Group Presentation. February 2010

Transcription

1 Group Presentation February 2010

2 Vision - Goal...what is a greater welfare for human kind, but health? Socrates Adage Our Vision To continuously develop the quality of the healthcare services we provide Our Goal To provide value for money quality services for people in need, while at the same time rewarding shareholders 2

3 Overview Owns and operates a nationwide, private network in Greece, comprising 86 medical units (18 Hospitals, 51 Medical Centres, 3 Ophthalmologic Centres & 9 Rehabilitation Centres) and Recently expanded in Balkans with 5 Medical Centres in Albania Active in both Primary (Medical Centres) and Secondary (Hospitals & Rehabilitation Centres) healthcare services (accessible by c. 90 per cent. of the Greek population) Operates 1,583 hospital beds as of 30/09/2009 mil FY 2005 FY 2006 FY 2007 FY 2008 Sales EBITDA % EBITDA Margin 2,604 (as of 30/09/2009) employees and more than 10,200 cooperating doctors Listed on ATHEX with a mil market cap as of 30/09/ % controlled by Axon Group - as of 30/09/2009 Sales CAGR of 19.33% and EBITDA CAGR of 27.42% for the period FY 05 FY 08 9M 09 FY 08 FY 07 FY 06 FY 05 In-patients 50,678 66,210 60,089 51,972 49,210 MC Visits 536, , , ,

4 Milestones Initial Expansion Acquisition Drive Positioning for further Growth Present Started in 1989 by 65 doctors as one business unit (Medical Centre) with a total surface of 400 m 2 Organic growth Axon Group acquires 20 per cent. Expansion outside Athens Wave of 9 acquisitions (2001) First newly built Maternity Hospital Genesis (Joint Venture with 142 local med. doctors) 120 mil. capital injection in H2 07 Increased foreign institutional participation % stake in IASO (30/09/2009), major maternity hospital in Athens of Euromedica (1991) Euromedica initially floated on ATHEX (1994) Newly built General Hospital of Rhodes (Joint Venture with 179 local med. doctors) Contracts with state funds and private insurance companies 3 new hospitals currently under construction & 4 at the planning face Real Estate of mil commercial value (as of 30/09/2009) Expansion in new market segments (e.g.: rehabilitation, neuropsychiatry) Total units surface 77,000 m 2 First investment outside Greece (Albania) 38 units Total units surface 127,239 m 2 48 medical & 4 supportive units were added in our portfolio; in total 86 medical & 5 supportive units 4 Data as of 28/02/2009

5 Geographical Presence 30 cities - 2 countries Tirana: 1 DC Sukth: 1 DC Babru: 1 DC Bilisht: 1 DC Kucova: 1 DC ALBANIA Florina: 1 RC (1) Serres: 1 DC, 1 DC (2) Alexandroupoli: 1 DC Didymoticho: 1 DC Kavala: 1 DC, 1 RC (2) Thessaloniki: 5 GH, 1 MH, 9 DC, 1 RC (2), Kastoria: 1 DC Kozani: 1 GH, 1 MH, 1 DC, 1 RC (2) Ptolemaida: 1 DC Katerini: 1 DC Limnos: 1 DC (2) 1 ΝΗ, 1 OnC (2) Corfu: 1 GH (2), 1 DC Larisa: 1 GH, 1 MH, 2 DC, 3 RC Grevena: 1 DC (2) Trikala: 1 DC, 1 DC (2) Mytilene: 1 DC Volos: 3 DC Karditsa: 1 NH, 1 DC, 1 RC (2) Zakynthos: 1 DC (2) Athens (broader area): 1 GH, 17 DC, 3 OC Achaia: 1 RC (2), 1 NH (2) Corinth: 1 DC Rhodes: 1 GH (1) Currently only operational as luxury accommodation (2) Under Construction Heraclion: 1 MH, 1 DC GH: General Hospital DC: Diagnostic (Medical) Centre Rethymnon: 1 DC Euromedica Owned Network MH: Maternity Hospital NH: Neuropsychiatric Hospital RC: Rehabilitation Centre OC: Ophthalmologic Centre OnC: Oncology Centre Greece: 22 prefectures, 25 cities, 81 medical units (18 H, 51 DC, 3 OC and 9 RC) Albania: 5 cities, 5 medical units (DC) 5 Data as of 28/02/2009

