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Investor Presentation
NYSE MKT:HLTH โ€ข TSX:NHC
November 2016
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, 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 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.sedar.com or at www.sec.gov. Any forward-looking statements that
we make are based on assumptions as of today, and we undertake no obligation to update them.
The Companyโ€™s management has approved the financial outlooks contained in this presentation.
2
Summary
o Own, operate and manage ambulatory surgical centers
(ASCs) and surgical hospitals
๏‚ง 4 Surgical Hospitals, 10 ASCs, 5 Clinics, 36 Partner facilities
๏‚ง 8 Markets, 7 States
o Unique direct-to-patient marketing model
o Capitalizing on trend toward increased consumerism in
healthcare
o Healthcare delivery shifting towards lower cost, high quality
outpatient setting
o 2015 revenue of $229.2 million and adjusted EBITDA of
$42.1 million
3
Investment Highlights
Business model driven by organic growth and acquisitions
Unique marketing model and proprietary technology a strategic
advantage
Disciplined M&A approach that has resulted in accretive
acquisitions in a fragmented market
Favorable payor mix (predominantly commercial) and procedure
mix
Under leveraged balance sheet; limited capex and working capital
requirements
Compelling value proposition for physicians, patients and payors
4
5
Financial Performance
(US$ Millions)
$-
$10
$20
$30
$40
$50
$60
$-
$50
$100
$150
$200
$250
$300
2012 2013 2014 2015 2016E*
Adj.EBITDA(LessNCI)
Revenue
Total Revenue Adj. EBITDA (Less NCI)
Revenue and Adjusted EBITDA (Less NCI)
Growth Strategy
6
Drive organic growth
โ€’ Multiple marketing channels drive volume growth
โ€’ Concertis, Inc. โ€“ bundled payments
Acquisition opportunities
โ€’ Highly fragmented market
โ€’ Ability to cross-sell service lines
Service lines and specialties
โ€’ Optimized case mix
โ€’ Higher acuity procedures, higher levels of reimbursement
Operational leverage
โ€’ Drive cost reductions in recently acquired facilities
โ€’ Economies of scale
Industry 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 > 6,000 ASCs
o 70%+ owned by
independents
7
Nobilis Footprint
Other operations
o Nobilis manages all
owned facilities
o 36 Partner Facilities
Facility Market Equity
First Surgical
Hospital
Houston, TX 51%
First Street Surgery
Center (HOPD)
Houston, TX 51%
Southwest Freeway
Surgery Center
Houston, TX 100%
Kirby Surgical Center Houston, TX 25%
Hermann Drive
Surgical Hospital
Houston, TX 55%
Dickinson ASC Houston, TX 100%
Plano Surgical
Hospital
Dallas, TX 100%
Dallas Metro (HOPD) Dallas, TX *40%
Northstar Healthcare
Surgery Center
Scottsdale, AZ 100%
Scottsdale Liberty
Hospital
Scottsdale, AZ 60%
1
3
24
5
2
1
2
2
1
1 1
2
Relationship Facilities
(DTC, IOM)
JV Facilities Owned Facilities36 1 8
8
*Through the JV structure at Dallas Metro, Nobilis owns
40% of the management company and receives additional
income from Nobilis sourced cases through an MSA
*Marketing/Ancillary services provided
o 8 Markets
o 7 States
New Acquisition - Arizona Vein and Vascular
9
o 4 ASCs and 5 Clinics
๏‚ง Phoenix and Tucson, AZ markets
๏‚ง 11 ORs, 30 beds
๏‚ง Combined 37k sq ft clinical space
o $20M 2015 Revenue
o $7.9M 2015 Adj. EBITDA
o $7.1M 2015 Net Income
o ~4800 cases 2015
o Commercial Payors
o AZ Vein & Vascular Brand
Transaction Details
10
Transaction
o The purchase price is $22 million plus a
performance-based earn-out based on
growth in Adjusted EBITDA
o The purchase price is comprised of:
๏‚ง $17.5 million cash
๏‚ง $2.25 million in the form of a
convertible note
๏‚ง $2.25 million of restricted stock
o Multiple of 2.8x EBITDA
o Dr. Phillip Wall will be joining Nobilis as
President of Vascular Division
o Closed 10/28/16
Growth Strategy
o Nobilis will expand Arizona Vein & Vascular
procedures to facilities in the Houston and
Dallas markets concurrent with closing
o The Company expects to drive additional volume
into these expansion locations utilizing its
proprietary marketing capabilities
o Accretive to 2016 EPS
Optimized Procedure & Payor Mix
Procedure Mix:
o New technologies allow more complex
surgical cases in outpatient setting
o Better case mix results in higher
average reimbursement rates than
ASC industry average
o Optimized case mix leads to highly
specialized surgical staff and increased
center efficiencies
Payor Mix:
o Payor mix consists predominantly of
commercial payors
o Strategically adding in-network
contracts to lower out-of-pocket costs
for patients and total costs for payors
and drives referrals from managed
care companies
Case Mix FY 2015
Gen
4%
Pain 29%
Bariatric 22%
Spine 13%
Plastic 9%
Orthopedic
8%
Other 10%
Gyn
5%
11
Revenue Model
o Profit margin driven by relative ownership
levels (Nobilis ownership ranges 25% โ€“100%,
Average 65%)
o In addition, Nobilis receives percentage of
marketing-generated cases, driving overall
effective profit percentage higher
o Marketing (DTC & Sales) cases typically have
higher profit margin
1 Management fees range from 2%โ€“8%
Anesthesia
+ Surgeon
Nobilis Facility
Payor
Commercial,
Government, Self-Pay
Facility Fee
Professional Fees
% of Profit + Management Fee1
12
Direct-to-Consumer Marketing
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
Unique Patient Acquisition Strategy
Physician Sales
o Build and execute marketing plans on behalf of physicians
o Helps expand physiciansโ€™ practices
o High ROI for Nobilis
13
Lead Generation
6 branded surgical
procedures marketed
directly to patients via
omni-channel marketing
strategy
Concierge Service
Inside sales team + IT
platform to maximize
patient experience
Patient Tracking
Patient follow-up,
experience surveys,
referrals
Direct-to-Consumer Marketing
14
Conversion to Surgical Patient
Patient education, medical
review, insurance verification,
surgical scheduling
Our Brands:
Patient Coordinators
will interact with a
patient an average
of 17 times
Patient Coordinators
Nobilis Patient Journey Platform
o Ensures that each step of the patient journey is
reviewed and managed by a dedicated Patient
Coordinator from time of initial contact through
post surgical recovery
End-to-End Concierge Model
o Leverages Nobilisโ€™ proprietary scheduling
applications
o Designed for standardized data entry for
corporate reporting consolidation, connection to
EMRs, faster onboarding of new facilities, post-
operative follow-up program with outcomes and
patient satisfaction data
15
7 Branded Surgical Procedures
16
Minimally invasive back and neck surgeries
Non-pharmaceutical surgical implant for the relief of
chronic migraine pain
Minimally invasive bariatric surgery
Minimally invasive surgeries for gynecological conditions
Minimally invasive relief of foot and ankle pain due to nerve
entrapment, other podiatric issues
Treats non-spine joint issues for patients of all ages, types
Treats both enhancements & threatening vascular problems
Physicians
Devote more time to treating
patients
Generate additional patient volume
Grow their practice
Increased profitability
Benefits of DTC Marketing
Nobilis Health
Enhanced physician recruitment/
retention
Incremental patient volume
High return on revenue per case
Scalable
17
Physician Marketing
o In-house marketing team works
one-on-one with physicians to
develop and distribute
customized marketing plans
o Lower partner acquisition costs /
increased partner profitability
o Enhanced recruitment and
retention
Nobilis ROI
Average
5:1
18
Disciplined M&A Strategy
19
o Currently pursuing portfolio companies in strategic geographical regions
o All portfolio opportunities fulfill key criteria that expand overall footprint while
maximizing accretive value of combined entity:
โ€’ Multi-facility portfolio
โ€’ Ability to overlay marketing
โ€’ Strategic geographic market
โ€’ Positive EBITDA
o Nobilis will continue to seek and pursue other non-portfolio opportunities,
including:
โ€’ Facilities available at fair market value that Nobilis can quickly turn around and
sustain profitable operations
โ€’ Acquisitions of unique differentiators that add value and capabilities with the needs
of a strong in-network system
โ€’ Ancillary businesses with system-wide revenue producing potential
Concertis
A Technology Platform that Transforms
Healthcare Delivery
o Concertis connects providers with payors
to implement new reimbursement
methodologies focused on patient
outcomes
o This is effectively an in-network model at
higher than in network rates and
accelerated payment timeline
20
Payor
Ancillaries Surgeon Facility
Concertis Products:
o Clinical Integration Network
Formation and Administration
o Population Health Management
o Care Coordination
โ€œBundled payments are the future of reimbursement in
medicine. At Nobilis we are well-positioned to take
advantage of this."
