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Page 1: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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April 2013

Page 2: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Andrés Varas

CEO Cruz Blanca Salud

Team

Marcelo Bermúdez

CFO Cruz Blanca Salud

Page 3: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Our message

Innovative solutions for our clients

Expansion of current facilities and M&A

Diversification in the generation of

cash flow

•New outpatient centers + Integramédica

+ Sonorad

+ Integramédica Perú

•Hospital expansion # medical consultations

# beds

•Hospital in Santiago

•Three business areas Provider

Insurance

International

•Strengthening providers

business (increase its

share in revenues)

Services with cero cost

for our affiliates

•Health plans with

preferred provider in our

own network

(1) 2006 – 2011 compound annual growth in health expenditure

Source: Fonasa, Superintendencia de Salud and Cruz Blanca Salud

We are positioned to gain market share in an industry

that growths 10%(1) per year

•Prospecting opportunities

Page 4: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Our company

One of Chile´s leading healthcare groups (~ US$1,0 billion sales in 2012)

THREE BUSINESS AREAS

Insurance / Isapre Cruz Blanca / Life Insurance Co. /

Provider

Hospitals / Clínica Reñaca / Clínica Antofagasta /

/ Clínica San José / Clinical Service /

Outpatient / Integramédica / Sonorad /

/ Clínica Santa Lucía / Dr. Pilar Gazmuri /

International / Resomasa / Integramédica Perú /

+ 6.560 employees

+ 2.000 doctors

SUCCESFUL BUSINESS MODEL

Commercial synergies

Health plans with preferred provider in our

own network

• +40% of the new plans sold

• 47% of our Isapre’s expenditure is

captured by our hospitals in their regions

of influence

Services with cero cost for our affiliates

Cost synergies

• Controlled claims rate

• Supply contracts / Centralized back office

• Lower financing cost

Attractive value proposition

for our customers

Page 5: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

z

Successful business model

Insurance #2 Isapre in revenues

• +590.000 avg beneficiaries • +314.000 avg policy holders • 78 branch offices throughout the country

Life Insurance Co.

International Hospitals

Outpatient

Initiating Latam expansion

• Perú (outpatient)

#1 provider of private outpatiente service • 24 centers throughout Chile • +1.254 avg consultation rooms • ~5.350.000 visits

Leading hospitals in their regions

• 3 hospitals • 366 beds • ~23.800 hospitalizations • Santiago hospital project

5

Page 6: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

To double our EBITDA in 5 years through organic growth (2010 – 2015)

Expanding offering of health plans to market segments enrolled in the public insurer

Growing in the provider business

Main driver: Outpatient business

Increasing profitability of current facilities and expanding capacity

Low cost closed plans

New outpatient centers:

• 16 Integramédica centers • 6 Sonorad centers • 6 Integramédica Perú centers

Santiago hospital project:

• 128 beds • 22 consultation rooms

• 298 beds (first stage)

Strategic guideline

6

Increasing synergies among our businesses

Hospitals master plans

Provider Insurance International Outpatient

Hospitals

Page 7: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Ownership structure (december 2012)

Main shareholders with a strategic long term vision

Said Group

40,64%

Other

shareholders

21,42%

Securities funds

19,76%

Stockbrokerage

houses

8,25%

Private pension

funds (AFPs)

4,46%

Mutual funds

4,53%

Insurance

companies

0,96%

Page 8: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

8

FINANCIAL

RESULTS

Page 9: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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560,3

734,9 831,2 942,7

2009 2010 2011 2012

16,0

62,3

80,3

77,6 3,5

2009 2010 2011 2012

2,1

19,7

34,4

36,9 6,1

2009 2010 2011 2012

Revenues

Net profit

EBITDA

Consolidated results (US$ millions)

CAGR (10-12) CAGR (10- 12)

CAGR (10-12)

2011 revenues include business interruption insurance payment to

Integramédica (US$ 3,5 million)

2011 net profit includes insurance payment to Integramédica due to property

damage and business interruption (US$ 6 million)

2011 EBITDA includes business interruption insurance payment to

Integramédica (US$ 3,5 million)

Fx rate: Ch$500/US$

Sustained revenue growth;

+10% CAGR in the last three

years

Page 10: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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2010 2011 2012

Current assets 129 264 222

Non-current assets 534 594 704

Total Assets 664 858 926

Current liabilities 171 234 259

Non-current liabilities 308 264 286

Equity (Controlling shareholders) 157 331 352

Equity (Minority interest) 27 29 28

Total Liabilities + Shareholder's equity 664 858 926

Net financial debt (NFD) 232 69 144

NFD / EBITDA 3,7 x 0,8 x 1,8 x

NFD / Equity 1,3 x 0,2 x 0,4 x

Summary balance sheet Revenues breakdown 2012

EBITDA breakdown 2012

US$943 million

US$78 million

Consolidated results (US$ millions)

Fx rate: Ch$500/US$

Balanced generation of cash flow

943

(49)

4

101

201

686

CBS

Others(1)

International

Hospitals

Outpatient

Insurance

78

(1)

(0)

16

35

28

CBS

Others(1)

International

Hospitals

Outpatient

Insurance

(1) Consolidation adjustments and other minor subsidiaries (Holding Cruz Blanca Salud S.A. and Servicios de Gestión Ltda.)

