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EVHC Bank of America Merrill Lynch Presentation May 2015
EVHC Bank of America Merrill Lynch Presentation May 2015
May 2015
FORWARD-LOOKING STATEMENTS
Certain statements and information in this presentation may be deemed to be forward-looking statements within the meaning of the Federal
Private Securities Litigation Reform Act of 1995. Forward-looking statements may include, but are not limited to, statements relating to our 2015
Adjusted EBITDA and Adjusted EPS guidance, objectives, plans and strategies, and all statements (other than statements of historical facts) that
address activities, events or developments that we intend, expect, project, believe or anticipate will or may occur in the future, including EVHCs
ability to successfully complete any pending acquisitions, annualized revenue contribution from recent acquisitions and annual estimated patient
encounters from recent acquisitions. Any forward-looking statements herein are made as of the date of this presentation, and we undertake no
duty to update or revise any such statements. Forward-looking statements are not guarantees of future performance and are subject to risks and
uncertainties. Important factors that could cause actual results, developments and business decisions to differ materially from forward-looking
statements are described in our filings with the Securities and Exchange Commission from time to time, including in the section entitled Risk
Factors in our Annual Report on Form 10-K and Quarterly Reports on Form 10-Q . Among the factors that could cause future results to differ
materially from those provided in this presentation are: decreases in our revenue and profit margin under our fee-for-service contracts due to
changes in volume, payor mix and third party reimbursement rates, including from political discord in the federal budgeting process; the loss of
existing contracts; failure to accurately assess costs under new contracts; difficulties in our ability to recruit and retain qualified physicians and
other healthcare professionals, and enforce our non-compete agreements with our physicians; failure to implement some or all of our business
strategies, including our efforts to grow our Evolution Health business and cross-sell our services; lawsuits for which we are not fully reserved; the
adequacy of our insurance coverage and insurance reserves; our ability to successfully integrate strategic acquisitions; the high level of
competition in the markets we serve; the cost of capital expenditures to maintain and upgrade our vehicle fleet and medical equipment; the loss of
one or more members of our senior management team; our ability to maintain or implement complex information systems; disruptions in disaster
recovery systems , management continuity planning, or information systems; our ability to adequately protect our intellectual property and other
proprietary rights or to defend against intellectual property infringement claims; challenges by tax authorities on our treatment of certain physicians
as independent contractors; the impact of labor union representation; the impact of fluctuations in results due to our national contract with FEMA;
potential penalties or changes to our operations, including our ability to collect accounts receivable, if we fail to comply with extensive and complex
government regulation of our industry; the impact of changes in the healthcare industry, including changes due to healthcare reform; our ability to
timely enroll our providers in the Medicare program; our ability to restructure our operations to comply with future changes in government
regulation; the outcome of government investigations of certain of our business practices; our ability to comply with the terms of our settlement
agreements with the government; our ability to generate cash flow to service our substantial debt obligations; and other factors discussed in our
filings with the Securities and Exchange Commission.
2
NON-GAAP FINANCIAL MEASURES
In this presentation, we refer to Adjusted EBITDA, Adjusted EBITDA Margin and Adjusted EPS, which are not financial measures calculated and
presented in accordance with generally accepted accounting principles in the United States of America (GAAP). Adjusted EBITDA is defined as
net income (loss) before equity in earnings of unconsolidated subsidiary, income tax benefit (expense), loss on early debt extinguishment, other
income (expense), net, realized gains (losses) on investments, interest expense, net, equity-based compensation expense, transaction costs
related to acquisition activities, related party management fees, restructuring charges, severance and related costs, adjustment to net loss
(income) attributable to non-controlling interest due to deferred taxes, and depreciation and amortization expense. Adjusted EBITDA Margin
represents Adjusted EBITDA divided by net revenue. Adjusted EPS is defined as diluted earnings per share adjusted for expenses related to
EVHCs secondary offerings, amortization expense, equity-based compensation expense, restructuring charges and loss on early debt
extinguishment, net of an estimated tax benefit. Adjusted EBITDA for the quarter ended March 31, 2014, has been presented to conform to the
current-period presentation by including transaction costs related to acquisition activity in the definition of Adjusted EBITDA.
These non-GAAP financial measures are commonly used by management and investors as performance measures and liquidity indicators.
