Investor Presentation - Jefferies · Investor Presentation June 2014. ... AMD, glaucoma, ALZ are...

Investor PresentationJune 2014

Forward Looking Statement

2

The matters discussed in this presentation may include forward-looking statements, which

could involve a number of risks and uncertainties. When used in this presentation, the

words “will,” “believes,” “intends,” “anticipates,” “expects” and similar expressions are

intended to identify forward-looking statements. Actual results could differ materially from

those expressed in, or implied by, such forward looking statements. Except as expressly

required by the federal securities laws, the Company undertakes no obligation to update

such factors or to publicly announce the results of any of the forward-looking statements.

See the Company’s most recent earnings press release for explanation of non-GAAP

financial measures used in this presentation as well as reconciliation from GAAP to

non-GAAP metrics. Some of the products and/or product features discussed in this

presentation may be works in progress and not yet generally available for sale.

Why Merge Matters

3

images are

growingyou need to do

more with less

regulationsare pervasive

consolidationis happening

{ ARCHIVE • ACCESS • DIAGNOSE }

{ EDUCATE • EXECUTE • ADAPT }

{ AUTOMATE • ADOPT • INTEGRATE }

{ CONNECT • CENTRALIZE • EVOLVE }

Expanded radiology offering

2009Confirma

Acquisition

Our History of Innovation

4

Expanded interoperability, radiology and cardiology offerings

2010AMICAS

Acquisition 2011OIS

Acquisition

2008Merrick

Invests InMerge

2010Stryker

Acquisition

Entered specialty orthopedics marketplace

2011LaunchedRad MUSolution

975 doctorsutilize Merge MU solutions

2012Launched

Cloud ArchiveSolution

2013LaunchediConnectNetwork

Surescripts and athenahealthsign on as partners

2010LaunchediConnect

100+ Clients

Entered eye care market

2012Launched

eClinical OS

2 million+ active patients since launch

For population health and advanced interoperability

2014Will Launch

Retinal Screening

Our Solutions Portfolio

5

Imaging & Interoperability

Cardiology Clinical Trials

RadiologyInteroperabilityCloud Archive

Eye Care Orthopedics

CardiologyHemodynamics

EDCCTMS

Merge Cardiology Solutions are #1 in KLAS!

6

Industry Leader!

Merge Named Top 10 Overall in KLAS

7

KLAS Overall Software Vendor Rankings 2013

Merge KLAS Special Report

8

Merge KLAS Report – Overall Performance

1. Customers Buying In• Enterprise imaging strategy• Image enabling the EMR• Focus and transparency

2. Footprint Expanding• Clients plan to expand imaging suite• Clients plan to stay at rate above

market average• Clients looking into adding

interoperability and cardiology

3. Cerner Integration Ready to Pay Off

9

We Are the Leader in Interoperability

1010

iConnectEnterprise Clinical Platform

iConnectEnterprise Archive

2013 Frost & Sullivan Product Leadership Award, Medical Imaging Interoperability Solutions Market

2013 IHS VNA Global Market Leader

2013 IHS VNA Market Leader, Americas

10

We’ve Made Enterprise Imaging Real

11

Chicago, IL

{ iConnect Access & Enterprise Archive, Merge PACS,Merge Cardio & Hemo }

Findlay, OH

{ iConnect Access & Enterprise Archive, Merge PACS,Merge Cardio & Hemo }

San Diego, CA

{ iConnect Access, Enterprise Archive & Outpatient Radiology}

{ iConnect Access and/or Enterprise Archive, Radiology PACS, Merge Cardiology Solutions }

MI, WI, MO, TX, TN, AL, FL Ministries

Every Image, Every EHR, Every Time

12

Why iConnect Network?White Space Opportunity

13

What Are the Key Drivers?

14

Referral GrowthIncrease referring

physician loyalty and

expand business

Cost Savings Save time and money by

eliminating excess HL7

interfaces

Meaningful UseHelp community

physicians meet the imaging

requirement & attest

The Imaging Marketplace

15

Each year in the USA,

800M+ studies are done; 372M are outpatient

Meaningful Use now makes

interoperabilitymandatory

EHR adoption among referring

physicians is nearing 60%

12%of every visit

800Million studies

60%EHR Adoption

MU2Mandates

12% of every PCP visit in the

USA results in an imaging order

(44 Million)

How iConnect Network Works

16

Merge Can Help with Referral Leakage!

• Average employed physician group refers more than 20% of potential revenue out-of-network

• While most organizations are (rightly focused) on building stronger physician relationships to curb leakage, they fail to realize that breakdowns in referral coordination drive 40% of leakage

17

$20M Average annual revenue leaked,

300-bed hospital with 100 employed

physicians

Sources: The Advisory Board and referralMD

EDUCATEin-network providers about their referral patterns

QUANTIFY & TRACK patient retention with web-based solutions

IDENTIFYthe right markets & providers to build clinical networks

HOW TO IMPROVE REFERRAL LEAKAGE

Turn Referral Leakage into Referral “Keepage”

18

Source: Data from Mission Point Health Systems

Clients Work With Many Referring Physicians

19

Imaging Center / Hospital System

Allscripts

Cerner

Epic

eClinicalWorks

athena

NexGen

And They Work with Many Different EHRsHow will providers connect all disparate EHRs to imaging data & studies?

