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8-K - CURRENT REPORT - TEAM HEALTH HOLDINGS INC.d296793d8k.htm

Exhibit 99.1

 

LOGO

 

 

 

FOR IMMEDIATE RELEASE       INVESTOR CONTACT:
      David Jones
     

Executive Vice President and

Chief Financial Officer

      865-293-5299
      MEDIA CONTACT:
      Tracy Young
      Vice President, Communications
      800-818-1498

Team Health Holdings, Inc., Announces Fourth Quarter and

Fiscal 2011 Financial Results

Fiscal 2011 Fourth Quarter Highlights

 

   

Net Revenue less provision for uncollectibles grew 17.4% to $462.0 million over the prior year fourth quarter

 

   

Net earnings were $13.3 million; $16.8 million after excluding after tax contingent purchase expense of $3.5 million ($5.8 million pretax); $20.6 million after excluding the after tax non-cash amortization expense of $3.8 million ($6.1 million pretax) and after tax contingent purchase expense

 

   

Diluted net earnings per share of $0.20; $0.25 after excluding after tax contingent purchase expense; $0.31 after excluding the after tax non-cash amortization and contingent purchase expense

 

   

Adjusted EBITDA increased 9.5% to $43.9 million over the prior year fourth quarter

KNOXVILLE, Tenn. – February 7, 2012 – Team Health Holdings, Inc. (“TeamHealth”) (NYSE: TMH), one of the largest suppliers of outsourced healthcare professional staffing and administrative services to hospitals and other healthcare providers in the United States, today announced results for its fourth quarter and full fiscal year 2011.

“We are pleased with our fourth quarter results, as we delivered healthy growth across revenues, operating earnings and Adjusted EBITDA. With the solid performance in the fourth quarter, our full year results exceeded both our initial and increased revised financial performance targets for 2011,” said TeamHealth President and Chief Executive Officer, Greg Roth.

 

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“The strength of our financial performance demonstrates the effectiveness of our balanced and integrated approach to achieving our revenue growth goals. Once again, all of our growth drivers delivered major contributions to revenue, which include same contract, acquisitions and net contract growth, despite sequentially lower same contract volume growth throughout 2011. For the quarter, acquisition growth was the largest component of consolidated revenue growth as we benefited from recent acquisitions that closed in the third quarter of 2011. Net new contract growth also performed well as we benefited from investments made in our sales and marketing process. Finally, same contract revenue contributed solid growth, driven by increases in estimated collections per visit, despite a limited volume growth environment. In addition, our military business delivered revenue growth for the second consecutive quarter, and we believe the improving revenue trends reflect continued stabilization of this division. Moving into 2012, we remain well positioned, with a healthy acquisition pipeline and continued opportunities for both new contract wins and same contract revenue growth.”

Lynn Massingale, M.D., Executive Chairman of TeamHealth, added, “We are pleased with our continued progress and the successful execution of our growth plan in 2011 and we look forward to delivering strong operating and financial performance in 2012. Our recent acquisitions and net sales efforts reinforce the appeal of our model and our reputation as a desirable partner to physician groups serving hospitals with the highest expectations of quality and service. We remain dedicated to delivering the highest quality of patient care and our proprietary information technology systems and infrastructure investments enable us to help hospitals drive patient safety, operational efficiency and customer satisfaction goals.”

Fiscal 2011 Fourth Quarter Results

Net revenue less provision for uncollectibles (“revenue less provision”) increased 17.4% to $462.0 million from $393.4 million in the fourth quarter of 2010. Acquisitions contributed 7.8%, new contracts, net of terminations contributed 6.1%, and same contract revenue contributed 3.5% of the increase in quarter-over-quarter growth in net revenue less provision.

Same contract revenue less provision increased 3.8% to $374.4 million from $360.5 million in the fourth quarter of 2010. Increases in estimated collections on fee-for-service visits of 5.8% provided approximately 4.2% of same contract revenue growth between quarters. Fee for service volume growth provided a 0.4% increase in same contract

 

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revenue growth as the number of visits increased 0.5% from the same contract volume reported in the fourth quarter of 2010. Declines in contract and other revenue, primarily associated with our locum tenens division, constrained same contract revenue growth by 0.8%. Acquisitions contributed $30.8 million of growth and net new contract revenue increased by $23.9 million between quarters.

