NASHVILLE, Tenn. ─ (May 3, 2016) ─ AmSurg Corp. (NASDAQ: AMSG) today announced financial results for the first quarter ended March 31, 2016. The Company’s results for the quarter included:
- Net revenues of $724.7 million, up 27% from $570.4 million for the first quarter of 2015;
- Net earnings attributable to AmSurg common shareholders of $28.6 million;
- Adjusted net earnings of $46.6 million, an increase of 47% compared with the first quarter of 2015;
- Net earnings per diluted share attributable to AmSurg common shareholders of $0.53
- Adjusted net earnings per diluted share of $0.82, up 32%, on a 12% increase in diluted shares outstanding, if converted, primarily due to the Company’s December 2015 common stock offering; and
- Adjusted EBITDA of $120.1 million, up 28% compared with the first quarter of 2015.
See page 6 for a reconciliation of all GAAP and non-GAAP financial results.
“AmSurg had a great start to 2016 with a substantial increase in first-quarter revenues and adjusted EPS, driven primarily by nearly $1 billion of acquisitions completed in 2015,” said Christopher A. Holden, President and Chief Executive Officer of AmSurg. “In addition, we produced strong organic growth for the first quarter, with same-center revenues for our Ambulatory Services division increasing 8.8% and same-contract revenue for our Physician Services division growing 12.0%. Each division continued to benefit from increased volume and improved reimbursement during the first quarter. The quarter had one additional business day compared with the same prior-year quarter, which contributed 1.7% to the growth in both divisions.
“Physician Services expanded the Company’s strong presence in the Phoenix, Arizona, market during the first quarter with our second acquisition of a neonatology practice in that market. Subsequent to the quarter end, Ambulatory Services completed the purchase of one surgery center and Physician Services purchased a physician practice in Jacksonville, Florida, that established our presence in the greater northeast Florida market. Our pipeline of potential acquisitions is robust, and we are evaluating opportunities for Ambulatory Services and across all our Physician Services specialties.”
First-quarter net revenues for Ambulatory Services grew 8% to $307.1 million from $283.9 million for the first quarter of 2015. Same-center revenue increased 8.8% for first quarter of 2016 compared with the first quarter of 2015, comprised of a 5.0% increase in procedures per day, a 1.7% increase due to an additional operating day in the first quarter of 2016 and a 2.1% increase in net revenue per procedure. Our revenue growth over the same quarter last year was reduced by the impact of nine centers that were deconsolidated in 2015 and that represented 5.5% of revenue for the first quarter of 2015. Adjusted EBITDA increased 13% to $53.6 million for the first quarter of 2016 from $47.3 million for the first quarter of 2015, and adjusted EBITDA margin increased 80 basis points to 17.5% from 16.7%.
At the end of the first quarter, Ambulatory Services operated 256 ASCs and one surgical hospital, having merged two ASCs during the quarter. Ambulatory Services had six ASCs under letter of intent at the end of the quarter and one center under development, which is expected to open in late 2016.
For the first quarter of 2016, net revenues for Physician Services increased 46% to $417.5 million from $286.5 million for the first quarter of 2015. Adjusted EBITDA rose 43% to $66.5 million for the quarter compared with $46.4 million for the first quarter of 2015, and adjusted EBITDA margin was 15.9% compared with 16.2%.
The comparable-quarter increase in Physician Services revenues was comprised of growth of 10.1% in same-contract revenues, 1.2% in net new contract revenues and 34.4% in acquisition revenues. Same-contract growth in net revenues totaled 12.0% for the first quarter of 2016, which included a 7.3% increase in patient encounters per day, a 1.7% increase due to an additional operating day in the first quarter of 2016 and a 3.0% increase in net revenue per patient encounter.
At March 31, 2016, AmSurg had cash and cash equivalents of $85.9 million and availability under its $500 million revolving credit facility of $345 million. Net cash flows from operations, less distributions to noncontrolling interests, were $25.0 million for the first quarter. The Company’s ratio of total debt at the end of the first quarter to trailing 12 months EBITDA as calculated under the Company’s credit agreement was 4.1.
AmSurg today adjusted its financial and operating guidance for 2016 and for the second quarter of the year. The Company’s guidance is as follows:
- Revenues in a range of $3.09 billion to $3.13 billion;
- A same-center revenue increase of 4% to 6% for Ambulatory Services and same-contract revenue growth of 4% to 6% in Physician Services;
- Adjusted EBITDA of $592 million to $601 million;
- Adjusted EPS in a range of $4.28 to $4.35; and
- For the second quarter of 2016, adjusted EPS in a range of $1.06 to $1.09.
Non-GAAP Adjusted EBITDA guidance for the full year of 2016 excludes interest expense, income taxes, depreciation, amortization, share-based compensation, transaction costs, changes in contingent purchase price consideration, gain or loss on deconsolidations and discontinued operations. Non-GAAP Adjusted EPS guidance for the second quarter and full year of 2016 exclude acquisition-related transaction costs, acquisition-related amortization expense, gains and losses on future deconsolidation transactions and share-based compensation expense, net of the tax impact thereon. The exact amount of such exclusions are not currently determinable but may be significant and may vary significantly from period to period (see page 6 for a reconciliation of all GAAP and non-GAAP financial results).
