Investor PresentationNovember 2009
Bumrungrad Hospital Public Company Limited
2
Recent UpdatesRecent UpdatesBangkok Facility• 7 additional floors (of which 4 are outpatient clinics) of the new BI Clinic Building opened on 30 May 08, resulting
in increase in outpatient capacity to 4,500 visits per day
• Renovation of the inpatient beds in the existing hospital building started in Feb 08; 298 rooms are completed as of Oct 09
• Launched Healthy Living Club in mid-June 08 to attract domestic patients; 19,000 members as at Nov 09
International Expansion• Asia Renal Care:
− Successfully acquired 60% (cumulative group holding) of a chain of 14-clinic dialysis operator in Thailand in Feb 09
− Number of clinics increased to 105, in 7 Asian countries as at Oct 09
• AHI in the Philippines:
− The expansion plans, including renovation of existing building and construction of a new 14-storey building with additional outpatient & inpatient capacity, are on schedule
− Bumrungrad International Limited’s shareholding in AHI increased to 56.4% from conversion of management fee into equity
• Bumrungrad International Limited’s shares in Bumrungrad Hospital Dubai have been sold back to Istithmar
3
AgendasAgendas
• Introduction to BH
• BH Financial Performance
• Bumrungrad International, Bangkok
• Bumrungrad International Limited
• Business Strategy
4
Fact SheetFact Sheet
Shareholding Structure
Others, 51.17%
Bangkok Insurance Pcl.
13.16%
Sinsuptawee AM8.67%
Bangkok Bank Pcl.1.08%
Istithmar5.94%
Temasek5.94%
UOB Kay Hian (HK) - Client Account
8.04%Littledown
Nominees Limited 96.00%
As of Mar 2009
Net Profit Contribution
Bumrungrad International
Hospital, Bangkok94.55%
Bumrungrad International
Limited5.45%
For the year 2008
Total Net Profit = THB 1,191 million
• Established in 1980; listed on SET in 1989• Major operations divided into Bangkok facility and international business
Bangkok FacilityFacilities
One of the largest and most sophisticated private hospitals in South-East Asia538 inpatient beds and 4,500 outpatient capacity per dayThailand’s leading tertiary medical center
Accreditation1st hospital in Asia to receive US JCI Accreditation1st private hospital in Thailand with Thai Hospital Accreditation
Patient Volume & RevenueOver one million patients treated annuallyInternational following with 420,000 international patients from 190 countries
Services19 specialist departments; 102 sub-specialist departments
International PresenceAsian Hospital Inc. in the Philippines with 253-bed capacityBumrungrad Al Mafraq Hospital, a public hospital in Abu Dhabi with 488 beds (management contract)Asia Renal Care with a chain of 105 dialysis clinics in 7 Asian countries
With a 29 year track record, BH is now the leading healthcare service provider in South-East Asian region
5
Regional Presence Regional Presence
10 Locations
South Korea
2 Locations
Japan
33 Locations
Taiwan
13 Locations
Philippines
1
Bangkok, Thailand
17 Locations
Thailand
2
United Arab Emirates
4
3
Philippines
22 Locations
Singapore
5
6
7
8 Locations
Malaysia
8
Presence in 8 countries, with 108 clinic and hospital locations
6
Group StructureGroup StructureCore business of BH is the renowned Bumrungrad Hospital
Owns main hospital building
Bumrungrad Hospital Public Company Limited
(“BH”)
Bumrungrad MedicalCenter Ltd.
(“BMC”)Comprehensive wellness
center specializing in preventive care
Vitallife Corporation Ltd.
(“Vitallife”)
100.0% 100.0%
Note: As of Nov 2009
31.5%
CDE Trading Co., Ltd.
(“CDE”)
30.0%
Dormant
Asian Hospital Inc.(“AHI”)
Asia Renal Care Ltd.(“ARC”)
56.4% 100.0%
Asia Renal Care (Thailand) Co., Ltd.(“ARC Thailand”)
51.0%49.0%* The strategic partners of Bumrungrad International Limited are:
- Istithmar 19.5%- Temasek 19.5%- Asia Financial Holding 19.5%- Bangkok Bank 10.0%
Bumrungrad Al Mafraq Hospital
ManagementContract
International business
BumrungradInternational Ltd.*
Asia Global Health Ltd.
(“AGH”)
100.0%
Regional healthcare opportunities
Asia Global Research Co., Ltd.
