Astrana Health Inc. · NASDAQ:ASTH
Astrana Health — Apollo Medical Holdings — Investor Presentation (September 2023)
43 slides from Astrana Health's investor presentation, Sep 13, 2023
Slide 1: Apollo Medical Holdings September 2023
Apollo Medical Holdings September 2023 Powered by Technology. Built by Doctors. For Patients.
Slide 2: Forward-looking statements
This presentation contains forward - looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 , Section 27A of the Securities Act and Section 21E of the Exchange Act. Forward - looking statements include any statements about the Compa ny's business, financial con
Slide 3: ApolloMed At-A-Glance
3 ApolloMed is a technology - powered, value - based healthcare platform that enables the delivery of high - quality, coordinated, efficient, and accessible care for all through the following business segments: Care Enablement delivers an integrated clinical and administrative platform to enable pay
Slide 4: Accelerating high quality, accessible, value-based care across all patient populations
(1) Medicare Advantage, Managed Medicaid, Commercial, ACA Exchange, and Medicare FFS (2) ApolloMed 2019 to 2023E revenue and adj. EBITDA growth, using midpoint of 2023 guidance for both metrics. Please refer to th e “2023 Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use
Slide 5: We have laid a solid foundation for rapid growth
64% 20% 12% 4% Medicare Medicaid Commercial Other third parties Longstanding R elationships with N ational and L ocal P ay e rs + Many more payers 2019 2020 2021 2022 2023 Revenue 1 Average tenure: ~15 years 88% 5% 3.3% 3.7% Capitation Risk pool settlements & incentives Management fee income Fee-for
Slide 6: Payer agnostic platform captures outsized TAM
Payer agnostic platform captures outsized TAM and delivers better experience for patients, providers, and payers Source: CMS and HCP - LAN (2021) 6 Be tter for patients Enhanced patient experience and care continuity across payer, plan, and stage of life Better for providers Can be empowered across
Slide 7: VBC infrastructure and tech stack drives replicable and scalable results
VBC infrastructure and tech stack drives highly replicable and scalable results across all patients, allowing providers to grow and succeed across value - based arrangements • 1.3M patients managed in value - based contracts 1 • We serve Medicare Fee - for - Service (Original Medicare), Medicare Adv
Slide 8: Providers face complex administrative and care coordination hurdles
Providers currently face complex administrative and care coordination hurdles Reporting Contracting Claims Data Aggregation Billing Coding Hospitals Clinics Referrals Authorization Clearinghouse IT Credentials Quality Providers PR Labs Many More Payers Diagnostics ? 8
Slide 9: ApolloMed acts as a single payer and connects health ecosystem participants
ApolloMed acts as a “single payer,” connects health ecosystem participants, and integrates clinical, tech, and administrative support for providers 9 ApolloMed is paid to assume risk for the care of our patients 1 We reimburse providers in a subscription model and share savings, aligning incentives
Slide 10: ApolloMed segments enable our mission
Care Partners ACO Network Independent Physician Associations and Networks Restricted Knox Keene License 10 Specialists Ancillary Primary Care Providers Care Delivery Care Delivery provides high quality and accessible health care services through a patient - centric care delivery organization, includ
Slide 11: The care enablement model wraps around providers' operations
Care Partners ACO Network Independent Physician Associations and Networks Restricted Knox Keene License 11 Specialists Ancillary Primary Care Providers Care Delivery Patient Care Enablement Contracting & Credentialing Revenue Cycle Authorization Provider Relations UM 1 & Care Management Clinical Pro
Slide 12: A physician-centric approach providing flexibility and scale
We are changing healthcare through a physician - centric approach that provides flexibility and scale for our providers Industry Status Quo ApolloMed Patients supported throughout care journey by our ecosystem and care teams Entrepreneurial physicians can remain independent and partner with ApolloMe
Slide 13: Platform powered by proprietary technology suite
Our platform is powered by our proprietary technology suite, connecting patients, providers, and payers Provider Point of Care Application EHR 1 Data Patient Care Management ApolloMed Care Team CM/DM, PAC, SDoH , etc. 3 Communications Patient Management / RPM / Real - Time Clinical AI Care Mgmt / Wo
Slide 14: ApolloMed flywheel
