cern - analyst report - uofa

8/4/2019 CERN - Analyst Report - UofA

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UNIVERSITY OF OREGON

INVESTMENT GROUP

Covering Analyst: Andy Dingler

Email: [email protected]

The University of Oregon Investment Group (UOIG) is a student run organization whose purpose is strictly educational.

Member students are not certified or licensed to give investment advice or analyze securities, nor do they purport to be.Members of UOIG may have clerked, interned or held various employment positions with firms held in UOIGs portfolio. In

addition, members of UOIG may attempt to obtain employment positions with firms held in UOIGs portfolio.

November 19th 2010

Technology

Cerner Corporation

RECOMMENDATION: Sell

BUSINESS OVERVIEW

Cerner Corporation was founded in 1979 and opened on NASDAQ exchange in 1986 as CERN. Cerners

revenue is derived by implementing software solutions, clinical content, hardware, healthcare devices andservices to numerous healthcare facilities. Cerner has clients in over 8,500 facilities, including

approximately 2,300 hospitals; 3,400 physician practices with over 30,000 physicians 600 ambulatory

Stock Data

Price (52 weeks) 72.05 92.95

Symbol/Exchange CERN / NASDAQ

Beta 1.029

Diluted SharesOutstanding

85.34 M

Average daily volume(3 month average)

647 M

Current market cap 745 M

Current PriceDividend

Dividend Yield

86.16 (Nov 15, 2010)

N/A

Valuation (per share)

DCF Analysis 67.84

Comparables AnalysisTarget PriceCurrent Price

94.26

80.89

86.16 (Nov 15, 2010)

Summary Financials (Millions)(2009A)

RevenueNet Income

1,672 M

193 M

Operating Cash Flow 389 M


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C e r n e r C o r p o r a t i o n u n i v e r s i t y o f o r e g o n i n v e s t m e n t g r o u p

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facilities. These facilities consist of laboratories, ambulatory centers, cardiac facilities, radiology clinics-

surgery centers 700 home health facilities and 1,500 retail pharmacies. Their fundament strategy for growth

is to invest in research and development for new technology within the healthcare industry.

Cerner is headquartered in North Kansas City, Missouri and also has many supplemental offices inAustralia, Brussels, Canada, Belgium, China, Singapore, Spain and England. The companys primary

business is the sale of healthcare information technologies (HIT), which helps eliminates error, variance and

waste for healthcare providers and consumers around the world.

Cerners revenue is broken down into four different segments. System Salesincludes sales of software,

technology resale (hardware and sublicensed software), software upgrades, installation fees, transaction

processing and subscriptions. The main driver in this segment is the companys newest software Cerner,

Millenium 2007, that was launched late in 2006. This software provides streamlined solutions to a whole

range of healthcare-providing deficiencies. Their software is usually sold through Cerners technology

distribution channel, and bundles its software with other necessary hardware and accessories to provide

complete technology solutions to their clients. Cerner usually outsources the hardware and accessory

software to help minimize their production cost. Servicesconsist of the companies consulting and assisting

expertise on project management, and employee training. In this segment they also provide technical

solutions to clientele problems, such as remote hosting, application management, and other resolutions.

Support and Maintenanceis provided to all clients for a fee after the companys technological solutions have

been completely implemented at the customers work site. This segment provides a 24 hour, 7 days a week

emergency software support line. The last segment is Reimbursed Travel,where Cerners clients pay Cerners

traveling expenses and shipping cost. We have to account this as revenue because it is already included in

the sales and clients operating expenses.

Historically, Cerner has never paid dividends and has no plan to in the future. Their Management believes

it is in the shareholders best interest for the company to reinvest funds in the operation of the business.

Cerner does not pay dividend but they have had four previous 2 for 1 stock splits in, May 1992, March

1993, August 1995, and the latest in January 2006.

BUSINESS AND GROWTH STRATEGIES

Cerners overall growth relies heavily on organic growth through leveraging and implementing strategic

investments in research and development. Some of the most recent innovations include their CareAware,

Cerner Healthe, Cerner ITWorks and Cerner RevWorks services. The company believes investing heavily in

R&D and being able to come out with the latest advancements technologies to surpass all of its directcompetitors is evident by their Cerner Millennium software.

Cerner has a strong presence globally in more than 25 countries and they believe that they have a good

opportunity to gain market share outside of the United States because there has been an increase in demand

for health information technologies.


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In the United States healthcare providers are starting to heavily invest in HIT systems to meet the newregulatory standards as described in The HITECH act, were by 2012 all health records are required tobecome completely digitized. Another aspect of growth in the United States is from the recently passedhealthcare reform legislation that enforces all American to be insured by 2014. This is expected to increasethe consumers in the healthcare industry by about 32 million people. Cerner believes the increase indemand for healthcare coverage will provide a strong incentive for their providers to maximize efficiencywhich will create the need for our clients to further leverage HIT investments, all of which represent a long-term positive for HIT.

Another way Cerner grows its revenue in the past and expects to in the future is by cross-selling additional

services and applications to its current clients. The additional products or services that Cerner promotes

work in cohesive fashion with its original product of enhancing their HIT capabilities. This proves Cerner

with baseline revenue they can rely on as their backbone through economic struggles. However as their

client base expands their potential of revenue sources increases as well.

On the opposite side of growing revenues Cerners management team has created an aggressive plan in 2003

and has kept to their goals to date of maintaining earnings growth which is evident by their net earnings

increasing annually by more than 20% over the last five - and ten- year periods. They believe in continuing

this strong growth and the primary areas of concentration are

To become more efficient in implementing their software by leveraging tools and methodologiesthey developed to reduce the amount of effort required in the implementation phase

To take advantages of their heavy investments in R&D by addressing additional markets that do notrequire significant research and development, but can also contribute to their revenue growth

Concentrating and working towards reducing their general and administrative spending expense, soit declines as a percent of revenue to below the revenue growth rate.

In their recent conference call Marc Naughton their executive vice president said Cerner feels confident in

maintaining the 20% margins and that they meet their goal set back in 2003 of obtaining 20% operating

margins by increased profitability in their professional services, and managed services and support business

models along with ongoing leverage of investments in R&D and SG&A expense. Note that these figures

are non-GAAP results and are accounted before share-based compensation expenses are taken out and will

not be equivalent to the figures found in the Discounted Cash Flow Analysis

In addition, Cerner makes a lot of acquisitions that help expand its software and IP portfolios. The

companys most recent acquisition was IMC healthcare for 15.7 million in cash. This acquisition expanded

their employer health initiatives such as employer health centers, occupational health services and wellness

programs.


