![]() January 2009 www.amedisys.com NASDAQ: AMED We encourage everyone to visit the Investors section on our website at www.amedisys.com, where we have posted additional important information such as press releases, profiles concerning our business and clinical operations and control processes, and SEC filings. We intend to use our website to expedite public access to time-critical information regarding the Company in advance of or in lieu of distributing a press release or a filing with the SEC disclosing the same information. Exhibit 99.1 |
![]() Forward-Looking Statements This presentation may include forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. These forward- looking statements are based upon current expectations and assumptions about our business that are subject to a variety of risks and uncertainties. Additional information regarding factors that could cause actual results to differ materially from those discussed in any forward-looking statements are described in reports and registration statements we file with the SEC, including our Annual Report on Form 10-K and subsequent Quarterly Reports on Form 10-Q and Current Reports on Form 8-K, copies of which are available on the Amedisys internet website http://www.amedisys.com or by contacting the Amedisys Investor Relations department at (800) 467- 2662. We disclaim any obligation to update any forward-looking statements in this presentation. |
![]() Investment Highlights Focus on home nursing and related services to Medicare population Large, growing and highly fragmented industry Strong internal growth and cash flow with low recurring routine cap ex Proven operating model supported by sophisticated technology system Demonstrated ability to identify and integrate acquisitions Liquidity availability to fund external growth Extensive delivery platform ideally positioned for Medicare care management initiatives Experienced management team |
![]() William F. Borne Chairman and Chief Executive Officer CEO since founding the Company in 1982 Larry R. Graham President and Chief Operating Officer, Director Joined Amedisys in 1996; COO since 1999; President since 2004 Dale E. Redman, CPA Chief Financial Officer Joined Amedisys in February 2007 Alice Ann Schwartz Chief Information Officer Joined Amedisys in 1998, CIO since 2004, SVP Clinical Operations since 2003 Jeffrey Jeter Chief Compliance Officer Joined Amedisys in 2001 Management Team |
![]() Corporate Overview Founded in 1982, publicly listed 1994 534 2 locations in 37 states Leading provider of home health services ] Services include skilled nursing and therapy 94% of Home Health revenue is episodic based (both Medicare & non-Medicare) 1 For the nine-month period ended September 30, 2008 2 Both home health and hospice, inclusive of joint venture agencies, as of December 31, 2008 3 Annualized visits per year 4 Forecasted 2008 annual results as of 10/28/08 and reaffirmed 11/20/08 5 Forecasted 2009 annual results as of 1/06/09 Revenue Mix Stats 14,500 employees Daily visits = 18,300 6,750,000 visits per year 2008 revenue guidance = $1.175 billion 4 2009 revenue guidance = $1.475 billion 5 1 3 |
![]() Patient Overview Average patient is 81 years old Higher acuity patient Patient is taking an average of 13 medications ] 14 medications for greater than two episodes |
![]() Patient Overview 84.1% of patients have two episodes of care or less: ] 66.4% of patients have only one episode of care ] 17.7% have only a second episode of care |
![]() Our Locations 1 As of December 31, 2008, inclusive of joint ventures. National home nursing provider located in 37 states and Puerto Rico . Largest provider in the Southern and Southeastern United States. – 484 home nursing locations – 50 hospice locations 1 1 |
![]() Our Strategy Focus on Medicare-eligible patients Emphasize internal growth Select, acquire and integrate quality home care agencies Focus on providing a cost-efficient operating structure Develop and deploy specialized programs for chronic diseases and conditions Expand care coordination platform Start-up activities |
![]() Medicare Revenue Market Size 2006: Medicare spending for home health reached $14 billion and hospice was $9.2 billion, giving a combined total of $23.2 billion 2017: Home health will contribute $36 billion and hospice $20 billion of the projected $56 billion Source: CBO's March 2008 Baseline: MEDICARE MEDICARE Home Health and Hospice Revenue $ in billions |
