39th Annual J.P. Morgan Healthcare Conference
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Forward-Looking Statements
Statements contained in this presentation, including the question and answer portion of the presentation, other than statements of historical fact, are forward-looking statements.
In some cases, you can identify forw ard-looking statements by terms such as "may," "w ill," "should," "could," "would," "expects," "plans," "anticipates," "believes," "estimates,"
"projects," "predicts," "potential," or the negative of those terms, and similar expressions and comparable terminology intended to identify forward-looking statements. These forward-looking statements include, w ithout limitation, statements regarding the anticipated timing and strength of the opportunities available to Surgery Partners, Inc. and its subsidiaries (the "Company"), as well as the future financial position of the Company, including financial targets, business strategy, plans and objectives for future operations and future operating results and cash flows. These statements are subject to risks and uncertainties, including, without limitation: the duration and severity of the COVID-19 outbreak in the United States and the regions in which we operate; the impact to the state and local economies of prolonged restrictions as a result of the pandemic generally; our ability to respond nimbly to challenging economic conditions; the unpredictability of our case v olume both in the current environment and if and w hen restrictions are eased; our ability to preserve or raise sufficient funds to continue operations throughout this period of uncertainty; the impact of our cost-cutting measures on our future performance; our ability to cause distributions from our subsidiaries; the responsiveness of our payors, including Medicaid and Medicare, to the challenging operating conditions, including their willingness and ability to continue paying in a timely manner and to advance payments in a timely manner, if at all; the impact of COVID-19 related stimulus programs, including the CARES Act, and uncertainty in how these programs may be administered, monitored and modified in the future; our ability to execute on our operational and strategic initiativ es; the timing and impact of our portfolio optimization efforts; our ability to continue to improve same-facility volume and revenue growth on the timeline anticipated, if at all; our ability to successfully integrate acquisitions; the anticipated impact and timing of our ongoing efficiency efforts, as well as our ongoing procurement and revenue cycle efforts; the impact of adverse weather conditions and other events outside of our control; and the risks and uncertainties set forth under the heading "Risk Factors" in our 2019 Annual Report on Form 10-K and our Quarterly Reports on Form 10-Q for the quarters ended March 31, 2020, June 30, 2020 and September 30, 2020, and discussed from time to time in our reports filed with the Securities and Exchange Commission (the "SEC"). You should read the Company's annual report and all other filings w ith the SEC, av ailable at www.sec.gov, for a discussion of these and other risks and uncertainties. The forward-looking statements contained in this presentation speak only as of the date of the presentation, and the Company undertakes no obligation to update or revise any forward-looking statements for any reason, except as required by law. The business of the Company is subject to substantial risks and uncertainties, including those referenced above. I nvestors, potential investors, and others should give careful consideration to these risks and uncertainties and should not place considerable reliance on the forward-looking statements contained in this presentation.
Data and Information Contained in this Presentation
This presentation also contains market research, estimates and forecasts, which are inherently subject to uncertainties and actual events or circumstances may differ materially from events and circumstances reflected in this information. Certain data in this presentation was obtained from v arious external sources, and neither the Company nor its affiliates, advisers or representatives has verified such data with independent sources. Accordingly, neither the Company nor any of its affiliates, advisers or representatives makes any representations as to the accuracy or completeness of that data or has any obligation to update such data after the date of this presentation. Such data involves risks and uncertainties and is subject to change based on v arious factors. The trademarks included herein are the property of the owners thereof and are used for reference purposes only. Such use should not be construed as an endorsement of the products or services of such owners.
Non-GAAP Financial Measures
This presentation contains certain non-GAAP financial measures. A "non-GAAP financial measure" is defined as a numerical measure of a company's financial performance that excludes or includes amounts so as to be different than the most directly comparable measure calculated and presented in accordance w ith GAAP in the statements of income, balance sheets or statements of cash flow of the company. We present non-GAAP financial measures when we believe that the additional information is useful and meaningful to inv estors. Non-GAAP financial measures do not have any standardized meaning and are therefore unlikely to be comparable to similar measures presented by other companies. The presentation of non-GAAP financial measures is not intended to be a substitute for, and should not be considered in isolation from, the financial measures reported in accordance with GAAP. Reconciliations of these non-GAAP measures are included in our filings w ith the SEC and slides 49 and 50.