(“AGR”)Clinical research
100.0%
7
Dr. Sinn AnurasGroup Medical Director
Management TeamManagement TeamBH’s management team comprises individuals with extensive experience in healthcare management
Mr. Curtis SchroederGroup CEO
K. Linda LisahapanyaManaging Director
Mr. Dennis BrownCEO
Bumrungrad International Ltd.
Note: As of May 2009
Mr. Theo SeilerCEO
Asian Hospital Inc.Philippines
Mr. Mack BannerCEO
Bumrungrad International, Bangkok
Mr. C.B. LimCEO
Asia Renal Care LimitedSingapore
Mrs. Lee Chan KhorCFO
Bumrungrad International, Bangkok
Ms. Karen CarterCOO
Bumrungrad International, Bangkok
Mr. John NickensCEO
Bumrungrad Al Mafraq Hospital Abu Dhabi, U.A.E.
Mr. Anthony TanCEO
Vitallife Corporation Ltd.
Ms. Janice ChanCEO
Bumrungrad International Holdings (Hong Kong) Limited
Mr. James MashCEO
Asia Global Research
8
Third Party Recognitions: 2008 Third Party Recognitions: 2008 -- A Year of AwardsA Year of Awards1. Thailand’s “Best Small Cap Company” 2008
Awarded by Hong Kong-based Asiamoney magazine in January ’09, based on survey of investment managers
2. Wall Street Journal Award RecognitionRank No.1 – Most Admired Thai Companies
Rank no. 4 overall among Thailand’s top 10 companies
6. Thailand Most Innovative Company By Chulalongkorn University’s school of business
3. Award of Excellence, Outstanding Achievementand Special Recognition inAPPLIED MEDICAL INFORMATICS 2008
4. Thailand Tourism Award 2008Award of Excellence (top prize)
5. Best International Medical Travel WebsiteWashington D.C., 9 December 2008
7. Most Desirable Companies to Work for in ThailandBumrungrad ranks #7 overall and #1 in healthcareBy Business.com Magazine
8. Company with Very Good Corporate Governance ScoringBy Thai Institute of Directors Association
9. Thailand Quality Class (TQC) 2008By Office of Thailand Quality Award
9
Operating PerformanceOperating Performance 20042004--20082008Total Revenue
Net Income
EBITDA
1,3511,664
1,9282,070
2,155
0
500
1,000
1,500
2,000
2,500
3,000
2004 2005 2006 2007 2008
EBIT
DA
(TH
B m
m)
12% CAGR829
5,8096,807
7,896
8,584
8,925
0
2,000
4,000
6,000
8,000
10,000
12,000
2004 2005 2006 2007 2008
Sale
s (T
HB
mm
)
11% CAGR
458
1,053935
1,096
1,147
1,191
0
300
600
900
1,200
1,500
1,800
2004 2005 2006 2007 2008
Net
Inco
me
(TH
B m
m) 6% CAGR
DILUTED EPS
1.011.21 1.26
1.29
1.370.56
0.0
0.5
1.0
1.5
2.0
2004 2005 2006 2007 2008
Dilu
ted
EPS
(TH
B)
Source: Audited FS
Source: Audited FS Source: Audited FS
8% CAGR
One-time items of THB458 million in 2007 due share of profit in investment in GCS Thailand, netted off with impairment of software system H2000
9,413
BH reported a one-time gain on share of profit in investment in CDE Trading (Previously GCS Thailand) in 2007 of THB 829 million, mainly from sale of GCS Thailand’s assets
1,605
Source: Audited FS
1.85
10
Revenue from Hospital Operations
6,523 6,711
0
2,000
4,000
6,000
8,000
9M08 9M09
9M09 Update9M09 Update
Source: Audited FS
EBITDA
Source: Audited FS
3%1,648 1,701
0
500
1,000
1,500
2,000
9M08 9M09
3%
Net Income
Source: Audited FS
• Revenue from hospital operations was up 3% as a result of:
− Inpatient revenue growth of 3%
− Outpatient revenue growth of 5%
• EBITDA increased by 3%, in line with the increase in revenue from hospital operations
• Net income increased by 5% because of lower interest expense and effective tax rate
