EX-99.1 2 d628787dex991.htm EX-99.1 EX-99.1
Investor Presentation
Leading Home Health & Hospice
November 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.
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 except as required by law.
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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.


Company Overview
3
Overview
Founded in 1982,
publicly listed 1994
499 care centers in 37
states
Over 14,000 employees
Projected revenue in
2013 of approximately
$1.2 billion
Amedisys Home Health Care Centers (405 locations)
Amedisys Hospice Care Centers (94 locations)
Locations current as of 9/30/2013


Business Segments
4
Business
Segment
% of
Revenue
Reimbursement Type
HH -
Medicare
64%
Paid episodically (over a 60-
day episode of care)
HH –
Non-Medicare
15%
67% paid per visit; remainder
paid episodically
Hospice
21%
Mainly Medicare; paid at a
daily rate
1
Revenue mix based on 3Q13 revenue


Estimated Market Share –
Medicare Revenue
5
Note: Estimated market share of total 2011 Medicare reimbursement


6
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%


Medicare Reimbursement
7
2014 final rule (rebasing)
Sustainable growth rate legislation (Doc Fix)
Co-payment proposals
Hospice rebasing (U-shaped reimbursement)
Nursing home reimbursement
Reimbursement Considerations
Reimbursement Considerations


Favorable Long Term Trends
Compelling demographics
Patient preference
Low cost of care delivery
Increased payor and hospital focus
8
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
9
Current
Business
Dynamics
Issues
Fee for service based
High volume / low margins
“Retail”
relationships
Patients with multiple
conditions and physicians
Poor coordination /
communication
Misaligned incentives
Minimal data interchange
Regulatory limitations on
services
Limited physician
coordination


Future Trends
10
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


Strategic Plans
Shared service care centers
Patient care management
AMS3, next generation operating system
Bundled payment initiatives
Hospital partnerships
Established 3 new joint ventures in 2013
Actively involved in 2 ACOs
11


Shared Service Model
All care centers organized into shared service centers
63 shared service centers planned
Completed by the end of 2013
12
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


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


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
14


Capital Expenditures
15
PeopleSoft
IT Security
AMS3 Development


Bundles –
CMS Bundled Payment for Care Initiative
16
MD Spending 14%
Hospital
Discharge
Bundle Spending -
$10,000 to $15,000 per bundle
CMS to set target price for relevant services during bundle
Participants share savings and “at risk”
for costs greater than target
Amedisys is participating in five bundle sites
57 home health care centers across all sites
Agreed to terms with ~20 hospital partners; negotiating with additional partners
2 sites “go live”
on Jan. 1st
with the remaining 3 sites starting on Apr. 1st
Model 3 –
90 Day Post-Acute Bundle


Performance Initiatives
Business development staff investment
Clinician productivity improvement
50 care centers identified for exit in Q1
27 closed
6 sold
6 retained
11 under letter of intent or definitive agreement to be sold
Overall, negative contribution care centers represent a $5 million
quarterly drag on EBITDA in Q313
Of these, we are closing or consolidating 19 with quarterly combined
losses of $1 million
17


DOJ Settlement and Financing
Agreement in principle to pay $150 million
No admission of wrongdoing
Looking to avoid expense and distraction of ongoing
litigation
Negotiating settlement agreement and corporate
integrity agreement
$115 million due at time settlement agreement is signed
$35 million due six months afterward
Funded with cash on hand and revolver (credit facility
amended to accommodate settlement)
18


Summary Financial Results
19
($ in millions, except per share data)
2011
(1)
2012
(1)
3Q12
(2)
3Q13
(2)
Adjusted Net Revenue
$ 1,464
$ 1,488
$364
$302
Gross Margin %
46.7%
43.5%
43.2%
41.8%
Adjusted EBITDA
$ 157
$ 103
$26
$9
Adjusted EBITDA Margin
10.7%
6.9%
7.2%
2.9%
Adjusted EPS
$2.29
$1.08
$0.28
($0.01)
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 September 30, 2013 and September 30, 2012 are
adjusted for certain items totaling  $144.9 million and $1.0 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 November 12, 2013


