![]() Investor Presentation Leading Home Health & Hospice May 2013 clinical quality innovative care models better communities 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 that could cause actual results to differ materially from those described in this presentation. You should not rely on forward-looking statements as a prediction of future events. 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 at (800) 467-2662. We disclaim any obligation to update any forward-looking statements or any changes in events, conditions or circumstances upon which any forward-looking statement may be based except as required by law. 2 www.amedisys.com NASDAQ: AMED We encourage everyone to visit the Investors Section of 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. or by contacting the Amedisys Investor Relations department Additional information regarding factors that could cause actual results to differ |
![]() Company Overview 1 3 • Founded in 1982, publicly listed 1994 • 524 care centers in 38 states • 15,100 employees • Projected revenue in 2013 of approximately $1.3 billion • Largest provider of skilled home health services • 4 th largest hospice business 1 For the quarter ended March 31, 2013 |
![]() Business Segments 4 Business Segment % of Revenue Reimbursement Type HH - Medicare 65% Paid episodically (over a 60- day episode of care) HH – Non-Medicare 15% Majority paid per visit; remainder paid episodically Hospice 20% Mainly Medicare; paid at a daily rate 1 Revenue mix based on 1Q13 revenue 65% 15% 20% Revenue Mix ¹ HH - Medicare Hospice HH - Non-Medicare |
![]() Care Center Locations 1 5 Home Health Care Centers (427) Hospice Care Centers (97) 1 As of March 31, 2013 |
![]() Estimated Market Share – Medicare Revenue 6 13.6% 13.6% 5.7% 7.9% 56.8% 12.5% 17.1% Home Health Amedisys Public Peers For Profit Hospital-based Non-Profit 1.5% 12.1% 45.2% 7.8% 33.4% Hospice Amedisys Public Peers For Profit Hospital-based Non-Profit |
![]() 7 Home Health/Hospice Medicare Spend Home Health Source: CBO March 2013 Baseline report (10 year CAGR) Hospice Source: 2011 actual hospice spending with growth rate based on “Other Services” section of CBO March 2013 Baseline report (10 year CAGR) Population growth estimates provided by Tetrad; CAGR is for 2012-2017 (5 years) Compound Annual Growth Rates (CAGR) Home Health Expenditures = 4.4% Hospice Expenditures = 5.2% 65+ Population = 3.6% 75+ Population = 2.6% 15 15 16 17 17 19 20 21 22 24 19 19 20 21 21 22 24 25 27 28 $- $5 $10 $15 $20 $25 $30 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 Hospice Home Health |
![]() Medicare Reimbursement 8 Reimbursement Considerations Reimbursement Considerations - - - -2.0% -2.4% -5.2% 1.9% -2.3% -4.2% -6.0% -3.0% 0.0% 3.0% 6.0% 2013 2012 2011 2010 Home Health Industry AMED Specific -1.1% Industry AMED Specific 1.1% 2.4% 1.8% 1.4% -6.0% -3.0% 0.0% 3.0% 6.0% 2013 2012 2011 2010 Hospice Expected in July • 2014 rebasing • Sustainable growth rate legislation (Doc Fix) • Co-payment proposals • 2014 proposed rule • Hospice rebasing (U-shaped reimbursement) • Nursing home reimbursement 2014 - Proposed 2014 - Proposed |
![]() Favorable Long Term Trends • Compelling demographics • Patient preference • Low cost of care delivery • Increased payor and hospital focus 9 Inpatient Hospital LTAC IRF SNF Hospice Home Health Average Cost of Stay $11,700 $38,664 $17,398 $11,728 $11,321 $5,257 Average Length of Stay 5 days 26 days 13 days 27 days 86 days 120 days Average Per Diem Cost $2,388 $1,470 $1,338 $431 $132 $44 Source: MedPAC March 2013 report; hospital information is for inpatient facilities only and is estimated based on patient discharges |
![]() Traditional Home Health and Hospice 10 Current Business Dynamics Issues • Fee for service based • High volume / low margins • “Retail” relationships • Patients with multiple conditions • Limited physician coordination • Poor coordination / communication • Misaligned incentives • Minimal data interchange • Regulatory limitations on services |
