Evolent Health Investor and Analyst Day

Transcription

1 Evolent Health Investor and Analyst Day May 25,

2 Safe Harbor Statement All statements other than statements of historical fact included in this presentation are forward-looking statements. You can identify forward-looking statements by the fact that they do not relate strictly to historical or current facts. These statements may include words such as may, might, will, should, expects, plans, anticipates, estimates, aims, predicts, potential, or continue, the negative of these terms and other comparable terminology. These forward-looking statements, which are subject to risks, uncertainties and assumptions, may include projections of our future financial performance, our anticipated growth strategies and anticipated trends in our business. There are important factors that could cause our actual results, level of activity, performance or achievements to differ materially from the results, level of activity, performance or achievements expressed or implied by the forward-looking statements. This presentation includes certain non-gaap financial measures. Tables reconciling such non-gaap financial measures are set forth herein. Non-GAAP Financial Measures In addition to disclosing financial results that are determined in accordance with GAAP, we present and discuss Adjusted Revenue, Adjusted Transformation Revenue and Adjusted Platform and Operations Revenue, which are all non-gaap financial measures, as supplemental measures to help investors evaluate our fundamental operational performance. Each of these adjusted measures are adjusted to reflect the reorganization of Evolent Health, Inc. (the Reorganization ) as if it had occurred on the first day of the relevant period as described in Results of Operations Evolent Health, Inc. Adjusted Results in our Quarterly Report on Form 10-Q for the quarter ended September 30, 2015 and are adjusted to exclude the impact of purchase accounting adjustments, stock-based compensation expenses and transaction expenses related to the Reorganization and our IPO. In addition, Adjusted EBITDA is also adjusted to exclude depreciation and amortization expense, other income (expense), interest (income) expense, net income (loss) attributable to non-controlling interests, provision (benefit) for income taxes, income (loss) from affiliate and gain on consolidation. These adjusted measures do not represent and should not be considered as alternatives to GAAP measurements, and our calculations thereof may not be comparable to similarly entitled measures reported by other companies. A reconciliation of these adjusted measures to the comparable GAAP financial measures is presented in the attached tables. We believe these measures are useful across time in evaluating our fundamental core operating performance. Management also uses certain of these measures to manage our business, including in preparing its annual operating budget, financial projections and compensation plans. We believe that certain of these measures are also useful to investors because similar measures are frequently used by securities analysts, investors and other interested parties in their evaluation of companies in similar industries. 1

3 Agenda Marketplace Overview and D.C. Insider Panel Evolent Operations and Technology Panel Lunch Break Customer Panel Sustained and Scalable Growth for the Future Q&A with Evolent executive team 10:00am 11:00am 11:00am 12:00pm 12:00pm 12:30pm 12:30pm 1:15pm 1:15pm 2:00pm 2

4 Opening Remarks Frank Williams Chief Executive Officer Co-Founder 3

5 Our Industry is Experiencing a Significant Shift to Value-Based Care government goals payer goals of Medicare FFS payments link 90% to quality / value by % of Medicare Advantage members in VBC by retail projections 86M lives in retail market by provider goals of business in value-based 75% arrangements by Projected Market for Value-Based Care Services 2020 $3.2 trillion health insurance spend $1.6 trillion in provider value-based care Available market at 2-5% of premium $45B + Total Addressable Market Sources: 1. HHS Press Office. "Better, Smarter, Healthier: In Historic Announcement, HHS Sets Clear Goals and Timeline for Shifting Medicare Reimbursements from Volume to Value." HHS.gov. Department of Health and Human Services, 16 Jan Web. 24 May "Humana Takes a Bold Step Forward in Population Health with the Formation of Transcend and Transcend Insights." Humana Healthcare. Haumana Healthcare, 24 Mar Web. 24 May "20 Health Systems, Insurers Agree to Make 75% of Contracts Value-based." The Advisory Board. The Advisory Board, 29 Jan Web. 24 May

6 Evolent Health vision what we do business model differentiation Build a national network of providers transforming care under value-based payment initiatives Provide integrated technology, intellectual capital and scalable services to enable business model transformation Long-term contracts, recurring revenue model, embedded organic growth, scalable margins Provider-driven, broad integrated platform, payer agnostic, proven clinical / financial results 5

7 Evolent Health: Platform for Value-Based Care 1.2M lives currently on the platform $164M in adjusted revenues In 2015* Evolenteers in 2016 Founded in 2011, Evolent Health was established with capital, assets and intellectual property from UPMC, The Advisory Board, TPG Growth and our network of health systems partners *Unadjusted revenues in 2015 were $96.9M 6

