The document is an investor presentation for an unnamed company. It begins with standard legal disclaimers about the use of forward-looking statements and estimates in the presentation. The rest of the presentation provides an overview of the company, including its mission and solutions, the industries it serves, its strategic advantages, innovations, growth strategy, financial overview and appendix with adjusted EBITDA reconciliation.
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The Medicare Access and CHIP Reauthorization Act (MACRA) appears to be a reporting challenge for many healthcare provider systems with few resources for managing the menagerie of measures. Indeed, with more than 270 measures in play, many systems have yet to jump in, but the deadline is inevitable. A plan of action is possible by recognizing and acting on these eight challenge areas:
Challenge #1: High-level performance insight
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Measures aligned with desired outcomes drive improvement.
Improvement teams focus on processes they can impact.
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Data management.
Scalability.
Ongoing maintenance.
Adoption.
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The fundamental principles of the Affordable Care Act recognize that the volume-based, fee-for-service payment model is unsustainable and that a value-based healthcare delivery system is essential. With the emergence of Accountable Care Organizations (ACOs), providers are incentivized to implement payment reforms and participate in shared savings programs that seek to balance quality of care, access to care and cost of care.
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In today’s improvement-driven healthcare environment, organizations must ensure that improvement measures help them reach desired outcomes and focus on the opportunities with optimal ROI. With data science-based analysis, health systems leverage machine learning to determine if improvement measures align with specific outcomes and avoid the risk and cost of carrying out interventions that are unlikely to support their goals.
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Measures aligned with desired outcomes drive improvement.
Improvement teams focus on processes they can impact.
Outcome-specific interventions might impact other outcomes.
Identifies opportunities with optimal ROI.
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Conventus webinar video providing key success strategies and tactics for improving productivity, profitability, and patient care. The one-hour video features host Susan Lieberman of Conventus and Stevie Davidson of Health Informatics Consulting.
2. 2
Safe Harbor / Disclaimer
This presentation includes forward-looking statements within the meaning of the Private Securities Litigation Reform
Act of 1995, which relate to future, not past, events and are subject to risks and uncertainties. The forward-looking
statements, which address the Company's expected business and financial performance and financial condition,
among other matters, contain words such as: “believe,” “could,” “opportunities,” “continue,” “expect,” “may,” “will,” or
“would” and other words and terms of similar meaning.
Forward-looking statements by their nature address matters that are, to different degrees, uncertain, such as
statements about expected income; earnings; revenues; and growth. Although the Company believes the
expectations reflected in such forward-looking statements are based upon reasonable assumptions, it can give no
assurance that the expectations will be attained or that any deviation will not be material. Readers are cautioned not to
place undue reliance on these forward-looking statements, which speak only as of the date on which they are made.
Factors that could cause actual results to differ materially from these forward-looking statements can be found in the
Company’s Annual Report on Form 10-K, Quarterly Reports on Form 10-Q and the Company’s other reports filed with
the Securities and Exchange Commission. These or other uncertainties may cause the Company’s actual future
results to be materially different than those expressed in any forward-looking statements. The Company undertakes
no obligation to update or revise any forward-looking statements.
This presentation also contains estimates and other statistical data made by independent parties and by us relating to
market size and growth and other data about our industry. This data involves a number of assumptions and limitations,
and you are cautioned not to give undue weight to such estimates. In addition, projections, assumptions and estimates
of our future performance and the future performance of the markets in which we operate are necessarily subject to a
high degree of uncertainty and risk.
This presentation also contains non-GAAP financial measures. You can find a reconciliation of the non-GAAP financial
measures to the most directly comparable GAAP financial measures in the appendix to this presentation.