Home Health Segment
20
($ in millions, continuing operations)
3Q12
(1)
4Q12
(1)
1Q13
(1)
2Q13
(1)
3Q13
(1)
Medicare Revenue
$227
$224
$213
$205
$194
Non-Medicare Revenue
$63
$56
$50
$46
$43
Total Revenue
$290
$280
$263
$251
$237
Gross Margin %
41.8%
42.1%
42.6%
42.8%
40.6%
Contribution
$31
$28
$27
$26
$17
Contribution %
10.7%
10.0%
10.2%
10.2%
7.0%
1.
Results as reported in our Quarterly Earnings Release Form 8-K for the quarter ended Sep. 30, 2013 as filed with the Securities and Exchange Commission on Nov. 12, 2013


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Home Health Operating Statistics
Medicare
3Q12
(1)
4Q12
(1)
1Q13
(1)
2Q13
(1)
3Q13
(1)
Admissions
47,429
47,730
50,117
47,825
45,481
Same store admissions growth
1%
1%
3%
0%
(2%)
Recertification rate
43.2%
39.9%
37.8%
36.4%
37.1%
Revenue per episode
$2,864
$2,846
$2,778
$2,831
$2,822
Visits per episode
18.9
18.4
17.5
17.7
17.3
Non-Medicare
Admissions
23,469
21,209
21,675
18,283
17,884
Visits
535,280
465,248
423,903
381,770
359,822
1.
Results as reported in our Quarterly Earnings Release Form 8-K for the quarter ended Sep. 30, 2013 as filed with the Securities and Exchange Commission on Nov. 12, 2013


Hospice Segment
22
($ in millions, continuing operations)
3Q12
(1)
4Q12
(1)
1Q13
(1)
2Q13
(1)
3Q13
(1)
Total Revenue
$74
$72
$67
$65
$65
Gross Margin %
48.6%
48.4%
47.1%
47.2%
46.5%
Contribution
$16
$14
$12
$13
$12
Contribution %
21.3%
19.3%
17.6%
19.6%
18.9%
Operating Statistics
Total admissions
4,667
4,629
4,957
4,655
4,352
Same store revenue growth
13%
3%
(5%)
(11%)
(13%)
Average daily census (ADC)
5,592
5,381
5,071
5,006
4,917
Average length of stay (ALOS)
102
106
103
99
98
1.
Results as reported in our Quarterly Earnings Release Form 8-K for the quarter ended Sep. 30, 2013 as filed with the Securities and Exchange Commission on Nov. 12, 2013


23
Summary Balance Sheet
Assets
Dec. 31, 2012
Sep. 30, 2013
Cash
$         15
$        44
Accounts Receivable, Net
169
111
Property and Equipment
157
160
Goodwill
210
208
Other
180
232
Total Assets
$       731   
$      755
Liabilities and Equity
Debt
$       103
$      71
Other Liabilities
174
157
DOJ Settlement Reserve
0
150
Equity
454
377
Total Liabilities and Equity
$       731  
$      755
Leverage Ratio
1.10x
2.68x
(1)
Days Sales Outstanding
42
32
($ in millions)
1.
Total debt in leverage ratio calculation includes reserve for $150 million preliminary DOJ settlement


24
Liquidity
1
1.
Availability under revolver of  $143 million
2.
Scheduled debt repayments include $4M per quarter of term loan payments and $40M of principal payments related to senior notes
3.
Other cash flows for 2012 include refinancing costs associated with credit agreement signed on October 26, 2012, retirement of long-term debt and
acquisitions.
($ in millions)
2012
3Q13YTD
2013F
Cash Flow From Operations
$ 69
$94
$ 105-110
Capital Expenditures
48
29
40-45
Debt  repayments
2
29
32
56
Cash Flow, Net
(8)
33
4-14
Beginning Cash
48
15
Other
3
(25)
(4)
End Cash
$   15
$44


Guidance
25
(Continuing operations only.  $ in millions, except per
share data)
1Q13
2Q13
3Q13
YTD
2013 Guidance
Revenue
(1)
$329
$316
$302
$947
$1,240-$1,250
Adj. EPS –
Earnings Release
(1)
$0.15
$0.18
($0.01)
$0.32
Legal Costs
(1)
$0.04
$0.03
$0.02
$0.09
Adjusted EPS -
Guidance
$0.11
$0.15
($0.02)
$0.23
$0.20-$0.25
1.
Results as reported in our Quarterly Earnings Release Form 8-K for the quarter ended Sep. 30, 2013 as filed with the Securities and Exchange Commission on Nov. 12, 2013. 
Based on 31.7 million diluted shares.


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
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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
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