INVESTOR DAY RAMSAY HEALTH CARE /GNRALE DE SANT MARCH 12 th 2015 - - PowerPoint PPT Presentation

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INVESTOR DAY RAMSAY HEALTH CARE /GNRALE DE SANT MARCH 12 th 2015 - - PowerPoint PPT Presentation

Mar 18, 2024 348 likes •535 views

INVESTOR DAY RAMSAY HEALTH CARE /GNRALE DE SANT MARCH 12 th 2015 2015/03/12 I I INTRODUCTION PASCAL ROCH Chief Executive Officer DENIS CHARLES Group Head of Operations ARNAUD JEUDY Chief Financial Officer

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INVESTOR DAY

RAMSAY HEALTH CARE /GÉNÉRALE DE SANTÉ

MARCH 12th 2015

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INTRODUCTION

PASCAL ROCHÉ › Chief Executive Officer DENIS CHARLES › Group Head of Operations ARNAUD JEUDY › Chief Financial Officer

Investor day 2

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ON A FACT-BASED APPROACH, FRANCE NEEDS TO ADAPT BUT HAS A HUGE POTENTIAL

3

17,42 10,36 4,77 3,82 2,90 2,85 2,24 2,13 2,06 2,03

The 5th World Economy (2014) 1

(in billion $)

1 Source IMF

128 95 57 31 28 28 17 13 13 10 8 8 8 8 8

31 French companies among the World top 500 global companies1

1 Source Fortune 500

13 13 9 5 2

France USA Russia UK Japan

Quality of Education

(number of Mathematical Fields Awards)

Investor day

73 73 72 61 France UK Germany Italy

In 2050, with the UK, the largest country in Europe (in million of habitants) 1

1 Source INSEE

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MEDICAL SERVICES OF PRIVATE CLINICS ARE FINANCED BY THE PUBLIC HEALTH SYSTEM WITHIN THE ONDAM BUDGET

MEDICAL SERVICES OF PRIVATE CLINICS ARE FINANCED BY THE PUBLIC HEALTH SYSTEM WITHIN THE ONDAM BUDGET

4

MEDICAL CONSUMPTION HAS INCREASED FASTER THAN GNP 1

1 Source: OECD

€245bn

ONDAM ≈€175bn

« ONDAM » €175bn

«Every year, the "Projet de loi de finances" (funding law project) voted by the Parliament sets a target for national funding dedicated to health expenses, expressed as a National Statutory Healthcare Spending Objective ("Objectifs National de Dépenses d'Assurance Maladie" ONDAM)

Others € 35bn Medicines €35bn

Investor day

4.0% 8.4% 9.0% 10.1% 11.0% 11.7% 12.70% 17%

30% 66% 75%

20% 30% 40% 50% 60% 70% 80% 0% 5% 10% 15% 20% 1945 1960 … 1990 1995 2000 2005 2010 2015 … 2030

Share of chronical diseases in medical expenses in France (%) Medical consumption vs GNP in France (%)

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ONDAM BUDGET WILL KEEP ON INCREASING EVERY YEAR

5 6 chapters in ONDAM Voted objective Ambulatory care Hospitals included in DRG Hospitals not included in DRG Care for elderly people Care for disabled people Other care 2 objectives : ODMCO, MIGAC 2 objectives : ODAM, OQN 1 objective in common No objective No objective ONDAM is characterized by an amount and its evolution, both voted and achieved. It is expressed in 6 chapters regrouped in 4 categories

100 107 114 120 124 128 133 138 143 147 151 154 158

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 … 2017

ONDAM BUDGET (INDEX 100 IN 2001)

≈170

2% growth

per year

€80bn €77bn €17bn €1bn

Non hospital treatments Hospitals Medico social sector Others

ONDAM in 2013 Investor day

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›€79bn for healthcare facilities (MSO) ›A market split between 2 main categories : − Non profit actors ; − For profit actors. ›2% annual growth expected up to 2017

AN INCREASING FRENCH HEALTHCARE MARKET…

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70 72 75 77 79 81 82 84 60 65 70 75 80 85 90 2010 2011 2012 2013 2014 2015 2016 2017 Forecast

34% 25% 17%

0% 20% 40% 60% 80% 100% Activity (sessions) Beds ONDAM budget shares Public Private

› 410,000 beds, 20% over capacity › The number of MSO private clinics has decreased by 46% in the last 20 years 1 › A private sector key for the French health system, too big to fail › Groups are increasing their market share within the private sector

∑ = 2,000 actors Investor day

A MASSIVE AND SECURE MARKET PRIVATE ACTORS ARE MORE EFFICIENT HOSPITAL MARKET (IN €BN) A MARKET WHICH IS CALLING FOR FURTHER CONSOLIDATIONS

