Corporate presentation May 2017 FLRY3
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1 Corporate presentation May 2017 FLRY3
2 Agenda Overview and Strategy Financial Performance Healthcare Sector in Brazil Expansion Plan Ownership Structure and Governance 2
3 Agenda Overview and Strategy Financial Performance Healthcare Sector in Brazil Expansion Plan Ownership Structure and Governance 3
4 We have a history as an innovative player in several fronts in the healthcare sector 1982 Pioneer in the implementation of automated client service system Implementation of barcode system for safer identification of exams. V a lo r (s e g u n d o s ) 2004 Results of exams with historical data. 40,00 32,00 24,00 16,00 Tempo de Protrombina 2007 Knowledge management Integrated Medical Centers For the 4 th consecutive time, the technical area received accreditation from College of American Pathologist, highlighting our technical quality and reliability. 8,00 0,00 16/11/ /10/2009 5/10/ /9/2009 7/9/ /8/2009 Data Resultado Referência Máxima Referência Mínima 1983 First exams at the Diagnostic Center. Fleury is the first to offer integrated medicine solutions First company in the world to publish exam results on the Internet Diversified check-up Itaim PSC Launch of a+ Medicina Incubator of innovations Diagnóstica, the first national in client experience. brand in the sector. Use or art and culture in service innovation Agreement with Quest diagnostics for mass spectrometry s tests. Partnership with IBM Watson Health for Genomics. 4
5 Our knowledge management allows us to create pioneer products and services, with recognized medical quality 1.8 thousand qualified physicians (Mar/2017) 25 scientific bulletins¹ 54 papers published¹ 155 medical update meetings¹ 221 articles published in the 26 th Knowledge Symposium in São Paulo/Brazil in 2016¹ # of New Products² # Medical Consultancy Services (in thousands)³ Gross revenue from new products and services correspond to 1% of Grupo Fleury s gross revenue in the LTM LTM LTM ¹Source: Grupo Fleury 2016 ²Source: Grupo Fleury s cumulative data since ³Registered electronically 5
6 Our identity pillars make us unique Competency Map Information Complete portfolio of exams: Customer Service Excellence Customer service excellence Presence in major economic centers Clinical Analyses Reliability Imaging Medicine and Health Expertise High quality exams: - State of the art methodologies and technologies. - Renewed international certifications. - Highly specialized technical staff to perform exams. - Physicians trust over the diagnostics. Extensive performance in the healthcare value chain Innovation, research and development We are the best choice for our clients in each business, segment and geography. Diagnostic Information Integration Integrated information analysis: Medical Knowledge Management We provide several diagnostic solution products: Integrated Report, Evolutionary Medical Report, Artificial Intelligence (decision trees), etc. Comprehensive and Conclusive Diagnostics 6
7 How patient service centers (PSCs) and B2B models work Patient Service center model B2B model in hospitals Grupo Fleury Clinical analysis, imaging services Insurers, HMOs (SulAmérica, Patients Amil, etc) (clients) $ monthly payment Hospitals Clinical analysis, imaging services (Delivered by Fleury) $ payment for servicesgrupo rendered Fleury Insurers, HMOs (SulAmérica, Patients Amil, etc) (clients) $ monthly payment Healthcare coverage Healthcare coverage $ payment for services rendered $ payment for services rendered Source: Company and Credit Suisse Research 7