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Cerner will most likely continue to acquire companies that will help contribute to the growth of their

software solutions suites and benefit their overall position in the industry. Overall the companys main

growth will contribute to growing revenues, expanding margins and organic growth with R&D.

MANAGEMENT AND EMPLOYEE RELATIONS

CEO: Neal Patterson is the chief executive officer and co-founder of Cerner. He is currently 60 years oldand began his professional career in 1973 as an information system consultant with Arthur Andersen & Co.It was not tell 1979 when he and two Arthur Andersen colleagues, Cliff Illig and Paul Gorup decided toform Cerner. Patterson is on his 31st year as Cerners CEO and is developing the largest stand-alonesupplier of healthcare information technology. He is widely respected for his visions and strategic thinkingand his abilities of transforming the healthcare industry by reducing cost and increase efficiency.

Neal has been named in the Modern Healthcares 100 Most Powerful People in Healthcare five times. Heserves as a trustee the Midwest Research Institute and is active in healthcare leadership networks and localentrepreneurial organizations. His annual salary compensation is 1.75 Million.

PORTFOLIO HISTORY

Cerner is currently held in the Tall Firs portfolioPurchase DateJanuary 9, 2009Shares300Purchase cost36.52Current Price86.16Market Value - 25,848Realized Gain135.93%

RECENT NEWS

November 11, 2010Cerner Signs Reseller Agreement with MedAssetsThis agreement allows Cerner to market MedAssetss entire suite of web-based revenue cycle technologies.This will enhance Cerners clients revenue cycle, and will help accelerate cash flow while reduceadministrative cost for Cerner.

October 27, 2010Cerner Seeks Incentives for $63M Warehouse and Data CenterCerner is seeking $50 million in industrial revenue bonds from Kansas City to build a 50,000-square footwarehouse and date center. Cerner is seeking multiple 10-year bonds to help it buy and install computers

and other equipment for the center.

July 19, 2010 - Mather Swindells to Join CernerSwindells joins Cerner as senior executive in Cerners Global organization. He brings 20 years of healthcareand technology experience and has built one of the largest and most respected advisory professional servicebusiness supporting healthcare provisions in the UK. This is extremely beneficial for Cerner as stated intheir last conference call during their latest health conference they had nearly 100 clients from the UKinterested in their healthcare information technology.


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Jan 11, 2010Cerner Receives FDA Clearance for Medical Device Connectivity SolutionIn 2007 Cerner launched the next generation of device connectivity solutions called CareAware. Thisproduct provides the ability to correlate and trend various sources of information including variouswaveforms, of heart rate and blood pressure. Just recently this product was cleared by the FDA and opensup another revenue line that Cerner will be able to receive from its clients.

Dec 18, 2009Cerner to Acquire IMC Health Care Inc.IMC Health Care, Inc., is a provider of employer sponsored on-site health centers. This acquisition willhelp Cerners employer health initiatives, such as on-site employer health centers, pharmacies and wellnessprograms. Since IMC Health Care had a strong history of exceptional on-site health centers andoccupational expertise, this acquisition will strengthen Cerners position as a provider of comprehensive.The IMC acquisition is expected to close in the first quarter of 2010 and will not have any material impacton Cerners 2010 financial Results.

INDUSTRY

As healthcare technologies improve healthcare cost increases as the average age of living increases. Thisoccurs because when individuals get older they require more medical help and thus will pay more in healthcare expenses. Annual physician visits have grown roughly with the US population; the number of visits peryear has been around 3.13. As technology continues to advance the elderly are living longer and are morewilling to undergo more treatments. The average age of the U.S population is expected to increase from 35to 37.4 by 2015; the main drive in this are the baby boomer generations as there are 40.4 million senioradults in the U.S. Due to the Patient Protection and Affordable Care Act of 2010, occurring in 2014 thedoor will open to 32 million more Americans and physician visit are bound to increase. According toIBISWORLD, physician visits are predicted to have a 4.78 percent increase. Over the last two yearshealthcare has slowed down but still has significantly outpaced GDP. In 2008 and 2009 healthcares share

of GDP was 17.6% and 19% respectively with the one year increase being healthcares largest one-yearincrease ever.

In addition to the health reform bill, insuring an estimated 32 million Americans, it will allow young-adultsto stay on their parents insurance to the age of 26. Also the Patient Protection and Affordable Care Act(PPACA) will soon prohibit children from being denied coverage because of their health status and notlettinganyones coverage get dropped when they get sick. All these factors will play a role helping reducethe number of patients who are unable to pay bills and therefore increase the industry revenue. In additionthis will push hospitals to their capacity limits as they will be seeing more people each day, thus requiring ahigher demand for HIT systems as hospitals will need to become more efficient.

Currently, the HIT industry has no company holding a dominant share of the market. For companies tokeep pace they must continuously invest in research and development and make strategic acquisitions toimprove their overall market share. Companies also have high R&D expense and have to constantly winover clients for their contracts. Most HIT providers experience seasonal sales which occur at the end of theyear for hospitals and other healthcare providers because of the HIT industry usually sees higher revenue inthe fourth quarter and their lowest in the first.

The HIT industry depends on the overall healthcare industry for sources of revenue and therefore hasincreasing regulations and governing laws for HIT providers. Since HIT medical devices are responsible for


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the livelihood of patients worldwide, the company could be in severe trouble if there is a malfunction orfailure of one of their products.

S.W.O.T.ANALYSIS

Strengths

Existing clients provide future revenue growth through add-ons to already purchased softwaresolutions. These add-ons are usually a large source of revenue for the company

Unlike some of Cerners competitors, Cerner does not charge additional fees for a client to acquirethe newest updates on software the client has already purchased

Favorable conditions looking forward with recurring revenue and clients contract bids Capitalizing on capital expenditure expenses by strategically building company hubs which help

minimize their cost

Cross-selling additional services and applications to its current clientsWeaknesses

Revenues are not recognized in a timely fashion as their sale process is long. Consisting ofnegotiation, installing, clients taking a while to adapt and that revenues are recognized once certain

stages are meet.