1 Source: FHP, 2012

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4% 1% 0,47% 0%

  • 0,05%

0,16%

  • 0,21%
  • 0,24%
  • 4%
  • 2%

0% 2% 4%

2007 2008 2009 2010 2011 2012 2013 2014

1076€ 1086€ 318€ 352€

300 310 320 330 340 350 360 1050 1060 1070 1080 1090 1100

2011 2012 2013 2014

MSO patient average revenue Patient day of stay average revenue

WE ARE FACING FLAT TARIFFS BUT BY POSITIONING ON THE RIGHT ACTIVITIES WE ARE STILL ABLE TO EXTRACT VALUE

7 Investor day

DRG EVOLUTION (PUT IN PLACE IN 2006)

Besides, increasing subventions are currently put to place to favor : ›Quality outcomes ; ›Day surgery. which are at the heart of our strategy.

OUR EFFORTS ON CASE MIX AND LENGTH OF STAY COUNTERACT FLAT TARIFFS (€)

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A GROWING ACTIVITY ON A MID TO LONG TERM PERSPECTIVE…

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6% 26% 34% 34% 0-19 20-59 60-79 >80

Age distribution in FCR1

11% 39% 35% 15% 0-19 20-59 60-79 >80

Age distribution in MSO1

∑ = 68% ∑ = 50%

1 Source: ATIH, Insee & Roland Berger

MORE THAN 50% OF OUR CORE MARKET IS ABOVE 60 YEARS OLD THE FRENCH POPULATION WILL INCREASE DURING THE 15 COMING YEARS 2015

63.3m

French population in million2

2030

65.8m

French population in million2

2Source: INSEE

In 2050, Population including DOM-TOM will reach 73m

Investor day

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22% 48% 23% 7% 0-19 20-59 60-79 >80

…ENJOYING STRONG AND SUSTAINABLE DRIVERS

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OUR CORE MARKET IS GETTING BIGGER… ›Improvement of diagnostic methods (endoscopy) ›Improvement of treatments (ambulatory procedures, dosage form of drugs, local anesthesia) ›Generalization of key procedures (carpal tunnel, cataract, orthopedic prosthesis) › New diagnostic methods: predictive tests › Development of new treatments (new monoclonal antibodies, personalized medicine) and medical procedures (radiotherapy, non invasive procedures)

14,7 31,5 14,8 4,8 60-79 >80 60-79 >80 15 32,5 12 3,7 0-19 20-59 60-79 >80 24% 51% 19% 6% 0-19 20-59 60-79 >80 ∑ = 25% Age in million1

2015

∑ = 15.7m Age in %1 ∑ = 30% Age in %1 ∑ = 19.6m Age in million1

2030 …AND IS SUPPORTED BY THERAPEUTIC INNOVATIONS :

Investor day

1 Source: ATIH, Insee & Roland Berger 1Source: INSEE

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GÉNÉRALE DE SANTÉ & RAMSAY SANTÉ COMBINED GROUP AT A GLANCE

10 COMBINED GEOGRAPHICAL DIVERSITY

Legend

MCO +SSR Psychiatry

Paris

Investor day COMBINED REVENUES IN 2013

1 687 389 2 076

GdS Ramsay Sante

› 115 facilities › 1.5m of entries › 600 operating rooms MAIN FIGURES ›13,000 beds ›2,900 places ›23 clinics with obstetric authorization ›34,800 baby deliveries per year ›445k emergencies entries in 24 clinics ›6 cancer institutes ›5,000 practitioners ›20,000 employees

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GENERALE DE SANTÉ : A LEADER OF A HIGHLY FRAGMENTED MARKET…

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11.6% 12% 6.5% 3.5% 2010 2011 2012 2013 2014 EBITDA National groups average (EBITDA) Private sector average (EBITDA)

(a) Acquisition of Médi-Partenairesby Bridgepoint, current owner of Medipôle Sud Santé, announced in April 2014. Source: Roland Berger, based on 2012 revenues.

13% 7% 6% 4% 4% 2% 2%

(a)

ESTIMATED MARKET SHARES (2013)

Investor day

GDS : EBITDA (% OF REVENUES) – CONSTANT PERIMETER › Consistent and stable profitability › Higher profitability than competitors

2%

15-16%

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…FOLLOWING A CLEAR STRATGEY

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Footprint efficiency Focused case mix Size : the 3 scale effects Quality & brand equity

In this market performance is driven by four Key Success factors

  • More than 95% of clinics in the most

attractive quartiles Q1 and Q2

  • Specialist clinics: over the 61 clinics,
  • nly 7 with a mixed model
  • A high specialization

Générale de Santé

  • ~13% private market share
  • 32% of market share on health

territories covered

  • 150 beds / clinic
  • 20 clinics in national ranking1
  • 34% of clinics in national ranking1
  • Some strong clinic brand equity. e.g.