However, the items excluded from these non-GAAP financial measures are significant components in understanding and assessing the
Companys financial performance, and as a result, these measures should not be considered in isolation or as an alternative to GAAP measures
such as net income, cash flows provided by or used in operating, investing or financing activities or other financial statement data presented in the
Companys consolidated financial statements as an indicator of financial performance or liquidity. Since these non-GAAP financial measures are
not measures determined in accordance with GAAP and are susceptible to varying calculations, these measures, as presented, may not be
comparable to other similarly titled measures of other companies. Reconciliations of Adjusted EBITDA to net income for the periods presented are
included in Supplemental Materials presented herein. Reconciliations for the forward-looking full-year 2015 Adjusted EBITDA and Adjusted EPS
projections presented in this presentation are not being provided due to the number of variables in the projected full-year 2015 Adjusted EBITDA
and Adjusted EPS ranges and thus EVHC does not currently have sufficient data to accurately estimate the individual adjustments for such
reconciliations. All comparisons included in this presentation are for the first quarter of 2015 to the comparable 2014 period, unless otherwise
noted.
3
KEY HIGHLIGHTS
Net Revenue ($ in billions) Highlights
Envision
Strong Growth: Q1 2015 revenue up 23%; Adjusted EBITDA up 16%
Organic growth, including increased level of contract starts, driven by customer
demand for differentiated services
Improved capital structure with sufficient liquidity to pursue strategic acquisitions
30% 35%
70% 65%
Leading player focused on episodic care Accelerated EmCare growth via service line Expanded service solutions to improve quality
expansion and integration of services and lower costs
Track record of strong organic growth
Re-aligned AMR to drive new revenue Extended clinical capabilities outside the
opportunities and improved margins hospital through Evolution Health
Outsized returns delivered to shareholders
through public markets Positioned for population health management
in the evolving healthcare landscape
History of Successfully Evolving the Business Model Within a Dynamic Healthcare Environment
Note: Adjusted EBITDA as defined in Non-GAAP Financial Measures. Prior periods have been adjusted accordingly for comparability purposes.
See reconciliation in supplemental materials.
5
POSITIONED AT THE NEXUS OF THE EVOLVING LANDSCAPE
Envision Customers Changing Market Dynamics
Communities
Healthcare reform driving new models of
delivery and reimbursement
Healthcare
Payors
Facilities
6
MULTIPLE LEVERS TO DRIVE STRONG AND
CONSISTENT GROWTH
Proven Track Record of Delivering Strong Growth Through a Combination of New Contracts,
Same-Contract Revenue Growth and Disciplined Value-Enhancing Acquisitions
7
EMCARE: ROBUST GROWTH PLATFORM WITH
SIGNIFICANT MOMENTUM
23.2 %
Expansion of Multiple Service Lines
20.5 % 13.3 %
7.7 % Creative Healthcare System Partnership Models
3.2 %
14.9 %
1.9 %
Share Gains from Local and Regional Groups
12.9 %
10.1 %
8.0 % 13.7 %
Continued Healthcare Facility Outsourcing
Long-Term History of Highly Visible, Recurring Revenue with Recent Acceleration in Growth
1. EmCare net new contract growth in 2012 of 9.9% includes acquisition growth contribution of 1.9%. Same store contracts growth shown above is calculated using total
contracts as the denominator. When calculating net revenue growth contribution from same-store contracts using only contracts in existence for the entirety of both
year-over-year periods in the denominator, 2012 same store contract growth was 6.3%, 2013 was 2.4%, 2014 was 5.5% and 1Q 2015 was 5.0%.
8
AMR: LEADING OUTSOURCED PROVIDER OF
COMMUNITY-BASED MEDICAL TRANSPORTATION SERVICES
7% 4%
AMR Competitive Advantages
Substantial scale advantages in ambulance services Strong brand recognition and national contracting
(more than 2x nearest competitor) capabilities
AMR Medicine drives best of class clinical Managed transportation service offering
outcomes and improved patient experience
Technology investments
Clear Leader in Ambulance Market with Growing Positions in Complementary Service Lines
1. Management estimates of 2014 market size and AMR outsourced market position.
2. Envision outsourced market share represents fixed-wing market only (total market size represents all air medical transportation services).
9
AMR: BUSINESS REALIGNMENT ACCELERATED
GROWTH, LED TO MARGIN IMPROVEMENTS
Achieved Q1 2015 Revenue Growth of 13.5% over Q1 2014 Future AMR Margin Improvements Primarily
Driven by Technology Investments
Note: Adjusted EBITDA as defined in Non-GAAP Financial Measures. See reconciliation in supplemental materials.
