New Frontier Health Q3 2020 Results
Dec 2, 2020
Disclaimer
Forward-Looking Statements
This presentation includes "forward-looking statements" within the meaning of the "safe harbor" provisions of the Private Securities Litigation Reform Act of 1995. The actual results of New Frontier Health Corporation (the "Company") may differ from the Company's expectations, estimates and projections and consequently, you should not rely on these forward-looking statements as predictions of future events. Words such as "expect", "estimate", "project", "budget", "forecast", "anticipate", "intend", "plan", "may", "will", "could", "should", "believes", "predicts", "potential", "continue", and similar expressions are intended to identify such forward-looking statements. These forward-looking statements involve significant risks and uncertainties that could cause the actual results to differ materially from the expected results, including, but not limited to, the Company's ability to manage growth; the Company's ability to execute its business plan, including its planned expansions, and meet its projections; rising costs adversely affecting the Company's profitability; potential litigation involving the Company; general economic and market conditions impacting demand for the Company's services, and in particular the effects of COVID-19 on the Company's business and financial condition as well as other economic and market conditions in the Chinese healthcare industry and changes in the rules and regulations that apply to such business, including as it relates to foreign investments in such businesses; and other risks and uncertainties indicated from time to time in the Company's filings with the U.S. Securities and Exchange Commission (the "SEC"). Most of these factors are outside of the Company's control and are difficult to predict. The Company cautions readers not to place undue reliance upon any forward-looking statements, which speak only as of the date made. The Company does not undertake or accept any obligation or undertaking to release publicly any updates or revisions to any forward-looking statements to reflect any change in its expectations or any change in events, conditions or circumstances on which any such statement is based, except as required by law.
Financial Information
The Company acquired UFH in a business combination that closed on December 18, 2019. The financial results for the years ended December 31, 2018 and 2019, and for the quarter ended September 30, 2019 presented herein are those of the Company's wholly owned subsidiary, Healthy Harmony Holdings, L.P. (the "Predecessor"), while the financial results for the quarter ended September 30, 2020, presented herein are those of the combined Company (the "Successor").
Industry and Market Data
In this presentation, we rely on and refer to information and statistics regarding market participants in the sectors in which the Company competes and other industry data. The Company obtained this information and statistics from third-party sources, including reports by market research firms and company filings.
Use of Non-IFRS Financial Matters
The discussion and analysis includes certain measures, including Adjusted EBITDA (before IFRS 16 adoption), Adjusted EBITDA Margin, Free Cash Flow and Pro-forma Adjusted EBITDA, and Pro-forma Adjusted EBITDA Margin, which have not been prepared in accordance with IFRS. These measures do not have any standardized meaning prescribed by IFRS and are therefore unlikely to be comparable to similar measures presented by other companies. These measures should be considered as supplemental in nature and not as a substitute for the related financial information prepared in accordance with IFRS. We use these measures to evaluate our operating results and for financial and operational decision-making purposes. We believe that Adjusted EBITDA and Pro-forma Adjusted EBITDA helps compare our performance over various reporting periods on a consistent basis by removing from operating results the impact of items that do not reflect core operating performance and helps identify underlying operating results and trends.
Adjusted EBITDA (before IFRS 16 adoption), is calculated as net loss plus (i) depreciation and amortization, (ii) finance expense/(income), (iii) other gains or losses, (iv) other expenses (such as share based compensation), (v) provision for income taxes, as further adjusted for (vi) certain monitoring fees paid to certain shareholders prior to the Business Combination, (vii) lease expense adjustments as a result of adoption of IFRS 16, (viii) transaction related costs, (ix) Gain on disposal of an associate and (x) Severance costs as a result of the restructuring process mainly in corporate headquarters since the second quarter of 2020. UFH adopted IFRS 16 on January 1, 2019, and recognized lease liabilities and corresponding "right-of-use" assets for all applicable leases, and recognized interest expense accrued on the outstanding balance of the lease liabilities and depreciation of right-of-use assets. As a result, the adoption of IFRS 16 caused depreciation and amortization and finance costs to increase in 2019 and excluded all applicable lease expenses in Adjusted EBITDA. For ease of comparison to prior periods, the Company eliminated the impact of IFRS 16 on Adjusted EBITDA.
