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Investor DayNYSE MKT:HLTH • TSX:NHC
May 17, 2016
Forward-Looking Information
This presentation contains forward-looking information (within the meaning of applicable securities laws)relating to the business of Nobilis Health Corp. (the "Company") and the environment in which itoperates. Forward-looking information may include statements regarding the objectives, businessstrategies to achieve those objectives, expected financial results, economic or market conditions, andthe outlook of or involving the Company and its business. Such forward looking information orstatements are typically identified by words such as "believe", "anticipate", "expect", "intend", "plan","will", "may" and other similar expressions.
Forward-looking information, including any financial outlooks, is provided for the purpose of providinginformation about management's expectations and plans about the future and may not be appropriatefor other purposes. Forward-looking information herein is based on various assumptions andexpectations that the Company believes are reasonable in the circumstances. No assurance can begiven that these assumptions and expectations will prove to be correct and the forward-lookinginformation, including the financial outlooks included in this Presentation, should not be unduly reliedupon. Those assumptions and expectations are based on information currently available to theCompany, including the historic performance of the Company's business. Such assumptions includeanticipated financial performance, current business and economic trends, and business prospects andare subject to the risks and uncertainties which are discussed in the Company's regulatory filingsavailable on the Company's web site at www.NobilisHealth.com, www.sedar.com or at www.sec.gov.Any forward-looking statements that we make are based on assumptions as of today, and we undertakeno obligation to update them.
The Company’s management has approved the financial outlooks contained in this presentation.
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Investment Highlights
Full-service healthcare development and management company
Unique direct-to-patient marketing model and proprietary technology
6 brands covering a wide variety of procedures
4 surgical hospitals, 5 ASCs, 33 partnered facilities
Favorable procedure and payor mix
Strong revenue and cash-flow growth
Disciplined M&A approach that has resulted in accretive acquisitions
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Industry Background
Traditional Hospitalso Full-service hospital
o Inpatient and outpatient
o > 5,700 hospitals
o 60%+ not-for-profit
Specialty Surgical Hospitals (SSHs)o Typically specialize in
orthopedics, spine, ENTo Inpatient and outpatiento ~ 300 SSHs
Ambulatory Surgical Centers (ASCs)o Outpatient onlyo > 6,000 ASCso 70%+ owned by
independents4
Nobilis Footprint
Other operations:o Nobilis manages all
owned facilities
o 33 Partner Facilities
o 10 Markets
o 8 States
Facility Market EquityFirst Surgical Hospital
Houston, TX 51%
First Street Surgery Center
Houston, TX 51%
Southwest Freeway Surgical Center
Houston, TX 100%
Kirby Surgical Center
Houston, TX 25%
Hermann Drive Surgical Hospital
Houston, TX 55%
Plano Surgical Hospital
Dallas, TX 100%
Dallas Metro (HOPD) Dallas, TX *40%
Northstar Healthcare Surgery Center
Scottsdale, AZ 100%
Scottsdale Liberty Hospital
Scottsdale, AZ 60%
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3
205
2
1
1
11
1
1
1 13
Relationship Facilities (DTC, IOM)
JV Facilities Owned Facilities33 1 8
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*Through the JV structure at Dallas Metro, Nobilis owns 40% of the management company and receives additional income from Nobilis sourced cases through an MSA
Optimized Procedure + Payor Mix
Procedure Mix:o New technologies allow more complex
surgical cases in outpatient settingo Better case mix results in higher
average reimbursement rates than ASC industry average
o Optimized case mix leads to highly specialized surgical staff and increased center efficiencies
Payor Mix:o Payor mix consists predominantly of
commercial payorso Strategically adding in-network
contracts to lower out-of-pocket costs for patients and total costs for payors and drives referrals from managed care companies
Case Mix FY 2015
Gen4%
Pain 29%
Bariatric 22%Spine 13%
Plastic 9%
Orthopedic8%
Other 10%
Gyn 5%
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Revenue Model
o Profit margin driven by relative ownership levels (Nobilis ownership ranges 25% –100%, Average 65%)
o Marketing (DTC & Sales) cases typically have higher profit margin
1 Management fees range from 2%–8%
Anesthesia+ Surgeon
Nobilis Facility
PayorCommercial,
Government, Self-Pay
Facility Fee
Professional Fees
% of Profit + Management Fee1
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Ancillary Services
Ancillary Verticalso Intraoperative Neuromonitoring (IOM)o Anesthesiao First Assist
Resultso Continuity of careo Increased patient + physician satisfactiono Improved patient outcomes
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Operations Management
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Key Proficiencies
o Patient care quality managemento Revenue cycle optimizationo Medical staff office and credentialingo Clinical & technical efficiencies o Accreditations and certificationso Supply chain managemento Personnel & HR efficiencies
Expected Results
o Scalable operational platformo Continuity of careo Increased patient, employee & physician satisfactiono Improved patient outcomeso Accretive earnings
Concertis, LLC
A Technology Platform that Transforms Healthcare Delivery
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Concertis
A Technology Platform that Transforms Healthcare Deliveryo Concertis connects providers with payors
to implement new reimbursement methodologies focused on patient outcomes
o This is effectively an in-network model at higher than in network rates andaccelerated payment timeline
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Payor
Ancillaries Surgeon Facility
Concertis Products:o Clinical Integration Network
Formation and Administrationo Population Health Managemento Care Coordination
“Bundledpaymentsarethefutureofreimbursementinmedicine. AtNobiliswearewell-positioned totakeadvantageofthis."
