Attached files
| file | filename |
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| 8-K - FORM 8-K - AMEDISYS INC | d452624d8k.htm |
| EX-99.2 - RECONCILIATIONS OF NON-GAAP TO GAAP FINANCIAL MEASURES - AMEDISYS INC | d452624dex992.htm |
 December
2012 Investor Presentation
Leading Home Health & Hospice
clinical
quality
innovative
care models
better
communities
Exhibit 99.1 |
 Forward-looking Statements
This presentation may include forward-looking statements as defined by the Private
Securities Litigation Reform Act of 1995. These forward-looking statements are based
upon current expectations and assumptions about our business that are subject to a
variety of risks and uncertainties that could cause actual results to differ materially
from those described in this presentation. You should not rely on forward-looking
statements as a prediction of future events.
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.
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.
|
 Company
Overview 1
3
•
Founded in 1982, publicly listed 1994
•
533 care centers in 38
states
•
16,800 employees
•
$1.5 billion in 2011 revenue
•
Largest provider of skilled home health
services
•
4
th
largest hospice business
•
82% of revenue is Medicare
1
For the quarter ended September 30, 2012
Revenue Mix |
 Care Center
Locations 2012 4
436 -
Home health care centers
97 -
Hospice care centers
2 -
Hospice inpatient units
*As of September 30, 2012
U.S.
AMED
Counties
3,143
1,396
44%
65+ Population
41.1 M
26.9 M
65% |
 5
Medicare
Reimbursement
1
Amedisys
Revenue
1
2008 industry cut was 2.9%, however due to other HHRG changes overall
reimbursement was budget neutral.
Sequestration
$-
$0.4
$0.8
$1.2
$1.6
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Revenue
Projected Revenue
-6.0%
-4.0%
-2.0%
0.0%
2.0%
4.0%
Industry % Change
Amedisys |
 Washington
Update 6
Industry Groups
•
Partnership
•
NAHC
•
Alliance
Topics
•
2013 Medicare Final Rules
•
Sequestration / Fiscal Cliff
•
2014-2017 Rebasing
•
Copay
|
 Favorable Long
Term Trends •
Compelling demographics
•
Patient preference
•
Low cost of care delivery
•
Increased payor and hospital focus
7
*Source: Hospital numbers are from
US Census Bureau, others from MedPac March 2012 report
Hospital
LTAC
IRF
SNF
Hospice
Home
Health
Average Cost of Stay
$10,043
$38,582
$17,085
$10,833
$11,217
$5,706
Average Length of Stay
5 days
27 days
13 days
27 days
86 days
120 days
Average Per Diem Cost
$1,853
$1,450
$1,304
$400
$130
$48 |
 Today and
Tomorrow 8
Traditional
HHC & HSP
Care
Management
Solutions
•
Fee for service
•
High volume / low
margins
•
Technology investments
to drive efficiency
•
Need for scale
•
Clinical quality
•
Risk-bearing partnerships
•
Value driven
•
Clinical management
technology
•
Partnering with payors and
other providers
•
Superior outcomes |
 Post Acute Care
Challenges Today 9
Key Issues
Patient
Patient
Home
Home
Health
Payors
Post Acute
Physicians
Hospital
Facilities
Hospice
•
Poor care coordination
•
Misaligned incentives
•
Poor communication
•
Multiple conditions
•
Numerous physicians
•
Polypharmacy |
 Post Acute
– ACO / Bundling
10
•
Aligned incentives
•
Data exchange
•
Communications
•
Care Protocol
AMED Initiatives
Patient
Home
Home
Health
Payors
Post Acute
Physicians
Hospital
Facilities
Hospice
•
Healthcare at home
•
AMS3
•
Mercury Doc
•
Hospital partnerships
•
Managed care business
•
CMS Bundled payment
pilot |
 Post Acute
– Value Enhancement
11
CARE MANAGEMENT
•
Med. reconciliation
•
Multidisciplinary care
•
Telemonitoring
•
Focus on readmissions
CARE COORDINATION
•
Telefax
•
Connectivity –
Mercury Doc
CARE TRANSITIONS
•