© 2021 Surgery Partners - Confidential & Proprietary Information
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Agenda
1
2
3
Who We Are
What Makes Us Unique
How We Drive Shareholder Value
© 2021 Surgery Partners - Confidential & Proprietary Information
3
Who We Are
Section 1
© 2021 Surgery Partners - Confidential & Proprietary Information
1 Who We Are
Our Core Values are Foundational to Who We Are
PATIENTS | PROVIDERS | |
- Act with integrity and transparency
- Be accountable
- Drive clinical and service excellence
- Promote a culture of diversity and inclusion
EMPLOYEES | PAYORS | |
- Demonstrate compassion and kindness
- Set and exceed expectations
Each quadrant represents a Surgery Partners stakeholder
Enhancing patient quality of life through partnership
© 2021 Surgery Partners - Confidential & Proprietary Information
5
1 Who We Are
We are a Business Built Over the Course of 20+ Years…
Initial Public
Offering
Transformational
Journey
2004 | ||||||
Formation of | 2011 | 2014 | 2015 | 2017 | 2018 | 2020 |
Surgery | ||||||
Partners | ||||||
1996
Formation of Symbion
Healthcare
© 2021 Surgery Partners - Confidential & Proprietary Information
6
1 Who We Are
-
Resulting in the Leading Independent Surgical Facility
Operator
30 States | ~$1.9 Billion | 10%+ Adjusted EBITDA |
Adjusted Revenues(1) | Growth Target (2) |
116 Ambulatory Surgery Centers
17 Short-Stay
Surgical Hospitals
4,000
Affiliated
Physicians
600,000+
Annual Patients
(1) 2019 FY adjusted revenues of $1,857M, see page 50 for reconciliation to GAAP Rev enues | |
(2) See page 49 for reconciliation to Adjusted EBITDA | |
© 2021 Surgery Partners - Confidential & Proprietary Information | Note: Q3 2020 SEC reported ASC count of 110 based on Tax Identification Number |
7 | |
1 Who We Are
We Have a Diversified Mix, Focused on High Value-Add Specialties, Supported by an Aging Population
Surgery Partners' Case Mix
Other(2)Musculoskeletal(1)18%
38%
GI 19%
25%
Ophthalmology
✓
✓
✓
✓
Strength with high acuity patients
Leading musculoskeletal platform
Expansive network of surgical capabilities
Leading trend to lower cost setting
Over 50% of Net Revenue From Musculoskeletal Procedures
(1) Includes pain management.
© 2021 Surgery Partners - Confidential & Proprietary Information | (2) Includes cardiology, ENT, general surgery, plastic surgery, and other. | |
Note: Case mix is based on Nov ember 2020 YTD | 8 | |
1 Who We Are
And a Strong, Vertically Integrated Management Team
Wayne DeVeydt
Execut ive Chairman of the Board
27 Years Healthcare Experience
03 Years with Surgery Partners
Jennifer Baldock
EVP & Chief Administrative Officer
24 Years Healthcare Experience
11 Years with Surgery Partners
George Goodwin
American Group President
33 Years Healthcare Experience
22 Years with Surgery Partners
Eric Evans
Chief Execut ive Officer
15 Years Healthcare Experience
02 Years with Surgery Partners
Patricia Hannon
Chief Clinical Officer - Nat ional
35 Years Healthcare Experience
1 Year with Surgery Partners
Brad Owens
Nat ional Group President
26 Years Healthcare Experience
02 Years with Surgery Partners
Tom Cowhey
EVP & Chief Financial Officer
18 Years Healthcare Experience
03 Years with Surgery Partners
Laura Brocklehurst
SVP & Chief Human Resources Officer
21 Years Experience
02 Years with Surgery Partners
Tony Taparo
Chief Growt h Officer
32 Years Healthcare Experience
24 Years with Surgery Partners
Veteran management team, averaging over 25 years of experience
© 2021 Surgery Partners - Confidential & Proprietary Information
9
1 Who We Are