Page 11: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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#1 private outpatient service provider

Multiformat – multibrand strategy

• Integramédica = 16 outpatient centers

• Sonorad = 6 diagnostic centers

• Others (2 centers)

Outpatient services at affordable prices

• Medical consultation / Imaging / Dental /

Ancilliary services/ Others

Chile’s largest private clinical laboratory

• 27 specimen collection points

• Approximately ~4.000.000 annual lab tests

+1.800 doctors

Outpatient business: Integramédica

10%

90%

Integramédica

Others

% market share by revenues

#1 in revenues in the outpatient market

Source: Cruz Blanca Salud

Page 12: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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133.853

159.209

200.611

3.502

2010 2011 2012

24.182

29.451

34.668 3.502

2010 2011 2012

Revenues of 2012 reached US$201 million

(+26%; excluding non recurrent effects) o Growth in current outpatient centers

• Higher activity generated by the beneficiaries of

Isapre Cruz Blanca (18% of sales)

• Expansion and remodeling of outpatient centers

• Commercial agreements and initiatives with other

Isapres and Fonasa

o New businesses (Clínica Santa Lucía, Biolab, Pilar

Gazmuri and Sonorad)

o New outpatient centers (Puente Alto, Maipú y

Talca)

EBITDA of 2012 amounted to US$35 million

(+18%; excluding non recurrent effects) o Sales mix with greater ratio of diagnostic exams

and dental services which contribute with higher

margins

o Savings as result of price negotiations with

suppliers of reactives used in laboratories

o Newly acquired businesses (Clínica Santa Lucía

and Sonorad) effect and the start up expenses

of Puente Alto, Maipú and Talca centers

Integramédica, #1 private outpatient provider

2011 revenue includes business interruption insurance payment to

Integramédica (US$ 3,5 million)

2011 EBITDA includes business interruption insurance payment to

Integramédica (US$ 3,5 million)

Revenues

EBITDA and EBITDA margin

US$ thousands

US$ thousands / %

CAGR (10-12)

CAGR (10-12)

Fx rate: Ch$500/US$

Margen EBITDA

18,1% 20,3% 17,3%

Page 13: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Presence in three regions of the country

Leading hospitals in their geographic areas

(#1 in market share)

High complexity

37.000 sqm built

366 beds / 80 critical

81 medical consultations

Clinical Service one of the leading home

health care providers

Hospital business: Clínicas Reñaca, Antofagasta

and San José de Arica, and Clinical Service (home care)

Page 14: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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16.753

17.991

15.509

2010 2011 2012

85.618

96.552

100.709

2010 2011 2012

Revenues

EBITDA and EBITDA margin

US$ thousands

US$ thousands/ %

CAGR (10-12)

CAGR (10-12)

Revenues in 2012 reached US$101 million (+4%) o Greater activity in emergency rooms

o Higher lab test exams

o Competitive environment faced by Clínica

Reñaca

2012 EBITDA amounted to US$16 million (-14%) o Decrease of Clínica Reñaca´s occupancy rate (2pp

reduction)

o Higher clinical personnel expenses (collective

negotiations in Clínica Reñaca, Clínica San José

and paramedics in Clínica Antofagasta)

o The effect of a one-time extraordinary increase in

bad debt provisions due to an exhaustive

examination of Clínica Antofagasta´s account

receivables

Fx rate: Ch$500/US$

EBITDA margin

Leading hospitals in their geographic areas

19,6% 18,6%

15,4%

Page 15: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Insurance business: Isapre Cruz Blanca

Operating since the creation of the private

health system in Chile (1981)

Brand strengh (#2 in market share)

78 branch offices and three mobile offices

(nationwide coverage)

+314 th avg policy holders

+615 th avg beneficiaries

Regulatory framework undergoing revision

o Changes likely to provide increased certainty on

business regulation

Life Insurance Co. under development

% market share by revenues

#2 in revenues in the Isapre market

Source: Asociación de Isapres, December 2012 figures

27,8

21,6 20,1 17,3

13,1

Banmédica Cruz Blanca Colmena Consalud Masvida

Page 16: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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84,0% 84,2% 86,1%