Pre-discharge planning
•
Facility Care Coordination
•
Reporting
Facilities
Physician
Payors
Patient
Home
Agreements |
 Home
Health/Hospice Medicare Spend 12
Home Health Source: CBO March 2012 Baseline report
Hospice Source: CBO March 2010 Baseline report with growth rate based on Others section of CBO
March 2012 Baseline report. Hospice CAGR = 6.4%
Home Health CAGR = 5.9%
$19
$20
$21
$22
$23
$24
$26
$28
$30
$14
$15
$16
$17
$18
$19
$21
$22
$23
$
$10
$20
$30
$40
$50
$60
2011
2012
2013
2014
2015
2016
2017
2018
2019
Medicare Reimbursement
Home Health
Hospice |
 Market Share
– Medicare Revenue
13
Sources: Company financials, Medicare claims data
Non
Profit
For Profit
Non Profit
For Profit
1.5%
0.3%
5.5%
7.4%
31.2%
44.0%
10.0%
Hospice
Amedisys
LHCG
Gentiva
Chemed (Vitas only)
For Profit
Non Profit
Hospital Based
6.7%
2.6%
4.5%
1.5%
49.8%
20.0%
15.0%
Home Health
Amedisys
LHCG
Gentiva
Almost Family
For Profit
Non Profit
Hospital Based |
 Business
Fundamentals 14
Clinical
Excellence
Growth
Efficiency |
 Clinical
Excellence 15
•
Clinical Outcomes
–
Exceeded 8 out of 9 outcomes vs. footprint of reported measures as
reported by CMS
*
Lower % is better
Source: Medicare
Amedisys vs. Footprint –
Outcomes TTM June 2012
Clinical
Excellence
Growth
Efficiency
0
10
20
30
40
50
60
70
80
90
100
60
52
66
69
70
92
54
12
28
55
51
62
65
58
90
44
11
28
Ambulation
Transferring
Bathing
Pain
Breathing
Surgical Wounds
Mgmt of Oral
Meds
Emergent Care*
Acute Care
Hospitalization*
Amedisys
Footprint |
 16
Clinical Excellence
•
Survey Questions
–
Exceeded all 5 survey questions vs. footprint of reported measures
Efficiency
Clinical
Excellence
Growth
89
87
84
85
81
88
86
83
84
79
74
76
78
80
82
84
86
88
90
Professional care
Communicated well
Discussed Meds, pain,
safety
Rating of 9 or 10
Recommend
Survey Questions March 2012
Amedisys
Footprint |
 17
•
Clinical leadership
investment
•
Enhanced clinical processes
–
Telemonitoring
–
Patient care conferences
–
Medical director
involvement
•
Specialty Programs
–
Speech language
–
Behavioral health
–
Balanced for Life
•
Future technology upgrades
–
Patient-specific care
treatment
–
Patient portal
Clinical Excellence
Clinical
Excellence
Growth
Efficiency |
 Growth
18
•
Managed Care
•
Care
coordination
relationships
with
hospitals
and
health
systems
•
Market-specific
sales plans / CRM tool
–
Call metrics / Account tiering
•
Home health/hospice industry consolidation opportunities
Clinical
Excellence
Efficiency
Growth |
 Operational
Efficiency 19
•
Hospice point-of-care
•
Ongoing portfolio review
•
Staffing models and clinician productivity
•
Industry leading operating system (AMS)
–
Technical
–
Economic
–
Strategic
–
Clinical
–
Quality
–
Connectivity
Growth
Clinical
Excellence
Efficiency |
 Financial
Review 20 |
 Financial
Highlights 21
$-
$2.00
$4.00
$6.00
$8.00
$10.00
$12.00
$-
$300
$600
$900
$1,200
$1,500
$1,800
2004
2005
2006
2007
2008
2009
2010
2011
2012
Revenue
Projected Revenue
EPS
Projected EPS |
 22
Summary Financial Results
($ in millions, except per share data)
2010
(1)
2011
(1)
3Q11
(2)
3Q12
(2)
Continuing Operations
Net Revenue
$ 1,597
$ 1,466
$ 370
$ 377
Gross Margin %
50.1%
46.6%
45.4%
43.0%
Adjusted EBITDA
$ 256
$ 156
$ 29
$ 25
Adjusted EBITDA Margin
16.0%
10.7%
7.8%
6.6%
Fully-diluted EPS
$4.61
$2.27
$0.42
$0.33
(
1)The financial results for the years 2011 and 2010 are adjusted for certain items incurred in
2011 and 2010 and should be considered non-GAAP financial measures. A
reconciliation of these non-GAAP financial measures is included as Exhibit 99.2 to our Form 8-K filed with the Securities and Exchange Commission
on February 28, 2012.