That has Built a Solid Foundation to Capture Growth…
Where We Were | Where We Are | |
Solid, but un-pruned assets
Great platform, but fragmented
Lack of strategic clarity
FROM: A collection of great assets,
but under-managed…
Streamlined, surgical facility assets
Holistic infrastructure
Focused management and vision
TO: … A scalable platform with clear
strategic direction and purpose
© 2021 Surgery Partners - Confidential & Proprietary Information
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1 Who We Are
… Of the Over $150B Total Addressable Market (TAM)
Same-store volume growth
Expansion programs
Physician recruitment in
targeted specialties
Case shift in core specialties like Orthopedics, Spine & Cardiology
Idaho Falls Community
Hospital
Investment in innovative
technologies for service line
expansion
Surgical cases moving to | Consolidation of a fragmented |
outpatient setting - $60B+ | market through capital |
opportunity | deployment |
Several near and long-term catalysts to capture this opportunity
© 2021 Surgery Partners - Confidential & Proprietary Information | Note: Management's estimate of total addressable market consists of $55B+ HOPD surgical market, | |
$35B+ ASC market, and $60B of inpatient surgical cases with potential to move to outpatient setting. | 11 | |
What Makes Us Unique
Section 2
© 2021 Surgery Partners - Confidential & Proprietary Information
2 What Makes Us Unique
What Makes Us Unique
Uniquely positioned due to our focus on high growth specialties
Supported by our superior clinical quality and customer experience
Only independent surgical facility operator of national size and scale
Focused on consolidating an under-valued and fragmented industry with our distinctive scalable platform driving a more efficient and effective operation
Trusted partner of choice
© 2021 Surgery Partners - Confidential & Proprietary Information
13
2 What Makes Us Unique
What Makes Us Unique
Uniquely positioned due to our focus on high growth specialties
Supported by our superior clinical quality and customer experience
Only independent surgical facility operator of national size and scale
Focused on consolidating an under-valued and fragmented industry with our distinctive scalable platform driving a more efficient and effective operation
Trusted partner of choice
© 2021 Surgery Partners - Confidential & Proprietary Information
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2 What Makes Us Unique
Well Positioned to Capture $90B+ Existing Outpatient Surgical Market and ~$60B of Cases Migrating to Outpatient
Annual Revenue (US) Annual Volume Growth | |||
$500B+ | -2% | ||
Inpatient | $230B surgery | ||
$470B+ | 2% |
$55B+ surgery |
HOPD
$35B+ surgery | 6% |
ASC
$550B+
Office
$100B+
Home
Source: Bain & Co, McKinsey, Advisory Board, Sg2, AMA, Av anza, OECD, CMS, Management estimates
© 2021 Surgery Partners - Confidential & Proprietary Information
~$60B Incremental Shift of
Inpatient Surgical Cases
to the Outpatient Setting
15
2 What Makes Us Unique
Musculoskeletal and Cardio Procedures Make Up 60%+ of Inpatient to Outpatient Opportunity
Inpatient Surgical Procedures with
Potential to Shift to Outpatient Setting
Surgery Partners'
Clinical and
Operations platform well-positioned to accommodate shift
© 2021 Surgery Partners - Confidential & Proprietary Information | Source: Bain & Co | |
Note: Numbers may not sum due to rounding | 16 | |
2 What Makes Us Unique
We Have an Increasing Opportunity With the Highest Acuity
Specialties…
Case Volume by Specialty
+3x case growth over 8 years
- Net Revenue CAGR of +30% from 2012 to 2019