10
EVOLUTION HEALTH: INNOVATIVE SOLUTIONS PROVIDER
FOR HEALTHCARES MOST CHALLENGING PATIENT POPULATIONS
Focus on high risk, high cost and vulnerable populations with Comprehensive Population Assessment
advanced illness and multiple chronic conditions HRA, Mobile Diagnostics
Key customer segments: health plans, health systems and at- 24/7 Unplanned Care
risk providers In-Home, Virtual and Mobile Clinic
11
EVOLUTION HEALTH: INTEGRATION DRIVEN
GROWTH WITH DEMONSTRATED MARKET TRACTION
Strategic Innovation with Strong Market Traction and Recent Acceleration in Growth
12
RECENT EVENTS
Evolution Health joint venture with Ascension Health to complete phase-one roll out in
five markets by Spring 2015. Additional phases adding up to 18 more markets to be
completed over the next two years
Initial participation in Bundled Payment for Care Improvement (BPCI) initiative effective
July 1, 2015
13 Note: Adjusted EBITDA and Adjusted EPS are defined in Non-GAAP Financial Measures.
Financial Review
STRONG HISTORICAL REVENUE AND EBITDA GROWTH
$ 525
$1,555
17.9% 25.8%
$193
$ 475
$446
$3,300
$ 450
$3,108
$ 425
$405
$1,369
$ 400
$2,859
$152
$ 375
$345
$2,570 $1,385
$144
$ 350
$322
$2,410
$1,441
$ 325
$287
$1,381
$126
$ 300
$2,107
$130
$ 275
$1,934 $247
$1,344
$1,799 $ 250
$1,402
$127
$ 225
$215
$1,219
$2,843 $183
$363
$132
$ 200
$1,189
$1,154
$96
$2,359
$ 175
$152
$294
$261
$1,915
$ 150
$98
$1,667
$219
$ 125
$1,478
$106
$192
$1,226
$ 159
$ 100
$1,008
$119
$115
$888
$ 75
$745
$645
$84
$ 50
$46
$ 25
$0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
EmCare AMR
EmCare AMR
Note: $ in millions. Adjusted EBITDA as defined in Non-GAAP Financial Measures. Prior periods have been adjusted accordingly for comparability purposes. See
reconciliation in supplemental materials. 2008 2014 net revenue CAGR is 10.6% and 2008 2014 Adjusted EBITDA CAGR is 14.5%.
15
CONTINUED REVENUE AND EBITDA GROWTH IN 2015
Q1 2015 Financial Results Envision Q1 2015:
Revenue up 22.7%
Net Revenue Adjusted EBITDA Adjusted EBITDA up 16.3%
$1,245
EmCare
Revenue growth driven by:
$420
$1,014
$129 6.3% higher same-store volume,
including 7.5% higher ED volume
$370
$111 $101
Net new contract wins
$52
$35
$96
Acquisitions
$39
$33 $101
$35
$96
$33 Margin impacted by:
$825
$64 $72
AMR
Q2 2012 Q2 2013
Revenue growth driven by:
EmCare
Q2 2012
Q1 2014 Q1 2015
Q2 2013
Q1 2014 Q1 2015 7.8% higher same-market volume
EmCare AMR Margin expansion related to:
% Growth
EmCare 28.0%
AMR
% Margin
EmCare 11.1% 9.3%
Improved deployment
AMR 13.5% AMR 10.6% 12.3% Lower fuel costs
Envision 22.7% Envision 10.9% 10.4%
History of Strong Revenue and EBITDA Growth with Stable Cash Flows
17
Supplemental Materials
ADJUSTED EBITDA RECONCILIATION
Q1 Q1
($ in millions) 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2014 2015
$14.0 $39.1 $59.8 $84.8 $115.2 $131.7 $33.7 $41.2 $6.0 $24.8 $125.5 $33.4
Net income
(+) Depreciation and amortization
58.0 66.0 70.5 69.0 64.4 65.3 99.8 123.8 140.6 36.4 146.2 39.9
expense
- - - - - - - - - - - 1.7
(+) Severance and related costs
49.0 45.6 46.9 42.1 41.0 22.9 112.6 182.6 186.7 30.0 110.5 26.7
(+) Interest expense
(+) Realized (gain) loss on
0.2 0.5 -0.2 -2.7 -2.1 -2.5 - -0.4 -0.5 -0.6 -0.4 -
investments
-1.0 -2.3 -2.1 -2.1 -1.8 -1.0 32.0 -1.4 12.8 0.8 4.0 0.3
(+) Other expense (income), net
10.3 25 36.1 52.5 65.7 79.1 28.6 27.5 -1.0 16.7 89.5 22.5
(+) Income tax expense (benefit)
(+) Equity in earnings of
-0.1 -0.4 -0.8 -0.3 -0.3 -0.3 -0.4 -0.4 -0.3 0.0 -0.3 -0.1
unconsolidated subsidiary
$152.3 $182.5 $215.2 $247.1 $287.0 $322.1 $345.4 $404.5 $445.7 $110.8 $556.2 $128.9
Reported Adjusted EBITDA
9.7
Prior Period Insurance Case Reserve
$152.3 $182.5 $215.2 $247.1 $287.0 $322.1 $345.4 $404.5 $455.4 $110.8 $556.2 $128.9
Pro Forma Adjusted EBITDA
19 1. 2005 related party management fees represent both Laidlaw and Onex management fees and 2013 includes $20M to terminate the CD&R consulting
agreement