Radnet RDNT
Radnet RDNT
Radnet RDNT
Safe Harbor
This presentation contains forward-looking statements within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. Specifically, statements concerning RadNet s ability to continue to grow the business by generating patient referrals and contracts with radiology practices, integrate acquired businesses, recruit and retain technologists, and receive third-party reimbursement for diagnostic imaging services, as well as RadNet's financial guidance, among others, are forward-looking statements within the meaning of the Safe Harbor. Forward-looking statements are based on management's current, preliminary expectations and are subject to risks and uncertainties which may cause RadNet's actual results to differ materially from the statements contained herein. These risks and uncertainties as well as those risks set forth in RadNet s reports filed with the SEC, including RadNet s annual reports on Form 10-K, for the year ended December 31, 2010 and RadNet s Quarterly Report on Form 10-Q for the quarter ended March 31, 2011. Undue reliance should not be placed on forward-looking statements, especially guidance on future financial performance, which speaks only as of the date it is made. RadNet undertakes no obligation to update publicly any forward-looking statements to reflect new information, events or circumstances after the date they were made, or to reflect the occurrence of unanticipated events.
Introduction Diagnostic Imaging Industry Overview Overview of RadNet Financial Information and Core Strategy
RadNet Summary
Largest national owner and operator of fixed-site diagnostic imaging centers, with 206 locations
Founded as a one center CA operation in 1980 Largest fixed-site medical imaging center company in the U.S. Have emerged as the fastest growing consolidator in the highly fragmented imaging industry Have recently diversified the business to partner with hospitals and Accountable Care Organizations (Breast Oncology, Radiology Software, In-patient Staffing, Teleradiology)
Concentrated regional networks in CA, MD/DE, NJ and NY (203 of our 206 sites)
Strategy is to be the clear leader in regional markets Provides operational efficiencies and marketing and contracting benefits
Only imaging center player to provide exclusive managed care capitation arrangements with prominent medical groups and Independent Physician Associations (IPAs)
Provides sticky and predictable revenue base and substantial pull-through business Over 750,000 lives managed exclusively in California
Best positioned company to capitalize on industry dislocation caused by the continuing Medicare reimbursement pressure and the lack of availability of credit funding to the industry RadNet s management owns over 25% of common stock
Modalities
Routine Imaging
Nuclear Medicine Producers images of anatomical structures. Applications: Assesses organ function in heart, kidney, thyroid and bones. X-ray Records images of organs and structures on film.
Mammography What: Visualizes breast tissue. Why: primary screening tool for breast cancer.
PET- Determines metabolic activity. Applications: tumors, epilepsy and cardiac evaluation.
Ultrasound Produces visual images of internal organs. Applications: viewing soft tissue.
Introduction Diagnostic Imaging Industry Overview Overview of RadNet Financial Information and Core Strategy
Industry remains highly fragmented; vast number of mom-and-pop operators Historically, advanced imaging procedures have had slow and steady growth
MRI and CT Growth: 1-3% sustainable PET / CT Growth: >3% sustainable
Expanding cost-effective applications for diagnostic imaging Wider physician and payor acceptance for imaging Greater consumer and physician awareness of and demand for earlier intervention and preventive diagnostic screening
Overcapacity exists in advanced imaging modalities, particularly MRI In-office exemption from Stark Laws still allow physicians to own equipment and self-refer Availability of capital is constrained Vendor/OEM financing is limited Local banks and third party financing companies have significantly raised credit standards Medicare Reimbursement remains pressured and future healthcare legislation is uncertain The 2010 CMS Final Rule was superseded by healthcare reform which caps the utilization variable of the Medicare Fee schedule at 75% beginning January 1, 2011 (was previously scheduled to rise to 90% by 2013) We expect continued pressure from Medicare (20% of our business)
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Scale is Becoming Vital for Success; Industry Consolidation and Rationalization has Begun
mom-and-pop operators are struggling Not well capitalized and have a higher cost structure Single-modality facilities that are more impacted by reimbursement changes and competition from multi-modality facilities Unable to do network contracting or capitate with payors Small operators have less access to capital Vendor and bank financing has decreased dramatically for all but a few providers Smaller operators are less willing to give personal guarantees Higher facility accreditation / quality standards Fear of survival and many more sellers than buyers are driving acquisition multiples downward Marginal operators are choosing to close and can now be acquired at 3 4x EBITDA Other operators want to be consolidated into RadNet, which offers long-term stability
Introduction Diagnostic Imaging Industry Overview Overview of RadNet Financial Information and Core Strategy
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206 diagnostic imaging facilities in concentrated markets of CA, MD, DE, NJ, NY and FL
Vast majority of facilities are multi-modality RadNet has scale and competitive relevance in all its markets Provides operational efficiencies and marketing and contracting benefits
NY 24
NJ
17
DE - 15 CA 101
MD - 46
FL 3
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Extensive offering of all routine imaging procedures partially insulates us from reimbursement cuts (like the DRA), which generally impact MRI, CT and PET/CT modalities disproportionately
2010 Scan Volume by Modality 2010 Scan Volume by Modality 2010 Net Revenue by Modality (1) 2010 Net Revenue by Modality (1)
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Net Revenue by modality based upon global payments received from consolidated Imaging Centers from that period s dates of service. Excludes payments from hospital contracts, Breastlink, eRAD software operations, Imaging on Call teleradiology operations, center Joint Venture management fees and other miscellaneous operations.
