Attached files
| file | filename |
|---|---|
| 8-K - FORM 8-K - AMEDISYS INC | d8k.htm |
| EX-99.2 - RECONCILIATIONS OF NON-GAAP - AMEDISYS INC | dex992.htm |
 Investor Presentation
Leading Home Health Care & Hospice
March 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
91%
9%
Home Health
Hospice
Company overview
1
3
•
Founded in 1982, publicly listed 1994
•
553 locations in 45 states
•
Leading provider of home health services
-
Services include skilled nursing and therapy
services
•
Growing hospice business
•
95% of Home Health revenue is episodic
based (both Medicare & non-Medicare)
16,300 employees
Home Health Division:
-Total admits. and recerts. in 2010 ~ 502,000
-9.1 million visits in 2010
Hospice Division:
-
Average daily census = 2,880
-
Average length of stay = 87 days
2011
revenue
guidance
=
$1.65
billion
2
1
For the year ended December 31, 2010
2
Provided as of the date of our Form 8-K filed with the Securities and Exchange
Commission on February 22, 2011. Stats
Revenue Mix |
 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
486 -
Home Health locations
67 -
Hospice locations |
 Leading Home Health & Hospice
Home Health Division
6
•
Industry leader
–
Strong
national
footprint
–
486
locations
across
45
states
as
of
December
31,
2010
–
$356 million revenue in 4Q 2010
•
Strong clinical quality
•
Experienced divisional leadership
•
World-class technology platform
•
Well positioned to capitalize
on organic and consolidation
opportunities |
 Leading Home Health & Hospice
Hospice Division
7
•
67 locations across 20 states as of December 31
–
$38 million revenue in 4Q 2010
•
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 |
 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) |
 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 |
 Leading Home Health & Hospice
Focus on Clinical Outcomes
11
•
Exceeded or met 11 out of 12 outcomes vs. footprint
1
Lower % is better
Source: Medicare |
 Leading Home Health & Hospice
Industry Based
Best Practice
Quality Care Initiatives
12
Care Transition
Encore/Telehealth
Care Team Conference
Research & Development
Nurse Practitioners |
 Leading Home Health & Hospice
3%
6%
15%
12%
0%
5%
10%
15%
20%
2009
2010
Same Store Episodic-Based
Admission Growth
1
Home Health
Hospice
Growth -
Organic
13
•
Care transition coordinators
•
Professional sales force / Mercury Doc
•
Specialty programs
•
Health system & hospital partnerships
•
Clinical outcomes
•
Duke School of Medicine’s Institute on Care at the End of Life
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
Consolidation Opportunities
14
•
Home health and hospice industries are highly fragmented
–
10,500 home health provider numbers
–
3,400 hospice provider numbers
–
Most are single-site, small, local or regional providers
•
Small market share of publicly traded companies
–
Account for 15% of home health Medicare revenue market
–
Account for 12.5% of hospice Medicare revenue market
•
Focus
–
CON markets, footprint expansion, market depth, hospital system joint ventures
–
Hospice geographic expansion into Amedisys home health markets and market
depth
–
Revenue diversification strategies and care management expansion
opportunities
•
Positioned well for increase in opportunities expected in 2011
|
 Leading Home Health & Hospice
Efficiency
15
•
Flexible Labor Structure
–
Pay per visit structure
–
Response to volume fluctuations
•
Infrastructure Investment
–
Upgraded accounting and HR system to Peoplesoft
•
More back office efficiency
•
Greater scalability
–
Field computer refresh
•
Enhanced field wireless communication
•
Access to clinical support
–
Continued investment in state-of-the-art operating system
–
Hospice point of care in 2011 |
 Leading Home Health & Hospice
Efficiency
16
Cost of Revenue
•
Pay per visit focus
•
Reduction in overtime
•
Weekly visit metrics
Field Overhead
•
Streamline management infrastructure
•
Closures/Mergers
Hospice
•
Reduced pharma costs
1
Fourth quarter figure adjusted for holiday pay |
 Leading Home Health & Hospice
Industry Challenges/Opportunities
•
Regulatory focus on industry and Amedisys
–
Senate Finance Committee inquiry of public companies
–
Securities Exchange Commission investigation of public
companies
–
Department of Justice investigation
17
•
Home health reimbursement challenges
–
2011 reduction of 5.2%
–
Proposed 2012 reduction of ~2.9%
–
Rebasing
–
Face-to-face
–
Therapy reassessments
•
Home health Opportunities
–
Growth demographics
–
Moving to lower cost setting
–
Focus on outcomes
–
Value based performance
•
Hospice outlook
–
Stable reimbursement
–
Face-to-face |
 Leading Home Health & Hospice
Investment Rationale
•
Solid industry growth rate
•
Deploy technology
•
Clinical quality and innovation
•
Low cost setting in high cost healthcare industry
•
Scalable infrastructure
•
Expected industry consolidation
•
Strong liquidity and capital position
18
Tremendous
Opportunities |
 Leading Home Health & Hospice
Financial Review
19
*
*
*
*
*
*
*
*
*
*
* |
 Leading Home Health & Hospice
Financial highlights
20 |
 Leading Home Health & Hospice
21
Summary financial results
($ in millions, except per share data)
2009
2010
4Q09
4Q10
Net revenue
$1,513.5
$1,634.3
$405.5
$394.3
Period-over-period growth
27.5%
8.0%
19.2%
(2.8%)
Gross margin
789.0
813.9
208.1
193.5
Percent of revenue
52.1%
49.8%
51.3%
49.1%
CFFO
247.7
206.3
28.7
33.7
Adjusted EBITDA¹
261.8
242.0
71.3
54.8
Percent of revenue
17.3%
14.8%
17.6%
13.9%
Adjusted
Fully-diluted
EPS
2
$4.89
$4.29
$1.35
$0.95
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
which
are
detailed
in
our
Form
8-K
filed
with
the
Securities
and
Exchange
Commission
on
February
22,
2011).