AmSurg Corp. will hold a conference call to discuss this release today, May 3, 2016, at 5:00 p.m. Eastern time. Investors will have the opportunity to listen to the conference call over the Internet by going to www.amsurg.com and clicking “Investors” at least 15 minutes early to register, download, and install any necessary audio software. For those who cannot listen to the live broadcast, a replay will be available at these sites shortly after the call and continue for 30 days.
This press release contains forward-looking statements, including the Company’s financial and operating guidance for the first quarter and full year of 2016. These statements, which have been included in reliance on the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995, involve risks and uncertainties. Investors are hereby cautioned that these statements may be affected by important factors, including, but not limited to, the following risks: we may face challenges managing our Physician Services Division as a new business and may not realize anticipated benefits; we may become subject to investigations by federal and state entities and unpredictable impacts of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010; there may be governmental or commercial health changes designed to reduce the number of surgical procedures; we may fail to comply with applicable laws and regulations including the federal Anti-Kickback statue and similar state laws; we may not be able to successfully maintain effective internal controls over financial reporting; we may not be able to implement our business strategy, manage the growth in our business, and integrate acquired businesses; the attention of management may be diverted by the process of making new acquisitions; our substantial indebtedness and restrictions in our debt instruments could adversely affect our business or our ability to implement our growth strategy, or limit our ability to react to changes in the economy or our industry; we may not generate sufficient cash to service our indebtedness, including any future indebtedness; restricted covenants in our indenture documents may restrict our business strategies or could result in an acceleration of our debt; regulatory changes may obligate us to buy out interests of physicians who are minority owners of our surgery centers; we may not be able to successfully maintain our information systems and processes, implement new systems and processes, and maintain the security of those systems and processes; we may fail to effectively and timely transition to the ICD-10 coding system; we may fail to effectively manage and implement security measures protecting our information technology systems to protect confidential data; our disaster recovery systems or management continuity plans may be disrupted; we may face shortages or quality control issues of products, equipment, and medical supplies that could adversely affect our operations and profitability; enforcement authorities may conclude that our market share in any particular market is too concentrated or our clients’ commercial payor contract negotiating practices are illegal; we may be subject to litigation and investigations and liability claims for damages and other expenses not covered by insurance; we may be required to write-off a portion of our intangible assets; payments from third-party payors, including government healthcare programs, may decrease or not increase as our costs increase; there may be adverse developments affecting the medical practices of our physician partners; we may not be able to maintain favorable relations with our physician partners; our physician partners may fail to perform on their pro rata share of any indebtedness or lease agreements; we may not be able to grow our ambulatory services revenue by increasing procedure volume while maintaining operating margins and profitability at our existing surgery centers; we may not be able to compete for physician partners, managed care contracts, patients and strategic relationships; adverse weather and other factors beyond our control may affect our business; our legal responsibility to minority owners of our surgery centers may conflict with our interests and prevent us from acting solely in our best interests; we may be adversely impacted by changes in patient volume and patient mix; several client relationships generate a significant portion of our physician services revenues; our physician services contracts may be cancelled or not renewed or we may not be able to enter into additional contracts under terms acceptable to us; reimbursement rates, revenue and profit margin under our fee-for-service physician services payor contracts may decrease; we may not be able to timely or accurately bill for services; laws and regulations that regulate payments for medical services made by government healthcare programs could cause our revenues to decrease; we may not be able to enroll our physician services providers in the Medicare and Medicaid programs on a timely basis; our strategic partnerships with healthcare providers may not be successful; our segments of the market for medical services have a high level of competition; we may not be able to successfully recruit and retain physicians, nurses and other clinical providers; we may not be able to accurately assess the costs we will incur under new contracts; our margins may be negatively impacted by cross-selling to existing clients or selling bundled services to new clients; we may not be able to enforce non-compete agreements with our physicians and other clinical employees in some jurisdictions; there may be unfavorable changes in regulatory, economic and other conditions in the states where we operate; legislative or regulatory action may make our captive insurance company arrangement less feasible or otherwise reduce our profitability; our reserves with respect to our losses covered under our insurance programs may not be sufficient; and the other risk factors are described in AmSurg’s Annual Report on Form 10-K for the fiscal year ended December 31, 2015, as updated by other filings with the Securities and Exchange Commission. Consequently, actual results, performance or developments may differ materially from the forward-looking statements included above. AmSurg disclaims any intent or obligation to update these forward-looking statements.
AmSurg’s Ambulatory Services Division acquires, develops and operates ambulatory surgery centers in partnership with physicians throughout the U.S. AmSurg’s Physician Services Division, Sheridan, provides outsourced physician services in multiple specialties to hospitals, ASCs and other healthcare facilities throughout the U.S., primarily in the areas of anesthesiology, children’s services, emergency medicine and radiology. Through these businesses as of March 31, 2016, AmSurg owned and operated 256 ASCs and one surgical hospital in 34 states and the District of Columbia and provided physician services to more than 450 healthcare facilities in 29 states. AmSurg has partnerships with, or employs, over 5,000 physicians and other healthcare professionals in 38 states and the District of Columbia.