UBS Australian Healthcare Conference 201317 June 2013
Christopher Rex, Managing Director
• One of the largest & most successful private hospital operators in the world:
– Operating 117 hospitals & facilities across 4 countries
– 10,000 beds
– 30,000 staff
– Treating over 1 million patients per annum
– Extensive education & training, including Ramsay Training Institute, Graduate Employment & Future Leaders Programmes
• Revenue running at over $4 Billion
• Market capitalisation approx. $7.0 Billion
• Enterprise value approx. $8.0 Billion
RAMSAY HEALTH CARE – OVERVIEW
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3
CONSISTENTLY DELIVERING STRONG TOTAL SHAREHOLDER RETURNS (TSR)
31-May-133,201%
31-May-13251%
Ramsay Health Care Listed on ASX – 23 September 1997
Source: UBS
Compound Annual Rate of Growthover 15½ years
Ramsay Health Care TSR 25.0%
Vs.
S&P/ASX 100 Acc. Index 8.3%
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OPERATING REVENUE- Compound Annual Growth Rate (CAGR)
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
FY'98 FY'99 FY'00 FY'01 FY'02 FY'03 FY'04 FY'05 FY'06 FY'07 FY'08 FY'09 FY'10 FY'11 FY'12 FY'13
A$B
Operating Revenue CAGR, Operating Revenue
Es
tim
ate
CAGR of 23.2%
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CORE EPS - Compound Annual Growth Rate (CAGR)
0.00
20.00
40.00
60.00
80.00
100.00
120.00
FY'98 FY'99 FY'00 FY'01 FY'02 FY'03 FY'04 FY'05 FY'06 FY'07 FY'08 FY'09 FY'10 FY'11 FY'12
Ce
nts
pe
r S
ha
re
Core EPS CAGR, Core EPS
CAGR of 16.3%
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OUR FORMULA FOR SUCCESS
• Management and culture
– Long term, stable management team, special culture (“The Ramsay Way”)
– Ramsay can export proven management model and blend it with local expertise
• Modus operandi and strong growth strategy
– Ramsay’s growth strategy has remained clear and consistent
– Focused solely on operating & managing private hospitals
– Manage & invest for the long term
– Focus is on the provision of quality care – profits will follow
• Financially disciplined
– Growth only pursued if financial and strategic criteria and investment hurdles (15% ROIC) are satisfied
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STRONG GROWTH STRATEGY
OrganicBrownfield Capacity
Expansion
Public/Private Collaborations
AcquisitionsCreation of
Shareholder Value
� Underpinned by demographics, quality portfolio of hospitals, ongoingbusiness improvement
� Unmet demand driving Ramsay’s ongoinginvestment in capacity expansion
� Potential for more partnerships to develop/manage/provide hospital services in changing political and demographic landscape
� Exploring further acquisitions in existing and other markets
� Ramsay has proven it can export its management model
� Must add long-term value to shareholders
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Sustainable growth enhanced by focusing on hospitals and taking a prudent approach to acquisitions
+ + +
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RAMSAY HEALTH CARE IN 2013
• Solid performance across worldwide portfolio
• Completed projects to meet the growing demand in the ongoing brownfield capacity expansion programme (investing >$100m pa)
• Recently entered a JV with Malaysian conglomerate Sime Darby to expand healthcare footprint into SE Asia
• Acquisition of Peel Health Campus in WA – a privatised public hospital – 31 May 2013 completion
• Acquisition of Clinique de l’Union Toulouse, France – 8 June 2013 completion
• Selected in 2013 in the Global100 as one of the Most Sustainable Corporations in the World for the second year in a row
GEOGRAPHICAL SEGMENTS
77%
3%
13%
7%
Operating Revenue
Australia
Asia *
United Kindom
France
72%
3%
18%
7%
EBITDAR
Australia
Asia *
United Kingdom
France
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� Strong Australian business is the largest contributor to earnings and cash flow
* Asia shows Ramsay’s 50% share of the expected Ramsay Sime Darby joint venture Revenue and EBITDAR.
