Siloam Hospitals delivered double digit revenue growth in
Siloam Hospitals delivered double digit revenue growth in FY 18 FY 2018 Results
FY 2018 Results 2 Strong Revenue & Earnings Growth Revenue EBITDA / EBITDAR Revenu e EBITDAR & EBITDA In IDR Bn # %△ 1% 2 er 12% G CA R = 2 er ov GR CA 13% In IDR Bn = 5% ov 9% 6% 14% 9% 14% 3% Reclassified Siloam is the clear leader and fastest growing private hospital group in Indonesia serving all segments of the population Notes: GOR refers to revenues relating to medical support services, professional fees and consultation fees, drugs and medical supplies, room serv ice, administration, operating theatre, delivery rooms, registration fees and other services. NOR is calculated by deducting service costs (doctor consultation and professional fees) from GOR. EBITDA refers to income before depreciation, provisions for post-employment benefits, allowance for impairment in value, corporate income taxes and other expense and/or income (consisting primarily of financing
FY 2018 Results 3 Continued Growth of Revenue & Earnings in FY 2018 Q 4 Y-o-Y △ • Gross Operating Revenue (GOR) for FY-2018 of IDR 5. 96 billion, up 12% from FY-2017 • Professional Service Costs in in FY-2018 grew by 12% from FY-2017 • Net Operating Revenue (NOR) for FY-2018 was IDR 4. 49 trillion, up 13% from FY-2017 • Material Costs were 13% higher year-on-year in FY -2018 Vs FY-2017 • EBITDAR was IDR 1. 21 billion up 9% from FY 2017 • Rental charges rose by 28% in FY-2018 Vs FY 2017. • EBITDA was IDR 787 billion in FY-2018 up 6% from FY-2017 Notes: GOR refers to revenues relating to medical support services, professional fees and consultation fees, drugs and medical supplies, room serv ice, administration, operating theatre, delivery rooms, registration fees and other services. NOR is calculated by deducting service costs (doctor consultation and professional fees) from GOR. EBITDA refers to income before depreciation, provisions for post-employment benefits, allowance for impairment in value, corporate income taxes and other expense and/or income (consisting primarily of financing
FY 2018 Results Inpatient, Outpatient & Emergency Department Volume and Revenues Increased • Outpatient visits increased 8% in FY-2018 vs FY 2017. • Outpatient revenue per-visit grew 4% to IDR 850 K FY 2018 vs FY-2017 • Inpatient Admissions rose by 11% in FY-2018 to 205 thousand patients. • Inpatient revenue per-day grew 3% to IDR 4. 93 million in FY-2018 vs FY-2017 • Total Inpatient Days increased by 8% in FY-2018 • Average Days per inpatient Stay decreased by 3% • Emergency and Trauma Center visits were higher by 12% from the previous year. Notes: *Financials and operational metrics include all hospitals and clinics 4
FY 2018 Results 5 We initiated a rapid expansion stage in 2011 which has resulted in a network capacity of 7, 130 beds SH Mataram Mature BPJS New SH Bekasi Timur Owned Hospital s SH Balikpapan SH Lippo Cikarang 1996 SH Lippo Village 2002 SH Surabaya SH Kebon Jeruk SH Jambi 2011 SH MRCCC Leased Hospitals 2012 BIMC Nusa Dua Asri 2013# 2014 2016* SH Bangka Belitung SH Palangka Raya RSUPB SH Jember Sentosa SH Lubuk Linggau 2017* 2018 SH Palembang SH TB Simatupang SH Medan SH Samarinda SH Yogyakarta SH Cinere SH Bali SH Kupang SH Buton SH Bogor SH Makassar BIMC Kuta SH Purwakarta SH Labuan Bajo Hosana Medica SH Semarang # Issue SH Manado RSUS/SHLV Hospitals Segmentation Definition: • Our mature hospitals include all developments completed prior to 2016 • Approximately 70% of our hospitals are able to service BPJS patients, the hospitals we designate “BPJS” see 70% to 80% of patient volume and over 50% of revenues derived from public-insurance payers. Notes: *Financials and operational metrics include all hospitals and exclude clinics • New hospitals are typically in the early stages of rapid growth. IPO *Rights
