quality. compassion. care. - capio group - welcome · 2016-05-11 · • modern medicine giving...
TRANSCRIPT
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Quality drives productivity and growthPresident and CEO – Thomas Berglund
May 11, 2016
Quality. Compassion. Care.
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Respected as a long-term innovative partner to a public healthcare sector in change
Giving Capio
• Long-term corner stone investors
• Increased transparency
• Financing for expansion
With a clear strategy
Back on Nasdaq Stockholm on June 30,
2015 after 8+ years being privately owned
Capio AB (publ) – AGM 2016
• Modern Medicine giving Rapid Recovery to patients
• Modern Management empowering people making change happen
• Market Leadership by content and –step by step – by size
3
8%
54%38%
A pan-European footprint (2015)
Net sales: SEK 13.5 billions• About 12,400 employees (FTE) and
about 4.6 million patient visits in
Sweden, Norway, France and Germany
• Offers a broad range of medical,
surgical and psychiatric care of high
quality in our hospitals, specialist
clinics and primary care units
• Founded in 1994 in Gothenburg. De-
listed in 2006 and listed on Nasdaq
Stockholm in 2015. In the past nine
years Capio has:
– Developed a medical strategy
– Driven by an empowered
organization
– Invested in facilities and equipment
to build for the future
A leader in European healthcare
Capio today
Capio AB (publ) – AGM 2016
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University
hospital
Emergency
hospital
Local
hospital
Specialist
clinic
Primary care
unit
France
• 8 emergency hospitals
• 11 local hospitals
• 3 specialist clinics
Germany
• 5 general hospitals
• 4 specialist clinics
• 1 hospital with rehabilitation and
care facilities
• 7 outpatient clinics (Medical Care
Centers, MCC)
Norway
• 8 medical centers
• 2 specialist clinics
Sweden
• 1 emergency hospital
• 2 local hospitals
• 30 locations for specialist care
• 18 locations for psychiatric care
• 75 locations for primary care
Capio footprint 2015
Experience across all care levels
Nordic
Capio footprint
Capio AB (publ) – AGM 2016
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As the population structure develops
towards a larger share being elderly…
Population pyramid, EU 1960-2050
1960 2010
MenWomen X%
2050
15% 19% 29%70-74
65-69
60-64
55-59
45-49
35-39
50-54
40-44
30-34
25-29
20-24
15-19
10-14
5-9
0-4
75-79
80+
The European challenge is not going to ease
– demographic squeeze is driving need and costs...
Pressure to provide “quality healthcare with higher productivity” as fewer people
have to pay for an increasingly large share of the population
NorwayUnited KingdomGermany
FranceSweden
…the required healthcare expenditures
will continue to increase, while there will
be fewer people financing the healthcare
0
5
10
15
20
Total expenditure on health, GDPPercentage
Year
2030201020009080701960
Prognosis1
1 Future development based on extrapolation of historic OECD average CAGR from 2002-12
http://populatio
npyramid.net/
Share of populationX% OECD
Source: World Bank Source: OECD Health data 2014
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Source:
AVLOS – Sweden: Socialstyrelsen; Norway: Helsedirektoratet; France: ATIH; Germany: Federal Statistical Office's DRG browser; Finland: Eurostat ; UK: Health and Social Care Information
Centre; Spain: Eurostat; Best-practice - knee prosthesis: North Wales knee clinic; Best-practice - AMI: US Healthcare costs and utilization project
Ambulatory surgery – All countries excluding Germany: Eurostat; Germany: German association of ambulatory surgery; Best-practice - Inguinal hernia: NHS; Best-practice - Tonsillectomy: US
agency for healthcare research and quality
1 Goodman et al. 1997; 2 For Norway 2011 data and only reported as aggregated data for knee and hip prosthesis
Large gaps and slow implementation create
opportunities
Historic implementation of modern
medicine is a slow process…
17 YEARS1
Best-practice
proven
Best-practice
implemented
Use Capio’s know-how to transfer knowledge and speed up change
Knee
prosthesis
Acute
myocardial
infarction
2 >15
2 >15
6.62 8.84.4 5.3 9.82.4 4.0 12.5
6.8 7.64.1 6.7 8.0~3 4.0 8.4
AVLOS
Days
Inguinal
hernia (open
surgery)
Tonsillect
-omy
0 80
0 90
64 6643 46 6814 75
38 5721 30 514 85
Share of
ambulatory
surgery
%
Best-practice
…with large performance gaps between countries
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Henrik Kehlet Surgeon Copenhagen
Why is your patient in hospital today doctor?