![]() Future Trends 11 Home Health Coordinated Care Management Patient Home Hospice Post-Acute Facilities Payors Physicians Hospitals • Aligned incentives • Data exchange • Communications • Care Protocol • Outcome focused • Value driven Informal Care Givers |
![]() Care Management Initiatives • Patient care management • Shared service care centers • Bundled payment initiatives • Next generation operating system • Other – ACO partnerships – Enterprise-level relationships – Palliative care and medical home 12 |
![]() Patient Care Management 13 • “Right Care. Right Time. Right Place.” • Centralized support – Local clinical decisions – Exception reporting • Recertification review – Attainment of patient goals – Physician orders or medication changes – Hospitalization during episode • Utilization focus – Reduce care plan variability – Patient outcome driven |
![]() Shared Service Model • ~ 475 care centers organized into 70 “pods” – Completed by the end of 2013 – ~850 ADC; $20M in revenue per “pod” 14 Quality Care Operational Efficiency Leadership • Centralized functions (on-call, intake, scheduling) • Scheduling efficiency • Specialty clinician productivity • Clinical resource support • Consistency in care delivery/training • POD leadership supporting all care centers • Improved leadership turnover coverage |
![]() Bundles • CMS Bundled Payment for Care Initiative (BPCI) program – Amedisys focused on Model 3 (post-acute) – CMS to set target price for relevant services during bundle – Awardees share savings and “at risk” for costs greater than target • Amedisys in awardee process in 5 regions – Currently in Phase I -- a no-risk reporting and ramp-up period – Phase II (at risk), expected to begin October 1, 2013 – Developing partnerships with hospitals/other partners to manage • Also focused on ACOs and Model 2 bundles 15 |
![]() AMS3 Operating System • 4Q13 Development complete / implementation begins • Migrating to .Net platform Existing platform sun setting • Benefits of proprietary system – Low incremental spend – Ongoing flexibility and customization • Enhancements over existing system – Greater clinician productivity – Superior clinical management engine – Care center efficiencies – Interoperability – Billing efficiencies – Expect $10-$15M in net annual savings after fully rolled out 16 |
![]() Capital Expenditures 17 PeopleSoft IT Security AMS3 Development 28.4 36.4 64.0 44.4 48.3 48.0 2.4% 2.4% 4.0% 3.0% 3.2% 3.7% 0.0% 1.0% 2.0% 3.0% 4.0% 5.0% 6.0% 7.0% 0.0 25.0 50.0 75.0 100.0 125.0 2008 2009 2010 2011 2012 2013 |
![]() Summary Financial Results 18 (Continuing operations only. $ in millions, except per share data) 2011 (1) 2012 (1) 1Q12 (2) 1Q13 (2) Adjusted Net Revenue $ 1,464 $ 1,488 $ 371 $ 339 Gross Margin % 46.7% 43.5% 43.8% 43.2% Adjusted EBITDA $ 157 $ 103 $ 27 $ 17 Adjusted EBITDA Margin 10.7% 6.9% 7.3% 5.1% Adjusted EPS $2.29 $1.08 $0.29 $0.13 1. The financial results for the years 2012 and 2011 are adjusted for certain items incurred in 2012 and 2011 and should be considered non-GAAP financial measures. A reconciliation of these non-GAAP financial measures is included as Exhibit 99.2 to our Form 8-K filed with the Securities and Exchange Commission on March 12, 2013. 2. The financial results for the three-month period ended March 31, 2013 and March 31, 2012 are adjusted for the legal fees associated with investigations of $1.2 million and $2.2 million, respectively, and should be considered a non-GAAP financial measure. A reconciliation of this non-GAAP financial measure is included as Exhibit 99.2 to our Form 8-K filed with the Securities and Exchange Commission on April 30, 2013 |
![]() Home Health Segment 19 ($ in millions, continuing operations) 2011 (1) 2012 (1) 1Q12 (2) 1Q13 (2) Medicare Revenue $ 1,038 $ 953 $ 242 $ 221 Non-Medicare Revenue $213 $245 $59 $51 Total Revenue $ 1,251 $ 1,198 $ 301 $ 272 Gross Margin % 46.9% 42.3% 42.9% 42.3% Contribution $220 $124 $32 $26 Contribution % 17.6% 10.4% 10.5% 9.4% 1. Results as reported in our Annual Report on Form 10-K for the year ended December 31, 2012 as filed with the Securities and Exchange Commission on March 12, 2013. 2. Results as reported in our Quarterly Report on Form 10-Q for the quarter ended March 31, 2013 as filed with the Securities and Exchange Commission on April 30, 2013 |