Their clients need the latest technologically advanced software which forces rapid changes in theindustry. Cerner could potentially lose some of its market share if they cannot keep up

Opportunities

The HITECH Act portion of the 2009 Stimulus Bill will propel digital healthcare by requiringindividual electronic health records (EHR) which provides incentives for hospital to implement HIT

systems.

Health care spending is expected to have a compound growth of 6.18% to 2015 32 million people in the united state will be required to have insurance by 2014

Threats

Economic conditions adversely affect Cerner if there are changes in HIT adoptions rates,standardization in the industry with a competitors product, or policies of healthcare and regulations.


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Law suits from malfunctions to the companys products Foreign standard and policies for healthcare have a significant impact on Cerners international

market share

Unfavorable or changing foreign currency exchange ratesPORTERS 5FORCESANALYSIS

Supplier Power - Moderate

Components of Cerners software and technology solutions are produced by third-party suppliers since the

cost of developing the companys own solutions are relatively high.

Barriers to EntryModerate

As Cerner gets more experienced with HIT technologies and improves its efficiency in developing and

implementing its own software solutions, barriers to entry will get stronger. In addition, as Cerner grows

and expands, reputation and its clientele base opportunities of entry will slowly diminish.

Buyer PowerModerate

There are a lot of substitute products but it is difficult to completely change from one software suite to

another while maintaining low and reasonable switching cost.

Threat of SubstitutesHigh

The HIT industry is extremely competitive with many firms having comparable software or specializing in

specific applications that Cerner provides. The industry is still relatively young and no one has fully

emerged as a true market leader.

Degree of Rivalry - High

The healthcare information technology industry is very competitive and is more enticing as there will be a

stronger demand for healthcare in the near future. Numerous companies offer comparable software

solutions and propose as a threat in the future as they compete over profitable contracts

COMPARABLESANALYSIS

In my comparable analysis, I chose companies based on their, EBITDA and Net Margins. In addition I alsolooked at their expected revenue growth and capital structure. I chose three companies with no debt andtwo with debt as my companys equity to debt ratio is large and the two with debt are used to help even outthe comparables capital structure. The following descriptions were obtained from each companys mostrecent annual report.


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Quality Systems, Inc. QSII (33.33%)Quality Systems, Inc. Company develops and markets healthcareinformation systems that automate certain aspects of medical anddental practices, networks of practices such as physician hospitalorganizations (PHOs) and management service organizations(MSOs), ambulatory care centers, community health centers, andmedical and dental schools. The Company also provides revenuecycle management (RCM) services through the Practice Solutions

Division.

QSII is develops and markets healthcare information systems and is a direct competitor with Cerner. Eventhough Quality Systems, Incs capital structure consists of zero debt, they are still a good comparable toCerner who only has a debt to equity percent of 1.23%. QSII has two divisions that develop and marketsoftware. The NextGen divison develops and sells proprietary electronic medical records while QSIdivision incorporates a wide range of clinical tools including, periodontal charting, digital imaging of X-ray,and inter-oral camera images as part of the electronic patient record. One problem with QSII is that it does

not focus on independent hospital systems. Quality Systems, Inc multiples where given a weighting of33.33% due to their direct competition, similar cost structure and a strong beta correlation. In addition,QSII was weighted higher since they are only domestic and help offset the globalization aspect in the compssince BAX and MDRX have a greater global presence.

Allscripts-Misys Healthcare Solutions, Inc. MDRX (33.33%)Allscripts-Misys Healthcare Solutions, Inc. is a leading provider ofclinical software, services, information and connectivity solutions.Our businesses provide innovative solutions that inform physicians

with the right, information, that connect physicians to each other andto the entire community of care, and transform healthcare, improving

both the quality and efficiency of care. We provide various softwareapplications and services, including Electronic Health Records(EHR), practice management, revenue cycle management, clearinghouse services, and electronic prescribing.

MDRX provides health system solutions for hospitals, home health providers, hospices and skilled nursingfacilities that are seeking Emergency Department Information System (EDIS). I chose this companybecause Eclipsys was one of Cerners main competitors and they merged with MDRX. They offer acompetitive software solution suite and are direct competitors with Cerner as they have 160,000 physiciansand 800 hospitals. MDRX multiples where given a weighting of 33.33% for their international presence andbeing a direct competitor of Cerner

CareFusion Corporation, - CFN (33.33%)CareFusion Corporation provides various healthcare products andservices in the United States and internationally. It operates in twosegments, Critical Care Technologies, and Medical Technologies andServices. The Critical Care Technologies segment develops,manufactures, and markets equipment and related supplies for infusion,medication and supply dispensing, and respiratory care products. The

Medical Technologies and Services segment develops manufactures, and markets disposable infectionprevention products, software-based infection detection services, surgical and diagnostic instrumentation,


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and neurological monitoring equipment. The company serves hospitals and other healthcare facilitiescomprising oncology clinics, ambulatory surgical centers, clinics, long-term care facilities, and physicianoffices. (Yahoo finance)

CFN focuses on healthcare safety and productivity and they intend on continuing there global market share.Like Cerner, CFN provides services to hospitals and other healthcare providers to prevent medication errorwhile improving their efficiency. CFN plans to continue organic growth coupled with strategic acquisitionsthat enable them to further address customer needs. CFN multiples where given a lowering weighting of33.33% because of its big difference in debt to equity ratio.

Valuation Metrics Used

The multiples I selected to compare Cerner with its competitors were EV/Revenue, EV/Gross Profit, andEV/ EBIDTA.

EV/Revenue (33.33%)

I used this multiple to look at the companys ability to generate revenue in comparison to their size.

EV/Gross Profit (33.33%)I used EV/Gross profit which allows me to look at each companys performance relative to their size.

EV/EBITDA(33.33%)I used EV/EBITDA because each of my companies vary in revenue size and capital structure. Thismultiple allows me to look at each companys earnings without worrying about their capital structure.

DISCOUNTED CASH FLOWANALYSIS

I used the percent of revenue method to project line items into the future. I used Cerners offeredprojections on certain items for 4th quarter of 2010 and full year 2011 when available. Detailed projectionsare offered below.

RevenueThe companys primary sources of revenue are broken down into four segments; System Sales, Support andMaintenance, Service, and Reimbursed Travel.