2010 2011 2012

541.922 609.544 686.491

2010 2011 2012

21.315

32.143 28.329

2010 2011 2012

Isapre Cruz Blanca, #2 in revenues

Fx rate: Ch$500/US$

Revenues in 2012 reached US$686 million

(+13%) o Policy holders growth

• Higher health plans sales as a result of the

favorable economic cycle of the country

• Successful commercialization of MaxSalud plans

• Lower disenrollment rate

• Higher productivity of sales force

o A real increase in the price of health plans of

6,9% performed in July 2011 and 2,7% in July

2012, which is gradually captured according to

the turnover rate of the affiliates base

o Successful administration of collection

2012 EBITDA amounted US$28 million (-12%) o Higher claims rate (84,2% v/s 86,1%)

• Temporary disabilities claims increase

• Increase in hospitalizations expenses and elective

surgeries

o Offset by lower SG&A expenses as proportion of

sales (from 11,3% in 2011 to 10,6% in 2012)

Revenues

EBITDA and EBITDA margin

US$ thousands

US$ thousands / %

CAGR (10-12)

Claims rate %

EBITDA margin

CAGR (10-12)

3,9% 5,3%

4,1%

Page 17: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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INVESTMEN PLAN

2013 -2015

Page 18: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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34 32 24

21 18

16

5 5

4

1

11 14

10

34

60

56

6

Capex (2013- 2015): US$ 350 million

Life Insurance Co. US$ 6 million

Santiago hospital US$ 150 million

Perú US$ 35 million

Isapre US$ 14 million

Hospitals (existing) US$ 55 million

Integramédica US$ 90 million

Inorganic growth and development of new businesses

Analysis of growth through M&A (recently P. Gazmuri, Biolab, Resomasa, Clínica Santa

Lucía, Clinical Service and Sonorad)

Investment plan : 2013 - 2015

2012 2013 2014 2015

111

129

110

Fx rate: Ch$500/US$

Page 19: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Clinical

Service

Clínica Santa

Lucía

Sonorad

• Main outpatient center of the San Bernardo area of

Santiago

• Acquisition of 100% of equity = US$ 6,2 million

• 4.000 sqm / 75 consultation, exam and procedure rooms

• Home health care provider, #2 in market share

• Acquisition of 100% of equity = US$ 2,8 million

• Bed days 2011 = 11.480

Acquisitions 2011 - 2012

2011 2012

Biolab Centro de

Diagnóstico Dra.

Pilar Gazmuri

Clínica Santa Lucía Clinical Service Resomasa

(Peru)

Sonorad

• Outpatient network of diagnostic exams

• Acquisition of 100% of equity = US$ 13,8 million

• 6 outpatient centers / 670.000 lab exams / 180.000

imaging exams

Fx rate: Ch$500/US$

2011 2012

Revenues (US$ mm) 6,9 9,4

EBITDA (US$ mm)

0,7 1,4

2011 2012

Revenues (US$ mm) 3,4 3,0

EBITDA (US$ mm)

0,6 0,3

2011 2012

Revenues (US$ mm) 14,6 15,5

EBITDA (US$ mm)

1,2 2,1

Page 20: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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2011 2012 2013

Puente Alto

Talca

Maipú

Santiago

S. Bernardo

Integramédica

24 30 # centers

La Florida

S. Bernardo

15

Opened Location contract signed Acquisition

Reference:

Investment plan: Integramédica

2014

36

Integ. 24

2010

13 centers

13

Concepción

P. Gazmuri

Sonorad 6 centers Sonorad 7

Sonorad 8

Sonorad 11

Integ. 25

Others

Integ. 28

Integ. 22

2015

42

Integ. 26

Integ. 27 Integ. 23

Integ. 29

Sonorad 12

Sonorad 9

Sonorad 10

Page 21: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Investment plan : Integramédica

Recently opened:

• US$4,5 million investment

• Opened in December 2012

• 3.900 sqm

• Consultation rooms:

• 39 medical consultations

• 15 dental

• 5 kinesiology

• 10 sample collection points

• MRI

Fx rate: Ch$500/US$

• US$2,2 million investment

• Opened in December 2012

• 2.318 sqm

• Consultation rooms:

• 32 medical consultations

• 8 dental

• 4 kinesiology

• 8 sample collection points

Maipú

center

Talca

center

Page 22: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

22 Investment plan: Isapre Cruz Blanca

Max Salud

Life Insurance company

Fx rate: Ch$500/US$

• Group of closed plans initially sold only in Santiago

• Patients are served by a general practitioner (GP) and

specialists at Integramédica´s outpatient centers and a

defined hospital network

• The goal is to offer an integrated product; low cost and

high quality

• Target segment is the high-end of the public system

(FONASA)

