RAMSAY SANTÉ
BANK MEETING
2019, November 21st
ramsaysante.com WELCOME TO …
2 Ramsay Santé – Bank meeting – 2019, November 21st RAMSAY SANTÉ TODAY’S PRESENTERS
Pascal ROCHÉ Arnaud JEUDY Marcus NORD Group CEO Group CFO Nordics CFO
3 Ramsay Santé – Bank meeting – 2019, November 21st WE ARE ONE OF THE VERY RARE PLAYER BENEFITING FROM LONG-TERM SHAREHOLDERS
SHAREHOLDERS %
RAMSAY HEALTH CARE (UK) Limited 52.53
PREDICA 39.62
Subtotal Ramsay Health (UK) Limited / Predica 92.16
Dr. André Attia Group 6.59
Treasury shares 0.02
Other shareholders 1.23
TOTAL 100.0
4 Ramsay Santé – Bank meeting – 2019, November 21st WE ARE …
5 Ramsay Santé – Bank meeting – 2019, November 21st TABLE OF CONTENTS
I. Ramsay Santé’s new positioning as leader in integrated care in Europe
II. Recent highlights on the Capio integration
III. 2019 Performance
IV. Healthcare global trends and Ramsay Santé’s sustainable growth drivers
V. Q&A
6 Ramsay Santé – Bank meeting – 2019, November 21st A TRANSFORMATIONAL YEAR FOR RAMSAY SANTÉ, WITH THE INTEGRATION OF CAPIO
Acquisition of the Capio AB Group in Ramsay Santé revenue 2014 – 2019 (€m) November 2018 3401 Acquisition of the Merger of Générale HPM Group in de Santé and December 2015 +51.7% Ramsay Santé
+4.9% +0.3% 2234 +0.3% 2242 2124 2227 +24% 1712
2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019
7 Ramsay Santé – Bank meeting – 2019, November 21st FY = Fiscal year (July – June) RAMSAY SANTÉ IS NOW THE 2ND LARGEST PRIVATE CARE PROVIDER IN EUROPE
Main health actors in Europe, Turnover EURbn Pan-European
Fresenius Helios 8,7 Ramsay Santé * 4,0
Asklepios 3,3
Sana 2,6
Elsan 2,1
Rhön Klinikum 1,2 Praktikerjänst 1,1
Spire Healthcare 1,1
Aleris 0,5
8 Ramsay Santé – Bank meeting – 2019, November 21st * Full year equivalent FROM BEING THE LEADER OF PRIVATE HOSPITALIZATION IN FRANCE TO A LEADER IN INTEGRATED CARE IN EUROPE
Share of revenue MEDICINE SURGERY OBSTETRICS 73% DIALYSIS
REHAB 6%
IMAGING 4%
PSY 6%
TRANSPORT <0.5%
PRIMARY CARE 9% RAMSAY RAMSAY SANTÉ’S FOOTPRINT*
ELDERLY 2% Current
Share of revenue 72% 21% 2% 1% 3% 1% Ongoing
9 Ramsay Santé – Bank meeting – 2019, November 21st * Figures as at end June 2019 (including 12 months for Capio ) RAMSAY SANTÉ IS NOW THE UNDISPUTED LEADER IN KEY STRATEGIC MARKETS
36,000 FTEs #1 with a 21% of marketshare 7,600 liberal doctors #1 #2 > 200,000 short-term contracts
#2 #15 7m patients 20m consultations 36,000 deliveries 86 general hospitals 70 specialized clinics 26 rehab facilities 800 operating rooms 87 imaging equipment 6 healthcare transport companies 14 robots 45 emergency departments 25 dialysis centers Acknowledge quality leader 133 primary care centers 49 mental health facilities