6 Growth Strategy Growth Matrix ABROAD DOMESTIC Athens Provinces Albania Other Organic Acquisitive Acquisitive Existing Areas Hospitals Medical Centers Rehabilitation Neuropsychiatry Existing Areas Medical Centers + + New Segments Oncology Elderly Houses Alzheimer Treatment Dementia Treatment New Segments Hospitals Oncology Alzheimer Treatment Dementia Treatment Neuropsychiatry Rehabilitation Elderly Houses 6

7 Market Structure and Competition Sales Share of Private Hospitals (2007) Competitive Advantages Athens Medical 22.9% Other 47.7% Euromedica 10.3% 86 units, 30 cities, 2 countries with hospitals, medical centres & rehabilitation centres Euroclinic 4.7% Iaso 5.4% Hygeia 9.0% Operational & financial partnership with doctors Sales Share of Private Medical Centers (2007) Bioiatriki 21.2% More than 10,200 cooperating medicine doctors Other 59.5% Euromedica 8.5% Iatropolis 5.9% Low labour cost operator 1.8:1 employees/bed (as of 30/09/2009) Diagnostiki 2.5% Skin Laser 2.4% Source: ICAP, FY 2007 sales figures 7

8 Greek Healthcare Continued growth in healthcare spending Greek Health Spending ( bn) Life-expectancy increase Ageing population (over 65 steadily grows to 31.5% of population by 2050) Highest proportion of daily smokers out of OECD countries (38.6%) 25,000 20,000 15,000 10,000 5, Public Private Obesity a serious issue with 21.9% of adults classified as clinically obese Public CAGR: 8.9% Private CAGR: 11.0% Source: OECD Source: ICAP 8

9 Business Model Operational & investment partnership with doctors Doctors are shareholders in individual local subsidiaries Business model aligns financial and operating interests Also creates strong barrier-to-entry for rivals Efficient cost control Europrocurement (100% subsidiary) centralises buying of consumables Data Design (80% subsidiary) develops software and MIS applications for realtime financial and operational managerial information ICU at the General Hospital in Rhodes Personnel per bed ratio stands at 1.8:1, while competition averages at 2.9:1 (as of 30/09/2009) Clinical excellence Focusing on minimally invasive procedures: - Fewer clinical infections - Better quality services - Throughput optimisation, better margins, opportunity to grow business with minimal investments X-Ray at the General Hospital in Rhodes 9

10 Business Model (cont d) Expansion of Network Identification of areas with excess demand Favorable economic and demographic characteristics Potential partnership opportunities with local doctors leading to an extended and diversified network of units Activities in primary (diagnosis) and secondary (therapy) segments Diagnostic facilities provide direct revenues (c. 25%) Cross sales between units Doctors are able to offer full menu services to patients Presence in Rehabilitation Centers Leading facilities mil invested in Operating Theatre at Kyanous Stavros General Hospital in Thessaloniki FY 05 FY 06 FY 07 FY 08 9M 09 Total Acquisitions Refurbishment Equipment Total

11 Revenue Drivers and Sources P a t i e n t s D r i v e r s Introductions by Medical Doctors 81% Insurance Funds 17% S o u r c e s Allowance of Social Security Funds 61% Direct Private Payments 31% Walk-in Patients 2% Capitation Agreements 8% Medical Centres Hospitals 11

