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8-K - FY2016 FORM 8-K - Alliance HealthCare Services, Incaiq-8k_20170309.htm

Alliance HealthCare Services

News Release

Page 1 of 13

March 9, 2017

 

Exhibit 99.1

 

NEWS RELEASE

 

CONTACT

 

Rhonda Longmore-Grund

 

Executive Vice President

Chief Financial Officer

 

949.242.5300

 

ALLIANCE HEALTHCARE SERVICES REPORTS FOURTH QUARTER

& FULL YEAR 2016 RESULTS

Company Announces 2017 Guidance

NEWPORT BEACH, CA — March 9, 2017 — Alliance HealthCare Services, Inc. (NASDAQ: AIQ) (the “Company,” “Alliance,” “we” or “our”), a leading national provider of outsourced radiology, oncology and interventional services, announced today the results for the fourth quarter and full year ended December 31, 2016, and provided 2017 guidance.

Full Year 2016 Highlights

 

The Company reported revenue totaling $505.5 million, a $32.5 million or 6.9% increase year-over-year.

 

 

The Company generated $131.5 million of Adjusted EBITDA (as defined below), a $0.2 million or 0.2% increase year-over-year.

 

 

The Company continued to generate strong cash flow with $108.8 million in operating cash flows for full year 2016, compared to $92.5 million in the prior year.

 

 

Net Income Per Share before the impact of shareholder transaction expenses and one time step up gains from 2015 was $0.56 for full year 2016, compared to $0.15 in 2015.  GAAP Net Income per share was $0.04 for the full year 2016, compared to $0.62 in 2015.

 

 

Alliance Radiology revenue increased by 3.3% to $350.8 million with strong same-store volume growth of +1.6% for MRI and +6.7% for PET/CT for full year 2016.

 

 

Alliance Oncology revenue increased 7.3% to $107.2 million for full year 2016 with same-store volume growth of +2.9% for LINAC and +0.4% for SRS.

 

 

Alliance Interventional revenue increased 37.3% to $45.6 million for full year 2016.

 

 

Our results for this year were in line with full-year 2016 guidance for revenue, which ranged from $505 million to $535 million, and Adjusted EBITDA, which ranged from $130 million to $150 million.

 

Fourth Quarter 2016 Highlights

 

The Company reported revenue totaling $129.4 million for the fourth quarter, a $5.1 million or 4.1% increase over the fourth quarter of last year.

 

 

The Company generated $31.5 million of Adjusted EBITDA (as defined below) for the quarter, a $1.7 million or 5.2% decrease from the fourth quarter of last year.

 

 

Adjusted Net Income Per Share (as defined below) was $0.11, and GAAP net loss per share was $0.20 for the quarter.

 

 

The Company continued to generate strong cash flow with $26.7 million of quarterly operating cash flow.

 

 

 


Alliance HealthCare Services

News Release

Page 2 of 13

March 9, 2017

 

2016 Financial Results

“During 2016 we successfully executed a number of initiatives to position the Company for future accelerated growth. We continued to see positive same-store volume growth in our business segments in full year 2016. The heavy year-over-year price impact in our Radiology segment is largely behind us, having successfully renewed the majority of our contracts with customers over the last few years,” stated Tom Tomlinson, Chief Executive Officer and President of Alliance HealthCare Services. “Results for the fourth quarter trailed our internal expectations somewhat, driven primarily by continued physician capacity challenges in our Interventional business and some same-store volume softness across MRI and Stereotactic Radiosurgery. In addition, we began to absorb some impact from staff and resources we have added as we explore opportunities in China. Looking ahead, we expect our growth investments and improving execution to deliver strong growth in both revenue and earnings in 2017,” continued Mr. Tomlinson.

For full year 2016, revenue increased to $505.5 million, compared to $473.1 million in 2015. This increase was primarily due to an increase in Interventional, Radiology and Oncology revenue of $12.4 million, $11.2 million, and $7.3 million, respectively, when compared to 2015. Revenue for the fourth quarter of 2016 increased to $129.4 million, compared to $124.3 million in the fourth quarter of 2015. This increase was primarily due to increases in Radiology and Oncology revenue of $1.9 million and $3.8 million, respectively, partially offset by a decrease of $1.2 million in Interventional revenue.

For full year 2016, Adjusted EBITDA increased to $131.5 million, compared to $131.3 million in 2015. The year-over-year increase was primarily due to increases in earnings from Radiology and Oncology, partially offset by Corporate investments as well as a decline in the Interventional segment. Adjusted EBITDA growth in both Radiology and Oncology was driven by year-over-year same-store volume growth as well as the addition of new partnerships such as Pacific Cancer Institute and the Northern Alabama Cancer Care Network. Alliance’s Adjusted EBITDA for the fourth quarter of 2016 decreased 5.2% to $31.5 million from $33.3 million in the fourth quarter of 2015. The Radiology and Oncology segments continued to provide quarter-over-quarter growth in Adjusted EBITDA, offset, however, by Corporate investments as well as a decrease in Interventional earnings. Increases in Radiology and Oncology were attributable to strong continued same-store volume growth across both divisions and net new sales and partnerships. The declines in the Interventional business was driven by challenges in physician capacity as well as additional platform investments made to strengthen management and development capabilities. Corporate / Other Adjusted EBITDA decreased due to additional investments in organization, systems and infrastructure to support expanded workforce, entities and partnerships, and gains on asset sales that occurred in the fourth quarter of 2015 that did not recur in the fourth quarter of 2016.

