Apollo Medical Holdings Investor Presentation Deck

Made public by

Apollo Medical Holdings

sourced by PitchSend

1 of 27

Creator

apollo-medical-holdings

Category

Healthcare

Published

October 2022

Slides

Transcriptions

#15 apollomed Apollo Medical Holdings October 2022 Powered by Technology. Built by Doctors. For Patients. CC C#2Forward-looking statements This presentation contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act and Section 21E of the Exchange Act. Forward-looking statements include any statements about the Company's business, financial condition, operating results, plans, objectives, expectations and intentions, expansion plans, integration of acquired companies and any projections of earnings, revenue, EBITDA, Adjusted EBITDA or other financial items, such as the Company's projected capitation and future liquidity, and may be identified by the use of forward-looking terms such as "anticipate," "could," "can," "may," "might," "potential," "predict," "should," "estimate," "expect," "project," "believe," "plan," "envision," "intend," "continue," "target," "seek," "will," "would," and the negative of such terms, other variations on such terms or other similar or comparable words, phrases or terminology. Forward-looking statements reflect current views with respect to future events and financial performance and therefore cannot be guaranteed. Such statements are based on the current expectations and certain assumptions of the Company's management, and some or all of such expectations and assumptions may not materialize or may vary significantly from actual results. Actual results may also vary materially from forward-looking statements due to risks, uncertainties and other factors, known and unknown, including the risk factors described from time to time in the Company's reports to the U.S. Securities and Exchange Commission (the "SEC"), including without limitation the risk factors discussed in the Company's Annual Report on Form 10-K for the year ended December 31, 2021, and subsequent Quarterly Reports on Form 10-Q. Because the factors referred to above could cause actual results or outcomes to differ materially from those expressed or implied in any forward-looking statements, you should not place undue reliance on any such forward-looking statements. Any forward-looking statements speak only as of the date of this presentation and, unless legally required, the Company does not undertake any obligation to update any forward-looking statement, as a result of new information, future events or otherwise. apollomed 2#3Key acronyms 0 O 0 0 0 ACO: Accountable Care Organization ACO REACH: Accountable Care Organization Realizing Equity, Access, and Community Health AIPBP: All-Inclusive Population-Based Payments APC: Allied Physicians of California IPA CMMI: Centers for Medicare and Medicaid Innovation Center CMS: Centers for Medicare & Medicaid Services DC: Direct Contracting DCE: Direct Contracting Entity DME: Durable Medical Equipment Health Plan / Payers: Health Insurance Companies HMO: Health Maintenance Organization IPA: Independent Practice Association. NCI: Non-Controlling Interest apollomed 0 0 0 NMM: Network Medical Management, Inc. MSA: Master Service Agreement MSO: Management Services Organization NGACO: Next Generation Accountable Care Organization PCP: Primary Care Physician PMPM: Per Member Per Month SNF: Skilled Nursing Facility VIE: Variable Interest Entity 3#4ApolloMed investment highlights Ⓒ Mi 01 apollomed 1. 2. Large and growing TAM with significant whitespace ahead across market segments (see slide 10) Proven model for 25+ years with demonstrable clinical outcomes across all populations MA, Managed Medicaid, Commercial, ACA Exchange, Medicare FFS, etc. Focus on aligning with and helping independent providers win 3. Help them achieve the same scale and outcomes as an integrated delivery system • Unlocks differentiated independent provider market 5. 4. Proprietary technology platform with data moat, custom built for providers Multiple drivers for growth with a scalable and repeatable playbook led by differentiated leadership team Industry-leading unit economics - growing revenue at 38% YoY(1) profitably while maintaining positive EBITDA margins (1) ApolloMed YE2021 to mid-point of YE2022E revenue growth 6. 