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Alliance Healthcare Services Reports Results for the First Quarter Ended March 31, 2014
NEWPORT BEACH, Calif.--(BUSINESS WIRE)-- Alliance HealthCare Services, Inc. (NASDAQ:AIQ) (the "Company" or "Alliance"), a leading national provider of outsourced radiology and radiation therapy services, announced results for the first quarter ended March 31, 2014.
First Quarter 2014 Highlights
First Quarter 2014 Financial Results
"We are pleased by the first quarter performance of our oncology business, which is up 13% over the prior year period on a revenue basis. This strong growth is driven by significant increases in same store volumes for both linear accelerator and stereotactic radiosurgery, which increased by 13.7% and 4.4%, respectively, over the prior year. In addition, we benefited as a result of new revenue generated from Alliance Oncology's relationship with the Medical University of South Carolina (MUSC). Despite the impact of severe weather on our radiology service line around the country during the first quarter, Alliance Radiology revenues rebounded to plan levels in March and we have seen this performance carry forward into April," stated Tom Tomlinson, Chief Executive Officer and President of Alliance HealthCare Services."
Tomlinson continued, "We continue to be encouraged by the progress of our growth strategy, building towards our goal of being the indispensable partner of choice to our hospital customers, and delivering value across our radiology and radiation therapy service lines. We are confident that the steps we are taking to transform Alliance will help us differentiate our business model and drive continued success across our service offerings. We continue to expect improvement in healthcare services volumes, including increased patient flow, due to the Affordable Care Act, in the remaining portion of the year. Our focus on helping our hospital customers drive volume growth, and executing on our strategic plan gives us confidence that we will achieve full year guidance."
Revenue for the first quarter of 2014 was $105.4 million compared to $110.4 million in the first quarter of 2013. Of the total $5.0 million decrease, the sale of our Professional Radiology Services business line in December 2013 and pruning of unprofitable business in our Imaging Division impacted the total by $3.9 million. Organically, first quarter 2014 revenue decreased by 1% compared to the first quarter of 2013.
Alliance's Adjusted EBITDA decreased 6.3% to $33.0 million from $35.2 million in the first quarter of 2013. Of the $2.2 million decrease year over year, approximately $0.9 million was due to a prior year gain on the sale of an Oncology center and a one-time gain in one of our unconsolidated joint ventures. In addition, we invested approximately $1 million to build our consultative, sales, marketing, and strategic business development capabilities through our Enhanced Value Proposition (EVP) offering to our hospital customers--now branded the Alliance RAD360 Program.
Alliance's net income, computed in accordance with generally accepted accounting principles ("GAAP"), totaled $1.9 million in the first quarter of 2014 and ($2.4) million in the first quarter of 2013.
Alliance's historical income tax rate has been 42%, compared to the GAAP income tax rate of 43.8% in the first quarter of 2014 and 5.4% in the first quarter of 2013.
Net income on a diluted basis, computed in accordance with GAAP, increased to $0.18 per share in the first quarter of 2014 compared to ($0.23) per share for same quarter of 2013. Net income (loss) per share on a diluted basis was impacted by ($0.10) in the first quarter of 2014 and ($0.19) in the first quarter of 2013 in the aggregate due to restructuring charges, transaction costs, legal matter expenses and differences in the GAAP income tax rate from our historical income tax rate.
Cash flows provided by operating activities totaled $19.0 million in the first quarter of 2014 compared to $10.5 million in the first quarter of 2013. This increase was mainly attributed to strong collections on accounts receivable in addition to interest savings in connection with the debt refinancing completed during 2013. In the first quarter of 2014, capital expenditures were $5.7 million compared to $5.6 million in the first quarter of 2013.
Alliance's net debt, defined as total long-term debt (including current maturities) less cash and cash equivalents, decreased $9.4 million to $485.6 million at March 31, 2014 from $495.0 million at December 31, 2013. Cash and cash equivalents were $29.1 million at March 31, 2014 and $34.7 million at December 31, 2013. As a result of the Company's successful term loan refinancing in 2013, the Company's net debt was increased by $16.5 million related to fees and expenses incurred and $3.1 million due to the change in the unamortized discount on the old and new term loans. The Company's net debt, as defined above, divided by the last twelve months Consolidated Adjusted EBITDA was 3.34x for the twelve month period ended March 31, 2014 compared to 3.66x for the twelve month period ended a year ago. The Company's total debt, as defined above, divided by the last twelve months Consolidated Adjusted EBITDA was 3.54x for the twelve month period ended March 31, 2014 compared to 3.88x for the twelve month period ended a year ago.
