Jefferies Healthcare Conference. June 2016

Transcription

1 Jefferies Healthcare Conference June 2016

2 Today s Speakers John Figueroa Chief Executive Officer Vic Breed Chief Financial Officer Joined Genoa in July 2014 Previously served the dual roles of CEO of Apria Healthcare Group Inc. and Coram LLC, as well as CEO and Director of Omnicare, and earlier served as President of McKesson Corporation s US Pharmaceutical Group. Joined Genoa in October 2006 Previously the EVP of Finance and Operations for medical device company, ClearMedical, Inc., as well as Senior VP for Solucient, LLC and earlier served as the COO and CFO for HBS International.

3 Agenda Genoa Overview Mental Health Market Who we are and who we serve Financial Overview

4 Advent Sponsor Overview One of the largest and most experienced global private equity firms $29 billion in assets under management as of December 2015, across developed and emerging markets Discrete sector focus across five global sector teams, including Business & Financial Services; Healthcare; Industrial; Retail, Consumer & Leisure; and Technology, Media & Telecom Advent recapitalized Genoa, a QoL Healthcare Company on April 30, 2015 Nautic Partners remains minority investor

5 General Overview Largest Nationwide Provider of Mental Health Pharmacy Services Founded in 2000 and headquartered in Seattle, Washington 300+ pharmacies and telepsychiatry services across 41 states and DC We serve approximately 500,000 patients annually Fully integrated inside Community Mental Health Centers (CMHCs) In 2015, we opened 41 new pharmacies and completed 9 pharmacy acquisitions Reached over 8.5M scripts and $900M Revenue in 2015 In addition, we acquired 1DocWay creating Genoa Telepsychiatry In 2016 we are on track to exceed 10M scripts and Revenue of +$1B

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7 Business Overview Genoa is the largest pharmacy and telepsychiatry operator in the United States specialized in serving the needs of the behavioral health community Manages complex and chronic mental illnesses through high touch patient pharmaceutical care and remote psychiatry Primary care medications are integrated into our pharmacy care model Personalized and outcomes driven care produces 90% medication adherence rates and reductions of hospitalizations (40%) and emergency room visits (12%) Fully integrated inside Community Mental Health Centers (CMHCs) The majority of Genoa consumers are individuals who suffer from one or more disabling serious mental conditions and are insured through government programs such as Medicaid and Medicare. The majority of those with Medicare coverage are also dual-eligible. (1)

8 National Quality of Care Concerns More than half of Medicaid beneficiaries with disabilities have a behavioral health disorder 80 percent of beneficiaries with schizophrenia or bipolar disorder received psychiatric medications during the year, but only about half maintained a continuous supply of those medications Mathematica Policy Research - Improving the Quality of Behavioral Health Care for Medicaid Beneficiaries, May 2015

9 Market Overview Mental Health 1:4 adults, or ~61.5m Americans, experiences mental illness in any given year (1) 1:17 adults, or ~13.6m Americans, lives with a serious mental illness (1) In 2014, there were nearly 119 medicines in development to treat mental illness, including 36 for schizophrenia (2) In 2013, 29.5 million adults used prescription drugs for mental health treatment and a mental health patient is dispensed on average 48 prescriptions a year, compared to the total population average of 12 per year Market-wide shift towards outpatient care driven by: Emphasis on lowering cost Move towards a recovery based care model Percentage of Adults with Past Year Serious Mental Illness who Used Various Services Prescription Medicine, 62% Outpatient Services, 47% In 2015, US medicine spend for the mental health market was $21 Billion. Total spend was $425 billion. (3) Inpatient Services, 8% (1) The National Alliance on Mental Illness Fact Sheet. (2) Medicines in Development, Mental Illnesses 2014 Report presented by America s Biopharmaceutical Research Companies. (3) IMS Institute for Healthcare Informatics, Medicine Use and Spending in the US, April 2016

10 Favorable Legislative Environment Mental Health Parity Legislation The Mental Health Parity and Addiction Equity Act of 2008 provides for equal coverage between psychiatric or mental health services and physical medical health services (1) Several states have adopted parity laws requiring private insurance policies to have the same deductibles, number of office visits, inpatient visits and co-payments for mental health disorders as for other illnesses Patient Protection and Affordable Care Act Enables most people who were uninsured to get insurance through an insurance exchange, resulting in healthcare coverage for over 90% of Americans (1) Significantly expands options for affordable coverage through Medicaid expansion Healthcare Reform will Spur Revenues Reform to provide more Americans with insurance and brings mental health and substance abuse coverage on par with that of medical and surgical services Healthcare exchanges are subject to the Federal Mental Health Parity Law resulting in more individuals having comparable coverage for mental health (1) IBISWorld report Mental Health & Substance Abuse Centers in the US, May 2011.