4#5ApolloMed at-a-glance Apollo Medical Holdings ("ApolloMed") is a leading physician-centric, technology- powered, risk-bearing healthcare company Our end-to-end technology solutions enable providers to succeed in value-based care arrangements where they "quarterback" patient care to deliver better outcomes We manage over 1.2M lives through a network of 14 IPAs and 9,800+ contracted physicians, working with 20+ payer partners We have a 25+ year track record of profitable growth in our core geographic areas and a comprehensive strategy to grow nationally 1.2M+ Managed lives 9,800+ Contracted physicians 66%(1) Fewer hospital admits per 1,000 vs. benchmark $186M(2,3) TTM adj. EBITDA 20+ Payer partners 71% (¹1) Fewer ER visits per 1,000 vs. benchmark $955M(3) TTM revenue 10-15% Long-term EBITDA margin Source: CMS, Chronic Conditions Data Warehouse (CCW), competitors' IR, and internal figures. Internal figures for capitated MA patients Note: Information as of 12/31/2021 unless otherwise noted; competitor and national information provided is 2019 data unless otherwise noted (1) Internal Medicare patient data from consolidated IPAs from Jan 2021 - Sept 2021; (2) See "Reconciliation of Net Income to EBITDA and Adjusted EBITDA" and "Use of Non-GAAP Financial Measures" slides for more information: (3) TTM as of 6/30/2022 apollomed 5#6A growing national footprint addressing the needs of a diverse set of patients Revenue Breakdown by Member Population 1H 2022 (% of Total Revenue) Geographic Footprint Served by ApolloMed IPAs and medical groups Served by ApolloMed's APA ACO Planned expansion apollomed 16% 27% I Medicare 5% 52% Medicaid Commercial ■ Other Third Parties 6#7ApolloMed is a scaled player with a proven and profitable model Business Model (1) Members Served Serves All Patient Types(1,8) Market Capitalization (⁹) 2022E Revenue (10) 2022E Adj. EBITDA (10) apollomed Affiliate- provider model 1.2M $2.1B $1,055M- $1,085M(11) $136M- $166M(12) PRIVIA. HEALTH Affiliate- provider model 856k(2) $5.1B $1,262.5M(2) $58.5M(2) agilon health Affiliate- provider model 352k(3) x $8.7B $2,625M(3) $5M (3) CanoHealth P3 Staff / Clinic Model 282k(4) $2.9B $2,875M(4) $200M(4) Health Partners Affiliate- provider model 67k(5) x $1.2B $975M (5) ($85.5M) (5) OAK STREET HEALTH Staff / Clinic Model 134k(6) X $6.0B $2.135M(6) ($307.5M)(6) + one medical Staff / Clinic Model 790k(7) X $3.4B N/A(7) N/A(7) (1) Based on recent company filings or investor presentations; (2) Privia Health Q2 2022 Earnings Release (Aug 2022); (3) agilon health Q2 2022 Earnings Release (Aug 2022): (4) Cano Health Q2 2022 Earnings Release (Aug 2022); (5) P3 Health Partners Preliminary Q4-YE 2021 Press Release (March 2022); (6) Oak Street Health Q2 2022 Earnings Release (Aug 2022): (7) One Medical Q2 2022 Earnings Release (Aug 2022); (8) Patient types include Medicare (incl. Medicare Advantage), Medicaid, and Commercial members; (9) Diluted shares outstanding as of Q2 2022 10-Qs, stock prices as of 8/23/22; (10) Peer 2022E Revenue and Adj. EBITDA based on midpoint of Company provided guidance; (11) ApolloMed 2022E Revenue as reported its Q2 2022 earnings release; (12) Please refer to the "2022 Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA" and "Use of Non-GAAP Financial Measures" slides for more information Capollomed 7#8Industry overview apollomed#9The U.S. healthcare landscape is rapidly moving towards value-based care... Fee-for-service Lack of incentives to improve chronic health conditions Driving a trend of rapidly increasing medical costs Rising patient dissatisfaction with provider relationship and quality of care Value-based care apollomed S ET Providers incentivized to improve general health of patients Compensation models in place to lower the overall cost of care Patients with better access and better care experience CMS, COVID-19, payer contracting, and focus on quality while lowering total cost are driving shift in healthcare Fee-for-service Value-based care C#10... Leading to a significant and growing market opportunity Source: CMS and HCP-LAN (2021) apollomed $920B+ $700B+ $340B+ ~$2T apollomed Managed Medicare Commercial • Medicaid Total TAM 10#11However, the current healthcare system makes it very