899946
0
200
400
600
800
1,000
9M08 9M09
5%
THB million THB million
THB million
11
Margins & TrendMargins & Trend
• Gross margin and EBITDA margin are on a rising trend over
the past 5 years, signifying the efficiency of the operations
• Net profit margin, however, was more dependent on the
effective tax rate
• BH used up all of its tax-loss-carried-forward in 2005 and paid
full tax rate in 2006 onwards
Gross Margin Trend
38.7%38.3%38.5%37.6%
35.6%37.6%
20%
25%
30%
35%
40%
45%
2004 2005 2006 2007 2008 9M09
Net Profit Margin Trend vs. Effective Tax Rate
17.1%
13.6%13.3%13.9%15.5%16.1%
27.4%27.7%28.5%28.6%
17.2%12.8%
0%
5%
10%
15%
20%
25%
2004 2005 2006 2007* 2008 9M090%
20%
40%
60%
80%
100%Net Margin (LHS)Effective Tax Rate (RHS)
* Net margin in 2007 includes one-time non-operating items
EBITDA Margin Trend
24.5%23.4%
24.5% 24.2% 24.3% 24.6%
15%
20%
25%
30%
2004 2005 2006 2007 2008 9M09
12
LeverageLeverageDebt to Equity
Net Debt to Equity
0.290.270.31
0.28
0.37 0.39
0.00
0.10
0.20
0.30
0.40
0.50
2004 2005 2006 2007 2008 9M09
0.540.41
0.350.39
1.03
0.68
0.00
0.30
0.60
0.90
1.20
2004 2005 2006 2007 2008 9M09
x
x
Interest Coverage
17.7
28.1
18.818.7
11.4
15.6
0.0
10.0
20.0
30.0
2004 2005 2006 2007 2008 9M09
x
• Improvement of the balance sheet over the years, both in terms of D/E and interest coverage as the long-term debt is gradually paid-off
• Loan was refinanced on 1 Oct 09, with additional credit line of THB 1.4 billion, extended repayment schedule and lower interest rate
13
The Current Economic EnvironmentThe Current Economic Environment
Source: McKinsey on Finance, Winter 2009
Accelerate refurbishment of existing BI
Hospital Building
Focus on domestic market
Open new international markets
Tight cost control: no service effect
Conserve & manage cash
Continue Bumrungrad International
Limited’s investments as planned
Hold on Dubai
Healthcare during recessionsHealthcare during recessions…… Our action plansOur action plans……
14
Bumrungrad International Hospital, BangkokBumrungrad International Hospital, Bangkok
15
Revenue BreakdownRevenue Breakdown
Inpatient vs. Outpatient (% of revenue) Method of Payment (% of revenue)
• Revenue contribution from outpatient continues as majority share following worldwide trends towards ambulatory care; BI Clinic well positioned for future growth.
• Corporate contracts increasing especially from foreign accounts; self-pay remains the primary method of payment.
46% 47% 49% 49% 51% 51%
49%54% 53% 51% 51% 49%
0%
25%
50%
75%
100%
2004 2005 2006 2007 2008 9M09
Inpatient Outpatient
As of Sept 2009
Self-pay72%
Corporate contracts
16%Insurance
12%
16
Volume Contribution by Nationality Revenue Contribution by Nationality
International PatientsInternational PatientsGrowth in International Patients • International patients remain a solid customer base; BH served
approximately 420,000 international patients in 2008
• Two main sources of international patients: - Domestic expatriate community - Foreign “medical tourists”
• Due to the generally high revenue intensity for international patients, foreign patients revenue expanded at a rate of 11% CAGR (5 years)
• Top growing countries are the Middle East and Mongolia, while the US is the most affected by the global economic meltdown & Thailand’s political situation.
