presentation for may 2011-final - listed...
TRANSCRIPT
Investor Presentation
May 2011
Bumrungrad Hospital Public Company Limited
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DisclaimerDisclaimer
• The information contained in this presentation is for information purposes only and does not constitute an offer or invitation to sell or the solicitation of an offer or invitation to purchase or subscribe for shares in Bumrungrad Hospital Public Company Limited (the "Company") in any jurisdiction nor should it or any part of it form the basis of, or be relied upon in connection with, any contract or commitment whatsoever.
• This presentation is being communicated only to persons who have professional experience in matters relating to investments and/or to persons to whom it is lawful to communicate it under the laws of applicable jurisdictions. Other persons should not rely or act upon this presentation or any of its contents.
• Certain information and statements made in this presentation contain the Company's forward-looking statements. All forward-looking statements are the Company's current expectation of future events and are subject to a number of factors that could cause actual results to differ materially from those described in the forward-looking statements. Prospective investors should take care with respect to such statements and should not place undue reliance on any such forward-looking statements.
• This presentation has been prepared by the Company solely for the use at this presentation. The information in this presentation has not been independently verified. No representation, warranty, express or implied, is made as to, and no reliance should be placed on, the fairness, accuracy, completeness or correctness of the information and opinions in this presentation. None of the Company, any of its affiliates or any of their respective agents, advisors or representatives, shall have any liability (in negligence or otherwise) for any loss or damage howsoever arising from any use of this presentation or its contents or otherwise arising in connection with this presentation. The information presented or contained in this presentation is current as of the date hereof and is subject to change without notice and its accuracy is not guaranteed. None of the Company, any of its affiliates or any of their respective agents, advisors or representatives, makes any undertaking to update any such information subsequent to the date hereof.
• This presentation should not be construed as legal, tax, investment or other advice. No part of this presentation shall be relied upon directly or indirectly for any investment decision-making or for any other purposes. Prospective investors should undertake their own assessment with regard to any investment and should obtain independent advice on any such investment’s suitability, inherent risks and merits and any tax, legal and accounting implications which it may have for them.
• Certain data in this presentation were obtained from various external data sources, and none of the Company, any of its affiliates or any of their respective agents, advisors or representatives have verified such data with independent sources. Accordingly, the Company makes no representation as to the accuracy or completeness of those data, and such data involve risks and uncertainties and are subject to change based on various factors.
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AgendaAgenda
• Overview
• Bumrungrad International Hospital, Bangkok
• Bumrungrad International Limited
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Fact SheetFact Sheet
Shareholding Structure
Others, 44.82%
UOB Kay Hian (HK) - Client Account ,
8.28%
Bangkok Dusit Medical Services
Pcl., 11.11%
Thai NVDR, 11.63%
Bangkok Bank Pcl., 1.08%
Sinsuptawee AM, 8.66%
Bangkok Insurance Pcl. , 14.42%
As of March 2011
• Established in 1980; listed on SET in 1989• Major operations divided into Bangkok facility and international business
Bangkok FacilityFacilities
One of the largest and most sophisticated private hospitals in South-East Asia
538 licensed inpatient beds and over 4,000 outpatient capacity per dayThailand’s leading tertiary medical center
Accreditation1st hospital in Asia to receive US JCI Accreditation1st private hospital in Thailand with Thai Hospital Accreditation
PatientsOver one million patients treated annually International following with over 400,000 international patients from
190 countriesServices
34 specialist centers
International PresenceAsian Hospital Inc. in the Philippines with 217-bed capacityMafraq Hospital, a public hospital in Abu Dhabi with 463 beds (management
contract)
With a 30-year track record, BH is now the leading healthcare service provider in South-East Asian region
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Private Hospitals
Group StructureGroup StructureCore business of BH is the renowned Bumrungrad International Hospital, Bangkok
Comprehensive wellness center specializing in preventive care
Vitallife Corporation Ltd.(“Vitallife”)
100.0%
Note: As of March 2011
31.5%
Asian Hospital Inc.(“AHI”)
56.5%
* Strategic partners of Bumrungrad International Limited are:- Istithmar 19.5%- Temasek 19.5%- Asia Financial Holding 19.5%- Bangkok Bank 10.0%
Mafraq Hospital
ManagementContract
International business
BumrungradInternational Ltd.*
100.0%
Asia Global Research Co., Ltd.(“AGR”)
Clinical research
Bumrungrad Hospital Public Company Limited
(“BH”)
Bangkok Chain Hospital PCL doing business as
Kasemrad Hospital Group
Operates Bumrungrad International Hospital, Bangkok
24.99%
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Management TeamManagement TeamBH’s management team comprises individuals with extensive experience in healthcare management
K. Linda LisahapanyaManaging Director
Mr. Dennis BrownCEO
Bumrungrad International Ltd.