![]() Home Nursing Market Source: CMS Oscar data books and Medpac reports |
![]() Industry Growth Drivers Trend from inpatient to home-based care: – Patient preference – Payor incentives – Technology advancements Demographics – aging population – 8,000 Americans will become Medicare eligible each day beginning in 2011 and by 2030, 57.8 million baby boomers will be eligible for Medicare benefits Increased prevalence of chronic and co-morbid conditions 1 Source: United States Census Bureau 1 |
![]() Internal Growth Internal revenue growth 28% for Q3 2008 and 27% for the first Internal growth driven by: – Overall industry growth – Increase in episodic-based admissions • Focus on start-ups – Increase in episodic-based recertification's • Higher acuity levels and co-morbidities, requiring more intensive services – Increase in episodic-based revenue per episode • Development of therapy intensive specialty programs • Focus of the new Medicare payment system |
![]() Start-Up Strategy Start-ups typically generate $1.5 - $2.0 million in run-rate revenue by the end of their second year of operations ~ 18 months to recoup the $250,000 - $350,000 investment 35 home health and 5 hospice start-ups completed in 2008 * Reported numbers are for home health start-ups Yearly Start-Ups |
![]() Acquisition Strategy |
![]() TLC Integration TLC Integration Complete Detailed plan to wind-down TLC corporate – Converted all agencies as of September 15, 2008 – Closed all regional billing centers as of October 24, 2008 – Minor number of corporate employees remained until December 31, 2008 |
![]() High Quality Health Care Source: OCS Corporate Comparative Report Period: 1/1/08 – 9/30/08 |
![]() Higher Acuity Level Patients Source: OCS BBI Reporter Corporate Comparative Report Date Range: 2005-2007 Case Mix |
![]() 18 High Quality Outcomes Outcomes – June 2008 Amedisys vs. Nation 1 Lower % is better Source: www.medicare.gov |
![]() High Quality Health Care Care Management – 13 disease management programs – 70 clinical tracks Specialty Division – Balanced For Life first program in division – Serves higher acuity patients – Rolled out to 178 locations through 2008 |
![]() Investments in Technology |
![]() Comprehensive Compliance Program Local Level • Point of care system enhances clinical documentation accuracy with real-time assessment input • Clinical nurse review of assessments • Physician review/approval • Standardized care plans • Weekly case conferences • Monthly audits • End of episode case review Regional Level Corporate Level • Unannounced compliance & billing audits • Regional directors monitor compliance status and resolve errors • Real-time monitoring capability of local level activity via Point of Care system • Compliance training for all employees • Compliance concerns hotline • Compliance review of metric variances • Compliance manager site visits • Semi-annual clinical/compliance reviews • Annual Sarbanes-Oxley audit • Annual billing competency testing http://www.amedisys.com/pdf/Compliance3/Compliance_Controls.pdf |
![]() Medicare Reimbursement Implemented in October 2000 – Base payment for 60-day episode of care – Adjusted for patient acuity and market factors 2008 CMS issued reimbursement changes – Better alignment of reimbursement with patient needs – Expands HHRG’s from 80 to 153 – More integrated reimbursement for therapy – Allocation of more dollars to later episodes – Benefits agencies with a greater mix of higher-acuity patients 2009 Changes – Market basket increase of approximately 3% – Increase offset by 2.75% case mix creep adjustment – No rural add-on payment |
![]() Financial Highlights Increasing revenue Strong operating cash flow/low cap ex requirements Consistent EPS growth Strong balance sheet to fund future growth – $250 million active shelf registration – $139 million unused revolving credit facility through September 2008 1 2008 EPS - After adding back certain expenses related to the integration of TLC Health Care Services, Inc.) |