For full year 2016, net income totaled $0.5 million, compared to $6.7 million in 2015. The $6.2 million decrease is largely due to the net impact of a $10.7 million non-cash gain in the second half of 2015 which did not recur in 2016, as well as a $6.6 million increase in certain expenses related to Tahoe Investment Group Co., Ltd.’s (“Tahoe’s”) majority ownership purchase of common stock from the Company’s former shareholders on March 29, 2016 (“Tahoe Transaction”). These expenses were borne by both the buyer and sellers involved in the Tahoe transaction and not by the Company. Excluding the one-time cash gain and the expenses related to the Tahoe transaction on a tax-effected basis, the net income attributable to Alliance would have been $1.7 million in 2015, compared to $6.1 million in the current year.

For full year 2016, GAAP net income per share on a diluted basis was $0.04 per share, compared to $0.62 in 2015. Excluding the impact of the one-time non-cash gain and the expenses related to the Tahoe Transaction, GAAP net income per share on a diluted basis would have been $0.56 for full year 2016, compared to $0.15 in 2015. Adjusted Net Income Per Share was $0.85 and $1.28 for full years 2016 and 2015, respectively. GAAP net income per share on a diluted basis was impacted by net charges of $0.81, compared to $0.66 in 2015, which were comprised of: severance and related costs; restructuring charges; transaction costs; shareholder transaction costs; deferred financing costs in connection with the Tahoe Transaction; impairment charges; legal matters expense, net; changes in fair value of contingent consideration related to acquisitions; non-cash gain on step acquisition; other non-cash (benefits) charges; and differences in the GAAP income tax rate from our historical income tax rate of 42.5%.

Cash flows provided by operating activities totaled $108.8 million for full year 2016, compared to $92.5 million in 2015. For the full year 2016, total capital expenditures, including cash paid for equipment purchases and deposits on equipment and including capital leases, totaled $74.7 million compared to $82.9 million in 2015. Growth capital expenditures totaled $33.2 million and maintenance capital expenditures totaled $41.5 million.

 


Alliance HealthCare Services

News Release

Page 3 of 13

March 9, 2017

 

Alliance’s gross debt, defined as total long-term debt (including current maturities but excluding the impact of deferred financing costs), decreased $4.5 million to $573.2 million at December 31, 2016 from $577.7 million at December 31, 2015. Alliance’s net debt, defined as total long-term debt (including current maturities but excluding the impact of deferred financing costs) less cash and cash equivalents, increased $11.4 million to $551.0 million at December 31, 2016 from $539.6 million at December 31, 2015. Cash and cash equivalents were $22.2 million at December 31, 2016 and $38.1 million at December 31, 2015.

Alliance’s total debt, as defined above, divided by the last twelve months Consolidated Adjusted EBITDA was 4.03x for the twelve month period ended December 31, 2016, compared to 4.13x for the quarter ended September 30, 2016 and 4.10x for the year ended December 31, 2015. Alliance’s net debt, as defined above, divided by the last twelve months Consolidated Adjusted EBITDA was 3.87x for the twelve month period ended December 31, 2016, compared to 3.83x for the year ended December 31, 2015.

Full Year 2017 Guidance

“With respect to our guidance for 2017, we are looking for balanced growth in Revenue and Adjusted EBITDA. The revenue momentum that has been evident throughout the previous year will enable us to drive earnings growth as we leverage existing investments that have been made in new clinical sites and strengthening our team. We will also make meaningful progress towards our long-term goal of reducing leverage to the 3.5x Adjusted EBITDA range,” stated Mr. Tomlinson.

Alliance’s full year 2017 guidance ranges are as follows:

(in millions)

 

Ranges

Revenue

 

$529 - $540

Adjusted EBITDA

 

$135 - $140

Capital expenditures

 

$54 - $70

Maintenance

 

$30 - $35

Growth

 

$24 - $35

Decrease in long-term debt, net of the change in

   cash and cash equivalents (before investments in

   acquisitions), before growth capital expenditures

   or free cash flow before growth capital expenditures

 

$50 - $55

Decrease in long-term debt, net of the change

   in cash and cash equivalents (before investments in

   acquisitions), after growth capital expenditures

   or “free cash flow after growth capital expenditures”

 

$19 - $26

Full Year 2016 Earnings and 2017 Guidance Conference Call

Investors and all others are invited to listen to a conference call discussing fourth quarter 2016 and full year 2016 results as well as 2017 guidance. The conference call is scheduled for Thursday, March 9, 2017 at 5 p.m. Eastern Time. Additionally, a live webcast of the call will be available on the Company’s website at www.alliancehealthcareservices-us.com. Click on “About Us,” then, “Investor Relations.” You will find the Audio Presentation in the “News & Events” section. A replay of the webcast will be available on the Company’s website until May 9, 2017.

