EX-99.1 2 dex991.htm INVESTOR RELATIONS SLIDE SHOW IN USE BEGINNING FEBRUARY 26, 2009 Investor Relations Slide Show in use beginning February 26, 2009
Investor Day 2009
www.amedisys.com
NASDAQ: AMED
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 a
prediction of future events. 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 or any changes in events, conditions
or circumstances upon which any forward-looking statement may be based.

Important Website Information
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.

Overview/Vision
William Borne
Founder/Chairman/
Chief Executive Officer

Financial Highlights
$-
$200,000
$400,000
$600,000
$800,000
$1,000,000
$1,200,000
2003
2004
2005
2006
2007
2008
$142,473
$227,089
$381,558
$541,148
$697,934
$1,187,415
Revenue
$-
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
$90,000
2003
2004
2005
2006
2007
2008
$8,407
$20,504
$30,102
$38,255
$65,113
$86,682
Net Income

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
1
Increased prevalence of chronic and co-morbid conditions
1
Source: United States Census Bureau

2008 Medicare Benefit
Outlays by Service
Source: Winter 2007 -
KPMG’s Washington Healthcare Update

Projected Savings

25% of beneficiaries account for approximately 85% of
Medicare spending
12% of beneficiaries account for approximately 69% of
Medicare spending
5% of beneficiaries account for approximately 43% of Medicare
spending
These chronically ill beneficiaries see 14 physicians a year, fill
an average of 50 different prescriptions, account for 76% of all
hospital admissions, account for 88% of all prescriptions filled
and
72%
of
physicians
visits
The least expensive 50% of Medicare beneficiaries account for
only
4%
of
spending
1
Holtz-Eakin
D. High-cost Medicare beneficiaries. Congressional Budget Office, pp. 1-12 (May 2005) http://www.cbo.gov/ftpdocs/63xx/doc6332/05-03-
MediSpending.pdf; CBO Budget Options, Health Care, p. 77 (Dec. 2008)
2
Testimony
of
Gerard
F.
Anderson,
Ph.D.,
Johns
Hopkins
Bloomberg
School
of
Public
Health,
Health
Policy
and
Management
,
before
the
Senate
Special
Committee on Aging, “The Future of Medicare: Recognizing the Need for Chronic Care Coordination, Serial No. 110-7, pp. 19-20 (May 9, 2007); CBO Budget
Options, Health Care, p. 77 (Dec. 2008)
3
“
High
Cost
Medicare
Beneficiaries,”
Congressional
Budget
Office,
p.
4
(May
2005)
Medicare Beneficiary Recipients
1
1
2
3

Public
Referral sources
Fiscal intermediaries
Administrative
CMS
MedPac
GAO
Policy makers
Influences

Seen as commodity based with downward pricing pressure
Size
Technology
Performance Metrics
Financial strength
Move to a value-added company that improves the healthcare
system
Add value
•
New medical model
•
Policy changes
Commodity Based To Value Added

Old Medical Model

New Medical Model

Why needed?
Potential solutions
Home care infrastructure
Amedisys information and communication technology
capabilities
New model of care
Future of health care
Comprehensive, Continuous Chronic
Care Management in the Home

The Alliance is a national consortium of home health care
organizations and providers that raises awareness about home
health care and its proven ability to deliver quality, cost-
effective, patient-centered care for patients.
Members:
Almost Family, Inc.
Amedisys, Inc.
Bayada Nurses
Gentiva Health Services, Inc.
HCR ManorCare
Interim Healthcare
LHC Group, Inc.
Liberty Home Care
NAHC (National Association for Home Care & Hospice)
VNAA (Visiting Nurse Associations of America)
Alliance For Home Health
Quality and Innovation

Finalizing legislative messaging
Awareness campaign
Revitalizing Congressional Home Health Working Group
Research
Launched research project with Avalere (results expected early
April 2009) to demonstrate home health value proposition in
avoiding re-hospitalization
Quality working groups
Close partnership with CMS, AHQA and NQF on numerous quality
demonstration initiatives
Alliance Recent Developments

Collateral Legislation
Home health legislation
Independence at Home
Medical Home

Operations
Larry Graham
President/
Chief Operating Officer

Business Strategy
Three pronged business strategy
Grow
–
Internally
–
Acquisitions
–
Start-ups
Operationally efficient
Quality outcomes

0
100
200
300
400
500
600
3/31/06
6/30/2006
9/30/2006
12/31/2006
3/31/2007
6/30/2007
9/30/2007
12/31/2007
3/31/2008
6/30/2008
9/30/2008
12/31/2008
12
12
13
14
17
17
27
29
38
44
44
48
229
235
249
261
273
296
311
325
442
454
461
480
241
247
262
275
290
313
338
354
480
498
505
528
Home health agencies
Hospice agencies
Home Health and Hospice Agencies
Growth