I projected each of these four segments separately, and their projections are found in the revenue model inthe appendix.

System SalesRevenues from the 3rd quarter 2010 increased by 13% compared to the revenues from the 3rd quarter 2009.This increase was a result of a strong increase in their demand for licensed software and technology resale.Cerners main platform, Cerner Millennium, has been out for three years and has almost been fully adoptedby their clients. Sometime in the near future I project that Cerner will come out with a new softwareplatform before 2014, when the new health bill requires everyone in the United States to be insured. Iprojected this to happen in 2013 and during this time I project that Cerners software revenues growth will


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fall like it did in 2007, as the newest software becomes available and customers slowly adapt to it. This timearound Cerner will see a quicker return on their new software as the healthcare industry will be moredigitalized and are more acquainted to this era of healthcare . Once Cerners clients acquire their newplatform, I projected that system sales growth will slow down going into perpetuity as Cerner turns itsconcentration to Support and Maintenance and Services.

Support and MaintenanceRevenues increased 7% during the 3rd quarter 2010 compared to the same quarter in 2009. This increasewas driven by the growth of Cerner Millennium applications. I projected Cerners support and Maintenanceto increases, marginally to 2013 as their clients will need to be more efficient to maintain the increase indemand for healthcare. Once Cerner comes out with their new platform, I forecasted an increase in growthas their clients will need to adapt to the new platform. Going to perpetuity, I forecasted a decrease in themarginal growth of support and maintenance as their clients have fully grasped the new platform.

ServicesRevenues increased by 18% during the 3rd quarter 2010 compared to the same quarter in 2009.

Management said that more and more of their clients are starting to choose to have their software hosted byCerner remotely, instead of purchasing the hardware itself. As a result I projected an increase in servicerevenue going forward and that a potential cloud shift may occur.

Reimbursed TravelHistorically, reimbursed travel has been a very small percent of total revenue and has a historical averagearound 2 percent of revenues. In the future I do not really see this changing. The huge increase isattributed to the new platform coming out and Cerner traveling around to their clients.

In Cerners most recent conference call they predicted that their 4th quarter total revenue will be between$490 million and $510 million. I went with a moderate approach and took the average and predicted 4th

quarter total revenue to be 500,999 million. They also predicted that 2011s total revenue growth will bebetween a 13 and 20% increase because of the uncertainty of the healthcare industry right now I went with aconservative approach and took a 15.2% increase for 2011.

Software Development ExpenseI projected it to maintain around 15% of revenue as Cerner revenue is more derived by its research anddevelopment expense. The reason for the initial increase in software development expense is the increase inresearch and development cost. Cerner announced that at the end of 2009 they had two thousandassociates engaged in research and development activities. I forecast this to continue until Cernerannounces its new platform. Going towards perpetuity I trimmed the software and development expense toreturn back to its 15% of revenue.

AmortizationThe company projected amortization for 2010-2014 of 60,176, 68,339, 73,316, 76,534, and 78,411 of whichI took the 2014 percent increase for of 2.45% going into perpetuity.

General and Administrative ExpenseIn the their last conference call Cerner said that they can and want to control their G&A expense and expectit to decrease going forward. Given this information I forecasted the general and administrative expense tobe slightly less than its historical average.


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Working CapitalThe company has not given me any indication that would alter its working capital. The two main changesthat I forecasted were an increase in cash and cash equivalents up to 2013 in order to acquire acquisitions,and in 2013 and 2014 cash and cash equivalents decrease to acquire companies. Then I took the historicalaverage of 14.21 going out to perpetuity. The company also predicted their values for current installment oflong-term debt for 2011-2014 to be 25, 25, 20, and 20 of which I carried 20 million out to perpetuity.

The big change in net working capital for 2008 was a direct result of Cerner coming out with its new CernerMillennium platform, Cerners clients were adapting to it fast enough which caused a buildup in short-terminvestments and inventory. Since I am forecasting that Cerner will come with a new platform in 2013 Iforecasted a similar drop in short-term investments and inventory as in 2008 but with it slightly higher sincethey are carrying extra short-term investment.

The large decrease in net working capital for quarters 1, 2 and 3 of this year were a direct result of theuncertainty of the health reform bill. Cerners two main liquidity sources are cash and cash equivalents and

short-term investments. This is why there is a large increase in them from the year prior. I see Cerner usingthis safety cushion until the health reform bill is completely in place. I forecasted that by 2015 Cerner willgo back to its historical averages for these two with 14.21% of revenue for cash and equivalent and 9%percent of revenue for short-term investments and inventory.

Capital ExpendituresCerner is trying to maintain and control their capital expenditures going forward. I forecasted capitalexpenditures to increase marginally to 2014, to complete Cerners expansion, and then I decline it to 8.6%going into perpetuity.

Tax Rate

The 2010 quarter 1-3 tax rate was 35.3 percent. Based on the companys guidance I predicted a tax rate of35% going forward.

Cost of DebtThe most recent debt rate that CERN announced was in the 4 th quarter of 2009, of 5.54%. This was thefirst payment of seven equal annual installments on their Great Britain Pound Note Agreement.

BetaI derived Cerners beta using a 5-year monthly regression against the S&P 500. I reached a beta of 1.02 witha standard error of .20. This beta is lower than Cerner has had in the past but I believe that this beta isaccurate as Cerner has been decreasing their debt and now have a really high equity to debt ratio.


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Prices Weighting

Comparables Implied Price 90.92 50%

DCF Implied Price 60.70 50%

Weighted Implied Price 75.81 100%Current Price 86.16

Overvalued -12.01%

RECOMMENDATION

Currently Cerner is only held in the Tall

Firs portfolio and has a return on

investment of 135.93% in almost twoyears. Looking forward I believe Cerner

Corporation is in an ideal position and is

led by an experienced management team with Neal Patterson at the helm. They have a proven track record,

and I believe they are a strong company going forward. Qualitatively, my Comparable Analysis shows the

company with a 5.52% undervaluation. On the other hand my Discounted Cash Flow shows a 29.51%

overvaluation. The overall implied price is 75.83 with an overvaluation of 11.99%. This can be attest to the

uncertainty surrounding the healthcare bill and that the company is currently fair valued to its stock price.

This is why I recommend taking our earnings and selling Cerner.