Mr. Theo SeilerCEO
Asian Hospital Inc.Philippines
Mr. Mack BannerCEO
Bumrungrad International, Bangkok
Mrs. Lee Chan YowCFO
Bumrungrad International, Bangkok
Ms. Karen CarterCOO
Bumrungrad International, Bangkok
Mr. John NickensCEO
Mafraq Hospital Abu Dhabi, U.A.E.
Mr. Anthony TanCEO
Vitallife Corporation Ltd.
Dr. Suthipong TreeratanaCEO
Asia Global Research Co., Ltd.
Dr. Sinn AnurasGroup Medical Director
Mr. Dennis BrownCorporate CEO
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BumrungradBumrungrad International Hospital, BangkokInternational Hospital, Bangkok
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BHBH’’ss Core AttributesCore AttributesBangkok Flagship Facility
Medical Tourism
Quality
Financial Strength
Operational Competitiveness
Selective Growth
• 1st hospital in Asia to receive US JCI Accreditation (since 2002)
• JCI ‘Disease-Specific’ certifications: heart and stroke programs (2006), diabetes and kidney programs (2010)
• 1st private hospital in Thailand with Thai Hospital Accreditation (since 1999)
• 1st private hospital to receive Thailand Quality Class standard (2008) - based on US Baldrige Award
• Efficient workflow with comprehensive hospital management system
• 1st hospital in Asia to implement: robotic pharmacy dispensing
system automated laboratory system
• Recognized as leading desired employer and innovative provider
• More experience treating international patients with over 400,000 international patients from 200 countries
• Diverse international patient base, with 40% international volume
• Established specialized international services to accommodate international patients
• Proven long-term revenue & profit growth
• Stable margins and strong cash flow
• Strong financial metrics (as at March 2011);
Net debt to EBITDA 1.20x
Net debt to equity 0.60x
ROA 14.8%
ROE 27.1%
• Opportunities for growth:
Operationalize recently expanded capacity
International investments -Bumrungrad International Limited
Complementary businesses, wellness & anti-aging through Vitallife & VitechPro
• Over past two years, completed renovation of inpatient facilities and increased capacity with new outpatient facilities
• Emphasis on physician recruitment & program development
• Ongoing marketing initiatives directed towards Thai and International patients
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Certifications and AwardsCertifications and AwardsC
ertif
icat
ions
and
Aw
ards
Thailand Tourism Award: “Award of Outstanding Performance in Medically-Oriented Establishment”by The Tourism Authority of Thailand
Best Practice Workplace Award on Labor Relations and Labor Welfare Award 2010by the Ministry of Labor
Thailand’s Top 10 Most Innovative Companies 2010 By Chulalongkorn University’s school of business
Prime Minister’s Export Award 2010 for Best Service Provider (Hospital Service)
JCI ‘Disease-Specific’ Certifications: Diabetes Mellitus and Chronic Kidney Disease
Wall Street Journal Award Recognition: top 10 most admired companies overall, quality and corporate reputation
Best Practice Workplace Award on Labor Relations and Labor Welfare Award 2009 by the Ministry of Labor
“Growth Excellence Awards” by Frost & Sullivan “Growth Excellence Awards” by Frost & Sullivan
2009 “Thailand’s Top 10 Most Innovative Companies” award By Chulalongkorn University’s school of business
1st private hospital to receive Thailand Quality Class standard - based on US Malcolm Baldrige Award
1st hospital to win Award of Excellence, healthcare tourism category, 2008 Thailand Tourism Award
Wall Street Journal Award Recognition Rank No.1 – Most Admired Thai Companies Award of Excellence, Outstanding Achievement and Special Recognition in Applied Medical Informatics 2008
Best Website for International Medical Travel awarded at 2008 Consumer Health World Awards, USA
Thailand Most Innovative Company By Chulalongkorn University’s school of business
Thailand’s “Best Small Cap Company” 2008 awarded by Hong Kong-based Asiamoney magazine