1,253
1,557 1,6591,862
2,055
0
500
1,000
1,500
2,000
2,500
2004 2005 2006 2007 2008
OP
D R
even
ues
OPD
International Revenues
1,314
1,620 1,654
1,915 1,871
0
500
1,000
1,500
2,000
2,500
IPD
Rev
enue
s
IPD 13% CAGR9% CAGRNote: Revenues net of doctors’ fees
THB mn THB mn
36% 41% 41%
62% 59% 59% 59%
40%38% 41%
60%64%
0%
20%
40%
60%
80%
100%
2004 2005 2006 2007 2008 9M09
% o
f Vol
ume
International Thais
49% 54% 55%
47% 46% 45% 46%
55%54%53%
46%51%
0%
20%
40%
60%
80%
100%
2004 2005 2006 2007 2008 9M09
% o
f Rev
enue
International Thais
17
Inpatient Capacity - Open Beds
Capacity
649
Outpatient Visit Capacity per day
Bangkok Facility Expansion PlanBangkok Facility Expansion Plan
• Bumrungrad International Bangkok plans to expand and upgrade its facilities over the next 5 years
• The facilities will give a better overall hospital experience for the patients
Outpatient: 4,500 6,000 visits per dayInpatient: 500 650 beds
Renovation Expansion
• BI Hospital Building• BI Clinic Building
• BH Tower
+
540
486486486486486458
109
0
100
200
300
400
500
600
700
2009 2010E 2011E 2012E 2013E 2014E M ax
BH TowerBI Hospital Building
6,0006,0005,700 5,100
4,500 4,800
0
1,000
2,000
3,000
4,000
5,000
6,000
2009 2010E 2011E 2012E 2013E 2014E
Opening of BI Clinic: 17th Fl
Renovation of BI Hospital Building• Women’s Center• Digestive Disease Center
Opening of BI Clinic: 19th & 20th Fl
Opening of BI Clinic: 21st Fl
Opening of BI Clinic: 18th Fl
* BI Clinic Building was opened in mid-2008, resulting in increase in outpatient capacity from 3,500 visits per day to 4,500 visits per day
18
CAPEX Program CAPEX Program
0
500
1,000
1,500
2009A/E 2010E 2011E 2012E 2013E 2014E
Construction in ProgressEquipment & softwareBuilding and Construction
0
500
1,000
1,500
2009A/E 2010E* 2011E 2012E 2013E 2014E
BH TowerBI Hospital BuildingBI Clinic BuildingMaintenance
CAPEX allocated by project
905
1,130
937
1,161
896
CAPEX allocated by asset type
1,038
Bt million
Bt million
Total CAPEX for the capacity expansion and renovation over the next 5 years (2010-2014):
(Excluding Maintenance CAPEX)
- New BI Clinic Building Bt 335 million
- Existing BI Hospital Building Bt 604 million
- BH Tower Bt 660 million
Total Bt 1,599 million
905
1,130
937
1,161
8961,038
19
An All New Concept An All New Concept –– BI ClinicBI Clinic
Ground Floor Lobby
Sky Lobby
Ground Floor Lobby, Parking and 5 floors of clinic space of the new outpatient building are now open
Welcome Center
New Clinics
20
Complete Renovation Complete Renovation –– Existing Inpatient WardsExisting Inpatient Wards
• The rolling renovation of the inpatient wards of existing hospital building started in Feb 2008; and scheduled to be finished by Aug 2010
• As of Oct 09, 298 rooms have been renovated
The hospital room of the future – today!
21
Bumrungrad International Limited Bumrungrad International Limited
22
Bumrungrad International Limited Bumrungrad International Limited Capital InfoCapital Info
Total: THB 3,898 millionBBL
THB 422 million
Asia Renal CareTHB 2,590 million
(USD 75 million)
Remaining commitment by Bumrungrad International Limited’s shareholders is THB 450 million,Pro-rated by shareholding percentage (THB 142 million for BH)
Total: THB 3,898 million
BHTHB 1,008 million
IstithmarTHB 823 million
TemasekTHB 823 million
Asia Financial HoldingsTHB 823 million
Asian HospitalTHB 666 million(USD 20 million)
Bumrungrad Hospital Dubai, THB 94 million (USD 2.7 million)
Working CapitalTHB 548 million
Capital Injected InvestmentsNote: As of December 2008
23
Bumrungrad International Limited Bumrungrad International Limited Current PortfolioCurrent Portfolio
Asian Hospital, Inc. (“AHI”)
Other shareholders:Dr. Garcia 8.2%Insular Life 11.8%Filinvest 8.3%Others 15.3%
56.4%** Total percentage of ownership
Asia Renal Care Ltd.(“ARC”)
100%
Bumrungrad Al Mafraq Hospital, Abu Dhabi
Management Contract
Investments
Ownership
Partners Contractor:Health Authority of Abu Dhabi
Amount & Year invested (by Bumrungrad International Limited)
USD 75 million 2007 NA2007
USD 10 million 2005USD 10 million 2008
Business 346-bed private hospital Chain of dialysis clinics(105 clinics) 460-bed public hospital
-
To update
24
Asian Hospital, the Philippines (AHI) Asian Hospital, the Philippines (AHI)
• 2002: Opened as a 253-bed private hospital, one of the largest in the southern Luzon corridor of metropolitan Manila, the Philippines
• Feb 2005: Acquired by Bumrungrad International Limited
• Sept 2009:
− Bumrungrad International Limited’s shareholding in AHI increased from 43% to 56.4% from the conversion of management fees into equity and new capital injection
− Since the acquisition, the hospital has turned around and started to make profit in 2007
− With the hospital operating at almost its full capacity, AHI is undergoing an expansion plan over the next two years to increase the number beds to 346 beds
25
Asia Renal Care Limited (ARC) Asia Renal Care Limited (ARC)
• 1997: Established by reputable financial investors
• June 2007: Acquired 100% by Bumrungrad International Limited
• Sept 2009:
− Headquartered in Singapore and is the leading private provider of dialysis and related services in Asia
− Operates inpatient and free-standing outpatient dialysis clinics in 7 countries (Singapore, Malaysia, Philippines, Taiwan, South Korea, Japan and Thailand), providing regular treatment to approximately 5,600 patients
− Holds leading positions in most of the high growth markets it operates, with established platform to further expand into other suitable Asian and Middle Eastern markets
− Expanded into Thailand in Feb 09 by acquiring Nephromed Group, a chain of 14 dialysis clinics
− The management plans to aggressively expand the number of clinics over the next three years
No of Clinics
67
105
8277
4960
0
20
40
60
80
100
120
2004 2005 2006 2007 2008 'Sept 09
26
Bumrungrad Al Mafraq Hospital, Abu DhabiBumrungrad Al Mafraq Hospital, Abu Dhabi,, U.A.E. U.A.E.
