2. Forward-Looking Information
This presentation contains forward-looking information (within the meaning of applicable securities laws)
relating to the business of Nobilis Health Corp. (the "Company") and the environment in which it
operates. Forward-looking information may include statements regarding the objectives, business
strategies to achieve those objectives, expected financial results, economic or market conditions,
industry specific information, and the outlook of or involving the Company and its business. Such forward
looking information or statements are typically identified by words such as "believe", "anticipate",
"expect", "intend", "plan", "will", "may" and other similar expressions.
Forward-looking information, including any financial outlooks, is provided for the purpose of providing
information about management's expectations and plans about the future and may not be appropriate for
other purposes. Forward-looking information herein is based on various assumptions and expectations
that the Company believes are reasonable in the circumstances. No assurance can be given that these
assumptions and expectations will prove to be correct and the forward-looking information, including the
financial outlooks included in this Presentation, should not be unduly relied upon. Those assumptions
and expectations are based on information currently available to the Company, including the historic
performance of the Company's business. Such assumptions include anticipated financial performance,
current business, industry and economic trends, and business prospects and are subject to the risks and
uncertainties which are discussed in the Company's regulatory filings available on the Company's web
site at www.NobilisHealth.com, www.sec.gov, or at www.sedar.com. Any forward-looking statements that
we make are based on assumptions as of today, and we undertake no obligation to update them.
The Company’s management has approved the financial outlooks contained in this presentation.
2
3. Unique Patient Acquisition Model
3
o Acquires patients from physician
partners who are not obligated to bring
cases to their facility
o Physicians often form partnerships with
inequitable percentages:
o Productive doctors resent less
productive doctors
o Management Co. only manages and
does not drive patients to centers
o No growth drivers – must rely on
physician partners to grow their
practices to then bring more patients
o No vertical integration
Traditional Model The Nobilis Model
o Acquire patients through:
o Marketing programs
o Network of primary care
physician partners
o Physician employees
o Physicians typically don’t own
equity in Nobilis facilities
o Nobilis owns and manages its
facilities
Nobilis Network
of Primary Care
Physicians
Physician
Partners
Direct to
Consumer
Marketing
Joint Marketing
with Physicians
Nobilis Employed
Primary Care
Physicians
o We drive patient flow to our facilities
o We control the patient experience
across the entire continuum of care
o Patient acquisition
o Primary care
o Ancillaries
o Surgeries
4. Nobilis at a Glance
4
o 4 surgical hospitals, 10 ASCs and 13 multi-specialty clinics
• 10 markets across 5 states
• 35 partner facilities
o Core strategy - optimized case mix across the portfolio
• Higher acuity procedures, higher levels of
reimbursement
• Focus on minimally invasive procedures
o Unique direct-to-patient marketing model
• Brand procedures and drive additional surgical volume
to portfolio of facilities
• Capitalizes on growing trend of “consumerism” in
healthcare
• Drives organic growth
o Strong, scalable platform to expand to nationwide player
o Compelling value proposition for physicians, patients, and
payors
o $321 million in revenue and $37 million in Adjusted EBITDA
, LTM June 2017
• Low capex requirements
Company Overview Geographic Locations
Markets with Nobilis
owned facilities
Markets with Nobilis
partner facilities
5. Investment Highlights
o 66% of all surgeries are outpatient with >50% performed in ASCs vs. 32% in 2005
o Lower cost, high quality outpatient setting; trend toward increased consumerism in healthcare
o Abundance of desirable acquisition opportunities due to fragmented market
5
Attractive Industry
Fundamentals
Unique Marketing Model
Favorable Payor and
Procedure Mix
Patient-Centric Value
Proposition
Attractive Financial Profile
Experienced Management
Team
o Multiple marketing channels drive volume growth
o Proprietary technology platform targets prospective patients
o Strong value proposition: Superior patient experience that expands physicians’ practices
o Marketing segment targets higher acuity cases resulting in a highly attractive case mix
o Procedure diversification increases the stability of the revenue base
o Minimal government payor reduces risk of Medicare/Medicaid rate changes.