Growth -
Internal
2008 internal revenue growth of 28%
Internal revenue growth targeting to be 15% through 2009
Internal revenue comprised volume (internal admissions &
internal recertifications) and rate variance

(1) Internal episodic-based revenue growth is the percent increase in our base/start-up episodic-based revenue for the period as a percent of the total episodic-based revenue of the prior period.
(2) Internal episodic-based admission growth is the percent increase in our base/start-up episodic-based admissions for the period as a percent of the total episodic-based admissions of the prior period.
(3) Internal episodic-based recertification growth is the percent increase in our base/start-up episodic-based recertifications for the period as a percent of the total episodic-based recertifications of
the prior period.
Growth –
Internal Episodic Volume
16%
21%
27%
27%
28%
26%
28%
28%
30%
13%
15%
13%
11%
10%
7%
13%
14%
11%
37%
34%
32%
32%
35%
32%
26%
23%
20%
0%
5%
10%
15%
20%
25%
30%
35%
40%
December 31, 2006
March 31, 2007
June 30, 2007
September30,
2007
December31,
2007
March 31, 2008
June 30, 2008
September30,
2008
December31,
2008
Revenue growth (1)
Admission growth (2)
Recertification growth (3)

28,019
31,599
31,376
32,672
34,002
38,859
53,561
53,203
53,748
22,726
24,300
27,032
29,441
31,839
34,464
46,236
48,367
49,773
46,716
48,974
53,958
55,983
60,940
65,295
94,203
94,986
98,592
-
20,000
40,000
60,000
80,000
100,000
120,000
December 31, 2006
March 31, 2007
June 30, 2007
September 30, 2007
December 31, 2007
March 31, 2008
June 30, 2008
September 30, 2008
December 31, 2008
Admissions (1)
Recertifications (2)
Completed episodes (3)
Episodic-Based Growth -
Volume
(1)
Episodic-based
admissions
are
defined
as
the
number
of
patients
admitted
to
our
agencies
during
the
period
for
the
first
60-day
episode
of
care
where
payors
reimburse
us
for
services
provided
on
an
episodic-basis,
which
include
Medicare
and
other
insurance
carriers,
including
Medicare
Advantage
programs.
(2)
Episodic-based
recertifications
are
defined
as
the
number
of
patients
recertified
to
our
agencies
during
the
period
for
an
additional
60-day
episode
of
care
where
payors
reimburse
us
for
services
provided
on
an
episodic-basis,
which
include
Medicare
and
other
insurance
carriers,
including
Medicare
Advantage
programs.
(3)
Episodic-based
completed
episodes
are
defined
as
the
number
of
patients
that
have
either
reached
the
end
of
their
60-day
eligibility
period
or
terminated
their
service
before
the
60-day
eligibility
period
has
lapsed
where
payors
reimburse
us
for
services
provided
on
an
episodic-basis,
which
include
Medicare
and
other
insurance
carriers,
including
Medicare
Advantage
programs.

Case mix weight
Wage index adjustment
–
Acquisitions can cause adjustments
Acuity impacts case mix
Episodic-Based Growth –
Rate Growth

$2,264
$2,339
$2,339
$2,339
$2,339
$2,270
$2,270
$2,270
$2,270
$2,612
$2,644
$2,671
$2,679
$2,666
$2,680
$2,852
$2,879
$2,981
$1,700
$1,900
$2,100
$2,300
$2,500
$2,700
$2,900
$3,100
12/31/2006
3/31/2007
6/30/2007
9/30/2007
12/31/2007
3/31/2008
6/30/2008
9/30/2008
12/31/2008
Revenue Per Episode
CMS Base Rate(1)
AMED Avg. Medicare-Based Revenue(2)
Average Medicare Revenue per Completed Episode
(1)
Medicare
program
base
episodic
rates
are
set
through
Federal
legislation.
The
actual
base
episode
payment
rate
paid
by
Medicare,
vary
depending
on
the
home
health
resource
groups
(“HHRGs”)
to
which
Medicare
patients
are
assigned.;
the
per
episode
payment
is
typically
reduced
or
increased
by
such
factors
as
our
patient’s
clinical,
functional,
and
services
utilization
characteristics.
(2) Amedisys
average episodic-based revenue per completed episode is the average episodic-based revenue earned for each episodic-based completed episode of care.
Growth –
Rate Growth