Reported net earnings were $13.3 million in the fourth quarter of 2011, or $0.20 diluted net earnings per share, compared to a net loss of $36.0 million, or $0.56 diluted net loss per share in the same period of 2010. Financial results for the fourth quarter of 2011 included $5.8 million ($3.5 million after-tax) of contingent purchase expense associated with acquisitions that contained a contingent payment component of the total purchase price. Excluding this adjustment, net earnings for the fourth quarter of 2011 were $16.8 million and diluted net earnings per share were $0.25. Financial results for the fourth quarter of 2010 included a non-deductible goodwill impairment charge of $48.8 million, a $2.3 million loss associated with the December 2010 bond redemption and $3.9 million of contingent purchase expense totaling $55.0 million on a pre-tax basis ($52.6 million after-tax). Excluding these adjustments, diluted net earnings for the fourth quarter of 2010 were $16.5 million and diluted net earnings per share were $0.26.

As a result of the Company’s increased pace of acquisitions during 2011, non-cash amortization expense increased to $6.1 million ($3.8 million after tax) in the fourth quarter of 2011 compared to $4.1 million ($2.6 million after tax) in 2010. Excluding the non-cash amortization expense and previously noted adjustments in each period, diluted net earnings per share were $0.31 in the fourth quarter of 2011 and $0.29 in 2010.

Fourth quarter 2011 net earnings per share were also impacted by transaction costs of $1.5 million ($0.9 million after tax or $0.01 per share), a higher effective state tax rate, and an increase in fully diluted outstanding shares between quarters.

Cash flow provided by operations in the fourth quarter of 2011 was $43.7 million compared to $50.4 million in the same quarter in 2010. Included in operating cash flows were contingent purchase price payments of $3.5 million and $3.2 million, respectively, in 2011 and 2010. Excluding the impact of contingent purchase price payments, the $6.5 million decrease in operating cash flow between quarters was principally the result of an increase in the funding of accounts receivable in part associated with an increase in net revenue from new contracts and acquisitions.

Adjusted EBITDA increased 9.5% to $43.9 from $40.0 million in the same quarter in 2010. Adjusted EBITDA margin was 9.5% compared to 10.2% for the same quarter in 2010. The change in margin was primarily due to lower operating margins on new

 

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contracts associated with initial startup costs and higher provider costs. See “Non-GAAP Financial Measures Reconciliation” and “Adjusted EBITDA” below for the definitions of Adjusted EBITDA Margin and Adjusted EBITDA and its reconciliation to net earnings.

Fiscal 2011 Full Year Results

Revenue less provision in the year ended December 31, 2011 increased 14.9% to $1.75 billion from $1.52 billion in fiscal 2010. Same contract revenue contributed 4.0%, acquisitions contributed 5.1%, and new contracts, net of terminations contributed 5.9% of the increase in year-over-year growth in net revenue less provision.

Same contract revenue less provision increased 4.6% to $1.36 billion from $1.30 billion in 2010. Increases in estimated collections on fee for service visits of 5.2% provided approximately 3.8% of same contract growth between periods. Fee for service volume growth increased 2.5%, which contributed 1.9% of same contract growth between years. Declines in contract and other revenue, primarily associated with our military and locum tenens divisions, constrained same contract growth by 1.0%. Acquisitions contributed $76.8 million of growth between years while net new contract revenue increased by $88.9 million.

Reported net earnings were $65.5 million, or $0.98 diluted net earnings per share in 2011, compared to $6.8 million, or $0.11 diluted net earnings per share, in 2010. Financial results for 2011 included an increase in discounted carrying value of prior year professional liability reserves of $5.3 million ($3.2 million after tax), contingent purchase expense of $13.6 million ($8.3 million after tax), and a loss on the refinancing of debt of $6.0 million ($3.6 million after tax), totaling $24.9 million on a pre-tax basis ($15.1 million after tax). Excluding these adjustments, net earnings were $80.6 million and diluted net earnings per share were $1.21 for the year. Financial results for 2010 included a reduction of professional liability reserves related to prior years of $7.2 million ($4.4 million after tax), contingent purchase expense of $13.3 million ($8.1 million after tax), an impairment charge of $50.3 million ($49.7 million after tax), and costs associated with the Company’s bond redemption of $18.4 million ($11.2 million after tax), totaling $74.8 million on a pre-tax basis ($64.7 million after tax). Excluding these adjustments, net earnings were $71.5 million and diluted net earnings per share were $1.11 in 2010.