 

The conference call can be accessed at 877.638.4550 (International callers can dial 443.961.0596). Interested parties should call at least five minutes prior to the call to register. A telephone replay will be available until May 3, 2017. The telephone replay can be accessed by calling 800.585.8367. The conference call identification number is 10068564.

 


Alliance HealthCare Services

News Release

Page 4 of 13

March 9, 2017

 

Definition of Non-GAAP Measures

Total Adjusted EBITDA and Adjusted Net Income Per Share are not measures of financial performance under generally accepted accounting principles in the United States (“GAAP”).

For a more detailed discussion of these non-GAAP financial measures and a reconciliation to the most directly comparable GAAP financial measure, see the section entitled “Non-GAAP Measures” included in the tables following this release.

About Alliance HealthCare Services

Alliance HealthCare Services (NASDAQ: AIQ) is a leading national provider of outsourced medical services including radiology, oncology and interventional. We partner with healthcare providers and hospitals to provide a full continuum of services from mobile to fixed-site to comprehensive service line management and joint venture partnerships. We also operate freestanding clinics and Ambulatory Surgical Centers (“ASCs”) that are not owned by hospitals or providers.

As of December 31, 2016, Alliance operated 625 diagnostic radiology and radiation therapy systems, including 113 fixed-site radiology centers across the country, and 33 radiation therapy centers and SRS facilities. With a strategy of partnering with hospitals, health systems and physician practices, Alliance provides quality clinical services for over 1,100 hospitals and other healthcare partners in 46 states, where approximately 2,450 Alliance Team Members are committed to providing exceptional patient care and exceeding customer expectations. For more information, visit www.alliancehealthcareservices-us.com.

Forward-Looking Statements

This press release contains forward-looking statements relating to future events, including statements related to the Company’s long-term growth strategy and efforts to diversify its business model, the Company’s plans to expand its Interventional Division, both organically and through one or more acquisitions, the Company’s expectations regarding growth across the Company’s divisions, the expansion of its service footprint and revenue growth, maximizing shareholder value, and the Company’s Full Year 2017 Guidance, including its forecasts of revenue, Adjusted EBITDA, capital expenditures, and decrease (increase) in long-term debt. 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 Company’s ability to comply with reporting obligations and other covenants under the Company’s debt instruments, the failure of which could cause the debt to become due; the accuracy of the Company’s estimates regarding its capital requirements; the effect of intense levels of competition and overcapacity in the Company’s industry; changes in the methods of third party reimbursements for medical imaging, oncology and interventional 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 or lack thereof in the market for radiology, oncology, interventional 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 and equity 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, costs, delays and impediments to completing the acquisitions, 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, 2016, 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.

 


Alliance HealthCare Services

News Release

Page 5 of 13

March 9, 2017

 

ALLIANCE HEALTHCARE SERVICES, INC.

CONDENSED CONSOLIDATED STATEMENTS OF INCOME

AND COMPREHENSIVE INCOME

(in thousands, except per share amounts)

 

 

 

Quarter Ended December 31,

(unaudited)

 

 

Year Ended December 31,

(audited)

 

 

 

2016

 

 

2015

 

 

2016

 

 

2015

 

Revenues

 

$

129,387

 

 

$

124,337

 

 

$

505,549

 

 

$

473,054

 

Costs and expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cost of revenues, excluding depreciation and amortization

 

 

73,761

 

 

 

72,676

 

 

 

285,746

 

 

 

269,104

 

Selling, general and administrative expenses

 

 

25,162

 

 

 

22,173

 

 

 

96,663

 

 

 

88,471

 

Transaction costs

 

 

900

 

 

 

1,332

 

 

 

1,886

 

 

 

3,296

 

Shareholder transaction costs

 

 

703

 

 

 

1,853

 

 

 

4,219

 

 

 

1,853

 

Severance and related costs

 

 

724

 

 

 

616

 

 

 

3,910

 

 

 

1,347

 

Impairment charges

 

 

632

 

 

 

 

 

 

632

 

 

 

6,817

 

Depreciation expense

 

 

14,295

 

 

 

12,643

 

 

 

54,972

 

 

 

48,595

 

Amortization expense

 

 

3,068

 

 

 

2,418

 

 

 

10,561

 

 

 

9,325

 

Interest expense, net

 

 

9,067

 

 

 

6,659

 

 

 

34,506

 

 

 

26,241

 

Other income, net

 

 

(337

)

 

 

(1,931

)

 

 

(6,586

)

 

 

(12,255

)

Total costs and expenses

 

 

127,975

 

 

 

118,439

 

 

 

486,509

 

 

 

442,794

 

Income before income taxes, earnings from unconsolidated

   investees, and noncontrolling interest

 

 

1,412

 

 

 

5,898

 

 

 

19,040

 

 

 

30,260

 