This will however be equity accounted in the Ramsay Group Statutory accounts
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Sime Darby Asian JV
Peel Health Campus
Clinique de l’Union
Joint venture agreement with Sime Darby announced on 26 March 2013, completion expected on 1 July 2013
FURTHER EXPANSION OF FOOTPRINT IN ASIA - JV WITH SIME DARBY
Joint Venture Company
Ramsay Sime Darby Health Care
Ramsay Health Care
3 Indonesian Hospitals
Sime Darby Healthcare
3 Malaysian Hospitals
Nursing & Health Science College
Ramsay Health Care
50%
Sime Darby 50%
� JV enterprise value of approx. A$500 million
� Pro forma FY 2012 revenue of approx. A$175 million
� Ramsay to pay ‘true up’ payment of approx. A$120 million to achieve 50% ownership
SDMC Subang Jaya
SDMC Ara Damansara
SDMC Park City
RS Premier Jatinegara
RS Premier Bintaro
RS Premier Surabaya
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EXPANSION INTO ASIA - STRATEGIC RATIONALE
• First major step into Asia since acquiring Indonesian hospitals in 2005
• Aim of the joint venture will be to build a quality portfolio of hospitals throughout Asia
• 600 million people in ASEAN with rising middle class demanding quality healthcare
• Leverages off Ramsay’s management expertise & SimeDarby’s Asian networks
• Opportunities for value creation via key synergies such as procurement; medical tourism and productivity benchmarking
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PEEL HEALTH CAMPUS WA
Peel Health Campus in South Perth, WA:
− 152 bed public hospital
− Located 70km south of Perth
− Offers medical, surgical, maternity and rehabilitation services
− Over 40,000 emergency presentations per annum
− EPS neutral in FY 2014 and mildly accretive thereafter
− Opportunity to further develop site
− Fits with Ramsay’s broader strategy of seeking public/private collaborations
− 31 May 2013 completion
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CLINIQUE DE L’UNION, FRANCE
Clinique de l’Union Toulouse, France:
− Acquisition of approx. 90% of the operating business
− 8 June 2013 completion
− Property to be acquired by ICADE Santé
− A leading 531 bed medical, surgical, obstetric hospital
− 43,000 inpatients and 26,000 emergency presentations pa
− Gross revenue circa €65 million
− Mildly EPS accretive in FY 2014
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Industry Fundamentals
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STRONG INDUSTRY FUNDAMENTALS- GLOBAL
Growth in demand for health care will continue to be supported by:
• Ageing population
• Increased chronic disease burden
• Increased expectations
• Increased capabilities:
– Surgical techniques
– Devices
– Pharmacology
– Biotechnology
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• By 2050, the number of people aged 65+ will total just under 1.5 billion, or 16% of the global total. In 1950, it was only 5%. (UN 2009).
• This ageing population is without parallel in the history of humanity.
AN AGEING WORLD
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GLOBAL MARKET TRENDS IN HEALTHCARE
• Governments around the world are increasingly concerned about the rising costs of health care
• Patients demanding and willing to pay for higher quality health care
• Increasing GDP and affordability driving growth for private operators
• Significant growth in health care spend expected in emerging markets
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STRONG INDUSTRY FUNDAMENTALS
• Balanced health care system
– Cultural
– Political
– Financial
• Industry features
– Respected private providers
– Choice & access
– Low cost attractive insurance product
– Comprehensive cover
– Community rated
– 30% rebate
– Lifetime health cove
UNDERPINS ONGOING STRONG PARTICIPATION IN PRIVATE HEALTH
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THE ROLE OF THE PRIVATE SECTOR IN AUSTRALIA
• Treat 43% of all hospital patients (3.6 million);
• Provide 33% of all hospital beds;
• Perform 66% of all elective surgery;
• Of the 664 Diagnostic Related Groups undertaken in Australian public hospitals, 660 are performed in private hospitals;
• Growth in separations – last 10 years:
– 23.1% in public acute hospitals;
– 66.9% in private hospital;
• If current rates of growth continue, in 2021 private hospitals will be treating 50% of all hospital patients
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THE ROLE OF THE PRIVATE SECTOR IN PUBLIC HEALTHCARE
• In Australia, State governments are looking more to the private sector to build, own and operate public hospitals (eg Qld Health
Blueprint)
• State Governments are procuring more input from private sector in planning, building & operating public hospitals eg Joondalup; Midlands; Sunshine Coast & Northern Beaches
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• Joondalup Health Campus
– 650 bed public/private hospital
– $393m expansion completed in March 2013
– Largest hospital in Perth’s northern corridor
– Agreement with WA government
– Treated public & private patients since 1996
– In 2012 – 90,000 Emergency Department presentations (one of busiest in the country); 60,000 admissions
SUCCESSFUL PUBLIC/PRIVATE COLLABORATIONS
• Sunshine Coast University Private Hospital
– Public/Private 200 bed hospital being built in partnership with Queensland health
– 5 year contract to treat public patients
– Opening in late 2013
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SUMMARY OF MARKET DYNAMICS
• Ageing demographic & growing disease burden - leading to increased demand for healthcare
• Rising costs - leading governments across the globe to consider healthcare reform
• Private sector offers efficient & effective models of healthcare delivery
• An expansion of the traditional private sector role by way of involvement in public healthcare delivery is inevitable
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OUTLOOK
• Positive market dynamics indicate strong upside for Ramsay
• Growing and ageing population will continue to drive our investment in capacity expansion
• Remain positive about opportunities overseas including emerging markets and the opportunity to apply our proven health care management expertise in these markets
• Continue to investigate acquisition opportunities in existing markets in both the private and public sectors
• Given strong industry fundamentals and continuing implementation of our successful growth strategy and barring unforeseen circumstances, Ramsay reaffirms FY 2013 upgraded guidance for Core NPAT and Core EPS growth for the Group to 13% - 15%
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QUESTIONS
UBS Healthcare Conference June 2013