As a result of the acquisitions completed in both 2010 and 2011, non-cash amortization expense increased to $17.8 million ($11.1 million after tax) in 2011 compared to $14.4 million ($9.3 million after tax) in 2010. Excluding the non-cash amortization expense and previously noted adjustments in each fiscal year, diluted net earnings per share were $1.38 in 2011 and $1.25 in 2010.

 

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Fiscal 2011 net earnings per share were also impacted by transaction costs of $4.1 million ($2.5 million after tax or $0.04 per share) compared to $0.8 million ($0.5 million after tax or $0.01 per share) in 2010, a higher effective state tax rate, and an increase in fully diluted outstanding shares between years.

Cash flow provided by operations in 2011 was $98.8 million compared to $109.9 million in 2010. Included in operating cash flow were contingent purchase price payments of $15.5 million and $4.1 million, respectively, in 2011 and 2010. Excluding the impact of contingent purchase price payments, the $0.4 million increase in operating cash flow was principally the result of improved profitability, absence of cash costs associated with the bond redemption in 2010 and reduced interest payments during 2011, offset by an increase in accounts receivable funding and tax payments between periods. Included in operating cash flow in 2010 were $15.1 million of cash costs associated with the bond redemption, including $2.8 million of accrued interest payments on bonds that were redeemed. During 2011, total net cash used for acquisitions, including contingent payments reported in operating cash flow, was $141.3 million compared to $56.4 million for the same period in 2010.

Adjusted EBITDA increased 13.4% to $188.5 million from $166.3 million in 2010 and Adjusted EBITDA margin was 10.8% compared to 10.9% in 2010. See “Non-GAAP Financial Measures Reconciliation” and “Adjusted EBITDA” below for the definition of Adjusted EBITDA and its reconciliation to net earnings.

As of December 31, 2011, the Company had cash and cash equivalents of $9.9 million and $200.0 million of available borrowings under a revolving credit facility (without giving effect to $6.6 million of undrawn letters of credit). The Company’s total outstanding debt was $420.0 million, including $25.0 million outstanding under its revolving credit facility, which reflected $2.5 million of term debt payments and a $34.5 million reduction of outstanding revolver borrowings during the fourth quarter of 2011.

Conference Call

As previously announced, TeamHealth will hold a conference call tomorrow, February 8, to discuss its fiscal fourth quarter and full-year 2011 results at 8:30 a.m. (Eastern Standard Time). The conference call can be accessed live over the phone by dialing

1-877-941-1427, or for international callers, 1-480-629-9664. A replay will be available one hour after the call and can be accessed by dialing 1-877-870-5176, or for international callers, 1-858-384-5517. The passcode for the live call and the replay is 4509237. The replay will be available until February 15, 2012.

 

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Interested investors and other parties may also listen to a simultaneous webcast of the conference call by logging onto the Investor Relations section of the Company’s website at www.teamhealth.com. The on-line replay will remain available for a limited time beginning immediately following the call in the Investor Relations section of the Company’s website at www.teamhealth.com.

To learn more about TeamHealth, please visit the company’s Web site at www.teamhealth.com. TeamHealth uses its Web site as a channel of distribution for material Company information. Financial and other material information regarding TeamHealth is routinely posted on the Company’s Web site and is readily accessible.

About TeamHealth

TeamHealth (Knoxville, Tenn.) (NYSE: TMH) was founded in 1979 and has become one of the largest suppliers of outsourced healthcare professional staffing and administrative services to hospitals and other healthcare providers in the United States. Through its six principal service lines located in 15 regional sites, TeamHealth’s more than 7,100 affiliated healthcare professionals provide emergency medicine, hospital medicine, anesthesia, and pediatric staffing and management services to more than 730 civilian and military hospitals, clinics, and physician groups in 47 states. For more information about TeamHealth, visit www.teamhealth.com.