3. Press Ganey Overview
Mission
To help healthcare organizations reduce patient and caregiver
suffering and improve clinical quality, safety and the overall
patient experience
Transformational Solutions
Patient Experience
Caregiver Engagement
Clinical Quality
Reliability & Safety
3
4. 4
Disruptive Forces In Healthcare
Shift to value-based models/Population health
Process to outcome measures
Narrow networks
Growth in Spending
Patient-centricity
Caregiver Engagement / Care coordination
Operational integration and advanced analytics
Demand for reliable measures
Honor consumer through transparency
Brand awareness / Patient Loyalty/ Market Share
Increased patient engagement
Focus on performance and outcomes
Expanded CAHPS programs
Care Redesign
Market ResponseHealthcare Dynamics
Expanding Regulation
Rise of Consumerism
5. Industry Leader With Partners Across
The Continuum Of Care
80%+
60%+
80%+
70%+
Note: All information as of 12/31/15 5
Acute Hospitals
Major Teaching Hospitals
MD Groups w/ >50 Physicians
Acute Hospitals w/ 100+ Beds
10. 4.5
3.9
3.7
0.0
1.0
2.0
3.0
4.0
5.0
6.0
Low Middle High
AverageLengthofStay(Days)
Reliability Score Rank by Tercile
1. Reliability and length of stay data derived from our 2013 HCAHPS all-facilities database, N=2,289,639.
2. Based on Medicare Spending by Claim, 2014 Hospital Compare and Billian’s 2014 data, N=3,080.
15.0%
8.7%
5.9%
12.1%
0%
4%
8%
12%
16%
20%
Bottom Decile Top Decile
~6% less spending
due to
readmissions
Patient Experience Solution Foundational To
Clinical And Financial Performance
Average Length of Stay by Patient Experience
Reliability Tercile (1)
Lower Cost of Care, Higher Operating Margin
for Top Performers on HCAHPS (2)
Patient Experience is a Powerful Tool for Performance Improvement
Hospital Net Margin
10
% of Spending on Readmission
HCAHPS Overall Rating
11. 71 70
77
82
75 76
84
31
23
42
37
50
63
47
0
20
40
60
80
100
Nurse Responsiveness Physician Pain Medication Discharge Rating
AverageNationalPercentileRank
Top Quintile of Employee Engagement Bottom Quintile of Employee Engagement
National Percentile Rank Based on Employee Engagement Scores (1)
Employee Engagement Improves Patient Experience
1. Based on Engagement data from 36 projects, year 2014. HCAHPS data from 2014 PG Database.
Complementary Solutions
Accelerate Performance Improvement
11
Created by Healthcare Metrics Team.
12. 12
Census Based Surveying Enables Innovation:
Transparency Study
• Census Based Surveying increases patient data by 80%
• UT Transparency has resulted in 50%+ of docs in 90th percentile in 2014
Dr. Campbell
Press Ganey Data
1164 Reviews
4.6 Stars vs Vitals 2.5
Dr. Leiser
Press Ganey Data
74 Reviews
4.9 Stars vs. Vitals 2.5
13. Industry Leading Sales
And Client Management Teams
13
375+
Client Facing Associates
Transformational Consultants
Sales Professionals
Advisory Professionals
Account Management Supporting Clients
39
72
120
141
Geographically-based model for majority of client base
14. Innovation And Thought Leadership
Offer Deeper Value To Clients
Executive Council
members of Press
Ganey nonprofit
Speaking
engagements
Clients at national
conference
Attendees across
regional symposiums
Monthly user logins
for improvement
solutions
14
Investing in Thought Leadership
28 245+
2,800
1,000+
265,000+
Industry articles in key
trade publications
Participants in the
online community
Custom analytic reports
generated annually
300+
26,0003,000+
Participants in
CNO Quarterly Best
Practices Roundtable
250
16. Total Addressable Market
16
Quality, Safety,
Consulting, Other
ExistingClientsProspects
Patient
Experience
Caregiver
Engagement
$319 Million (2015 PGND Revenue)
Patient Engagement,
Care Coordination, Other Consulting
$865 Million
$294 Million
$2.7 Billion
New SolutionsExisting Solutions
$4.2 Billion Total Addressable Market
