32
36th Annual J.P. Morgan Healthcare Conference Jim Skogsbergh President and Chief Executive Officer Dominic J. Nakis Chief Financial Officer and Treasurer San Francisco, California January 9, 2018

36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

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Page 1: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

36th Annual J.P. Morgan Healthcare Conference

Jim Skogsbergh

President and Chief Executive Officer

Dominic J. NakisChief Financial Officer and Treasurer

San Francisco, CaliforniaJanuary 9, 2018

Page 2: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

The following material and presentation contains information which is forward-looking within the meaning of federal securities law. These forward-looking statements are based on

the current plans and expectations of Advocate Health Care Network (“Advocate”) that, although believed to be reasonable, are subject to a number of known and unknown

uncertainties and risks inherent in the operation of health care facilities, many of which are beyond Advocate’s control, tha t could significantly affect current plans and expectations

and Advocate’s future financial position and results of operations. These forward-looking statements speak only as of the date made. Investors are cautioned not to unduly rely on

such forward-looking statements. This presentation should be reviewed in conjunction with Advocate’s December 31, 2016 and September 30, 2017 continuing disclosure reports.

Page 3: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Overview & Strategic Focus

Jim SkogsberghPresident and Chief Executive Officer

Page 4: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Advocate Health Care

Chicagoland/Central IL

1,350 Employed4,970 Physician Partners

6,300 Medical Staff

11 Acute Care4 Teaching / 1 Children’s5 Level 1 Trauma Centers

Home Health / HospicePalliative Care / LTACH

SNF Partnerships

Physicians Hospitals Post-Acute

37,000 Associates

Associates

$6.0 B. Total Revenue$660+ M. Community Benefits

Financials Location

Page 5: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Mission Driven

MISSION - To serve the health needs of individuals, families and communitiesthrough a wholistic philosophy rooted in our fundamental understanding of humanbeings as created in the image of God.

VALUES - Compassion, equality, excellence, partnership and stewardship guide ouractions as we work together to provide health services to others in our communities.

PHILOSOPHY - Is grounded in the principles of human ecology, faith and community-based health care. These principles arise from an understanding of human beings as awhole person in light of their relationship to God, themselves, their families and thesociety in which they live.

Page 6: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

More than $783 M community

National Recognition

Page 7: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Increase patient retention,

scale and new revenue

Create consumer-friendly

experience enabled by digital

technology to build loyalty

Standardize and innovate to

reduce cost

Maintain unrelenting focus on

safety and health outcomes

REVENUE GROWTH

CONSUMERS

COSTS

SAFETY & QUALITY

Advocate 2025: Trends & Implications

Page 8: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

SAFETY

QUALITY

AFFORDABILITY

ADVOCATECARE®

OUTSTANDING CARE

EXPERIENCE

CONSUMER-FRIENDLY

TRANSACTIONS

RETENTION

SCALE

NEW REVENUE

Strong Physician and Associate Engagement

Page 9: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

• Current decline 54%

• 2018 decline target 75%

• Culture of safety

Serious Safety Event

VolumeHRU’s and Physician

Champions increase event

reporting

Safety initiatives

to decrease harm

$118

$89

$32

$108$100

$89

$139

$156$165

$91

$46

0

50

100

150

200

250

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Insurance Expense

ZERO Serious Safety Events by 2020

Page 10: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Saved taxpayers $60.6 million

Achieved shared savings 2nd consecutive year

Ranked 2nd nationallyin savings out of 432 ACOs

Achieved 97.28% of total quality points

Through the Medicare Shared Savings Program in 2016:

Page 11: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Improved Public Exchange Performance

• 68,000 lives

• Collaborative Product with BCBSIL

• Break even performance in 2017 projected

• Significant 2018 premium increase

Page 12: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Retail Clinics Drive Patient Acquisition

• 56 clinics opened May 2016

• Nearly 400,000 visits to-date

• 62 percent new to Advocate

• $25 million additional 2017 downstream revenue

Page 13: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal
Page 14: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Advocate Aurora Health• Full asset merger

• Single board of directors – equal representation

• Co-CEOs

• Dual headquarters

• Combined executive team

• Continue existing brands

• Consolidated financial statements

Page 15: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Advocate Aurora Strategic Value Drivers

• Adjacent markets in contiguous states

• Complementary expertise

• Alignment of strategic plans and strong cultures

• Embrace population health

• Enhanced scale and operational synergies

• Investment yield upside

Page 16: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Advocate Well Positioned

• National leader in safety and health outcomes

• Top decile workforce engagement

• Strong physician partnerships

• #1 in brand recognition

• Financial strength

• Advocate Aurora Health

Page 17: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Financial Profile

Dominic J. NakisChief Financial Officer and Treasurer

Page 18: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Over 1 Million Value Contracted Lives2014 2015 2016 2017 YTD*

Global Capitation

Commercial HMO 203,000 206,000 253,000 257,000

Medicare Advantage 34,000 37,000 47,000 47,000

Partial Capitation

Commercial HMO 28,000 31,000 36,000 38,000

Shared Savings

Commercial PPO/EPO 185,000 207,000 303,000 444,000

Medicare Shared Savings 134,000 146,000 136,000 144,000

Medicaid FHP 72,000 97,000 95,000 86,000

Total Lives 656,000 724,000 870,000 1,016,000

*November 2017

Page 19: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Revenue Growing

$390 $414 $412 $488

$1,303

$4,548$4,816 $4,981

$5,100

$4,854

$0

$500

$1,000

$1,500

$2,000

$2,500

$3,000

$3,500

$4,000

$4,500

$5,000

$5,500

$6,000

$6,500

$7,000

2013 2014 2015 2016 2017 Projected

Re

ven

ue

s in

mill

ion

s

Risk Based Revenues Net Patient Service & Other Revenues including Shared Savings