Most Desirable Companies to Work for in Thailand, Rank 7 for overall and Rank 1 in healthcare, by Business.com Magazine
Company with very good corporate governance scoring by Thai Institute of Directors Association
2007: Received ISO 15189 (Medical laboratory certification )
2006: JCI ‘Disease-Specific’ certifications: Heart and Stoke programs
2002: 1st hospital in Asia to receive US JCI Accreditation
2001: Received ISO 14001 for environmental management and was 1st hospital in Asia to receive ISO 9001:2000
1999: 1st private hospital awarded Thailand Hospital Accreditation (HA) and received ISO 9002:1994
2008:
2009:
2010:
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World Class Inpatient FacilitiesWorld Class Inpatient FacilitiesRenovation of all rooms completed in May 2010Renovation of all rooms completed in May 2010
• Inpatient experience offers hotel-like ambience and room design
Priority on patient safety
Less “clinical” feeling
Warm and restful environment
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Expanded Outpatient FacilitiesExpanded Outpatient FacilitiesNew OPD Tower with similar high quality ambience opened in June New OPD Tower with similar high quality ambience opened in June 20082008
Ground Floor Lobby
Sky Lobby
Clinic area design enhances privacy, in a pleasant and calming environment, with efficient workflows
Welcome Center New Clinics
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StrategyStrategy
• Focus on physician recruitment and targeted specialties
• Domestic marketing efforts include Healthy Living Club membership program, advertisements, fairs, and packages
• International marketing through multiple channels
• Proven growth with increasing penetration in referral markets
• Selectively pursuing overseas expansion – BumrungradInternational Limited
• Extend success in wellness, anti-aging and other complementary business lines
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Operating PerformanceOperating Performance 20062006--20102010Total Revenue
Net Income
EBITDA
1,946 2,070 2,155 2,2592,452
0
500
1,000
1,500
2,000
2,500
3,000
2006 2007 2008 2009 2010
EBIT
DA
(TH
B m
n)
6% CAGR
8297,896
8,559
8,882 9,33810,069
0
2,000
4,000
6,000
8,000
10,000
12,000
2006 2007 2008 2009 2010
Rev
enue
s (T
HB
mn)
6% CAGR
458
1,1451,096
1,191 1,246
1,25863
0
500
1,000
1,500
2,000
2006 2007* 2008 2009 2010**
Net
Inco
me
(TH
B m
n)
4% CAGR
DILUTED EPS
1.261.29
1.37 1.441.45
0.56 0.07
0.0
0.5
1.0
1.5
2.0
2006 2007 2008 2009 2010
Dilu
ted
EPS
(TH
B)
Source: Audited FS
Source: Audited FS Source: Audited FS
4% CAGR
*One-time profit of THB 458 million in 2007 was share of profit in investment in GCS Thailand, netted off with impairment of hospital software system** One-time loss of THB 63 million in 2010 was loss on the translation adjustment from the sale of Asia Renal Care (ARC) Group
9,388
BH reported a one-time gain on share of profit in investment in CDE Trading (previously GCS Thailand) in 2007 of THB 829 million, mainly from sale of GCS Thailand’s assets
1,603
Source: Audited FS
1.85
1.521,321
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Margins & TrendMargins & Trend
Margins have been strong and relatively stable over time
Net Profit Margin Trend
13.3% 12.5%13.3%
17.1%
13.9%
0%
10%
20%
30%
2006 2007* 2008 2009 2010
* Net margin in 2007 includes the benefit of one-time non-operating items
EBITDA Margin Trend
24.2%24.7% 24.3% 24.2% 24.4%
0%
10%
20%
30%
2006 2007 2008 2009 2010
15
679769
27.4%25.8%
0
200
400
600
800
1,000
1Q10 1Q110%
10%
20%
30%
40%
EBITDAEBITDA Margin
Total Revenue
2,628 2,803
0
1,000
2,000
3,000
4,000
1Q10 1Q11
1Q11 Update1Q11 Update
Source: Audited FS
EBITDA
Source: Audited FS
Net Income
Source: Audited FS
THB million THB million
THB million
7%13%
369416
14.0%14.8%
0
100
200
300
400
500
1Q10 1Q115%
10%
15%
20%
25%Net Profit Net Profit Margin
• Higher growth of net profit compared to growth of total revenues was driven by a lower rate of increase in cost of hospital operations and administrative expenses.
