      $ 22,019   

Income taxes paid, net of refunds

     149        (2,357

Supplemental disclosure of non-cash investing and financing activities:

    

Net book value of assets exchanged

   $ 53      $ 26   

Comprehensive gain (loss) from hedging transactions, net of taxes

     628        (201

Equipment debt assumed in connection with acquisitions

     —          25,973   

Equipment purchases in accounts payable

     178        1,616   

Contingent consideration for acquisitions

     3,775        —     

Noncontrolling interest assumed in connection with acquisitions

     5,036        42,360   

 

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ALLIANCE HEALTHCARE SERVICES, INC.

ADJUSTED EBITDA

(in thousands)

Adjusted EBITDA, as defined by the Company’s management, represents net income (loss) before: interest expense, net of interest income; income taxes; depreciation expense; amortization expense; net income (loss) attributable to noncontrolling interests; non-cash share-based compensation; severance and related costs; loss on extinguishment of debt; fees and expenses related to acquisitions, costs related to debt financing, non-cash impairment charges, and other non-cash charges included in other (income) expense, net, which includes non-cash losses on sales of equipment. The components used to reconcile net income (loss) to Adjusted EBITDA are consistent with our historical presentation of Adjusted EBITDA. Adjusted EBITDA is not a measure of financial performance under generally accepted accounting principles in the United States, or “GAAP.”

Management uses Adjusted EBITDA, and believes it is a useful measure for investors, for a variety of reasons. Management regularly communicates its Adjusted EBITDA results and management’s interpretation of such results to its board of directors. Management also compares the Company’s Adjusted EBITDA performance against internal targets as a key factor in determining cash incentive compensation for executives and other employees, largely because management feels that this measure is indicative of how our diagnostic imaging and radiation oncology business is performing and is being managed. Management believes that Adjusted EBITDA is a particularly useful comparative measure within the Company’s industry. The diagnostic imaging and radiation oncology industry continues to experience significant consolidation. These activities have led to significant charges to earnings, such as those resulting from acquisition costs, and to significant variations among companies with respect to capital structures and cost of capital (which affect interest expense) and differences in taxation and book depreciation of facilities and equipment (which affect relative depreciation expense), including significant differences in the depreciable lives of similar assets among various companies. In addition, management believes that because of the variety of equity awards used by companies, the varying methodologies for determining non-cash share-based compensation expense among companies and from period to period, and the subjective assumptions involved in that determination, excluding non-cash share-based compensation from Adjusted EBITDA enhances company-to-company comparisons over multiple fiscal periods and enhances the Company’s ability to analyze the performance of its diagnostic imaging and radiation oncology business.

Adjusted EBITDA may not be directly comparable to similarly titled measures reported by other companies. In addition, Adjusted EBITDA has other limitations as an analytical financial measure. These limitations include the fact that Adjusted EBITDA is calculated before recurring cash charges including interest expense, income taxes and severance costs, and is not adjusted for capital expenditures, the replacement cost of assets or other recurring cash requirements of the Company’s business. Adjusted EBITDA also does not reflect any cost for equity awards to employees. In the future, the Company expects that it may incur expenses similar to the excluded items discussed above. Accordingly, the exclusion of these and other similar items in the Company’s non-GAAP presentation should not be interpreted as implying that these items are non-recurring, infrequent or unusual. Management compensates for the limitations of using Adjusted EBITDA as an analytical measure by relying on the Company’s GAAP results to evaluate its operating performance and by considering independently the economic effects of the items that are or are not reflected in Adjusted EBITDA. Management also compensates for these limitations by providing GAAP-based disclosures concerning the excluded items in the Company’s financial disclosures. As a result of these limitations, however, Adjusted EBITDA should not be considered as an alternative to net income (loss), as calculated in accordance with GAAP, or as an alternative to any other GAAP measure of operating performance.

 

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The calculation of Adjusted EBITDA is shown below:

 

     Second Quarter Ended June 30,     Six Months Ended June 30,     Twelve months
Ended June 30,

2011
 
     2010     2011     2010     2011    

Net income (loss) attributable to Alliance HealthCare Services, Inc.

   $ 80      $ (4,040   $ (2,083   $ (6,443   $ (37,013

Income tax benefit

     (73     (2,237     (686     (3,580     (23,693

Interest expense and other, net

     12,819        12,000        26,123        23,735        48,815   

Amortization expense

     3,087        4,609        5,893        7,935        14,481   

Depreciation expense

     23,094        23,197        46,785        45,249        90,785   

Share-based payment (included in selling, general and administrative expenses)

     1,324        1,207        2,830        2,596        5,282   

Noncontrolling interest in subsidiaries

     1,227        1,730        1,974        2,583        4,499   

Severance and related costs

     81        266        543        730        1,189   

Transaction costs

     436        1,810        787        2,182        3,834   

Impairment charges

             42,095   

Other non-cash charges (included in other (income) and expenses, net)

     429        257        508        367        462   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDA

   $ 42,504      $ 38,799      $ 82,674      $ 75,354      $ 150,736   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

The leverage ratio calculations for the 12 months ended June 30, 2011 are shown below:

 

     Consolidated      Less:
Unrestricted
Subsidiaries
    Credit
Agreement
 

Total debt

   $ 673,156       $ (7,232   $ 665,924   

Last 12 months Adjusted EBITDA

     150,736         (2,689     148,047   

Pro forma acquisitions in last 12 month period (1)

     598         —          598   
  

 

 

    

 

 

   

 

 

 

Last 12 months Adjusted EBITDA, as adjusted

     151,334         (2,689     148,645   

Leverage ratio

     4.45x           4.48x   

 

(1) Gives pro-forma effect to acquisitions occurring during the last twelve months pursuant to the terms of the Credit Agreement.

