Investor Presentation
May 15, 2024
© 2024 Modivcare® Inc.
Disclaimer
This presentation has been prepared by ModivCare, Inc., a Delaware corporation (the "Company"), for informational purposes only and contains general information about the activities of the Company that does not purport to be complete. Nothing in this presentation shall constitute or form part of, nor should be construed as, an offer or invitation to subscribe for, underwrite or otherwise acquire any securities of the Company or any of its respective affiliates, nor should it or any part of it form the basis of, or be relied on in connection with, any contract to purchase or subscribe for any securities of the Company or any of its respective affiliates, or with any other contract or commitment whatsoever. Nothing in this presentation shall constitute an offer to sell or a solicitation of an offer to buy securities in any jurisdiction in which such offer or sale would be unlawful. If the Company were to conduct an offering of securities in the future, a prospectus or an offering document relating to such offering of securities will be able to be obtained from the underwriters or the initial purchasers of such offering or from the Company. You are advised to obtain a copy of such prospectus or offering document and to carefully review the information contained or incorporated by reference therein before making any investment decision. No representation or warranty, express or implied, is made as to, and no reliance should be placed on, the fairness, accuracy, completeness or correctness of the information or opinions contained herein, and any reliance you place on them will be at your sole risk. The Company, its affiliates and advisors do not accept any liability whatsoever for any loss howsoever arising, directly or indirectly, from the use of this document or its contents, or otherwise arising in connection with this document.
Forward Looking Statements
Certain statements contained in this presentation constitute "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995. These statements are predictive in nature and are frequently identified by the use of terms such as "may," "will," "should," "expect," "believe," "estimate," "intend," and similar words indicating possible future expectations, events or actions. The updated outlook discussed herein constitutes forward-looking statements. Such forward-looking statements are based on current expectations, assumptions, estimates and projections about our business and our industry, and are not guarantees of our future performance. These statements are subject to a number of known and unknown risks, uncertainties and other factors, many of which are beyond our ability to control or predict, which may cause actual results to be materially different from those expressed or implied herein, including but not limited to: government or private insurance program funding reductions or limitations; implementation of alternative payment models or the transition of Medicaid and Medicare beneficiaries to Managed Care Organizations; our inability to control reimbursement rates received for our services; cost containment initiatives undertaken by private third-party payors and an inability to maintain or reduce our cost of services below rates set forth by our payors; the effects of a public health emergency; inadequacies in our information technology systems; changes in the funding, financial viability or our relationships with our payors; pandemics and other infectious diseases; disruptions to our contact center operations caused by health epidemics or pandemics; delays in collection of our accounts receivable; any impairment of our goodwill and long-lived assets; any failure to maintain or to develop reliable, efficient and secure information technology systems; any inability to attract and retain qualified employees; any disruptions from acquisition or acquisition integration efforts; estimated income taxes being different from income taxes that we ultimately pay; our contracts not surviving until the end of their stated terms, or not being renewed or extended; our failure to compete effectively in the marketplace; our not being awarded contracts through the government's requests for proposals process, or our awarded contracts not being profitable; any failure to satisfy our contractual obligations or to maintain existing pledged performance and payment bonds; any failure to estimate accurately the cost of performing our contracts; any misclassification of the drivers we engage as independent contractors rather than as employees; significant interruptions in our communication and data services; not successfully executing on our strategies in the face of our competition; any inability to maintain relationships with existing patient referral sources; certificates of need laws or other regulatory and licensure obligations that may adversely affect our personal care integration efforts and expansion into new markets; any failure to obtain the consent of the New York Department of Health to manage the day to day operations of our licensed in-home personal care services agency business; changes in the case-mix of our personal care patients, or changes in payor mix or payment methodologies; our loss of existing favorable managed care contracts; our experiencing labor shortages in qualified employees and management; labor disputes or disruptions, in particular in New York; becoming subject to malpractice or other similar claims; our operating in the competitive remote patient monitoring industry, and failing to develop and enhance related technology applications; any failure to innovate and provide services that are useful to customers and to achieve and maintain market acceptance; our lack of sole decision-making authority with respect to our minority investment in Matrix and any failure by Matrix to achieve positive financial position and results of operations; the cost of our compliance with laws; changes to the regulatory landscape applicable to our businesses; changes in budgetary priorities of the government entities or private insurance programs that fund our services; regulations relating to privacy and security of patient and service user information; actions for false claims or recoupment of funds; civil penalties or loss of business for failing to comply with bribery, corruption and other regulations governing business with public organizations; changes to, or violations of, licensing regulations; our contracts being subject to audit and modification by the payors with whom we contract; a loss of Medicaid coverage by a significant number of Medicaid beneficiaries following the expiration of the COVID-19 public health emergency under the Families First Coronavirus Response Act (2020); our existing debt agreements containing restrictions that limit our flexibility in operating our business; our substantial indebtedness and lease obligations; any loss of available financing alternatives; our ability to incur substantial additional indebtedness; and the results of the remediation of our identified material weaknesses in internal control over financial reporting. The Company has provided additional risk factors related information in our most recently filed annual report on Form 10-K and subsequent filings with the Securities and Exchange Commission that could impact future performance. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date the statements were made. We undertake no obligation to update or revise any forward- looking statements contained in this presentation, whether as a result of new information, future events or otherwise, except as required by applicable law.