$1.5 Billion
17. Expanding CAHPS Requirements
Will Accelerate Improvement Efforts
2%17 2%2%
2%
Hospital Outpatient
Surgery Departments
Voluntary Anticipated Mandatory
2016 2017 2018
Ambulatory Surgery Centers Voluntary Anticipated Mandatory
Pediatric Inpatient Hospitals
Emergency Departments Planning Anticipated Voluntary Anticipated Mandatory
Long Term Care Hospitals Planning Anticipated Voluntary Anticipated Mandatory
Inpatient Psychiatric Facilities Planning Anticipated Voluntary
Inpatient
Dialysis
ACOs
Medical Practices
Hospice
Home Health
Mandatory
Inpatient Rehab Facilities Planning Anticipated Voluntary Anticipated Mandatory
Voluntary
20. Financial Overview
20
Revenue
Predictability
Retention: 97% client retention / 95% revenue retention 3-year average 2013-2015
Visibility: Average contract life for top 100 patient experience clients is 2.8 years
Existing Solutions: $1.5B White space
New Solutions: $2.7B Opportunity
Cost of Revenue: Greater percentage of insights from electronic platform
Technology Improvements: Redesign of platforms for collecting and sharing data
Sales Force: Broader product offering
Unlevered Free Cash Flow: 79% of EBITDA from 2012 to 2015
Balance Sheet: deleveraged and lower interest rates
Organic
Growth
Operating
Leverage
Cash Flow
Long Term Growth Targets
Revenue: 7-9% organic / 2-3% acquisition
Adjusted EBITDA: 13-15%
24. Adjusted EBITDA Reconciliation
1. Includes costs associated with modification of equity awards in connection with the liquidating distribution and IPO of $70,438 in May of 2015.
2. Write-off of unamortized deferred financing fees, loss on original issue discount and lender fees in connection with debt refinancings.
3. Non-cash property and equipment and intangible impairment charges related to the discontinuation of certain clinical solutions in 2013.
4. Management fees paid to Vestar.
5. Transaction costs incurred in connection with completed and potential acquisitions.
6. Expense associated with executive separation agreements and targeted employee headcount reductions.
7. Primarily consists of professional fees incurred in connection with corporate strategic planning and technology consulting projects, as well as expenses and revenue credits related
to client retention due to the discontinuation of certain clinical solutions and software applications.
Fiscal Year ended December 31
($ in thousands) 2012A 2013A 2014A 2015A
Net income (loss) $(7,391) $99 $15,583 $(36,627)
Interest expense 32,157 24,644 19,832 11,163
Income tax expense (benefit) (604) 5,926 13,196 7,528
Depreciation & amortization 27,202 32,468 35,102 41,224
EBITDA $51,364 $63,137 $83,713 $23,288
Equity-based compensation(1) 14,256 9,787 8,034 86,745
Extinguishment of debt (2) 7,185 7,922 2,894 1,750
Non-cash impairment charges (3) - 2,579 - -
Management fee to related party (4) 968 907 1,047 553
Acquisition expenses (5) 1,327 902 462 945
Severance (6) 2,797 625 1,084 2,095
Loss on disposal of property & equipment - 274 1,719 307
Other non-comparable items (7) 1,465 2,159 3,606 1,802
Adjusted EBITDA $79,362 $88,292 $102,559 $117,485
24
25. Unlevered Free Cash Flow
Fiscal Year ended December 31
($ in thousands) 2012A 2013A 2014A 2015A
Adjusted EBITDA $79,362 $88,292 $102,559 $117,485
Capital Expenditures (18,191) (17,230) (19,414) (26,197)
Unlevered Free Cash Flow $61,171 $71,062 $83,145 $91,288
Free Cash Flow Conversion (1) 77% 80% 81% 78%
1. Free Cash Flow Conversion defined as % of Adjusted EBITDA.
25
26. Capitalization
As Reported
($ in thousands) 12/31/12 12/31/13 12/31/14 12/31/15
Cash $7,845 $32,635 $6,962 $35,235
Total Debt $431,851 $434,423 $418,319 $189,267
Net Debt $424,006 $401,788 $411,357 $154,032
LTM Adjusted EBITDA $79,362 $88,292 $102,559 $117,485
Total Net Leverage 5.3x 4.6x 4.0x 1.3x
26