![]() 20 Home Health Operating Statistics 2011 (1) 2012 (1) 1Q12 (2) 1Q13 (2) Medicare Admissions 202,603 200,590 51,153 52,122 Same store admissions growth (5)% 0% (2)% 2% Recertification rate 44.4% 42.2% 43.5% 37.7% Revenue per episode $3,027 $2,874 $2,882 $2,782 Visits per episode 18.7 18.7 18.6 17.4 Non-Medicare Admissions 73,880 93,016 23,192 22,423 Visits 1,754,255 2,074,446 504,398 436,035 Revenue / Visit $121.30 $118.30 $116.97 $117.42 1. Results as reported in our Annual Report on Form 10-K for the year ended December 31, 2012 as filed with the Securities and Exchange Commission on March 12, 2013. 2. Results as reported in our Quarterly Report on Form 10-Q for the quarter ended March 31, 2013 as filed with the Securities and Exchange Commission on April 30, 2013. |
![]() Hospice Segment 21 ($ in millions, continuing operations) 2011 (1) 2012 (1) 1Q12 (2) 1Q13 (2) Total Revenue $ 218 $ 290 $ 69 $ 67 Gross Margin % 46.5% 48.3% 47.4% 47.1% Contribution $49 $62 $15 $12 Contribution % 22.6% 21.4% 21.9% 17.5% Operating Statistics Total admissions 15,889 19,161 4,902 4,992 Same store revenue growth 19% 13% 17% (5)% Average daily census (ADC) 4,197 5,427 5,190 5,091 Average length of stay (ALOS) 88 99 91 103 1. Results as reported in our Annual Report on Form 10-K for the year ended December 31, 2012 as filed with the Securities and Exchange Commission on March 12, 2013 2. Results as reported in our Quarterly Report on Form 10-Q for the quarter ended March 31, 2013 as filed with the Securities and Exchange Commission on April 30, 2013. |
![]() 22 Summary Balance Sheet Assets Dec. 31, 2012 Mar. 31, 2013 Cash $ 15 $ 7 Accounts Receivable, Net 169 145 Property and Equipment 157 156 Goodwill 210 210 Other 180 194 Total Assets $ 731 $ 712 Liabilities and Equity Debt $ 103 $ 79 Other Liabilities 174 171 Equity 454 462 Total Liabilities and Equity $ 731 $ 712 Leverage Ratio 1.10x 0.95x Days Sales Outstanding 42 37 ($ in millions) |
![]() 23 Liquidity 1 1. Unused revolver of $143 million 2. 1Q13 scheduled debt repayment includes $20M principal payment of senior notes due in March 2013, at end of quarter $20M in senior notes remain outstanding and are due in March 2014 3. Other cash flows include refinancing costs associated with credit agreement signed on October 26, 2012, retirement of long-term debt and acquisitions. ($ in millions) 2012A 1Q13A 2013F Cash Flow From Operations $ 69 $32 $ 94-99 Capital Expenditures 48 10 45-50 Scheduled debt repayments 2 29 24 36 Cash Flow, Net (8) (2) 8-18 Beginning Cash 48 $15 Other 3 (25) (6) End Cash $ 15 $7 |
![]() 1Q13 Announced Initiatives • Exiting 50 low-performing care centers – ~15 will be consolidated with other care centers – ~35 will be divested – ~$10M annualized run rate EBITDA improvement • Corporate cost savings – ~$5M annualized run rate EBITDA improvement • Patient care management – Consistency in care – Improved utilization and outcomes 24 |
![]() 25 Guidance ¹ Calendar Year 2013 ² Net revenue: $1.28 - $1.32 billion EPS: $0.45 - $0.55 Diluted shares: 31.5 million 1. Guidance based on continuing operations excluding the effects of any one-time costs associated with our announced market exit activity or corporate expense initiatives. 2. Provided as of the date of our form 8-K filed with the Securities and Exchange Commission on April 30, 2013. |
![]() Investment Rationale • Favorable demographic trends • Positive attributes of home based care • IT infrastructure/scalability • Clinical quality and innovation • Strong liquidity and capital position • Market share capture opportunities 26 Efficient Core Business Care Mgmt Solutions |
![]() Contact Information Tom Dolan SVP Finance and Treasurer Amedisys, Inc. 5959 S. Sherwood Forest Boulevard Baton Rouge, LA 70816 Office: 225.299.3391 Fax: 225.298.6435 tom.dolan@amedisys.com 27 |