Income tax (benefit) expense

 

 

(285

)

 

 

1,232

 

 

 

2,852

 

 

 

6,536

 

Earnings from unconsolidated investees

 

 

(363

)

 

 

(344

)

 

 

(1,290

)

 

 

(3,391

)

Net income

 

 

2,060

 

 

 

5,010

 

 

 

17,478

 

 

 

27,115

 

Less: Net income attributable to noncontrolling interest

 

 

(4,194

)

 

 

(5,262

)

 

 

(16,985

)

 

 

(20,373

)

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

 

$

(2,134

)

 

$

(252

)

 

$

493

 

 

$

6,742

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Comprehensive income (loss), net of taxes:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

 

 

2,060

 

 

 

5,010

 

 

 

17,478

 

 

 

27,115

 

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

 

 

122

 

 

 

(29

)

 

 

104

 

 

 

(178

)

Reclassification adjustment for losses included in net income, net

   of taxes

 

 

181

 

 

 

18

 

 

 

417

 

 

 

18

 

Comprehensive income, net of taxes

 

 

2,363

 

 

 

4,999

 

 

 

17,999

 

 

 

26,955

 

Less: Comprehensive income attributable to noncontrolling interest

 

 

(4,194

)

 

 

(5,262

)

 

 

(16,985

)

 

 

(20,373

)

Comprehensive (loss) income attributable to Alliance HealthCare

   Services, Inc.

 

$

(1,831

)

 

$

(263

)

 

$

1,014

 

 

$

6,582

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Loss) income per common share attributable to Alliance HealthCare Services, Inc.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Basic

 

$

(0.20

)

 

$

(0.02

)

 

$

0.05

 

 

$

0.63

 

Diluted

 

$

(0.20

)

 

$

(0.02

)

 

$

0.04

 

 

$

0.62

 

Weighted average number of shares of common stock and

   common stock equivalents:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Basic

 

 

10,897

 

 

 

10,742

 

 

 

10,866

 

 

 

10,741

 

Diluted

 

 

10,897

 

 

 

10,802

 

 

 

10,959

 

 

 

10,849

 

 

 


Alliance HealthCare Services

News Release

Page 6 of 13

March 9, 2017

 

ALLIANCE HEALTHCARE SERVICES, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

(Audited)

(in thousands)

 

 

 

December 31,

 

 

 

2016

 

 

2015

 

ASSETS

 

 

 

 

 

 

 

 

Current assets:

 

 

 

 

 

 

 

 

Cash and cash equivalents

 

$

22,241

 

 

$

38,070

 

Accounts receivable, net of allowance for doubtful accounts

 

 

77,496

 

 

 

73,208

 

Prepaid expenses

 

 

9,568

 

 

 

13,463

 

Other current assets

 

 

3,853

 

 

 

3,206

 

Total current assets

 

 

113,158

 

 

 

127,947

 

Plant, property and equipment, net

 

 

204,814

 

 

 

177,188

 

Goodwill

 

 

119,130

 

 

 

102,782

 

Other intangible assets, net

 

 

198,977

 

 

 

162,923

 

Other assets

 

 

23,785

 

 

 

32,820

 

Total assets

 

$

659,864

 

 

$

603,660

 

LIABILITIES AND STOCKHOLDERS’ DEFICIT

 

 

 

 

 

 

 

 

Current liabilities:

 

 

 

 

 

 

 

 

Accounts payable

 

$

28,185

 

 

$

20,796

 

Accrued compensation and related expenses

 

 

24,895

 

 

 

19,933

 

Accrued interest payable

 

 

3,308

 

 

 

3,323

 

Current portion of long-term debt

 

 

17,298

 

 

 

17,732

 

Current portion of obligations under capital leases

 

 

3,354

 

 

 

2,674

 

Other accrued liabilities

 

 

29,323

 

 

 

36,453

 

Total current liabilities

 

 

106,363

 

 

 

100,911

 

Long-term debt, net of current portion

 

 

515,407

 

 

 

540,353

 

Obligations under capital leases, net of current portion

 

 

12,686

 

 

 

10,332

 

Deferred income taxes

 

 

25,818

 

 

 

23,020

 

Other liabilities

 

 

9,093

 

 

 

6,664

 

Total liabilities

 

 

669,367

 

 

 

681,280

 

 

 

 

 

 

 

 

 

 

Stockholders’ deficit:

 

 

 

 

 

 

 

 

Common stock

 

 

110

 

 

 

108

 

Treasury stock

 

 

(3,138

)

 

 

(3,138

)

Additional paid-in capital

 

 

61,353

 

 

 

29,297

 

Accumulated comprehensive income (loss)

 

 

10

 

 

 

(511

)

Accumulated deficit

 

 

(197,900

)

 

 

(198,393

)

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

 

 

(139,565

)

 

 

(172,637

)

Noncontrolling interest

 

 

130,062

 

 

 

95,017

 

Total stockholders’ deficit

 

 

(9,503

)

 

 

(77,620

)

Total liabilities and stockholders’ deficit

 

$

659,864

 