Tomlinson commented, "As we move further into 2014, the strong performance in our oncology division during the first quarter provides us increased confidence in our 2014 outlook and validates our full-service, partnership model. Our pipeline of new opportunities is growing and consistent with the commentary on our last call, we are investing in our sales and business development team. Within Alliance Radiology the team has made strong progress in building our RAD360 capabilities, including the recent acquisition of OnPoint's technology suite. Our team responded well to the challenging weather in Q1, resulting in positive same store volume in March for MRI. Additionally, we have a number of significant hospital and system strategic partnership opportunities in our business development pipeline. I remain confident these investments will enable us to unlock the significant growth potential of Alliance Radiology, ensure we remain focused on generating strong free cash flow, and create long-term growth for our shareholders."
Full Year 2014 Guidance
Alliance is confirming its full year 2014 guidance ranges as follows:
First Quarter 2014 Earnings Conference Call
Investors and all others are invited to listen to a conference call discussing first quarter 2014 results. The conference call is scheduled for Wednesday, May 7, 2014 at 5:00 p.m. Eastern Time. The call will be broadcast live on the Internet and can be accessed by visiting the Company's website at www.alliancehealthcareservices-us.com. Click on Audio Presentations in the Investors section of the website to access the link.
The conference call can be accessed at (877) 638-4550 or (973) 582-2737. Interested parties should call at least five minutes prior to the call to register. A telephone replay will be available until August 6, 2014. The telephone replay can be accessed by calling (855) 859-2056 or (404) 537-3406. The conference call identification number is 40420120.
Definition of Non-GAAP Measures
Adjusted EBITDA and Adjusted Net Income Per Share are not measures of financial performance under generally accepted accounting principles in the United States, or "GAAP."
For a more detailed discussion of these non-GAAP financial measures and a reconciliation to the most directly comparable GAAP financial measure, see the section entitled "Non-GAAP Measures" included in the tables following this release.
About Alliance HealthCare Services
Alliance HealthCare Services is a leading national provider of outsourced radiology and radiation therapy services based upon annual revenue and number of systems deployed. Alliance focuses on MRI, PET/CT and CT through its Imaging division and radiation therapy through its Oncology division. With approximately 1,800 team members committed to providing exceptional patient care and exceeding customer expectations, Alliance provides quality clinical services for over 1,000 hospitals and other healthcare partners in 43 states. Alliance operates 497 diagnostic imaging and radiation therapy systems. The Company is the nation's largest provider of advanced diagnostic mobile imaging services and one of the leading operators of fixed-site imaging centers, with 123 locations across the country. Alliance also operates 30 radiation therapy centers, including 18 stereotactic radiosurgery facilities, many of which are operated in conjunction with local community hospital partners, providing treatment and care for cancer patients. With 18 stereotactic radiosurgery systems in operation, Alliance is among the leading providers of stereotactic radiosurgery nationwide.
This press release contains forward-looking statements relating to future events, including statements related to the Company's cost savings plan and long-term growth, including its efforts to expand the Radiation Oncology Division and hospital and healthcare group partnerships; the Company's expectations with respect to customer retention, new sales and growth in radiology services volume, and their impact on 2014 results, the Company's Full Year 2014 Guidance, including its forecasts of revenue, Adjusted EBITDA, cash capital expenditures, cost savings due to refinancing of the Company's credit facility and decrease in long-term debt. In this context, forward-looking statements often address the Company's expected future business and financial results and often contain words such as "expects," "anticipates," "intends," "plans," "believes," "seeks" or "will." Forward-looking statements by their nature address matters that are uncertain and subject to risks. Such uncertainties and risks include: changes in the preliminary financial results and estimates due to the restatement or review of the Company's financial statements; the nature, timing and amount of any restatement or other adjustments; the Company's ability to make timely filings of its required periodic reports under the Securities Exchange Act of 1934; issues relating to the Company's ability to maintain effective internal control over financial reporting and disclosure controls and procedures; the Company's high degree of leverage and its ability to service its debt; factors affecting the Company's leverage, including interest rates; the risk that the counterparties to the Company's interest rate swap agreements fail to satisfy their obligations under these agreements; the Company's ability to obtain financing; the effect of operating and financial restrictions in the Company's debt instruments; the accuracy of the Company's estimates regarding its capital requirements; the effect of intense levels of competition in the Company's industry; changes in the methods of third party reimbursements for diagnostic imaging and radiation oncology services; fluctuations or unpredictability of the Company's revenues, including as a result of seasonality; changes in the healthcare regulatory environment; the Company's ability to keep pace with technological developments within its industry; the growth or lack thereof in the market for imaging, radiation oncology and other services; the disruptive effect of hurricanes and other natural disasters; adverse changes in general domestic and worldwide economic conditions and instability and disruption of credit markets; difficulties the Company may face in connection with recent, pending or future acquisitions, including unexpected costs or liabilities resulting from the acquisitions, diversion of management's attention from the operation of the Company's business, and risks associated with integration of the acquisitions; and other risks and uncertainties identified in the Risk Factors section of the Company's Form 10-K for the year ended December 31, 2013, filed with the Securities and Exchange Commission (the "SEC"), as may be modified or supplemented by our subsequent filings with the SEC. These uncertainties may cause actual future results or outcomes to differ materially from those expressed in the Company's forward-looking statements. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof. The Company does not undertake to update its forward-looking statements except as required under the federal securities laws.