10 Ramsay Santé – Bank meeting – 2019, November 21st OUR EUROPEAN EXECUTIVE TEAM, SEASONED, WITH A STRONG MEDICAL AND MANAGEMENT BACKGROUND Pascal Roché, Group CEO Odile Agopian, Head of Arnaud Jeudy, mental health for France, Group CFO GP Caroline Desaegher, Head of Damien Michon, Head of France for Communication & MSO and rehab, 25 of experience in Brand the healthcare sector Pierre Dupérat , Group Chief Investment, Audit Per-Helge Fagermoen, and Risk Officer Head of Norway, Physiotherapist, joined in 2008 Henrik Brehmer, Head of Public Affairs and Strategy Britta Wallgren, Head of Sweden, Anesthetist, MD since 2009 François Demesmay, Head of medical innovation and patient Thomas Kiaer, Head of experience, GP Denmark, Orthopedic Surgeon Anne-Claire Liberge, Martin Reitz, Head of Chief of staff Germany, MD since 2008 Jamel Ouanda, Chief Jean de Faultrier, Integration & best practices Group Legal Officer 11 Ramsay Santé – Bank meeting – 2019, November 21st Counsel TABLE OF CONTENTS
I. Ramsay Santé’s new positioning as leader in integrated care in Europe
II. Recent highlights on the Capio integration
III. 2019 Performance
IV. Healthcare global trends and Ramsay Santé’s sustainable growth drivers
V. Q&A
12 Ramsay Santé – Bank meeting – 2019, November 21st THE CAPIO INTEGRATION IS AHEAD OF SCHEDULE
Key integration dates since November 2018
Nov. 2018 Dec. 2018 Feb. 2018 March 2019 June 2019 Aug. 2019 Sept. 2019
CoC with Delisting Debt New ExCo Capital increase Squeeze- Sale of 3 Release of New brand 98.51% of of Capio syndication appointed out & PPA facilities in results shares AB France
Project Status and Key Achievements
› Appointment of a dedicated Chief Integration Officer, also in charge of identifying and sharing best practices › New ExCo appointed › 18 integration workstreams ; over 281 tasks delivered › Merger of both French headquarters ongoing › Completion of all negotiations with major suppliers › New brand › PPA effective › First common fiscal year › Launch of a Group Innovation hub
13 Ramsay Santé – Bank meeting – 2019, November 21st THE SYNERGIES WILL BE BEATEN AND, MOREOVER, WITH VERY LONG-TERM PROSPECTS
RGdS ExCo appointed Define a new group L2 organization in place + new clusters organization and governance 1st European Work Council has taken place on June 25th to operate as one company Integration comitology implemented
Compare and select best-of-both More than 70 best practices identified in various fields (eg. medical, talents, …) medical processes and tools, 2 best practices already being detailed (Nordics’ shared services center leveraging strengths from the two and Project Primordial in France) companies 6 other best practices identified as top priority
Explore all possible levers to Synergies commitment : totally confident to deliver the €20m commitment ! maximize revenue and cost synergies (short/ mid/ long term Leveraging the RGdS solid experience in delivering efficiency programs portfolio of opportunities) within Capio
Create a new set of values Understanding of cultural elements within the new combined Group and an inclusive culture for all colleagues Communication tools deployed Preparation of our new strategic plan
14 Ramsay Santé – Bank meeting – 2019, November 21st ACTIVELY MANAGING OUR ASSET PORTFOLIO HAS BEEN AND WILL BE A MAJOR STRATEGIC FOCUS IN ORDER TO SECURE OUR LEADING POSITION, AND THUS ENABLE US TO INVEST TO FURTHER GROW
ACTIVE MANAGEMENT PORTFOLIO & IMPLEMENTATION OF OUR BOLT-ON ACQUISITIONS DIVESTMENT OF NON STRATEGIC CLUSTERIZATION STRATEGY ASSETS