 

$

603,660

 

 

 


Alliance HealthCare Services

News Release

Page 7 of 13

March 9, 2017

 

ALLIANCE HEALTHCARE SERVICES, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(Audited)

(in thousands)

 

 

 

Year Ended December 31,

 

 

 

2016

 

 

2015

 

Operating activities:

 

 

 

 

 

 

 

 

Net income

 

$

17,478

 

 

$

27,115

 

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

 

 

 

 

 

 

 

 

Provision for doubtful accounts

 

 

2,255

 

 

 

2,911

 

Share-based payment

 

 

2,713

 

 

 

1,701

 

Depreciation and amortization

 

 

65,533

 

 

 

57,920

 

Amortization of deferred financing costs

 

 

8,126

 

 

 

2,554

 

Accretion of discount on long-term debt

 

 

513

 

 

 

481

 

Adjustment of derivatives to fair value

 

 

727

 

 

 

29

 

Distributions from unconsolidated investees

 

 

1,335

 

 

 

3,880

 

Earnings from unconsolidated investees

 

 

(1,290

)

 

 

(3,391

)

Deferred income taxes

 

 

1,780

 

 

 

6,350

 

Gain on sale of assets, net

 

 

(1,133

)

 

 

(1,883

)

Changes in fair value of contingent consideration related to acquisitions

 

 

(4,790

)

 

 

 

Non-cash gain on step acquisition

 

 

 

 

 

(10,672

)

Other non-cash gain

 

 

(423

)

 

 

(209

)

Impairment charges

 

 

632

 

 

 

6,817

 

Excess tax benefit from share-based payment arrangements

 

 

(100

)

 

 

5

 

Changes in operating assets and liabilities, net of the effects of acquisitions:

 

 

 

 

 

 

 

 

Accounts receivable

 

 

(6,270

)

 

 

(7,112

)

Prepaid expenses

 

 

3,567

 

 

 

(877

)

Other current assets

 

 

1,267

 

 

 

1,494

 

Other assets

 

 

(881

)

 

 

2,607

 

Accounts payable

 

 

8,040

 

 

 

3,442

 

Accrued compensation and related expenses

 

 

4,962

 

 

 

(1,363

)

Accrued interest payable

 

 

(15

)

 

 

168

 

Income taxes payable

 

 

868

 

 

 

40

 

Other accrued liabilities

 

 

3,888

 

 

 

454

 

Net cash provided by operating activities

 

 

108,782

 

 

 

92,461

 

Investing activities:

 

 

 

 

 

 

 

 

Equipment purchases

 

 

(56,401

)

 

 

(55,511

)

Increase in deposits on equipment

 

 

(11,768

)

 

 

(15,751

)

Acquisitions, net of cash received

 

 

(25,912

)

 

 

(49,140

)

Proceeds from sale of assets

 

 

1,830

 

 

 

1,941

 

Net cash used in investing activities

 

 

(92,251

)

 

 

(118,461

)

 

 


Alliance HealthCare Services

News Release

Page 8 of 13

March 9, 2017

 

ALLIANCE HEALTHCARE SERVICES, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (continued)

(Audited)

(in thousands)

 

 

 

Year Ended December 31,

 

 

 

2016

 

 

2015

 

Financing activities:

 

 

 

 

 

 

 

 

Principal payments on equipment debt and capital lease obligations

 

$

(16,925

)

 

$

(12,697

)

Proceeds from equipment debt

 

 

7,101

 

 

 

27,049

 

Principal payments on term loan facility

 

 

(5,200

)

 

 

(9,951

)

Proceeds from term loan facility

 

 

 

 

 

29,850

 

Principal payments on revolving loan facility

 

 

(61,000

)

 

 

(33,000

)

Proceeds from revolving loan facility

 

 

63,000

 

 

 

50,500

 

Payments of debt issuance costs and deferred financing costs

 

 

(25,741

)

 

 

(808

)

Distributions to noncontrolling interest in subsidiaries

 

 

(23,526

)

 

 

(21,659

)

Contributions from noncontrolling interest in subsidiaries

 

 

1,411

 

 

 

1,732

 

Issuance of common stock

 

 

1

 

 

 

1

 

Excess tax benefit from share-based payment arrangements

 

 

100

 

 

 

(5

)

Proceeds from exercise of stock options

 

 

614

 

 

 

25

 

Settlement of contingent consideration related to acquisitions

 

 

(825

)

 

 

 

Proceeds from shareholder transaction

 

 

28,630

 

 

 

 

Net cash (used in) provided by financing activities

 

 

(32,360

)

 

 

31,037

 

Net (decrease) increase in cash and cash equivalents

 

 

(15,829

)

 

 

5,037

 

Cash and cash equivalents, beginning of period

 

 

38,070

 

 

 

33,033

 

Cash and cash equivalents, end of period

 

$

22,241

 

 

$

38,070

 

Supplemental disclosure of cash flow information:

 

 

 

 

 

 

 

 

Interest paid

 

$

25,368

 

 

$

23,373

 