FY 2018 Results 6 Siloam has 34 Hospitals spanning 22 provinces Operational Hospitals (34) Hospital operational in Q 4 -2018 (1) Future Potential Developments (16) Maluku: Sulawesi: 19. 0 m 1. 7 m Papua: 3. 6 m Sumatra: 52. 2 m Kalimantan: 21. 3 m Java: 160. 3 m Nusa Tenggara: 9. 6 m Bali: 4. 2 m Notes: *Financials and operational metrics include all hospitals and exclude clinics
FY 2018 Results Hospital Outpatient and ED Activity Notes: *Financials and operational metrics include all hospitals excluding clinics 7
FY 2018 Results Hospital Outpatient Data Notes: *Financials and operational metrics include all hospitals and exclude clinics 8
FY 2018 Results Hospital Inpatient Activity Notes: *Financials and operational metrics include all hospitals and exclude clinics 9
FY 2018 Results Hospital Inpatient Activity Notes: *Financials and operational metrics include all hospitals and exclude clinics 10
FY 2018 Results Occupancy & Equipment Utilization rate Notes: *Financials and operational metrics include all hospitals and exclude clinics 11
FY 2018 Results Solid Growth of Revenue, EBITDAR & EBITDA (115%) Note: EBITDAR refers to income before depreciation, provisions for post-employment benefits, allowance for impairment in value, corporate income taxes, rental and other expense and/or income. *Financials and operating metrics include all hospitals and exclude clinic * EBITDA margins are for each individual segment and exclude clinics and other centralized costs 12
FY 2018 Results Revenue & EBITDA Details. In IDR Bn Q 4 ’ 18 Q 4 ’ 17 1, 569 1, 406 11% 5, 965 5, 306 12% 387 349 11% 1, 475 1, 314 12% 1, 181 1, 033 14% 4, 490 3, 691 22% 75% 75% 70% Material Cost 465 402 16% 1, 788 1, 577 13% Gross Profit 716 631 13% 2, 707 2, 384 14% 46% 45% 45% Operating Expenses (i) 427 326 31% 1, 488 1, 267 17% EBITDAR 331 305 9% 1, 215 1, 118 9% % to GOR 21% 22% 20% 21% % to NOR 28% 30% 27% 30% 58 47 23% 226 176 28% 221 215 3% 787 742 6% % to GOR 14% 15% 13% 14% % to NOR 19% 21% 18% 20% GOR Service Cost NOR % to GOR Rental(ii) EBITDA(iii) ∆% FY ’ 18 FY ’ 17 ∆% Notes: (i) Excluding Rental (i) Reclassified, please see Financial Statements note 39. (ii) Represents rental expenses for the land buildings, Siloam is leasing from FREIT, PT Lippo Karawaci Tbk and other parties (iii) EBITDA refers to income before depreciation, provisions for post-employment benefits, allowance for impairment in value, corporate income taxes and other expense and/or income (consisting primarily of financing income and others-net). (4) Operational metrics will differ slightly on slide 2 as figures on slide two don’t include clinics. 13
FY 2018 Results Balance Sheet In IDR Bn FY 18 FY 17 ∆% Assets Cash & Equivalent 216 930 (-77%) Other Current Assets 1, 550 1, 241 +25% Property and Equipment 4, 080 2, 631 +55% Other Non-Current Assets 1, 849 2, 794 -34% Total Assets 7, 695 7, 596 1% 252 184 +37% Other Liabilities 1, 126 1, 098 +7. 4% Shareholders' Equity 6, 317 6, 314 +0% Total Liabilities & Equity 7, 695 7, 596 +1% 0. 04 0. 03 Liabilities & Equity Debt Gearing Ratio 14