Pro-forma Adjusted EBITDA, is calculated as net loss plus (i) depreciation and amortization, (ii) finance expense/(income), (iii) other gains or losses, (iv) other expenses (such as share based compensation), (v) provision for income taxes, as further adjusted for (vi) certain monitoring fees paid to certain shareholders prior to the Business Combination, (vii) lease expense adjustment as a result of adoption of IFRS 16, (viii) transaction related costs, (ix) Gain on disposal of an associate, (x) Severance costs as a result of the restructuring process mainly in corporate headquarters since the second quarter of 2020 and (xi) Pro-forma adjustments in PXU. See slide 46 for further information on these pro-forma adjustments.
Adjusted EBITDA margin is calculated by dividing Adjusted EBITDA (before IFRS 16 adoption), by total revenue and Pro-forma Adjusted EBITDA margin is calculated by dividing Pro-forma Adjusted EBITDA by total revenue.
Free cash flow is calculated as 1) cash flow generated from operating activities 2) minus release of restricted cash, 3) minus capital lease payments, 4) add interest expense paid, 5) add one-off transaction expense related to the business combination, 6) minus capital expenditure on existing operations of the facilities.
A reconciliation of non-IFRS forward looking information to their corresponding IFRS measures are not included in this presentation as they cannot be provided without unreasonable effort because of the inherent difficulty of accurately forecasting the occurrence and financial impact of the various adjusting items necessary for such reconciliation that have not yet occurred, are out of our control, or cannot be reasonably predicted.
Table of Contents
Overview
Q3 2020 Business Highlights
Q3 2020 Financial Results
Growth Initiatives
Appendix A - Industry Overview
Appendix B - Additional Materials
Beijing United Family Hospital North (2020)
Leading Private Healthcare Service Provider in China
One of the LARGEST privatehealthcare service providers in China by revenue 2019A total revenue: RMB ~2.45bn
TOP-RANKED brand amonghigh-end private hospitals
COMPREHENSIVE
SERVICE OFFERING covering 30+ specialties
2015A-2019A CAGR: 15.1%
9 hospitals1 14 clinics1 1,000+ licensed beds 800+ physician staff 1000+ physician consultants 2019A outpatient visits: ~633,000 2019A inpatient visits: ~11,000
Source: Company; As of Dec 31, 2019
1. Includes 2 hospitals under construction,14 directly operated clinics
Operating Assets2
2019A Pro-Forma Adjusted EBITDA: RMB 483mm
2015A-2019A CAGR: 30.4%
Beijing United Family ONLY JCI and CAP accredited hospital
FIRST da Vinci and MAKO in private hospital
GCP certification from CFDA for conducting clinical drug trials
2. Operating assets include Beijing, Shanghai Puxi, Tianjin, Qingdao and Beijing Rehab Hospitals as well as Bo'Ao and Hangzhou Clinics and post-partum care worker business
ALL3 JCI accredited
3. All hospital and clinics with at least 3 years of operating experience are accredited or re-accredited on a 3-year cycle. The newest Qingdao and Shanghai Pudong hospitals were not yet eligible in the 2017 audit, but
Qingdao will be included in the 2020 audit and Pudong will be eligible in the next cycle.
Nationwide Geographic Footprint
Guangzhou
Hainan
Shenzhen2
Source: Company; As of Dec 31, 2019
1. 5 hospitals in Beijing Cluster including Qingdao United Family and Tianjin United Family
2. UFH is expected to be given the exclusive right to manage New Frontier Group's 64,000 sq. meter flagship Shenzhen city center hospital as part of the transaction
Diversified Foundation for Future Growth
MULTI-SPECIALTY SERVICE OFFERING1
DIVERSIFIED PAYER STRUCTURE2
REVENUE MIX BETWEEN SERVICE & PHARMACYBROADER ADDRESSABLE MARKET WITH MORE LOCAL PATIENTS3
Expat 46%
Source: Company
Local 71%
1. OB/GYN: Obstetrics and Gynecology; Peds: Pediatrics; Ortho: Orthopaedics; FM: Family Medicine; IM: Internal Medicine; ER: Emergency Room; PPR: Post-Partum Rehab
2. Split by revenue from insurance / self-pay patients
3. Split by volume of expat and local Chinese patients
Comprehensive Provider with Entire "Lifecycle" Coverage
Hub-and-spoke model creates comprehensive healthcare services platform with multiple patient touchpoints
One of the Most Reputable Private Healthcare Brands in China
