EX-99.1 2 dex991.htm INVESTOR RELATIONS SLIDE SHOW - JANUARY 13, 2009 Investor Relations Slide Show - January 13, 2009
January 2009
www.amedisys.com
NASDAQ: AMED
We
encourage
everyone
to
visit
the
Investors
section
on
our
website
at
www.amedisys.com,
where
we
have
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as
press
releases,
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concerning
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business
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and
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intend
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website
to
expedite
public
access
to
time-critical
information
regarding
the
Company
in
advance
of
or
in
lieu
of
distributing
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press
release
or
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filing
with
the
SEC
disclosing
the
same
information.
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.
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
in
this
presentation.

Investment Highlights
Focus on home nursing and related services
to Medicare population
Large, growing and highly fragmented industry
Strong internal growth and cash flow
with low recurring routine cap ex
Proven operating model supported
by sophisticated technology system
Demonstrated ability to identify
and integrate acquisitions
Liquidity availability to fund external growth
Extensive delivery platform ideally positioned
for Medicare care management initiatives
Experienced management team

William F. Borne
Chairman and Chief Executive Officer
CEO
since
founding
the
Company
in
1982
Larry R. Graham
President
and
Chief
Operating
Officer,
Director
Joined
Amedisys
in
1996;
COO
since
1999;
President since 2004
Dale E. Redman, CPA
Chief Financial Officer
Joined
Amedisys
in
February
2007
Alice Ann Schwartz
Chief Information Officer
Joined
Amedisys
in
1998,
CIO
since
2004,
SVP Clinical Operations since 2003
Jeffrey Jeter
Chief Compliance Officer
Joined
Amedisys
in
2001
Management Team

Corporate Overview
Founded in 1982, publicly
listed 1994
534
2
locations in 37 states
Leading provider of home
health services
]
Services include skilled
nursing and therapy
94% of Home Health revenue
is episodic based (both
Medicare & non-Medicare)
1
For the nine-month period ended September 30, 2008
2
Both home health and hospice, inclusive of joint venture agencies, as of December 31, 2008
3
Annualized visits per year
4
Forecasted 2008 annual results as of 10/28/08 and reaffirmed 11/20/08
5
Forecasted 2009 annual results as of 1/06/09
Revenue Mix
Stats
14,500 employees
Daily visits = 18,300
6,750,000
visits per year
2008 revenue guidance = $1.175
billion
4
2009 revenue guidance = $1.475 billion
5
1
3

Patient Overview
Average patient is 81 years old
Higher acuity patient
Patient is taking an average of 13
medications
]
14 medications for greater than
two episodes

Patient Overview
84.1% of patients have two episodes of care or less:
]
66.4% of patients have only one episode of care
]
17.7% have only a second episode of care

Our Locations
1
As of December 31, 2008, inclusive of joint ventures.
National
home
nursing
provider
located
in
37
states
and
Puerto
Rico
.
Largest provider in the Southern and Southeastern United States.
–
484 home nursing
locations
–
50 hospice locations
1
1

Our Strategy
Focus on Medicare-eligible patients
Emphasize internal growth
Select, acquire and integrate quality home
care agencies
Focus on providing a cost-efficient
operating structure
Develop and deploy specialized programs
for chronic diseases and conditions
Expand care coordination platform
Start-up activities

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

Home Nursing Market
Source: CMS Oscar data books and Medpac
reports

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

Internal Growth
Internal revenue growth 28% for Q3 2008 and 27% for the first
nine months of 2008
Internal growth driven by:
–
Overall industry growth
–
Increase in episodic-based admissions
•
Focus on start-ups
–
Increase in episodic-based recertification's
•
Higher acuity levels and co-morbidities, requiring
more intensive services
–
Increase in episodic-based revenue per episode
•
Development of therapy intensive specialty
programs
•
Focus of the new Medicare payment system

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
35 home health and 5
hospice start-ups completed
in 2008
* Reported numbers are for home health start-ups
Yearly Start-Ups

Acquisition Strategy

TLC Integration
TLC Integration Complete
Detailed plan to wind-down TLC corporate
–
Converted all agencies as
of September 15, 2008
–
Closed all regional billing centers as of
October 24, 2008
–
Minor number of corporate employees
remained until December 31, 2008

High Quality Health Care
Source: OCS Corporate Comparative Report
Period: 1/1/08 –
9/30/08

Higher Acuity Level Patients
Source: OCS BBI Reporter Corporate Comparative Report          
Date Range:   2005-2007
Case Mix

18
High Quality Outcomes
Outcomes –
June 2008
Amedisys
vs. Nation
1
Lower % is better
Source: www.medicare.gov

High Quality Health Care
Care Management
–
13 disease management programs
–
70 clinical tracks
Specialty Division
–
Balanced For Life first program in
division
–
Serves higher acuity patients
–
Rolled out to 178 locations through 2008