15 Appendices
FY 2018 Results 16 Mature East Hospitals Name SH Kebon Jeruk Place W. JAKARTA SH Surabaya E. JAVA GPs & Date Bed Operatio Specialist Nurses Opened Capacity nal Beds s Centre of Excellence 2002 285 214 212 333 Cardiology, Urology, Orthopedics, Emergency 2002 160 159 244 Cardiology, Emergency SH Manado N. SULAWESI 2012 238 177 115 192 Emergency SH Balikpapan E. KALIMANTA N 2002 232 165 97 140 Orthopedics, Emergency RS Grha Ultima Medika W. NUSA TENGGARA 2017 69 26 46 60 SH Makassar S. SULAWESI 2012 362 215 142 218 SH Samarinda E. KALIMANTAN 2016 34 10 22 20 Accreditation Land/Building Ownership JCI A Emergency Cardiology, Emergency, Endocrinology Emergency 3 rd Party
FY 2018 Results 17 Mature West Hospitals GPs & Date Bed Operatio Specialist Nurses Opened Capacity nal Beds s Name Province Centre of Excellence MRCCC Siloam Semanggi S. JAKARTA 2011 334 176 187 248 SH Cinere DEPOK 2012 50 33 24 42 SH Palembang S. SUMATER A 2012 357 150 126 157 Gastroenterology, Emergency SH TB Simatupang S. JAKARTA 2013 269 116 142 128 Cardiology, Emergency, Neuroscience, Oncology Cancer, Liver, Emergency Cardiology SH Lippo Village TANGERA NG 1996 308 274 279 373 Cardiology, Orthopedics, Neuroscience, Emergency SH Lippo Cikarang BEKASI 2002 164 118 90 150 Occupational Health, Emergency SH Jambi E. SUMATER A 2011 119 107 70 125 Emergency 2014 356 129 103 112 Emergency, Trauma RS Siloam Dhirga Surya Medan N. SUMATER A Accreditation JCI A Land/Building Ownership
FY 2018 Results Mature Distinct Segment Hospitals Date Name BPJS Place GPs & Bed Operatio Specialist Nurses Opened Capacity nal Beds s Centre of Excellence SH Denpasar (Mature East) BALI 2013 281 124 141 177 SH Asri (Mature West) S. JAKARTA 2014 49 42 117 78 Urology BIMC Kuta (Mature East) BALI 2013 19 18 46 62 Tourists, Emergency BIMC Nusa Dua (Mature BALI East) 2013 39 24 60 60 Cosmetic Surgery, Emergency SE. SULAWESI 2016 140 80 31 76 Emergency W. JAVA 2014 235 220 74 216 Emergency SH Buton SH Purwakarta Cardiology, Orthopedics, Tourists, Emergency SH Kupang E. NUSA TENGGARA 2014 416 110 62 152 Emergency SH Labuan Bajo E. NUSA TENGGAR A 2016 124 90 25 70 Emergency SGH (RSUS) TANGERAN G 2012 640 250 131 201 Emergency Accreditation 18 Land/Building Ownership JCI A 3 rd Party
FY 2018 Results 19 New Hospitals Name Place GPs & Date Bed Operatio Specialist Nurses Opened Capacity nal Beds s Centre of Excellence RS Umum Putera Bahagia CIREBON 2017 114 94 68 123 Emergency SH Bogor W. JAVA 2017 246 56 68 57 Emergency RS Siloam Bangka BANGKA BELITUNG 2017 412 33 39 51 Emergency RS Hosana BEKASI Bekasi 2017 101 60 26 56 Emergency RS Siloam Yogyakarta YOGYAKARTA 2017 141 30 58 73 Emergency Siloam Medika Blu Plaza BEKASI 2017 56 36 33 53 Emergency RS Siloam Silampari S. SUMATERA 2018 175 40 29 45 Emergency SH Jember E. JAVA 2018 323 30 39 45 Emergency RS Umum Sentosa BEKASI 2017 50 50 37 57 Emergency Accreditation Land/Building Ownership
FY 2018 Results Name SH Semarang Place Central Java SH Palangka Kalimantan Raya GPs & Date Bed Operatio Specialist Opened Capacity nal Beds s Nurses Centre of Excellence Accreditation 20 Land/Building Ownership 2018 23 22 47 75 Emergency 3 rd Party 2018 199 34 20 44 Emergency 3 rd Party
FY 2018 Results Siloam Clinics – BPJS Clinics 11/6/2020 21