-Dr.NeilBadlani
Aligning Payors, Providers, and Facilities
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Concertis Aligns Payors, Providers, and Facilities
o Opportunity to enhance relationships with commercial payors and develop relationships with self-insured employers
o Greater savings on bundles than large, acute-care facilitieso Physicians encouraged to cooperate for enhanced revenue
incentiveso Represents a significant marketing opportunity
CIN & Care Navigation
o Clinical Integration is coordination of care across a continuum of services including physicians, hospitals, and ancillary services.
o Achieving Clinical Integration§ Negotiate with payors§ Bring physicians into our narrow network§ Provide warranty for care§ Distribute payment
o Our care navigators are trained health care professionals who serve as patient concierges, guiding patients though the entire episode of care from diagnosis to post-surgical compliance with discharge orders.
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Technology Platform
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Patient Portal
Patients
Health Information Exchange
DataTranslator
Electronic Medical Records
EnterpriseData
Warehouse
PatientAccounting
SupplyChain
ActivityBased
AccountingClaims
AdjudicationClinical
Outcomes
ClinicalCoordination
RiskManagement
StatisticalModeling
PatientData
Modeler
StandardClinical
Modeling
Physicians
Facilities
Patients
Firewall
Firewall
Marketing
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Direct-to-Consumer MarketingMarket Nobilis branded surgical procedures direct to consumers
Patient Acquisition Strategy
Physician SalesBuild and execute marketing plans for physicians
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Patient Coordinators will interact with a
patient an average of 17 times
Patient Coordinators
Nobilis Patient Journey Platformo Ensures that each step of the patient journey is
reviewed and managed by a dedicated Patient Coordinator from time of initial contact through post surgical recovery
End-to-End Concierge Modelo Leverages Nobilis’ proprietary scheduling
applications
o Designed for standardized data entry for corporate reporting consolidation, connection to EMRs, faster onboarding of new facilities, post-operative follow-up program with outcomes and patient satisfaction data
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Lead GenerationDirect-to-Patient marketing via an omni-channel marketing strategy
Concierge ServiceInside sales team + IT platform to maximize patient experience
Patient TrackingPatient follow-up, experience surveys, referrals
Direct-to-Consumer Marketing
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Conversion to Surgical PatientPatient education, medical review, insurance verification, surgical scheduling
Our Brands:
Marketing Technology
OWNED + EARNED MEDIABlog Posts, Web Pages, Press Releases
SEARCH + SOCIAL
Generates Traffic, Educates Prospects Builds Brands,Produces Though Leadership, Reduces Churn
micro-conversations: Likes, Shares, RTs, Links SERP Clicks
CTA’S + LANDING PAGESmicro-conversations: form completion
TOFU
MOFU
BOFU
Content: Generates Prospects
Content: Generates Marketing Qualified Leads (SQLs)
Content: Converts Sales Qualified Leads (SQLs)
SALES INTERACTIONGenerates Customers
RETENTIONReduces Churn
Free whitepapers, guides, eBooks,
videos, checklists
Webinars, case studies, free samples, catalogs,
FAQ sheets, Spec sheets, brochures
Free trials, demos, assessments, consultations,
estimates, coupons
Offers
Lead
Nur
turin
g, S
corin
g,
Segm
enta
tion,
Inte
llige
nce
Thought leadership content, deliverables fulfilled, expectations
met or exceeded, client-facing advanced content
Lead GenerationData-based Prospect Targeting
SEOContent Distribution
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ConversionLead FormPhone Call
SalesProprietary CRM
Human Touch
Intelligence + ReportingProprietary Technology
More Lead GenerationEnables
Physician Marketing
o In-house marketing team works one-on-one with physicians to develop and distribute customized marketing plans