o Unique marketing model increases case volumes and provides superior patient experience
o Offer optimal surgical environments that result in better overall quality of care
o Offer ancillary and complementary services that lead to better efficiency and better outcomes
o Low leverage
o Low capital expenditure requirements
o Stable cash balance
o Strong management team with M&A and healthcare experience
o Seasoned Ops team leads to financial and operation efficiencies
o Strong in-house and outside legal team to safely navigate complex healthcare space
6. Nobilis Business Overview
6
Favorable Case Mix
Strong Case Volume Growth
Favorable Payor Mix (~96% non-gov’t )
Note: Unless otherwise dated, figures are based on the LTM period ended 6/30/2017, pro forma for the full year impact of the AZ Vein acquisition.
Note 2: Case mix based on number of cases; payor mix based on revenue.
ENT 4% General
Surgery 4%
Ortho 7%
Pain 27%
Spine 18%
Bariatrics 21%
Plastic
Surgery 10%
GYN 3%
Other 7%
AETNA 20%
BCBS 17%
CIGNA
9%
UHC 34%
Other
Commercial 12%
Self Pay 5% WC 3% Medicare 1%
8,740
17,814
20,459
25,190
-
5,000
10,000
15,000
20,000
25,000
30,000
2014 2015 2016 2017 E
7. Surgical Setting Background
Traditional Hospitals
o Full-service hospital
o Inpatient and outpatient
o > 5,700 hospitals
o 60%+ not-for-profit
Specialty Surgical
Hospitals (SSHs)
o Typically specialize in
orthopedics, spine, ENT
o Inpatient and outpatient
o ~ 300 SSHs
Ambulatory Surgical
Centers (ASCs)
o Outpatient only
o > 5,500 ASCs
o 70%+ owned by
independents
7
Source: Becker’s.
Nobilis Health
8. Unique Patient Acquisition Strategy
8
Nobilis Brands
Lead Generation Concierge Service
§ Inside sales team and IT platform
to maximize patient experience
§ 9 brands marketed directly to
patients via omni-channel
marketing strategy
Patient Tracking Conversion to Surgical Patient
§ Patient education, medical
review, insurance verification,
and surgical scheduling
§ Patient follow-up, experience
surveys, and referrals
o Marketing and technology platform that targets prospective patients
o Unique value proposition to physicians; superior patient experience
o Generates higher acuity cases vs. traditional referral model
o Scalable revenue driver
o Portfolio effect: direct cases to specific facilities on a procedure-by-
procedure basis for best return
o In-house marketing team works one-on-one with physicians to
develop and distribute customized marketing plans
o Build and execute marketing plans on behalf of physicians
o Helps to expand physicians’ practices, while also driving
additional volume to facilities
o High average ROI
Direct-to-Consumer Marketing Physician Sales
High-Touch Marketing Model
10. Growth of the ASC Industry
o Industry growth
‒ Efficient cost structures
‒ Increased government focus on healthcare
‒ Aging population
‒ Newly insured access care
o Remains highly fragmented
• Independent operators, hospitals and small chains
comprise 78% of the 5,500 ASCs in the U.S.
o Economies of scale drive partnership decision for
physician-owned practices
Source: CSM, Equity Research, IBIS healthcare expenditures estimates, Becker’s.
Projected ASC Industry Revenue
Outpatient Surgeries Moving to ASCs: 1981 to 2016
($ in billions)
10
Factors Influencing ASC/SSH Demand
Steady reimbursement
rates from government
payors support a stable
operating environment at
ASCs & SSHs
Increased ASC/SSH Abilities
Government Funding
Advances in surgical
techniques & technology
have increased the number
& types of outpatient
procedures driving higher
patient volumes
As the economy improves,
greater disposable income
will enable patients to
better afford out-of-pocket
expenses at ASCs &
SSHs
Disposable Income
Growing Insured Population
The insured population
is expected to grow 2%
annually through 2017
$16 $17
$19 $20 $21 $22 $23
$25
$27
$30
$32
$34 $36
$38
$40
$0
$5
$10
$15
$20
$25
$30
$35
$40
$45
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015E
2016E
2017E
2018E
2019E
2020E
ASCs, 6%
Hospital
Outpatient,
84%
ASCs, 50%
Hospital
Outpatient,
50%
11. 27%
17% 17%
13%
10% 9%
4% 3% 2% 1%
0%
5%
10%
15%
20%
25%
30%
GI
Ortho.