13%
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Dividend PaymentDividend Payment
0.400.400.400.400.30
0.450.40 0.40 0.45 0.50
0.00
0.20
0.40
0.60
0.80
1.00
2006 2007 2008 2009 2010
FinalInterim
Bt per share
Payout Ratio
49.0%50.0% 49.0% 49.8% 52.0%
0%
20%
40%
60%
80%
2006 2007* 2008 2009 2010
• The board of directors announced the 2010 dividend payment with details as follows:
Dividend payment for the year 2010 of
Bt 0.90 per share0.75 0.80 0.850.80
* Net profit used to calculate the dividend payout ratio in 2007 is:
2007 net profit Baht 1,605 million
- share gain from GCS - Baht 829 million
+ dividend received from GCS + Baht 418 million
= Net profit for dividend payment Baht 1,195 million
0.90
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LeverageLeverageNet Debt to EBITDA
Net Debt to Equity
x
x
Interest Coveragex
0.60
0.31
0.150.23
0.27 0.28
0.00
0.10
0.20
0.30
0.40
0.50
0.60
0.70
0.80
2006 2007 2008 2009 2010 1Q11
1.20
0.550.69
0.370.45
0.59
0.00
0.20
0.40
0.60
0.80
1.00
1.20
1.40
2006 2007 2008 2009 2010 1Q11
18.8
36.035.9
24.8
17.7 18.7
0.0
10.0
20.0
30.0
40.0
2006 2007 2008 2009 2010 1Q11*
• Net debt to EBITDA and Net debt to Equity ratios were higher due to an increase in Bt 3,570 million short-term loans from the purchase of common shares of Bangkok Chain Hospital PCL doing business as Kasemrad Hospital Group on 18 March 2011.
• Interest expenses related to the purchase of common shares of Kasemrad Hospital Group to calculate interest coverage ratio was Bt 3.5 million based on remaining days in the quarter after the transaction settled.
• *If we assumed impact for the full quarter, interest expenses from this transaction will be Bt 51 million and interest coverage ratio will be 15.1x.
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Overall Volume TrendOverall Volume Trend
• 1Q11 total visits increased by 2.8% compared to 1Q10.
• 1Q11 total admission increased by 2.4% compared to 1Q10.
• ADC decreased in 1Q11 due to lower length of stays compared to 1Q10.
• Focus on campus expansion and physician recruitment.
• The additional clinic space will allow Bumrungrad International Hospital to recruit doctors in sub-specialties to enhance capacities in providing advanced medical care to patients.
Total Visits per DayVisits
1.6% 12.6% 8.8% 2.4%
2,715 2,645 2,654 2,694 2,7592,759
2,313
2,8892,759 2,837
0
1,000
2,000
3,000
1Q 2Q 3Q 4Q 1Q2009 2010
Total Admission per Day
2011
2.8%
8073
79 79 8181
64
8877
83
0
100
1Q 2Q 3Q 4Q 1Q2009 2010 2011
2.0% 12.1% 11.1% 2.0% 2.4%
Average Daily CensusADC
315290
317 318355355
305
359322
347
0
100
200
300
400
1Q 2Q 3Q 4Q 1Q
2009 2010
12.9% 5.3% 13.4% 1.1%Admissions
2.4%
2011
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Revenue IntensityRevenue Intensity
Revenue per Admission
Revenue per Visit
5,221 5,119 5,072 5,2825,5095,509
5,403 5,3065,544 5,796
0
2,000
4,000
6,000
1Q 2Q 3Q 4Q 1Q2009 2010
5.5%
Bt
Bt 5.5% 4.6% 5.0%
15.9% 22.0%
• Revenue per visit growth resulted from
increased consumption in outpatient
ancillary services and annual price
adjustment.
• Revenue per admission continued to grow
compared to the prior year.
5.2%
1.3%
2011
166,326 174,619 169,899 175,699192,846192,846
213,041172,043 181,527
199,321
0
60,000
120,000
180,000
240,000
1Q 2Q 3Q 4Q 1Q2009 2010 2011
3.3% 3.4%
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Revenue BreakdownRevenue Breakdown
49% 49% 51% 51% 50% 50%
50%51% 51% 49% 49% 50%
0%
25%
50%
75%
100%
2006 2007 2008 2009 2010 1Q11
OutpatientInpatient
Inpatient vs. Outpatient - (% of revenue) Method of Payment (% of revenue)
3M10
Insurance13%
Corporate Contracts - Intl
7%
Corporate Contracts - Domestic
9%
Self-pay71%
• Revenue contribution from outpatient service was flat at 50% in 1Q11
• Revenue breakdown in 1Q11: Outpatient revenue growth of 8% y-o-y
Inpatient revenue growth of 6% y-o-y
• Revenue by method of payment:
Self-pay remains the primary method of payment
Increasing trend on international corporate contracts
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Volume Contribution by Nationality
Revenue Contribution by Nationality
International ContributionInternational Contribution
41% 41% 40%
59% 59% 60%
45%41% 42%
58% 55%59%
0%
20%
40%
60%
80%
100%
2006 2007 2008 2009 2010 1Q11
% o
f Vol
ume
International Thais
54% 54% 54.70%
45% 46% 45.30%
60%57%55%
43% 40%46%
0%
20%
40%
60%
80%
100%
2006 2007 2008 2009 2010 1Q11
% o
f Rev
enue
International Thais
• International revenue in 1Q11: Up 6% y-o-y, primarily from volume growth
• Top 5 countries revenue contribution (3M11)
- UAE 11%
- US 6%
- Myanmar 4%
- Oman 3%
- Bangladesh 3%
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Bangkok Facility Expansion Plan
Inpatient Services
Outpatient Service Plan to open 5 clinic floors at Bumrungrad International Clinic in 2012
CAPEX • Baht 1.1bn through mid-2012
Plan to add about 28 ICU beds in Bumrungrad Hospital Building to serve more high acuity patients
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Strategic investment in Kasemrad
Transaction Overview
BH has purchased 415,624,000 shares, equivalent to a 24.99% ownership stake, in Bangkok Chain Hospital PCL doing business as Kasemrad Hospital Group (“Kasemrad”).