 

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Forward Looking Statements

Statements and information contained herein that are not historical facts and that reflect the current view of Team Health Holdings, Inc. (the “Company”) about future events and financial performance are hereby identified as “forward looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Some of these statements can be identified by terms and phrases such as “anticipate,” “believe,” “intend,” “estimate,” “expect,” “continue,” “could,” “should,” “may,” “plan,” “project,” “predict” and similar expressions. The Company cautions that such “forward looking statements,” including without limitation, those relating to the Company’s future business prospects, revenue, working capital, professional liability expense, liquidity, capital needs, interest costs and income, wherever they occur in this or in other statements attributable to the Company, are necessarily estimates reflecting the judgment of the Company’s senior management and involve a number of risks and uncertainties that could cause actual results to differ materially from those suggested by the “forward looking statements.” Factors that could cause our actual results to differ materially from those expressed or implied in such forward-looking statements include but are not limited to current or future government regulation of the healthcare industry, exposure to professional liability lawsuits and governmental agency investigations, the adequacy of insurance coverage and insurance reserves, as well as those factors detailed under the caption “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in the Company’s most recent annual report on Form 10-K and the most recent quarterly report on Form 10-Q filed with the Securities and Exchange Commission. The Company’s “forward looking statements” speak only as of the date hereof and the Company disclaims any intent or obligation to update “forward looking statements” herein to reflect changed assumptions, the occurrence of unanticipated events, or changes to future operating results over time.

Non-GAAP Financial Measures Reconciliation

In this release we refer to Adjusted EBITDA and Adjusted EBITDA margin, which are financial measures that are calculated and presented on the basis of methodologies other than in accordance with generally accepted accounting principles in the United States of America (“GAAP”). Adjusted EBITDA is defined as net earnings before interest expense, taxes, depreciation and amortization, as further adjusted to exclude the non-cash items and the other adjustments shown in the table under “Adjusted EBITDA” below. Adjusted EBITDA margin represents Adjusted EBITDA divided by net revenues less provision for uncollectibles. For a reconciliation of Adjusted EBITDA to the most directly comparable GAAP measure, we refer you to the table under “Adjusted EBITDA”.

 

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Team Health Holdings, Inc.

Consolidated Balance Sheets

 

     As of
December 31,
 
   2010     2011  
     (In thousands)  

Assets

    

Current Assets:

    

Cash and cash equivalents

   $ 30,337      $ 9,855   

Accounts receivable, less allowance for uncollectibles of $194,833 and $265,293 in 2010 and 2011, respectively

     241,238        307,874   

Prepaid expenses and other current assets

     21,211        24,021   

Receivables under insured programs

     15,492        14,129   

Income tax receivable

     2,179        1,438   
  

 

 

   

 

 

 

Total current assets

     310,457        357,317   

Investments of insurance subsidiary

     87,781        94,300   

Property and equipment, net

     35,159        34,674   

Other intangibles, net

     60,866        101,910   

Goodwill

     174,439        232,215   

Deferred income taxes

     45,791        36,188   

Receivables under insured programs

     28,639        31,581   

Other

     38,706        40,082   
  

 

 

   

 

 

 
   $ 781,838      $ 928,267   
  

 

 

   

 

 

 

Liabilities and shareholders’ (deficit) equity

    

Current liabilities:

    

Accounts payable

   $ 18,556      $ 22,356   

Accrued compensation and physician payable

     131,043        153,674   

Other accrued liabilities

     106,824        109,649   

Current maturities of long-term debt

     4,250        35,000   

Deferred income taxes

     38,438        38,068   
  

 

 

   

 

 

 

Total current liabilities

     299,111        358,747   

Long-term debt, less current maturities

     399,500        385,000   

Other non-current liabilities

     151,980        167,120   

Shareholders’ (deficit) equity:

    

Common stock ($0.01 par value; 100,000 shares authorized and 64,489 and 65,589 shares issued and outstanding at December 31, 2010 and 2011, respectively)

     645        656   

Additional paid-in capital

     522,992        541,216   

Accumulated deficit

     (593,295     (527,774

Accumulated other comprehensive earnings

     905        3,302   
  

 

 

   

 

 

 

Shareholders’ (deficit) equity

     (68,753     17,400   
  

 

 

   

 

 

 
   $ 781,838      $ 928,267   
  

 

 

   

 

 

 

 

 

-continued-

 

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Team Health Holdings, Inc.