8 Evolent Health National Network of Partners A National Network of Leading Provider-Led Risk Bearing Organizations Example Partner Systems From Around the Country Live Markets Developing Markets 7

9 Health Systems Face a Myriad of Value Contracting Choices, All With Distinct Operational Requirements Health System Medicare Value Program Managed Medicaid Contract Payer-Delegated Risk Arrangement Employer Contract Exchanges Doubling down on risk: Pioneer ACO, Next Gen, MSSP, Medicare Advantage, etc. Medicaid experimenting with risk, consumerism Payer risk deals with key success factors utilization management, population health management Employercentered medical homes High performance networks Private exchanges Premium sensitivity public exchanges (narrow networks), point of care 8

10 Evolent s Integrated Platform Enables Providers to Build a Complex New Business and Deliver Value Capture Value Create Value Blueprint Payer Value Alliance / Employer Value Advantage Health Plan Value Edge Delivery Network Alignment System Transformation Identifi Technology Solution Population Health Performance Financial & Admin. Mgmt Broad offering across clinical and financial continuum Full continuum of data for comprehensive view Physician-driven clinical program development for all at-risk populations Performance-driven network alignment Fully-integrated, payer agnostic platform 9

11 Multiple Sources of Growth Drive Strong Topline Results $ in Millions Transformation Platform and Operations Adjusted Revenue CAGR* 170% $100.9 $163.5 $8.3 $ Lives on Platform 28K 174K 433K 718K Lives on platform as % of total population in existing Evolent customer markets Lives on platform as % of total US population 0.3% 0.01% 0.9% 0.06% 1.9% 0.14% 2.2% 0.22% *Unadjusted revenues in 2015 were $96.9M Source: 10

12 Recurring Revenue With Scalability as Mix Transitions to Platform and Operations (P&O) Revenue Model Business Model Drivers % of 2015 Adj. Revenue* Transformation (Business Plan Development and Implementation) Fixed fee Recognized over life of engagement Attractive entry point to new client Good visibility to forward revenue 23% Project-based Platform & Operations (Population and Health Plan Management) Variable fee based on lives (PMPM) Recognized as services delivered Long-term contracts Aligned with customers High visibility due to recurring revenue model Embedded growth in clients Creates network effect High margin on incremental lives 77% *Unadjusted revenues in 2015 were $96.9M 11

13 Investments in National Platform Drive Scale and Long-Term Margin Expansion Investment Scope and Current P&L Impact Long-Term Benefits Local Market Investments Investment in local market resources and Shared Services Platform Embedded services, long-term contracts, sticky relationships Local market scale efficiencies as clients add lives to the platform Scaled National Investments Up-front investment in fully-scaled National Support Platform Comprehensive platform increases savings opportunity and TAM Scale benefits generate efficiencies across national platform Marginal cost to serve incremental lives is low 12

14 Investment Thesis Strong position in a large and growing market Differentiated solution and integrated platform Proven results Attractive economic model 13

15 D.C. Insider Panel 10:00-11:00 am Chris Dawe, Yvette Fontenot, Dan Todd 14

16 D.C. Insider Panelists Chris Dawe, Principal, Transformation at Evolent Health and former health policy advisor at the White House Dan Todd, Principal, Todd Strategy and former senior policy advisor at the Senate Finance Committee and Centers for Medicare and Medicaid Services Yvette Fontenot, Partner, Avenue Solutions and former Deputy Director of Health and Human Services Office of Health Reform 15

17 D.C. Insider Panel Q&A 16

18 Operations and Technology Panel 11:00 am-12:00 pm Tom Peterson, Chad Pomeroy, Frazer Buntin, Dr. Marcus Zachary 17

19 Evolent Operations and Technology Panelists Tom Peterson, Chief Operating Officer, Evolent Health Chad Pomeroy, Chief Technology Officer, Evolent Health Frazer Buntin, Regional Market President, Southeast, Evolent Health Dr. Marcus Zachary, Medical Executive, West Region, Evolent Health 18

20 Launching a New Business Rapidly with New Competencies Capture Value Required Competency Build Value Strategy, P&L, Operating Plan Contracts with Payers / Employers for Value Start or Optimize Provider-Owned Health Plan Evolent Platform Blueprint Payer Value Alliance Employer Value Advantage Health Plan Value Edge Build Cost-Effective Network Delivery Network Alignment Create Value Align Physicians, Transform System Aggregate Data, Run Predictive Models, Route to Workflow Execute Clinical and Administrative Interventions Manage Back Office, Administrative Process for Value Business System Transformation Identifi Technology Solution Population Health Performance Financial and Administrative Management 19