-Dr. Neil Badlani,
Chief Medical Officer
Aligning Payors, Providers, and Facilities
21
Concertis Aligns Payors, Providers, and Facilities
o Opportunity to enhance relationships with commercial payors and
develop relationships with self-insured employers
o Greater savings on bundles than large, acute-care facilities
o Physicians encouraged to cooperate for enhanced revenue
incentives
o Represents a significant marketing opportunity
Third Quarter Discussion Points
๏‚ง Revenues Increase to $70.7M
๏‚ง Net Loss of $2.8M
๏‚ง Adjusted EBITDA of $4.3M
๏‚ง Cash Increases to $19.6M
๏‚ง $4.7 million in Additional Incremental Sales, Marketing and Ancillary Expenses
๏‚ง Secured $82.5M Financing
๏‚ง Closed 2 Acquisitions
๏‚ง Arizona Vein & Vascular
๏‚ง Dickinson ASC
22
2016 Full Year Guidance Reiterated for Revenue & Adj EBITDA
o Strong platform for scalable growth into national markets
o Compelling value proposition for physicians, patients and payors
o Focus on minimally invasive procedures aligned with market trends
o Lean balance sheet; limited capex and working capital requirements
Poised for Continued Growth
2015 2016E Change2
Revenue $229M $281M +23%
Adjusted EBITDA
(Less NCI)
$42M $53M +26%
23
Financial Guidance (Not including acquisitions)1
1While our pipeline remains strong, as evidenced by the recently closed acquisition of Arizona Vein and Vascular, the
timing of acquisitions is always uncertain. Therefore, from this point forward, Nobilis will no longer provide guidance
that includes acquisitions. As we close future acquisitions we will provide additional guidance.
2Assumes 20% organic revenue growth and 21% organic Adj. EBITDA growth on facilities/companies acquired after
January 1, 2015 (including acquisitions in 2016)

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Nobilis health ir_deck_nov final

  • 1. Investor Presentation NYSE MKT:HLTH โ€ข TSX:NHC November 2016
  • 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, 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 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.sedar.com or at www.sec.gov. Any forward-looking statements that we make are based on assumptions as of today, and we undertake no obligation to update them. The Companyโ€™s management has approved the financial outlooks contained in this presentation. 2
  • 3. Summary o Own, operate and manage ambulatory surgical centers (ASCs) and surgical hospitals ๏‚ง 4 Surgical Hospitals, 10 ASCs, 5 Clinics, 36 Partner facilities ๏‚ง 8 Markets, 7 States o Unique direct-to-patient marketing model o Capitalizing on trend toward increased consumerism in healthcare o Healthcare delivery shifting towards lower cost, high quality outpatient setting o 2015 revenue of $229.2 million and adjusted EBITDA of $42.1 million 3
  • 4. Investment Highlights Business model driven by organic growth and acquisitions Unique marketing model and proprietary technology a strategic advantage Disciplined M&A approach that has resulted in accretive acquisitions in a fragmented market Favorable payor mix (predominantly commercial) and procedure mix Under leveraged balance sheet; limited capex and working capital requirements Compelling value proposition for physicians, patients and payors 4
  • 5. 5 Financial Performance (US$ Millions) $- $10 $20 $30 $40 $50 $60 $- $50 $100 $150 $200 $250 $300 2012 2013 2014 2015 2016E* Adj.EBITDA(LessNCI) Revenue Total Revenue Adj. EBITDA (Less NCI) Revenue and Adjusted EBITDA (Less NCI)
  • 6. Growth Strategy 6 Drive organic growth โ€’ Multiple marketing channels drive volume growth โ€’ Concertis, Inc. โ€“ bundled payments Acquisition opportunities โ€’ Highly fragmented market โ€’ Ability to cross-sell service lines Service lines and specialties โ€’ Optimized case mix โ€’ Higher acuity procedures, higher levels of reimbursement Operational leverage โ€’ Drive cost reductions in recently acquired facilities โ€’ Economies of scale
  • 7. Industry 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 > 6,000 ASCs o 70%+ owned by independents 7