- Case mix aligned with higher acuity
172,902 | |||
115,671 | |||
80,712 | 88,761 | ||
78,136 | |||
52,838 | |||
15,051 | 14,090 | ||
Other(1) | GI | Ophthalmology | MSK |
2012 Nov '20 TTM
© 2021 Surgery Partners - Confidential & Proprietary Information | (1) Includes Cardiology, ENT, General Surgery, Plastic Surgery and Other | 17 |
2 What Makes Us Unique
-
Which Are Projected to Grow at a Disproportionately
Higher Rate
Migration of Orthopedic, Spine and Cardio procedures will fuel rapid ASC growth
Percentage of procedures performed in ASCs
80% | |||||||
70% | 68% | 66% | |||||
58% | 61% | ||||||
60% | |||||||
52% | |||||||
50% | |||||||
44% | |||||||
40% | |||||||
33% | 30% | ||||||
30% | |||||||
20% | |||||||
10% | 7% | 10% | |||||
10% | |||||||
4% | |||||||
0% | |||||||
Cardiology | Spine | Orthopedics | Other | ||||
2015 | 2018 | mid-2020s |
© 2021 Surgery Partners - Confidential & Proprietary Information | Source: Bain & Co |
18 | |
2 What Makes Us Unique
Leading Musculoskeletal & Cardio Platform
Musculoskeletal
Cardio
$3 billion | 9%+ |
Annual savings by shifting | Surgery Partners' historic |
50% of joint cases to ASCs(1) | orthopedic case growth |
11 | 80%+ |
Robots added in 2020, | Surgery Partners' facilities |
bringing total to 30 | perform MSK procedures |
17 | 6 |
Cardiac catherization | PCI procedures |
procedures approved in 2019 | approved in 2020 |
6%+ | 60%+ |
Surgery Partners' historic | Surgery Partners' facilities |
cardio case growth | with potential for Cardio |
© 2021 Surgery Partners - Confidential & Proprietary Information | (1) "New Research Highlights the Safety and Cost Savings Associated with Ambulatory Surgery Centers," UNH Research, 2020. | 19 |
2 What Makes Us Unique
Considerable Growth Ahead for Joint Replacements…
Inpatient and Outpatient Hip & Knee Replacement Forecast
Volume (millions)
2.0 | 57% | |||||
1.5 | 48% | |||||
40% | ||||||
15% | 31% | |||||
23% | ||||||
1.0 | 15% | |||||
0.5 | 85% | 77% | 69% | 60% | 52% | 43% |
- | ||||||
2018A | 2020P | 2022P | 2024P | 2026P | 2028P | |
Inpatient | Outpatient |
CAGR '18 - '28P
Outpatient = 20%
Inpatient = -0.7%
Outpatient volume expected to increase over 1 million casesand to
comprise over 50%of total knee & hip volume
© 2021 Surgery Partners - Confidential & Proprietary Information | Source: "Ev olution of Total Joint Replacements: From Hospital to Surgery Center", Sg2, 2019 | 20 |
2 What Makes Us Unique
-
And Medicare Continues to Advantage Outpatient
Surgical Facilities
Recent CMS Changes
Approved Total Joint Replacements
- 2020- Total Knee Arthroplasty approved for ASCs
- 2021- Total Hip Arthroplasty approved for ASCs
Eliminated Inpatient-Only List
- ~300 musculoskeletal procedures will be removed from the inpatient-only list over a three-year period, including 266 codes for 2021
- ~1,400 additional procedures are expected to be removed from the inpatient-only list over a three-year period
2.4% headline ASC increase, 2.9% SGRY mix-adjusted rate increase in 2021
20% cost savings for hip
replacements(1)
17% cost savings for knee
replacements(2)
500,000 fewer overnight
stays for patients(3)
$3B annual savings(3)
(1) Savings compares: Commercial Hip - $34.3K cost inpatient vs. $27.6K cost in ASC; Medicare Hip - $13.8K cost inpatient vs. $11K cost in ASC.
(2) Savings compares: Commercial Knee - $34.3K cost inpatient vs. $28.6K cost in ASC; Medicare Knee - $14.9K cost inpatient vs. $12.4K cost in ASC.
(3) Assumes half routine joint replacements performed in hospitals on an inpatient basis moved to ASCs.