difficult to succeed ELL IT PR ? Labs |+!!!! Credentials do Quality ? Hospitals Diagnostics + ? ? Clinics Capollomed Coding 07 Ua Provider Group Do Do Referrals Claims Billing 學學 B Data Aggregation Authorization Clearinghouse Contracting 500G Reporting United Healthcare aetna Anthem. BlueCross Humana Cigna CENTENE Corporation Medicare Medicaid HEE Many More Payers#12Platform overview apollomed#13ApolloMed acts as a "single payer" by taking on risk-based contracts, connecting health ecosystem participants, and holistically supporting the care process aetna Contracting United Healthcare 20+ total payers Claims Quality Processing Programs 14 IPAS 308 >9,800 providers apollomed Anthem. BlueCross 00 000 (a) m Utilization & Care Population Management Health Capitated Payments Urgent Care apollomed 30 090 Clinical Programs 88 $ Reimbursement, Capitation, Shared Savings Hospitals COVERED CALIFORNIA Data Revenue Ops Analytics & Aggregation Cycle Automation Reporting Clinics Medicare Multiple population types IM Diagnostics Medicaid Q Point of Care Support + Labs Payer Tools 13#14The ApolloMed ecosystem, powered by proprietary technology, connects patients, providers, and payers Patient Provider Care Plans Transition of Care Clinic Setting EHR(¹) 1 010110 010 001 101101 010/ 808 Data Point of Care Application ApolloMed Payer Tools Eligibility & Benefits Prior Authorization Claims Adjudication Communications 100% automated 70% automated ApolloMed Care Team P CM/DM, PAC, SDOH, etc. (3) 90% automated Preventive Care Alerts & Analytics Care Management Other Clinical Inputs Diagnostics RPM Notes Care Mgmt / Workflow Tools Lab Results Survey Results ADT(2) Alerts ApolloMed Engine & Data Lake Technological expertise + Clinical experience Operational excellence Patient Management/RPM/Real-Time Clinical Al (1) EHR: Electronic Health Record; (2) Admission, Discharge, and Transfer; (3) CM: Care Management, DM: Data Management, PAC: Post Acute Care, SDOH: Social Determinants of Health apollomed 14#15Our proprietary point-of-care application is EHR-agnostic, enabling seamless transitions through our ecosystem and best-in-class care ApolloMed Payer Tools + Patient Provider Care Plans Transition of Care Clinic Setting 1ºh EHR(¹) 010110 molo OMOOI 101101 81808 Data Point of Care Application Eligibility & Benefits Prior Authorization Claims Adjudication Communications automated ApolloMed Care Team B CM/DM, PAC, SDOH, etc.(3) 70% automated 90% automated Preventive Care Alerts & Analytics Care Management Other Clinical Inputs Diagnostics RPM Notes Care Mgmt / Workflow Tools Lab Results Survey Results ADT Alerts ApolloMed Engine & Data Lake Overview ApolloMed providers use our point of care software before, during, and after patient encounters The software is EHR-agnostic and contains analytics for chronic conditions, quality measures, and other care information Providers can also use the software to check patients' eligibility and benefits, request referrals or authorizations, and submit claims Patient Management/RPM/Real-Time Clinical Al (1) EHR: Electronic Health Record; (2) Admission, Discharge, and Transfer; (3) CM: Care Management, DM: Data Management, PAC: Post Acute Care, SDOH: Social Determinants of Health apollomed 15#16Automated payer tools reduce administrative burden for physicians and create operational efficiencies Patient Provider I T Care Plans Transition of Care Clinic Setting 1ºh EHR(¹) I Data Point of Care Application ApolloMed Payer Tools Eligibility & Benefits Prior Authorization Claims Adjudication 100% automated Communications ApolloMed Care Team B CM/DM, PAC, SDOH, etc.(3) 70% automated 90% automated Preventive Care Alerts & Analytics Care Management Other Clinical Inputs Diagnostics RPM Notes Care Mgmt / Workflow Tools Lab Results Survey Results ADT Alerts ApolloMed Engine & Data Lake Overview To date, we have auto- approved more than 1M prior authorization requests and auto-adjudicated more than 9M claims, which would cost -$16M in labor at market rates Automated prior authorization allows patients to get access to care more quickly and more easily, and allows our UM team to focus on more complex cases Automated claims processing helps our providers be paid more quickly and more accurately Patient