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C e r n e r C o r p o r a t i o n u n i v e r s i t y o f o r e g o n i n v e s t m e n t g r o u p h t t p : / / u o i g . u o r e g o n . e d u

The University of Oregon Investment Group33.33% 33.33% 33.33% 100.00%

($ in Millions except per share data) CERN QSII MDRX CFN Weighted Average

Stock Characteristics Min Max Avg. Median

Current Price 13.17 86.72 51.00 51.36 86.16 62.57 18.16 23.49 34.74

50 Day Moving Avg. 13.17 80.8 50.28 49.51 80.8 64.81 18.7 24.42 35.98

200 Day Moving Avg. 12.61 81.11 48.17 45.17 81.11 60.05 17.95 23.97 33.99

Beta 0.49 1.02 1.03 0.88 1.02 0.96 0.79 0.88 0.88

Size

ST Debt (MRQ) 0 15 8.95 4 25.75 0 0 4 1.33332

LT Debt (MRQ) 0 4,360 1,168 93 93 0 0 1,386 462

Cash and Cash Equiv. (MRQ) 107 2,300 792 212 212 107 143 1,019 423

Minority Interest 0 232 46.42 0 0.12 0 0 0 0

Diluted Share Count 85.34 587 221.25 148.4 85.34 29.057 148.4 223 133.48

Market Cap 1,822 30,148 9,548 5,146 7,353 1,818 2,695 5,238 3,250

Enterprise Value 1,715 32,455 9,979 5,517 7,260 1,711 2,552 5,609 3,291

Profitability Margins

Gross Margin 47.49 77.52 0.67 53.2 77.52% 60.89% 53.20% 47.49% 53.86%

EBIT Margin 3.49 25.54 0.19 18.54 18.54% 25.54% 16.85% 12.34% 18.25%

EBITDA Margin 7.59 29.43 0.25 22.95 29.43% 27.65% 19.77% 16.75% 21.39%

Net Margin 2.02 16.26 0.11 12.18 12.18% 16.26% 8.93% 4.35% 133.48

Credit Metrics

Interest Expense (MRQ) 0 24 9.14 1.7 1.7 0 0 20 7

Debt/Equity (MRQ) 0 27 0.09 2 1.62% 0.00% 0.00% 26.54%8.85%

Debt/EBITDA (LTM) 0 211 0.77 23 22.94% 0.00% 0.00% 211.15% 70.38%

EBITDA/Interest Expense (LTM) 0 122 91.99 33 305 0 0.00 32.92 11

Operating Results

Revenue (LTM) 217.5 12,735 3,931 1,763 1,763 308 705 3,929 1,647

Gross Profit (LTM) 108.7 6,058 1,992 1,367 1,367 188 375 1,866 809

EBITDA (LTM) 16.5 2923 868.24 519 519 85 139 658 294

Valuation Weighted Avg.

EV/Revenue 3.70 x 4.12 x 5.55 x 3.62 x 1.43 x 3.53 x

EV/Gross Profit 6.40 x 5.31 x 9.12 x 6.81 x 3.01 x 6.31 x

EV/EBITDA 17.58 x 13.99 x 20.09 x 18.32 x 8.52 x 15.64 x

Metric Implied Price Weight

EV/Revenue 74.11 33.33%

EV/Gross Profit 102.48 33.33%

EV/EBITDA 96.19 33.33%

Price Target 90.92

Current Price 86.16Undervalued 5.52%

APPENDIX 1COMPARABLEANALYSIS


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The University of Oregon Investment Group

($ in Thousands except per share data) 0.125 1.125 2.125 3.125 4.125 5.125 6.125 7.125 8.125 9.125 10.12

2007 2008 2009 2010 Q123 2010 Q 4 E 2010 A+E 2011 E 2012 E 2013 E 2014 E 2015 E 2016 E 2017 E 2018 E 2019 E 2020 E

Total Company Revenue 1,519,877 1,676,028 1,671,864 1,350,021 500,999 1,851,020 2,132,359 2,456,338 2,838,581 3,306,442 3,801,700 4,315,180 4,727,267 5,046,665 5,277,857 5,484,07

% Y/Y Growth 10.29% 10.27% -0.25% 10.72% 15.20% 15.19% 15.56% 16.48% 14.98% 13.51% 9.55% 6.76% 4.58% 3.91Cost of Revenue 280,110 296,063 281,198 225,443 82,665 308,108 352,692 404,559 464,676 536,966 612,834 690,429 756,363 807,466 844,457 877,45

% Revenue 18.43% 17.66% 16.82% 16.70% 16.50% 16.65% 16.54% 16.47% 16.37% 16.24% 16.12% 16.00% 16.00% 16.00% 16.00% 16.00

Gross Profit 1,239,767 1,379,965 1,390,666 1,124,578 418,334 1,542,912 1,779,666 2,051,779 2,373,905 2,769,476 3,188,866 3,624,751 3,970,904 4,239,198 4,433,400 4,606,62

Gross Margin 81.57% 82.34% 83.18% 83.30% 83.50% 83.35% 83.46% 83.53% 83.63% 83.76% 83.88% 84.00% 84.00% 84.00% 84.00% 84.00Operating Expenses

Sales and Clients 505,139 545,046 511,036 426,072 158,364 584,436 673,898 756,773 867,003 1,005,420 1,144,101 1,280,231 1,432,548 1,548,387 1,683,943 1,776,89% Revenue 33.24% 32.52% 30.57% 31.56% 31.61% 31.57% 31.60% 30.81% 30.54% 30.41% 30.09% 29.67% 30.30% 30.68% 31.91% 32.40

Software Development Expense 270,576 272,519 271,051 202,024 74,148 276,172 319,854 393,014 454,173 512,499 577,858 647,277 709,090 757,000 791,679 822,61

% Revenue 17.80% 16.26% 16.21% 14.96% 14.80% 14.92% 15.00% 16.00% 16.00% 15.50% 15.20% 15.00% 15.00% 15.00% 15.00% 15.00

Depreciation 99,342 119,334 125,992 90,856 33,316 124,172 143,934 167,031 195,862 231,451 269,921 310,693 340,363 363,360 380,006 394,85

% Revenue 6.54% 7.12% 7.54% 6.73% 6.65% 6.71% 6.75% 6.80% 6.90% 7.00% 7.10% 7.20% 7.20% 7.20% 7.20% 7.20