Ranks top for medical quality among high-end private hospitals by patients, doctors and government regulators
◼ 2003 - The designated healthcare institution for foreigners during the SARS period
◼ 2010 - Official designated medical institutions for the Shanghai World Expo
◼ 2016 - Ranked No.2 in China Private Hospital Valuable Brands
◼ 2016 - Ranked No.18 in China Private Hospital Conglomerates Top 50 League
◼ 2015 - Named as Most Investment-Worthy Healthcare Company
◼ 2018 - The designated Well-Known Trademark
◼ 2016 - Ranked No.1 in China Top 100 Private Hospitals
◼ 2018 - Ranked No.1 repeatedly as The Best Employer among all private hospitals
Ranking score of private brands among monthly households income >RMB 27K1,2,3
1.85
1.64
D
Source: Company, Company Analysis
1.37
1.75
UFHA
B
C
E
UFH
1.64
A
B
C
D
E
UFH
A
1. Survey Question 4: Please rank the following private hospital brands' medical quality. Screening criteria: Have had any kind of medical treatment in private hospital in past 36 months
2. Scoring methods: a) Score 5 for brand ranked 1st; Score 3 for brand ranked 2nd; Score 1 for brand ranked 3rd; b) Divide summed score by the number of respondents
3. Sample size for Beijing, Shanghai and Guangzhou were 105, 110 and 62 respondents, respectively
B
C
D
E
Asset Overview
UFH
JCI- Accredited
Beijing City Cluster
Shanghai City Cluster
Greater Bay Cluster
Source: Company; As of Dec 31, 2019 Note:
1. New Shanghai Puxi is the expansion of the old Shanghai Puxi
2. Includes satellite clinics associated with hospitals
3. Includes Building A and additional capacity from Building B expansion; Revenue per sqm only accounts for the 20,057 sqm currently in use
4. Stands for the maximum bed capacity as of fiscal year-end
5. Stands for the maximum number of consultation rooms designed
2019 Revenue / Pro-forma Adjusted EBITDA1 Summary
FY2019 Revenue (in million RMB)
2,449
1,811
Tier 1 Operating Tier 2 OperatingExpansion
Assets Y-o-y Growth
& Other Assets
Assets
Total
9%
21%
170%
19%
Revenue per Bed2 Beijing3 14.0
1.7 1.5 4.6
Shanghai4 10.8
280
359
Notes:
1. See slide 46 for a reconciliation of net loss to Pro-forma Adjusted EBITDA
2.Revenue per bed is calculated based on the weighted average maximum bed capacity of the fiscal year
3.Refferring to Beijing United Family Hospital in Chaoyang as its associated clinics
4.Referring to Shanghai Puxi United Family Hospital and its associated clinics. Maximum bed capacity for Shanghai Puxi United Family Hospital increased with the relocation to new site in Q4 2019
Significant White Space for Growth in Tier 1 Cities1
Tier 1 Cities
Total Resident Population4
~74 million
Tier 1 Cities
Target Addressable Market3
~4.1 million
~5%
Tier 1 Cities # of UFH Patients2
~200,000
Significant white space within Tier 1 Cities for future growth
Source: Company Analysis, National Bureau of Statistics
1. Tier 1 Cities include Beijing, Shanghai, Guangzhou and Shenzhen
2. Number of unique UFH patients in Tier 1 cities in 2019
3. Addressable market includes target expatriate population, local population with out-of-pocket payment and local population with premium healthcare insurance coverage as of 2018
4. Number of residents in Beijing, Shanghai, Guangzhou and Shenzhen as of 2018
Q3 2020 BUSINESS HIGHLIGHTS
Shanghai United Family Pudong Hospital
Q3 2020 Operational and Financial Snapshot
Operational Snapshot
Outpatient Visit
152,951 Visits
Outpatient ASP
-0.5% YoY 21.7% QoQ
RMB 2,580 9.4% YoY
Inpatient AdmissionInpatient ASP
2,210 Admissions
-15.1% YoY
7.3% QoQ
RMB 103,386 15.2% YoY
Compared to 39.4% in 3Q19
1. See slide 46 for a reconciliation of net loss to Adjusted EBITDA (before IFRS 16 Adoption)
Utilization Rate33.7%
Financial Snapshot
Total Revenue
RMB 626.6 mn
3.7% YoY 14.1% QoQ
Adjusted EBITDA
(before IFRS 16 Adoption)1
RMB 89.9 mn 162.8% YoY
Notes:
Strong Revenue Growth for Both Local and Expat Patient Base
Y-o-y % of 2020 Quarterly Revenue
2019 Rev. Level
2020 Q1
◼ Continued strong local demand
contributed to the rapid recovery, demonstrating high resilience of our local customer base
◼ Revenue from expat patients also recovered strongly in the quarter despite continued restrictions on inbound travel to China through the end of Q3
Q2
LocalExpatTotal
Notes:
1. Above this line indicates y-o-y growth while below the line means y-o-y decline due to COVID-19.
Q3
◼ On September 28th, Chinese government announced to ease the travel restrictions of foreign nationals into China. As a result, we expects to see continued recovery of expat patient base
Strong Growth in Major Specialties despite headwinds in Obstetrics and Pediatrics
More Local Patients
All Major Specialties Recovered in Q3 Except for OB / Peds
Patient Mix1
Notes:
1. By number of patients
2. As of September 2020
2020Q3 Revenue Y-o-y Growth
(%)
Overall
Emergency
Surgery
OrthopedicsInternal MedicineOBGYNFamily MedicinePediatrics
◼ OB/GYN: Lower admissions due to nation-wide low birth rates in 2020
◼ Pediatrics: Lower admissions throughout UFH's facilities, as schools remained closed and enhanced personal hygiene and protective measures for school children were implemented
GZU: Positive EBITDA for 6 Consecutive Months with 9% EBITDA Margin in Oct.
After only 21 months of Operations1
Guangzhou United Family Hospital 2020 Monthly Revenue (Y-o-y%)
Notes:
1. Since the hospital obtained its OB license
New Project Update: Shenzhen New Frontier United Family Hospital
◼ Shenzhen New Frontier United Family Hospital ("SZU") is on track with its construction schedule despite the effect of COVID-19 situation, and is expected to commence operations in Q3 2021
◼ Upon completion, SZU will be the largest UFH hospital with a gross floor area of 63,645 sqm and 350 beds, with state-of-the-art equipment including PET/CT and linear accelerator. SZU is planning to have 22 specialties ranging from Obstetrics, pediatrics, family medicine, emergency medicine to oncology, internal medicine and general surgery
◼ Top management positions such as GM, CMO, CNO, CRO, HR Director are confirmed while some specialty chairs are being finalized
◼ Marketing campaigns to promote SZU and educate local market are under preparation and are planning to launch in Q1 / Q2 2021
New Project Update: Beijing Jingbei Women and Children's United Family Hospital
◼ Beijing Jingbei Women and Children's United Family Hospital ("DTU") is designed as a level III Women and Children's hospital with 200 licensed beds, aiming to provide comprehensive OB/ GYN, PPR, pediatrics and other consumer healthcare services (e.g. dental, ophthalmology, dermatology, vaccination, etc.) to attract and capture affluent younger customers in the north-west of Beijing
◼ Expected to complete construction and soft open in March 2021
◼ Secured the recruitment of a number of external clinical talents in core specialties incl. OB, gynecology, Pediatrics, PPR and FM with confirmed staff internal transfer plan from other UFH facilities in Beijing to support the new hospital
Ramp-up Strategy
Hospital Revenue (mm RMB)
1,100
1,050
1,000
1997
950
900
850
800
750
700
650
600
550
500
450
400
350
300
250
200
150
100
50
0
1998
1999
2000
2001
2002
2003
2004
2005
Source: Company (Unaudited); As of September 30, 2020
1. Since the hospital obtained its OB license
2. Run-rate revenue is defined as quarterly revenue * 4
Due to capacity bottleneck with only 5,886 sqm, Shanghai hospital struggled to take on additional patient volume and develop higher acuity services. Capacity issue was solved in October 2019 when Shanghai hospital moved to a new site with 19,172 sqm of facility size
by Sep-20 (Month 251)
TJU (6,900 sqm)
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
3. Only 20,057 sqm Building A is currently in use and contributes revenue for now; total GFA is 30,057 sqm which includes Building A and additional capacity from Building B expansion
BJU (24,959 sqm)PXU (previously 7,559 sqm; 20,844 sqm after relocation)GZM (69,008 sqm) 20Q3 Run
Rate Revenue2 (RMB 237mm)
PDU (28,471 sqm) 20Q3 Run
Rate Revenue2 (RMB 158mm)
by Sep-20 (Month 231)
2018
2019
2020
Lease Renewal of Building 1 of Beijing United Family Hospital
Situation Overview and Plan for BJU Building 1 Lease Expiration
◼ The lease on Building 1 of the BJU campus started in 1995 and was renewed in 2016.
◼ The renewal expires on December 31, 2020, and an extension agreement has not yet been reached.
◼ Provisions are underway for potential non-renewal, with plans for certain
existing operations to be relocated to the existing UFH satellite clinics and
other UFH facilities in Beijing.
◼ Majority of the clinics will be relocated to Building 2, in addition to some newly-leased, street front commercial space adjacent to the hospital.
