Team Health Holdings, Inc. Announces First Quarter 2014 Financial Results
KNOXVILLE, Tenn., April 29, 2014 /PRNewswire/ --
2014 First Quarter Highlights
- Net revenue increased to $641.7 million; 11.4% over the prior year first quarter
- Net earnings attributable to Team Health Holdings, Inc. ("Net earnings") were $23.8 million; $38.3 million after adjustments
- Diluted net earnings per share of $0.33; Adjusted EPS of $0.54
- Adjusted EBITDA increased 19.2% to $71.8 million
- Consistent with prior guidance, 2014 net revenue growth is projected to be between 11% and 12%, inclusive of Medicaid parity, but excluding other potential benefits from healthcare reform
Team Health Holdings, Inc. ("TeamHealth" or the "Company") (NYSE: TMH), one of the largest providers of outsourced physician staffing solutions for hospitals in the United States, today announced results for its first quarter of 2014.
"We are pleased with our financial performance for the first quarter of 2014 as we generated double digit revenue and earnings growth, while expanding our Adjusted EBITDA margin over the prior year," said TeamHealth Chief Executive Officer, Greg Roth.
"Similar to other healthcare providers, we saw the continuation of soft utilization trends further impacted by challenging weather conditions in several of our markets during the quarter. Despite the current operating environment, all three of our primary growth drivers contributed to an increase in net revenue of over 11% and we realized improvements in our operating margins. We continued to benefit from the Medicaid parity program and we anticipate additional opportunities from the expansion of coverage that began this quarter, primarily from an improving payor mix and support for volume growth as the newly insured begin to access the healthcare system. While we realized some modest improvements in our payor mix in the quarter, we believe it will take additional time to fully discern the impact of healthcare reform on our 2014 financial results. As we look ahead into the remainder of 2014, we believe that we remain well positioned to achieve continued revenue and earnings growth in 2014. We are implementing our acquisition strategy, executing on new contract sales, driving improvements in same contract performance, and delivering strong operating cash flows. We continue to project full year 2014 annual net revenue growth of between 11% and 12%. Our first quarter performance exceeded our annual Adjusted EBITDA margin target of 10.5% as a result of the continued focus on revenue cycle performance, including Medicaid parity, and cost efficient operations. Over the remainder of the year, we will look to drive continued revenue growth and operating efficiencies that could provide some modest upside to our annual margin target. As we have gained additional insight into the Medicaid parity program, we now anticipate the 2014 revenue benefit will be in the range of $32 million and $34 million. Consistent with our previous commentary, except for Medicaid parity revenue, our current guidance does not include other benefits that we may see from healthcare reform in 2014," concluded Mr. Roth.
Lynn Massingale, M.D., Executive Chairman of TeamHealth, added, "We are pleased with our start to 2014 and we look forward to delivering strong operating and financial performance for the remainder of the year. Moving forward, we continue to utilize our national infrastructure and strong physician leadership to drive operational improvements across our growing network of high quality affiliated providers, while making investments in patient safety, risk management, operational efficiency and customer satisfaction. Our priority is to deliver the highest quality of patient care and our proprietary information technology systems and infrastructure investments enable us to accomplish these goals."
2014 First Quarter Results
Net revenue increased 11.4% to $641.7 million from $575.9 million in the first quarter of 2013. Acquisitions contributed 7.2%, same contract revenue contributed 2.6% and net sales growth contributed 1.6%, of the increase in quarter-over-quarter growth in net revenue.
Same contract revenue increased $14.9 million, or 2.9%, to $526.6 million from $511.7 million in the first quarter of 2013. An increase of 9.1% in estimated collections on fee for service visits provided a 6.2% increase in same contract revenue growth between quarters while a 3.1% decrease in same contract volumes constrained growth by 2.2%. Contract and other revenue constrained same contract revenue growth between quarters by 1.1%. Acquisitions contributed $41.2 million of revenue growth, and net new contract revenue increased by $9.6 million between quarters. The benefit from Medicaid parity revenue recognized in the first quarter was $8.8 million, of which $8.1 million is same contract revenue. Medicaid parity contributed 1.5% to consolidated revenue growth and 1.6% to same contract revenue growth between quarters.