Amortization 53,475 51,132 63,611 50,015 10,161 60,176 68,339 73,316 76,534 78,411 80,332 82,300 84,317 86,382 88,499 90,66

% Revenue 3.52% 3.05% 3.80% 3.70% 2.03% 3.25% 3.20% 2.98% 2.70% 2.37% 2.11% 1.91% 1.78% 1.71% 1.68% 1.65

General and administrative 107,152 113,049 126,970 99,611 37,593 137,204 148,839 169,487 194,443 225,499 254,714 280,487 283,636 290,183 303,477 315,33

% Revenue 7.05% 6.75% 7.59% 7.38% 7.50% 7.41% 6.98% 6.90% 6.85% 6.82% 6.70% 6.50% 6.00% 5.75% 5.75% 5.75

Total Operating Expenses 1,035,684 1,101,080 1,098,660 868,578 313,582 1,182,160 1,354,863 1,559,621 1,788,015 2,053,280 2,326,926 2,600,988 2,849,954 3,045,312 3,247,602 3,400,36

% Revenue 68.14% 65.70% 65.71% 64.34% 62.59% 63.87% 63.54% 63.49% 62.99% 62.10% 61.21% 60.28% 60.29% 60.34% 61.53% 62.00

EBIT 204,083 278,885 292,006 256,000 104,752 360,752 424,803 492,158 585,890 716,196 861,940 1,023,763 1,120,950 1,193,886 1,185,798 1,206,26

% Revenue 13.43% 16.64% 17.47% 18.96% 20.91% 19.49% 19.92% 20.04% 20.64% 21.66% 22.67% 23.72% 23.71% 23.66% 22.47% 22.00Other (Expense) Income -1,385 -510 367 -566 0 -566 0 0 0 0 0 0 0 0 0

% Revenue -0.09% -0.03% 0.02% -0.04% 0.00% -0.03% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00Interest Expense 11,937 10,548 8,493 5,280 1,403 6,683 14,500 16,703 19,302 22,484 25,852 29,343 32,145 34,317 35,889 37,29

% Revenue 0.79% 0.63% 0.51% 0.39% 0.28% 0.67% 0.68% 0.68% 0.68% 0.68% 0.68% 0.68% 0.68% 0.68% 0.68% 0.68Interest Income 13,206 13,604 8,801 7,571 3,357 10,928 17,485 20,142 23,276 27,113 31,174 35,384 38,764 41,383 43,278 44,96

% Revenue 0.87% 0.81% 0.53% 0.56% 0.67% 0.59% 0.82% 0.82% 0.82% 0.82% 0.82% 0.82% 0.82% 0.82% 0.82% 0.82

Interest Income (Expense), Net 1,269 3,056 308 2,291 1,954 2,128 2,985 3,439 3,974 4,629 5,322 6,041 6,618 7,065 7,389 7,67

% Revenue 0.08% 0.18% 0.02% 0.17% 0.39% 0.11% 0.14% 0.14% 0.14% 0.14% 0.14% 0.14% 0.14% 0.14% 0.14% 0.14

Other and In te rest Income (E xpenses), Ne t (116) 2,546 675 1,725 1,954 3,679 2,985 3,439 3,974 4,629 5,322 6,041 6,618 7,065 7,389 7,67

% Revenue -0.01% 0.15% 0.04% 0.13% 0.39% 0.20% 0.14% 0.14% 0.14% 0.14% 0.14% 0.14% 0.14% 0.14% 0.14% 0.14

Pre-tax Income 203,967 281,431 292,681 257,725 106,706 364,431 427,788 495,597 589,864 720,825 867,262 1,029,805 1,127,568 1,200,952 1,193,187 1,213,93

% Revenue 13.42% 16.79% 17.51% 19.09% 21.30% 19.69% 20.06% 20.18% 20.78% 21.80% 22.81% 23.86% 23.85% 23.80% 22.61% 22.14Less Taxes (Benefit) 76,842 92,773 99,216 91,090 37,347 128437.1151 149,725.91 173458.8275 206452.5001 252288.837 303541.8125 360431.581 394648.9127 420333.105 417615.306 424878.14

Tax Rate 37.7% 33.0% 33.9% 35.3% 35.0% 35.2% 35.0% 35.0% 35.0% 35.0% 35.0% 35.0% 35.0% 35.0% 35.0% 35.0

Net Income127,125 188,658 193,465 166,635 69,359 235,994 278,062 322,138 383,412 468,536 563,721 669,373 732,919 780,619 775,571 789,05

Net Margin 8.36% 11.26% 11.57% 12.34% 12.75% 13.04% 13.11% 13.51% 14.17% 14.83% 15.51% 15.50% 15.47% 14.69% 14.39

A dd B ack Deprec ia tion and A mort iza tion 152 ,817 170,466 189,603 140,871 49,375 190,246 212,273 240,347 272,396 309,862 350,253 392,993 424,680 449,742 468,504 485,52

% Revenue 10.05% 10.17% 11.34% 10.43% 9.86% 10.28% 9.95% 9.78% 9.60% 9.37% 9.21% 9.11% 8.98% 8.91% 8.88% 8.85

A dd B ac k Inte re st Exp ens e*( 1-Ta x Ra te ) 7 ,4 40 7,071 5,614 3,414 912 4,330 9,425 10,857 12,547 14,614 16,804 19,073 20,895 22,306 23,328 24,24

% Revenue 0.49% 0.42% 0.34% 0.25% 0.18% 0.23% 0.44% 0.44% 0.44% 0.44% 0.44% 0.44% 0.44% 0.44% 0.44% 0.44

Operating Cash Flow 287,382 366,195 388,682 310,920 119,646 430,566 499,761 573,342 668,354 793,013 930,777 1,081,439 1,178,494 1,252,667 1,267,404 1,298,82

% Revenue 18.91% 21.85% 23.25% 23.03% 23.88% 23.26% 23.44% 23.34% 23.55% 23.98% 24.48% 25.06% 24.93% 24.82% 24.01% 23.68

Current Assets 818,564 858,873 1,146,318 761,130 1,002,511 1,002,511 1,233,356 1,445,309 1,582,225 1,734,229 2,108,043 2,401,829 2,631,197 2,808,974 2,937,655 3,052,43