The reconciliation from net loss to Adjusted EBITDA for the 2011 guidance range is shown below (in millions):

 

     2011 Full Year
Previous

Guidance Range
    2011 Full Year
Updated

Guidance Range
 

Net loss

   ($ 18   ($ 4   ($ 20   ($ 16

Income tax benefit

     (10     (2     (15     (12

Depreciation expense; amortization expense; interest expense and other, net; noncontrolling interest in subsidiaries; share-based payment and other expenses

     178        181        175        178   
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDA

   $ 150      $ 175      $ 140      $ 150   
  

 

 

   

 

 

   

 

 

   

 

 

 

 

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ALLIANCE HEALTHCARE SERVICES, INC.

SELECTED STATISTICAL INFORMATION

 

     Second Quarter Ended
June 30,
 
     2010      2011  

MRI

     

Average number of total systems

     275.0         287.6   

Average number of scan-based systems

     235.5         243.9   

Scans per system per day (scan-based systems)

     8.41         8.08   

Total number of scan-based MRI scans

     129,241         126,674   

Price per scan

   $ 380.29       $ 373.56   

Scan-based MRI revenue (in millions)

   $ 49.1       $ 47.3   

Non-scan based MRI revenue (in millions)

     5.0         5.2   
  

 

 

    

 

 

 

Total MRI revenue (in millions)

   $ 54.1       $ 52.5   
  

 

 

    

 

 

 

PET and PET/CT

     

Average number of systems

     119.3         121.3   

Scans per system per day

     5.74         5.32   

Total number of PET and PET/CT scans

     44,569         41,490   

Price per scan

   $ 1,066       $ 1,020   

Total PET and PET/CT revenue (in millions)

   $ 48.3       $ 42.8   
  

 

 

    

 

 

 

Radiation oncology

     

Linear accelerator treatments

     19,171         23,649   

Cyberknife patients

     199         533   

Total radiation oncology revenue (in millions)

   $ 10.4       $ 20.4   
  

 

 

    

 

 

 

Revenue breakdown (in millions)

     

Total MRI revenue

   $ 54.1       $ 52.5   

PET and PET/CT revenue

     48.3         42.8   

Radiation oncology revenue

     10.4         20.4   

Other modalities and other revenue

     8.6         12.1   
  

 

 

    

 

 

 

Total revenues

   $ 121.4       $ 127.8   
  

 

 

    

 

 

 
Total fixed-site revenue (in millions)    2010      2011  

Second quarter ended June 30

   $ 29.1       $ 31.2   

 

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ALLIANCE HEALTHCARE SERVICES, INC.

SELECTED STATISTICAL INFORMATION

IMAGING DIVISION REVENUE GAP

(in millions)

The Company utilizes the imaging division revenue gap as a statistical measure of its client losses and new client contracts. The imaging division revenue gap is calculated by measuring the difference between (a) the imaging division annualized revenue run rate lost as a result of clients choosing to terminate contracts with the Company, excluding clients for which Alliance provides professional radiology services, interim services and clients that the Company elects to terminate, and (b) projected new imaging division annualized revenue from new client contracts, excluding professional radiology services and interim services, commencing service in the quarter.

The annualized revenue run rate lost from customers choosing to terminate service may not be representative of the revenues such customers would have generated had they remained our customers.

The projected annualized revenue from new client contracts is calculated using contractual pricing where agreed upon, and assumptions with respect to pricing and reimbursement levels for all other new customer relationships. The projected annualized revenue from new client contracts is also calculated using assumptions with respect to customer ramp-up and scan volumes. Our assumptions are based on our experience in the industry and our expectations with respect to pricing and volume trends, and may not reflect actual revenue from new clients for a number of reasons, including greater than expected macroeconomic challenges impacting the imaging business, the variance in ramp-up time of customers adding new service lines, unexpected changes in business conditions and greater than expected competition for imaging services. See “Forward-Looking Statements” for a discussion of the other risks and uncertainties that may cause actual future results or outcomes to differ materially from those expressed above.

The imaging division revenue gap for the last four calendar quarters and the last twelve month period ended June 30, 2011 is as follows:

 

     (a)
Revenue
Lost
    (b)
New
Revenue
     Imaging Division
Revenue Gap
 

2010

       

Third Quarter

   ($ 10.8   $ 11.5       $ 0.7   

Fourth Quarter

     (8.4     7.0         (1.4

2011

       

First Quarter

     (5.1     12.9         7.8   

Second Quarter

     (13.3     3.8         (9.5

Last Twelve Months Ended June 30, 2011

   ($ 37.6   $ 35.2       ($ 2.4

 

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