Consolidated Statements of Operations

 

     Three Months Ended December 31,  
     2010     2011  
     (In thousands, except per share data)  

Net revenues

   $ 692,787      $ 846,635   

Provision for uncollectibles

     299,349        384,601   
  

 

 

   

 

 

 

Net revenues less provision for uncollectibles

     393,438        462,034   

Cost of services rendered (exclusive of depreciation and amortization shown separately below)

    

Professional service expenses

     304,846        362,484   

Professional liability costs

     13,169        16,464   

General and administrative expenses (includes contingent purchase compensation expense of $3,893 and $5,774 in 2010 and 2011, respectively

     42,587        47,275   

Other income

     (582     (974

Impairment of intangibles

     48,797        —     

Depreciation

     2,905        3,044   

Amortization

     4,052        6,116   

Interest expense, net

     4,615        3,581   

Loss on extinguishment of debt

     2,261        —     

Transaction costs

     122        1,496   
  

 

 

   

 

 

 

(Loss) earnings before income taxes

     (29,334     22,548   

Provision for income taxes

     6,697        9,245   
  

 

 

   

 

 

 

Net (loss) earnings

   $ (36,031   $ 13,303   
  

 

 

   

 

 

 

 

     Three Months Ended December 31,  
     2010     2011  

Net (loss) earnings per share

    

Basic

   $ (0.56   $ 0.20   
  

 

 

   

 

 

 

Diluted

   $ (0.56   $ 0.20   
  

 

 

   

 

 

 

Weighted average shares outstanding

    

Basic

     64,274        65,412   

Diluted

     64,274        67,075   

 

 

-continued-

 

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Team Health Holdings, Inc.

Consolidated Statements of Operations

 

     Year Ended December 31,  
     2010     2011  
     (In thousands, except per share data)  

Net revenues

   $ 2,671,374      $ 3,141,678   

Provision for uncollectibles

     1,152,110        1,396,350   
  

 

 

   

 

 

 

Net revenues less provision for uncollectibles

     1,519,264        1,745,328   

Cost of services rendered (exclusive of depreciation and amortization shown separately below)

    

Professional service expenses

     1,170,208        1,348,255   

Professional liability costs

     46,356        65,982   

General and administrative expenses (includes contingent purchase compensation expense of $13,311and $13,575 in 2010 and 2011, respectively)

     149,122        169,147   

Other (income) expenses

     (1,017     242   

Impairment of intangibles

     50,293        —     

Depreciation

     11,503        12,208   

Amortization

     14,416        17,756   

Interest expense, net

     20,552        12,782   

Loss on extinguishment and refinancing of debt

     17,122        6,022   

Transaction costs

     843        4,149   
  

 

 

   

 

 

 

Earnings before income taxes

     39,866        108,785   

Provision for income taxes

     33,065        43,264   
  

 

 

   

 

 

 

Net earnings

   $ 6,801      $ 65,521   
  

 

 

   

 

 

 

 

     Year Ended December 31,  
     2010      2011  

Net earnings per share

     

Basic

   $ .11       $ 1.01   
  

 

 

    

 

 

 

Diluted

   $ .11       $ 0.98   
  

 

 

    

 

 

 

Weighted average shares outstanding

     

Basic

     64,177         65,041   

Diluted

     64,641         66,580   

 

-continued-

 

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Team Health Holdings, Inc.

Consolidated Statements of Cash Flows

 

     Three Months Ended December 31,  
   2010     2011  
   (In thousands)  

Operating activities

    

Net (loss) earnings

   $ (36,031   $ 13,303   

Adjustments to reconcile net (loss) earnings:

    

Depreciation

     2,905        3,044   

Amortization

     4,052        6,116   

Amortization of deferred financing costs

     480        198   

Equity based compensation expense

     762        1,349   

Provision for uncollectibles

     299,349        384,601   

Impairment of intangibles

     48,797        —     

Deferred income taxes

     4,400        10   

Loss on extinguishment of debt

     978        —     

Loss on disposal of equipment

     1        —     

Loss on assets held for sale

     67        —     

Equity in joint venture income

     1,390        1,174   

Changes in operating assets and liabilities, net of acquisitions:

    

Accounts receivable

     (281,157     (392,642

Prepaids and other assets

     3,028        3,826   

Income tax accounts

     (10,433     669   

Accounts payable

     2,523        6,957   

Accrued compensation and physician payable

     9,833        12,488   

Other accrued liabilities

     (655     (488

Contingent purchase liabilities

     683        2,296   

Professional liability reserves

     (542     754   
  

 

 

   

 

 

 

Net cash provided by operating activities

     50,430        43,655   

Investing activities

    

Purchases of property and equipment

     (4,625     (5,925

Cash paid for acquisitions, net

     (662     —     

Purchases of investments at insurance subsidiary

     (27,534     (26,843

Proceeds from investments at insurance subsidiary

     34,228        25,558   
  

 

 

   

 

 

 

Net cash provided by (used in) investing activities

     1,407        (7,210

Financing activities

    

Payments on notes payable

     (1,063     (2,500

Payments on 11.25% senior subordinated notes

     (45,523     —     

Proceeds from revolving credit facility

     —          154,500   

Payments on revolving credit facility

     —          (189,000

Payments of financing costs

     —          (520

Proceeds from exercise of stock options

     56        940   

Tax benefit from exercise of stock options

     —          54   

Proceeds from issuance of common stock under stock purchase plans

     385        922   
  

 

 

   

 

 

 

Net cash used in provided by financing activities

     (46,145     (35,604
  

 

 

   

 

 

 

Increase in cash and cash equivalents

     5,692        841   

Cash and cash equivalents, beginning of period

     24,645        9,014   
  

 

 

   

 

 

 

Cash and cash equivalents, end of period

   $ 30,337      $ 9,855   
  

 

 

   

 

 

 

Supplemental cash flow information:

    

Interest paid

   $ 6,420      $ 3,617   

Taxes paid

   $ 12,934      $ 8,663   

 

-continued-

 

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Team Health Holdings, Inc.

Consolidated Statements of Cash Flows

 

     Year Ended December 31,  
   2010     2011  
     (In thousands)  

Operating activities

    

Net earnings

   $ 6,801      $ 65,521   

Adjustments to reconcile net earnings:

    

Depreciation

     11,503        12,208   

Amortization

     14,416        17,756   

Amortization of deferred financing costs

     2,001        1,313   

Equity based compensation expense

     2,104        4,053   

Provision for uncollectibles

     1,152,110        1,396,350   

Impairment of intangibles

     50,293        —     

Deferred income taxes

     7,070        7,886   

Loss on extinguishment and refinancing of debt

     4,815        1,654   

Loss on disposal of equipment

     23        253   

Loss on assets held for sale

     67        —     

Equity in joint venture income

     (492     (1,057

Changes in operating assets and liabilities, net of acquisitions:

    

Accounts receivable

     (1,150,878     (1,447,870

Prepaids and other assets

     (8,029     3,428   

Income tax accounts

     (4,999     605   

Accounts payable

     787        3,629   

Accrued compensation and physician payable

     9,158        21,408   

Contingent purchase liabilities

     9,249        (1,918

Other accrued liabilities

     (1,201     3,384   

Professional liability reserves

     5,068        10,196   
  

 

 

   

 

 

 

Net cash provided by operating activities

     109,866        98,799   

Investing activities

    

Purchases of property and equipment

     (11,898     (11,977

Cash paid for acquisitions, net

     (52,368     (125,828

Purchases of investments at insurance subsidiary

     (79,460     (88,561

Proceeds from investments at insurance subsidiary

     78,372        84,866   

Other investing activities

     5        90   
  

 

 

   

 

 

 

Net cash used in investing activities

     (65,349     (141,410

Financing activities

    

Payments on notes payable

     (4,250     (408,750

Proceeds on notes payable

     —          400,000   

Payments on 11.25% senior subordinated notes

     (203,025     —     

Proceeds from sale of common stock

     21,762        —     

Proceeds from revolving credit facility

     109,800        269,000   

Payments on revolving credit facility

     (109,800     (244,000

Payments of financing costs

     —          (8,303

Stock issuance costs

     —          (491

Proceeds from the issuance of common stock under stock purchase plans

     385        1,794   

Proceeds from exercise of stock options

     617        12,825   

Tax benefit from exercise of stock options

     —          54   
  

 