8 Brand recognition, with focus on the premium and upperintermediate segments high growth and margin segments Federal District Paraná Rio Grande do Sul Pernambuco Bahia Rio de Janeiro São Paulo Fleury: The best and most trusted brand in the Brazilian Market. Leader in the premium segment. Clínica Felippe Mattoso: Premium brand in Rio de Janeiro. Strong in imaging services. Weinmann: Top of Mind brand in Rio Grande do Sul. a+: National brand, launched in Strong potential for capturing intermediary segment. Diagnoson a+ and Labs a+: Cobranding strategy in Bahia and Rio de Janeiro to provide image and clinical analyses services at the same place ("one-stop-shop"). São Paulo (44 PSCs) Rio de Janeiro (41 PSCs) South (36 PSCs) Northeast (23 PSCs) Federal District (01 PSC) Premium Intermediate (26) (18) (07) (34) (22) (14) (01) (22) (01) Basic 8
9 Grupo Fleury is focused on providing premium and intermediary level services Grupo Fleury s Market share Visits (%)¹: São Paulo Metropolitan Region: Other Metropolitan Regions: 9% Premium 10% 40.6% share in premium segment Rio de Janeiro 15.8% 30% 27% 24% Upper Intermediate Intermediate SP 8.8% share in upper intermediate segment Rio Grande do Sul 18.5% Paraná 5.9% 36% Fleury brand focus Basic a+sp brand focus Bahia 10.5% Pernambuco 9.1% ¹Source: Grupo Fleury s estimates, based on ANS. Market Share considers single customers from payers in one year over total addressable number of lives in metropolitan region 9
10 B2B Footprint Operations in hospital portfolio 22 hospitals in 5 Brazilian states Strategy Operations in hospital: to be a national benchmark for strategic partnerships through differentiation and highquality services. Lab to lab: to be a national market leader in the segment of high-complexity medical diagnosis. Levers 01 Paraná 03 Distrito Federal 03 Rio Grande do Sul 13 São Paulo 02 Rio de Janeiro Lab-to-lab: geographical coverage with strong presence in the Southeast region of Brazil. Profitability: increase automation, process efficiency and mix improvement. Differentiation in customer service. Growth: same store sales and new contracts. Increase in more complex exams with higher average price. Growth in the premium segment. Increased profitability due to operational efficiency gains. Differentiation in customer service. Increase in more complex exams with higher average price. 10
11 The Company s markets gathers 68% of the beneficiaries of private medicine Current cities Adjacencies 35% beneficiaries 33% beneficiaries 26 cities Average of 1.4MM inhabitant/city 19% of country population 40% of country population for income classes A and B 2.2 thousand cities Average of 33 thousand inhabitant/city 36% of country population 31% of country population for income classes A and B New markets 32% beneficiaries 3.3 thousand cities Average of 28 thousand inhabitant/city 46% of country population 29% of country population for income classes A and B 11
12 Agenda Overview and Strategy Financial Performance Healthcare Sector in Brazil Expansion Plan Ownership Structure and Governance 12
13 Our history makes us one of the greatest and most respected healthcare companies in Brazil Since 1926 providing complete diagnostic medicine portfolio: ~3.5 thousand types of exams in 37 different areas: Clinical Analyses (Routine, pathology and high complexity exams): 58 MM exams and R$ 1.4 bn of gross revenue. Imaging and others: 4 MM exams and R$ 977 MM of gross revenue. 