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1 Quality drives productivity and growth President and CEO Thomas Berglund May 11, 2016 Quality. Compassion. Care.

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Page 1: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Quality drives productivity and growthPresident and CEO – Thomas Berglund

May 11, 2016

Quality. Compassion. Care.

Page 2: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Respected as a long-term innovative partner to a public healthcare sector in change

Giving Capio

• Long-term corner stone investors

• Increased transparency

• Financing for expansion

With a clear strategy

Back on Nasdaq Stockholm on June 30,

2015 after 8+ years being privately owned

Capio AB (publ) – AGM 2016

• Modern Medicine giving Rapid Recovery to patients

• Modern Management empowering people making change happen

• Market Leadership by content and –step by step – by size

Page 3: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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8%

54%38%

A pan-European footprint (2015)

Net sales: SEK 13.5 billions• About 12,400 employees (FTE) and

about 4.6 million patient visits in

Sweden, Norway, France and Germany

• Offers a broad range of medical,

surgical and psychiatric care of high

quality in our hospitals, specialist

clinics and primary care units

• Founded in 1994 in Gothenburg. De-

listed in 2006 and listed on Nasdaq

Stockholm in 2015. In the past nine

years Capio has:

– Developed a medical strategy

– Driven by an empowered

organization

– Invested in facilities and equipment

to build for the future

A leader in European healthcare

Capio today

Capio AB (publ) – AGM 2016

Page 4: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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University

hospital

Emergency

hospital

Local

hospital

Specialist

clinic

Primary care

unit

France

• 8 emergency hospitals

• 11 local hospitals

• 3 specialist clinics

Germany

• 5 general hospitals

• 4 specialist clinics

• 1 hospital with rehabilitation and

care facilities

• 7 outpatient clinics (Medical Care

Centers, MCC)

Norway

• 8 medical centers

• 2 specialist clinics

Sweden

• 1 emergency hospital

• 2 local hospitals

• 30 locations for specialist care

• 18 locations for psychiatric care

• 75 locations for primary care

Capio footprint 2015

Experience across all care levels

Nordic

Capio footprint

Capio AB (publ) – AGM 2016

Page 5: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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As the population structure develops

towards a larger share being elderly…

Population pyramid, EU 1960-2050

1960 2010

MenWomen X%

2050

15% 19% 29%70-74

65-69

60-64

55-59

45-49

35-39

50-54

40-44

30-34

25-29

20-24

15-19

10-14

5-9

0-4

75-79

80+

The European challenge is not going to ease

– demographic squeeze is driving need and costs...

Pressure to provide “quality healthcare with higher productivity” as fewer people

have to pay for an increasingly large share of the population

NorwayUnited KingdomGermany

FranceSweden

…the required healthcare expenditures

will continue to increase, while there will

be fewer people financing the healthcare

0

5

10

15

20

Total expenditure on health, GDPPercentage

Year

2030201020009080701960

Prognosis1

1 Future development based on extrapolation of historic OECD average CAGR from 2002-12

http://populatio

npyramid.net/

Share of populationX% OECD

Source: World Bank Source: OECD Health data 2014

Page 6: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Source:

AVLOS – Sweden: Socialstyrelsen; Norway: Helsedirektoratet; France: ATIH; Germany: Federal Statistical Office's DRG browser; Finland: Eurostat ; UK: Health and Social Care Information

Centre; Spain: Eurostat; Best-practice - knee prosthesis: North Wales knee clinic; Best-practice - AMI: US Healthcare costs and utilization project

Ambulatory surgery – All countries excluding Germany: Eurostat; Germany: German association of ambulatory surgery; Best-practice - Inguinal hernia: NHS; Best-practice - Tonsillectomy: US

agency for healthcare research and quality

1 Goodman et al. 1997; 2 For Norway 2011 data and only reported as aggregated data for knee and hip prosthesis

Large gaps and slow implementation create

opportunities

Historic implementation of modern

medicine is a slow process…

17 YEARS1

Best-practice

proven

Best-practice

implemented

Use Capio’s know-how to transfer knowledge and speed up change

Knee

prosthesis

Acute

myocardial

infarction

2 >15

2 >15

6.62 8.84.4 5.3 9.82.4 4.0 12.5

6.8 7.64.1 6.7 8.0~3 4.0 8.4

AVLOS

Days

Inguinal

hernia (open

surgery)

Tonsillect

-omy

0 80

0 90

64 6643 46 6814 75

38 5721 30 514 85

Share of

ambulatory

surgery

%

Best-practice

…with large performance gaps between countries

Page 7: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Henrik Kehlet Surgeon Copenhagen

Why is your patient in hospital today doctor?