12 Balance Sheet Data M 2009 Assets 9M 2009 FY 2008 FY 2007 FY 2006 FY 2005 Total Assets Total Fixed Assets 518, , , , , ,000 Tangible Assets Intangible Assets 370, , , , , , ,610 57, ,638 51, ,000 Current Assets 202, , ,756 95,751 75, ,000 Accounts Receivable Other Current Assets Total Assets Equity and Liabilities 162,525 39, , ,390 44, , , , ,293 80,032 15, ,573 65,560 9, ,629 Total Liabilities Long Term Bank Liablilities 513, , , , , , ,700 56, ,329 42, , M 2009 Tangible Assets Intangible Assets Accounts Receivable Other Current Assets Other Long Term Liabilities 21,158 22,687 35,716 16,084 14,593 Short Term Bank Liabilities Other Short Term Liabilities S/H's Equity Minorities Total Liabilities and Equity 95, , ,211 43, ,358 83, , ,178 41, ,255 89, , ,149 30, ,293 48,896 95, ,874 40, ,573 37,682 88, ,534 28, ,629 Note: Values in 000 Financial Ratios 9M 2009 Debt/Equity 1.77 Current Assets/Current Liabilities 0.91 FY 2008 FY 2007 FY 2006 FY Fixed Assets/Long Term Liabilities Note: Consolidated Data - IFRS

13 Profit & Loss Data ,000 Turnover FY 2008 Turnover 229,123 FY 2007 FY 2006 FY , , , , , ,000 50, ,000 35,000 30,000 25,000 20,000 15,000 10,000 5, EBITDA Gross Profit 47,695 46,226 33,638 25,650 Gross Profit Margin 20.82% 24.09% % 19.03% EBITDA 39,105 33,042 25,149 18,877(1) EBITDA Margin 17.07% 17.22% 15.95% 14.01% EBT -14,319 31,375 11,217 6,982 EBT Margin -6.25% 16.35% 7.01% 5.18% EAT -11,599 20,912 6,351 3,518 Available to: EAT Margin -5.06% 10.90% 4.02% 2.61% Shareholders 2,624 2,623 4,071 2,766 Minority Rights -14,222 18,289 2, EPS ( ) n/a Financial Ratios ROE n/a 8.49% 5.16% 3.36% ROA n/a 3.51% 1.87% 1.22% (1) Earnings before Interest Taxes Depreciation Amortization and Investment Income 13 Note: Values in 000 Note: Consolidated Data - IFRS

14 Operating Profitability 9M M 2009 Turnover 200, , ,000 50, ,000 5, ,000-10,000-15,000 9M M 2009 EAT 9M M M M 2008 Turnover 188, ,375 Gross Profit 40,049 32,795 Gross Profit Margin 17% 17% Operating EBITDA 33,499 27,448 EBITDA Margin 15% 14% Operating EBT 8,804-15,848 EBT Margin 4% -8% Operating EAT 6,170-10,173 EAT Margin 3% -5% Note 1: Excluding Investment Results Note 2: Values in 000 Note 3: Consolidated Data - IFRS 14

15 Organic & Acquisitive Growth Values in 000 TOTAL with 2008 M&A 2008 units units 2006 units 2005 units TOTAL with 2007 M&A 2007 units 2006 units 2005 units TOTAL with 2006 M&A Turnover 229,123 12,572 16,007 2, , ,868 6,007 1, , ,029 2, , ,761 EBITDA 39,105 3,477 3, ,700 33,159 1, ,369 24, ,709 18,877 EBT 9,663 3,211 3, ,455 13,767 2, ,806 10, ,202 6,736 EAT 6,448 2,387 2, ,240 8,694 1, ,663 6, ,609 3,290 Note: Not including IASO Results 2006 units 2005 units 15

16 Group Profitability Sales m CAGR: 19.33% CAGR of sales revenue is driven by: An increase in number of facilities operated by Euromedica 5 in January 2001 (677 hospital beds) ,1 191,9 134,8 158,0 FY 05 FY 06 FY 07 FY in December 2005 (827 hospital beds) 58 in December 2007 (1,343 hospital beds) 86 in January 2010 (1,583 hospital beds) EBITDA m CAGR: 27.42% EBITDA growth is attributed to: The increase in number of units (more than doubled in 2.5 years) % 17.2% 15.9% 14.0% 39,1 33,1 25,1 18,9 FY 05 FY 06 FY 07 FY 08 Margin increases due to - Procurement gains - Facilities maturing - Absorption of fixed costs across broader revenue base - Shift towards higher margin/less invasive cases EBITDA Margin 16