43%
41%
58%
27%
0%
10%
20%
30%
40%
50%
60%
70%
Hospital Referral
Physician Referral
Referral Source
Amedisys
National Norm
Source: OCS Corporate Comparative Report
Period: 1/1/08 –
9/30/08
Professional Sales Force
Over 800 sales force for home health
Target both the doctor and discharge planners

More than 70 Clinical Tracks
Care Management

Reported Purchase Price
Number of Deals
$148.6m
8
$17.8m
9
$120.5m
10
$478.1m
6
92
17
49
145
Growth -
Acquisitions

Prospect/LOI
Due Diligence
Integration Planning
Documents
Agency Conversion
-IT Infrastructure
-Point of Care
-Processes
Staffing Model
Pay Per Visit
Clinical Tracks
Mercury Doc
Care
Management
Programs
45-60 Days
30 –
180 Days
30 Days
180 + Days
Closing Day
Growth -
Acquisitions

Home health start-ups
typically generate $1.5 -
$2.0
million in run-rate revenue in
its second year of operation
~ 18 months to recoup the
$250,000 -
$350,000
investment
35 home health and 5
hospice start-ups completed
in 2008
Project 40 home health and 5
hospice start-ups for 2009
Yearly Start-Ups
Growth –
Start-ups

Automated mileage
Paperless
Targeted discipline
LPN vs. RN
Therapist Assistant vs. Therapist
Quality Care Coordinator -
QCC
Regional based
Efficiencies

Exceeded or met 10 out of 12 outcomes versus national
outcome average
Recorded improved or consistent scores in 11 of 12 categories
on a sequential basis
Outcomes –
June 2008
Amedisys vs. Nation
1
Lower % is better
Source: www.medicare.gov
High Quality Outcomes

Approximately $69 million in revenue in 2008
48 owned locations at December 31, 2008
Intend to open five new locations through startups in 2009
Occasional stand alone hospice acquisitions
Hospice

Clinical Operations
Alice Ann Schwartz
Chief Information Officer/
Senior Vice President of
Clinical Operations

Overview
Overview of patients served/clinical trends
How we deliver care (clinical platform)
Clinical regulatory results
Care management programs
Competitive advantages
Future clinical direction

Patients Served/Clinical Trends
Average Patient Age
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
# of Patients
Age Distribution
65 and Older
-
2008
-
10%             14%
18%            
23%
21%
11%
3%

Guideline
–
As poly pharmacy
needs increase, co-morbidities
and complexities increase.
As clinical complexities
increase, service levels
naturally increase.
Our average patient
medications have
increased year over year
Poly Pharmacy Trends

Predictive Stratification of High
Hospitalization Risk Patients
Amedisys
National
Diff
Very High
10%
6%
4%
High
41%
28%
13%
Moderate
39%
43%
(4%)
Low
9%
20%
(11%)
Very Low
1%
3%
(2%)
Very High
10%
High
41%
Moderate
39%
Low
9%
Very Low
1%
Amedisys

Functional Trends
The organization’s profile is one of increasing poly pharmacy needs,
increased hospitalization risk and increased functional debility.
Functional Trends Graph

Diagnosis Trend

Medicare Average Episodes per Patient (1)
(1)
Medicare average episodes per patient is calculated by dividing the total number of completed Medicare episodes in the period by
the total number of Medicare patients
who completed episodes in the period.
(2)
Medicare average episode per patient for this period does not include TLC agencies that were not converted to Amedisys's operating platforms as of the reporting period.
As comorbidities
and complexities increase,
service levels are impacted
Average Episode/Patient

0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
1-60
61-120
121-180
181-240
241-300
301-360
361-420
421-480
481-540
541-600
129,411
33,808
12,828
6,691
3,815
2,426
1,657
1,190
853
599
2008 Patients by Service Days
•
85% receive care/
discharged within 2
episodes
•
10% received care within
4 episodes
•
5% -
Chronic Subset
Days
Patients
Percentage
1-60
129,411
              
66.96%
61-120
33,808
                
17.49%
121-180
12,828
                
6.64%
181-240
6,691
                    
3.46%
241-300
3,815
                    
1.97%
301-360
2,426
                    
1.25%
361-420
1,657
                    
0.86%
421-480
1,190
                    
0.62%
481-540
853
                       
0.44%
541-600
599
                       
0.31%
Total
193,278
          
100.00%
Patient Length of Stay

0%
10%
20%
30%
40%
50%
60%
70%
1-60
61-120
121-180
181-240
241-300
301-360
361-420
421-480
481-540
541-600
2008
2007
Patient Length of Stay –
2008 vs. 2007

