Capio France Presentation to investors at Capio Clinique de Domont, Paris March 22, 2017 Philippe Durand, Head of Capio France
Agenda The company The market The strategy 2
This is Capio in France A significant proportion of Capio Mostly DRG payment since 2005 Self employed doctors 3
This is Capio in France Coherent clusters in key regions Capio France Sales of 561 MEUR 22 units, mostly MSO : - 8 emergency hospitals - 10 local hospitals - 3 specialist clinics - 1 day surgery center 734.5 no. of patients out of which more than 81% are outpatients 4 >25% market share in surgery in almost every local market
This is Capio in France Recognized as most advanced in Modern Medicine A leadership recognized by our peers 5
This is Capio in France Recognized as most advanced in Modern Management An ambitious training program recognized by industry peers 6
Agenda The company The market The strategy 20170322 Investors meeting 7 2017-03-21
Market growth and funding A solid public financing basis Market growth (%) Market growth >3% in volumes but managed c.2% through strong regulation Split of healthcare expenditures (%) Spendings level is decided annually by the government and approved by Parliament Public financing remains strong at 78% and stable over time A growing market due to new patients needs 8
Market size and private provision The largest private market in Europe Total spending on French healthcare expenditure, 2012 2 EUR bn Relevant healthcare market for Capio Private care Public care 47 47 64 16 48 21 17 4 132 67 65 Private provision represents c.50% of total Relevant market (acute care) for Capio represents c. 20 billion GPs and specialists 32 Medicine, Surgery, and Obstetrics (MSO) Hospital care Rehab., post -acute and psychiatry Total healthcare Split fairly stable along the years The private market leads the change in the industry 9
Healthcare environment price trends Under tension to protect deficits Healthcare expenditures & GDP To avoid higher deficits, Government keeps healthcare spendings growth as close as possible from GDP growth Considering volumes growth higher than GDP, this drives price decrease 10
Tariff construction Application to March 2017 tariffs Annual % of increase (decrease) 2017 ONDAM - national healthcare spendings target 2,10 Volumes regulation & government cost-cutting plan -3,00 Take back of tax and social cuts (only for private providers) -0,49 Prudential coefficient (*) -0,70 Total price increase (decrease) -2,09 (*) Applicable in case ONDAM target is exceeded The Government sets ONDAM target for the year It then sets tariffs after taking into consideration natural volumes increase and some cost-cuttings requests to the providers 11
France Market summary Conclusion A market mostly publicly financed but largely privately run Fundamental demographic and social trends sustain market growth A strong public regulation seeking for efficiency of the system and pushing the shift from inpatients to outpatients Top private providers focused on quality and productivity have room to benefit Capio well positioned due to systematic implementation of Modern Medicine
Agenda The company The market The strategy 20170322 Investors meeting 13 2017-03-21
The strategy A systematic approach to quality Increased focus on patient needs Mobilize patients through deeper involvement Monitor process all along the care chain Measure results 14
Modern Medicine and Modern Management Quality drives productivity Our 2 strategic pillars have positive effects on performance! 15
Modern Medicine and Modern Management Focus on AVLOS reduction
Modern Medicine and Modern Management Capio ahead of the market Source: ATIH and company data Still room for improvement compared to Swedish practices!
Modern Medicine and Modern Management Ambulatory is the future of the market From 31 % to 100% depending on the units! From 38 % to 92 % on cruciate ligamentoplasty The transfers to ambulatory will continue! 18 2017-03-21
Modern Medicine and Modern Management Capio is leading the ambulatory trend Source: ATIH and company data Ambulatory is the future of hospitalization!
Modern Medicine and Modern Management How do we achieve this? PURCHASING MEDICAL PRESCRIPTION MODERN MEDICINE ORGANISATION PROD SUPPORT HUMAN RESOURCES IT MARKETING Medical protocols drive 80% of our processes and costs
Modern Medicine and Modern Management Consolidation and star network strategy Consolidation strategy Increasing productivity Closing beds Merging Regroup existing facilities into new facilities Optimize flows and cost of operations Attract new doctors and patients Star network A star network is a physical and virtual network around main units Modern main units with a large set of activities attracting both patients and doctors Several small specialized units (e.g., day care center, rehabilitation and post-acute, psychiatry) Individual medical practices, consultations and homecare in areas surrounding Capio s clinics Proximity care centres Health Insurance/ Regional Health Authority Day care centres General practitioners Surgery Maternity Daycare Medicine Consultancies Emergencies Capio clinic Rehab Specialists Compli-mentary Insurances Homecare Dedicate doctors to local points of care Improve accessibility for patients Attract new patients 2007: Importing of Capio Model to France Today: Strong regional hubs Future: Integrated regional hubs structured along a star network
Consolidation strategy Regroup facilities to improve leverage Increasing productivity Closing beds Merging DOMONT Dedicated daycare centre Done To come by 2018 ST VINCENT : Regroup Orangerie rehab beds into St Vincent clinic MEDIPOLE: Regroup 2 existing clinics + 4 clinics from Mutualité into a new building ATLANTIQUE : Regroup Mail clinic onto Atlantique clinic BELHARRA : Regroup 3 existing clinics Into a new building ORANGE : Regroupe Provence clinic on Orange clinic QUINT FONSEGRIVES: Regroup 2 existing clinics in a new building Increased synergies lower fixed costs nicer environment 22 3 programs were sponsored by Regional Health Authorities
Consolidation and star network A clear regional footprint: example of the Bayonne area 2 1 4 3 23 Belharra : core unit with emergency, ICU, maternity, Aguilera : moving from surgery to geriatric medicine; dedicated to expand our offer in the South West of the area 3 Jean Le Bon : mostly ambulatory, dedicated to expand our offer in the North of the area Cardio center : focused factory, JV with the public hospital (75% Capio) Offer the best medical service to the population through focused and coordinated centers 1 2 4 2017-03-21
Capio s star network in the Val d Oise region 1 CCB : Core unit with emergencies, ICU, maternity, 2 2 Domont : Dedicated daycare centre Ermont 3 1 3 Cormeilles : Short stay medical & surgical center - 3 The development of Capio in Val d Oise region is a good example of the implementation of the star network, which saves the healthcare offer by favoring the efficiency of technical equipment, thus increasing added value for the patient. 24
Additional initiatives Develop the geriatric business Very strong demand from GPs Can add-on up to 1% organic growth annually Completed In Progress 25
Additional initiatives Strengthened procurement strategy Strengthening of our actions in FY17 European & French levels leverage on volumes Suppliers should become partners of modern medicine Short-term and long-term actions 26 2017-03-21
Additional initiatives Digitalization : the E-Fitback tool Connect the patient to us before and after treatment Before : improved patient preparation After : secures patient follow-up Overall improves: - Service level - Productivity - Quality data capture - Long-term connection to the patient and GP Already sponsored by 2 Regional Health Authorities 27
Conclusion Strengthened procurement strategy Prices decrease, BUT: Operating model is designed to drive productivity Strategy is supported by Health Authorities Strong local implementations to attract best medical teams New perspectives for sales development and productivity (geriatry, digital, procurement) A strong asset within Capio 28