Optha.
Pain
Other
ENT
Plastic
Podi.
Urol.
Neuro.
Dynamics Driving Industry Growth
o Case volume at ASCs projected to increase by 9 -
12% through 2025
o 5,500 ASCs in U.S., 90% have some degree of
physician ownership
o Many ASCs focus on elective procedures which are
common in affluent urban and suburban areas with
large proportions of commercially insured patients
o Nobilis’ focus à 40% of the market with higher
reimbursement
Specialty Procedures
Orthopedics
Knee arthroscopy, carpal tunnel, rotator
cuff repair, incise finger tendon sheath
and wrist endoscopy
Pain
Management
Injection lumbar / sacral, injection
cervical, thoracic and destruction
neurolytic agent
Bariatrics
Gastric bypass, sleeve gastrectomy,
adjustable gastric band, biliopancreatic
diversion with duodenal switch
Source: Wall Street Research, Becker’s.
11
Average ASC Industry Payor Mix
Industry Dynamics ASC Industry Specialty Mix
Top Procedures
Nobilis Key
Procedures
67%
18%
11%
4%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Commercial Medicare FFS Worker's Comp
/ Other
Medicaid
12. Advanced Imaging 13%
Arthrocentesis / Injections
5%
Rehab & Chiropractic
14%
Standard Imaging
13%
E&MVisits
17%
Fusion Surgery
Spinal Decom. / Laminec.
Vertebral Augmentation
23%
27%
25%17%
-9%
-5%
-2%
2%
Less Complex Procedures Shift to Outpatient
o Less complex spine procedures shifting from inpatient to outpatient
o Key spine procedures have stronger tailwinds due to demographics and improvements in technology
o ~31 million Americans experience back pain at any given time
o ~600,000 Americans undergo spine surgery every year
Lumbar / Thoracic Fusion
Cervical Fusion
No Procedure and
Diagnostics
Spinal Decompression/
Laminectomy
Vertebral Augmentation
Procedures
Revision Spinal Procedure
Note: Growth rate data reflects U.S. market. 12
Source: Wall Street Research.
-11%
Inpatient Spine Discharges 2014 – 2019 Outpatient Spine Volumes 2014 – 2019
Nobilis Key
Procedures
14. Growth Strategy
14
1 Marketing Expertise Drives Organic Growth 2
3 4
o Multiple marketing channels to drive volume growth
at hospitals, ASCs, and ancillaries
o Bundled payment capabilities
o Strategically adding new marketing brands to
portfolio
o 360 Concierge
o Highly fragmented market with many ideal
acquisition targets
o Focus on targets that allow Nobilis to cross-sell
service lines and leverage marketing capabilities
o Pursuing INN targets that are sensitive to Nobilis’
marketing platform and allow the Company to
leverage existing facilities
o Continue optimizing case mix to maximize revenue
potential
o Increase the volume of high acuity procedures that
benefit from higher levels of reimbursement
o Identify and develop additional service lines
appropriate for outpatient environment
o Focus on driving cost reductions throughout
system and in recently acquired facilities
o Identify and achieve greater economies of scale as
Nobilis continues acquiring new businesses and
expanding its platform
Acquisition Opportunities
Service Lines and Specialties Operational Leverage
15. Ancillary Services
o Initiated through
Hermann Drive Surgical
Hospital in September
2016
o Set up to process
~4,000 tests on a
monthly basis
First Assist (Staffing)
o Cover 100% of
outpatient spine cases
through qualifying DTC
o Specialties: spine,
bariatrics, ENT,
orthopedic, plastic,
general
o Focused on spine procedures
o 100% of DTC cases
o 7 States
o 44 different facilities (both
Nobilis and non-Nobilis
facilities)
o Specialties: spine, neuro,
ortho, CV, ENT