![]() 1 We have reclassified certain costs from our general and administrative expenses to our cost of service for health care insurance costs and other miscellaneous expenses, which are associated with our direct care employees, to conform to the current year presentation. 2 EBITDA is defined as net income before provision for income taxes, net interest expense, and depreciation and amortization. EBITDA should not be considered as an alternative to, or more meaningful than, income before income taxes, cash flow from operating activities, or other traditional indicators of operating performance. This calculation of EBITDA may not be comparable to a similarly titled measure reported by other companies, since not all companies calculate this non-GAAP financial measure in the same manner. ($ millions, except per share data) Summary Financial Results 2006 2007 3Q07 Net revenue Period-over-period growth Gross margin Margin Operating income Margin EBITDA Margin Fully-diluted EPS Period-over-period growth 3Q08 Net Income $541.1 41.8% 288.9 53.4% 65.7 12.1% 75.7 14.0% 38.3 $1.72 22.0% $697.9 29.0% 368.9 52.9% 96.6 13.8% 114.0 16.3% 65.1 $2.48 44.2% $180.9 32.0% 96.5 53.3% 25.7 14.2% 33.7 18.6% 20.2 $0.77 60.4% $321.6 77.7% 170.4 53.0% 43.6 13.6% 49.4 15.3% 23.5 $0.87 13.0% 1 2 |
![]() 2006 2007 3Q07 Agencies at period end¹ Period-over-period growth Episodic-Based Completed Episodes Period-over-period growth Episodic-Based Admissions Period-over-period growth Episodic-Based Revenue per Episode Period-over-period growth Total Visits Period-over-period growth 3Q08 DSO 1 Inclusive of home health and hospice locations and joint ventures 360 30.9% 4,302,830 25.2% 129,649 19.9% 219,855 27.1% $2,661 1.0% 51.3 275 3,437,881 108,140 172,930 $2,634 52.9 344 1,102,913 32,672 53,958 $2,672 49.3 511 48.5% 1,879,573 70.4% 53,203 62.8% 94,986 76.0% $2,868 7.3% 56.7 Summary Performance Results |
![]() Summary Balance Sheet ($ in millions) Dec. 31, 2007 Sept. 30, 2008 Assets Cash Accounts Receivable, Net Property, Plant and Equipment Goodwill Other Total Assets Liabilities and Stockholders’ Equity Debt All Other Liabilities Stockholders’ Equity Total Liabilities and Stockholders’ Equity $ 5.7 179.8 80.4 701.1 83.7 $ 1,050.7 $ 359.7 162.7 528.3 $ 1,050.7 $ 56.2 96.3 68.3 332.5 33.8 $ 587.1 $ 24.0 116.1 447.0 $ 587.1 |
![]() Accounts Receivable Note: On average we collect over 99% of our Medicare revenue. On average we collect approximately 86% of our non-Medicare revenue September 30, 2008 December 31, 2007 Medicare 139,765 $ 78,502 $ Estimated revenue adjustments (6,928) (3,622) Medicare patient accounts receivable, net 132,837 74,880 Non-Medicare 66,898 34,397 Allowance for doubtful accounts (19,967) (12,968) Non-Medicare patient accounts receivable, net 46,931 21,429 Patient accounts receivable, net 179,768 $ 96,309 $ |
![]() Accounts Receivable Historically, Amedisys collects over 99% of its Medicare receivables – Collections in 2008 have followed historical norms |
![]() Guidance 1 Guidance excludes the effects of future acquisitions, if they are made. 2 Provided as of the date of our Form 8-K filed with the Securities and Exchange Commission on October 28, 2008 and reaffirmed on November 20, 2008 3 Provided as of the date of our Form 8-K filed with the Securities and Exchange Commission on January 6, 2009 Calendar Year 2008 Net revenue: $1.150 - $1.175 billion EPS: $3.20 - $3.25 (after adding back certain expenses related to the integration of TLC Health Care Services, Inc.) Diluted shares: 26.9 million Calendar Year 2009 Net revenue: $1.425 - $1.475 billion EPS: $4.10 - $4.30 Diluted shares: 27.5 million 3 2 1 |
![]() Summary Focus on home nursing and related services to Medicare population Large, growing and highly fragmented industry Strong internal growth and cash flow with low recurring routine cap ex Proven operating model supported by sophisticated technology system Demonstrated ability to identify and integrate acquisitions Liquidity availability to fund external growth Extensive delivery platform ideally positioned for Medicare care management initiatives Experienced management team |
![]() Contact Information Kevin B. LeBlanc Director of Investor Relations Amedisys, Inc. 5959 S. Sherwood Forest Boulevard Baton Rouge, LA 70816 Office – 225.292.2031 Fax – 225.295.9653 kleblanc@amedisys.com We encourage everyone to visit the Investors section on our website at www.amedisys.com, where we have posted additional important information such as press releases, profiles concerning our business and clinical operations and control processes, and SEC filings. We intend to use our website to expedite public access to time-critical information regarding the Company in advance of or in lieu of distributing a press release or a filing with the SEC disclosing the same information. |