Non-GAAP Financial Information
In addition to the financial measures prepared in accordance with generally accepted accounting principles in the United States ("GAAP"), this investor presentation includes presentations of EBITDA, Adjusted EBITDA, Adjusted EBITDA margin, and Adjusted G&A Expense for the Company and its segments, and Adjusted EPS for the Company, all of which are performance measures that are not recognized under GAAP, as well as free cash flow for the Company, which is a liquidity measure that is not recognized under GAAP. EBITDA is defined as net income (loss) before: (1) interest expense, net, (2) provision (benefit) for income taxes and, (3) depreciation and amortization. Adjusted EBITDA is calculated as EBITDA before (as applicable): (1) restructuring and related costs, (2) transaction and integration costs, (3) settlement related costs, (4) cash settled equity, (5) stock-based compensation, (6) impairment of goodwill, (7) COVID-19 related costs, net of grant income, and (8) equity in net (income) loss of investee, net of tax. Adjusted EBITDA margin is calculated as Adjusted EBITDA, divided by service revenue, net. Adjusted G&A Expense is calculated as G&A expense before (as applicable): (1) restructuring and related costs, (2) transaction and integration costs, (3) settlement related costs and (4) stock-based compensation. Adjusted EPS is calculated as Adjusted Net Income divided by the diluted weighted-average number of common shares outstanding as calculated for Adjusted Net Income. Free cash flow is calculated as cash flow from operations less our applicable capital expenditures included in our purchase of property and equipment line in our Statements of Cash Flows. Reconciliations of the non-GAAP financial measures to their most directly comparable GAAP financial measures are included at the end of this presentation. We do not provide an updated outlook for net income (loss) in this presentation on a basis consistent with GAAP or a reconciliation of forward-lookingnon-GAAP financial measures to their most directly comparable GAAP financial measures on a forward-looking basis because we are unable to predict items contained in the GAAP financial measures without unreasonable efforts. Our non-GAAP performance measures exclude expenses and amounts that are not driven by our core operating results and may be one time in nature. Excluding these expenses makes comparisons with prior periods as well as to other companies in our industry more meaningful. We believe such measures allow investors to gain a better understanding of the factors and trends affecting the ongoing operations of our business. We consider our core operations to be the ongoing activities to provide services from which we earn revenue, including direct operating costs and indirect costs to support these activities. As a result, our net income or loss in equity investee is excluded from these measures, as we do not have the ability to manage the venture, allocate resources within the venture, or directly control its operations or performance. Our non-GAAP liquidity measure is included because it reflects an additional way of viewing our liquidity that, when viewed together with our GAAP results, provides management, investors, and other users of our financial information with a more complete understanding of factors and trends affecting our cash flows. Our use of the term free cash flow is not intended to imply, and no inference should be made, however, that the reported amounts are free to be used without restriction for discretionary expenditures, as our use of these funds may be restricted by the terms of our outstanding indebtedness, including our credit facility, and otherwise earmarked for other non-discretionary expenditures. Our non-GAAP financial measures may not provide information that is directly comparable to that provided by other companies in our industry, as other companies in our industry may calculate non-GAAP financial measures differently. In addition, there are limitations in using non-GAAP financial measures because they are not prepared in accordance with GAAP, may be different from non-GAAP financial measures used by other companies, and exclude expenses that may have a material impact on our reported financial results. The presentation of non-GAAP financial measures is not intended to be considered in isolation from or as a substitute for the most directly comparable financial measures prepared in accordance with GAAP. We urge you to review the reconciliations of our non-GAAP financial measures to the most directly comparable GAAP financial measures included below, and not to rely on any single financial measure to evaluate our business.
