EX-99.1 2 dex991.htm INVESTOR RELATIONS SLIDE SHOW Investor Relations Slide Show
Amedisys, Inc.
www.amedisys.com
NASDAQ: AMED
September 2008
Exhibit 99.1


1
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 Quarterly Reports on 10-Q, 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.
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 care
management initiatives
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
Dale E. Redman, CPA -
Chief Financial
Officer
-
Joined Amedisys
in February 2007
-
CFO of United Companies
-
Ernst & Young


4
Corporate Overview
1
Leading provider of home nursing services
504
2
locations throughout the United States
Services include skilled nursing and therapy
Home Health =94% revenue, Hospice = 6% revenue
94% of Home Health revenue is episodic based (both Medicare &
non-Medicare)
1)
For the six-month period ended June 30, 2008
2)
Both home health and hospice, inclusive of joint venture agencies, as of June 30, 2008


5
Our
Locations
1
1) As of June 30, 2008
National
home
nursing
provider
located
in
35
states.
Largest
provider
in
the Southern and Southeastern United States
-
458 home nursing
locations
-
46 hospice locations


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


7
Medicare Revenue Market Size
2006: Medicare
spending for home
health reached $14
billion                   
was $9.2 billion,
giving a combined
total of $23.2 billion
2017: Home Health
will contribute $36
billion
$20 billion
projected $56 billion
Source: CBO's
March 2008 Baseline: MEDICARE
MEDICARE Home Health and Hospice Revenue
and hospice
and hospice
of the


8
Home Nursing Market
Industry is highly fragmented
9,200
Medicare-certified nursing agencies
Most are single-site, 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
-
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
According to the United States Census Bureau


10
Internal Growth
-
Overall industry growth
-
Expanded and more effective sales force
-
Comprehensive range of clinical programs
-
Enhanced referral source education efforts
-
Focus on start-ups
Strong internal growth in episodic-based admissions
-
Approximately 13% for Q2 2008 and 10% for the first six
months of 2008
Internal revenue growth 28% for Q2 2008 and 27% for the
first six months of 2008
Internal growth 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
13 home health start-ups completed through June 30, 2008
* Reported numbers are for home health start-ups
Yearly Start-Ups
8
13
25
36
32
13
0
5
10
15
20
25
30
35
40
45
2003
2004
2005
2006
2007
2008
Projected
Completed
27
40


12
Acquisition Strategy
Acquisition rationale:
-
Industry leadership
-
Leverage our operating/business systems
-
Value accretion through synergies and agency profitability
enhancement
Acquisition criteria:
-
Defined pricing objectives
-
Targeted geographic profile
-
Compatible payor mix
-
Consistent clinical metrics
-
Expandable referral base
-
Opportunities for future internal growth


13
TLC Integration
Detailed plan to wind-down TLC corporate
-
Converted all agencies as of September 15, 2008
-
Converted ~ 17 agencies per month
-
Closing all regional billing centers by October 2008;
closed 2 regional billing centers through August 2008
-
Converted Human Resources, Accounts Payable and
Payroll mid-April


14
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 completed


15
High Quality Health Care
Care Management
-
12 disease management programs
-
70 clinical tracks
Specialty Division
-
Balanced For Life first program in division
-
Targets higher acuity patients
-
Rolled out to 96 locations through June 2008; 150 total locations
targeted for roll out by year end 2008


16
Comprehensive Compliance Program
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
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
Annual billing competency
testing
Corporate Level
Regional Level
Local Level


17
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
-
Expands HHRG from 80 to 153
-
More integrated reimbursement for therapy
-
Better alignment of reimbursement with patient needs
-
Allocation of more dollars to later episodes
-
Should benefit agencies with a greater business mix of higher-
acuity patients


18
Financial Highlights
Increasing revenue
Cash flow/low cap ex requirements
Consistent EPS growth
Strong balance sheet to fund future growth
-
$250 million active shelf registration
-
$138 million unused revolving credit facility through June
2008


19
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
2Q07
Net revenue
Period-over-period growth
Gross margin
Margin
Operating income
Margin
EBITDA
Margin
Fully-diluted EPS
Period-over-period growth
2Q08
Net Income
$541.1
41.8%
305.7
56.5%
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%
109.8
15.7%
65.1
$2.48
44.2%
$169.5  
27.5%
89.7  
52.9%
24.0  
14.2%
26.3
15.5%
14.9
$0.57
35.7%
$312.7  
84.5%
163.9  
52.4%
38.8 
12.4%
44.3
14.2%
20.4
$0.76
33.3%
1) EBITDA would have been $47.0 million after adding back $2.7 million ($1.6 million, net of income taxes) in certain TLC
Health Care Services, Inc. integration costs.
2) EPS
would
have
been
$0.82
after
adding
back
$0.06
per
diluted
share
for
certain
TLC
Health
Care
Services,
Inc
integration
costs in 2Q08.
1
2


20
Summary Performance Results
2006
2007
2Q07
Agencies at period end
1
Period-over-period growth
Completed Medicare Episodes
Period-over-period growth
Episodic-Based Admissions
Period-over-period growth
Revenue per Episode
Period-over-period growth
Total Visits
Period-over-period growth
2Q08
DSO
1)
Inclusive of home health and hospice locations
360
30.9%
4,302,830    
25.2%
129,649
19.9%
208,547
20.6%
$2,666
1.2%
51.3
275
3,437,881
108,140  
172,930
$2,634
52.9
313
1,049,008
31,376  
51,219
$2,671
46.8
504
61.0%
1,852,263    
76.6%
53,561
70.7%
87,055
70.0%
$2,852
6.8%
51.4


21
Summary Balance Sheet
($ in millions)
Dec. 31, 2007
June 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
$   1.7
161.9
78.5
697.5
82.9
$ 1,022.5
$379.2
147.3
496.0
$ 1,022.5
$   56.2
96.3
68.3
332.5
33.8
$  587.1
$24.0
116.1
447.0
$  587.1


22
Guidance
1)
Provided as of the date of our form 8-K filed with the Securities and Exchange Commission on July 17, 2008
Calendar
Year
2008
1
Net revenue:
$1.100 -
$1.150 billion
EPS:
$3.00 -
$3.10
(after adding back certain expenses related to
the integration of TLC Health Care Services, Inc.)
Diluted shares:
26.9
million


23
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


24
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