© 2021 Surgery Partners - Confidential & Proprietary Information | Sources: "New Research Highlights the Safety and Cost Savings Associated with Ambulatory Surgery Centers," UNH Research, 2020. |
21 | |
2 What Makes Us Unique
Differentiated and Highly Capital Efficient Approach to Growing and Enhancing Orthopedics & Cardiology…
7. Supply chain initiatives
6. Payer strategies
5. In-Market and New Market Transactions
1. Demographic and site of service trends leading to future growth
2. Physician Recruitment
3. Add orthopedics and cardiology as a new service line
4. Expansion of orthopedic / cardiology service line (e.g., total joint program)
© 2021 Surgery Partners - Confidential & Proprietary Information
22
2 What Makes Us Unique
…. Leading to 9%+ Orthopedic Service Line Volume Growth
90 Locations
109k Orthopedic Procedures
650+ Orthopedic Physicians
97%+ Joint Case Growth at ASCs(1)
Orthopedic Case Volume
© 2021 Surgery Partners - Confidential & Proprietary Information | (1) Nov ember YTD '20 compared to Nov ember YTD '19 |
23 | |
2 What Makes Us Unique
Musculoskeletal has Proven Most Resilient Through COVID Disruption
Year-over-year surgical cases by key service lines
(1)
© 2021 Surgery Partners - Confidential & Proprietary Information | (1) Represents March and April 2020 | |
Note: Not days adjusted | 24 | |
2 What Makes Us Unique
What Makes Us Unique
Uniquely positioned due to our focus on high growth specialties
Supported by our superior clinical quality and customer experience
Only independent surgical facility operator of national size and scale
Focused on consolidating an under-valued and fragmented industry with our distinctive scalable platform driving a more efficient and effective operation
Trusted partner of choice
© 2021 Surgery Partners - Confidential & Proprietary Information
25
2 What Makes Us Unique
We Hold Ourselves to the Highest Standards…
Average Deficiencies per Survey(1) | Average Deficiencies per Survey(2) | |
25% Fewer | ||
10.00 | Deficiencies | 40.00 |
8.4 | ||
30.00 | ||
6.3 | ||
5.00 | 20.00 | |
10.00 | ||
0.00 | 0.00 | |
Surgery Partners | All Other | |
ASCs |
48% Fewer | |
Deficiencies | |
33.7 | |
17.6 | |
Surgery Partners | All Other |
Surgical Hospitals
© 2021 Surgery Partners - Confidential & Proprietary Information | (1) For ASCs - 2019 Health & Life Safety Tags | |
(2) For Hospitals - 2018 The Joint Commission surv eys | 26 | |
2 What Makes Us Unique
- And Regularly Report and Benchmark Our Performance to Emphasize our Culture of Safety…
Sample Metrics | Sample Reporting | |
- Patient burns
- Wrong site procedures
- Surgical site infections rate
- Patient falls
- Hospital transfers
- ER visits within 24 hours of discharge
- Hospital admissions ✓ Normothermia rate
within 24 hours of | upon arrival to the |
discharge | PACU |
✓ Unplanned | ✓ Toxic anterior |
anterior vitrectomy | segment syndrome |
rate | (TASS) rate |
© 2021 Surgery Partners - Confidential & Proprietary Information
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2 What Makes Us Unique
… With A Proven Record of Exceptional Clinical Care…
© 2021 Surgery Partners - Confidential & Proprietary Information
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2 What Makes Us Unique
-
And Clinical Efficacy that Results in a Better Patient
Experience
Nationwide Hospitals | Surgery Partners(1) | |
Best in Class Patient Experience
(1) Includes hospitals that were owned / operated by Surgery Partners FY2019 | ||
© 2021 Surgery Partners - Confidential & Proprietary Information | Note: Based on CMS star rating score | 29 |
2 What Makes Us Unique
We Focus on Patient Experience…
96
Facility
93 | 88 | |
Process | 94 | Financial |
Overall
Patient
Experience
94 | 95 |
Personal | People |
Cleanliness and comfort
Communication on insurance and financial responsibility
Exceptional administrative and clinical staff
Kept informed and procedure explanations
Patient experience and registration workflow