Income taxes refunded, net

 

 

(3,852

)

 

 

(664

)

Supplemental disclosure of non-cash investing and financing activities:

 

 

 

 

 

 

 

 

Net book value of assets exchanged

 

 

170

 

 

 

199

 

Capital lease obligations related to the purchase of equipment

 

 

6,558

 

 

 

11,273

 

Changes in equipment purchases in accounts payable and accrued equipment

 

 

(4,591

)

 

 

3,700

 

Extinguishment of note receivable

 

 

 

 

 

3,071

 

Transfer of equity investment as consideration in step acquisition

 

 

 

 

 

721

 

Transfer of assets as consideration in acquisitions

 

 

9,900

 

 

 

477

 

Transfer of fair value of equity investment in step acquisition

 

 

 

 

 

13,645

 

Noncontrolling interest assumed in connection with acquisitions

 

 

39,141

 

 

 

36,231

 

Mandatorily redeemable noncontrolling interest in connection with acquisition

 

 

 

 

 

2,386

 

Fair value of contingent consideration related to acquisitions

 

 

420

 

 

 

5,750

 

 

 


Alliance HealthCare Services

News Release

Page 9 of 13

March 9, 2017

 

ALLIANCE HEALTHCARE SERVICES, INC.

NON-GAAP MEASURES

Total Adjusted EBITDA and Adjusted Net Income Per Share (the “Non-GAAP Measures”) are not measures of financial performance under generally accepted accounting principles in the U.S. (“GAAP”).

Total Adjusted EBITDA, as defined by the Company’s management, is consistent with the definition in the Company’s Credit Agreement and represents net (loss) income before: income tax (benefit) expense; interest expense, net; depreciation expense; amortization expense; share-based payment; severance and related costs; net income attributable to noncontrolling interest; restructuring charges; transaction costs; shareholder transaction costs; impairment charges; legal matters expense, net; changes in fair value of contingent consideration related to acquisitions; non-cash gain on step acquisition; and other non-cash (benefits) charges, which include non-cash (gains) losses on sales of assets. The components used to reconcile net (loss) income to Total Adjusted EBITDA are consistent with our historical presentation of Total Adjusted EBITDA.

Adjusted Net Income Per Share, as defined by the Company’s management, represents net (loss) income before: severance and related costs; restructuring charges; transaction costs; shareholder transaction costs; deferred financing costs in connection with shareholder transaction; impairment charges; legal matters expenses, net; changes in fair value of contingent consideration related to acquisitions; non-cash gain on step acquisition; other non-cash (benefits) charges; and differences in the GAAP income tax rate compared to our historical income tax rate. The components used to reconcile net (loss) income per share to Adjusted Net Income Per Share are consistent with our historical presentation of Adjusted Net Income Per Share.

Management uses the Non-GAAP Measures, and believes they are useful measures for investors, for a variety of reasons. Management regularly communicates the results of its Non-GAAP Measures and management’s interpretation of such results to its board of directors. Management also compares the Company’s results of its Non-GAAP Measures against internal targets as a key factor in determining cash incentive compensation for executives and other employees, largely because management feels that these measures are indicative of how our radiology, oncology and interventional businesses are performing and are being managed. 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 radiology, oncology and interventional businesses.

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. The Non-GAAP Measures have certain limitations as analytical financial measures, which management compensates for 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 the Non-GAAP Measures. 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 and because the Non-GAAP Measures may not be directly comparable to similarly titled measures reported by other companies, however, the Non-GAAP Measures should not be considered as an alternative to the most directly comparable GAAP measure, or as an alternative to any other GAAP measure of operating performance.

 


Alliance HealthCare Services

News Release

Page 10 of 13

March 9, 2017

 

The calculation of Adjusted EBITDA is shown below:

 

 

 

Quarter Ended December 31,

 

 

Year Ended December 31,

 

(in thousands)

 

2016

 

 

2015

 

 

2016

 

 

2015

 

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

$

(2,134

)

 

$

(252

)

 

$

493

 

 

$

6,742

 

Income tax (benefit) expense

 

 

(285

)

 

 

1,232

 

 

 

2,852

 

 

 

6,536

 

Interest expense, net

 

 

9,067

 

 

 

6,659

 

 

 

34,506

 

 

 

26,241

 

Depreciation expense

 

 

14,295

 

 

 

12,643

 

 

 

54,972

 

 

 

48,595

 

Amortization expense

 

 

3,068

 

 

 

2,418

 

 

 

10,561

 

 

 

9,325

 

Share-based payment (included in “Selling, general and

   administrative expenses”)

 

 

526

 

 

 

459

 

 

 

3,176

 

 

 

1,701

 

Severance and related costs

 

 

724

 

 

 

616

 

 

 

3,910

 

 

 

1,347

 

Net income attributable to noncontrolling interest

 

 

4,194

 

 

 

5,262

 

 

 

16,985

 

 

 

20,373

 

Restructuring charges

 

 

 

 

 

620

 

 

 

1,635

 

 

 

1,327

 

Transaction costs

 

 

900

 

