32 slides from Mlp Saglik Hizmetleri As Class B's investor presentation, Mar 7, 2018
Slide 1: MLP Care Analyst Meeting Liv Hospital Ulus, March 7th 2018
MLP Care Analyst Meeting Liv Hospital Ulus, March 7th 2018
Slide 2: MLP Overview
MLP Overview Dr. Muharrem Usta – Chairman and CEO 2
Slide 3: Summary
Summary Results above our expectations Growth across all segments Double digit growth in Net Sales and EBITDA Declining leverage ratio and expected reduction in FX loss and interest expenses* Proforma for TL600m capital increase at the IPO 3
Slide 4: MLP: The #1 Private Hospital Group in Turkey
MLP: The #1 Private Hospital Group in Turkey 17 Cities 29 Hospitals; 5.300+ Beds; More than the #2 2x the size of 2nd Largest 17.000+ Staff and #3 Competitors Combined Competitor 2.000+ Doctors Addresses All Price Segments 3 JCI Accredited Hospitals Revenues:2.6 billion TL in the Turkish Market 3 Ce
Slide 5: Strong Growth and Successful Financial Performance
Strong Growth and Successful Financial Performance Net Sales (TLm) EBITDA¹ (TLm) EBITDAR¹ (TLm) %19 %25 %26 CAGR 2014-2017 CAGR 2014-2017 CAGR 2014-2017 • Acquisition of 6 hospitals • 2 brand new • Opening of a University (2 of which are in Istanbul) • Opening of a hospitals in Hospital in Istanbul
Slide 6: Strong Financial Performance in 2017
Strong Financial Performance in 2017 Net Sales (TLm) EBITDAR¹ (TLm) EBITDA¹ (TLm) Growth %19 %29 %31 Margin Healthy balance sheet post IPO Net profit proforma for TL600m capital increase; TL47m (vs. reported net loss of TL 133m) Proforma Net debt / EBITDA: 1.9x (vs. reported ratio of 3.4x) ¹ EBITD
Slide 7: Share of Private Hospitals is Increasing in Total Healthcare Market
Share of Private Hospitals is Increasing in Total Healthcare Market Healthcare Expenditure by Provider Total Number of Beds (’000) • Total Healthcare 210 189 Expenditure: TL 76 billion 25% (2015) 164.4 165.9 79% 87% 43% 12% • Capacity expansion in the 13% 21% private sector 2009 2015 Private Public
Slide 8: A System where all the Participants are Satisfied
A System where all the Participants are Satisfied General Health Services Regime Providing Key players and the Healthcare System Patients with Options Regulation Funding Service Providers GHS* Healthcare reforms started in 2004 •Treasury •MOH •Ministry of •SSI Patients %981 of the Population is co
Slide 9: Growth Continues in All Payor Types
Growth Continues in All Payor Types Revenue Breakdown by Payor Type Balanced Revenue Portfolio 40% SSI Insurance provides access to the majority of Turkey’s 66% population 6% Revenue from PMI grew by 6x in the last five years Revenue from Top-up Insurance grew by more than 2x in 2017 31% Med
Slide 10: Clear Leader in Private Hospital Services
Clear Leader in Private Hospital Services JCI accreditation SRC1 Gold Standard in Global Health Global standard in surgical excellence • JCI standardized services; competitive advantage Services Market through surgical centers of excellence • 40% of the bed capacity is in the attractive market of Is
Slide 11: Clear Leader in Private Hospital Provision
Clear Leader in Private Hospital Provision Turkish Healthcare Sector1 Growing Levels of Affluance in Turkey2 Top end of the Private 2016-2023 Hospital market CAGR Income Bracket PPP will likely Distribution (%) 9% 15% 9% attract patients from Private Hospital public hospitals and market High (>$50k)
Slide 12: Clinical Excellence and World Class Service Offering
Clinical Excellence and World Class Service Offering CAGR Top academic physicians choose MLP Care for: Growth continues with Academicians 2015–2017 Strong and reliable brand 2.133 12% 1.708 1.833 Leading market share -1% State-of-the-art infrastructure 1.530 University affiliations 1.525 1.555
Slide 13: Unique Business Model Addressing Multiple Price Points
Unique Business Model Addressing Multiple Price Points General Overview of the Concept and Positioning Relative Average Price per Payor Type 29 Total Hospitals in Portfolio 3 Premium 13 22 Number of hospitals including a particular concept Note: Three hospitals (Ereğli, Avcılar and Çanakkale) are op
Slide 14: Exceptional Operational and Financial Performance in 2017
Exceptional Operational and Financial Performance in 2017 Net Sales EBITDAR* EBITDA* 2.6 billionTL 597 million TL 409 million TL 19% growth 29% growth 31% growth Capacity Avg. Length of Number of Beds 5,330 Utilization Stay +708 %69 1.7 days +110 basis points -0.2 days *EBITDA and EBITDAR figures ha
Slide 15: Two New Hospitals Commenced Operations in 2017
Two New Hospitals Commenced Operations in 2017 MLP Florya University Hospital Samsun Liv Location İstanbul Samsun Opening Date March 2017 June 2017 Key Statistics 250 beds 75 beds 50,714 m2 6,800 m2 68 doctors 45 doctors 6 operating rooms 2 operating rooms 445 staff 190 s
Slide 16: Financial Performance
Financial Performance Burcu Öztürk – CFO 16