8.8thousandemployees and 1.8 thousand physicians. Present in the country s main economic centers with diversified business lines. GrossRevenueofR$2.4bn. Operatingcash-flowgenerationofR$530MM. EBTIDA of R$ 535 MM and 24.6% margin. ROIC 1 of36.0% and Grupo Fleury s Net Promoter Score (NPS)² reached 72.7% in 1T17. Service Center (84% of revenues) Operationsin Hospitals (14% of revenues) Reference laboratory (1% of revenues) Business lines 145 Patient Service Centers (PSCs) with more than 101 thousand m² in 1Q17 Clinical Analysis in 22 hospital institutions in 1Q17 Medium and high complexity exams to other laboratories and hospitals 1 ROIC adjusted without goodwill. ² NPS including brands RJ. Figures in LTM otherwise as indicated. 13
14 Company s Revenue Breakdown has changed since 2010 Revenue Breakdown (R$ MM) 2, % % 19.7% 59.9% Labs D Or Acquisition 1, % 1, % 17.2% 15.7% 14.8% 16.5% 52.8% 43.5% CAGR +16.2% 1, % 16.7% 16.5% 44.5% 1, % 15.7% 16.8% 50.0% 2, % 16.1% 16.3% 50.4% 16.2% 16.3% 17.2% 50.4% % 16.5% 16.8% 51.2% +15.0% % 15.8% 17.6% 50.2% Q16 1Q17 Regional brands RJ² B2B Regional brands excl. RJ¹ Fleury brand ¹ It includes the Regional Brands PSCs in the South Regions, São Paulo, Federal District and the Northeast Region. ² It includes the PSCs in Rio de Janeiro under the brands Labs a+ and Felippe Mattoso. 14
15 Financial Highlights 1Q17 Main indicators: Gross revenue R$ 642 million Net revenue R$ 588 million EBITDA R$ 173 million Net income 15.0% 15.7% 42.3% Highlights: Gross revenue increased 15.0% in the 1Q17. Double-digit growth in all regional brands: RJ brands (+21.5%), regional brands excl. RJ (+20.3%) and Fleury brand (+12.8%). Same Store Sales of the PSCs 1 increased 15.1%: highlight to RJ brands (+21.6%) and regional brands excl. RJ (+19.0%). Cancellation index reached 2.3% (-63bps). As a consequence, the net revenue increased by 15.7%. EBITDAmarginof29.5% an improvement of 551 bps. 82.6% expansion in net income. Operating cash flow of R$ 85.9 MM, with operating cash flow conversion to EBITDA of 49.6%. R$ 82 million 82.6% Evolution in return and customer service indicators: ROIC without goodwill reached 36.0% vs. 23.8% in the 1Q16. Grupo Fleury s NPS 2 reached 72.7% - a 657 bps expansion. Operating Cash Flow R$ % million Fleury Grouplaunchedfive new units in the 1Q17, two fast sites under Fleury brand in São Paulo and three a+ Paraná. 1 PSCs: Patient Service Center 2 NPS: Net Promoter Score 15
16 1Q17 Results PSCs Same Store Sales YoY(%) Net Revenue (R$ MM) +15.7% 13.8% 9.0% 10.1% 11.0% 15.1% Q16 2Q16 3Q16 4Q16 1Q17 1Q16 2Q16 3Q16 4Q16 1Q17 Costs ex. D&A (R$ MM) and Costs ex. D&A / Net Revenue (%) SG&A ex. D&A (R$ MM) and SG&A ex. D&A / Net Revenue (%) 64.6% 65.8% +10.3% 64.2% 69.3% 61.6% 11.4% 10.9% -10.0% 10.0% 11.4% 8.9% Q16 2Q16 3Q16 4Q16 1Q17 1Q16 2Q16 3Q16 4Q16 1Q17 ¹ EBITDA ajusted in 2015 and 2014 excluding non recurring. 16
17 Financial Indicators have shown sustainable growth Quarterly EBITDA (R$ MM) and margin (%) Quarterly Operating Cash Flow (R$ MM) / EBITDA LTM (%) 24.0% % % % % % % % % 86 50% 1Q16 2Q16 3Q16 4Q16 1Q17 1Q16 2Q16 3Q16 4Q16 1Q17 Annual EBITDA¹ (R$ MM) and margin (%) Annual Operating Cash Flow (R$ MM) / EBITDA LTM (%) 17.7% % % % % % % % CAGR +33.5% % 75% % % ¹ EBITDA ajusted in 2015 and 2014 excluding non recurring. 17
18 Return and Customer s Satisfaction Indicators have shown sustainable growth ROIC ¹ Net Promoter Score NPS ² 32.9% 36.0% 64.6% 66.1% 69.3% 73.0% 72.3% 72.7% 26.0% 23.4% 20.8% 14.1% 16.0% LTM 1Q17 4Q15 1Q16 2Q16 3Q16 4Q16 1Q17 ¹ ROIC adjusted without goodwill. ² NPS measures the level of recommendation to family and friends after the use of our services. The methodology was updated in