• Management contract signed with the Health Authority of Abu Dhabi for 4 years, December 2007 - 2011
• In-patient capacity of 460 acute care beds, 28 intensive care and 14 special care baby unit beds
• Patient volume of ~310,000 patients, including more than 25,000 inpatients annually
• Simultaneously, a new modern hospital building will be constructed on an adjacent site starting this year that will replace the current facility by mid-2011
27
Bumrungrad International LimitedBumrungrad International Limited In SummaryIn Summary
Bumrungrad International Limited is profitable, with significant improvement in net profit from USD 1.5 million in 2007 to USD 5.5 million in 2008, as the three operating projects in the portfolio are profitable
- AHI has become profitable and is generating good internal cash flow
- ARC continues to be a stable source of profits
- Management fees from Bumrungrad Al Mafraq Hospital is also accretive
Expansion plans of the existing projects are now set
- Capacity expansion of AHI
- Acquisition of clinics by for ARC
Bumrungrad International Limited’s management continues to pursue additional investment opportunities in the region
28
20092009--2010 Strategy: 2010 Strategy: Growth from Insight, Intelligence and InnovationGrowth from Insight, Intelligence and Innovation
− The renovation and expansion of the Bangkok campus not only adds capacity, but also totally re-invents the way healthcare services are delivered
− New outpatient clinics are designed to be more “patient-centric”, serving the often different needs of Thai and international patients
− New inpatient “rooms of the future” incorporate the latest of the following:
+ Bedside medication administration technology
+ Total communication and entertainment
+ Environmental control
+ Patient safety & evidence based design
− The Result: Bumrungrad is back on top as Asia’s premier healthcare facility
1. New Patient Experience
29
− Bumrungrad’s 10 year investment in advanced IT has resulted in a clearly differentiated product, improved patient safety and efficiency resulting in some of the industry’s highest margins and ROA.
− As part of its commitment to best practices, Bumrungrad Hospital in Bangkok is the first in Asia to implement a robotic pharmacy dispensing system and automated laboratory system, which will be fully integrated with its IT system.
− With Microsoft as a strategic alliance partner, Bumrungrad will remain at the world-wide forefront of IT healthcare technology to the benefit of the patients and shareholders.
2. IT Innovation
20092009--2010 Strategy: 2010 Strategy: Growth from Insight, Intelligence and InnovationGrowth from Insight, Intelligence and Innovation
30
− Bumrungrad’s vision of the next generation of healthcare IT resulted in the 2007 sale to Microsoft of its software development company and the continued advantages of the strategic alliance.
− Long before others, Bumrungrad anticipated and exploited the “medical tourism” opportunity in1997 and is now at the vanguard of the next wave in medical travel: “The Global Care Option”
− Bumrungrad International Limited is leveraging Bumrungrad’s brand equity to attract world-class investment partners to invest in healthcare opportunities throughout Asia and the Middle East. All of Bumrungrad International Limited’s operating investments are profitable and growing.
3. Anticipating Long-Term Trends
20092009--2010 Strategy: 2010 Strategy: Growth from Insight, Intelligence and InnovationGrowth from Insight, Intelligence and Innovation