© 2021 Surgery Partners - Confidential & Proprietary Information | Note: Based on patient satisfaction surveys conducted from Dec '19 - May '20 | 30 |
2 What Makes Us Unique
- Which has Resulted in a Best-in-Class Patient Net Promoter Score
Patient Net Promoter Score
94
89
79
62
62
© 2021 Surgery Partners - Confidential & Proprietary Information | Note: Surv ey conducted from Dec '19 - May '20 | 31 |
2 What Makes Us Unique
What Makes Us Unique
Uniquely positioned due to our focus on high growth specialties
Supported by our superior clinical quality and customer experience
Only independent surgical facility operator of national size and scale
Focused on consolidating an under-valued and fragmented industry with our distinctive scalable platform driving a more efficient and effective operation
Trusted partner of choice
© 2021 Surgery Partners - Confidential & Proprietary Information
32
2 What Makes Us Unique
Surgery Partners is the Only Pure-Play of National Size and Scale
Surgical Facility
Revenue(1)
Revenue | % of Total | |
$1.9B 95%+
$1.3B ~15%
$2.5B ~1%
NA NA
$2.6B ~15%
Parent
Company
Public
Only Pure-Play
Surgery Center
Operator
Priv ate
Div ision of Env ision
Div ision of UHG
Div ision of HCA
Div ision of Tenet
Number of
Surgical
Facilities(2)
133
250+
230+
140+
334
Specialty Focus
- MSK, Cardiovascular, & Ophthalmology
- Gastrointestinal
- MSK & Cardiovascular
- NA
- MSK
(1) Surgery Partners data reflects 2019 FY adjusted revenues of $1,857M, see page 50 for reconciliation to GAAP Rev enues, Env ision based on LTM 6/30/2018 data, | ||
SCA rev enues based on CFO.com article 5/15/2019 and Tenet based on 2019Aresults pro forma for SCD acquisition per 12/10/2020 Investor Presentation. | ||
(2) Reflects latest av ailable data from company websites; Tenet data is pro forma for SCD acquisition based on 12/10/2020 Inv estor Presentation. | ||
© 2021 Surgery Partners - Confidential & Proprietary Information | Note: Based on most recent publicly available data | |
Source: Company filings and websites | 33 | |
2 What Makes Us Unique
What Makes Us Unique
Uniquely positioned due to our focus on high growth specialties
Supported by our superior clinical quality and customer experience
Only independent surgical facility operator of national size and scale
Focused on consolidating an under-valued and fragmented industry with our distinctive scalable platform driving a more efficient and effective operation
Trusted partner of choice
© 2021 Surgery Partners - Confidential & Proprietary Information
34
2 What Makes Us Unique
Well Positioned to Capture Share in a Fragmented Market
Number of ASCs in the U.S.
Total = 5,851 ASCs
Other Multi-site | |
Operators | Independent Single-site ASCs |
(10%) | |
(36%) | |
National | |
Platforms | Hospital Affiliated ASCs |
(18%) | |
(36%) | |
Chains with | Single facility providers |
multiple sites | |
Number of POHs in U.S.
~
94%
(6%)
Total Addressable Market: ~$90B+ Current and ~$60B+ Incremental To Come
© 2021 Surgery Partners - Confidential & Proprietary Information | Note: Total number of ASCs reflects only Medicare-certified ASCs. "National Operators" includes SGRY, USPI (pro forma for Dec '20 SCD acquisition), SCA, AmSurg, and HCA | |
Source: Becker's ASC Rev iew, VMG, Market participant interviews, KaufmanHall, J.P. Morgan, Bain & Company, and management estimates | 35 | |
2 What Makes Us Unique
Surgery Partners has Invested in Systems and Processes to Build a Platform Capable of Driving Acquisition-led Growth
Managed Care
• Invested in key talent
• Continuing to enhance our health plan value proposition through higher acuity service line expansions and growing regional presence/depth
- Piloting enterprise-wide contract management system
Revenue Cycle | ||||
• Invested in key talent | ||||
• | Restructured shared | |||
service center | ||||
• | Migrated 95%+ of facilities | |||
to unified clearinghouse | ||||
• | Investing in denials | |||
management and | ||||
coding technologies | Data / Analytics | |||
• | Invested in key talent | • | Migrating disparate | |