Standardized Outcome Index
Standardized Outcome Index

Outcomes –
June 2008
Amedisys vs. Nation
1
Lower % is better
Source: www.medicare.gov
Outcomes

Advanced age
Complex poly pharmacy needs
Higher hospitalization risk
Increasing functional trends
Organizational change in diagnostic subsets serviced
Trend of improving quality
Clinical Summary

Point of Care
Point of Care
Encore
Encore
•
Standardizing the
assessment
•
Identifying acute
exacerbations in the
community
•
Outcome based care
Linking at home clinical events
to physician oversight
Integrated DM
outreach services
Mercury Doc
Care Delivery Model

Level
Action
Review
State
Local regulatory audits are
conducted by state surveyors to
ensure compliance with
Medicare regulations
If an agency has a condition
level survey where issues are
not resolved by the return
survey, the site’s provider
number could be terminated
Intermediary
(Payment Processor)
Intermediaries conduct annual
pre and post payment reviews to
ensure compliance with Billing
Regulations
Providers placed on a payment
edit will have episodes reviewed
for a quarterly period. If the
payment denial rate is <15% the
provider is removed from the
edit. If they demonstrate >15%,
the edit will go into the next
quarter.
>4-5
quarters
–
potential
for
statistical sampling.
Federal
•
Cost Report Reviews
•
RAC Audit Recoveries
•
Whistle Blower
•
Federal Investigations
All Federal level inquiries could
result in monies paid back to the
government. Sanctions, reduced
market capitalization caused by
compliance concern.
Three Levels of Review for a
Medicare Provider

State Survey Level
Three types of survey citations:
Deficiency Free (perfect)
Standard Level
Condition Level
Our clinical strategy:
Mine all deficiencies
Root cause analysis
Embed advanced care protocols

57
50
100
150
200
250
2005
2006
2007
2008
Surveys by Outside Regulators
•
2005 –
Averaged 5 surveys/month
State Survey Level

•
2005 –
Averaged 5 surveys/month
State Survey Level

•
2005 –
Averaged 5 surveys/month
State Survey Level

•
2005 –
Averaged 5 surveys/month
•
2008 –
Averaged 16 surveys/month by regulators
State Survey Level

State Survey Level

A commitment to ongoing improvement of Clinical Practice
Internal Clinical Audits

•
2005 –
Perfect surveys averaged approx. 1 quarter of all
monthly surveys
State Survey Level –
Perfect
Surveys

•
2005 –
Perfect surveys averaged approx. 1 quarter of all
monthly surveys
State Survey Level –
Perfect
Surveys

•
2005 –
Perfect surveys averaged approx. 1 quarter of all
monthly surveys
State Survey Level –
Perfect
Surveys

•
2005 –
Perfect surveys averaged approx. 1 quarter of all
monthly surveys
•
2008 –
Perfect surveys represent almost half of all monthly
surveys conducted by outside regulators
State Survey Level –
Perfect
Surveys

•
As a system, average 2-11 provider edits annually
•
No trend of concerning pre or post payment denials
•
No provider number has ever extended into a 4th
quarter edit
•
No provider in the history of Amedisys has ever had a statistical
sampling applied to recoup monies
Intermediary Level

No Known:
Cost report impropriety inquires
RAC audits
Whistleblower allegations
Active federal investigations
Federal Level

Care Management Programs
14 care management programs
Evidenced based standards of care
Process of identification
Clinical credentialing
Growth/outcome tracking
Center of Clinical Excellence recognition

Category
Clinician
Count
Advanced Diabetes
4,639
Advanced Cardiac
4,973
Advanced Stroke
2,999
Advanced Wound
2,146
Total
14,757
Clinical Credentialing Achieved
Category
Units
Awarded
Diabetes
20,876
Cardiac
17,406
Stroke
8,997
Wound
10,730
Total
58,009
Continuing Education Units
2008 Summary
•
Credentialing Awarded –
14,757
•
CEUs Awarded –
58,009
Clinician Credentialing –
2008

Competitive Advantage
Industry leader in clinical outcomes
Year
over
year
trend
–
improved
quality
and
reduced
survey
risk
A commitment to embedding research based practice into our
care protocols
Engrained clinical competencies/credentialing infrastructure
Advanced care management platform
Successful at servicing the high acuity patient with complex
co-morbid needs

Next 24 –
36 Months
Continued clinical outcome improvements
Continued growth of deficiency-free surveys/reduced
regulatory risk
Continued reduction of the Hospitalization Rate
Continued
migration
of
our
technical
platform
–
CCM
Predictive, stratified, patient-centered care
Our Clinical Future