ALLIANCE HEALTHCARE SERVICES, INC.
Adjusted EBITDA and Adjusted Net Income Per Share (the "Non-GAAP Measures") are not measures of financial performance under generally accepted accounting principles in the United States, or "GAAP."
Adjusted EBITDA, as defined by the Company's management, represents net income (loss) before: interest expense, net of interest income; income taxes; depreciation expense; amortization expense; net income (loss) attributable to noncontrolling interests; non-cash share-based compensation; severance and related costs; restructuring charges; fees and expenses related to acquisitions, costs related to debt financing, legal matter expenses, non-cash impairment charges, and other non-cash charges included in other (income) expense, net, which includes non-cash losses on sales of equipment. The components used to reconcile net income (loss) to Adjusted EBITDA are consistent with our historical presentation of Adjusted EBITDA.
Adjusted Net Income Per Share, as defined by the Company's management, represents net income (loss) before: restructuring charges; fees and expenses related to acquisitions; legal matter expenses; and differences in the GAAP income tax rate compared to our historical income tax rate. The components used to reconcile net income (loss) per share to Adjusted Net Income Per Share are consistent with our historical presentation of Adjusted Net Income Per Share.
Management uses the Non-GAAP Measures, and believes they are useful measures for investors, for a variety of reasons. Management regularly communicates the results of its Non-GAAP Measures and management's interpretation of such results to its board of directors. Management also compares the Company's results of its Non-GAAP Measures against internal targets as a key factor in determining cash incentive compensation for executives and other employees, largely because management feels that these measures are indicative of how our diagnostic imaging and radiation oncology businesses are performing and are being managed. The diagnostic imaging and radiation oncology industry continues to experience significant consolidation. These activities have led to significant charges to earnings, such as those resulting from acquisition costs, and to significant variations among companies with respect to capital structures and cost of capital (which affect interest expense) and differences in taxation and book depreciation of facilities and equipment (which affect relative depreciation expense), including significant differences in the depreciable lives of similar assets among various companies. In addition, management believes that because of the variety of equity awards used by companies, the varying methodologies for determining non-cash share-based compensation expense among companies and from period to period, and the subjective assumptions involved in that determination, excluding non-cash share-based compensation from Adjusted EBITDA enhances company-to-company comparisons over multiple fiscal periods and enhances the Company's ability to analyze the performance of its diagnostic imaging and radiation oncology businesses.
In the future, the Company expects that it may incur expenses similar to the excluded items discussed above. Accordingly, the exclusion of these and other similar items in the Company's non-GAAP presentation should not be interpreted as implying that these items are non-recurring, infrequent or unusual. The Non-GAAP Measures have certain limitations as analytical financial measures, which management compensates for by relying on the Company's GAAP results to evaluate its operating performance and by considering independently the economic effects of the items that are or are not reflected in the Non-GAAP Measures. Management also compensates for these limitations by providing GAAP-based disclosures concerning the excluded items in the Company's financial disclosures. As a result of these limitations and because the Non-GAAP Measures may not be directly comparable to similarly titled measures reported by other companies, however, the Non-GAAP Measures should not be considered as an alternative to the most directly comparable GAAP measure, or as an alternative to any other GAAP measure of operating performance.
The reconciliation of Adjusted EBITDA to net income (loss) is shown below:
The leverage ratio calculations as of March 31, 2014 are shown below:
The reconciliation of (loss) earnings per diluted share - GAAP to adjusted (loss) earnings per diluted share non-GAAP is shown below:
The reconciliation from net income to Adjusted EBITDA for the 2014 guidance range is shown below (in millions):
ALLIANCE HEALTHCARE SERVICES, INC.
The Company utilizes same store volume growth as a historical statistical measure of the MRI and PET/CT imaging procedure, linear accelerator treatment and SRS case growth at its customers in a specified period on a year-over-year basis. Same store volume growth is calculated by comparing the cumulative scan, treatment or case volume at all locations in the current year quarter to the same quarter in the prior year. The group of customers whose volume is included in the scan or treatment volume totals is those that received service from Alliance for the full quarter in each of the comparison periods. A positive percentage represents growth over the prior year quarter and a negative percentage represents a decline over the prior year period. Alliance measures each of its major imaging and oncology modalities, MRI, PET/CT, linear accelerator and SRS, separately.
The imaging division same store volume growth/(decline) for the last four calendar quarters ended March 31, 2014 is as follows:
The oncology division same store volume growth for the quarter ended March 31, 2014 is as follows:
Source: Alliance HealthCare Services, Inc.