ApolloMed creates a flywheel powered by deep experience, an extensive provider network, and proprietary technology Providers will succeed in value - based arrangements with ApolloMed Personalized & effective care will engage patients and lower the total cost of care Improved care pathways and predic
Slide 15: ApolloMed is growing in 30+ markets
ApolloMed is growing in 30+ markets in 8 counties across 3 states 15 Served by ApolloMed’s Care Partners (IPAs, ACO), Care Delivery, and Care Enablement Served by ApolloMed’s Care Partners (ACO) and Care Enablement New CA San Francisco San Mateo Nevada Clark Texas Tarrant Harris Core CA Los Angeles
Slide 16: Two clear levers combine to drive rapid growth
Two clear levers combine to drive rapid growth Data as of Q3 2022; (1) Note that in CA markets we have capability to more quickly accelerate new patients along risk ladder, an d start patients beyond PCP Cap Only; (2) Increasing risk in value - based contracts corresponds to larger opportunity size
Slide 17: Multi-faceted growth strategy across our markets
Multi - faceted growth strategy across our markets Where we are today Growth strategy Recent developments Core CA New CA Ex - CA x 5 counties across core CA geographies x Extensive and long - standing provider network x 80% member growth since acquisition x Provider count increased by 110% x 58% inc
Slide 18: Consistent clinical outcomes across diverse populations
Consistent clinical outcomes across diverse populations and demographics Medicare Advantage and ACO Clinical Outcomes Purpose - built technology platform enables best - in - class clinical outcomes to be delivered for all Americans Ethnicities Served 5 48% 21% 12% 6% 13% (1) Figures based on analysi
Slide 19: Key takeaways
10% - 17% adj. EBITDA margins over the last 4 years 2 Bed days 54% below benchmark; ER visits 61% below benchmark 3 1.3M members in VBC arrangements across Medicare, Medicaid, and Commercial 4 27% 4 - year EBITDA CAGR with 15% EBITDA margins at scale Key takeaways Strongly positioned to create a fut
Slide 20: Appendix
Appendix 6) apollomed
Slide 21: Financial Data
Financial Data 6) apollomed
Slide 22: Strong track record of revenue growth and EBITDA profile
561 687 774 1144 1300 - 1500 2019 2020 2021 2022 2023E We have a strong track record of revenue growth and a robust EBITDA profile ($ in millions) Revenue 26% CAGR ($ in millions) Adjusted EBITDA 1 27% CAGR Source: Internal data; (1) Adjusted EBITDA is calculated as earnings before interest, taxes,
Slide 23: ApolloMed is a scaled player with a proven and profitable model
ApolloMed is a scaled player with a proven and profitable model Business Model 1 Affiliate - provider model Affiliate - provider model Affiliate - provider model Affiliate - provider Model Affiliate - provider model Members Served 1.3M 2 1.1M 3 495.9k 4 272.5k 5 104.1k 6 Serves All Patient Types 1,
Slide 24: Scaling three business segments
ApolloMed is working to scale its three business segments: Care Enablement, Care Partners, and Care Delivery 24 For the three months ended June 30, 2023 (1) Balance includes general and administrative expenses and depreciation and amortization . (2) Income from operations for the intersegment elimin
Slide 25: 2023 Guidance
2023 Guidance ($ in millions, except for per share information) Actual YE 2022 Results 2023 Guidance Range Total Revenue $1,144.2 $1,300.0 - $1,500.0 Net Income 1 $50.5 $49.5 - $71.5 EBITDA 1,2 $110.1 $89.5 - $129.5 Adjusted EBITDA 2 $140.0 $120.0 - $160.0 EPS - Diluted $1.08 $0.95 - $1.20 (1) Net i
Slide 26: 2023 Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA
2023 Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA ($ in millions) Low High Net income $ 49.5 $ 71.5 Interest expense 1.0 1.0 Provision for income taxes 23.0 38.0 Depreciation and amortization 16.0 19.0 EBITDA 1 $ 89.5 $ 129.5 Loss (income) from equity method investments $ (0.8
Slide 27: Reconciliation of Net Income to EBITDA and Adjusted EBITDA (Q2 2023)
Reconciliation of Net Income to EBITDA and Adjusted EBITDA (Q2 2023) ($ in millions) 2023 2022 (restated) 2023 2022 (restated) Net income $ 17.5 $ 11.3 $ 30.0 $ 22.7 Interest expense 3.6 1.9 6.9 2.9 Interest income (3.3) (0.4) (6.3) (0.5) Provision for income taxes 14.0 5.4 20.9 12.2 Depreciation an
Slide 28: TTM and Year-end Reconciliation of Net Income to EBITDA and Adjusted EBITDA
TTM and Year - end Reconciliation of Net Income to EBITDA and Adjusted EBITDA ($ in millions) TTM ended June 30, 2023 2022 2021 2020 2019 Net income $ 53.0 $ 45.7 $ 46.1 $ 122.1 $ 15.8 Interest expense 11.9 7.9 5.4 9.5 4.7 Interest income (7.8) (2.0) (1.6) (2.8) (2.0) Provision for income taxes 49.6
Slide 29: Summary of Selected Financial Results – Breaking Out Excluded Assets