Referring Physicians

Who Sends Referrals?

20

clinicians & facilities

Sources: The Advisory Board and referralMD

iConnect® Network

• Share imaging information between referring physicians and imaging centers on EHR networks

• Provide radiology reports as structured data directly into the physicians’ EHR

• Currently partnered with SurescriptsClinical Network Services (CNS) and athenahealth

• Will continue to add more partners to expand our reach

21

Current Customers Include:

With Universal Viewer via Web Browser

22

Imaging Report

Hospital Feedback

23

“We’ve worked with Merge for several years, so it was an easy choice to implement Merge’s VNA and iConnect Network for a

comprehensive, enterprise-wide imaging strategy…Despite having an HIE in place, we needed a single solution that handles imaging as it becomes more important to healthcare as a whole. With iConnect Network, we’ll meet MU2 requirements

for the exchange of images and, most importantly, enable better access to imaging for physicians in order to

provide the best care for our patients.”

Dave Holland, CIO, Southern Illinois Healthcare

Five Elements of Service

24

EHR Integration: Result / Report

Delivery

E-Ordering/ Referrals

Pre-Certification: Patient Pay / Clinical

Decision Support

Consumer Engagement /

Scheduling

Data Mining & Analytics

25

26

iConnect Retinal ScreeningAdvanced Interoperability Solution

for Population Health

What Problems Will We Solve?

27

diabetes, AMD, glaucoma, ALZ are

Increasing globally

institutions need

More Revenue with Volume

countries & socialized medicine need

Less Cost with More ServiceNo Complete Solutions

just band-aids

{ 382M DIABETICS WORLD WIDE – GROWS ~6% ANNUALLY }

{ DETECT DISEASE – TREAT EARLY – REDUCES COSTS }

{ DETECT DISEASE & INCREASE BILLABLE PROCEDURES }

{ NEED HARDWARE, SOFTWARE, CLOUD, ANALYTICS, ENGAGEMENT }

How Will iConnect® Retinal Screening Work?

• Primary providers will capture images and upload to iConnect Cloud Archive

• Client owned reading center will interpret images in Merge Eye Care PACS™

• Image reports will route to iConnect Network

• iConnect Network will deliver image reports to disparate providers’ EHRs

28

Disparate Sites

The CompleteiConnect

Retinal ScreeningSolution

Every ACO and payer is focused on diabetic care management and this complements their strategy

What’s Next for iConnect Retinal Screening?

• Currently undergoing a pilot program launch with Ontario Telemedicine Network

• First phase will offer diabetic retinopathy screening once available in late Q2

• Future stages of solution will include screenings for:

• Glaucoma• Age-related macular degeneration • Other serious neurological diseases

29

Financial Information

30

Financial Improvements in Past Year

31

• Excludes $14M of sales in 2013 from discontinued, low-margin products

• Reorganized operations in late 2013 for annual savings of $6M

• Generated NET INCOME in Q1 2014 for first time in 3 years

• Debt refinanced in April 2013 (at half the interest rate) & again in April 2014 (to significantly reduce covenants, including none for 1 year)

• Total of $25M paid in first year of new debt (compared to no debt principal payments in 2012 and 2011)

Continued Innovations for Subscription

Offerings

• iConnect Network, iConnectCloud Archive (formerly Merge Honeycomb) and Merge eClinical OS

• Subscription backlog growth of 40% in 2013, 23% YoY as of Q1 2014

Aligned Costs

for Modest Topline

Growth in 2014

Improved Cash Flow by Significantly

Reducing Cash

Interest

• NOTE: See Q4 2013 and Q1 2014 earnings releases for guidance details

Moving Beyond “Are You Financially Stable?”

32

$12.5

$8.5

$7.2

$9.0

$10.2$9.2

$10.6

$15.3$14.2

$13.5

19.5%

14.8%

12.5%

16.7%

Adjusted EBITDA %

20.0%

-15%

-10%

-5%

0%

5%

10%

15%

20%

25%

30%

$0

$5

$10

$15

$20

$25

$30

Q1 2013 Q2 2013 Q3 2013 Q4 2013 Q1 2014

Adjusted EBITDA Cash from business ops Adjusted EBITDA %

28.0 27.9 27.5 26.1 25.5

9.4 9.7 9.5 8.5 8.2

26.6 20.0 20.7

19.3 17.4

$64.0

$57.6 $57.7

$53.9$51.1

58.5%

59.1%

56.6%

60.2%

61.9%

40.0%

45.0%

50.0%

55.0%

60.0%

65.0%

$0

$10

$20

$30

$40

$50

$60

$70

$80

$90

$100

Q1 2013 Q2 2013 Q3 2013 Q4 2013 Q1 2014

Maintenance Subscription

Non Recurring Gross Margin %

Gross Margin % (net of D&A)

Thank You

33