Reported net earnings for the quarter were $23.8 million, or $0.33 diluted net earnings per share, compared to net earnings of $18.2 million, or $0.26 diluted net earnings per share, in the first quarter of 2013. The financial results for the first quarter of 2014 included $10.1 million of contingent purchase and other acquisition compensation expense ($7.0 million after-tax) and non-cash amortization expense of $11.1 million ($7.5 million after tax). Excluding these items, net earnings for the first quarter of 2014 would have been $38.3 million and Adjusted EPS would have been $0.54 per share. The results in the first quarter of 2014 include a $1.8 million ($1.1 million after tax) net gain on the sale and disposal of assets, including the sale of certain assets related to our clinic operations. Financial results for the first quarter of 2013 included $10.3 million of contingent purchase and other acquisition compensation expense ($6.5 million after-tax), and non-cash amortization expense of $8.9 million ($5.9 million after-tax). Excluding these items, net earnings for the first quarter of 2013 would have been $30.5 million and Adjusted EPS would have been $0.44 per share. See "Non-GAAP Financial Measures Reconciliations" and "Adjusted Earnings Per Share" below for the definition of Adjusted EPS and its reconciliation to net earnings and diluted earnings per share attributable to Team Health Holdings, Inc.
Cash flow provided by operations for the quarter was $34.2 million compared to $33.3 million in the first quarter of 2013. There were $0.1 million of contingent purchase payments made in the first quarter of 2014 and no contingent purchase payments in 2013. Excluding the impact of these items, operating cash flow in 2014 reflected an increase of $0.9 million between quarters.
Adjusted EBITDA for the quarter increased 19.2% to $71.8 million from $60.2 million in the first quarter of 2013, and Adjusted EBITDA margin increased to 11.2% compared to 10.5% for the same quarter in 2013. See "Non-GAAP Financial Measures Reconciliations" and "Adjusted EBITDA" below for the definitions of Adjusted EBITDA Margin and Adjusted EBITDA and its reconciliation to net earnings attributable to Team Health Holdings, Inc.
As of March 31, 2014, the Company had cash and cash equivalents of approximately $56.6 million and $250.0 million of available borrowings under its revolving credit facility (without giving effect to $6.1 million of undrawn letters of credit). The Company's total outstanding debt was $497.5 million as of March 31, 2014.
Conference Call
As previously announced, TeamHealth will hold a conference call tomorrow, April 30, 2014, to discuss its first quarter 2014 results at 8:30 a.m. (Eastern Time). The conference call can be accessed live over the phone by dialing 1-877-407-0784, or for international callers, 1-201-689-8560. A replay will be available one hour after the call and can be accessed by dialing 1-877-870-5176, or for international callers, 1-858-384-5517. The passcode for the live call and the replay is 13579991. The replay will be available until May 2, 2014.
Interested investors and other parties may also listen to a simultaneous webcast of the conference call by logging onto the Investor Relations section of the Company's website at www.teamhealth.com. The on-line replay will remain available for a limited time beginning immediately following the call.
To learn more about TeamHealth, please visit the company's Web site at www.teamhealth.com. TeamHealth uses its Web site as a channel of distribution for material Company information. Financial and other material information regarding TeamHealth is routinely posted on the Company's Web site and is readily accessible.
About TeamHealth
TeamHealth (Knoxville, Tenn.) (NYSE: TMH) is one of the largest providers of outsourced physician staffing solutions for hospitals in the United States. Through its 19 regional locations and multiple service lines, TeamHealth's more than 9,800 affiliated healthcare professionals provide emergency medicine, hospital medicine, anesthesia, urgent care, and pediatric staffing and management services to more than 860 civilian and military hospitals, clinics, and physician groups in 46 states.