The purchase consideration is Bt 3,532,804,000 at a price of Bt 8.5 per share.
This investment will be financed with Bt 3.57 billion loan facility. The increased debt balances of the Company remain within prudent levels.
Major Shareholders BH
Minority Shareholders
KH
747.94 mn shares 415.62 mn shares 499.10 mn shares
44.99% 24.99% 30.02%
Benefits expected to be generated
This investment expands the interests of the Company in the Thai healthcare sector, supported by the broader market coverage of Kasemrad's successful, multi-facility network and established presence serving a broad variety of Thai patient needs.
The shares purchased are eligible to participate in any future dividends paid to the common shareholders of Kasemrad, and will allow the Company to reflect its share of any earnings generated by Kasemrad in its future financial performance.
Both companies share growth oriented strategies, and have agreed to a joint effort to pursue mutually beneficial opportunitiesfor collaboration, as and when appropriate, that prioritize patient care, integrity, and providing a suitable financial return to shareholders.
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Investment Rationales
Potential for new investment
Medical education and recruitment cooperation
Technology transfer and sharing
Centralization- back office and laboratory services
Potential for tertiary referral to Bumrungrad
25
Summary of Financial Information Related to the Purchase of Summary of Financial Information Related to the Purchase of KasemradKasemrad SharesShares
Transaction Date Draw down and share trade settlement on 23 March 2011
Amount & Tenor Bt 3,570 mn with a one year term
Interest rate •The rate is a 6 month floating rate with multiple alternatives for the reference rate at the choice of the borrower•The rate for the initial 6 month term is 3.7%
BH plans to refinance this facility during the next year with a longer term loan, and has already received serious
expressions of interest from the banking community to provide financing for this amount with a term of up to 8
years, if desired.
Loan Facility
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BumrungradBumrungrad International Limited International Limited
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Asian Hospital, the Philippines (AHI) Asian Hospital, the Philippines (AHI)
• 2002: Opened as a private hospital, one of the largest in the southern Luzon corridor of metropolitan Manila, the Philippines
• Feb 2005: Acquired by Bumrungrad International Limited
• 2010:
A 217-bed private hospital
Since the acquisition, the hospital has turned around and became profitable in 2007
With the hospital operating at near full utilization, AHI is undergoing expansion of both inpatient and outpatient capacity, including an increase to a total of 300-350 beds over time
Facts & Figures:
Ownership (by Bumrungrad International Limited):from conversion of management fees into equity & and new capital injection@ acquisition 43.0%@ present 56.5%
- Amount and year invested: (by Bumrungrad International Limited)2005 USD 10 million2008 USD 7 million
Other shareholders:Dr. Garcia 8.2%Insular Life 11.8%Filinvest 8.3%Others 15.3%
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MafraqMafraq Hospital, Abu DhabiHospital, Abu Dhabi,, U.A.E. U.A.E.
• Management contract signed with the Health Authority of Abu Dhabi for 4 years, December 2007 - 2011
• Inpatient capacity of 463 acute care beds, 33 critical care beds and 14 Neonatal intensive care beds
• Patient volume of over 280,000 patients, including more than 17,000 inpatients annually
• Simultaneously, a new modern hospital building is being constructed on an adjacent site that will replace the current facility
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BumrungradBumrungrad International Limited International Limited -- In SummaryIn Summary
Bumrungrad International Limited is making a positive contribution to the operating profits of BH
- AHI is profitable and generating good internal cash flow
- Management fees from Mafraq Hospital are accretive
Capacity expansion plans for AHI are progressing well
Bumrungrad International Limited is focusing on expansion opportunities
- In the hospital sector
- In Asian markets which are supportive of private sector healthcare
- Where valuations are reasonable
- Project timing is difficult to predict given decision points of asset sponsors or governments