17 Operational Statistics Values in Hospitals 9M after M&A M before M&A 9M Total hospitalization days 146, , , , , ,785 Total number of beds Total number of inpatients 49,616 47,990 65,003 60,089 51,972 49,210 Average hospitalization days (No new Patients/bed hospital Occupancy Ratio (%) acquisitions) Average revenue per patient ( ) 2,469 2,370 2,384 2,304 2,351 2,211 Average revenue per bed/day ( ) Average revenue per day ( ) 448, , , , , ,069 Medical Centers Total number of visits 536, , , , , , ,720 Total visits per day 2,471 2,052 2,069 2,230 1,763 1,457 1,379 Average revenue per visit ( ) FY FY FY FY Note: Calculations do not include data of Panagia Hospital of Thessaloniki, Rehabilitation Centers and Neuropsychiatric Hospitals 17

18 Operational Statistics (cont d) Values in Hospitals 9M after M&A M before M&A Total hospitalization days 260, , , , ,668 Total number of beds 1,363 1,251 1,247 1,359 1,071 Total number of inpatients 50,678 50,448 48,763 66,210 60,619 Average hospitalization days Patients/bed Occupancy Ratio (%) Average revenue per patient ( ) 2,653 2,628 2,500 2,554 2,408 Average revenue per bed/day ( ) Average revenue per day ( ) 492, , , , ,900 9M FY FY Note: Calculations do not include data of Panagia Hospital of Thessaloniki 18

19 Competition at a Glance Total Assets (Values in mil.) Hospital Beds 1, Hygeia Euromedica Athens Medical 31/12/ /09/ Iaso 2,000 1,500 1, ,351 1,583 1,200 Hygeia Euromedica Athens Medical Iaso 630 Personnel per Bed Ratio Hygeia Euromedica Athens Medical Iaso 19 Data as of 30/09/2009 Source: Published Financial Statements

20 Acquisition Approach One of the initially acquired units was a General Hospital Change in performance of this particular unit is shown below Euromedica invested a total of 7.9m on building, refurbishment and equipment GENERAL HOSPITAL COMPARISON MATRIX 2003 (Before) 2006 (After) % Change Revenues (mil. ) % Number of Patients 15,479 17,466 13% Hospitalisation Days 53,932 56,483 5% Average Days of Stay % Average Revenue (1) per Patient ( ) 800 1,090 36% Average Revenue (1) per Hospitalisation Days ( ) % (1) Revenue does not include medical, prosthetic, hemodynamic, cardiologic surgery, sanitary and consumable materials. 20

21 Stock Market Data Shareholders Structure Axon Group: 64.85% Foreign Institutional Investors: 13.01% Domestic Institutional & Other Investors: 22.14% Athens Exchange Quote: EUROM Bloomberg: EUROM GA Equity Reuters: EMDr.AT Market Capitalization as of 30/09/2009: mil. Graph 01/10/ /09/2009 Average Daily Trading Volume: Jan. - Sep. 2009: 18,025 shares Increased participation of Foreign Institutional Investors (Dec. 06: 8.24% - Sep. 09: 13.01%) Data as of 30/09/

22 Medical Units Kyanous Stavros General Hospital Commissioned in1966 in Thessaloniki. Refurbished in 2000 and 2008 Personnel 288 Building area 6,696 m 2 Center of excellence for heart : cardiothoracic surgery, vascular surgery coronary angiography, angioplasty, coronary angioplasty 15,000 in-patients and more than 7,000 out-patients annually Operational Statistics 9M M 2008 Number of Patients 10,948 11,179 Hospitalization Days 27,224 28,443 Number of beds Kyanous Stavros General Hospital in Thessaloniki Average Days of Stay Occupancy ratio (%)