Forward Looking Statements
Statements and information contained herein that are not historical facts and that reflect the current view of the Company about future events and financial performance are hereby identified as "forward looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995. Some of these statements can be identified by terms and phrases such as "anticipate," "believe," "intend," "estimate," "expect," "continue," "could," "should," "may," "plan," "project," "predict" and similar expressions. The Company cautions that such "forward looking statements," including without limitation, those relating to the Company's future business prospects, revenue, working capital, professional liability expense, liquidity, capital needs, interest costs and income, wherever they occur in this or in other statements attributable to the Company, are necessarily estimates reflecting the judgment of the Company's senior management and involve a number of risks and uncertainties that could cause actual results to differ materially from those suggested by the "forward looking statements." Factors that could cause our actual results to differ materially from those expressed or implied in such forward-looking statements include but are not limited to current or future government regulation of the healthcare industry, exposure to professional liability lawsuits and governmental agency investigations, the adequacy of insurance coverage and insurance reserves, as well as those factors detailed under the caption "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" in the Company's most recent annual report on Form 10-K and the most recent quarterly report on Form 10-Q filed with the Securities and Exchange Commission. The Company's "forward looking statements" speak only as of the date hereof and the Company disclaims any intent or obligation to update "forward looking statements" herein to reflect changed assumptions, the occurrence of unanticipated events, or changes to future operating results over time.
Non-GAAP Financial Measures Reconciliations
In this release we refer to Adjusted EBITDA, Adjusted EBITDA margin and Adjusted EPS which are financial measures that are calculated and presented on the basis of methodologies other than in accordance with generally accepted accounting principles in the United States of America ("GAAP"). Adjusted EBITDA is defined as net earnings attributable to Team Health Holdings, Inc. before interest expense, taxes, depreciation and amortization, as further adjusted to exclude the non-cash items and the other adjustments shown in the table under "Adjusted EBITDA" below. Adjusted EBITDA margin represents Adjusted EBITDA divided by net revenue. Adjusted EPS is defined as diluted earnings per share attributable to Team Health Holdings, Inc. excluding non-cash and other adjustments, including the impact of contingent purchase and other acquisition compensation expense and amortization expense relating to purchase accounting for historical acquisitions and the other adjustments shown in the table under "Adjusted Earnings Per Share." For a reconciliation of each of Adjusted EBITDA and Adjusted EPS to the most directly comparable GAAP measure, we refer you to the tables under "Adjusted EBITDA" and "Adjusted Earnings Per Share," respectively.
Team Health Holdings, Inc.
Consolidated Balance Sheets
December 31, |
March 31, 2014 |
||||||
(Unaudited) |
|||||||
Assets |
|||||||
Current assets: |
|||||||
Cash and cash equivalents |
$ |
32,331 |
$ |
56,603 |
|||
Accounts receivable, less allowance for uncollectibles of $377,644 and |
392,430 |
404,977 |
|||||
Prepaid expenses and other current assets |
35,029 |
31,497 |
|||||
Receivables under insured programs |
22,961 |
20,128 |
|||||
Total current assets |
482,751 |
513,205 |
|||||
Investments of insurance subsidiary |
84,081 |
88,638 |
|||||
Property and equipment, net |
53,434 |
56,159 |
|||||
Other intangibles, net |
173,178 |
164,268 |
|||||
Goodwill |
428,311 |
428,750 |
|||||
Deferred income taxes |
44,546 |
45,862 |
|||||
Receivables under insured programs |
39,532 |
41,349 |
|||||
Other |
55,577 |
52,211 |
|||||
$ |
1,361,410 |
$ |
1,390,442 |
||||
Liabilities and shareholders' equity |
|||||||
Current liabilities: |
|||||||
Accounts payable |
$ |
27,700 |
$ |
27,396 |
|||
Accrued compensation and physician payable |
201,998 |
175,279 |
|||||
Other accrued liabilities |
128,749 |
134,848 |
|||||
Income tax payable |
3,014 |
15,053 |
|||||
Current maturities of long-term debt |
17,969 |
19,688 |
|||||
Deferred income taxes |
39,063 |
38,767 |
|||||
Total current liabilities |
418,493 |
411,031 |
|||||
Long-term debt, less current maturities |
483,594 |
477,812 |
|||||
Other non-current liabilities |
190,842 |
201,996 |
|||||
Shareholders' equity: |
|||||||
Common stock, ($0.01 par value; 100,000 shares authorized, 70,016 and |
700 |
701 |
|||||
Additional paid-in capital |
642,633 |
649,023 |
|||||
Accumulated deficit |
(376,593) |
(352,748) |
|||||
Accumulated other comprehensive earnings |
447 |
1,049 |
|||||
Team Health Holdings, Inc. shareholders' equity |
267,187 |
298,025 |
|||||
Noncontrolling interest |
1,294 |
1,578 |
|||||
Total shareholders' equity including noncontrolling interest |
268,481 |
299,603 |
|||||
$ |
1,361,410 |
$ |
1,390,442 |
Team Health Holdings, Inc.