› Clusterization of all new French › Launch of remediation plans to › Market still fragmented and facilities done - current update of increase efficiency in some Capio calling for further consolidation medical projects France facilities › Restructuring of the Swedish › Tactical opportunities to reinforce business areas : › Ongoing merger & closing of our key clusters complementaries facilities located in a › merger of the proximity care same healthcare territory and the digital Capio Go › Strategic and financial hurdles business areas respected › 3 facilities outside of existing clusters › launch of a dedicated elderly sold in France › Proven ability to integrate and and mobility business area deliver synergies › Sale of non-core business acquired through M&A activity (dental & home help in Sweden)
› Sale of loss-making activity in Norway 15 Ramsay Santé – Bank meeting – 2019, November 21st and one facility in Germany TABLE OF CONTENTS
I. Ramsay Santé’s new positioning as leader in integrated care in Europe
II. Recent highlights on the Capio integration
III. FY2019 Performance
IV. Healthcare global trends and Ramsay Santé’s sustainable growth drivers
V. Q&A
16 Ramsay Santé – Bank meeting – 2019, November 21st FY2019 PERFORMANCE GOOD RESULTS AND SOLID PERSPECTIVES
REVENUE (€m) EBITDA (€m)
+51.7% +29.4%
3401,1 330,8 2241,5 255,6
FY2018 FY2019 FY2018 FY2019 . Improvement in EBITDA margin on a like-for-like basis . +2.1% on a like-for-like basis, with 1 additional business day GROUP NET PROFIT (€m) 28% Île-de-France 32% Auvergne-Rhône-Alpes Nord - Pas de Calais - Picardie +12.3% Provence Alpes Côte d'Azur 8,2 11% Bourgogne Franche Comté 10% 7,3 Other regions 3% 5% 11% FY2018 FY2019 Capio
17 Ramsay Santé – Bank meeting – 2019, November 21st ACTIVITY IS IN POSITIVE TERRITORY DESPITE THE CHALLENGING ENVIRONMENT
Former Ramsay Générale de Santé perimeter
› Ophthalmology up by 3.9% +1.6% +1.9% › Positive outcomes of our ED SURGERY › Orthopedics up by 1.4% EDs model › ENT surgery up by 2.8%
› Endoscopy down by (0.3)% MEDICINE +0.3% REHAB +4.9% › Very positive trend showing › Interventional medicine up by 6% the dynamic of rehab
MENTAL GYN-OBST. (4.2)% › Deliveries down by (5.3)% +0.7% › Some isolated activity falls ; › Gynecology surgery down by HEALTH overall dynamic activity (1.5)%
18 Ramsay Santé – Bank meeting – 2019, November 21st KEY FINANCIAL INDICATORS
NET DEBT (€m) AV. BILLING DAY *
1641,7 18,4 927,1 17,4
FY2018 FY2019 FY2018 FY2019
CASH (€m) REAL ESTATE VALUE PORTFOLIO (€m)*
368,5 781 308 715
FY2018 FY2019 FY2018 FY2019
* Only former Ramsay Générale de Santé scope 19 Ramsay Santé – Bank meeting – 2019, November 21st WE BENEFIT FROM A HEALTHY AND SCALABLE FINANCIAL STRUCTURE
Ramsay Santé leveraging profile
Nov 18: Oct-14: Closing of the Dec-15: acquisition of merger between acquisition of Capio Ramsay and GdS HPM
4,3 4,0 3,9 3,8 3,7 3,7 3,7 3,5 3,6 3,6 June 2018 pro- forma leverage: 4.03
June 2014 December June 2015 December June 2016 December June 2017 December June 2018 June 2019 2014 2015 2016 2017