◼ Losses in patient maternity rooms will be supplemented by a new space in
the new Beijing Jingbei Women and Children's United Family Hospital
("DTU")
Various Strategic Co-operations Kick-Off in Qingdao
Signing of Cooperation Agreement with | ||
Opening of Oncology Center at QDU | ||
Shandong University Qilu Hospital | ||
◼ Offer UFH patients a deeper bench in medical specialty | ◼ | Completed construction of its Radiation Therapy Cancer |
talents with multi-site practice of top public hospital (i.e. Qilu | Treatment Center | |
Hospital) physicians | ◼ | To be managed jointly by QDU and Icon under profit-sharing |
◼ Provide traditional patients of the public tertiary facility options | model | |
to seek faster access and more personalized care at UFH | ||
Qingdao facility |
◼ Housing a state-of-the-art Varian Linac
◼ Expected to attract cancer patients, who could also bring revenues from imaging, laboratory and surgery to the hospital
The various new co-operations are expected to help enhance UFH's medical capability and expand its patient base
Notes:
1. Icon Corporation is the largest cancer diagnosis and treatment service provider in Australia
Strategic Priorities for 4Q 2020
◼ Market Level Organizational Consolidation and Optimization
◼ Ramp-up of Newly Opened Facilities (Shanghai Puxi, Shanghai Pudong and Guangzhou)
◼ Invest in Core Markets and Expand Capabilities in Selected Specialties
◼ Prepare for launch of New Internet Hospital Initiative
◼ Continue with Cost and Cash Control / Business Recovery Post Coronavirus
◼ Prepare for the Launch of Beijing Datun Hospital and Shenzhen Hospital
Shanghai United Family Hospital
Q3 Revenue Continued Recovering and Recorded Y-o-y Growth
Revenue
(in million RMB)
Y-o-y Growth
14%
-25%
-13%
4%
Operating Tier 1Operating Tier 2 & Other AssetsExpansion
Outpatient and Inpatient Volume by Segment
Y-o-y Growth
Y-o-y Growth
164,010
11%
163,436
-41%
0% 22%
-23%
-3% 28%
18Q1
18Q2
18Q3
18Q4
19Q1
19Q2
19Q3
19Q4
20Q1
20Q2
20Q3
18Q2
Y-o-y Growth
20%
2,912
-21%
18Q1
18Q3
18Q4
19Q1 19Q2 19Q3 19Q4
Operating Tier 1Operating Tier 2 & Other AssetsExpansion
20Q1
Notes:
1. Due to lower admissions in the pediatrics department throughout UFH facilities, as schools stayed closed and enhanced personal hygiene and protective measures for school children were implemented
-24%
-15%
-30% 25%
20Q2
20Q3
ASP1 Increased in Q3 Due to Higher Acuity Procedures
9%
Y-o-y Growth
18Q1
18Q1
18Q2
18Q3
18Q4
19Q1
19Q2
19Q3
19Q4
20Q1
20Q2
20Q3
1. Average selling price
Notes:
18Q2
18Q3
18Q4
19Q1
19Q2
Y-o-y Growth
19Q3
2%
19Q4
-3%
20Q1
13%
11%
20Q2
16%
9%
20Q3
15%
Adjusted and Pro-forma Adjusted EBITDA1
Pro-forma Adjustments1
Y-o-y Growth
Tier 1 Operating
AssetsTier 2 Operating and Other Assets
Unallocated HQ ExpensesTotal
Notes:
1. See slide 46 for a reconciliation of net loss to Adjusted EBITDA (before IFRS 16 Adoption) and Pro-forma Adjusted EBITDA
Operating Expenses
Lowered Cost Structure Due to Cost Saving Initiatives
Notes:
1. 2020 Q3 decreases primarily due to a reduction in rental expenses as a result of government policies implemented during the pandemic.
2. 2020 Q3 increases due to fair value appreciation of plant and equipment, contracts with insurers related to the business combination, and full depreciation of the expanded PXU facility.
3. 2020 Q3 is an expense of RMB0.6 million due to the increase in trade receivable as a result of revenue growth.