Consolidated Statements of Comprehensive Earnings
Three Months Ended March 31, |
|||||||
2013 |
2014 |
||||||
(Unaudited) |
|||||||
Net revenues before provision for uncollectibles |
$ |
1,006,349 |
$ |
1,104,173 |
|||
Provision for uncollectibles |
430,404 |
462,523 |
|||||
Net revenue |
575,945 |
641,650 |
|||||
Cost of services rendered (exclusive of depreciation and amortization shown |
|||||||
Professional service expenses |
452,769 |
501,280 |
|||||
Professional liability costs |
18,656 |
20,295 |
|||||
General and administrative expenses (includes contingent purchase and other |
58,121 |
62,177 |
|||||
Other income |
(1,281) |
(2,161) |
|||||
Depreciation |
4,086 |
4,571 |
|||||
Amortization |
8,873 |
11,126 |
|||||
Interest expense, net |
3,799 |
3,408 |
|||||
Transaction costs |
462 |
1,018 |
|||||
Earnings before income taxes |
30,460 |
39,936 |
|||||
Provision for income taxes |
12,254 |
16,018 |
|||||
Net earnings |
18,206 |
23,918 |
|||||
Net earnings attributable to noncontrolling interest |
52 |
73 |
|||||
Net earnings attributable to Team Health Holdings, Inc. |
$ |
18,154 |
$ |
23,845 |
|||
Net earnings per share of Team Health Holdings, Inc. |
|||||||
Basic |
$ |
0.27 |
$ |
0.34 |
|||
Diluted |
$ |
0.26 |
$ |
0.33 |
|||
Weighted average shares outstanding |
|||||||
Basic |
68,000 |
69,835 |
|||||
Diluted |
70,015 |
71,430 |
|||||
Other comprehensive (loss) earnings, net of tax: |
|||||||
Net change in fair value of investments, net of tax of $(16) and $325 for |
(30) |
602 |
|||||
Comprehensive earnings |
18,176 |
24,520 |
|||||
Comprehensive earnings attributable to noncontrolling interest |
52 |
73 |
|||||
Comprehensive earnings attributable to Team Health Holdings, Inc. |
$ |
18,124 |
$ |
24,447 |
Team Health Holdings, Inc.
Consolidated Statements of Cash Flows
Three Months Ended March 31, |
|||||||
2013 |
2014 |
||||||
(Unaudited) (In thousands) |
|||||||
Operating Activities |
|||||||
Net earnings |
$ |
18,206 |
$ |
23,918 |
|||
Adjustments to reconcile net earnings: |
|||||||
Depreciation |
4,086 |
4,571 |
|||||
Amortization |
8,873 |
11,126 |
|||||
Amortization of deferred financing costs |
255 |
253 |
|||||
Equity based compensation expense |
1,538 |
2,974 |
|||||
Provision for uncollectibles |
430,404 |
462,523 |
|||||
Deferred income taxes |
(6,650) |
(1,937) |
|||||
Loss (gain) on disposal or sale of assets |
79 |
(1,842) |
|||||
Equity in joint venture income |
(699) |
(927) |
|||||
Changes in operating assets and liabilities, net of acquisitions: |
|||||||
Accounts receivable |
(440,075) |
(475,070) |
|||||
Prepaids and other assets |
7,395 |
7,357 |
|||||
Income tax accounts |
12,137 |
12,039 |
|||||
Accounts payable |
(4,577) |
(59) |
|||||
Accrued compensation and physician payable |
(14,643) |
(27,648) |
|||||
Contingent purchase liabilities |
8,888 |
8,724 |
|||||
Other accrued liabilities |
(1,932) |
2,192 |
|||||
Professional liability reserves |
10,040 |
5,979 |
|||||
Net cash provided by operating activities |
33,325 |
34,173 |
|||||
Investing Activities |
|||||||
Purchases of property and equipment |
(3,370) |
(5,919) |
|||||
Sale of property and equipment |
125 |
2,776 |
|||||
Cash paid for acquisitions, net |
(12,000) |
(2,454) |
|||||
Purchases of investments by insurance subsidiary |
(26,812) |
(11,975) |
|||||
Proceeds from investments by insurance subsidiary |
19,727 |
8,344 |
|||||
Net cash used in investing activities |
(22,330) |
(9,228) |
|||||
Financing Activities |
|||||||
Payments on notes payable |
(4,063) |
(4,063) |
|||||
Proceeds from revolving credit facility |
— |
27,500 |
|||||
Payments on revolving credit facility |
— |
(27,500) |
|||||
Stock issuance costs |