  • 8. Nobilis Footprint Other operations o Nobilis manages all owned facilities o 36 Partner Facilities Facility Market Equity First Surgical Hospital Houston, TX 51% First Street Surgery Center (HOPD) Houston, TX 51% Southwest Freeway Surgery Center Houston, TX 100% Kirby Surgical Center Houston, TX 25% Hermann Drive Surgical Hospital Houston, TX 55% Dickinson ASC Houston, TX 100% Plano Surgical Hospital Dallas, TX 100% Dallas Metro (HOPD) Dallas, TX *40% Northstar Healthcare Surgery Center Scottsdale, AZ 100% Scottsdale Liberty Hospital Scottsdale, AZ 60% 1 3 24 5 2 1 2 2 1 1 1 2 Relationship Facilities (DTC, IOM) JV Facilities Owned Facilities36 1 8 8 *Through the JV structure at Dallas Metro, Nobilis owns 40% of the management company and receives additional income from Nobilis sourced cases through an MSA *Marketing/Ancillary services provided o 8 Markets o 7 States
  • 9. New Acquisition - Arizona Vein and Vascular 9 o 4 ASCs and 5 Clinics ๏‚ง Phoenix and Tucson, AZ markets ๏‚ง 11 ORs, 30 beds ๏‚ง Combined 37k sq ft clinical space o $20M 2015 Revenue o $7.9M 2015 Adj. EBITDA o $7.1M 2015 Net Income o ~4800 cases 2015 o Commercial Payors o AZ Vein & Vascular Brand
  • 10. Transaction Details 10 Transaction o The purchase price is $22 million plus a performance-based earn-out based on growth in Adjusted EBITDA o The purchase price is comprised of: ๏‚ง $17.5 million cash ๏‚ง $2.25 million in the form of a convertible note ๏‚ง $2.25 million of restricted stock o Multiple of 2.8x EBITDA o Dr. Phillip Wall will be joining Nobilis as President of Vascular Division o Closed 10/28/16 Growth Strategy o Nobilis will expand Arizona Vein & Vascular procedures to facilities in the Houston and Dallas markets concurrent with closing o The Company expects to drive additional volume into these expansion locations utilizing its proprietary marketing capabilities o Accretive to 2016 EPS
  • 11. Optimized Procedure & Payor Mix Procedure Mix: o New technologies allow more complex surgical cases in outpatient setting o Better case mix results in higher average reimbursement rates than ASC industry average o Optimized case mix leads to highly specialized surgical staff and increased center efficiencies Payor Mix: o Payor mix consists predominantly of commercial payors o Strategically adding in-network contracts to lower out-of-pocket costs for patients and total costs for payors and drives referrals from managed care companies Case Mix FY 2015 Gen 4% Pain 29% Bariatric 22% Spine 13% Plastic 9% Orthopedic 8% Other 10% Gyn 5% 11
  • 12. Revenue Model o Profit margin driven by relative ownership levels (Nobilis ownership ranges 25% โ€“100%, Average 65%) o In addition, Nobilis receives percentage of marketing-generated cases, driving overall effective profit percentage higher o Marketing (DTC & Sales) cases typically have higher profit margin 1 Management fees range from 2%โ€“8% Anesthesia + Surgeon Nobilis Facility Payor Commercial, Government, Self-Pay Facility Fee Professional Fees % of Profit + Management Fee1 12
  • 13. Direct-to-Consumer Marketing 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 Unique Patient Acquisition Strategy Physician Sales o Build and execute marketing plans on behalf of physicians o Helps expand physiciansโ€™ practices o High ROI for Nobilis 13
  • 14. Lead Generation 6 branded surgical procedures marketed directly to patients via omni-channel marketing strategy Concierge Service Inside sales team + IT platform to maximize patient experience Patient Tracking Patient follow-up, experience surveys, referrals Direct-to-Consumer Marketing 14 Conversion to Surgical Patient Patient education, medical review, insurance verification, surgical scheduling Our Brands:
  • 15. Patient Coordinators will interact with a patient an average of 17 times Patient Coordinators Nobilis Patient Journey Platform o Ensures that each step of the patient journey is reviewed and managed by a dedicated Patient Coordinator from time of initial contact through post surgical recovery End-to-End Concierge Model o Leverages Nobilisโ€™ proprietary scheduling applications o Designed for standardized data entry for corporate reporting consolidation, connection to EMRs, faster onboarding of new facilities, post- operative follow-up program with outcomes and patient satisfaction data 15