FY 2018 Results LIST OF SILOAM CLINICS NO NAMA SILOAM CLINIC WILAYAH STATUS Tangerang BPJS 1 Siloam Clinic Cyberpark 2 Siloam Clinic Robson Cikarang BPJS 3 Siloam Clinic Jababeka Cikarang BPJS 4 Siloam Clinic Chandra Sentosa Bekasi BPJS 5 Siloam Clinic dr Netty Bali BPJS 6 Siloam Clinic Harapan Kita Tangerang BPJS 7 Siloam Clinic Permata Tangerang BPJS 8 Siloam Clinic Meruya Jakarta Barat BPJS 9 Siloam Clinic Balikpapan BPJS 10 Siloam Clinic Labuan Bajo NTT BPJS 11 Siloam Clinic Gading Serpong Tangerang BPJS 12 Siloam Clinic Bona Indah Jakarta Selatan BPJS 13 Siloam Clinic Graha Raya Tangerang BPJS 14 EMC Cianjur BPJS 15 Siloam Clinic Cisoka Tangerang BPJS 16 Siloam Clinic Bogor Barat Bogor BPJS 17 Siloam Clinic Bogor Selatan Bogor BPJS 18 Siloam Clinic Jakabaring Palembang BPJS 19 Siloam Clinic Mertoyudan Kab. Magelang BPJS 20 Siloam Clinic Pondok Cabe Tangerang BPJS 21 Siloam Clinic Sleman Jogja Non BPJS 22 Siloam Clinic Jatimakmur Bekasi Non BPJS 11/6/2020 22
FY 2018 Results Comprehensive Licensing Requirements for New Hospitals Status of Selected Projects for 2018 -2019* In order to be able to fully commission a new hospital, we have to go through a licensing process involving local governments and provincial health departments. This involves more than 40 licenses and can be summarized into 6 most critical licenses. Status Ambon Banjarmasin Batu Lippo Mall Pasar Baru Tegalrejo Beds >100 <100 >100 Planned Opening 2019 2018 2019 Environmental License (AMDAL) Building Permit (IMB) Nuisance Permit (HO) Hospital Building Permit (IMRS) P P P P P Certificate of Proper Building Function (SLF) Operational License (IO) * As of Dec P 23
FY 2018 Results Corporate Structure OTHER MAJORITY SHAREHOLDERS > 5% 5. 32% LIPPO RELATED COMPANIES 63. 48% PUBLIC < 5% 31. 20% As of 31 Mar 2018 No of Outstanding Shares : 22, 771, 585, 119 Code : LPKR. JK ; LPKR IJ CVC CAPITAL PARTNERS 25. 87% LIPPO KARAWACI RELATED COMPANIES 51. 05% As of 31 Dec 2018 No. Of Outstanding Shares : 1, 624, 765, 625 PUBLIC 23. 08% 24
FY 2018 Results Our initial growth strategy relied on leasing hospitals, while we increasingly own new developments 18 of our hospitals are leased from FREIT or related parties, while 11 are Owned and 5 are 3 rd Party leases BPJS 5 Sale and Leaseback of Hospitals 10. 6%* Sublease of Hospitals Sale and Leaseback of Hospitals 51. 05%* Mature East 2 3 Mature West 2 3 New 5 4 4 6 Our early “asset light” strategy allowed the group to expand more rapidly without accessing excessive financing. We increasingly intend to retain ownership of newer developments. Our management of hospital development and construction ensures more efficient permitting and a responsive layout for projected needs. In Indonesia Ownership Interest In Singapore Contractual Relationship * As of 31 December 2018 Hospital selling prices are determined through independent valuation, with rental rates determined to generate a long-term stable return over 20 years. 25