20 Ramsay Santé – Bank meeting – 2019, November 21st WHERE DO WE STAND AS TO THE DEAL BUSINESS PLAN ?
2019 2019 2018 PF 2019 PF Published figures Pro-forma
Sales 3,842 3,938 3,401.1 3,953.9 Growth % - +2.5% (11.5)% +2.9%
EBITDA 367 374 330.8 364.2 % sales 9.6% 9.5% 9.7% 9.2%
Current operating profit n/a n/a 156.9 168.3
Operating result n/a n/a 118.8 126.3
Net result n/a n/a 15.3 13.8
Solid EBITDA margin ; Capio is besides a much more CAPEX light business
21 Ramsay Santé – Bank meeting – 2019, November 21st RESILIENT PROFITABILITY IN FRANCE DESPITE THE TARIFFS’ DECREASE ; c. 20% EBITDAR and c. 12% EBITDA
2009 – 2019 EBITDA evolution (€m) & margin (%) – Ramsay Générale de Santé Published figures, without Capio
269,8 265,9 265,6 270,0 248,9 259,1 255,6 20,0% 237,0 239,7 229,2 225,8 18,0% 220,0 205,6 16,0% 14,0% 170,0 12,0% 12,4% 12,1% 12,7% 12,0% 12,2% 12,0% 120,0 11,6% 11,9% 12,1% 11,4% 11,5%10,0% 8,0% 70,0 6,0% 4,0% 20,0 2,0% - 30,0 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 0,0%
Positive tariffs' evolution Neutral tariffs' evolution Negative tariffs' evolution
22 Ramsay Santé – Corporate Plan TABLE OF CONTENTS
I. Ramsay Santé’s new positioning as leader in integrated care in Europe
II. Recent highlights on the Capio integration
III. FY2019 Performance
IV. Healthcare global trends and Ramsay Santé’s sustainable growth drivers
V. Q&A
23 Ramsay Santé – Bank meeting – 2019, November 21st KEY MACRO DYNAMICS ON THE HEALTHCARE MARKET
People are more The ongoing digitization Improvements of Out-of hospital shift health conscious of healthcare technology
Using analytics to provide People want on- demand high care Democratization of Shift in the healthcare personalised services that information industry cater individual needs quality
SUMMARY TRENDS OF SUMMARY Increase in consumer Change in purchasing Cost of healthcare for Cost of healthcare consciousness in using power consumers is provision is increasing technology increasing
24 Ramsay Santé – Bank meeting – 2019, November 21st IN FRANCE, A REALLY POSITIVE REGULATORY OUTLOOK FOR PRIVATE PROVIDERS
MULTI-YEARS VISIBILITY QUALITY BASED FUNDING ON TARIFFS . Rebalance of activity – based funding by . New regulation for the healthcare rewarding best in class quality : good for us ! industry . Innovation driver . Enables mid-term planning . Minimum tariffs at +0.2% + IFAQ per year for 2020, 2021, 2022
COEFFICIENT PRUDENTIAL POSITIVE TARIFFS FOR 2020 . 100% back in 2019 . Positive news after 6 years of consecutive tariffs’ decrease and LY positive tariffs . Increase of hospitals’ ONDAM from 2.1% to 2.4%
… AND BESIDES, WE CONSIDER MA SANTÉ 2022 AS AN OPPORTUNITY FOR US
25 Ramsay Santé – Bank meeting – 2019, November 21st AND WE BENEFIT FROM 4 MAIN BUSINESSES WITH STRONG VALUE CREATING PATHWAYS, AND LEADING POSITIONS TOO FOR SESSION SPECIALTIES
FROM STAND ALONE VALUE … TO ADDING VALUE THROUGH A JOINED-UP CREATING BUSINESSES … APPROACH TO PROVIDE INTEGRATED PATHWAYS
MSO IMAGING ~ 80% €1,774.2m €2,125.0m €56.9m€70.2 €71.5m 73 facilities 33 imaging centers (+14 vs FY16) EBITDAR margin c. 36% - 40% EBITDAR margin ~ 25% 82 imaging equipment (vs 74 in c. 14% - 16% 2016) 887 activity 147 heavy equipment authorizations FY2016 FY2019 authorizations FY2016 FY2019
REHAB ~ 30% MENTAL HEALTH