• 8.639 policy holders at the end of 2012

• Flexible business model for possible outcomes from

Isapre´s regulation changes

• Seeks to participate in new health market segments,

which have had a strong development through the last

years (US$411 million market)

• Diversification in the generation of revenues

• Group synergies

Additional products

Health insurance

Mandatory personal accident

insurance

Complementary companies

insurance

Page 23: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Investment plan: Clínica Reñaca

Fx rate: Ch$500/US$

(40% of advance) Master plan ~ US$21 million

Remodeling and expansion of the

Hospital

Operating room remodeling

Increase of parking space

Additional 10.870 sqm

28 new beds by 4Q’14 (with the

capability of an additional 54 beds)

Page 24: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Investment plan: Clínica Antofagasta and San José

Fx rate: Ch$500/US$

Master plan Clínica Antofagasta

• Maternity hospital - Pediatric

• Starting in 2013

• US$15 million investment

• 5.670 sqm

• 70 additional beds at the beginning of 2015

Master plan Clínica San José

• Outpatient center

• Starting in 2013

• US$3 millones investment

• 1.285 sqm

• 22 new consultation rooms for 2015

Page 25: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Investment plan: new projects

Perú Recently initiated activities in Perú:

• Creation of the subsidiary Cruz Blanca Salud Perú S.A.C.

• Acquisition of Resomasa (imaging)

• Analysis of opportunities in the outpatient, hospital and insurance

businesses in Perú

• Integramédica Perú development plan: 2 centers per year for the

next 3 years; reaching a total of 6 new centers

• Contract signed for the first location in Megaplaza

Independencia, which allows to open the first outpatient center

for the end of 2013. The center will have 3.000 sqm surface

with an investment of US$4,9 million

Fx rate: Ch$500/US$

Page 26: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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Perú

New Hospital

in Santiago

Investment plan: new projects

• Property acquired (42.000 sqm)

• Total estimated investment of US$ 170 million (US$20

million already invested in 2012)

• Initial capacity of 298 beds (up to 432 beds)

• New subsidiary created: Inversiones Clínicas CBS S.A.

Fx rate: Ch$500/US$

Page 27: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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• Decision on which health insurance to

choose (public or private) is made by policy

holders

• Policy holders contribute a mandatory 7%

of their salary, with a cap, and can contribute

an additional voluntary amount

• Employers only collect employee

contributions and pay them to insurers

• Members decide according to their health

plan where to get care

• Insurers pay care providers up to the plan

coverage and members pay the difference

(“copayment”)

Fonasa

(public health

insurance)

Policy holders and

their dependants

(together

“beneficiaries”)

Public provider

(outpatient or hospital)

Private provider

(doctors, outpatient or

hospital)

Institutional

mode

Closed or

preferred

provider

plans

Free election

mode

Lower income population

Q: 82%

$: 65%

Higher income

population

Q: 18%

$: 35%

(1) Source: Cruz Blanca Salud, from Superintendencia de Salud (National Health Authority) figures and Fonasa (National Health

Fund). Does not include Armed Forces, worker’s compensation, medical leave expenditures and voluntary health insurance

(2) Fx Rate: Ch$500/US$

Insurance

Market(1)

US$ 9.583

million

Can be the same

Closed or preferred

provider (outpatient or

hospital)

Cruz Blanca Salud

business areas

Isapre

(mandatory

private health

insurance)

Appendix: Industry dynamics

Page 28: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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The information contained herein shall not be deemed an indication of the state of the company’s

business, financial condition, results of operations and/or prospects.

The company assumes no responsibility for, or makes any representation or warranty, express or

implied, with respect to, the accuracy, adequacy or completeness of the information contained

herein.

The Company expressly disclaims any liability based on such information, errors therein or omissions

therefrom.

The information contained herein has been prepared to assist interested parties in making their own

evaluation of the company and does not purport to be all-inclusive or to contain all the information

that a potential counterparty may desire. In all cases, interested parties should conduct their own

independent investigation and analysis of the company. Interested parties can only rely on the result

of their own investigation and the representations and warranties made in any definitive agreement

that may be executed.

Prospective investors who require additional information or have questions regarding the company

should direct correspondence to or contact: Joaquín Solís de Ovando ([email protected]).

Disclaimer

Page 29: Presentación CB - Bupa.cl · 2015-02-05 · Resomasa Clínica Santa Lucía Clinical Service (Peru) Sonorad Outpatient network of diagnostic exams • Acquisition of 100% of equity

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April 2013