(476) |
— |
|||||
Payments of financing costs |
(1) |
— |
|||||
Proceeds from exercise of stock options |
12,228 |
1,949 |
|||||
Tax benefit from exercise of stock options |
5,215 |
1,441 |
|||||
Net cash provided by (used in) financing activities |
12,903 |
(673) |
|||||
Net increase in cash and cash equivalents |
23,898 |
24,272 |
|||||
Cash and cash equivalents, beginning of period |
41,240 |
32,331 |
|||||
Cash and cash equivalents, end of period |
$ |
65,138 |
$ |
56,603 |
|||
Supplemental cash flow information: |
|||||||
Interest paid |
$ |
3,827 |
$ |
3,659 |
|||
Taxes paid |
$ |
1,514 |
$ |
4,437 |
Team Health Holdings, Inc.
Adjusted EBITDA
We present Adjusted EBITDA as a supplemental measure of our performance. We define Adjusted EBITDA as net earnings attributable to Team Health Holdings, Inc. before interest expense, taxes, depreciation and amortization, as further adjusted to exclude the non-cash items and the other adjustments shown in the table below. We present Adjusted EBITDA because we believe it assists investors and analysts in comparing our performance across reporting periods on a consistent basis by excluding items that we do not believe are indicative of our core operating performance.
Adjusted EBITDA is not a measurement of financial performance or liquidity under generally accepted accounting principles. In evaluating our performance as measured by Adjusted EBITDA, management recognizes and considers the limitations of this measure. Adjusted EBITDA does not reflect certain cash expenses that we are obligated to make, and although depreciation and amortization are non-cash charges, assets being depreciated and amortized will often have to be replaced in the future, and Adjusted EBITDA does not reflect any cash requirements for such replacements. In addition, other companies in our industry may calculate Adjusted EBITDA differently than we do or may not calculate it at all, limiting its usefulness as a comparative measure. Because of these limitations, Adjusted EBITDA should not be considered in isolation or as a substitute for net earnings, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles.
The following table sets forth a reconciliation of net earnings attributable to Team Health Holdings, Inc. to Adjusted EBITDA.
Three Months Ended March 31, |
|||||||
2013 |
2014 |
||||||
(In thousands) |
|||||||
Net earnings attributable to Team Health Holdings, Inc. |
$ |
18,154 |
$ |
23,845 |
|||
Interest expense, net |
3,799 |
3,408 |
|||||
Provision for income taxes |
12,254 |
16,018 |
|||||
Depreciation |
4,086 |
4,571 |
|||||
Amortization |
8,873 |
11,126 |
|||||
Other income(a) |
(1,281) |
(2,161) |
|||||
Contingent purchase and other acquisition compensation |
10,258 |
10,144 |
|||||
Transaction costs(c) |
462 |
1,018 |
|||||
Equity based compensation expense(d) |
1,538 |
2,974 |
|||||
Insurance subsidiary interest income |
422 |
500 |
|||||
Severance and other charges |
1,661 |
348 |
|||||
Adjusted EBITDA |
$ |
60,226 |
$ |
71,791 |
(a) Reflects gain or loss on sale of assets, realized gains on investments, and changes in fair value of investments associated with the Company's non-qualified retirement plan. |
|||||||
(b) Reflects expense recognized for historical and estimated future contingent payments and other compensation expense associated with acquisitions. |
|||||||
(c) Reflects expenses associated with accounting, legal, due diligence and other transaction fees related to acquisition activity. |
|||||||
(d) Reflects costs related to options and restricted shares granted under the Team Health Holdings, Inc. 2009 Amended and Restated Stock Incentive Plan. |
Team Health Holdings, Inc.