o Covers most NHC
facilities
o Helps recruit partner
physicians
o Specialties: spine,
bariatrics, ENT,
orthopedic, plastic,
general
o Launched April 2017 as a
hospital outpatient
department of Plano
Surgical Hospital
o Provides patients and
physicians with a partner
in the continuum of care
15
Laboratory Neuromonitoring Anesthesia Physical Therapy
o Nobilis is actively seeking potential
M&A targets in the ancillary services
space
o Typically focus on acquisitions with
revenue potential system wide
o Increased capabilities position
Nobilis to execute alternative
payment methodologies for payors
o 2016 revenue of $20.4 million
o 2015 revenue of $2.3 million
o Maximizes revenue by capturing
additional revenue streams per
patient
o Continuity of care for patients
o Helps recruit top physicians
o Increased patient & physician
satisfaction
o Improve patient outcomes
o Accretive earnings
Benefits Financial Contribution Development
17. Concertis Strategy
17
Bundled Payment Surgical Procedures Primary Care Practice
o Less expensive to acquire than specialists
o Allows Nobilis to control patient experience across the
continuum of care
o Feeds volume into bundled payment and
360Concierge
o Achieves clinical integration
o Additional covered lives under Nobilis’ control equates
to leverage with payors
o Bring physicians into our narrow network
o Our care navigators are trained health care
professionals who serve as patient concierges, guiding
patients though the entire episode of care from
diagnosis to post-surgical compliance with discharge
orders.
o Concertis negotiates with payors (insurance
companies and self-insured employers) to combine
reimbursement for multiple providers and facilities in a
single, comprehensive bundled payment that covers all
of the services involved in a patient’s episode of
care. As a result, patients no longer receive multiple
bills from facilities and providers. The facility receives
the reimbursement, and distributes it to the providers,
ensuring physician alignment with the ASC or hospital.
o Provides a warranty for surgical services
o Concertis’ patient coordinators work with patients for
30-60 days post surgery, and all complications and
readmissions occurring during the warranty period are
covered within the initial bundled payment, alleviating
financial risk for both payors and patients.
o Currently performing procedures in three markets.
18. Concertis at a Glance
18
Concertis Model
o Concertis is Nobilis’ subsidiary that executes alternative patient acquisition and
reimbursement strategies.
o Concertis currently offers three products:
o Bundled Payments
o Concierge360
o Primary Care Practice Acquisition
o This portfolio of products coupled with the Company's facilities and ancillary services
comprise the Clinically Integrated Network (CIN)
o Clinical integration coordinates care across a continuum of services including physicians,
hospitals, and ancillary services
o A CIN can contract with payors for all of its providers, regardless of whether they are
owned/employed
o Controlling the entire patient experience from aligned primary care providers, to facilities,
surgeries, and ancillary services improves patient outcomes while encouraging more
efficient cost control for Nobilis, patients, and physicians.
19. 360 Concierge Summary
19
3.
Insurance
Verification
5.
Scheduling
5.
RN Surgical
Clearance, if
applicable
2.
PA/MD Review,
if applicable
Follow-Up
1.
Patient Care
Manager
Assigned
4.
Explanation
of Benefits &
Costs
6.
Scheduling
7.
