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Published byHenry Gordon Modified over 9 years ago
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Draft 1 1 February 14, 2006 UBS Global Healthcare Conference
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Draft 2 2 Cautionary Note Regarding Forward-looking Statements HCA’s management will be making some forward-looking statements during today’s presentation. Those forward-looking statements are based on management’s current expectations and are subject to risks and uncertainties that may cause those forward looking statements to be materially incorrect. The presentation may contain certain (non-GAAP) measures – you may refer to the Company’s financial filings on Form 10-K or Form 10-Q for reconciliation. These non-GAAP financial measures should not be considered an alternative to GAAP financial measures. Certain of those risks and uncertainties are discussed in HCA’s filings with the Securities and Exchange Commission, including the company’s report on Form 10-K and its quarterly reports on form 10-Q, to which you are referred. Management cautions you not to rely on, and makes no promises to update any of the forward looking statements.
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Draft 3 3 Largest, publicly traded, healthcare provider with 182 hospitals 182 hospitals 94 freestanding surgery centers 94 freestanding surgery centers Located in 22 states, London, England and Geneva, Switzerland Located in 22 states, London, England and Geneva, Switzerland NYSE: HCA Sky Ridge Medical Center Denver, CO StoneCrest Medical Center Nashville, TN Capital Regional Medical Center Tallahassee, FL Hospital Corporation of America Hospital Corporation of America
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Draft 4 4 HCA 2005 Highlights HCA 2005 Highlights Revenues totaled $24.5 billion up 4.3% (same facility 4.8%) EPS (GAAP basis) up 24% to $3.19 per diluted share EPS excluding gains on sale of facilities, impairments, foreign tax repatriation and hurricane expenses, increased 15% tax repatriation and hurricane expenses, increased 15% Cash flow from operations totaled $3.2 billion vs. $3.0 billion in 2004 2004 Repurchased 36.7 million shares of stock ($1.9 billion) Increased dividend 13% to $0.17 per quarter
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Draft 5 5 Returns Improved in 2005 Return Analysis % change from Prior Year Return on Stockholders’ Equity Return on Stockholders’ Equity Return on Invested Capital Return on Invested Capital 20032004 2005
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Draft 6 6 Revenue trends favorable. Net Revenue / Adjusted Admission % change from Prior Year Managed Care Revenue/AA % Change from Prior Year 5.4%6.3% Medicare Revenue/AA % Change from Prior Year Revenue Per Unit Growth Revenue Per Unit Growth Favorable Medicare, Medicaid and managed care revenue yield per adjusted admission. Medicaid Revenue/AA % Change from Prior Year 7.5% *adjusted for uninsured discount
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Draft 7 7 Effective expense management significantly contributed to favorable earnings performance. Cash Operating Expense/Adjusted Admission % Change from Prior Year Same Facility Expense Management Favorable Expense Management Favorable
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Draft 8 8 Labor management favorable: Wages managed to efficient levels.Wages managed to efficient levels. Wage Rate % Change from Prior Year Productivity improvedProductivity improved Manhours / Adjusted Admission % Change from Prior Year As Reported Solid Labor Management SWB as a % of net revenue favorable.SWB as a % of net revenue favorable. Salary, Wages & Benefits % of Net Revenue *adjusted for uninsured discount
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Draft 9 9 199920002001200220032004 +2.7%+2.8%+2.7% +2.5%+0.6% +0.7% Volume Trends +2.5%+2.6% +0.0% +1.3% Equivalent Admissions Same Facility % Change from PY Equivalent Admissions Same Facility % Change from PY Admissions Same Facility % Change from PY Admissions Same Facility % Change from PY 2005 +0.1% +1.4%
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Draft 10 Admission Trends Same Facility Admissions growth appears more favorable adjusting for change in DPUs and one day admits. Admissions Adjusting for DPU and one day admits % Change from Prior Year +2.7% +1.0% +0.8% +1.4% +0.6% +0.1% +0.7% +0.6% +0.8% +0.3% One day admits DPU effect Admissions DPU effect Admissions +2.6% +0.8% +1.4% +2.0% +1.4% +1.3% +0.8% +0.1% +0.6% Adjusted Admissions % change from Prior Year Adjusted admissions reflect continued growth in outpatient services and the observation day effect.
