HEALTHCARE STAFFING EDUCATION & TRAINING SEARCH

Transcription

1 HEALTHCARE STAFFING EDUCATION & TRAINING SEARCH February 2006

2 This presentation contains forward-looking statements. Statements that are predictive in nature, that depend upon or refer to future events or conditions or that include words such as expects, anticipates, intends, plans, believes, estimates, and similar expressions are forward-looking statements. These statements involve known and unknown risks, uncertainties and other factors that may cause our actual results and performance to be materially different from any future results or performance expressed or implied by these forward-looking statements. These factors include the following: our ability to attract and retain qualified nurses and other healthcare personnel; costs and availability of short-term leases for our travel nurses; demand for the healthcare services we provide, both nationally and in the regions in which we operate; the functioning of our information systems; the effect of existing or future government regulation and federal and state legislative and enforcement initiatives on our business; our clients' ability to pay us for our services; our ability to successfully implement our acquisition and development strategies; the effect of liabilities and other claims asserted against us; the effect of competition in the markets we serve, and other factors set forth under the caption Risk Factors in the Company's 10-K for the year ended December 31, Although we believe that these statements are based upon reasonable assumptions, we cannot guarantee future results. Given these uncertainties, the forward-looking statements discussed on this presentation might not occur. Specifically, while it is Cross Country Healthcare s intention to update its financial guidance quarterly, it should not be assumed that our silence over time means that actual events are occurring as expressed or implied in such forward-looking statements.

3 Our Mission Build the nation s leading provider of Staffing and Other Human Capital Management services to the Healthcare Industry.

4 Investment Highlights Long-term demand for healthcare services at a time of an unprecedented nursing shortage Trend toward outsourced labor in healthcare Strong revenue visibility Strong cash flow No direct third party or government reimbursement risk Proven record of financial performance Strong, experienced management team

5 Cross Country Overview Certified JCAHO healthcare staffing company Leading national healthcare staffing provider 20 years of history in the industry National client base of approximately 3,000 hospitals, pharmaceutical companies and other healthcare providers 88% of Honor Roll hospitals in annual ranking by US News & World Report Approximately 93% of revenue from healthcare staffing and 7% from non-staffing businesses 76% of total revenue from travel staffing Strong and Diverse Client Relationships No client represents more than 3% of revenue

6 Industry Growth Drivers Fundamental growth drivers remain unchanged: Continued scarcity and aging of nursing professionals Aging population demanding more hospital services State and Federal legislation re: minimum nurse staffing levels and mandatory overtime Hospitals desire for outsourcing and variable cost model Nursing professionals desire for job flexibility and better working conditions The temporary healthcare staffing industry accounted for approximately $11 billion in revenue in 2004 Prior market slowdown due to: Hospital Business Cycle: Focus on costs to facilitate staff nurse productivity and reduce contract staffing Soft Job Market: Nurses working more shifts; many parttime nurses working full-time equivalent hours Lower than expected in-patient admissions Current market dynamics: Improving labor dynamics leading to more favorable price and supply environment; hospital admissions remain weak

7 Demand for Healthcare Staffing Increasing demand for healthcare services due to aging of the baby boomers Increasing utilization of outsourced labor U.S. Healthcare Staffing Market Growth in Hospital Admissions $7.9 $10.0 Revenue ($Billions) $12.5 $11.4 $11.2 $11.7 $ P 2006P Projected Growth +5% +7% (mm) Revenue By Segment Travel Nursing $1.7 $1.9 Per Diem Nursing $4.6 $4.8 Locum Tenens $1.1 $1.4 Allied Health/Other $3.7 $4.4 Sources: Staffing Industry Analysts, Inc. estimates and projections. HCFA.

8 Occupations With Largest Job Growth Nursing Aids, Orderlies and Attendants 343,000 Waiters/Waitresses 367,000 General and Operations Managers 376,000 Cashiers 414,000 Food Prep and Service Workers 454,000 Customer Service Reps 460,000 Retail Salespersons 596,000 Postsecondary Teachers 603,000 Registered Nurses 623, , , , , , , ,000 Number of New Jobs Created Source: U.S. Bureau of Labor Statistics

9 Nursing Supply Average Age of Registered Nurses NCLEX Exam Participants (Thousands) Industry estimates reflect that 30 states are currently experiencing a nursing shortage, and by 2020, 44 states and the District of Columbia are projected to have shortages This situation will continue to deteriorate Average age of RNs continues to increase RNs seeking alternative careers Increasing RN retirements Sources: National Sample Survey of Registered Nurses and Fitch, Inc.

10 New RNs vs. Retiring RNs New Entrants and Losses from the Licensed Pool of RNs for Selected Periods 400, , , , , , , ,000 New Entrants Losses Source: Projected Supply, Demand and Shortages of Registered Nurses: HRSA, July 2002

11 Significant Outsourcing Opportunity Amount Type Duration Approx. 92% of RN Staffing in Hospitals Direct Hire Full/Part Time Employee Approx. 8% of RN Staffing in Hospitals is Outsourced Travel 25% Per Diem 75% Permanent 8-26 Weeks 1-3 Shifts/ Week Use of Temporary Workers Increases Contract Labor as Pct. Of Personnel Expense 4.7% 5.5% 6.3% 6.9% 8.0% 8.1% Total acute care hospital spending on nursing services was approximately $60-$65 billion in 2002 Hospital contract labor as a percentage of personnel expenses increased 72% from 1997 to 2002 Source: Shoemaker and Howell, Trends in the Use of Contract Labor Among Hospitals, 8/20/04