FY 2018 Results Specialist access for primary healthcare demand • Public-Private. Partnerships ve Re • perati High standards and accessible medical care through a strong focus on clinical governance and affordable price points Post-O • hab Our vision is to provide affordable and accessible healthcare to all socio-economic segments Continuum of care at primary, secondary, tertiary & Siloam’s Integrated quaternary levels Centers of Excellence: Neuroscience, • Integrated Healthcare Delivery Model: Cardiology, Cancer, Orthopedic, Urology, Fertility • Access to Centres of • Hub and Spoke strategy for specialized services via Digital Tele-Medicine Excellence through hub • Pioneering investments in Indonesia’s healthcare & spoke system and sector Tele- medicine – Comprehensive Cancer Centre opened in 2011 – Indonesia’s first Gamma Knife installed in 2012 • Best in class and highly accessible healthcare Tertiar services platform through: y – Rapid expansion of network across Indonesia – Attracting and retaining the best doctors with strong focus on doctors’ welfare (SDPDP) Secondar – Equip hospitals with State-of-the-Art facilities y such as 128 slice CT Scan and 1. 5 T MRI Primary Research & Education • Primary clinics for corporate clients • Public-Private-Partnership (PPP) model • RSUS – 1 st hospital using public sector model – Additional demand from BPJS patients – Gateway to Indonesia’s “Universal Healthcare Coverage” • Integrated platform with UPHMS and others • Medical training at RSUS, SHLV, and 26
FY 2018 Results Our affiliation with UPH Medical Sciences is key in acquiring, training and retaining professional staff • • • Future workforce Systems based curriculum converged with PBL Best practice replication Clinical placement Foundation for Innovation Overseas training –Singapore/Australia/USA/China Centre of Excellence and Global Reputation Clinical • Best practice Models • Remote Access Diagnosis (RAD) and Remote Access Clinical Management (RACM) • Telemedicine • Centres of Clinical Excellence/Accreditation • Teaching Hospital paradigm • Alignment – across teaching and service delivery • Affiliate with agencies such as ACORN/NUS/SGH/UOM • Leading edge research Research Education 27
FY 2018 Results Comparison Health Statistics Indonesi Vietna Malaysi Singapor a m a e Hospital beds per 10, 000 pops 9 20 19 20 2 12 12 20 Physician per 10, 000 pops Health Profesionals per 10, 000 pops Life expectancy at birth (years) IMR per 1, 000 live birth MMR per 100, 000 live birth % Government Expenditure % Private Expenditure Healthcare Spend as % of GDP 16 69 14 126 38 62 3 24 76 11 54 54 46 7 47 75 4 40 55 45 4 Per capita total expenditure on healthcare (USD) 299 391 1, 040 Health Professional per 10, 000 pops Australi a 117. 8 112. 4 79. 0 UK re Malaysia Chin 38 19 76 83 1 10 42 58 5 79 82 2 11 54 46 7 28 68 28 174 30 70 5 32 76 6 27 56 44 6 4, 047 2, 531 US A China Australia 24. 1 7. 4 7. 1 5. 5 Korea 4. 9 Vietna 4. 7 m 15. 7 Chin a Singapo 39 33 29 25 29 28 157 83 2 6 67 33 9 118 79 4 14 48 52 17 112 81 2 9 83 17 9 9. 1 South 27. 5 UK 9. 4 U K 31. 5 USA 267 731 4, 357 9, 403 Total Healthcare Spending as % of GDP Australi a 46. 8 Source : World Bank, WHO 2017 a India 7 7 75. 6 South Singapo India 157. 2 US A Korea South Korea 103 21 4. 2 2. 8 3, 377 17. 1 28
FY 2018 Results Indonesia’s Aging Population CHANGE OF INDONESIA’S POPULATION STRUCTURE IN 44 YEARS Pyramid Population Pyramid 1971 2015 Male Total population Female Life expectan cy Urban population Studen ts Other Employe s d Total Life Urban populati expectan populati on cy on year s years Mn Source: Kompas Newspaper 12 July 2017 edition. Mn 29
30 Care and Compassion for the Nation THANK YOU BALI • BALIKPAPAN • CIKARANG • DEPOK • JAKARTA • JAMBI • KUPANG • MAKASSAR • MANADO • MEDAN • PALEMBANG • PURWAKARTA • SURABAYA • TANGERANG
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