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
which
are
detaile
d in
our
Form
8-K
filed
with
the
Securities
and
Exchange
Commission
on
February
22,
2011).
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. |
 Leading Home Health & Hospice
22
Summary performance results
2009
2010
4Q09
4Q10
Agencies at period end
586
553
586
553
Period-over-period growth
11.0%
(5.6%)
11.0%
(5.6%)
Total visits
8,702,146
9,065,549
2,261,121
2,184,880
Period-over-period growth
24.2%
4.2%
13.5%
(3.4%)
Episodic-based admissions
231,782
253,763
59,694
61,937
Period-over-period growth
16.3%
9.5%
11.1%
3.8%
Episodic-based completed
episodes
411,975
424,988
108,360
105,475
Period-over-period growth
17.0%
3.2%
9.9%
(2.7%)
Episodic-based revenue per
episode
$3,166
$3,311
$3,260
$3,294
Period-over-period growth
10.9%
4.6%
9.7%
1.0% |
 Leading Home Health & Hospice
23
Summary balance sheet
Dec. 31, 2009
Dec. 31, 2010
Assets
Cash
$ 34.5
$ 120.3
Accounts Receivable, Net
150.3
141.5
Property and Equipment
91.9
138.6
Goodwill
786.9
791.4
Other
108.8
108.0
Total Assets
$ 1,172.4
$ 1,299.8
Liabilities and Equity
Debt
$ 215.2
$ 181.9
All Other Liabilities
220.9
238.2
Equity
736.3
879.7
Total Liabilities and Equity
$ 1,172.4
$ 1,299.8
Leverage Ratio
Leverage Ratio, Net of Cash
0.8x
0.7x
0.8x
0.3x |
 Leading Home Health & Hospice
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
25.0
30.0
35.0
40.0
45.0
50.0
55.0
DSO -
Net
(2)
24
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) |
 Leading Home Health & Hospice
25
Liquidity
•
Cash balance at 12/31/10 = $120M
•
Available line of credit (LOC): 12/31/10 = $235M
•
2011 Estimated CFFO -
Cap Ex = $110M -
$120M |
 Leading Home Health & Hospice
26
Guidance
1
Calendar
Year
2011
2
Net revenue:
$1.60 -
$1.65 billion
EPS:
$3.00 -
$3.30
Diluted shares
3
:
29.3 million
1
Guidance
excludes
the
effects
of
any
share
repurchases,
future
acquisitions,
any
non-recurring
costs
that
may
be
incurred
during
the
year
or
the
impact
of
any
future
Medicare
rate
changes.
2
Provided
as
of
the
date
of
our
Form
8-K
filed
with
the
Securities
and
Exchange
Commission
on
February
22,
2011.
3
Without
adjustment
for
any
shares
that
may
be
repurchased
under
our
Share
Repurchase
Program. |
 Leading Home Health & Hospice
Guidance
27
•
First quarter will see a significant
sequential decline from the 95 cent run rate in
the
4
th
quarter
–
5.2% rate cut will negatively impact quarter by 25 to 30 cents
–
$1.2 million impact in January due to bad weather
–
March leadership meeting will negatively impact quarter
–
Negative impact from increased payroll taxes
–
Weak volume in January and February followed by very strong March volume that will
carry over into second quarter
•
Remaining quarters will look similar in step up to 2009
|
 Leading Home Health & Hospice
Summary
28
Tremendous
Opportunities
•
Solid industry growth rate
•
Deploy technology
•
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
29
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
30 |