Summary of Selected Financial Results – Breaking Out Excluded Assets 29 Six Months Ended June 30, 2023 Six Months Ended June 30, 2022 $ in millions ApolloMed Consolidated Excluded Assets (1) ApolloMed Assets ApolloMed Consolidated Excluded Assets (1) ApolloMed Assets Revenue Capitation, net $ 600.8
Slide 30: Summary Balance Sheet – Breaking Out Excluded Assets
Summary Balance Sheet – Breaking Out Excluded Assets 30 (1) Includes APC Excluded Assets and certain other assets such as APC's minority interests in LMA and PMIOC where APC owns th e a sset but not the right to the dividends associated with those assets. $ in millions ApolloMed Consolidated Exclude
Slide 31: Summary Balance Sheet – Breaking Out Excluded Assets (continued)
Summary Balance Sheet – Breaking Out Excluded Assets (continued) 31 $ in millions ApolloMed Consolidated Excluded Assets (1) ApolloMed Assets ApolloMed Consolidated Excluded Assets (1) ApolloMed Assets Current liabilities Fiduciary payable, accounts payable and accrued liabilities $ 58.5 0.7 57.8 $
Slide 32: Summary Statement of Cash Flows – Breaking Out Excluded Assets
Summary Statement of Cash Flows – Breaking Out Excluded Assets 32 $ in millions ApolloMed Consolidated Excluded Assets (1) ApolloMed Assets ApolloMed Consolidated Excluded Assets (1) ApolloMed Assets Cash flows from operating activities Net income $ 30.0 0.9 29.1 $ 22.7 (10.1) 32.8 Adjustments to re
Slide 33: Summary Statement of Cash Flows (continued)
Summary Statement of Cash Flows – Breaking Out Excluded Assets (continued) 33 $ in millions ApolloMed Consolidated Excluded Assets (1) ApolloMed Assets ApolloMed Consolidated Excluded Assets (1) ApolloMed Assets Cash flows from investing activities Payments for business and asset acquisition, net of
Slide 34: Path to Global Risk
Path to Global Risk 6) apollomed
Slide 35: Succeeding across outpatient and inpatient risk contracts captures more upside (1/2)
We believe our ability to succeed at managing care across our outpatient and inpatient risk contracts allows us to capture significantly more upside than our peers (1/2) Facility / Hospital Outpatient Total Premium Dollar ApolloMed EBITDA from VBC We have an integrated inpatient - outpatient system
Slide 36: Succeeding across outpatient and inpatient risk contracts captures more upside (2/2)
Facility / Hospital Outpatient Total Premium Dollar Health plan We reduce administrative costs using our MSO’s proprietary automation tools — this allows us to profitably scale, enhancing operating leverage 3 1 1 1 VBE Rev COGS OpEx VBE EBITDA 3 3 Mgmt. Income from Non - Consolidated IPAs (1) Operat
Slide 37: Clear path moving contracts along the risk spectrum
We see a clear path to success as we continue to move our existing contracts along the risk spectrum and expect to do so in new markets as well FFS Professional Full Risk Global 37
Slide 38: Revenue generated by capitation from professional risk contracts
A significant part of our revenue today is generated by capitation from our professional risk contracts FFS Professional Full Risk Global 1 (1) Operating expenses excluding interest, tax, depreciation, and amortization 38
Slide 39: Additional revenue from full risk contracts shared with facility partners
We also receive additional revenue and upside from full risk contracts that we share with our facility partners FFS Professional Full Risk Global Facility / Hospital Outpatient ApolloMed EBITDA from VBC Health plan 1 1 1 Total Premium Dollar VBE Rev COGS OpEx VBE EBITDA Mgmt. Income from Non - Conso
Slide 40: With an RKK, managing the whole risk capitation dollar
With an RKK, we believe we will be able to manage the whole professional and facility risk capitation dollar and achieve more downstream synergies and upside FFS Professional Full Risk Global Total Premium Prof. + Facility Cap Medical Expense Overhead EBITDA from VBC VBE Rev COGS OpEx VBE EBITDA Pla
Slide 41: Key acronyms
Key acronyms ◦ ACO: Accountable Care Organization ◦ ACO REACH: Accountable Care Organization Realizing Equity, Access, and Community Health ◦ AIPBP: All - Inclusive Population - Based Payments ◦ APC: Allied Physicians of California IPA ◦ CMMI: Center s for Medicare and Medicaid Innovation Center ◦ C
Slide 42: Use of Non-GAAP Financial Measures
Use of Non - GAAP Financial Measures This presentation contains the non - GAAP financial measures EBITDA and Adjusted EBITDA, of which the most directly comparable fin ancial measure presented in accordance with U.S. generally accepted accounting principles (“GAAP”) is net income. These measures are
Slide 43: Investor relations contact
43 For inquiries, please contact: ApolloMed Investor Relations (626) 943 - 6491 investors@apollomed.net Carolyne Sohn, The Equity Group (408) 538 - 4577 csohn@equityny.com
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