Future Clinical Delivery Models
A nationwide standardized care delivery model that
predicatively stratifies all patients and delivers a higher
level of advanced treatments based upon patient
centered need
Our Clinical Future

Compliance
Jeffrey D. Jeter
Chief Compliance Officer

Data
Consistency
Edits
RETROSPECTIVE
CLAIMS REVIEWS
PRE-BILLING
COMPLIANCE COMMITTEE
Bill Borne –
Chief Executive Officer
Beth Boulet—Sr. VP-Internal Audit
Larry Graham –President/Chief Operating Officer
Jeffrey Jeter—Chief Compliance Officer
Cindy Philips—Sr. VP-Human Resources
Dale Redman—Chief Financial Officer
Paula Scarton—Vice President-Compliance
Alice Ann Schwartz—Chief Information Officer
Point
Of Care
Pre-Billing
Audits
Compliance
Oversight
Audits
Special/
Workplan
Audits
ENFORCEMENT
-
Zero Tolerance Policy
Complaint
Audits
COMPLIANCE
REPORTING
-
Compliance Hotline
-
HIPAA Hotline
-
SOX Hotline
-
Employee Exit Interviews
-
Monthly Compliance Polling
COMPLIANCE
TRAINING
-
New Hire online
Compliance Training
-
New Employee Orientation
-
Business Development
Training (Anti-Kickback)
-
Billing Compliance Training
-
Annual Employee
Compliance Training
-
HIPAA Compliance Training
SCREENING
-
OIG Exclusion Database
-
Criminal Background Checks
-
DMV Record Check
Quality
Care
Coord.
HIPAA
Records
Mgt
Physician
Consultant
Program
BOARD OF
DIRECTORS
CHIEF
COMPLIANCE
OFFICER
COMPLIANCE
DEPT. STAFF
Compliance Infrastructure

Tiered and Targeted Compliance Training
All employees receive General Compliance Training upon hire
and annually
New employees participate in special compliance training as part
of New Employee Orientation
Employees involved in the billing process are required to
complete additional compliance training annually
Employees working in Business Development roles receive
additional training specific to their function
Compliance Training

Compliance Training

Point of Care
All employees receive General Compliance Training upon hire
and annually
Improves accuracy and completeness of documentation
Significant
compliance
controls
–
such
as
automated
mileage
calculation, electronic patient signatures, time/date stamping
Enhances data consistency
Enables centralized monitoring and data aggregation
Compliance Technology

Compliance Scorecard
Risk-based auditing format—focusing on conditions that are
suggestive of potential
compliance problems
Integrates specific risk measures from across various internal
vantage points
Utilizes peer aberrance analysis, which is a comparative
methodology similar to that undertaken by the fiscal intermediary
and the government
Compliance Technology

Compliance Technology /
Compliance Scorecard
Consolidated Compliance Scorecard—Company-wide

Compliance Technology
Physician Consultant Payment Tracking
Monitors payments to Medical Directors
Tracks contract status and payments and will not allow
payments to be issued that are not consistent with Anti-
Kickback and Stark Safe Harbors
Oversight of all physician contracts and payments is maintained
by the Compliance Department

Compliance Technology / PCPT

Compliance Audit Process
Types of Compliance Audits:
1.
Compliance Oversight Audits
•
Scorecard Audits
2.
Complaint Audits
•
Compliance Hotline
•
Exit Interviews
•
Internal Polling
3.
Special Audits / Work Plan Audits
•
Florida Outlier Audit
•
Balanced for Life Audit
•
HIPAA Security Audits
4.
Referral Audits
•
Quality Care Coordinator Requests
•
Operational Leadership Requests

Compliance Audit Protocols
Audit Process:
Agencies are selected by Compliance Department based on
risk factors
Sample size is determined by the agency’s average census
Charts are reviewed by Clinical Audit Managers, who issue a
report containing their clinical findings, as well as
recommendations for remedial actions
Agencies with unacceptable audit results are placed in queue for
follow-up audit 6 months post-remediation

Compliance Oversight Audits
Evolution Of Compliance Oversight Audit Process
February of 2005—Compliance Oversight Audit Process
commences
Initially focused on high-impact revenue events:
(1) High Therapy
(2) Low LUPAs
(3) High Case Mix
-
Emphasis on agencies performing better than
Company norms
2008—Compliance Dashboard expands risk measures;
automation and scorecards launched