€188.9m €220.2m €160.3m €175.6m 35 facilities 27 facilities (+6 vs FY16) (+6 vs FY16) EBITDAR margin c. 25% - EBITDAR margin c. 21% - 30% 23% 80 authorizations (vs 66 in FY2016 FY2019 128 authorizations FY2016 FY2019 2016) A more CAPEX light activity
26 Ramsay Santé – Bank meeting – 2019, November 21st % of patients referred to WE HAVE LAUNCHED IN 2015 OUR STRATEGIC PLAN, LET’S DO IT 2020, TO ADAPT AND BUILD ON OUR STRENGTHS
DIGITALIZATION OPTIMIZATION INNOVATION TALENTS
1. Digitize doctor’s agenda 6. Optimize by cluster 12. Integrate doctors 19. Develop our ‘Talent for patient access consultation to our Pool’ approach 7. Launch a cost- 2. Develop new operations with a digital 20. Develop a DIGITAL efficiency program relationships with our service pack OLYMPE (DEFFI) patients and doctors, with 13. Set up a patient CRM 21. Develop international 8. “Keep” the patient digital program of health 14. Enter connected careers within facility management, social businesses 22. Involve all our staff in networks, newsletters, 9. Significantly optimize 15. Build geomarketing the RGDS Foundation mailing… our phone contact patient’s recruitment with its new positioning 3. Digitize the hospital performance actions admission process 10. Optimize our visibility 16. Create a CRM for GPs 4. Digitize patient feedback (physical, social and develop a set of to better manage patient networks…) services expectations 17. Test GPL 5. Digitize sale services 11. Optimize our over- 18. Test other referral (choice of single rooms, capacity partners (pharmacists, transportation, wifi…) para-medical professions…)
27 Ramsay Santé – Bank meeting – 2019, November 21st AS OF TODAY, WE HAVE REACHED A HIGH LEVEL OF IMPLEMENTATION OF OUR STRATEGIC PLAN
37 MSO & 20 rehab units now on 63% of eligible doctors Effiflux ; 141 Start’op workstreams connected Available among 54 MSO 180 FTEs working on our SSC; facilities ; 30% of penetration rate 4 waves of transfer
100% of doctors’ 19 out of 22 dialysis centers adherence relying on the new protocol
Supporting our medical DIGITALIZATION OPTIMIZATION Platform launched, efficiency teams savings at 8%
24K followers on In INNOVATION TALENTS 14 Ambassadors on jobs and 23K on Fb experiencing shortages
10 marketing Large engagement among our campaigns staff and the medical community
6 HC transport companies 600 medicine residents since 2012 acquired, revenue at €14m
Medical relationship managers 700 articles published in 2017, including pilot successfully completed 1,000 doctors & 2,600 patients
28 Ramsay Santé – Corporate Plan – Pre-read pack RAMSAY SANTÉ HAS CLUSTERIZED IN FRANCE ITS BUSINESS SINCE 2011…
FOCUS ON OUR ILE DE FRANCE CLUSTERS OUR 134 FACILITIES IN FRANCE
… WITH A UNIQUE FOOTPRINT IN KEY
29 Ramsay Santé – Bank meeting – 2019, November 21st TOWNS OF THE FUTURE THE CLUSTERIZATION OF OUR ASSETS HAS BEEN A KEY DRIVER TO IMPLEMENT CONSISTENT AND EFFICIENT TERRITORIAL STRATEGY OPTIMIZE #6
KEY OUTCOMES OF OUR CLUSTER 80+ PROJECTS OVER 2015 – 2019 … AND ILLUSTRATION STRATEGY AS TO DATE STILL MANY TO COME IN 2020 ONWARDS
MSO & REHAB 2015 - 2019 OPERATIONAL EFFICIENCY Optimize 8
A common management team Sell 10 Mutualization of support functions Close 4 New multidisciplinary functions (coordinator nurse) Brownfield 22 CAPEX optimization Acquire 2 + Capio Restructure 13 MEDICAL CONSISTENCY PSY 2015 - 2019 Medical specialization of our facilities Active doctors recruitment Optimize 8 General Hospital Sell - INNOVATIVE CARE General Hospital with an ED Close - Active development of outpatient care Rehab unit Integrated pathways (obesity / oncology) Imaging Brownfield 8 Acquire 2 Restructure 1 30 Ramsay Santé – Bank meeting – 2019, November 21st OUR SHARED SERVICES CENTER FOR FRANCE, GOOD IMPLEMENTATION PROGRESS WITH A HIGH LEVEL OF QUALITY AND EFFICIENCY ALREADY DELIVERED OPTIMIZE #7