% Revenue 53.86% 51.24% 68.57% 56.38% 200.10% 54.16% 57.84% 58.84% 55.74% 52.45% 55.45% 55.66% 55.66% 55.66% 55.66% 55.66

Current Liabilities 288,123 341,223 358,103 304,592 452,843 452,843 477,700 546,481 629,553 730,845 809,936 904,359 989,290 1,055,118 1,102,766 1,145,26

% Revenue 18.96% 20.36% 21.42% 22.56% 90.39% 24.46% 22.40% 22.25% 22.18% 22.10% 21.30% 20.96% 20.93% 20.91% 20.89% 20.88

Net Working Capital 530,441 517,650 788,215 456,538 549,668 549,668 755,656 898,829 952,672 1,003,384 1,298,107 1,497,470 1,641,907 1,753,856 1,834,889 1,907,17

% Revenue 34.90% 30.89% 47.15% 33.82% 109.71% 29.70% 35.44% 36.59% 33.56% 30.35% 34.15% 34.70% 34.73% 34.75% 34.77% 34.78

Change in Net Working Capital 85,785 (12,791) 270,565 (331,677) (238,547) 205,988 143,172 53,843 50,712 294,723 199,363 144,437 111,949 81,033 72,28

Capital Expenditures 180,723 182,400 108,099 75,341 40,725 116,066 170,589 236,791 296,632 338,249 374,848 401,312 406,545 428,966 453,896 471,63

% Revenue 11.89% 10.88% 6.47% 5.58% 8.13% 6.27% 8.00% 9.64% 10.45% 10.23% 9.86% 9.30% 8.60% 8.50% 8.60% 8.60Acquistions 24,061 5,719 3,529 14,486 1,703 16,189 18,338 21,125 30,657 38,024 43,720 43,152 42,545 45,420 47,501 49,35

% Revenue 1.58% 0.34% 0.21% 1.07% 0.34% 0.87% 0.86% 0.86% 1.08% 1.15% 1.15% 1.00% 0.90% 0.90% 0.90% 0.90

Unlevered Free Cash Flow (3,187) 190,867 6,489 552,770 77,217 536,862 104,845 172,254 287,223 366,028 217,487 437,613 584,967 666,332 684,974 705,55

Discounted Unlevered Free Cash Flows 76,327 94,457 141,442 214,955 249,669 135,209 247,961 302,097 313,637 293,854 275,87

APPENDIX 2DISCOUNTED CASH FLOWS ANALYSIS


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(In Millions)

Assumptions for Discounted Free Cash Flows ModelTax Rate 35% Terminal Growth Rate 3%

Risk-Free Rate 2.57% Terminal Value 8,698

Terminal Risk-Free Ra 4.25% PV of Terminal Value 2,928

Beta 1.029 Sum of PV Free Cash Flows 2345.48

Market Risk Premium 7.00% Firm Value 5,273

% Equity 98.75% LT Debt 93.28

% Debt 1.25% Cash 211.75

Cost of Debt 5.54% Equity Value 5,180

CAPM 9.77% Diluted Share Count 85.34

WACC 9.72% Implied Price 60.70

Terminal CAPM 11.45% Current Price 86.16

Terminal WACC 11.35% Overvalued -29.55%

Beta St. Deviatio Implied Price Under (Over) Valued

1.429 2.00 42.64 -50.51%

1.329 1.50 46.22 -46.35%

1.229 1.00 50.34 -41.57%

1.129 0.50 55.11 -36.04%

1.029 0.00 60.70 -29.55%

0.929 -0.50 67.33 -21.86%

0.829 -1.00 75.31 -12.60%

0.729 -1.50 85.08 -1.25%

0.629 -2.00 97.32 12.95%

APPENDIX 3DISCOUNTED CASH FLOWSANALYSISASSUMPTIONS

APPENDIX 4

BETASENSITIVITYANALYSIS


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(In thousands)

Total Revenue 2006A 2007A 2008A 2009A 2010 Q123 2010 Q 4 E 2010 A+E 2011 E 2012 E 2013 E 2014 E 2015 E 2016 E 2017 E 2018 E 2019 E 2020 E

System Sales 507,743 500,319 522,373 504,561 386,292 142,385 528,677 581,544 645,514 722,976 816,963 890,490 951,043 998,595 1,038,539 1,069,695 1,101,78

% of Revenues 36.85% 32.92% 31.17% 30.18% 28.61% 28.42% 28.56% 27.27% 26.28% 25.47% 24.71% 23.42% 22.04% 21.12% 20.58% 20.27% 20.09%

% Growth -1.46% 4.41% -3.41% 4.78% 10.00% 11.00% 12.00% 13.00% 9.00% 6.80% 5.00% 4.00% 3.00% 3.00%

Support and Maintenance 340,416 397,713 472,579 493,193 385,304 148,976 534,280 627,779 739,524 872,638 1,038,439 1,225,358 1,409,162 1,564,170 1,673,662 1,738,098 1,790,24

% of Revenues 24.70% 26.17% 28.20% 29.50% 28.54% 29.74% 28.86% 29.44% 30.11% 30.74% 31.41% 32.23% 32.66% 33.09% 33.16% 32.93% 32.64%

% Growth 16.83% 18.82% 4.36% 8.33% 17.50% 17.80% 18.00% 19.00% 18.00% 15.00% 11.00% 7.00% 3.85% 3.00%

Services 492,828 585,067 643,317 643,678 554,605 196,853 751,458 875,449 1,022,524 1,191,752 1,389,582 1,618,864 1,885,976 2,093,433 2,260,908 2,394,302 2,514,01

% of Revenues 35.76% 38.49% 38.38% 38.50% 41.08% 39.29% 40.60% 41.06% 41.63% 41.98% 42.03% 42.58% 43.71% 44.28% 44.80% 45.37% 45.84%

% Growth 18.72% 9.96% 0.06% 16.74% 16.50% 16.80% 16.55% 16.60% 16.50% 16.50% 11.00% 8.00% 5.90% 5.00%

Reimbursed travel 39,051 36,778 37,759 30,432 23,820 12,785 36,605 47,587 48,776 51,215 61,458 66,989 68,999 71,069 73,556 75,763 78,036

% of Revenues 2.83% 2.42% 2.25% 1.82% 1.76% 2.55% 1.98% 2.23% 1.99% 1.80% 1.86% 1.76% 1.60% 1.50% 1.46% 1.44% 1.42%