Change in
Leadership
SOX
Complaints
HIPAA
Hotline
Acquisition
Status
Start-Up
Status
Clinical
Oversight Risk
Stratification
Rookie DOO
Compliance
Hotline
Employee
Polling
Exit
Interviews
Case Mix
Marginal
Visits
Billing without
Orders
Standardized
Frequencies
FMR
Status
ADR Status
High Risk
Clinical Events
Reverse
Surveys
Trended
Surveys
State Surveys
Patient Satisf.
Surveys
Average Visits/
Episode
Eee/Contractor
Ratio
Total
Turnover
High Internal
Growth
High Revenue
Programs
Clinical
Oversight Audit
Results
Low
LUPAs
Trended
High Therapy
COP Audit
Results
Timely DC &
Past Due
Recerts
SYS Holds
Late OASIS
Locks
Unmet Weekly
Frequency
Outstanding
Orders
PI Audit
Results
High Therapy I
(14-19 visits)
High Therapy II
(20+ visits)
Missed Visits/
Homebound
Status
Questionable
Recertifications
Trended Low
LUPAs
High Gross
Margin
Comprehensive Compliance Risk Criteria:
Compliance Oversight Audits

Consolidated
Compliance Risk
100%
Roll-Up
#
Company
Average
Up to
2
Standard
Deviations
$
2
Standard
Deviations
Operational
Risks
#
Company
Average
Up to
2
Standard
Deviations
$
2
Standard
Deviations
Clinical Risks
#
Company
Average
Up to
2
Standard
Deviations
$
2
Standard
Deviations
Revenue Risks
#
Company
Average
Up to
2
Standard
Deviations
$
2
Standard
Deviations
Complaint Risks
#
Company
Average
Up to
2
Standard
Deviations
$
2
Standard
Deviations
Regulatory Risks
#
Company
Average
Up to
2
Standard
Deviations
$
2
Standard
Deviations
Environmental Risks
#
Company
Average
Up to
2
Standard
Deviations
$
2
Standard
Deviations
Compliance Scorecard

Compliance Scorecard:
Revenue Risks Subgroup
Gross Margin
Percentage
Homebound
Missed
Visits
Low LUPA
High Case Mix
Trended Low
LUPAs
Questionable
Recerts
High Revenue
Programs (BFL)
High Case
Mix
Billing without
Orders
High Therapy 1
(14-19 visits)
High Therapy 2
(20+ visits)
Trended High
Therapy

Compliance Scorecard:
Compliance Scorecard:
Clinical Risks Subgroup
Clinical Risks Subgroup
Standardized
Frequencies
PI Audit
Results
Clinical
Oversight Risk
Stratification
High Risk
Clinical
Events
ADR
Status
FMR
Status
COP Audit
Results
Patient
Satisfaction
Surveys

Compliance Scorecard:
Compliance Scorecard:
Operational Risks Subgroup
Operational Risks Subgroup
Timely DC &
Past Due
Recerts
Late OASIS
Locks
Outstanding
Orders
SYS Holds
Average Visits
Per Episode
Weekly
Frequency
Not Met

Compliance Scorecard:
Compliance Scorecard:
Environmental Risks Subgroup
Environmental Risks Subgroup
Start-Up Status
High Internal
Growth
Employee-to-
Contractor
Ratio
Acquisition
Status
Change in
Leadership
Total
Turnover
Rookie
DOO

Compliance Scorecard:
Compliance Scorecard:
Complaint Risk Subgroup
Complaint Risk Subgroup
HIPAA
Hotline
SOX
Complaints
Employee
Polling
Exit
Interviews
Compliance
Hotline

Compliance Scorecard:
Compliance Scorecard:
Regulatory Risk Subgroup
Regulatory Risk Subgroup
Trended
Survey
Deficiencies
Deficiency-Free
Survey ( -
)
State Survey
Deficiencies

Compliance Scorecard:
Drill-Down Capabilities
Consolidated
Compliance Risk
Risk Subgroup
Individual Metric
or
or
By Agency
By Agency

Corporate
Compliance
Audits
Clinical
Oversight
Audits
Quality
Management
Audits
Internal
Audit
Quality Care
Coordinator
Reviews
Sarbanes
Oxley
Audits
External
Auditor
(KPMG) Audits
State
Surveys
Fiscal
Intermediary
Review
Comprehensive Audit Universe

Compliance Enforcement
Amedisys Corporate Compliance Plan
Based on OIG Model Compliance Plans for
home health and hospice
Basic “Zero Tolerance Policy”
Because of the risks posed to the Company
and its shareholders by fraudulent behavior,
Amedisys will take a zero tolerance policy relative
to fraud, abuse and waste involving federal health
care programs
Expanded “Zero Tolerance Policy”
Certain conduct –
such as an employee
circumventing anti-fraud controls –
while not per
se fraud, is regarded as a violation of the
Compliance Plan resulting in disciplinary action