PROJECT’S PROGRESS AS AT END- MAIN QUALITY AND EFFICIENCY INDICATORS YEAR 2019
216 FTEs working on our platform Management in place KPI Target Baseline As at now New building finalized by March 2020 # of suppliers’ invoices by FTE 1,235 330 757
Share of project implementation # of patients’ invoices by FTE 5,284 3,865 4,683
# of payment recovery by FTE - 8,147 11,808 31% 24% # of payrolls by FTE 560 156 438
69% 76% OPERATIONAL EFFICIENCY
Plug and play Revenue # of facilities Quality of reporting Transferred To be transferred Over €5m of expected efficiency gains will be delivered
31 Ramsay Santé – Bank meeting – 2019, November 21st RAMSAY SERVICES, A FULLY PERSONALIZED AND SIMPLIFIED JOURNEY FOR OUR PATIENTS DIGITALIZE #3, 4 & 5
#K ONLINE ADMISSIONS VIA OUR PROJECT’S PROGRESS RAMSAY SERVICES PORTAL
54 out of 56 of our MSO facilities offering the online portal to our patients From 0 to 30% penetration rate, with best-in-class facilities reaching 90+% Ongoing connection of the former Capio France facilities
KEY BENEFITS
Accommodation revenue Launch of new services Patients’ satisfaction (NPS) Admission desk efficiency
32 Ramsay Santé – Bank meeting – 2019, November 21st OUR CSR ACTIONS ARE IMPLEMENTED TROUGH OUR FOUNDATION RAMSAY SANTÉ TALENTS #22
Illustration of 5 major projects launched since, built on both our business and medical expertise and already yielding tangible results
@Ramsay GDS Call for projects Creation of a stress Launch of #generations Collective actions Creation of the among employees & Observatory prevention among our facilities “Prevent2Care lab” practitioners
Raise awareness Use social media to Involve and unit Select and assist e- Select and assist in- about the dangers of make the foundation and employees and health start ups during house projects of stress the RGDS Brand known practitioners around 9 months, together “collective interest”
prevention projects with INCO OBJECTIVE
Mapping of medical ~23 000 followers (> AP- 22000 km walked A first cohort of 13 36 submitted projects consequences of HP FB page) ; across partner start up already ; 2 selected projects stress ; media commitment rate up to facilities to raise incubated ; 2d wave of and 10 others to be communication end of 3% ; thousands of money to be given to 20 SU in Paris and further analyzed
2017 conversation NPO Marseille ongoing RESULTS
33 Ramsay Santé – Bank meeting – 2019, November 21st IN THE NORDIC COUNTRIES, THE NORTHERN LIGHT STRATEGIC PLAN RELIES ON COMMON AMBITION IN TERMS OF QUALITY, INNOVATION AND EFFICIENCY
Digital: Specialized: Integrated: Talent: Digital tools and Scaled specialist One joint platform & Excellence with working practices services brand people