  • 16. 7 Branded Surgical Procedures 16 Minimally invasive back and neck surgeries Non-pharmaceutical surgical implant for the relief of chronic migraine pain Minimally invasive bariatric surgery Minimally invasive surgeries for gynecological conditions Minimally invasive relief of foot and ankle pain due to nerve entrapment, other podiatric issues Treats non-spine joint issues for patients of all ages, types Treats both enhancements & threatening vascular problems
  • 17. Physicians Devote more time to treating patients Generate additional patient volume Grow their practice Increased profitability Benefits of DTC Marketing Nobilis Health Enhanced physician recruitment/ retention Incremental patient volume High return on revenue per case Scalable 17
  • 18. Physician Marketing o In-house marketing team works one-on-one with physicians to develop and distribute customized marketing plans o Lower partner acquisition costs / increased partner profitability o Enhanced recruitment and retention Nobilis ROI Average 5:1 18
  • 19. Disciplined M&A Strategy 19 o Currently pursuing portfolio companies in strategic geographical regions o All portfolio opportunities fulfill key criteria that expand overall footprint while maximizing accretive value of combined entity: โ€’ Multi-facility portfolio โ€’ Ability to overlay marketing โ€’ Strategic geographic market โ€’ Positive EBITDA o Nobilis will continue to seek and pursue other non-portfolio opportunities, including: โ€’ Facilities available at fair market value that Nobilis can quickly turn around and sustain profitable operations โ€’ Acquisitions of unique differentiators that add value and capabilities with the needs of a strong in-network system โ€’ Ancillary businesses with system-wide revenue producing potential
  • 20. Concertis A Technology Platform that Transforms Healthcare Delivery o Concertis connects providers with payors to implement new reimbursement methodologies focused on patient outcomes o This is effectively an in-network model at higher than in network rates and accelerated payment timeline 20 Payor Ancillaries Surgeon Facility Concertis Products: o Clinical Integration Network Formation and Administration o Population Health Management o Care Coordination โ€œBundled payments are the future of reimbursement in medicine. At Nobilis we are well-positioned to take advantage of this." -Dr. Neil Badlani, Chief Medical Officer
  • 21. Aligning Payors, Providers, and Facilities 21 Concertis Aligns Payors, Providers, and Facilities o Opportunity to enhance relationships with commercial payors and develop relationships with self-insured employers o Greater savings on bundles than large, acute-care facilities o Physicians encouraged to cooperate for enhanced revenue incentives o Represents a significant marketing opportunity
  • 22. Third Quarter Discussion Points ๏‚ง Revenues Increase to $70.7M ๏‚ง Net Loss of $2.8M ๏‚ง Adjusted EBITDA of $4.3M ๏‚ง Cash Increases to $19.6M ๏‚ง $4.7 million in Additional Incremental Sales, Marketing and Ancillary Expenses ๏‚ง Secured $82.5M Financing ๏‚ง Closed 2 Acquisitions ๏‚ง Arizona Vein & Vascular ๏‚ง Dickinson ASC 22 2016 Full Year Guidance Reiterated for Revenue & Adj EBITDA
  • 23. o Strong platform for scalable growth into national markets o Compelling value proposition for physicians, patients and payors o Focus on minimally invasive procedures aligned with market trends o Lean balance sheet; limited capex and working capital requirements Poised for Continued Growth 2015 2016E Change2 Revenue $229M $281M +23% Adjusted EBITDA (Less NCI) $42M $53M +26% 23 Financial Guidance (Not including acquisitions)1 1While our pipeline remains strong, as evidenced by the recently closed acquisition of Arizona Vein and Vascular, the timing of acquisitions is always uncertain. Therefore, from this point forward, Nobilis will no longer provide guidance that includes acquisitions. As we close future acquisitions we will provide additional guidance. 2Assumes 20% organic revenue growth and 21% organic Adj. EBITDA growth on facilities/companies acquired after January 1, 2015 (including acquisitions in 2016)