Capio AB (publ) – AGM 2016
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Time
Functionalcapacity
Surgery
This is why patients are in hospital
In Addition:Sedation
Preparation side effects
Drug side effects
Drains, catheters
Fasting
Surgery = Trauma
Inflammation
Fever, Swollenness
Pain, Nausea, Fatigue
Anxiety
Capio AB (publ) – AGM 2016
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Normal situation When hospitalisedAnxiety, No control, Diminished
…and on top of that
Capio AB (publ) – AGM 2016
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Henrik Kehlet Surgeon Copenhagen
Does it have to be like this?
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Source: SKL, Kehlet Br J Anaesth. 1997 May;78(5):606-17
Prevent inflammation
Modern Medicine in surgery
Capio AB (publ) – AGM 2016
Meeting discharge criteria
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It takes the right culture and attitude
…and in addition
- Make the patient not only informed but fully involved
- Demystify healthcare as much as possibleCapio RRAC labelling
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14%15%16%
21%
15%
12%14%
17%
12%10%
Source: SKL (vantetider.se)
Specialist care – surgeries and proceduresSpecialist care - visits
Nation-wide Stockholm
Sweden has not yet met its target thresholds for waiting times, in particular outside of the Stockholm region
Performance on target levels for waiting times (‘vårdgarantiuppfyllelse’); Share of patients who have waited > 90 days
2011 20132012 2014 2011 20132012 2014
11%11%12%
17%
14%
5%6%
15%
8%8%
The Swedish healthcare system has its
challenges…
Long waiting times and an experienced lack of resources drive need for
increased productivity in the Swedish healthcare system
Capio AB (publ) – AGM 2016
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36% more time spent with patients, but a significant reduction of total staff time
Quality
6-8 patients per care team
9.6 min per patient and day10-12 patients per care team
13.1 min per patient and day1 = When the number of patients increases, the time for indirect care and rounds have increased proportionally * = Other tasks include e.g. telephone, tutorial/introduction, meetings, other administration, coordination, business outside ward, waiting/searching
SWEDENMore time for direct and indirect care1
From where we are to where we want to be
Capio AB (publ) – AGM 2016
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YES!
Taking
initiatives!
NO!
Waiting for
orders?
Group
Business area
Region
Main unit
Unit
Care unit
Capio decentralized responsibilities
Capio’s financial model
Modern Management
Empowered to do the best every day!
Capio AB (publ) – AGM 2016
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• Proposal from the Board of Directors to the shareholders at the Capio
AB (publ) AGM:
– A long-term incentive to employees to share the value creation to which they
contribute, for the benefit of patients, employees and shareholders
– A five year convertible bond with a possibility to convert to Capio shares at the end
of the term
– Share price plus a 20% premium
– The scope of the program implies maximum 2,5% dilution and
maximum MSEK 200
The joy of everyday’s work and the result of being part of the long-term development!
An offering to our employees – a five year
convertible
Capio AB (publ) – AGM 2016
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Organic sales growthNet sales
Net sales & organic sales growth1
1 2012 to 2014 adjusted for the structural changes made in 2014. Refer to Capio Annual Report 2015 note 33.