19 2016 Cash Flow Statement Net Income % (+) Net Income Adjustments % Net Financial Result % Depreciation and Amortization % Income and social contribution taxes % Share of profits (losses) of investees % (=) EBITDA % (+) Provisions % (+) Income Tax paid % (+) Others operating results % (+) Working capital: % Trade accounts receivables % Others assets and liabilities % (=) Operating Cash Flow % (+) Capital expenditures % (+) Accrued interest on financial investments % (+) Others investing activities % (=) Free Cash Flow to Firm (FCFF) % (+) Interest paid on debentures and loans % (+) Change in debt % (+) Capital increase (stock options) % (=) Free Cash Flow to Equity (FCFE) % (+) Dividends and interest on own capital % (=) Cash Flow % Convertion (Operating Cash Flow / EBITDA) 106% 103% bps 19
20 Agenda Overview and Strategy Financial Performance Healthcare Sector in Brazil Expansion Plan Ownership Structure and Governance 20
21 Health Sector Main Drivers Population Aging 2016 vs Life Expectancy (age) % 10% 13% 16% 17% 17% 15% 32% 14% 13% 12% 11% 10% 9% Population aging and higher life expectancy support long term growth for diagnostic medicine Variation of Beneficiaries vs. Formal Jobs (R$ Million) Health Care Insurance Penetration Health plans beneficiaries Brazil s net additions of formal jobs There is still room to grow number of beneficiaries. The employer is obliged to keep the retiree or former employee dismissed without cause in the healthcare plan as long as the benefit is offered to the active employees. Source: ANS, IBGE, CAGED and OECD 21 95% France 67% Canada 60% USA 55% Autralia 61% South Korea 33% Germany 25% Brazil 18% Chile 12% Greece 7% Mexico
22 The private medicine market is fragmented and still concentrated in the country s main economic centers Number of Beneficiaries Private Medicine in 2016¹ (Major Regions) Public Listed Labs Market Share in Revenues 2015² % (R$ 6.8 bi) Fleury + Other Listed Labs % (R$ 19.2 bi) SP RJ MG PR RS BA SC PE Others The Southeast region accounts for more than 62% of Brazil s private medicine. ~47.9 millions beneficiaries Brazil has approximately labs that provide diagnostic medicine that generate approximately R$ 26.0 billion in revenues. ¹Source: ANS data, December 2016 ²Source: ANS data and companies 22
23 Agenda Overview and Strategy Financial Performance Healthcare Sector in Brazil Expansion Plan Ownership Structure and Governance 23
24 Grupo Fleury Expansion Plan 5 Year Expansion Plan for Regional Brands ( ) Brand PSC Size and Complexity # PSCs Fleury a+ SP Rio de Janeiro (Labs a+ and Felippe Mattoso) South (Weinmann and a+) Total all brands Large 2 Medium 2 to 3 Small and fast sites 14 to 17 Total - range of PSCs openings 18 to 22 Large and medium 6 to 8 Small and fast sites 15 to 20 Total - range of PSCs openings 21 to 28 Large and medium 8 to 9 Small and fast sites 13 to 16 Total - range of PSCs openings 21 to 25 Medium and small 13 to 15 Total - range of PSCs openings 13 to
25 Agenda Overview and Strategy Financial Performance Healthcare Sector in Brazil Expansion Plan Ownership Structure and Governance 25
26 New Shareholder Structure Shareholder Structure² BradSeg¹ Physicians members¹ Integritas (Physicians members¹) Advent International¹ (Core) Other shareholders 16.3% 12.4% 11.9% 14.5% 44.9% Grupo Fleury Total Shares: 157,395,769 Board of Directors Composition 10 members: 03 appointed by Physicians members 02 appointed by Advent 02 appointed by Bradseg 03 Independent 1 Shares belonging to the Shareholder s Agreement ² Updated on May 31 st Four Board Advisory committees: Audit and Risk Management Finance Projects Compensation, Nomination and Company Performance. 26
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