Antony emergencies leadtime performance (9 minutes)

Going further : “Become the healthcare preference", switching from a B2B to a B2C model Investor day

4 pillars

1Published by top general public magazines

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CARE EXCELLENCE1 : SOME MEDALS OF HONOR

13 Bariatric surgery

4 ranked in top 25

Hip prothesis

8 ranked in top 50

Spine surgery

9 ranked in top 40

Cataract

7 ranked in top 50

Pneumology

8 ranked in top 50

Pacemakers

7 ranked in top 50 Myocardial infarction 8 ranked in top 40

1Source : Le Point, August 2014

Investor day

9 MSO ranked in top 50 General ranking

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Major short term project (2015)

99 88 100 98 2011 2012 2013 2014

Self financed CAPEX (in €m)

WE HAVE BEEN PREPARING THE FUTURE BY KEEPING A HIGH INVESTMENT LEVEL

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  • Marseille: First French private operator to invest in a Cyberknife

(radiotherapy)

  • Marseille: Innovative one day surgery facility (opening Sept. ‘16)
  • Dijon: regrouping 3 MSO in a clinic designed to simplify patient care

processes (opening Jan. ‘18)

2 1 3 2 1 3

2015 2016 2017 2018 Major mid term project (> 2015) Major project opened in 2014

Most clusters are involved in brownfield projects of development

Cluster without recent major development project

3 main innovative projects

Investor day These figures exclude the externalized CAPEX

Major project opened in 2013

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WE ARE THE CLEAR LEADER IN DAY SURGERY IN FRANCE, WHICH IS THE FUTURE OF HOSPITALISATION

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47.6% 49.2% 51.8% 54.6% 44.0% 46.0% 49.7% 39.3% 40.2% 42.7% 37.0% 39.0% 41.4%

2011 2012 2013 2014

GDS Private sector National average Public sector NA

Investor day

ANSWERS TO A NATIONAL SURVEY FOCUSED ON ONE DAY SURGERY 1 60% 28% 19%

WHAT IS ONE DAY SURGERY ? WOULD ACCEPT A ONE DAY SURGERY OPERATION ? IS IT THE FUTURE OF SURGERY ?

84% 16% 85% 15%

DO YOU TRUST ONE DAY SURGERY ?

78% 22% GÉNÉRALE DE SANTÉ IS AHEAD ITS COMPETITORS 2

1 Source: IFOP 2 Source : ATIH

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SWITCHING FROM A B2B TO A B2C MODEL : OFFERING INNOVATIVE SERVICES TO OUR PATIENTS

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PPRM ED SOLO NPS

Investor day

  • Emergencies Department :

Enhance the visibility of

short waiting times in GDS services ;

Develop services to meet

patient expectations.

  • Net Promoter Score :

Every patient is given the

  • pportunity to rate his experience

NPS is based on a direct question :

« How likely would you recommend this hospital to a relative or a friend

  • r a colleague ? »
  • Range of services proposed

to our patients in order to enrich their experience :

Better comfort ; Enternainement during

their stay at hospital.

  • Bring services in line with the

expectations of future parents :

Workshops and conferences Online registration process A personalized experience

(monthly newsletter), …

  • Patient, Practitioner

Relationship Management via a CRM tool adapted to

  • ur healthcare business
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  • Impact on Organization :

42% decrease of the avg. waiting time 25% decrease of the avg. length of stay

  • Impact on Volumes

+10% visits +140% traffic on the ED webpage

AN EXAMPLE OF INNOVATIVE SERVICES: THE ED PROJECT

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  • Enhance the visibility of short waiting times in GDS services
  • Develop a guide of high-quality standards for ED organization
  • Develop services to meet patient expectations (eg. comfort in waiting area)
  • Develop a health economics model for ED analysis

What : The ED project

  • Show waiting times (real time info refreshed every 5 min) on the web and in all relevant areas

– waiting rooms, hospital entrance and reception (first time in France)

  • Workshops with professionals to evaluate and develop recommendations for organization

standards

  • Focus Groups with patients and definition of GDS promises regarding the service quality
  • Data analysis based on activity and accountancy data

How ? Results in our test ED

Investor day

300000 320000 340000 360000 380000 400000 420000 440000 2010 2011 2012 2013 2014 # OF PATIENTS IN GDS EMERGENCY DEPARTMENT Cagr = 5%