 

 

1,332

 

 

 

1,886

 

 

 

3,296

 

Shareholder transaction costs

 

 

703

 

 

 

1,853

 

 

 

4,219

 

 

 

1,853

 

Impairment charges

 

 

632

 

 

 

 

 

 

632

 

 

 

6,817

 

Legal matters expense, net (included in “Selling, general and

   administrative expenses”)

 

 

 

 

 

1,088

 

 

 

106

 

 

 

6,915

 

Changes in fair value of contingent consideration related to

   acquisitions (included in “Other income, net”)

 

 

(150

)

 

 

 

 

 

(4,790

)

 

 

 

Non-cash gain on step acquisition (included in “Other income,

   net”)

 

 

 

 

 

(722

)

 

 

 

 

 

(10,672

)

Other non-cash charges (included in “Other income, net”)

 

 

1

 

 

 

59

 

 

 

325

 

 

 

864

 

Adjusted EBITDA

 

$

31,541

 

 

$

33,267

 

 

$

131,468

 

 

$

131,260

 

 

Adjusted EBITDA by segment is shown below:

 

 

 

Year Ended December 31,

 

(in thousands)

 

2016

 

 

2015

 

Adjusted EBITDA:

 

 

 

 

 

 

 

 

Radiology

 

$

96,828

 

 

$

94,475

 

Oncology

 

 

46,609

 

 

 

43,112

 

Interventional

 

 

3,935

 

 

 

5,175

 

Corporate / Other

 

 

(15,904

)

 

 

(11,502

)

Total

 

$

131,468

 

 

$

131,260

 

 

The leverage ratio calculations as of December 31, 2016 are shown below:

 

(dollars in thousands)

 

Consolidated

 

Total debt

 

$

573,247

 

Less: Cash and cash equivalents

 

 

(22,241

)

Net debt

 

$

551,006

 

Last 12 months Adjusted EBITDA

 

 

131,468

 

Pro-forma acquisitions in the last 12 month period(1)

 

 

10,784

 

Last 12 months’ Consolidated Adjusted EBITDA

 

$

142,252

 

Total leverage ratio

 

 

4.03

x

Net leverage ratio

 

 

3.87

x

 

(1)

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

 

 

 


Alliance HealthCare Services

News Release

Page 11 of 13

March 9, 2017

 

The reconciliation of (loss) income per diluted share attributable to Alliance HealthCare Services, Inc. – GAAP to Adjusted Net income Per Share is shown below:

 

 

 

Quarter Ended December 31,

 

 

Year Ended December 31,

 

 

 

2016

 

 

2015

 

 

2016

 

 

2015

 

(Loss) income per diluted share – GAAP

 

$

(0.20

)

 

$

(0.02

)

 

$

0.04

 

 

$

0.62

 

Reconciling charges (benefits) to arrive at Adjusted Net Income

   Per Share – non-GAAP:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Severance and related costs, net of taxes

 

 

0.04

 

 

 

0.03

 

 

 

0.21

 

 

 

0.07

 

Restructuring charges, net of taxes

 

 

 

 

 

0.03

 

 

 

0.09

 

 

 

0.07

 

Transaction costs, net of taxes

 

 

0.05

 

 

 

0.07

 

 

 

0.10

 

 

 

0.17

 

Shareholder transaction costs, net of taxes

 

 

0.04

 

 

 

0.10

 

 

 

0.22

 

 

 

0.10

 

Deferred financing costs in connection with shareholder

   transaction, net of taxes

 

 

0.10

 

 

 

 

 

 

0.29

 

 

 

 

Impairment charges, net of taxes

 

 

0.03

 

 

 

 

 

 

0.03

 

 

 

0.36

 

Legal matters expense, net, net of taxes

 

 

 

 

 

0.06

 

 

 

0.01

 

 

 

0.37

 

Changes in fair value of contingent consideration related to

   acquisitions, net of taxes

 

 

(0.01

)

 

 

 

 

 

(0.25

)

 

 

 

Non-cash gain on step acquisition, net of taxes

 

 

 

 

 

(0.04

)

 

 

 

 

 

(0.57

)

Other non-cash charges, net of taxes

 

 

 

 

 

 

 

 

0.02

 

 

 

 

GAAP income tax rate compared to our historical income

   tax rate

 

 

0.06

 

 

 

0.08

 

 

 

0.09

 

 

 

0.09

 

Total reconciling charges

 

 

0.31

 

 

 

0.33

 

 

 

0.81

 

 

 

0.66

 

Adjusted Net Income Per Share – non-GAAP

 

$

0.11

 

 

$

0.31

 

 

$

0.85

 

 

$

1.28

 

 

The reconciliation from net income to Adjusted EBITDA for the 2017 guidance range is shown below (in millions):

 

  

 

2017 Full Year

 

 

 

Guidance Range

 

Net income

 

$

1

 

 

$

2

 

Income tax benefit

 

 

 

 

 

(2

)

Interest expense and other, net; depreciation expense;

   amortization expense; share-based payment and

   other expenses; noncontrolling interest in subsidiaries

 

 

134

 

 

 

140

 

Adjusted EBITDA

 

$

135

 

 

$

140

 

 

 


Alliance HealthCare Services

News Release

Page 12 of 13

March 9, 2017

 

ALLIANCE HEALTHCARE SERVICES, INC.