Sales growth well in line with target over time – result growth with leverage
Group financial development 2012 – 2015
10,292
12,12712,960
13,486
2.5 2.3
4.1
2.9
1.0
2.0
3.0
4.0
5.0
6.0
0
3,000
6,000
9,000
12,000
15,000
2012 2013 2014 2015
Net Sales, MSEK Organic growth, %
Operating result (EBITA) and margin1
Operating margin (EBITA)Operating result (EBITA)
437
483
544
592
4.2
4.0
4.24.4
3.0
4.0
5.0
6.0
100
300
500
700
2012 2013 2014 2015
EBITA, MSEK Marginal, %
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Capio Group
2015 2014 ∆, %
Adj. net sales1 13,486 13,118 2.8
Organic sales growth, % 2.9 4.0
Adj. operating result (EBITDA)1 1,001 972 3.0
Margin, % 7.4 7.4
Adj. operating result (EBITA)1 592 544 8.8
Margin, % 4.4 4.1
Adj. profit for the period 326 288 13.2
Adj. EPS, SEK 2.44 2.29
Net capital expenditures -391 -429
In % of net sales 2.9 3.3
Net debt 2,936 3,440
Financial leverage 2.9 3.1
Capio AB (publ) – AGM 2016
1 2014 adjusted for structural changes in 2014. Refer to note 33 in Capio Annual Report 2015.2 Financial leverage 2014 based on reported operating result (EBITDA) of MSEK 1,102.
2
Q1 2016: Total sales growth of 3.6%, EBITA increased by 2.1%
Group financial development 2015
Quality drives productivity
in European healthcare
19Capio AB (publ) – AGM 2016
Capio Nordic
2015 2014 ∆, %
Adj. net sales1 7,243 6,944 4.3
Organic sales growth, % 4.6 5.1
Adj. operating result (EBITDA)1 458 411 11.4
Margin, % 6.3 5.9
Adj. operating result (EBITA)1 316 262 20.6
Margin, % 4.4 3.8
Net capital expenditures -135 -138
In % of net sales 1.9 1.9
Q1 2016: Total sales growth of 3.4%, EBITA increased by 10.0%
Good growth and result development
– Modern Management to drive
increased patient time and productivity
Segment – Capio Nordic
1 2014 adjusted for the handover of a contract business in 2014.
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Capio France
2015 2014 ∆, %
Adj. net sales 5,098 5,007 1.8
Organic sales growth, % 0.7 2.4
Adj. operating result (EBITDA)1 529 566 -6.5
Margin, % 10.4 11.3
Adj. operating result (EBITA)1 286 314 -8.9
Margin, % 5.6 6.3
Net capital expenditures -210 -252
In % of net sales 4.1 5.2
Q1 2016: Total sales growth of 5.6%, EBITA increased by 0.9%
Rapid Recovery strategy continues
to deliver in a challenging
pricing environment
Segment – Capio France
1 2014 adjusted for the sale-and leaseback transaction in 2014.
Capio AB (publ) – AGM 2016
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Capio Germany
2015 2014 ∆, %
Adj. net sales 1,145 1,155 -0.9
Organic sales growth, % 2.0 3.5
Operating result (EBITDA) 94 78 20.5
Margin, % 8.2 6.9
Operating result (EBITA) 74 55 34.5
Margin, % 6.4 4.9
Net capital expenditures -40 -27
In % of net sales 3.5 2.4
Q1 2016: Total sales growth of -3.7%, EBITA decreased by -8.6%
A platform for increased focus
on Modern Medicine
Segment – Capio Germany
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The patient in focus
• Implementing Modern Medicine, treatment times can be reduced as discharge criteria
can be reached faster
– Patients are less exposed to the hospital environment
– Shorter AVLOS and a continued shift from in- to outpatient treatments give
productivity gains
• Supported by Modern Management, which speeds up implementation
– Unnecessary delays for patients are reduced
– A decentralized and empowered organization makes a difference to our patients –
every day
Modern Medicine is the tool to put the medical profession in
the driving seat, making Modern Medicine real to patients
Market leadership by content
– and step by step – by size
Modern Medicine and Modern Management
Capio AB (publ) – AGM 2016