• | Centralized data warehouse | systems to end-state | ||
platforms |
Supply Chain
- Invested in key talent
- Migrated to one company-wide GPO
- Rationalizing implant vendors to secure best deals
- Investing in tools and processes to enhance compliance
Recruiting
- Invested in key talent
- Invested in data to better understand key physicians in target markets
- Launched innovative marketing programs
- Selected investments to enhance attractiveness of facilities (e.g., robotics)
© 2021 Surgery Partners - Confidential & Proprietary Information
36
2 What Makes Us Unique
We have Re-Focused on Short-Stay Surgical and are Re-Accelerating the Pace of Capital Deployment
Closed or Sold | Acquisitions | Transaction Highlights |
• Refocused portfolio on growing short-stay surgical assets
• 7 transactions to enhance presence and footprint in Idaho
• 4 transactions to enhance presence in Southern California market, including
✓ Bakersfield Heart Hospital (Oct 2020)
✓ GI-focused ASC (Dec 2020)
• Average multiple paid of ~7x since 2018
Surgery Partners has deployed ~$300 million of capital since early 2018;
Seeking to deploy an additional $100M+ in 2021
© 2021 Surgery Partners - Confidential & Proprietary Information
37
2 What Makes Us Unique
What Makes Us Unique
Uniquely positioned due to our focus on high growth specialties
Supported by our superior clinical quality and customer experience
Only independent surgical facility operator of national size and scale
Focused on consolidating an under-valued and fragmented industry with our distinctive scalable platform driving a more efficient and effective operation
Trusted partner of choice
© 2021 Surgery Partners - Confidential & Proprietary Information
38
2 What Makes Us Unique
We Have a Highly Flexible Model…
Multi-Site | Three-Way JVs |
Management | |
Facility |
Facilities | Two-Way JVs |
Facility
Services
Health
PayorsSystems
OR
We have a tailored approach to partnership and physician engagement
© 2021 Surgery Partners - Confidential & Proprietary Information
39
2 What Makes Us Unique
… Which Results in Highly Satisfied Physician Partners…
Physician Net Promoter Score
89
81
79
62
62
© 2021 Surgery Partners - Confidential & Proprietary Information | Note: Surv ey conducted in 2015; 366 respondents. | 40 |
2 What Makes Us Unique
… And Strong Physician Engagement and Retention
BETTER PARTNERS. BETTER CARE.
We are focused on physicians. Through decades of experience, we have observed that an outstanding patient experience begins with an outstanding physician relationship. Everyone wins when physicians have what they need to do their best work and can exercise autonomy within their place of work.
95%+
PARTNER
RETENTION(1)
We proudly boast 95%+ partner retention(1), and the findings from our most recent Net Promoter Score, the national ranking system used to measure satisfaction, nearly max out the upper end of the NPS scale.
© 2021 Surgery Partners - Confidential & Proprietary Information | (1) Physician partner retention based on 2019 data for 105 facility cohort |
41 | |
How We Drive Shareholder Value
Section 3
© 2021 Surgery Partners - Confidential & Proprietary Information
3 How We Drive Shareholder Value
Recognizing the Benefits of Our Transformational Journey
2018 | 2019 - 2020 | 2021 - 2024 |
Foundation of our | Executing on | Reaping the |
Transformational Journey | Our Strategy | Benefits |
Pruned Asset Base | Invested in Our Surgical Facilities | Top-Line Growth |
Recharged Organic Growth | Accelerated Organic Growth | Margin Expansion |
Rebuilt M&A Pipeline | Bolstered In-Market Pipeline | Capital Investment Returns |
Leveraged Scale | Leveraged Scale |
TRANSFORMATION | + | EXECUTION | = | DOUBLE-DIGIT |
EBITDA GROWTH | ||||
© 2021 Surgery Partners - Confidential & Proprietary Information
43
3 How We Drive Shareholder Value
Business Has Proven Resilient Through COVID-19 Disruption
Net Revenue Has Experienced Strong Rebound Since April
Same Facility Net Revenue vs. Prior Year
Same facility net revenue continues to