Adjusted Earnings Per Share
(in thousands, except per share data)
We present Adjusted earnings per share attributable to Team Health Holdings, Inc. ("Adjusted EPS") as a supplemental measure of our performance. We define Adjusted EPS as diluted earnings per share excluding non-cash and other adjustments, including the impact of contingent purchase and other acquisition compensation expense and amortization expense relating to purchase accounting for historical acquisitions. We present Adjusted EPS because we believe that it assists investors in understanding the impact of acquisition-related costs on our earnings per share and comparing our performance across operating periods on a consistent basis and provides additional insight into our core earnings performance. Adjusted EPS is not a measurement of financial performance or liquidity under generally accepted accounting principles. In evaluating our performance as measured by Adjusted EPS, management recognizes and considers the limitations of this measure. Adjusted EPS does not reflect certain cash expenses that we are obligated to make, and although contingent purchase and other acquisition compensation expense and amortization expense are non-cash charges in the period reported, such charges reflect historical or future cash payments in conjunction with our acquisition transactions. In addition, other companies in our industry may calculate Adjusted EPS differently than we do or may not calculate it at all, limiting its usefulness as a comparative measure. Because of these limitations, Adjusted EPS should not be considered in isolation or as a substitute for net earnings, operating income, basic and diluted earnings per share, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles.
The following tables set forth a reconciliation of diluted earnings per share to Adjusted EPS (note that some totals may not add due to rounding).
Three Months Ended March 31, |
|||||||||||||||
2013 |
2014 |
||||||||||||||
Diluted weighted average shares outstanding |
70,015 |
71,430 |
|||||||||||||
Net earnings and diluted net earnings per share |
$ |
18,154 |
$ |
0.26 |
$ |
23,845 |
$ |
0.33 |
|||||||
Adjustments: |
|||||||||||||||
Contingent purchase and other acquisition compensation |
6,492 |
0.09 |
6,963 |
0.10 |
|||||||||||
Amortization expense, net of tax of $(3,001) and $(3,588) |
5,872 |
0.08 |
7,538 |
0.11 |
|||||||||||
Net earnings and diluted earnings per share attributable to |
$ |
30,518 |
$ |
0.44 |
$ |
38,346 |
$ |
0.54 |
Team Health Holdings, Inc.
Revenue Analysis
The components of net revenue include revenue from contracts that have been in effect for prior periods (same contracts) and from net, new and acquired contracts during the periods, as set forth in the table below:
Three Months Ended March 31, |
|||||||
2013 |
2014 |
||||||
(in thousands) |
|||||||
Same contracts: |
|||||||
Fee for service revenue |
$ |
361,337 |
$ |
382,048 |
|||
Contract and other revenue |
150,384 |
144,562 |
|||||
Total same contracts |
511,721 |
526,610 |
|||||
New contracts, net of terminations: |
|||||||
Fee for service revenue |
41,672 |
46,015 |
|||||
Contract and other revenue |
16,550 |
21,807 |
|||||
Total new contracts, net of terminations |
58,222 |
67,822 |
|||||
Acquired contracts: |
|||||||
Fee for service revenue |
5,922 |
39,283 |
|||||
Contract and other revenue |
80 |
7,935 |
|||||
Total acquired contracts |
6,002 |
47,218 |
|||||
Consolidated: |
|||||||
Fee for service revenue |
408,931 |
467,346 |
|||||
Contract and other revenue |
167,014 |
174,304 |
|||||
Total net revenue |
$ |
575,945 |
$ |
641,650 |
The following table reflects the visits and procedures included within fee for service revenues described in the table above:
Three Months Ended March 31, |
|||||
2013 |
2014 |
||||
(in thousands) |
|||||
Fee for service visits and procedures: |
|||||
Same contract |
2,348 |
2,276 |
|||
New and acquired contracts, net of terminations |
322 |
521 |
|||
Total fee for service visits and procedures |
2,670 |
2,797 |
SOURCE Team Health Holdings Inc.
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