 

   

 

 

 

Net cash (used in) provided by financing activities

     (184,511     22,129   
  

 

 

   

 

 

 

Decrease in cash and cash equivalents

     (139,994     (20,482

Cash and cash equivalents, beginning of year

     170,331        30,337   
  

 

 

   

 

 

 

Cash and cash equivalents, end of year

   $ 30,337      $ 9,855   
  

 

 

   

 

 

 

Supplemental cash flow information:

    

Interest paid

   $ 23,316      $ 14,251   

Taxes paid

   $ 31,246      $ 34,573   

 

-continued-

 

12


Team Health Holdings, Inc.

Adjusted EBITDA

We present Adjusted EBITDA as a supplemental measure of our performance. We define Adjusted EBITDA as net earnings before interest expense, taxes, depreciation and amortization, as further adjusted to exclude the non-cash items and the other adjustments shown in the table below. We present Adjusted EBITDA because we believe it assists investors and analysts in comparing our performance across reporting periods on a consistent basis by excluding items that we do not believe are indicative of our core operating performance.

Adjusted EBITDA is not a measurement of financial performance or liquidity under generally accepted accounting principles. In evaluating our performance as measured by Adjusted EBITDA, management recognizes and considers the limitations of this measure. Adjusted EBITDA does not reflect certain cash expenses that we are obligated to make, and although depreciation and amortization are non-cash charges, assets being depreciated and amortized will often have to be replaced in the future, and Adjusted EBITDA does not reflect any cash requirements for such replacements. In addition, other companies in our industry may calculate Adjusted EBITDA differently than we do or may not calculate it at all, limiting its usefulness as a comparative measure. Because of these limitations, Adjusted EBITDA should not be considered in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles.

The following table sets forth a reconciliation of net earnings to Adjusted EBITDA.

 

     Year Ended December 31,      Three Months
Ended December 31,
 
     2010     2011      2010     2011  
     (In thousands)  

Net earnings (loss)

   $ 6,801      $ 65,521       $ (36,031   $ 13,303   

Interest expense, net

     20,552        12,782         4,615        3,581   

Provision for income taxes

     33,065        43,264         6,697        9,245   

Depreciation

     11,503        12,208         2,905        3,044   

Amortization

     14,416        17,756         4,052        6,116   

Impairment of intangibles(a)

     50,293        —           48,797        —     

Other expenses (income)(b)

     (1,017     242         (582     (974

Loss on extinguishment and refinancing of debt(c)

     17,122        6,022         2,261        —     

Contingent purchase expense(d)

     13,311        13,575         3,893        5,774   

Transaction costs(e)

     843        4,149         122        1,496   

Equity based compensation expense(f)

     2,104        4,053         762        1,349   

Insurance subsidiary interest income

     2,444        2,244         619        491   

Professional liability loss reserve adjustments associated with prior years

     (7,219     5,345         —          —     

Severance and other charges

     2,053        1,378         1,937        444   
  

 

 

   

 

 

    

 

 

   

 

 

 

Adjusted EBITDA

   $ 166,271      $ 188,539       $ 40,047      $ 43,869   
  

 

 

   

 

 

    

 

 

   

 

 

 

 

(a) Includes impairment of goodwill of $48,797 and $1,496 for impairment of intangibles for the year ended December 31, 2010.
(b) Reflects gain or loss on sale of assets, realized gains on investments, and changes in the fair value of investments associated with the Company’s non-qualified retirement plan.
(c) For 2010, reflects the loss on the redemption of the 11.25% Notes, including write-off of deferred financing costs of $4,815. For 2011, reflects the write-off of deferred financing costs of $1,654 from the previous term loan as well as certain fees and expenses associated with the 2011 debt refinancing.
(d) Reflects expense recognized for estimated future contingent payments associated with acquisitions.
(e) Reflects expenses associated with acquisition transaction fees.
(f) Reflects costs related to options and restricted shares granted under the Team Health Holdings, Inc. 2009 Stock Incentive Plan.