Strong Balance Sheet and Positive Free Cash Flow in Q3 2020
Notes:
1. Adjusted operating cash flow is defined as cash generated for operating activities less capital lease payments, adding back interest expense and one-off transaction related costs. See slide 45 for detailed reconciliation
2. Free cash flow is defined as operating cash flow less maintenance CAPEX
Qingdao United Family Hospital
Shared Risk Model
Managed Care
Risk shared by UFH and insurer
◼ Partnering with patients to use pro-active approaches to keep them healthy
◼ Patients stay healthy and we have healthy margins
◼ Giving patients transparency and predictability in their healthcare expenditures
Enhance Clinic Networks in Existing Markets
Integrated Healthcare Services Model Generating Significant Synergies. Continue to Replicate Outpatient Networks in Existing Markets
SUCCESSFUL HUB & SPOKE BUSINESS MODEL
Hospitals
Source: Company; As of Dec 31, 2019
Significant Referral Revenue from Beijing Clinics
(RMB mm)
9.7%
2016
2017
Beijing Hospital referral revenue from clinics
Contribution to hospital revenue
2018
2019
Upside Catalysts Delivering Additional Value
◼ Grow IVF from Tianjin to nationwide
◼ Focus on increasing acuity services (robotics, oncology, advance imaging) to drive ASP / margin and create higher barriers to competitors
◼ Develop internet hospital and online portal to further engage with patients
◼ Continued investment in the AI and mobile technology for data analytics, online consultation, risk underwriting, preventive care
◼ Continue deep specialization in select areas but maintain a comprehensive suite of services
◼ New centers of excellence: oncology, orthopedics, ENT, sleep center, geriatric center, gynecology, advanced surgical, etc.
◼ Strategic acquisitions of specialty hospitals, outpatient and services network to further complement our existing portfolio
◼ Management contracts include a right to acquire managed hospitals
Investment Highlights
APPENDIX A - INDUSTRY OVERVIEW
Rapid Growth in Demand for Healthcare Services
REVENUE FOR HEALTHCARE SERVICES IN CHINA - HOSPITALS & PRIMARY CARE
2013A
CAGR CAGR 13-18 (%) 18-23 (%)
2014A
2015A
2016A
2017A
2018A
2023E
22% 21%
11% 9%
PREMIUM HEALTHCARE EXPENDITURE2 IN CHINA
(US$ bn)1
40
2013A
2014A
2015A
2016A
2017A
2023E
CAGR CAGR 13-17 (%) 17-23 (%)
23% 20%
25% 22%
PrivatePublic
Source: NHFPC, Company Analysis
1. Exchange rate at USD:RMB = 1.00 : 6.80
2. Annual high-end medical spending by residents (Expatriate, Local out of Pocket, Local Insured Patients) in Tier 1 & Tier 2 cities of China Local out of Pocket is defined as affluent households with annual income > RMB 324K
1st tier2nd tier
Assumed addressable population all live in Tier 1 and Tier 2 cities; Tier 1 cities: Beijing, Shanghai, Guangzhou and Shenzhen; Tier 2 cities: 46 cities incl. Tianjin, Nanjing, Hangzhou, Chongqing, Chengdu, Ningbo and etc.
China is Under-penetrated in Private Healthcare
Countries and Regions
85
(US$ '000)GDP per capita
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
0
Asia
EU
NA
AU
LatAm & Africa
300
400
500
600
700
Private healthcare spending per capita (US$)
Source: EIU, Euromonitor, BMI, Hong Kong Food and Health Bureau; As of 2017
800
900
1,000
1,100
1,200
1. Tier 1 cities include Beijing, Shanghai, Guangzhou and Shenzhen. Private healthcare spending per capita assumed to mirror private vs. public hospital revenue trends in China
1,300
5,300
Top Trends in the Chinese Public and Private Hospital Sectors
TOP TRENDS IN THE PUBLIC HOSPITAL SECTOR
SCARCITY AND UNEVEN DISTRIBUTION OF QUALITY MEDICAL RESOURCES
Class III: 2,232 (8%)Class II: 7,944 (27%)
Class I: 9,282 (32%)Unrated: 9,682 (33%)
# of Hospitals in China
# of Annual Hospital Outpatient Visits (mm)
Class III: 1,628 (50%)Class II: 1,217 (37%)
Class I: 218 (7%)Unrated: 207 (6%)
IMMENSE PRESSURE ON PUBLIC HEALTHCARE SYSTEM
3+ hours
Average time to visit a physician
<5 mins
Actual time spent in a physician consultation
90+%
Average bed occupancy rate in public hospitals
EXPECTED DEFICIT OF THE BASIC SOCIAL MEDICAL INSURANCE
(RMB bn)
2020E
2026E
Deficit is expected to arise
TOP TRENDS IN THE PRIVATE HOSPITAL SECTOR
specialty / low acuity situations