Investments in Technology

Comprehensive Compliance Program
Local Level
•
Point of care system
enhances clinical
documentation accuracy
with real-time assessment
input
•
Clinical nurse review of
assessments
•
Physician review/approval
•
Standardized care plans
•
Weekly case conferences
•
Monthly audits
•
End of episode case review
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
•
Compliance training for all
employees
•
Compliance concerns hotline
•
Compliance review of metric
variances
•
Compliance manager site
visits
•
Semi-annual
clinical/compliance reviews
•
Annual Sarbanes-Oxley audit
•
Annual billing competency
testing
http://www.amedisys.com/pdf/Compliance3/Compliance_Controls.pdf

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
–
Better alignment of reimbursement with patient needs
–
Expands HHRG’s
from 80 to 153
–
More integrated reimbursement for therapy
–
Allocation of more dollars to later episodes
–
Benefits agencies with a greater mix of higher-acuity
patients
2009 Changes
–
Market basket increase of approximately 3%
–
Increase offset by 2.75% case mix creep adjustment
–
No rural add-on payment

Financial Highlights
Increasing revenue
Strong operating cash flow/low cap ex
requirements
Consistent EPS growth
Strong
balance
sheet
to
fund
future
growth
–
$250 million active shelf registration
–
$139
million unused revolving credit
facility through September 2008
1
2008 EPS -
After adding back certain expenses related to the
integration of TLC Health Care Services, Inc.)

1
We
have
reclassified
certain
costs
from
our
general
and
administrative
expenses
to
our
cost
of
service
for
health
care
insurance
costs
and
other
miscellaneous
expenses,
which
are
associated with our direct care employees, to conform to the current year presentation.
2
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
3Q07
Net revenue
Period-over-period growth
Gross margin
Margin
Operating income
Margin
EBITDA
Margin
Fully-diluted EPS
Period-over-period growth
3Q08
Net Income
$541.1
41.8%
288.9
53.4%
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%
114.0
16.3%
65.1
$2.48
44.2%
$180.9
32.0%
96.5
53.3%
25.7
14.2%
33.7
18.6%
20.2
$0.77
60.4%
$321.6  
77.7%
170.4
53.0%
43.6
13.6%
49.4
15.3%
23.5
$0.87
13.0%
1
2

2006
2007
3Q07
Agencies at period end¹
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
3Q08
DSO
1
Inclusive of home health and hospice locations and joint ventures
360
30.9%
4,302,830    
25.2%
129,649
19.9%
219,855
27.1%
$2,661
1.0%
51.3
275
3,437,881
108,140  
172,930
$2,634
52.9
344
1,102,913
32,672  
53,958
$2,672
49.3
511
48.5%
1,879,573    
70.4%
53,203
62.8%
94,986
76.0%
$2,868
7.3%
56.7
Summary Performance Results

Summary Balance Sheet
($ in millions)
Dec. 31, 2007
Sept. 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
$   5.7
179.8
80.4
701.1
83.7
$ 1,050.7
$  359.7
162.7
528.3
$ 1,050.7
$   56.2
96.3
68.3
332.5
33.8
$  587.1
$  24.0
116.1
447.0
$  587.1

Accounts Receivable
Note:
On average we collect over 99% of our Medicare revenue.
On average we collect approximately 86% of our non-Medicare revenue
September 30, 2008
December 31, 2007
Medicare
139,765
$                
78,502
$                  
Estimated revenue adjustments
(6,928)
                     
(3,622)
                     
Medicare patient accounts receivable, net
132,837
                  
74,880
                    
Non-Medicare
66,898
                    
34,397
                    
Allowance for doubtful accounts
(19,967)
                   
(12,968)
                   
Non-Medicare patient accounts receivable, net
46,931
                    
21,429
                    
Patient accounts receivable, net
179,768
$                
96,309
$                  

Accounts Receivable
Historically,
Amedisys
collects
over
99%
of
its
Medicare
receivables
–
Collections in 2008 have followed historical norms

Guidance
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 October 28, 2008 and reaffirmed on November 20, 2008
3
Provided as of the date of our Form 8-K filed with the Securities and Exchange Commission on January 6, 2009
Calendar Year 2008
Net revenue:
$1.150 -
$1.175 billion
EPS:
$3.20 -
$3.25
(after adding back certain expenses related to
the integration of TLC Health Care Services, Inc.)
Diluted shares:
26.9
million
Calendar Year 2009
Net revenue:
$1.425 -
$1.475 billion
EPS:
$4.10 -
$4.30
Diluted shares:
27.5
million
3
2
1

Summary
Focus on home nursing and related services
to Medicare population
Large, growing and highly fragmented industry
Strong internal growth and cash flow
with low recurring routine cap ex
Proven operating model supported
by sophisticated technology system
Demonstrated ability to identify
and integrate acquisitions
Liquidity availability to fund external growth
Extensive delivery platform ideally positioned
for Medicare care management initiatives
Experienced management team

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
We
encourage
everyone
to
visit
the
Investors
section
on
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.