EX-99.1 2 dex991.htm INVESTOR RELATIONS SLIDE SHOW Investor Relations Slide Show
Amedisys, Inc.
www.amedisys.com
NASDAQ: AMED
January 2007
Exhibit 99.1


1
Statements
contained
in
this
presentation
which
are
not
historical
facts
are
forward-looking
statements.
These
forward-looking
statements
and
all
other
statements
that
may
be
contained
in
this
presentation
that
are
not
historical
facts
are
subject
to
a
number
of
risks
and
uncertainties,
and
actual
results
may
differ
materially
than
those
forecasted.
Such
forward-looking
statements
are
estimates
reflecting
the
best
judgment
of
Amedisys,
Inc.
management
based
upon
currently
available
information.
Certain
factors
which
could
affect
the
accuracy
of
such
forward-looking
statements
are
identified
in
the
public
filings
made
by
Amedisys,
Inc.
with
the
Securities
and
Exchange
Commission,
and
forward-looking
statements
contained
herein,
or
other
public
statements
of
Amedisys,
Inc.
or
its
management
should
be
considered
in
light
of
those
factors.
Forward Looking Statements


2
Investment Highlights
Large, growing and fragmented industry
Focus on home nursing and related services to Medicare population
Strong internal growth and cash flow with low recurring cap ex
Proven operating model supported by sophisticated technology
system
Demonstrated ability to identify and integrate acquisitions
Substantial liquidity and balance sheet capacity to fund external
growth
Extensive delivery platform ideally positioned for Medicare disease
management initiatives and payor diversification
Experienced management team


3
Management Team
William F. Borne -
Chairman and Chief Executive Officer
-
CEO since founding the Company in 1982
-
Registered nurse, extensive hospital administrative and clinical
experience
Larry R. Graham -
President and Chief Operating Officer
-
Joined Amedisys in 1996; COO since 1999; President since 2004
-
General Health Systems
-
Arthur Andersen
John F. Giblin, CPA -
Chief Financial
Officer
-
Joined Amedisys in October 2006
-
CFO of Crawford & Company
-
Arthur Andersen


4
Corporate Overview
Leading provider of home nursing services
275
1
locations primarily in the southern United States
Services include skilled nursing and therapy
Medicare accounts for approximately 93% of revenue year-to-
date
Hospice care accounts for ~
7% of revenue year-to-date
1) As of December 31, 2006


5
14
14
13
13
11
11
26
26
49
49
40
40
18
18
4
4
41
41
16
16
1
1
5
5
1
1
5
5
7
7
3
3
3
3
Our Locations
1
Largest home nursing provider in the
southern United States
-
261 home nursing locations
(shown)
-
14 hospice locations
1) As of
December
3, 2006
CON State
Non-CON State
1
1
3
3


6
Our Strategy
Focus on Medicare-eligible patients
Develop and deploy specialized nursing programs
Expand disease management capabilities
Prioritize internal growth
Select, acquire and integrate quality home care agencies
Leverage cost-efficient operating platform


7
Home health
care is a $62.8
billion
industry
Home nursing
is
the
largest
segment
in the
home health
industry
Medicare
spending for
home nursing
totaled $13.1
billion
in 2005
Home Health Care Spending
Home Health Industry Expenditures ($ billions)
Medicare
Home Nursing
$13.1
Home Nursing
(Commercial,
Medicaid &
Other)
$23.3
Home Nursing
$46.1
Infusion
Therapy
$5.5
Durable Medical
Equipment
$2.8
Respiratory
Therapy
$8.4
Hospice $9.7
Source:  Company Reports, CMS and CIBC World Markets Corp. estimates for 2005


8
Home Nursing Market
Industry is highly fragmented
8,100 Medicare-certified nursing agencies
Most are single-site or small local or regional providers:
-
Independently-owned agencies
-
Visiting nurse associations
-
Facility-
and hospital-based agencies
Publicly-owned providers account for less than 7% of the
home nursing market


9
Industry Growth Drivers
Trend from inpatient to home-based care:
-
Patient preference
-
Payor incentives
-
Technology advancements
Demographics –
aging population
Increased prevalence of chronic and co-morbid conditions


10
Internal Growth
-
Overall industry growth
-
Expanded and more effective sales force
-
Comprehensive range of clinical programs
-
Enhanced referral source education efforts
-
Increased focus on start-ups
Strong internal growth in Medicare admissions
-
Approximately 11% for Q3 2006 and 13% year-to-date
Internal growth being driven by:


11
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
Yearly Start-Ups
8
13
25
40
36
0
10
20
30
40
2003
2004
2005
2006
2007
* As of December 31, 2006
Completed
Projected


12
Acquisition Strategy
Disciplined approach
Acquisition criteria:
-
Defined pricing objectives
-
Targeted geographic profile
-
Compatible payor mix
-
Consistent clinical metrics
-
Expandable referral base
-
Opportunities for internal growth
Target hospital-based and multi-site agencies
Seven acquisitions over the last twelve months; 15 agencies
representing $20 million in revenues


13
Investments in Technology
Strategic advantages from technology
Standardized processes:
-
Automated review of assessment forms
-
Automatic scheduling
-
Web-based HR and payroll system
Centralized management of clinical oversight/utilization:
-
Real-time episode analysis
-
Daily/weekly review of quality indicators
-
Executive information system
Point of care roll-out currently underway:
-
Rolled out to 72 sites as of 9/30/06 and 90 by year-end 2006
-
Target completion date: June 2007
-
Expect $1.0 -
$1.5 million in quarterly savings beginning 3Q 2007
-
One-time cap ex investment of $9 -
$10 million


14
Comprehensive Compliance Program
Local Level
Clinical nurse review of
assessments
Standardized care plans
Physician
review/approval
Weekly case conferences
Monthly audits
End of episode case
review
Point-of-care system
enhances clinical
documentation accuracy
with real-time
assessment input
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
Semi-annual
clinical/compliance
reviews
Compliance review of
metric variances
Compliance manager
site visits
Compliance training for
all employees
Compliance concerns
hotline
Annual Sarbanes-Oxley
audit


15
Medicare Prospective Payment System
Implemented in October 2000
Base payment for 60-day episode of care
-
Adjusted for patient acuity and market factors
-
Reviewed and updated annually
Encourages efficient delivery of care
Benefits high-quality/low-cost providers


16
Medicare Reimbursement
Outlook for 2007 and 2008
-
Market basket
-
Case mix weighting
-
Rural add-on
-
Therapy threshold


17
Financial Highlights
Increasing revenue
Expanding margins
Cash flow/low cap ex requirements
Consistent EPS growth
Strong balance sheet to fund future growth


18
EBITDA
is
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.
Rather,
EBITDA
is
presented
because
it
is
a
widely
accepted
supplemental
financial
measure
that
we
believe
provides
relevant
and
useful
information.
Our
calculation
of
EBITDA
may
not
be
comparable
to
a
similarly
titled
measure
reported
by
other
companies,
since
all
companies
do
not
calculate
this
non-GAAP
measure
in
the
same
manner.
1)
Per
share
amounts
have
been
adjusted
for
the
4:3
split
announced
by
the
Company
on
October
25,
2006.
The
record
date
for that split is November 27, 2006.
Summary Financial Results
1
CY2004
CY2005
2005
2006
Net revenue
$227.1
$381.6
$262.7
$397.1
Period-over-period growth
59.4%
68.0%
61.5%
51.2%
Gross margin
131.0
218.5
152.1
224.8
Margin
57.7%
57.3%
57.9%
56.6%
Operating income
33.4
50.1
38.2
46.5
Margin
14.7%
13.1%
14.5%
11.7%
EBITDA
37.4
57.2
43.3
53.8
Margin
16.4%
15.0%
16.5%
13.5%
Fully-diluted EPS
$1.14
$1.41
$1.08
$1.23
Period-over-period growth
81.0%
23.7%
28.6%
13.9%
Nine Months
Ended September 30,
($ millions, except per share data)


19
EBITDA
is
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.
Rather,
EBITDA
is
presented
because
it
is
a
widely
accepted
supplemental
financial
measure
that
we
believe
provides
relevant
and
useful
information.
Our
calculation
of
EBITDA
may
not
be
comparable
to
a
similarly
titled
measure
reported
by
other
companies,
since
all
companies
do
not
calculate
this
non-GAAP
measure
in
the
same
manner.
($ millions, except per share data)
Summary Quarter Financial Results
Q1
Q2
Q3
Net revenue
$127.2
$132.9
$137.0
Period-over-period growth
80.6%
66.0%
22.2%
Gross margin
71.4
76.2
77.2
Margin
56.2%
57.4%
56.3%
Operating income
12.7
15.7
18.2
Margin
10.0%
11.8%
13.3%
EBITDA
15.2
18.2
20.4
Margin
11.9%
13.7%
14.9%
Fully-diluted EPS
$0.34
$0.42
$0.48
Period-over-period growth
---
10.5%
33.3%
Calendar Year 2006