− Huge under supply of premium hospitals
Private hospitals in China are facing challenges that present unique opportunities for a branded comprehensive player like UFH
(2,300)
Source: Frost & Sullivan, PwC survey on urban middle class Chinese, National Health and Family Planning Commission, Company Analysis; As of 2016
Highly Fragmented Market
− Limited scaled players provide opportunity for a large,
branded player like UFH
Lack of a Comprehensive Service Provider
− Most private hospital systems are focused on a single
Willingness to Pay
− >80% of patients are willing to pay a premium to visit a private hospital
Aging Population and Commercial Healthcare Insurance are Key Long-Term Growth Drivers of Healthcare Services
RAPIDLY AGING POPULATION
China population aged 65+ (Persons mm) 400
200
0
2012A
2000A 2010A 2020E 2030E 2040E
China Population Aged 65+ (Persons mm)
Population Aged 65+ as % of Total Population
COMMERCIAL HEALTH INSURANCE GWP1 (US$ bn)2
2012A
2014A
2016A
Source: United Nations, China Insurance Yearbook, CIRC, McKinsey Global Institute, Company Analysis
2018E
2023E
1. Include all local and foreign players. Health insurance GWP (gross written premium) includes premium sold by both life and P&C insurers
2. PHI = Private Health Insurance
3. Exchange rate at USD:RMB = 1.00 : 6.80
HIGH-END PHI2 ADDRESSABLE POPULATION ('000)
2014A 2016ATier 1 cities
2018E 2023ETier 2 citiesCAGR CAGR 12-18 (%) 18-23 (%)
15% 15%
28% 25%
APPENDIX B - ADDITIONAL MATERIALS
Summary Shareholder Structure1,2 of NFH
61%
UFH Management
Free Float (%)
~90
10%
Capital Group
Other Public Investors
Note:
1. 131mm shares outstanding before accounting for roll-over NFH ESOP from UFH management and SPAC warrants (currently out-of-the-money).
2. As a result of the execution of the Fosun Director Nomination Agreement, Vivo Director Nomination Agreement, Irrevocable Proxies, and Director Support Letter Agreements, each Reporting Person may be deemed to be members of a "group" within the meaning of Section 13(d)(3) of the Exchange Act with NFPH, Vivo LP and Fosun with respect to the election of directors of the Issuer as described in Item 4 of this Amendment No. 1. As a result, the group may be deemed to have acquired beneficial ownership of all the Ordinary Shares beneficially owned by each member of the "group" and each Reporting Person may be deemed to beneficially own all of the Ordinary Shares beneficially owned by the group. As such, the group may be deemed to beneficially own in the aggregate 81,096,625 Ordinary Shares, which represents approximately 55.5% of the total outstanding Ordinary Shares.
Management Team of NFH
Chairman of the Board
▪ Chairman of NFH
▪ Chairman / Co-Founder of New Frontier Group
▪ Chairman of Nan Fung Group
▪ Former HK Financial
Antony Leung
Secretary
▪ Former Chairman of Blackstone Greater China, JP Morgan Asia
Executive Committee of the Board of Directors
▪ CEO of NFH
▪ Founder of United Family Healthcare
▪ President and Chairman of Executive Committee of NFH
▪ Medical industry experience: 35+ years
▪ CEO / Co-Founder of New Frontier Group
▪ Managing Partner, Co-CEO of Vivo Capital, CEO of Vivo Capital Greater China
Roberta Lipson
▪ One of the most well-regarded healthcare executives in China
Carl Wu
▪ Experienced healthcare entrepreneur (Co-founder of Care Alliance, YD Care, and Heal)
▪ Former Senior Managing Director and Chief Representative of Blackstone China
Shan Fu
▪ Former Managing Director at Blackstone
▪ Department of Foreign Investment in National Development and Reform Commission (NDRC)
▪ State Economic and Trade Commission
Experienced Board of Directors
Non-Independent
Directors
▪ Chairman of NFH
▪ Chairman / Co-Founder of New Frontier Group
▪ President and Chairman of Executive Committee of NFH
▪ CEO of NFH
▪ Founder of UFH
▪ CEO / Co-Founder of New Frontier Group
▪ Former Financial Secretary of Hong Kong
▪ Nan Fung Group Chairman and CEO
▪ Experienced healthcare entrepreneur (Co-founder of Care Alliance, YD Care, and Heal)
▪ Medical industry experience: 35+ years
Antony Leung ▪
Blackstone Chairman of Greater China
Carl Wu
▪ J.P. Morgan Chairman of Asia
▪ Founding member of Blackstone Asia Pacific and Blackstone China