▪ Digital point of access into ▪ Organic growth of our best-in- . One seamless customer . Modern Management all services class specialist pathways experience through all our through decentralisation services and empowerment ▪ Digital handling of one in ▪ Sub-specialisation via five visits Modern Medicine principles . One Capio brand with joint . Capio Management ▪ Digital pathways to ▪ Strong offering to grow with offering – one stop shop for Program (CMP) for support MM’s standardised private health insurance health and healthcare needs leadership development operating practices throughout life ▪ Consolidation through M&A . One team for collaboration ▪ “Always on” relation to and scale in our attractive . Reduced complexity and and support our customers in sickness specialties with strong minimal overhead and and in health demand decentralized management
▪ Joint digital ecosystem for . Joint shared services on a further technology solutions digital backbone
34 Ramsay Santé – Bank meeting – 2019, November 21st DIGITALIZATION IS SUPPORTING OUR INTEGRATED CARE PATHWAYS FOR BOTH PATIENTS AND DOCTORS
PREVENTION PRIMARY CARE HOSPITALIZATION FOLLOW-UP
Social Network
Online appointement
Online admission & marketing portail
Digital consultations
PATIENTS Online integrated care
Telehealth solutions
Diffusion of hospitalization reports
Online research platform
Start-up incubators
Online assistance
DOCTORS DOCTORS Care related IoT 35 Ramsay Santé – DI Healthcare ** the list of solutions non exhaustive ACROSS SCANDINAVIA, AND ESPECIALLY IN SWEDEN, PRIVATE PROVISION OF CARE HAS STEADILY INCREASED ITS SHARE OF MARKET
Swedish healthcare net cost (SEK bn, share in %)
SPECIALIST SPECIALIST PRIMARY CARE SOMATIC CARE PSYCHIATRIC CARE CAGR CAGR CAGR (%) 117.8 142.9 (%) 20.9 22.6 (%) 38.6 45.3
34% 37% +6.3% 7% 7% +5.0% 8% 9% +4.1%
66% +2.9% +4.9% +1.7% 63% 93% 93% 92% 91%
2013 2017 2013 2017 2013 2017 Public Private Public Private Public Private
Development going forward
Free patient choice well-established Continues to be attractive for some Specialty with challenged access, and private providers display good regions to solve supply issues with private has successfully attracted quality and access. Joint private provision (as tendering) talent reimbursement system benefits Little infrastructure required and private providers increasingly standardized operations
36 Ramsay Santé – Bank meeting – 2019, November 21st FOR EXAMPLE IN SWEDEN, AN INCREASING DEMAND FOR PRIVATE HEALTHCARE PROVISION AS ACCESSIBILITY AND EFFICIENCY ARE BECOMING MORE AND MORE A HURDLE
COST FOR HEALTHCARE IS GROWING WITHOUT WAITING TIMES INCREASING IN PUBLIC SECTOR CORRESPONDING PRODUCTION
Share of patients waiting for more than 90 days for treatment Development of net cost, Number of inpatient episodes and within specialist care in Sweden number of visits for Sweden
30,5% 28,1% 25,1% 20,9%
16,5% 15,4% 14,5% 14,0%
2011 2012 2013 2014 2015 2016 2017 2018
37 Ramsay Santé – Bank meeting – 2019, November 21st IN THE PRIMARY CARE MARKET ESPECIALLY, SOLID UNDERLYING GROWTH DRIVERS AND AN ALREADY LEADERSHIP POSITION TO BUILD ON
MARKETSHARE BY TYPE OF PROVIDER BY COUNTY #1 FOR PRIMARY CARE IN SWEDEN
Total 56% 44% # listed patients within Capio’s primary care centers in Sweden 104 units in Sweden Västra Götaland 57% 43% ; 8 in Norway Värmland 81% 19%
Västmanland 50% 50% 10% of the Swedish population listed Västerbotten 82% 18% within our centers Uppsala 56% 44% Stockholm 34% 66% Skåne 58% 42% A FRAGMENTED MARKET Östergötland 100% Örebro 89% 11% Primary care landscape in Sweden Primary market in France Kronoberg 68% 32% GPs 103,000
Halland 53% 47% Nurses 723,000
Gävleborg 62% 38% Specialist 55,000
Blekinge 72% 28% Radiology 9,000