Slide 17: Strong Growth in All Segment Revenues
Strong Growth in All Segment Revenues Domestic Patient Medical Tourism Ancillary Revenues Revenues Business TL 2.203 m TL 188 m TL 185 m 15% growth 66% growth 40% growth Strong Growth In Line Attactive for Foreign Patients Growth Continues in Ancillary With Our Strategy Share of patients from Euro
Slide 18: Exceptional Operational and Financial Performance
Exceptional Operational and Financial Performance General Overview Mature Hospitals Developing Hospitals Breakdown of Beds - 2017 Revenue2 (millionTL) / Growth (%) Revenue2 (millionTL) / Growth (%) 14% 8% 17% 176% 78% 22% 18 Mature Hospitals 9 Developing Hospitals 2 Managed Hospital Revenue Breakdow
Slide 19: Balanced Price and Volume Growth
Balanced Price and Volume Growth Mature Portfolio (TLm) Developing Portfolio (TLm) ∆19% 690 224 587 Outpatient 109 46 5 147 31 2016 Hospital Volume Price 2017 Hospital 2016 Hospital Volume Price 2017 Hospital Revenue Revenue Revenue Revenue ∆1% 283 Inpatient 1.122 1.003 5 36 114 179 69 2016 Hospital
Slide 20: Smart Cost Management
Smart Cost Management Hospital Cost Comparison as % of Sales Contribution 16.6% 17.5% Margin 11,7% 11,1% Material: Slight increase due to change in the revenue mix 7,6% 7,9% Doctor: Flat as doctor cost is ca. 95% 18,5% variable 19,7% Personnel: Decline on the back of operational leverage 24,5%
Slide 21: Strong Cash Flow
Strong Cash Flow Maintenance Capex 1 (TLm) Capex of New Hospitals (TLm) Free Cash Flow (TLm) 63% 73% %2.6 %2.6 % of Sales Remained flat as a percentage of Continued new hospital Strong free cash flow generation revenues at 2.6% investments maintained x% FCF / EBITDA 21
Slide 22: Deleveraging After Capital Injection Post IPO
Deleveraging After Capital Injection Post IPO Net Debt Currency Breakdown Proforma Net Debt / 2017 Proforma EBITDA declines from 3.4x to 1.9x 1,381 mTL 793 mTL (m TL) 2016 2017 Net profit/(loss) (49) (133) FX gains/(losses) (85) (168) Capital Increase IPO related costs - (12) of TL600m Net profit
Slide 23: Closing
Closing Dr. Muharrem Usta – Chairman and CEO 23
Slide 24: Outstanding Platform for Further Growth
Outstanding Platform for Further Growth Pendik (2018) Mersin (2018) Location İstanbul Mersin Plan Opened in Q1-18 To be opened in 2018 62,000 sqm 35,604 sqm Building construction complete Building construction complete License already available License already available 24
Slide 25: Outstanding Platform for Further Growth
Outstanding Platform for Further Growth Proven track record of greenfield expansions and M&A Total Hospitals 25 26 27 29 31 33 35 At Year End MLP has added on average c.400 beds p.a.1 Acquired 6 Opened one 2 New Hospitals Two potential Bed Greenfield through greenfield projects since 2014 hospital
Slide 26: Thank You
M LPCAR F MEDICALPARK — Vit/tospitaL | VA\ MEDICALPARK Thank You
Slide 27: Historical P&L Statements
Historical P&L Statements 2016 2017 TLm FY FY Revenue 2,160 2,576 Cost of service (-) (1,854) (2,171) Gross Profit 306 405 General administration expenses (-) (127) (215) Other income 198 380 Other expenses from operations (-) (169) (358) Operating Income 210 213 Finance expenses (-) (2741 (383) Net
Slide 28: Historical Balance Sheet
Historical Balance Sheet 2016 2017 TLm Dec 31 Dec 31 Cash and cash equivalents 111 218 Trade receivables 724 750 Inventory 45 51 Short term other assets 136 142 Short term assets 1,016 1,161 Fixed assets 1,173 1,220 Deferred tax assets 146 197 Long term other assets 101 143 Long term assets 1,420 1,
Slide 29: Reconciliation from Reported EBITDA to Adjusted EBITDA
Reconciliation from Reported EBITDA to Adjusted EBITDA TLm 2016A 2017A Net Profit / (Loss) Before Taxes (49) (133) Depreciation and Amortization of Tangible and Intangible Fixed Assets 153 175 Total Interest Expenses, Net of Interest Income and Gain on Financial Derivatives 263 374 Net (Gains) / Los
Slide 30: Cost Comparison as a % of Sales
Cost Comparison as a % of Sales Mature Hospitals Developing Hospitals 81% 80% 94% 94% 20% 21% 30% 30% 13% 13% 6% 7% 23% 21% 19% 18% 24% 24% 29% 28% 21% 21% 15% 17% 2016 2017 2016 2017 Material Doctor Personnel Rent Other Material Doctor Personnel Rent Other 30
Slide 31: Reconciliation from Contribution to Adjusted EBITDA
Reconciliation from Contribution to Adjusted EBITDA TLm 2016A 2017A Hospital Contribution Mature 319 392 Developing 18 27 A Total Hospital Contribution 337 418 Other Ancillary Business Contribution¹ Other Ancillary Business Revenues 133 185 Other Ancillary Business Costs (114) (149) B Total Other An
Slide 32: Outstanding Platform For Further Growth
Outstanding Platform For Further Growth Quick and successful ramp up in greenfields as well as acquisitions with typical range of 12-18 months to EBITDA-neutral hospitals Example of Greenfield Example of Acquisition Batıkent (Oct-2014) Yıldızlı (Sep-2014) Total Investment TL50m Total Investment Cost