% Growth -5.82% 2.67% -19.40% 20.28% 30.00% 2.50% 5.00% 20.00% 9.00% 3.00% 3.00% 3.50% 3.00% 3.00%

Total Revenue 1378038 1,519,877 1,676,028 1,671,864 1,350,021 500,998.76 1,851,020 2,132,359 2,456,338 2,838,581 3,306,442 3,801,700 4,315,180 4,727,267 5,046,665 5,277,857 5,484,07% Growth 10.29% 10.27% -0.25% 10.72% 15.20% 15.19% 15.56% 16.48% 14.98% 13.51% 9.55% 6.76% 4.58% 3.91%


APPENDIX 5-REVENUE PROJECTIONS


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($ in millions, except per share data) 2007 2008 2009 2010 Q123A 2010 Q 4 E 2011 E 2012 E 2013 E 2014 E 2015 E 2016 E 2017 E 2018 E 2019 E 2020 E

Net Revenues 1,520 1,676 1,672 1,350 501 2,132 2,456 2,839 3,306 3,802 4,315 4,727 5,047 5,278 5,484

Current Assets

Cash and Cash Equivalents 182.91 270.49 241.72 240.21 298.53 368.45 340.63 396.77 494.22 613.19 671.74 717.13 749.98 779.29

% of Revenues 12.03% 16.14% 14.46% 17.79% 14.00% 15.00% 12.00% 12.00% 13.00% 14.21% 14.21% 14.21% 14.21% 14.21%A/R 391.06 468.93 461.40 423.04 591.73 681.63 787.71 917.54 1 ,054 .97 1 ,197 .46 1 ,311 .82 1 ,400 .45 1 ,464 .61 1 ,521 .83

% of Revenues 25.73% 27.98% 27.60% 31.34% 27.75% 27.75% 27.75% 27.75% 27.75% 27.75% 27.75% 27.75% 27.75% 27.75%Prepaid Expenses and Other Current Assets 61.88 69.55 106.79 89.99 89.56 103.17 119.22 138.87 159.67 181.24 198.55 211.96 221.67 230.33

% of Revenues 4.07% 4.15% 6.39% 6.67% 4.20% 4.20% 4.20% 4.20% 4.20% 4.20% 4.20% 4.20% 4.20% 4.20%

Deferred Tax Assets 10.37 1.40 8.05 7.90 12.79 14.74 14.19 16.53 19.01 21.58 23.64 25.23 26.39 27.42

% of Revenues 0.68% 0.08% 0.48% 0.59% 0.60% 0.60% 0.50% 0.50% 0.50% 0.50% 0.50% 0.50% 0.50% 0.50%Short-Term Investments and Inventory 172.34 48.50 328.36 368.21 240.74 277.32 320.48 264.52 380.17 388.37 425.45 454.20 475.01 493.57

% of Revenues 11.34% 2.89% 19.64% 27.27% 11.29% 11.29% 11.29% 8.00% 10.00% 9.00% 9.00% 9.00% 9.00% 9.00%

Total Current Assets 818.56 858.87 1,146.32 761.13 1 ,233 .36 1 ,445 .31 1 ,582 .22 1 ,734 .23 2 ,108 .04 2 ,401 .83 2 ,631 .20 2 ,808 .97 2 ,937 .66 3 ,052 .44

% of Revenues 53.86% 51.24% 68.57% 56.38% 57.84% 58.84% 55.74% 52.45% 55.45% 55.66% 55.66% 55.66% 55.66% 55.66%

Current Liabilities

A/P 79.812 93.667 36.893 41.075 115.15 132.64 153.28 178.55 205.29 233.02 255.27 272.52 285.00 296.14

% of Revenues 5.25% 5.59% 2.21% 3.04% 5.40% 5.40% 5.40% 5.40% 5.40% 5.40% 5.40% 5.40% 5.40% 5.40%Current installments of long-term debt 14.26 30.116 25.014 26.995 25.00 25.00 15.00 15.00 15.00 15.00 15.00 15.00 15.00 15.00

% of Revenues 0.94% 1.80% 1.50% 2.00% 1.17% 1.02% 0.53% 0.45% 0.39% 0.35% 0.32% 0.30% 0.28% 0.27%Accrued Payroll and Tax WithHoldings 65.011 67.266 80.093 67.938 92.97 107.10 123.76 144.16 165.75 188.14 206.11 220.03 230.11 239.11

% of Revenues 4.28% 4.01% 4.79% 4.35% 4.36% 4.36% 4.36% 4.36% 4.36% 4.36% 4.36% 4.36% 4.36% 4.36%

Other Accrued Expenses 30.238 42.62 79.008 40.435 92.76 106.85 123.48 143.83 165.37 187.71 205.64 219.53 229.59 238.56

% of Revenues 1.99% 2.54% 4.73% 3.00% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35%Deferred Revenue 98.802 107.554 137.095 128.149 151.82 174.89 214.03 249.31 258.52 280.49 307.27 328.03 343.06 356.47

% of Revenues 6.50% 6.42% 8.20% 9.49% 7.12% 7.12% 7.54% 7.54% 6.80% 6.50% 6.50% 6.50% 6.50% 6.50%

Total Current Liabilities 288.123 341.223 358.103 304.592 477.70 546.48 629.55 730.84 809.94 904.36 989.29 1,055.12 1,102.77 1,145.27

% of Revenues 18.96% 20.36% 21.42% 22.56% 22.40% 22.25% 22.18% 22.10% 21.30% 20.96% 20.93% 20.91% 20.89% 20.88%


APPENDIX 6WORKING-CAPITAL MODEL


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APPENDIX 6SOURCES

www.sec.gov www.healthcare.gov

www.finance.yahoo.com www.seekingalpha.com IBIS World Fact Set Cerner Corp 10-k Baxter International Inc. 10-k Quality Systems, Inc. 10-k Allscripts-Misys Healthcare Solutions, Inc. 10-k
http://www.sec.gov/http://www.sec.gov/http://www.healthcare.gov/http://www.healthcare.gov/http://www.finance.yahoo.com/http://www.finance.yahoo.com/http://www.seekingalpha.com/http://www.seekingalpha.com/http://www.seekingalpha.com/http://www.finance.yahoo.com/http://www.healthcare.gov/http://www.sec.gov/

cern - analyst report - uofa

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