SELECTED STATISTICAL INFORMATION

 

 

 

Quarter Ended December 31,

 

 

 

2016

 

 

2015

 

MRI:

 

 

 

 

 

 

 

 

Average number of total systems

 

 

287.1

 

 

 

268.0

 

Average number of scan-based systems

 

 

220.8

 

 

 

218.5

 

Scans per system per day (scan-based systems)

 

 

9.25

 

 

 

9.33

 

Total number of scan-based MRI scans

 

 

137,068

 

 

 

138,395

 

Revenue per scan

 

$

313.22

 

 

$

304.71

 

Scan-based MRI revenue (in thousands)

 

$

42,933

 

 

$

42,171

 

Non-scan based MRI revenue (in thousands)

 

 

8,171

 

 

 

5,983

 

Total MRI revenue (in thousands)

 

$

51,104

 

 

$

48,154

 

PET/CT:

 

 

 

 

 

 

 

 

Average number of total systems

 

 

117.5

 

 

 

116.5

 

Average number of scan-based systems

 

 

111.5

 

 

 

108.3

 

Scans per system per day

 

 

5.55

 

 

 

5.44

 

Total number of PET/CT scans

 

 

34,637

 

 

 

35,315

 

Revenue per scan

 

$

873.85

 

 

$

876.40

 

Scan-based PET/CT revenue (in thousands)

 

$

30,268

 

 

$

30,950

 

Non-scan-based PET/CT revenue (in thousands)

 

 

958

 

 

 

1,014

 

Total PET/CT revenue (in thousands)

 

$

31,226

 

 

$

31,964

 

Oncology:

 

 

 

 

 

 

 

 

Linac treatments

 

 

28,096

 

 

 

20,134

 

Stereotactic radiosurgery patients

 

 

872

 

 

 

887

 

Total Oncology revenue (in thousands)

 

$

29,058

 

 

$

25,217

 

Interventional:

 

 

 

 

 

 

 

 

Visits

 

 

56,324

 

 

 

54,576

 

Total interventional revenue (in thousands)

 

$

10,990

 

 

$

12,213

 

Revenue breakdown (in thousands):

 

 

 

 

 

 

 

 

MRI revenue

 

$

51,104

 

 

$

48,154

 

PET/CT revenue

 

 

31,226

 

 

 

31,964

 

Other radiology revenue

 

 

6,557

 

 

 

6,844

 

Radiology revenue

 

 

88,887

 

 

 

86,962

 

Oncology revenue

 

 

29,058

 

 

 

25,217

 

Interventional revenue

 

 

10,990

 

 

 

12,213

 

Corporate / Other

 

 

452

 

 

 

(55

)

Total revenues

 

$

129,387

 

 

$

124,337

 

 

 

 


Alliance HealthCare Services

News Release

Page 13 of 13

March 9, 2017

 

ALLIANCE HEALTHCARE SERVICES, INC.

SELECTED STATISTICAL INFORMATION

RADIOLOGY AND ONCOLOGY DIVISION SAME-STORE VOLUME

The Company utilizes same-store volume growth as a historical statistical measure of the MRI and PET/CT imaging procedure, linear accelerator (“Linac”) treatment and stereotactic radiosurgery (“SRS”) case growth at its customers in a specified period on a year-over-year basis. Same-store volume growth is calculated by comparing the cumulative scan, treatment or case volume at all locations in the current year quarter to the same quarter in the prior year. The group of customers whose volume is included in the scan, treatment or case volume totals is only those that received service from Alliance for the full quarter in each of the comparison periods. A positive percentage represents growth over the prior year quarter and a negative percentage represents a decline over the prior year quarter. Alliance measures each of its major radiology and oncology modalities (MRI, PET/CT, Linac and SRS) separately.

The Radiology Division same-store volume (decline) growth for the last four calendar quarters ended December 31, 2016 is as follows:

 

 

Same-Store Volume

 

 

MRI

 

 

PET/CT

 

2016

 

 

 

 

 

 

 

Fourth Quarter

 

(1.2

)%

 

 

5.8

%

Third Quarter

 

1.1

%

 

 

5.3

%

Second Quarter

 

2.0

%

 

 

5.8

%

First Quarter

 

6.6

%

 

 

9.3

%

 

The Oncology Division same-store volume growth (decline) for the last four calendar quarters ended December 31, 2016 is as follows:

 

 

Same-Store Volume

 

 

Linac

 

 

SRS

 

2016

 

 

 

 

 

 

 

Fourth Quarter

 

1.5

%

 

 

(2.5

)%

Third Quarter

 

5.7

%

 

 

(4.6

)%

Second Quarter

 

(1.1

)%

 

 

(0.2

)%

First Quarter

 

5.6

%

 

 

9.0

%