Management/RPM/Real-Time Clinical Al (1) EHR: Electronic Health Record; (2) Admission, Discharge, and Transfer; (3) CM: Care Management, DM: Data Management, PAC: Post Acute Care, SDOH: Social Determinants of Health apollomed 16#17Our backend engine and data lake power our provider solutions, allowing for workflow automation and data ingestion from dozens of sources ApolloMed Payer Tools Other Clinical Inputs Patient Provider I T Care Plans Transition of Care Clinic Setting 1gh EHR(¹) I 00 1808 Data 101 Point of Care Application Eligibility & Benefits Prior Authorization Claims Adjudication Communications automated ApolloMed Care Team B CM/DM, PAC, SDOH, etc.(3) 70% automated 90% automated Preventive Care Alerts & Analytics Care Management Diagnostics RPM Notes Care Mgmt/ Workflow Tools Lab Results Survey Results ADT(2) Alerts ApolloMed Engine & Data Lake Overview Our backend engines ingest data from our proprietary applications, all major EHRS, 20+ different payers, our care teams, and clinical partners From there, the data can be accessed for reports and population health analytics, which are fed back into our apps We also proactively generate data-driven preventive alerts for care teams to act on Patient Management/RPM/Real-Time Clinical Al (1) EHR: Electronic Health Record; (2) Admission, Discharge, and Transfer; (3) CM: Care Management, DM: Data Management, PAC: Post Acute Care, SDOH: Social Determinants of Health apollomed 17#18Our care teams act on the uncovered insights, enabling patients to receive seamless and complete care throughout their healthcare journey ApolloMed Payer Tools Patient Provider Care Plans Transition of Care Clinic Setting 191 EHR(¹) I 00 1808 Data 101 Point of Care Eligibility & Benefits Prior Authorization Claims Adjudication Communications automated ApolloMed Care Team R CM/DM, PAC, SDOH, etc.(3) 70% automated 90% automated Preventive Care Alerts & Analytics Care Management Other Clinical Inputs Diagnostics RPM Notes Care Mgmt/ Workflow Tools Lab Results Survey Results ADT Alerts ApolloMed Engine & Data Lake Overview ApolloMed's care teams include inpatient & ambulatory care mgmt. teams, nurses, social workers, and translators. Empowered with workflow tools that surface insights from our data engines, our teams create care plans, ensure smooth transitions, help manage chronic disease, and close gaps in preventive care RPM and real-time clinical Al utilizing advanced risk- stratification allow ApolloMed providers to receive an additional layer of actionable insights and continue delivering high-quality care to their patients, tailored to their membership populations Patient Management/RPM/Real-Time Clinical Al (1) EHR: Electronic Health Record: (2) Admission, Discharge, and Transfer; (3) CM: Care Management, DM: Data Management, PAC: Post Acute Care, SDOH: Social Determinants of Health apollomed 18#19ApolloMed's large provider network and proprietary tech platform drive a virtuous cycle, powering growth and improving patient outcomes Providers drive member growth Providers succeed in value-based arrangements with ApolloMed apollomed incentives aligned join ApolloMed More providers vider-patient-ApolloMed Membership expands data moat Better tech drives tter outcomes Better outcomes increase value-based incentive payouts and decrease utilization. Machine learning models improve with more data 19#20Our value-based care platform aligns incentives and benefits for all stakeholders 0 • ☐ Providers Over $50 million paid to providers in value-based bonuses 86% of providers in newly acquired IPA use the ApolloMed point-of-care app within 1 year of acquisition (1) >95% provider retention (2) Payers New members from partnering with aligned physician groups Aligned incentives lead to predictable margins and upside via savings 20+ contracted payers Average 15-year tenure with key payers <16% total net revenue from any one payer (5) apollomed T 71% fewer ER visits (3) Patients 71% fewer bed days in hospital (3) 97% overall satisfaction (4) "I deeply appreciate your great health coaches... been living with diabetes for 20 years... My blood sugar level was -240 two months ago...has dropped to 88- 150. Thank you so much!" - Medicare Patient Communities 300,000+ member outreach calls and surveys completed