23 Medical Units (cont d) General General Hospital of Thessaloniki Commissioned 1978 in Thessaloniki and refurnished recently Personnel 322 Buildings area 11,000 m 2 Center of excellence of heart cardio-thoracic surgery, 18,000 in-patients and more than 5,000 out-patients annually Operational Statistics 9M M 2008 Number of Patients 14,989 13,368 Hospitalization Days Number of beds Average Days of Stay 43, , Occupancy ratio (%) General Hospital of Thessaloniki 23

24 Medical Units (cont d) Genesis Obstetric Gynecology & Surgery Hospital A private hospital exclusive for women s health care needs Operation started in full-time employees Greenfield project with 18, 682 m 2 constructed surface A successful joint venture with 142 maternity doctors, which reached the break-even point (EBITDA) in the first year of operations Operational Statistics 9M M 2008 Number of Patients 5,881 5,793 Hospitalization Days 22,481 22,856 Number of beds Genesis Obstetric Gynecology & Surgery Hospital in Thessaloniki Average Days of Stay Occupancy ratio (%)

25 Medical Units (cont d) General Hospital of Rhodes Commissioned in Rhodes in November 2006 Personnel 130 Buildings area 12,827 m 2 Greenfield Project. Joint Venture with 179 doctors, equipped with state-of-the-art medical devices. Operational Statistics 9M M 2008 Number of Patients 3,792 3,615 Hospitalization Days Number of beds 9, , Average Days of Stay Occupancy ratio (%) General Hospital of Rhodes Note: Occupancy ratio FY % 25

26 Medical Units (cont d) Panagia'' Hospital Established in 1974 in Thessaloniki Long term lease to the Greek Social Security Fund (IKA), since 1976 Type of agreement is a pre-ancestor of PPP agreements Number of beds 220 Total building surface 6,614 m 2 Land of 3,038 m 2 Medical Center of Peristeri Acquired in 1998 Personnel 31 Operational Statistics 9M M 2008 Total number of visits 28,213 Total visits per day , Panagia Hospital in Thessaloniki 26 Medical Center of Peristeri in Athens

27 Medical Units (cont d) New Rehabilitation Center of EUROMEDICA Group in Thessaloniki 3D Graphic Projection Representing an 28 mil total investment in a state-of-the-art Rehabilitation Center for Outpatient and Inpatient Nursing Currently under construction (95% of works completed as of 28/02/2010) Total surface of 13,232 m 2 Owned land of 20,000 m 2 Bed capacity 194 hospital beds Commissioning is planned for Q as of 31/03/2009

28 28 Group Organizational Chart

29 Corporate Social Responsibility Program Placing people s needs at the core of its philosophy and daily practice, EUROMEDICA has deployed a Corporate Social Responsibility Program, which revolves around the following six pillars: - supporting frontier areas of Greece - caring for the elderly - supporting sports - providing relief for ailing children - supporting education - working towards the promotion of science An Action Plan Committee was created, comprised of distinguished personalities of acknowledged prominence in diverse fields of expertise, in order to implement the EUROMEDICA s CSR Program. Members of the Committee are: - Nikolaos Legakis, Professor Emeritus of Microbiology, University of Athens - Dimitris Nanopoulos, Academic, Professor at Texas A&M University and President of the National Research and Technology Council - Mirella Papaikonomou, Scriptwriter - Elisabeth Plessa, Art Historian 29

30 Contact Details George M. Stamatakis Group Investor Relations Officer tel: (+30) fax: (+30) Kifisias Av., Athens, Greece Disclaimer This presentation belongs to Euromedica S.A. and it might contain certain forward looking statements/comments. Unless stated otherwise, these statements/comments are based on management s current expectations and are subject to uncertainty and changes in circumstances. Actual results may vary materially from the expectations that might be contained herein and viewers/listeners of this presentation are cautioned not to place undue reliance on any forward looking statements/comments. Euromedica S.A. undertakes no obligation to update or alter its forward looking statements/comments, whether as a result of new information, future events, or otherwise. This presentation serves only for informative purposes and it does not form or can be either referred as a buy, sell or hold solicitation for shares or for any other derivative or fixed income instruments. Investors must decide upon their investments, based on their own investing preferences, profile, financial status and advice from registered investment advisors/specialists. 30