21 Proven High Value Care Evolent Health s approach to evaluating impact and bending the cost curve MEASURING PROGRAM EFFECTIVENESS DELIVERING RESULTS 30% Inpatient admission 48% ED visits 10% PCP visits Care Innovations TM Validation Institute, an independent expert in population health outcomes measurement, has validated these results proving the effectiveness of Evolent s Complex Care program. * Cases and controls were matched on demographics, chronic conditions, co-morbidities (CCI), socioeconomic indicators, and a propensity score that includes 12 months of prospective health care cost and utilization 20

22 Identifi Enables Care Teams, Physicians and Administrators to Interoperate on a Single Platform Purpose-built by providers: Developed by UPMC over 15 years ago resulting in thousands of clinical rules honed iteratively over time Platform-agnostic: Data from various sources across the provider and payer spectrum unified in one location for improved accuracy Unique user experience: Singular patient profile reduces burden on providers, and integrated business applications provide executives with convenient portal for strategy status updates Integrated to create an different care delivery experience for the patient 21

23 Operations and Technology Panel Q&A 22

24 Evolent Customer Panel 12:30-1:15 pm Frank Williams, Eric Wagner, Mark Carter 23

25 Customer Panelists Eric Wagner, Executive Vice President, Insurance and Diversified Operations at MedStar Health, Washington, D.C.-Metro Area Mark Carter, Chief Executive Officer, Passport Health Plan, Louisville, Ky. 24

26 Introducing MedStar Health MedStar Health is a non-profit, community-based health system serving the Baltimore and Washington D.C. region o ~$4.5B in revenue o 1,200 employed physicians o Leading the market with 19% share in primary MSA with 5.7M lives o Medicaid health plan with ~$120M in revenue Several competitors starting or growing health plans, including Inova Health and Hopkins Heavy government buyer market Source: Eric Wagner, MedStar Health, presentation at Becker s Healthcare Conference, Value- Based Care Perspectives from the Frontier, April

27 Setting a Strategy 1 Considerable investment in hospital programs: Focus particularly on services outside inpatient setting (e.g., urgent care, large multi-specialty practices, etc.) 2 Commitment to aggressive expansion in population health: Develop, design and launch employee health plan to reduce growth in spend and retain more in-system Develop, design and launch Medicare Advantage health plan Expand Medicaid health plan to leverage scale and expertise Source: Eric Wagner, MedStar Health, presentation at Becker s Healthcare Conference, Value- Based Care Perspectives from the Frontier, April

28 Building a Platform 4 MSSP Track 3 3 Owned Medicare Advantage Plan Launched ,000 attributed lives 2 Employees Launched 2013, $100M risk premium (current run rate) $340M equivalent premium 1 Owned Medicaid Plan Launched 2012 $200M risk premium (in 2015) Launched pre-2012 in MD, expanded in DC in 2013 $600M risk premium (current run rate) $1.2 B in premium and equivalent premium Source: Eric Wagner, MedStar Health, presentation at Becker s Healthcare Conference, Value- Based Care Perspectives from the Frontier, April

29 Introducing Passport Health Plan Passport Health Plan is a leading nonprofit community-based health plan o Administering Kentucky Medicaid benefits to 270,000+ beneficiaries o Annual premium of approximately $1.7B o Sole-source contract for KY Medicaid Managed Care from o Expanded to offer state-wide coverage in Sept o 64% market share in Louisville; 22% across KY Received 12 individual top 15 rankings; 7 top 10 rankings (NCQA) Source: Mark Carter, Passport Health Plan, Medicaid Center of Excellence Presentation, May

30 Setting a Strategy 1 Continued investment in core functions: Enable margin-based segmentation Focus medical management on key segments Ensure appropriate coding of diagnoses Migrate physicians towards risk-based model 2 Additional growth priorities: Integrate marketing efforts Launch D-SNP product offering Expand provider network Develop and offer a public exchange product Source: Mark Carter, Passport Health Plan, Medicaid Center of Excellence Presentation, May

31 Customer Panel Q&A 30

32 Sustained and Scalable Growth for the Future 1:15-2:00 pm Seth Blackley, Mike Minor, John Tam Q&A featuring Frank Williams, Nicky McGrane, Tom Peterson, Chad Pomeroy 31

33 Panelists Seth Blackley President Evolent Health Mike Minor Regional Market President Evolent Health John Tam Executive VP, Strategy Evolent Health Q&A also featuring Frank Williams Chief Executive Officer Evolent Health Nicky McGrane Chief Financial Officer Evolent Health Tom Peterson Chief Operating Officer Evolent Health Chad Pomeroy Chief Technology Officer Evolent Health 32