Capio AB (publ) – AGM 2016

Page 8: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Time

Functionalcapacity

Surgery

This is why patients are in hospital

In Addition:Sedation

Preparation side effects

Drug side effects

Drains, catheters

Fasting

Surgery = Trauma

Inflammation

Fever, Swollenness

Pain, Nausea, Fatigue

Anxiety

Capio AB (publ) – AGM 2016

Page 9: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Normal situation When hospitalisedAnxiety, No control, Diminished

…and on top of that

Capio AB (publ) – AGM 2016

Page 10: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Henrik Kehlet Surgeon Copenhagen

Does it have to be like this?

Capio AB (publ) – AGM 2016

Page 11: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Source: SKL, Kehlet Br J Anaesth. 1997 May;78(5):606-17

Prevent inflammation

Modern Medicine in surgery

Capio AB (publ) – AGM 2016

Meeting discharge criteria

Page 12: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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It takes the right culture and attitude

…and in addition

- Make the patient not only informed but fully involved

- Demystify healthcare as much as possibleCapio RRAC labelling

Capio AB (publ) – AGM 2016

Page 13: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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14%15%16%

21%

15%

12%14%

17%

12%10%

Source: SKL (vantetider.se)

Specialist care – surgeries and proceduresSpecialist care - visits

Nation-wide Stockholm

Sweden has not yet met its target thresholds for waiting times, in particular outside of the Stockholm region

Performance on target levels for waiting times (‘vårdgarantiuppfyllelse’); Share of patients who have waited > 90 days

2011 20132012 2014 2011 20132012 2014

11%11%12%

17%

14%

5%6%

15%

8%8%

The Swedish healthcare system has its

challenges…

Long waiting times and an experienced lack of resources drive need for

increased productivity in the Swedish healthcare system

Capio AB (publ) – AGM 2016

Page 14: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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36% more time spent with patients, but a significant reduction of total staff time

Quality

6-8 patients per care team

9.6 min per patient and day10-12 patients per care team

13.1 min per patient and day1 = When the number of patients increases, the time for indirect care and rounds have increased proportionally * = Other tasks include e.g. telephone, tutorial/introduction, meetings, other administration, coordination, business outside ward, waiting/searching

SWEDENMore time for direct and indirect care1

From where we are to where we want to be

Capio AB (publ) – AGM 2016

Page 15: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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YES!

Taking

initiatives!

NO!

Waiting for

orders?

Group

Business area

Region

Main unit

Unit

Care unit

Capio decentralized responsibilities

Capio’s financial model

Modern Management

Empowered to do the best every day!

Capio AB (publ) – AGM 2016

Page 16: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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• Proposal from the Board of Directors to the shareholders at the Capio

AB (publ) AGM:

– A long-term incentive to employees to share the value creation to which they

contribute, for the benefit of patients, employees and shareholders

– A five year convertible bond with a possibility to convert to Capio shares at the end

of the term

– Share price plus a 20% premium

– The scope of the program implies maximum 2,5% dilution and

maximum MSEK 200

The joy of everyday’s work and the result of being part of the long-term development!

An offering to our employees – a five year

convertible

Capio AB (publ) – AGM 2016

Page 17: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Organic sales growthNet sales

Net sales & organic sales growth1

1 2012 to 2014 adjusted for the structural changes made in 2014. Refer to Capio Annual Report 2015 note 33.