Lab 3,864 units Public marketshare Private Marketshare
38 Ramsay Santé – Bank meeting – 2019, November 21st OUR APPROACH IS BASED ON SOLID AND TRUSTFUL PARTNERSHIPS WITH OUR KEY PARTNERS
RAMSAY SANTÉ AND PARTNERSHIP WITH THE LISTENING TO OUR PRACTITIONNERS WORK PUBLIC TO ENHANCE EMPLOYEES AND SIDE BY SIDE CARE OFFERING & PATIENTS QUALITY
• More than 2,750 publication since 2014 in France • 1,100 doctors and 3,000 patients involved in the medical studies • Medical students welcomed within our facilities in all our countries • Projects funded by the healthcare cooperation consortium in France and in Sweden
39 Ramsay Santé – DI Healthcare OUR STRATEGY HAS PROVIDED US WITH STRONG SUSTAINABLE ADVANTAGES
A CONSISTENT AND LEVERAGEABLE ASSET PORTFOLIO STRONG COMPLEMENTARITIES BETWEEN OUR BUSINESSES
Mid-term strategy to optimize a cluster Added volumes by driving cross- Primary Specialist General referrals care care hospitals Strong lever to attract doctors
One stop-shop approach 2 COMPLEMENTARIES ASSETS WHICH STRENGTHEN THE SPREAD AN ACKNOWLEDGED MEDICAL AND QUALITY KNOW-HOW OF A DIGITAL CULTURE AMONG OUR GROUP
Ramsay Services
CAPIO Go
40 Ramsay Santé – Bank meeting – 2019, November 21st AND A HIGH LEVEL OF INVESTMENT IN ORDER TO PREPARE FOR THE FUTURE
ILLUSTRATION OF MAJOR CAPEX PROJECTS IN FY2018 – FY2019
41 Ramsay Santé – DI Healthcare A UNIQUE INTEGRATED HEALTH OPERATOR IN EUROPE WITH GROWTH AND PROFITABILITY AVENUES
MARKET PATIENT QUALITY EFFICIENCY
. Strong underlying . New patients segments . Best-in-class in the . Best practices organic growth in the to enter into (eg. public Nordics and in France Nordics in Norway, increase of for quality valued by . Clusterization: next . Tenders recently won PHI in Sweden) patients, physicians projects (eg. Sollentuna, and payers maternity St Göran) . Becoming the health . Shared service center . Differentiating partner by leveraging . Innovation hub in France … and in the advantages to recruit our services approach launched in Malmö Nordics doctors in France (eg. Volvat membership (clinical research / in Norway, marketing . Public/Private . Worldwide internship) campaigns) collaboration procurement approach . Proven track-record of and JV with Ascension M&A . Very good brand asset . Brownfield . Operational excellence opportunities
42 Ramsay Santé – Bank meeting – 2019, November 21st KEY TAKE-AWAYS
1. In 2019, we have moved from being the leader in private hospitalization in France to a leadership position as an integrated health provider in Europe.
2. We have a unique and diversified set of activities in various countries with leadership footprint.
3. The Capio integration is ahead of schedule.
4. The environment in which we operate in our key countries is looking better, and we have built a model that will benefit from sustainable growth and profitability avenues.
5. We have delivered good results in FY 2019, and the rating agencies have confirmed their Group rating (S&P:BB- ; Moody’s: Ba3).
43 Ramsay Santé – Bank meeting – 2019, November 21st TABLE OF CONTENTS
I. Ramsay Santé’s new positioning as leader in integrated care in Europe
II. Recent highlights on the Capio integration
III. FY2019 Performance
IV. Healthcare global trends and Ramsay Santé’s sustainable growth drivers
V. Q&A
44 Ramsay Santé – Bank meeting – 2019, November 21st THANK YOU !
Ramsay Santé – Bank meeting – 2019, November 21st