11 Genoa s Growth Trajectory The July 2014 merger of two great companies created In November 2015, acquired 1DocWay creating with 216 locations In Aug 2000, the first Pharmacy for Qol Meds opened in Pittsburg, PA In Nov 2002, the first Pharmacy for Genoa Healthcare opened in Oregon City, OR was a major year of growth and acquisitions. We acquired 1DocWay in the telehealth space, acquired 9 pharmacies and opened 41 new locations.

12 Leading Geographic Footprint Genoa currently provides pharmacy and telepsychiatry services in 41 states and the District of Columbia -- 6 th largest US Drug Store Chain by store count

13 Where we stack up in the Pharmacy Rankings US Pharmacy Chains 2015 Sales ($M) 1 Walgreens 53, CVS Health 47, Walmart 23, Rite Aid 18, Kroger 9, Health Mart 8, Target 5, Albertsons/Safeway 4, Diplomat Pharmacy 2, Ahold USE 2, Costco 1, Medicine Shoppe 1, Publix Super Markets 1, H-E-B 1, Kmart/Sears Holdings 1, Southeastern Grocers 1, Hy-Vee We are among the Top 20 Retail Pharmacies according to the Chain Drug Review as of Aug Genoa, a QoL Healthcare Company Giant Eagle Fred's 825.5

14 Who we Serve: Consumers with Complex Behavioral Healthcare Needs Our high touch model is designed to provide services based on individual needs across the Care Continuum Most Severe Severe Moderately Severe Outpatient Hospital Residential Case Management, CSS Psychiatry and Medication Management Residential Key Pharmacy and Telepsychiatry Services: emars, blister card packaging, delivery, med carts, consulting, Pyxis 24/7 ER Psychiatry Triage Telemedicine Services Intensive Case Management ACT/PACT/FACT Community Support Services (CSS) Key services: Adherence packaging, prior authorization, delivery, data, online profile access Higher ratio of staff to consumers Services vary greatly on need Key Services: Prior authorization, refill synchronization, adherence packaging, delivery, data Key Services: Prior authorization, data, mail/delivery, convenience refill synchronization, call center, reminder calls Telepsychiatry to reduce wait times more independence

15 Services provided by Genoa s On-Site Pharmacy Genoa provides specialized services Full-service pharmacy, fill all medications - Increased communication with program staff - Clozapine Monitoring / Phlebotomy Services - Specialized and Synchronized Packaging (Convenient Adherence Packaging) - Prior Authorizations Assistance - Online access to consumer pharmaceutical records - Proprietary medication adherence analytics - Medication Profiles / Drug Utilization - Refill Management - Reminder calls / Synchronization / Medication Adherence - Delivery / Mail Options - 24 Hour On-Call Services - Assistance with Insurance Plans, including Medicare D Medication Administration Records MARs/eMARs Patient Assistance Program (PAP) assistance Billing Assistance Medication Counseling

16 Improving access to care Outpatient telepsychiatry provider that offers a simple, easy-to-use platform to connect mental health providers and patients. Over 4,000 shortfall of Mental Health Professionals Innovative solution for the unique needs of the behavioral health community Acceptable, effective, and accessible to our partners to deliver quality mental healthcare High demand from current clinic partners

17 Medication Adherence Genoa far exceeds retail pharmacy adherence averages A recent study conducted by the RAND Corporation found that average adherence rates for retail pharmacies is 50% (Predmore, Mattke, and Horvitz-Lennon, 2015). According to the study described on the following slide, 50% adherence translates to a 18.5% re-hospitalization rate. Genoa s average MPR is 90%, which according to this study translates to a re-hospitalization rate of 8.3%. In this example, this improvement correlates to $1.7 million** in savings per 1,000 clients served at a Genoa pharmacy versus retail pharmacy. *Assumes $16,416 per hospitalization per 2012 data from Healthcare Cost & Utilization Project, US Dept Health & Human Services

18 Historical Sales Growth Proven track record of growth and operational efficiency Revenue ($Millions) ~[VALUE] P

19 Historical FCF Growth Proven track record of growth and strong Free Cash Flow Conversion 95% 97% 97% 95% 90% 88% 86% P Low capital expenditure requirements Free Cash Flow FCF Conversion