Page 20: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

$300 $339 $331 $264 $172 $153

6.1%6.3% 6.1%

4.7%

4.1%3.3%

0%

5%

10%

$-

$100

$200

$300

$400

2013 2014 2015 2016 2016 Q3YTD

2017 Q3YTD

Do

llar

s in

Mill

ion

s

Operating Income Operating Margin

Operating Results Trend in Line with Peers

//

Page 21: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Operating Cash Flow is Solid

25

$567 $636 $633 $587 $420 $417

11.5% 12.0% 11.7% 10.5%10.1%

9.0%

0%

5%

10%

15%

$-

$100

$200

$300

$400

$500

$600

$700

2013 2014 2015 2016 2016 Q3YTD

2017 Q3YTD

Do

llars

in M

illio

ns

Operating Cash Flow Operating Cash Flow Margin

//

Page 22: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Investment Assets and Yields Contribute to Financial Strength

$343 $188

$(184)

$374

$326 $487

7.1%

3.2%

-2.6%

7.8%7.1%

8.8%

-20%

-10%

0%

10%

20%

$(200)

$(50)

$100

$250

$400

$550

2013 2014 2015 2016 2016 Q3 YTD 2017 Q3 YTD

Dolla

rs in

Mill

ions

Investment Income Investment Yield

27

29%

12%

28%

31%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Actual September 30

HedgeFunds

FixedIncome

PrivateEquity

PublicEquity

//

Page 23: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

$386 $508 $504 $402 $304 $270

182%

212%

196%

149% 149%

123%

0%

50%

100%

150%

200%

250%

$0

$150

$300

$450

$600

$750

$900

2013 2014 2015 2016 2016 Q3 YTD 2017 Q3 YTD

Do

lla

rs in

Mil

lio

ns

Cash Spending Capital Spend Ratio

35

//

Capital Spend Moderating

Page 24: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

$0.0

$20.0

$40.0

$60.0

$80.0

$100.0

$120.0

2017 2019 2021 2023 2025 2027 2029 2031 2033 2035 2037 2039 2041 2043 2045 2047 2049 2051

Deb

t Ser

vice

(in

$mill

ions

)

Total debt of $1.6 billion, annual debt service is level and average life is 18 years

Debt Profile – low, level & long

Page 25: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Debt Profile – Well DiversifiedUnderlying Debt Mix Net Interest Rate Mix

Renewal Risk Credit Provider Mix

$930, 60%

$321, 21%

$142, 9%

$100, 6%

$70, 4%

Fixed Rate

Weekly VRDOs

Tender Bonds

Direct Purchase

Windows VRDBs

$930, 60%

$326, 21%

$142, 9%

$165, 10%

Fixed Rate

Synthetic FixedRateIntermediate

$930, 60%

$212, 14%

$185, 12%

$100, 6%

$87, 5%

$49, 3%

Fixed Rate

Self Liquidity

JP Morgan

US Bank

Northern

Wells$49.2

$127.9 $144.2

$22.0

$50.0

$42.8

$77.5

$100.0

$69.7

$0

$50

$100

$150

$200

$250

2018 2019 2020 2021 2024

TermLoan

DP

TenderBonds

DirectPlacement

SBPA

Page 26: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Advocate Aurora Health Merger• Neither Advocate nor Aurora has agreed to assume any

liability for or otherwise guarantee the other party’s debt as part of the transaction

• Evaluation of optimal credit structure, and any potential refinancing of all or part of existing debt, will be determined based upon market conditions, management considerations and other factors

42

Page 27: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Strong Coverage & Capitalization

9.5 9.4 7.6 8.5 8.7 9.1

24.0% 23.2% 23.9% 21.8% 22.3% 20.2%

0%

5%

10%

15%

20%

25%

30%

35%

40%

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

9.0

10.0

2013 2014 2015 2016 2016 Q3YTD

2017 Q3YTD

Tim

es

Debt Service Coverage Ratio (times) Debt as % of Unrestricted Capitalization

31

//

Page 28: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Robust Cash to Debt Ratio

283 296 280 297 298 321

250

260

270

280

290

300

310

320

330

2013 2014 2015 2016 2016 Q3 2017 Q3

Per

cen

t

//

Page 29: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

$840 $899 $915 $979 $1,060 $838 $937 $945 $999 $1,037

100% 96% 97%

98%102%

50%

60%

70%

80%

90%

100%

110%

$500

$550

$600

$650

$700

$750

$800

$850

$900

$950

$1,000

2013 2014 2015 2016 2017 Q3 YTD

Do

lla

rs in

Mil

lio

ns

Assets PBO Percent Funded

33

//

Pension Plans Fully Funded

Page 30: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Substantial Liquidity Position

$4,518 $4,725 $4,712 $4,962 $4,966 $5,329

386383

368 370 371

353

330

340

350

360

370

380

390

$4,000

$4,200

$4,400

$4,600

$4,800

$5,000

$5,200

$5,400

2013 2014 2015 2016 2016 Q3 YTD 2017 Q3 YTD

Da

ys

on

Ha

nd

Do

llars

in M

illio

ns

Dollars Days Cash and Investments on Hand34

//

Page 31: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

Advocate Well Positioned• National leader in safety and health outcomes

• Strong brand

• Physician partnerships

• Top decile workforce engagement

• Balance sheet strength and solid operating performance

• AA+ (S&P), Aa2 (M) AA (F) bond ratings, stable outlooks

• Advocate Aurora Health42

Page 32: 36th Annual J.P. Morgan Healthcare ... - Advocate Health Care · The following material and presentation contains information which is forward-looking within the meaning of federal

• Close with Advocate logo slide