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Draft 11 Physician Recruitment Total Number of Physicians Recruited 2004 2005 Primary Care Specialists 701 55% 45% 384 53% 47% MOB Development 2006E2005 420,000 1,300,000 sq. ft. $62M sq. ft. $220M Currently 22 million square feet of medical office space in service.Currently 22 million square feet of medical office space in service. Total occupancy is 79%.Total occupancy is 79%. Medical office square footage coming on line. 83% increase in recruited physicians in 2005.83% increase in recruited physicians in 2005. 76% recruited physicians using in-house service.76% recruited physicians using in-house service.
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Draft 12 Uninsured Admissions Same Facility % of Total Admissions 20002001200220032004 Uninsured ER Visits Same Facility % of Total ER Visits N/A 5.9% vs. PY 1.9% vs. PY 7.3% vs. PY 11.6% vs. PY 13.7% vs. PY 15.2% vs. PY 7.2% vs. PY 3.7% vs. PY Uninsured Admissions Same Facility % Chg from Prior Year 2004: +9.7% 2005 3.3% vs. PY 5.1% vs. PY *2002 Totals based on 2003 Prior Year 15.0% vs. PY 5.3% 5.5% 5.4% 5.3% 5.5% 5.4% Oct Nov Dec Oct Nov Dec +14.7% +14.3% +17.0% Oct Nov Dec Oct Nov Dec 21.1% 20.6%20.3% Oct Nov Dec Oct Nov Dec 5.1% Dec YTD +9.5% Dec YTD 20.4% Dec YTD` 15.3% vs. PY Uninsured Volume Uninsured Volume
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Draft 13 HCA Hospitals Located in Growth Markets HCA Hospitals Located in Growth Markets Switzerland U.K. Percent Growth in Market Population 2000-2005 Compared to the National Average of 4.5% Percent Growth in Market Population 2000-2005 Compared to the National Average of 4.5% Las Vegas +22% Las Vegas +22% Southern California +9% Southern California +9% Denver +9% Denver +9% Dade +8% Dade +8% Nashville +8% Nashville +8% Panhandle +10% Panhandle +10% Tampa Bay +8% Tampa Bay +8% Dallas/Ft. Worth +12% Dallas/Ft. Worth +12% Austin +18% Austin +18% Richmond +8% Richmond +8% Palm Beach +11% Palm Beach +11% Houston +10% Houston +10% Kansas City +5% Kansas City +5% 182 Hospitals 94 Surgery Centers Generally 25%-40% Market Share 40% of facilities in Texas & Florida
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Draft 14 2000200120022003200420052006200720082009201020112012201320142015 95 100 105 110 115 120 125 Acute Care Utilization Index (2003=100) Baby Boomer Impact Accelerates 1.58% CAGR 2003-2012 121 119 117 115 113 112 110 108 106 105 103 102 100 98 97 96 1.7% 1.6% 1.5% 1.6% 1.5% 1.6% 1.5% 1.4% 1.56% 3-Year CAGR 1.59% 3-Year CAGR 1.58% 3-Year CAGR 1.62% 3-Year CAGR Socio-Demographics-Age Wave Driving Healthcare Utilization
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Draft 15 HCA Capital Expenditures Facility Expansion Projects New and Replacement Facilities IT&S and Patient Safety Routine Capital Billions 2003 $1.84 2004 $1.52 2005 $1.6 2006P $1.9 Dollars in Billions Capital Commitments: Houston, TX $517 million Pearland, TX new hospital (2007) Denver, CO $250 million new children’s hospital/ expansion of 3 hospitals San Antonio, TX $165 million new hospital with JV partner (2007) Atlanta, GA $130 million Emory John’s Creek, new hospital (2007) Salt Lake City, UT $85 million new hospital (2007/ 08)
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Draft 16 Capital Placed in Service by Year (Dollars in Millions) 2005 projects typically approved 24-30 months ago In Service Design & Permits Construction 9 mo. 18 mo. Approved Average Timeframe Western $249$499$373$466$641$791 Eastern $427$675$450$179$500$242 Total HCA $676$1,174$823$645$1,141$1,033