Surgery
o Nobilis’ proprietary care management IT solution
o A specially trained, caring, and knowledgeable Patient Care Manager will be assigned to each
patient
o A complimentary image review, if applicable
o A complimentary insurance evaluation to ensure patient’s out-of-pocket costs are as
low as possible
o Patients receive personalized step-by-step guidance from their Patient Care Manager
o All patients will now have access to the Nobilis Health network of top-tier specialists
o Continued vetting and training of specialists to ensure patients only see the best surgeons
o Keeps patients in the Nobilis network while enhancing physician and patient satisfaction
The 360 Concierge
Difference
360 Concierge
23. 23
Driving Efficiencies
o Systemwide reduction in force
completed April 2017
o Payroll system/productivity tools
• Redesign/restructure of payroll
system
• Enhanced reporting
‒ Implemented daily productivity
KPI’s at each facility
‒ Controls in place to manage
hiring process
Focused on reducing operational expenses at its facilities to further drive profitability
= Estimated $10 to $13 million in annualized cost savings à $8 million expected in 2017
Salaries and Benefits Medical Supplies SG&A
o GPO and local agreements
executed
o Custom packs/reprocessing
o Utilization
o Inventory consignment
o Physician co-marketing and direct-
to-consumer marketing
o Purchased services
o Utility contracts
$6 to $7
million
$2 to $3
million
$2 to $3
million
25. Goal: Self-source business and maximize ROI
We provide patients personalized treatment plans and
access to multi-disciplinary medical staff and physicians.
Sales & Marketing
1
Direct to Consumer
(DTC)
Lead Generation
ConciergeService
Conversion to Surgical
Patient
Patient Experience
Follow Up
Successful Patient Outcomes
Sales Outreach to
Referral Community
Physician Referral to
Nobilis Brand
Leverage concierge
service for enhanced
patient experience
3
360 Concierge
Sales Outreach
to Physicians
Physician & Patient
Conversion
Nobilis Facility
CaseAcquisition
2
Physician
Recruitment
Patient and Physician
Satisfaction
Sales and Marketing Strategy
25
Our Unique
Approach
26. Management Team
o Joined Nobilis in 2010
o Previously served as CFO, President and Executive Chairman of Nobilis
o Earned an MBA from Boston College, a J.D. from the University of Houston, and a B.A. from the
University of St. Thomas
26
Harry Fleming
Chief Executive Officer
Kenneth Efird
President
David Young
Chief Financial Officer
Patrick Yoder
Chief Revenue Officer
Marissa Arreola
Chief Strategy Officer &
President of Concertis
o Joined Nobilis in 2010
o Previously served as Chief Operating Officer & Chief Business Development Officer at Nobilis
o Founder & CEO of Diagnostic and Interventional Spine Centers
o Doctorate from Texas Chiropractic College
o Joined Nobilis in 2017
o Previously served as Divisional CFO for St. Jude Medical’s America division
o Licensed CPA
o Earned an MBA from the University of Texas at Austin
o Joined Nobilis in 2014
o 15 years of healthcare sales and business development
o Previously held successful sales leadership positions at Intuitive Surgical, Medtronic, and Pfizer
o Earned a B.A. from Rhodes College
o Joined Nobilis in 2016
o Partner at Baker Donelson, specializing in health law and served as a Director at Houston Methodist
Hospital System
o Earned a J.D. from the University of Houston and B.A. from Rice University
27. Management Team (Cont’d)
o Joined Nobilis in 2015
o Previously served as CFO at Northstar Healthcare LLC and Nobilis
o 20 years of financial and accounting reporting in the healthcare industry
o Earned an M.B.A. from Texas Woman’s University and a B.S. from Sacred Heart University
27
Kenneth Klein