since 2019 to improve engagement and patient experience 35,000+ patient visits to wellness center classes and/or seminars since 2018 99% of seniors would recommend the wellness center to a friend (6) (1) Active providers in AlphaCare; (2) Retention rate of active providers in core IPAS under retirement age (65); (3) Compared to 2019 CMS Medicare benchmarks: (4) For members surveyed in 2021, n-8191; (5) For Q1- Q4 2021; (6) Of members surveyed since 2020 Capollomed 20#21Clinical and financial outcomes apollomed#22Provider groups consistently demonstrate improvement in patient engagement after joining ApolloMed Annual Wellness Visit Rate 45% IPA 1 2018 70% 76% 2019 20% (1) The American Journal of Accountable Care, September 2021 Capollomed IPA 2 2018 41% 2019 48% 2% 2020 IPA 3 2018 8% 2020 Average National AWV Rate (24%)(1) We have been able to significantly improve our annual wellness visit (AWV) completion across diverse IPAs through our tech-enabled ecosystem that enables our care team to proactively engage our patients through the most effective medium 74% 2019 0% 2020 2019 IPA 4 34% 52% 2020 2021 22#23As we expand geographically, culturally competent care has helped us deliver clinical improvements among diverse Medicare and Medicaid populations ER visits / 1K Medicare Advantage patients 5% fewer 532 505 IPA 1 174 17% fewer 597 Year 1 498 IPA 2 174 Year 2 ER visits / 1K Managed Medicaid patients 37% fewer 423 266 IPA 1 210 ApolloMed Mature IPA 16% fewer 453 380 IPA 2 210 IPA 1 Members by Ethnicity 1% 16% 17% 24% 42% IPA 1 Hispanic / Latino Source: Internal data and analysis (1) AAPI includes Amerasian, Asian Indian, Asian/Pacific Islander, Cambodian, Chinese, Filipino, Hawaiian, Japanese, Korean, Laotian, Samoan, and Vietnamese Capollomed AAPI(1) IPA 2 Members by Ethnicity Black/African American 16% 7% 6% 71% IPA 2 White Other 23#24Overall, ApolloMed IPAs show superior clinical outcomes Medicare Advantage inpatient statistics comparison Hospital admits per 1,000 ER visits per 1,000 274 66% fewer 197 93 500 71% fewer 465 143 Average length of stay(1) 5.8 14% shorter 5.0 Benchmark Inpatient bed days per 1,000(1) 71% fewer Benchmark Competitor Benchmark Competitor Source: CMS, Chronic Conditions Data Warehouse (CCW), AHRQ, competitors' IR, and internal figures for capitated MA patients from Jan 2021-Sept 2021; competitor and national information provided is 2019 data unless otherwise noted (1) Competitor did not provide metrics for average length of stay, inpatient bed days per 1,000, or readmission rates (2) Risk Adjustment Factor score apollomed 1,594 Benchmark 462 National RAF(2) Avg. 1.00 Readmission rate (1) 17% 29% lower Benchmark 12% ApolloMed RAF(2) '18-¹21 0.90-1.05 24#25ApolloMed's model and platform work for both managed care and FFS populations, helping move FFS care into a value-based care framework $350,000 $300,000 $250,000 $200,000 $150,000 $100,000 $50,000 $0 Medicare FFS ER Expense per 1,000 Patients Q1 2019 Q2 2019 47% lower Q3 2019 Q4 2019 Q1 2020 Q2 2020 ER spend down 47% in two years Q3 2020 (1) Agency for Health Research and Quality, 2021; (2) 2021 Medicare FFS Readmit Rate from 1Q21-3021 apollomed Q4 2020 18% 16% 14% 12% 10% 8% 4% 2% 0% 13% 2019 Medicare FFS Readmit Rate 13% 12% (2) 2020 2021 Average National Readmit Rate (1) (17%) 29% lower than the nationwide average for Medicare patients 25

Download to PowerPoint

Download presentation as an editable powerpoint.

Related

Fiscal 3Q Investor Presentation image

Fiscal 3Q Investor Presentation

Healthcare

FY23 Full-Year Results Presentation image

FY23 Full-Year Results Presentation

Healthcare

Healthcare Network P&L Statement and Expansion Projects image

Healthcare Network P&L Statement and Expansion Projects

Healthcare

Accreditation and Quality Assurance Overview image

Accreditation and Quality Assurance Overview

Healthcare

Investment Highlights image

Investment Highlights

Healthcare

Investor Presentation image

Investor Presentation

Healthcare

IDEAYA Biosciences Interim IDE397 Phase 1 Clinical Data and Q1 2022 Corporate Update image

IDEAYA Biosciences Interim IDE397 Phase 1 Clinical Data and Q1 2022 Corporate Update

Healthcare

BioAtla Investor Presentation Deck image

BioAtla Investor Presentation Deck

Healthcare