RAMSAY SANTÉ BANK MEETING - Ramsay Santé
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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% 2227 +0.3% 2234 +0.3% 2242
2124
+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
RAMSAY SANTÉ’S FOOTPRINT *
REHAB 6%
IMAGING 4%
PSY 6%
TRANSPORT
RAMSAY SANTÉ IS NOW THE UNDISPUTED LEADER IN KEY STRATEGIC
MARKETS
#1 with a 21% of marketshare 36,000 FTEs
7,600 liberal doctors
> 200,000 short-term contracts
#1 #2
#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 21stOUR EUROPEAN EXECUTIVE TEAM, SEASONED, WITH A STRONG MEDICAL AND
MANAGEMENT BACKGROUND
Pascal Roché,
Group CEO Arnaud Jeudy,
Odile Agopian, Head of
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
Ramsay Santé – Bank meeting – 2019, November 21st
Officer
11 CounselTABLE 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 21stTHE 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 21stTHE 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
Communication tools deployed
all colleagues
Preparation of our new strategic plan
14 Ramsay Santé – Bank meeting – 2019, November 21stACTIVELY 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 GermanyTABLE 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 21stFY2019 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 7,3
10%
Other regions
3% 5% 11% FY2018 FY2019
Capio
17 Ramsay Santé – Bank meeting – 2019, November 21stACTIVITY IS IN POSITIVE TERRITORY DESPITE THE CHALLENGING
ENVIRONMENT
Former Ramsay Générale de Santé perimeter
› Ophthalmology up by 3.9% › Positive outcomes of our ED
SURGERY +1.6% › Orthopedics up by 1.4% EDs +1.9% model
› ENT surgery up by 2.8%
MEDICINE +0.3% › Endoscopy down by (0.3)% REHAB +4.9% › Very positive trend showing
› Interventional medicine up by 6% the dynamic of rehab
› Deliveries down by (5.3)% MENTAL
GYN-OBST. (4.2)% +0.7% › Some isolated activity falls ;
› Gynecology surgery down by HEALTH overall dynamic activity
(1.5)%
18 Ramsay Santé – Bank meeting – 2019, November 21stKEY 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 21stWE BENEFIT FROM A HEALTHY AND SCALABLE FINANCIAL STRUCTURE
Ramsay Santé leveraging profile
Nov 18:
Oct-14: Closing of the acquisition of
Dec-15:
merger between Capio
acquisition of
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 21stWHERE 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 21stRESILIENT 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%
237,0 229,2 239,7
225,8 18,0%
220,0 205,6
16,0%
14,0%
170,0
12,0%
12,4% 12,1%
120,0 12,7% 12,0% 12,2% 12,1% 12,0%
11,6% 11,9% 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 PlanTABLE 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 21stKEY MACRO DYNAMICS ON THE HEALTHCARE MARKET
SUMMARY OF TRENDS
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
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 21stIN 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 21stAND 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 €70.2
€56.9m €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 toWE 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 21stAS 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 packRAMSAY 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 FUTURETHE 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
30 Ramsay Santé – Bank meeting – 2019, November 21st
Restructure 1OUR 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 21stRAMSAY 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 21stOUR 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
OBJECTIVE
stress the RGDS Brand known practitioners around 9 months, together “collective interest”
prevention projects with INCO
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
RESULTS
communication end of 3% ; thousands of money to be given to 20 SU in Paris and further analyzed
2017 conversation NPO Marseille ongoing
33 Ramsay Santé – Bank meeting – 2019, November 21stIN 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 21stDIGITALIZATION IS SUPPORTING OUR INTEGRATED CARE PATHWAYS FOR BOTH
PATIENTS AND DOCTORS
PREVENTION PRIMARY CARE HOSPITALIZATION FOLLOW-UP
Social Network
Online appointement
PATIENTS
Online admission &
marketing portail
Digital consultations
Online integrated care
Telehealth solutions
Diffusion of
hospitalization reports
Online research platform
DOCTORS
Start-up incubators
Online assistance
Care related IoT
35 Ramsay Santé – DI Healthcare
** the list of solutions non exhaustiveACROSS 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% 63% +2.9% 93% 93% +4.9% 92% +1.7%
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 21stFOR 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 21stIN 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
Västerbotten population listed
82% 18%
within our centers
Uppsala 56% 44%
Stockholm 34% 66%
Skåne 58% 42%
A FRAGMENTED MARKET
Östergötland 100%
Örebro 89% 11% Primary market in France
Primary care landscape in Sweden
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 21stOUR 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 HealthcareOUR 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 21stAND A HIGH LEVEL OF INVESTMENT IN ORDER TO PREPARE FOR THE FUTURE
ILLUSTRATION OF MAJOR CAPEX PROJECTS IN FY2018 – FY2019
41 Ramsay Santé – DI HealthcareA 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 21stKEY 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 21stTABLE 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 21stTHANK YOU ! Ramsay Santé – Bank meeting – 2019, November 21st
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