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Draft 17 Two new ASCs; one expansion Three new imaging centers Two new oncology centers Three Hospital-based imaging expansions Seven Hospital-based surgery expansions 13 ICU/bed expansions Three major surgery expansions Eight ED expansions Seven Women’s Services expansions Interior/Exterior renovations, parking garages, etc. 2005 Major Capital Projects Coming On Line $95M (15%) Infrastructure Outpatient Inpatient $150M (23%) $400M (62%) Total $645M
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Draft 18 Eight new ASCs; two expansions; one replacement 15 new imaging centers One new oncology center Three Hospital-based imaging expansions Six Hospital-based surgery expansions Eight medical office buildings (on balance sheet) 17 ICU/bed expansions Six major surgery expansions 11 ED expansions Six Women’s Services expansions Interior/Exterior renovations, parking garages, etc. 2006 Major Capital Projects Coming On Line $90M (8%) Infrastructure Outpatient Inpatient $290M (26%) $630M (55%) Total $1.14B Emory Johns Creek (118 beds and 135,000 sq. ft. MOB) $130M (11%) Replacement Facility
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Draft 19 2006 Outpatient Under Development Ambulatory Surgery Centers Imaging Centers Oncology Centers Cath Lab Freestanding ER Total # of CentersAmount 11$65 1573 14 4 13 3 12 34 $167 (Dollars in Millions) Excludes Hospital-based Development
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Draft 20 Transactions totaling $130 million completed 20–30 imaging center and 8-10 surgery center transactions expected to be completed over the next 12 months Sarah Cannon Research Institute (Nashville) Austin Radiology Assoc. 2 imaging centers Austin Radiology Assoc. 2 imaging centers Diversified Radiology (Denver) 4 imaging centers/fifth under construction Diversified Radiology (Denver) 4 imaging centers/fifth under construction Thousand Oaks Diagnostic Imaging Thousand Oaks Diagnostic Imaging Millcreek Imaging Center Salt Lake City, UT Millcreek Imaging Center Salt Lake City, UT HCA Surgery Centers LAD Imaging Centers (Orange City, Deltona) LAD Imaging Centers (Orange City, Deltona) Total I Management, LLC (Tampa Bay Area) 5 imaging centers Total I Management, LLC (Tampa Bay Area) 5 imaging centers Outpatient Strategy Progressing First Health (Jacksonville) MDI 7 Centers MDI 7 Centers Ultra Open MRI (Tampa) 6 centers Ultra Open MRI (Tampa) 6 centers Hope Cancer Centers (Tallahassee) 3 centers Hope Cancer Centers (Tallahassee) 3 centers
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Draft 21 Net Cash Provided by Operating Activities Dollars in Millions HCA’s Cash Flow Remains Strong 6.9% * Reduced due to government settlement and investigation related costs * Reduced due to government settlement and investigation related costs Uses of Cash (1) Capital Reinvestment $1.6B in 2005 in existing markets and $1.9B in 2006 (2) Share Repurchase Program $12B in 8 years 36.7 million shares purchased in 2005 11.1 million shares purchased in 2006 under $1B open-market authorization (3) Dividend Policy Approx. 20 to 25 percent payout (4) Acquisitions – opportunistic $1B Health Midwest - April 2003 Austin, TX and Nashville, TN - pending acquisitions (5) Debt Repayment Debt/ cap – 64.8% at 12/31/05
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