Toll-Free Hotlines
Compliance Hotline
SOX Whistleblower Hotline
HIPAA Privacy Hotline
Toll Free, Available 24 hours/day, 7 days/week
Confidential, anonymous, non-retaliation policy
Exit Surveys
Given to all employees leaving Amedisys
Specific
compliance-related questions
Follow-up audits launched where necessary
Monthly Compliance Polling
90 active employees contacted monthly
Voluntary telephone questionnaire with CCO
Home health and hospice-specific questions
Follow-up audits launched where necessary
Compliance Reporting

Summary
Tiered and targeted training
Compliance-centric technology
Risk-based auditing
Zero tolerance
Varied reporting mechanisms

Financials
Dale Redman
Chief Financial Officer

Strong revenue growth
EPS growth of greater than 20% for six consecutive years
Stable margins
Low leverage
High cash flow
Financial Highlights

Financial Highlights

($ millions, except per share data)
Summary Financial Results
2006
2007
2008
Net revenue
$541.1
$697.9
$1,187.4
Period-over-period growth
41.8%
29.0%
70.1%
Gross margin
288.9
368.9
624.8
Margin
53.4%
52.9%
52.6%
CFFO
43.0
93.1
150.7
Adjusted EBITDA
1
75.7
109.8
181.4
Margin
14.0%
15.7%
15.3%
Adjusted fully-diluted EPS
2
$1.72
$2.32
$3.31
1
Adjusted EBITDA is defined as net income before provision for income taxes, net interest expense, and depreciation and amortization plus certain TLC integration costs and less the Alliance gain. Adjusted 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
Adjusted
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.
2
Adjusted diluted earnings per share is defined as diluted earnings per share plus the earnings per share effect of certain TLC acquisition costs and less the earnings per share effect of the Alliance gain. Adjusted diluted earnings per
share 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 Adjusted diluted
earnings per share 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

2007
2008
2006
Agencies at period end
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
354
30.9%
4,302,830 
25.2%
129,649
19.9%
219,855
27.1%
$2,660
1.0%
275
24.4% 
3,437,881
45.4%
108,140
32.7%
172,930
42.9%
$2,634
2.6%
Summary Performance Results
528
48.3%
7,004,200
62.8%
199,371
53.8%
353,076
60.6%
$2,854
7.3%

Summary Balance Sheet
($ in millions)
Dec. 31, 2007
Assets
Cash
Accounts Receivable, Net
Property and Equipment
Goodwill
Other
Total Assets
Liabilities and Stockholders’
Equity
Debt
All Other Liabilities
Stockholders’
Equity
Total
Liabilities
and
Stockholders’
Equity
Leverage Ratio
$ 2.8
175.7
79.3
733.9
78.5
$ 1,070.2
$ 328.6
180.3
561.3
$ 1,070.2
1.6x
$ 56.2
96.3
68.3
332.5
33.8
$ 587.1
$ 24.0
116.1
447.0
$ 587.1
0.2x
Dec. 31, 2008
$ 25.2
144.1
75.4
734.2
58.8
$ 1,037.7
$ 417.4
151.9
468.4
$ 1,037.7
2.4x
Mar. 31, 2008

Days Revenue Outstanding (DSO)
(1)
For the three-month period ended March 31, 2008, our calculation of days revenue excludes the patient accounts receivable assumed in the TLC Health Care Services, Inc. (“TLC”) and Family Home
Health Care, Inc. and Comprehensive Home Healthcare Services, Inc. (“HMA”) acquisitions at March 31, 2008 by our average daily net patient revenue, excluding the results of TLC and HMA for the three-
month period ended March 31, 2008.
(2) 
Our calculation of days revenue outstanding (gross) is derived by dividing our period ending gross patient accounts receivable (defined as the summation of our Medicare patient accounts receivable, net of
estimated revenue adjustments and our other outstanding patients
accounts receivable, before considering the allowance for doubtful accounts) at December 31, 2008, 2007 and 2006 by our average
daily
net patient revenue for the three-month periods ended December 31, 2008, 2007 and 2006, respectively.
(3) )
Our calculation of days revenue outstanding (net) is derived by dividing our ending net patient accounts receivable (i.e. net of
estimated revenue adjustments and allowance for doubtful accounts) at
December 31, 2008, 2007 and 2006 by our average daily net patient revenue for the three-month periods ended December 31, 2008 and 2007, respectively.