Roberta Lipson
▪ One of the most well regarded healthcare executives in China
▪ Citibank Head of China & Hong Kong and Private Bank for Asia
▪ Executive Director and the Co-CEO of Fosun International
▪ Managing Partner, Co-CEO and CEO of Vivo Capital in Greater China
▪ COO of NFH
▪ Executive Director and the Chairman of Fosun Pharma
▪ Senior Managing Director and Chief Representative of Blackstone
▪ Managing Director of New Frontier Group
Qiyu Chen
▪ Non-executive director and Vice Chairman of Sinopharm Group
Shan Fu
▪ Department of Foreign Investment in National Development and Reform Commission (NDRC)
▪ Blackstone Private Equity Group (HK)
David Zeng ▪
Barclays
▪ State Economic and Trade Commission
Independent Non-executive
Directors
▪ Senior Advisor of New Frontier Group
▪ Senior Advisor of New Frontier Group
▪ CEO of the Samling Group
▪ Hong Kong University Council Chairman
▪ Non-official member of the Executive Council of HKSAR
▪ Independent Non-Executive Director of Guangshen Railway
▪ Former CEO of Deloitte China
▪ Non-executive Chairman of MTR
▪ Former Executive Committee of Deloitte Touche Tohmatsu Limited
▪ Hong Kong Hospital Authority Chairman
▪ Member of Hong Kong Legislative Council
▪ Secretary for Commerce & Economic Development of HKSAR
▪ Independent Non-Executive Director of BC Technology Group
Dr. C H Leong
Frederick Ma
▪ Secretary for Financial Services and the Treasury for HKSAR
Lawrence Chia
▪ CFO of PCCW
▪ Over 30 years of experience in financial advisory and corporate finance in Greater China
Strong Cash Flow and Balance Sheet
(RMB million) | 3Q20 |
Operating Cash Flow & Free Cash Flow: | |
Cash Flow Generated from Operating Activities | 49 |
Less: Capital Lease Payments1 | (40) |
Add: Interest Expense Paid | 34 |
Add: One-off Transaction Expense Paid | 6 |
Adjusted Operating Cash Flow | 49 |
Less: Maintenance CAPEX | (15) |
Free Cash Flow | 34 |
CAPEX: | |
Maintenance CAPEX2 | 15 |
Expansionary CAPEX3 | 75 |
Total CAPEX | 90 |
Notes:
1. Due to IFRS 16 adoption, capital lease payments is categorized as cash used for financing activities.
2. Maintenance capex is defined as all capex spent for existing operations of the facilities.
3. Expansionary capex is defined as capex spent for building new facilities including the new site of Shanghai Puxi Hospital, Shanghai Pudong Hospital, Guangzhou Hospital and Beijing Jingbei Women and Children's United Family Hospital ("DTU")
Reconciliation of Non-IFRS Financial Measures
Net loss
(223)
(430)
(86) (70)
Less: Finance income
(1)
(2)
(1) (1)
Add: Finance costs
54
157
33 62
Add: Foreign exchange loss/(gain)
(13)
Less: Gain on disposal of a subsidiary
-
9 -
21 30
- (1)
Less: Other (income)/expenses, net
13
6
(6) 5
Add: Income tax expense/(benefit)
15 10
Operating (loss)/income
(24) 35
7 (163)
63 (198)
Add: Share-based compensation expense/(benefit) Add: Depreciation and amortization
2
34
10 (3)
88
342
85 105
Add: Discontinued monitoring fee payable to Fosun Pharma and TPG1 Add: One-off transaction costs
1
4
147
160
Add: Relocation costs of New Puxi Hospital Add: Severance costs
1 9 3 -
- 1 - 2
Adjusted EBITDA
84 140
Less: Lease expense adjustments as a result of IFRS 16 adoption Adjusted EBITDA (before IFRS 16 adoption)
3 - 79 (53) 26 2
6 - 349 (205)
(50) (50)
144 19
34 90
28
163
34 90
Add: PXU Pro-forma Adjustments2 Pro-forma Adjusted EBITDA
Notes:
1. Monitoring fee payable to TPG and Fosun is not related to business operation and is discontinued from 2020 onwards.
2. The adjustments include (i) giving a pro forma effect to annual rent reimbursement of approximately RMB15 million which took effect in November 2019 as if such reimbursement commenced on January 1, 2019, (ii) adding back RMB 3.7 million for additional rental expenses incurred prior to the PXU relocation due to space constraints, and (iii) RMB 3.7 million of ongoing net savings on fees payable to our business partner for this property in accordance with the rental reimbursement.
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New Frontier Health Corporation published this content on 02 December 2020 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 02 December 2020 13:28:05 UTC