 

-continued-

 

13


Team Health Holdings, Inc.

Revenue Analysis

The components of net revenue less provision for uncollectibles includes revenue from contracts that have been in effect for prior periods (same contracts) and from net new and acquired contracts during the periods, as set forth in the table below:

 

     Three Months Ended December 31,  
     2010      2011      % Change     Contribution  to
Growth
 
     (In thousands)  

Same contracts:

          

Fee for service revenue

   $ 263,202       $ 279,770         6.3     4.2

Contract and other revenue

     97,323         94,620         (2.8     (0.7
  

 

 

    

 

 

    

 

 

   

 

 

 

Total same contracts

     360,525         374,390         3.8        3.5   

New contracts, net of terminations:

          

Fee for service revenue

     16,790         34,849         107.6        4.6   

Contract and other revenue

     16,123         21,970         36.3        1.5   
  

 

 

    

 

 

    

 

 

   

 

 

 

Total new contracts, net of terminations

     32,913         56,819         72.6        6.1   

Acquired contracts:

          

Fee for service revenue

     —           25,683         —          6.5   

Contract and other revenue

     —           5,142         —          1.3   
  

 

 

    

 

 

    

 

 

   

 

 

 

Total acquired contracts

     —           30,825         —          7.8   

Consolidated:

          

Fee for service revenue

     279,992         340,302         21.5        15.3   

Contract and other revenue

     113,446         121,732         7.3        2.1   
  

 

 

    

 

 

    

 

 

   

 

 

 

Total net revenues less provision for uncollectibles

   $ 393,438       $ 462,034         17.4     17.4
  

 

 

    

 

 

    

 

 

   

 

 

 

The following table reflects the visits and procedures included within fee for service revenues described in the table above:

 

     Three Months Ended December 31,  
     2010      2011  
     (In thousands)  

Fee for service visits and procedures:

     

Same contract

     1,977         1,987   

New and acquired contracts, net of terminations

     133         401   
  

 

 

    

 

 

 

Total fee for service visits and procedures

     2,110         2,388   
  

 

 

    

 

 

 

 

-continued-

 

14


Team Health Holdings, Inc.

Revenue Analysis

The components of net revenue less provision for uncollectibles includes revenue from contracts that have been in effect for prior periods (same contracts) and from net new and acquired contracts during the periods, as set forth in the table below:

 

     Year Ended December 31,  
     2010      2011      % Change     Contribution to
Growth
 
     (In thousands)  

Same contracts:

          

Fee for service revenue

   $ 952,502       $ 1,026,626         7.8     4.9

Contract and other revenue

     345,782         332,015         (4.0     (0.9
  

 

 

    

 

 

    

 

 

   

 

 

 

Total same contracts

     1,298,284         1,358,641         4.6        4.0   

New contracts, net of terminations:

          

Fee for service revenue

     90,867         155,325         70.9        4.2   

Contract and other revenue

     97,716         122,181         25.0        1.6   
  

 

 

    

 

 

    

 

 

   

 

 

 

Total new contracts, net of terminations

     188,583         277,506         47.2        5.9   

Acquired contracts:

          

Fee for service revenue

     25,460         91,256         258.4        4.3   

Contract and other revenue

     6,937         17,925         158.4        0.7   
  

 

 

    

 

 

    

 

 

   

 

 

 

Total acquired contracts

     32,397         109,181         237.0        5.1   

Consolidated:

          

Fee for service revenue

     1,068,829         1,273,207         19.1        13.5   

Contract and other revenue

     450,435         472,121         4.8        1.4   
  

 

 

    

 

 

    

 

 

   

 

 

 

Total net revenues less provision for uncollectibles

   $ 1,519,264       $ 1,745,328         14.9     14.9
  

 

 

    

 

 

    

 

 

   

 

 

 

The following table reflects the visits and procedures included within fee for service revenues described in the table above:

 

     Year Ended December 31,  
     2010      2011  
     (In thousands)  

Fee for service visits and procedures:

     

Same contract

     7,178         7,355   

New and acquired contracts, net of terminations

     1,000         1,792   
  

 

 

    

 

 

 

Total fee for service visits and procedures

     8,178         9,147   
  

 

 

    

 

 

 

###

 

15