20
2004
Net Revenue
Revenue of $381.6 million       
in 2005; 68.0% year-over-
year growth
Revenue of $397.1 million     
year-to-date 2006; 51.2%
period-over-period growth
Revenue of $137.0 million
for 3Q 2006; 22.2%
quarter-over-quarter growth
Strong internal growth
Year-Over-Year Revenue
($ millions)
$0
$100
$200
$300
$400
$500
2003
2005
YTD 2006
Quarterly Revenue
($ millions)
$0
$20
$40
$60
$80
$100
$120
$140
$160
Q1
Q2
Q3
Q4
2005
2006


21
EBITDA
1
EBITDA of $57.2 million in
2005; 52.9% year-over-year
increase
EBITDA of $53.8 million
year-to-date 2006; 24.2%
period-over-period
increase
EBITDA of $20.4 million for 
3Q 2006; 25.8% quarter-
over-quarter increase
1)
EBITDA
is
net
income
before
provision
for
income
taxes,
net
interest
expense,
and
depreciation
and
amortization.
EBITDA
should
not
be
considered
as
an
alternative
to,
or
more
meaningful
than,
income
before
income
taxes,
cash
flow
from
operating
activities,
or
other
traditional
indicators
of
operating
performance.
Rather,
EBITDA
is
presented
because
it
is
a
widely
accepted
supplemental
financial
measure
that
we
believe
provides
relevant
and
useful
information.
Our
calculation
of
EBITDA
may
not
be
comparable
to
a
similarly
titled
measure
reported
by
other
companies,
since
all
companies
do
not
calculate
this
non-GAAP
measure
in
the
same
manner.
Year-Over-Year EBITDA
($ millions)
$0
$10
$20
$30
$40
$50
$60
$70
2003
2004
2005
YTD 2006
Quarterly EBITDA
($ millions)
$0
$10
$20
$30
Q1
Q2
Q3
Q4
2005
2006


22
Earnings Per Share
1
Fully-diluted EPS of $1.41
for 2005; 23.7% year-over-
year increase
Fully-diluted EPS of $1.23
year-to-date 2006; 13.9%
period-over-period
increase
Fully-diluted EPS of $0.48
for 3Q 2006; 33.3%
quarter-over-quarter
increase
1)
Results
have
been
adjusted
for
the
4:3
split
announced
by
the
Company
on
October
25,
2006.
The
record
date
for
that
split
is
November
27,
2006.
Year-Over-Year EPS
1
$0.00
$0.20
$0.40
$0.60
$0.80
$1.00
$1.20
$1.40
$1.60
2003
2004
2005
YTD 2006
Quarterly EPS
1
$0.00
$0.10
$0.20
$0.30
$0.40
$0.50
$0.60
Q1
Q2
Q3
Q4
2005
2006


23
Capitalization Summary
($ in thousands)
September 30, 2006
Actual
Adjusted
Cash and cash equivalents
$9,855
$84,655
Debt and capital lease obligations:
Long-term debt, including current portion
$47,137
$4,012
Capital lease obligations, including current portion
792
792
Total debt and capital lease obligations
47,929
4,804
Stockholders' equity
231,754
348,688
Total capitalization
$279,683
$353,492
Net debt / LTM EBITDA
0.6x
---


24
Guidance
1)
Excludes one time charges associated with payment in full and termination of the Company’s credit agreement.
2)
Assumes no market basket increase or utilization of proceeds.
CY2006
1
Net revenue:
$530 -
$540 million
EPS:
$1.73 -
$1.77
Diluted shares:
22.3 million
CY2007
2
Organic revenue growth:
~ 15%
EBITDA margin:
~ 15%


25
Investment Highlights
Large, growing and fragmented industry
Focus on home nursing and related services to Medicare population
Strong internal growth and cash flow with low recurring cap ex
Proven operating model supported by sophisticated technology
system
Demonstrated ability to identify and integrate acquisitions
Substantial liquidity and balance sheet capacity to fund external
growth
Extensive delivery platform ideally positioned for Medicare disease
management initiatives and payor diversification
Experienced management team


26
Contact Information
Larry Graham
President/COO
Amedisys, Inc.
5959 S. Sherwood Forest Boulevard
Baton Rouge, LA 70816
Office –
225.292.2031
Fax –
225.295.9624
lgraham@amedisys.com
John Giblin
CFO
Amedisys, Inc.
5959 S. Sherwood Forest Boulevard
Baton Rouge, LA 70816
Office –
225.292.2031
Fax –
225.295.9624
jgiblin@amedisys.com