Sales growth well in line with target over time – result growth with leverage

Group financial development 2012 – 2015

10,292

12,12712,960

13,486

2.5 2.3

4.1

2.9

1.0

2.0

3.0

4.0

5.0

6.0

0

3,000

6,000

9,000

12,000

15,000

2012 2013 2014 2015

Net Sales, MSEK Organic growth, %

Operating result (EBITA) and margin1

Operating margin (EBITA)Operating result (EBITA)

437

483

544

592

4.2

4.0

4.24.4

3.0

4.0

5.0

6.0

100

300

500

700

2012 2013 2014 2015

EBITA, MSEK Marginal, %

Page 18: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Capio Group

2015 2014 ∆, %

Adj. net sales1 13,486 13,118 2.8

Organic sales growth, % 2.9 4.0

Adj. operating result (EBITDA)1 1,001 972 3.0

Margin, % 7.4 7.4

Adj. operating result (EBITA)1 592 544 8.8

Margin, % 4.4 4.1

Adj. profit for the period 326 288 13.2

Adj. EPS, SEK 2.44 2.29

Net capital expenditures -391 -429

In % of net sales 2.9 3.3

Net debt 2,936 3,440

Financial leverage 2.9 3.1

Capio AB (publ) – AGM 2016

1 2014 adjusted for structural changes in 2014. Refer to note 33 in Capio Annual Report 2015.2 Financial leverage 2014 based on reported operating result (EBITDA) of MSEK 1,102.

2

Q1 2016: Total sales growth of 3.6%, EBITA increased by 2.1%

Group financial development 2015

Quality drives productivity

in European healthcare

Page 19: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Capio Nordic

2015 2014 ∆, %

Adj. net sales1 7,243 6,944 4.3

Organic sales growth, % 4.6 5.1

Adj. operating result (EBITDA)1 458 411 11.4

Margin, % 6.3 5.9

Adj. operating result (EBITA)1 316 262 20.6

Margin, % 4.4 3.8

Net capital expenditures -135 -138

In % of net sales 1.9 1.9

Q1 2016: Total sales growth of 3.4%, EBITA increased by 10.0%

Good growth and result development

– Modern Management to drive

increased patient time and productivity

Segment – Capio Nordic

1 2014 adjusted for the handover of a contract business in 2014.

Page 20: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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Capio France

2015 2014 ∆, %

Adj. net sales 5,098 5,007 1.8

Organic sales growth, % 0.7 2.4

Adj. operating result (EBITDA)1 529 566 -6.5

Margin, % 10.4 11.3

Adj. operating result (EBITA)1 286 314 -8.9

Margin, % 5.6 6.3

Net capital expenditures -210 -252

In % of net sales 4.1 5.2

Q1 2016: Total sales growth of 5.6%, EBITA increased by 0.9%

Rapid Recovery strategy continues

to deliver in a challenging

pricing environment

Segment – Capio France

1 2014 adjusted for the sale-and leaseback transaction in 2014.

Capio AB (publ) – AGM 2016

Page 21: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

21Capio AB (publ) – AGM 2016

Capio Germany

2015 2014 ∆, %

Adj. net sales 1,145 1,155 -0.9

Organic sales growth, % 2.0 3.5

Operating result (EBITDA) 94 78 20.5

Margin, % 8.2 6.9

Operating result (EBITA) 74 55 34.5

Margin, % 6.4 4.9

Net capital expenditures -40 -27

In % of net sales 3.5 2.4

Q1 2016: Total sales growth of -3.7%, EBITA decreased by -8.6%

A platform for increased focus

on Modern Medicine

Segment – Capio Germany

Page 22: Quality. Compassion. Care. - Capio Group - Welcome · 2016-05-11 · • Modern Medicine giving Rapid Recovery to patients ... – Driven by an empowered ... Total expenditure on

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The patient in focus

• Implementing Modern Medicine, treatment times can be reduced as discharge criteria

can be reached faster

– Patients are less exposed to the hospital environment

– Shorter AVLOS and a continued shift from in- to outpatient treatments give

productivity gains

• Supported by Modern Management, which speeds up implementation

– Unnecessary delays for patients are reduced

– A decentralized and empowered organization makes a difference to our patients –

every day

Modern Medicine is the tool to put the medical profession in

the driving seat, making Modern Medicine real to patients

Market leadership by content

– and step by step – by size

Modern Medicine and Modern Management

Capio AB (publ) – AGM 2016