exceed prior year in 4Q 2020
© 2021 Surgery Partners - Confidential & Proprietary Information | Note: Days Adjusted | 44 |
3 How We Drive Shareholder Value
Reaping the Benefits: Proven Organic Growth Model
Top-line Growth | Margin Expansion | Capital Investment | ||
Volume | Procurement | Acquisitions |
Rate | Revenue Cycle | Expansions |
Managed Care | Org / Workflow | De Novos |
Efficiencies |
+4-6% EBITDA p.a. | +3-5% EBITDA p.a. | +3-5% EBITDA p.a. |
Sustainable double-digit organic EBITDA growth model
© 2021 Surgery Partners - Confidential & Proprietary Information
45
3 How We Drive Shareholder Value
Reaping the Benefits: Sustainable Long-termDouble-Digit AEBITDA Growth
$ in Millions
$420+
~$315
~$259 | ||||||
$250 | ||||||
~ $235 | ||||||
to | ||||||
$260 | ||||||
12.5%+
Growth CAGR
2020-2024
2018A 2019A 2020P 2021P 2022P
Near-termMid-term
2023P 2024P Long-term
- Return to growth
- Standardization
- Rationalization
- High-end /exceed 4-6%same-store revenues
- Managed Care, Revenue Cycle & Procurement opportunities
- IFCH achieves profitability
- Medicare and Managed Care opportunity continues to drive strong same-store growth
- Capital deployment
© 2021 Surgery Partners - Confidential & Proprietary Information
46
3 How We Drive Shareholder Value
The Surgery Partners' Advantage
$150B+ Total | Purpose-built, Veteran | Focused on High |
Addressable Market | Management Team | Growth Specialties |
+ | + |
Superior Clinical | Independent, Trusted | |
Quality and Customer | Scalable Platform | |
Partner of Choice | ||
Experience | ||
+ | + |
Equating to Near, Mid & Long-termDouble-Digit Growth
© 2021 Surgery Partners - Confidential & Proprietary Information
47
Appendix
© 2021 Surgery Partners - Confidential & Proprietary Information
Reconciliation to Adjusted EBITDA
The following table reconciles Adjusted EBITDA to Income before income taxes, the most directly comparable GAAP financial measure (in millions and unaudited):
EBITDA Adjustments
2019 | |||
Income (loss) before income taxes | $ | 55 | |
Plus (minus): | |||
Net income attributable to non-controlling interests | (120) | ||
Interest expense, net | 179 | ||
Depreciation and amortization | 77 | ||
Equity-based compensation expense | 10 | ||
Transaction, integration & acquisition costs(1) | 36 | ||
Gain on disposals and deconsolidations, net | (4) | ||
Loss on litigation settlements & other litigation costs | 5 | ||
Loss on debt extinguishment | 12 | ||
Tax receivable agreement expense | 2 | ||
Impairment charges | 8 | ||
Adjusted EBITDA | $ | 259 | |
(1) | This amount includes transaction and integration costs of $19 million, acquisition costs of $3 million | |
© 2021 Surgery Partners - Confidential & Proprietary Information | and $14 million for start-up costs related to a de nov o surgical hospital. | 49 |
Reconciliation to Adjusted Revenues
The following table reconciles Adjusted Revenues(1) to GAAP Revenues, the most directly comparable GAAP financial measure (in millions and unaudited):
Revenue Adjustments | |||
2019 | |||
Revenues | $ | 1,831 | |
Plus (minus): | |||
Provision for doubtful accounts | 25 | ||
Adjusted Revenues | (1) | $ | 1,857 |
- In accordance with a new accounting standard that was effectiv e prospectively January 1, 2018, we reflected our estimated
prov ision for doubtful accounts net of rev enues rather than as an operating expense, as it had historically been presented. Adjusted Rev enues add back the estimated provision of doubtful accounts. We believe such an adjustment is appropriate, as the new standard did not affect historical results prior to 2018, which impacts historical comparability. Our calculation of adjusted revenues may not be comparable to similarly titled measures reported by other companies.
© 2021 Surgery Partners - Confidential & Proprietary Information
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Surgery Partners Inc. published this content on 11 January 2021 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 14 January 2021 18:19:03 UTC