12 Customized Staffing Models Office Network Assignment Length Transactional Intensity Availability Recruiting Activity Candidate EBITDA Margin Estimates Per Diem Decentralized; local offices in each major market Daily shift work High 24x7 availability to candidates and clients Local customers; local candidate pool Wide range of ages; married candidates; full- and part-time 6% to 10% Travel Centralized; few offices for nationwide coverage 13 weeks or longer Low 4 to 6 weeks lead time on orders Nationwide customers; national candidate pool Primarily younger, unmarried candidates; full-time 8% to 12% 2002E Nurse Staffing Industry Revenue: Approximately $6.0 Billion Travel 25% Per Diem 75% Source: Company Reports

13 Strategic Initiatives Obtain exclusive or preferred provider status with client hospitals Leverage Cross Country Healthcare s quality reputation JCAHO VHA CHCA Target new sources of eligible nurses Leverage #1 brand Med-Staff NovaPro Cross Country Local Assignment America Manage internal recruitment capacity

14 Vendor Consolidation Percent of Organizations By Industry Planning To Consolidate Staffing Vendors 60% 50% 40% 30% 20% 10% 0% 58% 41% 20% 17% Mfg/Industrial Healthcare Service/Retail Gov't/Ed Sources: 2003 Staffing Industry Analysts, Inc.

15 Exclusive / Preferred Provider Relationships Suite Of Staffing Solutions Education Assessments Technology Interview Servicing Vendor Management (Fixed-Term) Vendor Management (Flexible) Developing an orientation plan to ensure the RN s success. Leveraging technology to manage staffing needs and vendor relationships (StaffingOffice. com). Utilizing the Clinical Liaison Team (RNs) to reference, screen, and interview candidates. Reducing costs and improving efficiencies by consolidating staffing providers. Increasing revenue and guaranteeing workforce supply.

16 Different Strategies for Different Facilities Identifying the right mix of services based on a hospitals unique needs and total temporary staffing utilization. Total Temporary Staffing Spend $10 M $5 M $3 M $2 M $1 M $500 K StaffingOffice.com Low Primary Provider Vendor Management Single-Source Interview Servicing High Complexity of Implementation

17 Cross Country Recruitment Cross Country TravCorps Flagship brand recruits travel nurses and allied healthcare professionals Industry leading and single largest brand NovaPro Markets to experienced travel nurse looking to customize compensation package Cross Country Local Targets part-time and full-time nurses working within 50 miles of their home Assignment America Recruits registered nurses for long-term contracts from Englishspeaking foreign countries (Canada, UK, Ireland, New Zealand and Australia) Med-Staff Large recruiter and provider of travel nurses and per diem temporary healthcare professionals

18 Most Recognized Travel Staffing Brand Name Unaided awareness more than 3x greater than any other travel nursing brand 10% of hospital based nurses are very familiar with the Cross Country TravCorps brand Travel Staffing Company Brand Awareness Among Hospital Based Nurses 40% 30% 31% 20% 10% 10% 9% 7% 7% 6% 6% 6% 4% 4% 3% 2% 0% Brand A Brand B Brand C Brand D Unaided Brand Awareness % Very Familiar Source: Study conducted for Cross Country by The Brand Institute in January 2002.

19 Strong Referral Network/Extensive Database of Professionals REFERRALS ADS WEB Over 50% Proprietary Database of More than 200,000 Professionals Thousands of Healthcare Professionals Applied in 2005 Includes Candidate Work History, Geographic Preferences, etc. RECRUITER Establish Initial Dialogue with Candidates and Maintains Relationships Works with Candidates Throughout the Placement Process on First and Subsequent Assignments

20 Industry Leading Service Drives Nurse Retention Centralized Operating Structure Supports Large Volume of Placements Recruiter Works With Nurse to Choose Optimal Assignment Centralized Systems: Housing Benefits Education Payroll Clinical Hotline Recruiter Continues Relationship with Nurse, Targets Next Assignment Approx. 70% Of Nurses Renew For Consecutive Contracts

21 Financial Highlights Strong free cash flow Conservative balance sheet High revenue and earnings visibility Contracts typically 13 weeks in duration Minimal capital investment requirements Proven record of successfully integrating acquisitions

22 Financial Information (Amounts in $000, except per share data) Revenue Income From Continuing Operations Net Income Diluted EPS Operating Cash Flow 2000 $368 $6.7 $4.6 $0.20 $ $504 $9.6 $8.7 $0.34 $ $626 $33.0 $29.8 $0.88 $ $673 $26.4 $25.8 $0.79 $ $654 $20.6 $20.7 $0.63 $ $645 $15.3 $14.8 $0.45 $30.8 CAGR +11.9% +17.9% +26.3% +17.6% +21.6%

23 Revenue Growth Drivers Revenues ($ in millions) TravCorps $ % 6-year CAGR 9% 6-year Organic CAGR Heritage NovaPro $14.9 $25.5 ClinForce $28.3 $7.5 Med-Staff $82.1 $ Organic Growth $(11.3) $(73.7) $(35.1) $88.7 $92.9 $63.1 $642.8 $124.6 $324.4 Acquisition Organic Base $193.8 $193.8 Base

24 Key Healthcare Staffing Metrics Full-Time Equivalents (FTE s) 4,167 4,816 5,535 5,917 5,756 5,573 Avg./Revenue/FTE/Week $1,619 $1,865 $2,046 $2,069 $2,045 $2,068

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