December 31, 2007
December 31, 2008
Medicare
78,502
$                  
136,869
$                
Estimated revenue adjustments
(3,622)
                     
(7,220)
                     
Medicare patient accounts receivable, net
74,880
                    
129,649
                  
Non-Medicare
34,397
                    
73,101
                    
Allowance for doubtful accounts
(12,968)
                   
(27,052)
                   
Non-Medicare patient accounts receivable, net
21,429
                    
46,049
                    
Patient accounts receivable, net
96,309
$                  
175,698
$                
Accounts Receivable
Note:
On average we collect over 99% of our Medicare revenue.
On average we collect approximately 87% of our non-Medicare revenue
Combined we collect approximately 97.5% of all revenue
December 31, 2007
December 31, 2008
Medicare ERA + Non Medicare ADA
$17.1
$30.4
% of Revenue
2.5%
2.6%
($ in thousands)
($ in millions)

Liquidity
Available line of credit (LOC): 12/31/08
=
$160m
2009 Estimated CFFO -
Cap Ex -
Required Debt Pay   =
$140m

• Earnings before interest, taxes, depreciation and amortization ("EBITDA") and Adjusted EBITDA
2006
2007
2008
Net income
38,255
$                         
65,113
$                       
86,682
$                     
Add:
Provision for income taxes
23,642
                           
38,298
                         
54,714
                       
Interest expense (income), net
3,710
                             
(3,150)
                          
15,600
                       
Depreciation and amortization
10,106
                           
13,749
                         
20,406
                       
EBITDA (1)
75,713
                           
114,010
$                     
177,402
                     
Add:
   Certain TLC acquisition costs (2)
-
                                     
-
                                   
3,991
                         
Less:
   Alliance (3)
-
                                     
(4,212)
                          
-
                                 
Adjusted EBITDA (4)
75,713
$                         
109,798
$                     
181,393
$                   
• Adjusted Net Income Reconciliation
2006
2007
2008
Net income
38,255
$                         
65,113
$                       
86,682
$                     
Add:
Certain TLC acquisition costs (2)
-
                                     
-
                                   
2,446
                         
Less:
   Alliance (3)
-
                                     
(4,212)
                          
-
                                 
Adjusted net income (5)
38,255
$                         
60,901
$                       
89,128
$                     
• Adjusted Diluted Earnings Per Share Reconciliation
2006
2007
2008
Diluted earnings per share
1.72
$                             
2.48
$                           
3.22
$                         
Add:
Certain TLC acquisition costs (2)
-
                                     
-
                                   
0.09
                           
Less:
   Alliance (3)
-
                                     
(0.16)
                            
-
                                 
Adjusted diluted earnings per share (6)
1.72
$                             
2.32
$                           
3.31
$                         
Reconciliation of Non-GAAP Financial
Measures to GAAP Financial Statements
(1)
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.
(2)
Certain
TLC
integration
costs
incurred
primarily
for
the
payment
of
severances
for
TLC
employees
and
for
the
conversion
of
the
acquired
TLC
agencies
to
our
operating
systems
including
our
Point
of
Care
network.
(3)
Alliance
Home
Health,
Inc.
(“Alliance”),
a
wholly
owned
subsidiary
of
ours,
filed
for
Chapter
7
federal
bankruptcy
proceedings
in
September
2000.
That
case
is
now
concluded.
As
a
result,
the
remaining
$4.2
million
liabilities
of
Alliance
were
extinguished
and
we
are
not
liable
for
any
of
these
obligations.
The
discharge
of
the
liabilities
resulted
in
a
non-taxable
event.
(4)
Adjusted
EBITDA
is
defined
as
net
income
before
provision
for
income
taxes,
net
interest
expense,
and
depreciation
and
amortization
plus
certain
TLC
integration
costs
and
less
the
Alliance
gain.
Adjusted
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
Adjusted
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.
(5)
Adjusted
net
income
is
defined
as
net
income
plus
certain
TLC
acquisition
costs
and
less
the
Alliance
gain.
Adjusted
net
income
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
Adjusted
net
income
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.
(6)
Adjusted
diluted
earnings
per
share
is
defined
as
diluted
earnings
per
share
plus
the
earnings
per
share
effect
of
certain
TLC
acquisition
costs
and
less
the
earnings
per
share
effect
of
the
Alliance
gain.
Adjusted
diluted
earnings
per
share
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
Adjusted
diluted
earnings
per
share
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.

Summary
Strong revenue growth
EPS growth of greater than 20% for six consecutive years
Stable margins
Low leverage
High cash flow

Guidance
1
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 January 6, 2009 and reaffirmed on February 17, 2009
earnings call.
Calendar
Year
2009
2
Net revenue:
$1.425 -
$1.475 billion
EPS:
$4.10 -
$4.30
Diluted shares:
27.5
million

Q & A