34 Multiple Sources of Growth Drive Strong Topline Results $ in Millions Transformation Platform and Operations Adjusted Revenue CAGR* 170% $100.9 $163.5 $8.3 $ Lives on Platform 28K 174K 433K 718K Lives on platform as % of total population in existing Evolent customer markets Lives on platform as % of total US population 0.3% 0.01% 0.9% 0.06% 1.9% 0.14% 2.2% 0.22% *Unadjusted revenues in 2015 were $96.9M Source: 33

35 Client Penetration Large Market With Significant Runway for Embedded Growth $45BN Market Opportunity Grow Existing Populations Utilize Additional Capabilities Add New Clients: Regional Expansion Add New Clients: Beachhead 15 Rev*: $163.5M Add New Populations Embedded Growth New Client Growth Existing Regional New Clients *Adjusted Revenue 34

36 Building a Platform 4 MSSP Track 3 3 Owned Medicare Advantage Plan Launched ,000 attributed lives 2 Employees Launched 2013, $100M risk premium (current run rate) $340M equivalent premium 1 Owned Medicaid Plan Launched 2012 $200M risk premium (in 2015) Launched pre-2012 in MD, expanded in DC in 2013 $600M risk premium (current run rate) $1.2 B in premium and equivalent premium Source: Eric Wagner, MedStar Health, presentation at Becker s Healthcare Conference, Value- Based Care Perspectives from the Frontier, April

37 Medicaid in America program totals recent trends 74M 11.2M People receive Medicaid benefits people enrolled in Medicaid/CHIP between Summer 2013 and Jan 2015 care impact of all Medicaid beneficiaries participate 70% in managed care total spend $440B in combined federal and state spending on Medicaid 1/3 rd of total spend goes to Medicaid managed care companies Only 8 companies serve more than 4 states >70 of 194 Medicaid plans are PSHPs (track record of success Source: "Medicaid Benefits Data Collection." Medicaid Benefits Data Collection. The Henry J. Kaiser Family Foundation, Web. 24 May

38 Medicaid: State Programs Continue Shift to Managed Care With CMS Make Clear Signals Towards Value Medicaid Beneficiary Breakdown 2014 Medicaid Managed Growth by State Managed Care 67% 73% 74% 76% Non-Managed Care 33% 27% 26% 24% <0% growth 0-5% growth 5-15% growth 15-25% growth 25-40% growth >40% growth Source: Avalere 2014; PwC

39 CMS Has Set Targets to Link Medicare Payments and Care to Value and Quality Goal 1: Goal 2: Payments tied to quality or value Payments tied to quality or value through alternative payment models 85% 90% 50% 30% HHS is working with the Health Care Payment Learning and Action Network to coordinate with partners in the private, public, and non-profit sectors Source: HHS Press Office. "Better, Smarter, Healthier: In Historic Announcement, HHS Sets Clear Goals and Timeline for Shifting Medicare Reimbursements from Volume to Value." HHS.gov. Department of Health and Human Services, 16 Jan Web. 24 May

40 Final Q&A 39

41 Thank You Questions? 40

42 Appendix 41

43 Non-GAAP Reconciliation Evolent Health, Inc. Adjusted Results For the quarters ended December 31, 2015 and 2014, and for the years ended December 31, 2015, 2014 and 2013 (in millions) Q Evolent Health, Inc. as Reported Add: Evolent Health LLC Operations Add: Purchase Accounting Transformation $ 10.4 $ - $ 0.4 Evolent Health, Inc. as Adjusted Platform and operations (1) 35.9 Total revenue $ 46.0 $ - $ 0.7 Q Transformation $ - $ 8.4 (2) (1) (1) $ $ $ - $ 8.4 Platform and operations (2) Total revenue $ - $ Transformation $ 19.9 $ 15.8 (2) $ - $ 26.7 Platform and operations (3) 3.3 (1) Total revenue $ 96.9 $ Transformation $ - $ 36.3 (3) (3) (4) $ $ (1) (1) $ $ $ - $ 36.3 Platform and operations (4) Total revenue $ - $ Transformation $ 22.1 $ 12.5 (4) (5) $ - $ $ - $ 34.6 Platform and operations (5) Total revenue $ 25.7 $ 14.6 (5) $ - $ 40.3 (1) Represents adjustments to remove the results of purchase accounting. (2) Represents the results of operations of Evolent Health LLC for the period October 1, 2014, through December 31, (3) Represents the results of operations of Evolent Health LLC for the period January 1, 2015, through June 3, (4) Represents the results of operations of Evolent Health LLC for the period January 1, 2014, through December 31, (5) Represents the results of operations of Evolent Health LLC for the period September 23, 2013, through December 31,