CFO of Operations
Phil Ayres
VP of Marketing
o Joined Nobilis in 2017
o Previously served as Director of Marketing for Travelocity and Director of Online Marketing at
Hotels.com
o Earned a J.D. from University of Tennessee College of Law and a B.S. from Vanderbilt University
Marc Celia
EVP of Operations
o Joined Nobilis in 2017
o 20 years of operational and managerial experience in the healthcare industry
o VP of Continuous Improvement for United Surgical Partners International/ Tenet Healthcare
(“USPI”) and CEO of Memorial Hermann Surgical Hospital Kingwood, in Houston, Texas
o Earned a B.S. from Boston University and a M.S. from University of Maryland
Marcos Rodriguez
Chief Accounting Officer
o Joined Nobilis in 2016
o Began his career at Deloitte & Touche LLP and served five years as Director at Opportune LLP
o 19 years of financial and accounting reporting, external and internal audits, and SEC regulations
o Earned a B.S. from Louisiana State University and is a licensed CPA
Brandon Moreno
VP of Finance
o Joined Nobilis in 2014
o 10 years of finance and accounting experience in the healthcare industry,
including HCA and Tenet
o Earned an M.B.A. from University of Texas – San Antonio and a B.S. from New
York University
29. Nobilis Facilities
29
Facility Market Equity
Hospitals
First Nobilis Hospital Houston, TX 51%
Hermann Drive Surgical Hospital Houston, TX 54.75%
Plano Surgical Hospital Dallas, TX 100%
Scottsdale Liberty Hospital Scottsdale, AZ 75%
ASCs
First Nobilis Surgical Center (HOPD) Houston, TX 51%
Kirby Surgical Center Houston, TX 25%
Medical Park Drive Surgical Center (HOPD) Houston, TX 100%
Dallas Metro Dallas, TX 35%
Northstar Healthcare Surgery Center - Houston Houston, TX 100%
Northstar Healthcare Surgery Center - Scottsdale Scottsdale, AZ 100%
Chandler Surgery Center Phoenix, AZ 100%
Oracle Surgery Center Tucson, AZ 100%
Phoenix Surgery Center Phoenix, AZ 100%
Surprise Surgery Center Phoenix, AZ 100%
Clinics
Chandler Clinic Phoenix, AZ 100%
Oracle Clinic Tucson, AZ 100%
Phoenix Clinic Phoenix, AZ 100%
Surprise Clinic Phoenix, AZ 100%
Sugar Land Clinic Houston, TX 100%
Woodlands Clinic Houston, TX 100%
Clear Lake Clinic Houston, TX 100%
Katy Clinic Houston, TX 100%
Stone Oak Clinic San Antonio, TX 100%
Round Rock Clinic Round Rock, TX 100%
30. Facility Specialties Facility
Plano Surgical Hospital • Bariatrics • 26 Inpatient beds
• Spine • 6 OR’s
• Plastics • 2 Procedure Rooms
• Orthopedics
• General Surgery
• Pain management
Kirby Surgical Center • Orthopedics
• General surgery
• Pain
• ENT
• 4 OR’s
• 1 Procedure Room
Hermann Drive Surgical • Bariatrics • 22 Beds
Hospital • Spine • 18 Private rooms
• Plastics • 6 OR’s
• Orthopedics • 2 Procedure Rooms
• General Surgery
First Surgical Hospital • Bariatrics Hospital • 4OR’s
• 1 Procedure
Room
First Street Surgery Center • Spine
(HOPD) • Plastics
• Orthopedics
• General Surgery
ASC • 4OR’s
• Painmanagement
Northstar Healthcare Surgery • Spine • 3 ORs
Center - Houston • Bariatrics • 2 Treatment rooms
• General Surgery
• Pain
• Podiatry
• Plastics
• GI
Nobilis Facilities
30
31. Facility Specialties Facility
Northstar Healthcare Surgery • Plastics/Reconstructive • 4 OR’s
Center - Scottsdale • Orthopedics • 1 Procedure Room
• General Surgery
• Pain
• Bariatrics
• Podiatry
Scottsdale Liberty Hospital • Spine • 2 OR’s
• Orthopedic Surgery • 1 Procedure Room
• General Surgery • 12 Inpatient Beds
• Podiatry
• Bariatrics
• Migraine
• Vascular
Arizona Vein & Vascular Center • Vein • 4 Clinics
• 4 ASCs
• 15 OR’s
Hamilton Vein Center • Vein • 6 Clinics
• 20 RFAs
DeRosa Medical, P.C. • Health and Wellness
• Weight Loss
• Chronic Health Condition
Management
• 3 Primary Care Practices
Nobilis Facilities
31
