Insights and Trends in Allied Healthcare

Insights and Trends in Allied Health Care Staffing

Agenda Overview Where We’ve Been in Allied Key Trends and Issues Outlook Questions

Long Term Care 3.2 M

Physician Offices 2.4M

Home Health 1.1 M

Hospitals 4.7M

Ambulatory .5M

Dentist Offices 1.2M

Dentist Offices 1.2M

Dentist Offices 1.2M

14 Million people employed in the Healthcare Industry in the United States

Includes non-medical personnel

Hospitals employ 34% of the total

Healthcare Staffing projected to be a 9.5 billion dollar industry in 2013

Other Healthcare Offices .7M

Outpatient .6M

Healthcare Employment in the Industry

Source: Bureau of Labor Statistics, 2011 industry report

% indicates annual Growth rate vs. prior

year

Source: SIA U.S. Staffing Industry Forecast (September 2013)

Historical Growth of Healthcare Staffing

1%

-25%

-8%

11% 8%

4%

-30%

-25%

-20%

-15%

-10%

-5%

0%

5%

10%

15%

2008 2009 2010 2011 2012 2013P

US Healthcare Staffing Revenue Growth

2013 Low Growth For Healthcare Staffing

Source: Bureau of Labor Statistics, 2011 industry report

Health Care Professions

23%

21% 48%

8%

2002

Nursing Allied Per Diem Locums

13%

33% 31%

23%

2012

Source: Staffing Industry Analysts

Travel Nurse ($1.7B) 18%

Allied ($2.9B) 31%

Locum ($2.2B) 23% Per Diem

($2.7B) 28%

2012 US Healthcare Staffing by Segment

Source: SIA U.S Staffing Industry Forecast (September 2013)

Allied and Locum Tenens About Half of the US Healthcare Staffing Market

Allied Health Professions

Allied Health is used to identify a cluster of health professions, encompassing as many as 200 health careers: 5 million allied health care providers in the U.S. More than 80 different professions Approximately 33% of all health care providers work

in the allied space Allied health is involved (directly or indirectly) with

patient health

Other 24%

Pysical Therapists

27%

Occupational Therapists

17%

MT / MLT 9%

PTA 6%

Speech Language Pathologists 5%

OT Assistants / COTA 4%

Respiratory Therapists

4%

Pharmacists 3%

Phlebotomists <1%

$416M in Annualized Revenue (15% of the market)

Source: SIA 2013 Allied Health and Advanced Practice Benchmarking Survey

Allied Benchmark Survey Highlights Weakness

Therapy Current State

Impact of Legislation:

4 major changes listed below make up

the majority of the impact:

October 1, 2012 Claims that meet or exceed $3,700 will be subject to a manual

medical review.

January 1, 2013 New reporting requirements

March 1, 2013 Sequestration

April 1, 2013 Multiple Procedure Payment Reduction (MPPR)

10%

-3% -5%

0%

5%

10%

15%

2012 2013P

Gro

wth

in A

llied

Tem

p. S

taff

ing

Mar

ket

Source: SIA U.S Staffing Industry Forecast (September 2013)

Allied Health Growth Forecast Down in 2013

-3%

20%

12%

9%

9%

-7%

-9%

-19%

-30%

10%

Total Allied Health

Respiratory Therapists

Speech Therapists / Speech Pathologists

Medical Technologists / MLT

Pharmacists

Physical Therapists (PT)

Occupational Therapists (OT)

OT Assistants / COTA

PT Assistants

Other Allied Health

Allied Health Revenue Growth 1H13/1H12

Source: SIA 2013 Allied Health and Advanced Practice Benchmarking Survey

Allied Benchmark Survey Highlights Weakness

OT Assistants: ~ $50 million

PT Assistants: ~ $100 million

Occupational Therapists: ~ $300 million

Physical Therapists: ~ $500 million

Source: 2013 Allied Benchmarking Survey, Bureau of Labor Statistics, and Staffing Industry Analysts

U.S. staffing market for PT and OT about $1 billion

4%

8%

5%

8%

-3%

7% 8%

7% 8%

5%

-4%

-2%

0%

2%

4%

6%

8%

10%

Total Healthcare

Travel Nursing

Per Diem Nursing

Locum Tenens

Allied

Healthcare Staffing Growth Estimates and Forecast

2013 2014

Source: SIA U.S. Staffing Industry Forecast (September 2013)

2014 Forecast Shows Improvement

Source: National Health Expenditure Projections, Health Affairs, October 2013

US Health Spending to Rise Significantly

Dentist Offices 1.2M

According to the US Bureau of Labor and Statistics, Allied healthcare jobs are projected to grow at a significantly higher rate than all other job categories between 2010 - 2020.

Source: Employment Projections Program, U.S. Department of Labor, U.S. Bureau of Labor Statistics.

0

500

1,000

1,500

2,000

2,500

Allied*2010 2020 (P) 0

50,000

100,000

150,000

200,000

250,000

All Other Jobs2010 2020 (P)

+61% +14%

Allied Health Professions

Projected Outlook of Top Allied Occupations

Revenue Faster growth than the competition

Gross Margin

EBITDA

Impact of higher gross margins

Higher EBITDA margins

0% 5% 10% 15% 20% 25% 30% 35% 40%

Total, All Occupations

Health Diagnosing and Treating Practitioners

Clinical Laboratory Technologists & Technicians

Speech-Language Pathologists

Pharmacists

Respiratory Therapists

Physician Assistants

Occupational Therapists

Physical Therapists

14%

26%

13%

23%

25%

28%

30%

33%

39%

Source: Employment Projections Program, U.S. Department of Labor, U.S. Bureau of Labor Statistics.

Allied Q&A