© 2024 Modivcare® Inc.
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Company Overview
National Tech-Enabled Platform with Market-Leading Solutions
Supportive | Integrated Supportive Care |
Care | Addressing the Social Determinants of Health (SDoH) |
Transportation | Personal Care | Remote Monitoring |
Removing barriers to | In-home assistance with | Connective engagement |
accessing care | activities of daily living | preserving independence |
48 States | 7 States | 48 States |
National Reach | Largest in Northeast | Nationally Licensed |
~32M | ~28M | ~249K |
Lives Managed | Hours of Care | Active Patients |
~35M | ~17K | 2.5M+ |
Trips | Caregivers | Interactions |
Revenue | Adj. EBITDA |
$2.8B (1) | $186M (1) |
Company HQ
PCS, NEMT and RPM States
Key NEMT and RPM States
NEMT and RPM Presence
© 2024 Modivcare® Inc.
(1) Represents LTM 3//31/24. | 4 |
Note: See Appendix for presentation of Non-GAAP to GAAP reconciliation. |
Overview of Modivcare's Segments
Business Description
- of Consolidated Revenue / Adj. EBITDA
Non-Emergency Medical Transportation | Personal Care Services |
(NEMT) | (PCS) |
▪ Provides end-users of healthcare services | ▪ Non-medical home care for elderly and |
access to care | disabled individuals in need of assistance |
performing activities of daily living | |
71% LTM 2024 Q1 Revenue | 26% LTM 2024 Q1 Revenue |
58% LTM 2024 Q1 Adj EBITDA | 30% LTM 2024 Q1 Adj EBITDA |
Remote Patient Monitoring
(RPM)
- Health monitoring equipment and services for elderly and chronically ill individuals
3% LTM 2024 Q1 Revenue
12% LTM 2024 Q1 Adj EBITDA
Economic Model
- Capitated Contracts (86% Segment): Reoccurring base price per eligible life (Per Member Per Month or PMPM)
- Fee-for-Services(14% Segment): Fee-for-volumecost plus terms
- Reimbursement per billable service hour
- Average length of service 3-5 years
▪ | Re-occurring monthly device fee and |
subscription fee | |
▪ | Average length of service 3-5 years |
Example Use Case
Customers
▪ Scheduled transportation for a patient from | ▪ | In-home daily assistance for an individual | |
their home to a dialysis center and back | with a traumatic brain injury to progress | ||
home afterwards | towards successful inclusion in the | ||
community | |||
▪ | State and Managed Medicaid | ▪ | State and Managed Medicaid |
▪ | Medicare Advantage | ▪ | Specialty Benefit Programs |
(i.e. Traumatic Brain Injury) | |||
▪ | Private Pay |
▪ 24/7 monitoring and health data collection | |
allowing an individual with chronic heart | |
failure to maintain independence in the | |
home | |
▪ State and Managed Medicaid | |
▪ | Medicare Advantage |
▪ | Private Pay |
© 2024 Modivcare® Inc.
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Non-Emergency Medical Transportation (NEMT)
Non-Emergency Medical Transportation (NEMT)
Core Services
Multi-modal levels of service providing access to clinical care
v | Traditional Providers | v | Wheelchair Accessible |
v | Mileage Reimbursement | v | Public Transportation |
v | Rideshare | v | ALS/BLS and Other |
Revenue Breakdown (1)
Medicare
Advantage 16%
84% Medicaid
NEMT Differentiators
Size and Scale - Largest provider in the U.S.
Deepest Transportation Network - Strong relationships with
third-party network of transportation providers, developed over several decades
Deep History and Experience Underwriting - Strong historical relationship with
payors and domain expertise of contract underwriting
Member Experience - Best-in-class member experience through established transportation provider networks nationwide with 94% on-time performance
By the Numbers (1) | |
$2.0B | $131M |
Revenue | Adj. EBITDA |
32M | +7% to +8% |
Lives Managed | LT Targeted Revenue CAGR |
Note: See Appendix for presentation of Non-GAAP to GAAP reconciliation.
© 2024 Modivcare® Inc.
