Inv Presentation Nov 09 - listed companybh.listedcompany.com/misc/PRESN/20091118-BH-investorPR... · 2009-11-18 · ÖBumrungrad Al Mafraq Hospital, a public hospital in Abu Dhabi

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


Ms. Karen CarterCOO


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


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


Inv Presentation Nov 09 - listed companybh.listedcompany.com/misc/PRESN/20091118-BH-investorPR... · 2009-11-18 · ÖBumrungrad Al Mafraq Hospital, a public hospital in Abu Dhabi

Documents