o Lower partner acquisition costs / increased partner profitability
o Enhanced recruitment and retention
Nobilis ROIAverage
5:1
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Physician Marketing
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Physician Marketing
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Physician Marketing
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Disciplined M&A Strategy
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o Currently pursuing portfolio companies in strategic geographical regions
o All portfolio opportunities fulfill key criteria that expand overall footprint while maximizing accretive value of combined entity:
§ Multi-facility Portfolio§ Ability to Overlay Marketing§ Strategic Geographic Market§ Positive EBITDA
o Nobilis will continue to seek and pursue other non-portfolio opportunities, including:§ Facilities available at fair market value that Nobilis can quickly turn around and
sustain profitable operations§ Acquisitions of unique differentiators that add value and capabilities with the
needs of a strong in-network system§ Ancillary businesses with system-wide revenue producing potential
Investor Relations
Nobilis Health Corp. builds institutional depth through strategic long-term value creation.
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Key Analyst Coverageo Stephens: Dana Hamblyo Craig Hallum: Charles Haffo Mackie: Russell Stanley o PI Financial: Sheila Broughton o Sidoti & Co: Keith Hinton
Investor Activitieso Keynoteso Investor Days o Panel Speakerso Investor Road Showso Active PR
Building IR team to keep pace with growth
o Development of in-house team and procedureso Engaged Westwicke Partners, a premier, U.S.
based firm, to supplement our Canadian team
Enhancing IR Communications
o Working with Finance, Legal, Ops, to keep investors informed
o Management of Sell-side analyst expectations, alignment with projections
o Reduction of perceived risko Proving up-to-date industry intelligenceo Better communication of filing dates, conference
callso Improving access to key executives
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Revenue Cycle Management
$3,050
$4,677
$5,664
$9,654
$12,269
$0
$3,250
$6,500
$9,750
$13,000
2011 2012 2013 2014 2015
NetRevenueperCase
Patient/CaseManagement
Billing&Collection
ClaimRecovery
QualityAssurance&
Audit
NOBILIS
CENTRALBUSINESSOFFICE
AdmissionManagement
BenefitandCase
Coordination
HealthInformationManagement
BillingandPricing
Management
Collections&Analysis
Denial/Appeal
Management
PatientServiceCenter
Quality
Audit
CBO structure allows Nobilis to scale with rapid expansion and provides end-to-end functions to enhance collection and cash flow.
Financial Performance
(US$ Thousands)
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$-
$50,000
$100,000
$150,000
$200,000
$250,000
$300,000
$350,000
2012 2013 2014 2015 2016E
Adj.
EBIT
DA
Reve
nue
Total Revenue Adj. EBITDA
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Financial Update
o Q1 Update§ Revenue, Adjusted EBITDA and Cases
o One time expenses in Q1§ Marketing§ Legal, accounting, tax and consulting (IT)
o Why not filed on May 10th
§ Two items§ Debt covenants – future quarters§ Deconsolidation – selling business or assets
o The plan for timely filings in the future§ Hired CAO; hiring - Controller, AVP of Finance§ Internal controls§ Quarterly review plan
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o Strong platform for scalable growth into national markets
o Compelling value proposition for physicians, patients and payors
o Focus on minimally invasive procedures aligned with market trends
o Lean balance sheet; limited capex and working capital requirements
Growth Driverso Acquisitions
o Organic Growth
o Service Line & Specialties
o Operational Leverage
Poised for Continued Growth
2015 2016E Change
Revenue $229M $320M +40%
Adjusted EBITDA $42M $65M +54%
*Assumes 20% organic revenue growth and 21% organic Adj. EBITDA growth on facilities/companies acquired after January 1, 2015 (including acquisitions in 2016)
Financial Guidance*
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