(1) Represents LTM 3/31/24. | 7 |
NEMT | Quarterly Performance
Financial Performance | ||||
510 | Revenue ($mm) | Adj. EBITDA Margin | ||
$497 | $499 | |||
490 | $486 |
$479
$469
470
450
430 | 8% | |
8% | ||
7% | ||
410 | 6% | 6% |
390 |
370
350
1Q23 | 2Q23 | 3Q23 | 4Q23 | 1Q24 |
Key Metrics
9000 | Trips (000s) | Gross Profit per Trip ($) | 20 | |||||
8,824 | 18 | |||||||
8,798 | 8,808 | |||||||
8800 | ||||||||
8,735 | 16 | |||||||
8600 | 14 | |||||||
8400 | 12 | |||||||
8,202 | 10 | |||||||
8200 | ||||||||
$7.54 | $7.59 | 8 | ||||||
$6.56 | ||||||||
8000 | $6.30 | $6.32 | ||||||
6 | ||||||||
7800 | ||||||||
4 | ||||||||
7600 | 2 | |||||||
7400 | 0 | |||||||
1Q23 | 2Q23 | 3Q23 | 4Q23 | 1Q24 |
Note: See Appendix for presentation of Non-GAAP to GAAP reconciliation.
© 2024 Modivcare® Inc.
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NEMT | Operational Highlights
Omni-Channel
Member
Engagement
- Higher mix of digital reservations and ride support communications vs. reliance on traditional calls
Call to Trips Ratio
55% 52% 49%
42% 41%
1Q23 | 2Q23 | 3Q23 | 4Q23 | 1Q24 |
Multi-Modal
Network
- Optimizing level of service through selection of the lowest cost, medically appropriate mode of transportation
Rideshare, Mileage Reimbursement & Public Transit,
% of Trips
29% 32% 33% 34% 36%
1Q23 | 2Q23 | 3Q23 | 4Q23 | 1Q24 |
Digital Customer
Integration
- 360 Member Profile to increase data capture and member digital experience
Digital Reservation, % of Trips | 33% | |||||||||||||
27% | 28% | |||||||||||||
19% | 23% | |||||||||||||
1Q23 2Q23 3Q23 4Q23 1Q24
© 2024 Modivcare® Inc.
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NEMT | Client Relationship Dynamics
1 | States & Local Government Agencies |
Contract and Revenue Model
- Multi-year(3-5 years) both full risk and shared risk contracts
- Structured RFP process with general information released to the public
- Defined contract start and end dates results in easily trackable control pipeline
- Liquidated damages more prevalent and increasingly tied to diverse components
- Formal award process with scoring factored on various components
Key Objectives:
- Budget predictability
- Actuarial soundness
Key Attributes
2 | Managed Care Organizations |
Contract and Revenue Model
- Typically evergreen contracts with cancellation notice periods on both sides
- Some contracts requiring RFPs with others based on traditional relationship sales process
- Flexible contract type given upfront challenges on membership data
Key Objectives:
- Value-driven /cost focused
- Quality membership experience
3 | Healthcare Providers |
Contract and Revenue Model
- Annually recurring revenue stream (self-renewing)
- Large upsell / expansion potential (e.g. administrative hospital departments, outpatient visits)
- Administrative fee + ride cost pass through
Key Objectives:
- Healthcare provider throughput & reduction in appointment no-shows
- Differentiated patient experience
- Utilization control and visibility
- Improved outcomes, especially for at-risk providers
Why We Win
- National and Local Scale: Largest NEMT provider managing 30+ million trips across 30 million member lives
- Long-TenuredRelationships: Driving multi-year retention rates with ~300+ contracts with States, MCOs and other providers
- Extensive Partnership Network: Proven experience in building networks, credentialling and CMS compliance with transportation providers across 48 states
- Underwriting Expertise: Managed risk on behalf of payors with full risk contracts, delivering cost-effective and outcome improving solutions by providing clear ROI with enabling access to care
- Enterprise-LevelCompliance & Safety: Provides a vulnerable member population with peace of mind through the assurance of safe vehicles and credentialed drivers
- Developed Technology Platform: Platform leads NEMT with reach and breadth of capabilities
© 2024 Modivcare® Inc.
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Disclaimer
ModivCare Inc. published this content on 15 May 2024 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 15 May 2024 12:09:36 UTC.