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1.
Net Revenue by modality based upon global payments received from consolidated Imaging Centers from that period s dates of service. Excludes payments from hospital contracts, Breastlink, eRAD software operations, Imaging on Call teleradiology operations, center Joint Venture management fees and other miscellaneous operations.
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Recently acquired eRAD, Inc., provider of PACS/RIS products, and hired an industry leading software development team Will replace RadNet IT systems with eRAD and internally developed solutions by end of 2011 Expect a $2million+ annual savings in 2012 and beyond Seek to grow the eRAD solutions by continuing to sell them to other industry participants
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On January 3, 2011, we acquired Imaging on Call, a Poughkeepsie, New York, provider of preliminary and final remote radiology interpretation Services hospital-based radiology groups, hospitals and imaging centers Daytime and nighttime reads Joint Commission Accredited benefits with credentialing within hospital settings
Including RadNet s contracted radiology groups, RadNet s affiliated physicians now number over 350, larger than any other similar group in the United States Physicians licensed to do business in 28 states
1. Diversification strategy augments RadNet s product and service offering to Hospitals and Accountable Care Organizations 2. New businesses are less capital intensive, requiring less ongoing investment than RadNet s core business
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Co-founded RadNet in 1981 Over 25 years of experience in the development and management of successful healthcare businesses University of Illinois Medical School Board Certified in Nuclear Medicine and Internal Medicine residency as well as in a masters program in medical physics in the University of California system
Norman Hames Chief Operating Officer of Western Operations Jeff Linden
Deep experience in investment banking and private equity Dillon Read investment banking and Saratoga Partners private equity Archon Capital Partners backed by Milken family and NewsCorp Business development at Eastman Kodak Co-founder of Broadstream Capital Partners
General Counsel
Over 20 years of experience in the industry Was President of Diagnostic Imaging Services (14 imaging centers), which he sold to RadNet Operated imaging center for American Medical International (AMI)
Steve Forthuber Chief Operating Officer of Eastern Operations Mike Murdock
An attorney for the SEC Chairman of the Business Organizations Section (1974-75) and President (1979) of the Century City Bar Association and is a member of the Corporation, Banking and Business Law and Health Law Sections of the American Bar Association Advised on the roll-up, public financing and sale to RadNet of Diagnostic Imaging Services, Inc.
Chief Development Officer
23 years of healthcare experience; 18 of those years in radiology practice management Was COO of Radiologix Held various roles at PerSe Technologies' Physician Services Division, including Regional Vice President and Area Executive for the Northeast
Spent most of his career in senior financial positions with healthcare companies including American Medical International, Physician Reliance Network and Dental One Was CFO of Radiologix Responsible for merger and acquisition activities at RadNet 18
Introduction Diagnostic Imaging Industry Overview Overview of RadNet Financial Information and Core Strategy
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($ in millions)
% Margin
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+12.0%
$155.6mm $139.0mm
Q2 2010
Q2 2011
Q2 2010
Q2 2 011
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91.7 mm
Company completed a comprehensive refinancing on Apr. 6, 2010 $100mm undrawn/fully-available revolving line of credit (L+375bps*) due Apr. 6, 2015 $285mm Senior Term Loan (L+375bps*) due Apr. 6, 2016 $200mm Senior Unsecured Notes due Apr. 1, 2018 (10 3/8%) 2010 Free Cash Flow (EBITDA less CAPEX and Cash Interest) was $26mm; Represents an attractive Free Cash Flow Yield to equity holders and provides for deleveraging Future earnings and cash flow shielded by Federal and State NOLs of approximately $200 million
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Source: Per closing stock price as of September 29, 2011. Source: RadNet 10Q ended 6/30/11
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