(2) The financial results for the three-month period ended September 30, 2011 are adjusted
for the $574.1 million charge for the impairment of goodwill and other intangibles and
should be considered a non-GAAP financial measure. A reconciliation of this non-GAAP financial measure is included as Exhibit 99.2 to our
Form 8-K filed with the Securities and Exchange Commission on November 6, 2012
|
 Summary Division
Results 23
($ in millions)
2010
(1)
2011
(1)
3Q11
(2)
3Q12
(2)
Home Health
Net Revenue
$ 1,458
$ 1,248
$ 306
$ 301
Gross Margin %
51%
47%
45.4%
41.6%
Hospice
Net Revenue
$ 139
$ 218
$ 64
$ 75
Gross Margin %
47%
46%
45.7%
48.7%
Continuing Operations
(1) Results as reported in our Annual Report on Form 10-K for the year ended December 31,
2011 as filed with the Securities and Exchange Commission on February 28, 2012. For
2010 and 2011, net revenue is adjusted for a CMS bonus payment as the result of the pay for performance demonstration of
$3.6 and $4.7 million, respectively. In addition, 2010 net revenue is adjusted $3.7
million for the Georgia indigent care liability settlement. (2) Results as
reported in our Quarterly Report on Form 10-Q for the quarter ended September 30, 2012 as filed with the Securities and Exchange
Commission on November 6, 2012. |
 24
Summary Operating Statistics
(Numbers in thousands, except rev. per
episode)
2010
(1)
2011
(1)
3Q11
(2)
3Q12
(2)
Home Health
Total visits
8,899
8,335
2,085
2,121
Episodic-based
admissions
248
234
57
58
Completed episodes
416
392
97
95
Revenue per episode
$3,312
$3,005
$2,974
$2,835
Statistics are for continuing operations only.
(1) Results as reported in our Annual Report on Form 10-K for the year ended December 31,
2011 as filed with the Securities and Exchange Commission on February 28, 2012.
(2) Results as reported in our Quarterly Report on Form 10-Q for the quarter
ended September 30, 2012 as filed with the Securities and Exchange Commission on
November 6, 2012. |
 Summary
Operating Statistics 25
2010
(1)
2011
(1)
3Q11
(2)
3Q12
(2)
Hospice
Total admissions
11,275
15,889
4,589
4,706
Daily census
2,832
4,197
4,879
5,615
Average length of stay
88
88
86
87
Statistics are for continuing operations only.
(1) Results as reported in our Annual Report on Form 10-K for the year ended December 31,
2011 as filed with the Securities and Exchange Commission on February 28, 2012.
(2) Results as reported in our Quarterly Report on Form 10-Q for the quarter
ended September 30, 2012 as filed with the Securities and Exchange Commission on
November 6, 2012. |
 26
Summary Balance Sheet
Assets
Dec. 31, 2011
Sept. 30, 2012
Cash
$ 48
$ 39
Accounts Receivable, Net
148
163
Property and Equipment
148
151
Goodwill
335
367
Other
179
156
Total Assets
$ 858
$ 876
Liabilities and Equity
Debt
$ 145
$ 122
All Other Liabilities
193
182
Equity
520
572
Total Liabilities and Equity
$ 858
$ 876
Leverage Ratio
1.0x
1.2x
Days Sales Outstanding
35
39
($ in millions) |
 27
Liquidity
Available line of credit (LOC): 11/6/12 = $145M
($ in millions)
2011
2012
Cash Flow From Operations
$ 142
$ 87-95
Cap Ex
44
42-45
Debt repayments
38
45
Cash Flow, Net
60
0-5
Beginning Cash
120
Acquisitions
(132)
End Cash
$ 48 |
 28
Guidance
1
Calendar Year 2012
2
Net revenue:
$1.485 -
$1.505 billion
EPS:
$1.00 -
$1.06
Diluted shares:
30.2 million
1
Guidance based on continuing operations excluding the effects of the following: any
future acquisitions, if any are made, any costs associated with the closing of our new
credit agreement or any severance related charges.
2
Provided as of the date of our form 8-K filed with the Securities and Exchange Commission
on November 6, 2012.
|
 Investment
Rationale •
Favorable demographic trends
•
Positive attributes of home based care
•
IT infrastructure/scalability
•
Clinical quality and innovation
•
Strong liquidity and capital position
•
Market share capture opportunities
29
Efficient Core
Business
Care Mgmt
Solutions |
 Contact
Information Kevin B. LeBlanc
Director of Investor Relations
Amedisys, Inc.
5959 S. Sherwood Forest Boulevard
Baton Rouge, LA 70816
Office: 225.299.3391
Fax: 225.298.6435
kevin.leblanc@amedisys.com
30 |