瑞信-美股-医疗保健行业-一季度医疗设施行业总结：尽管流感比较严重，但总体结果仍喜忧参半-5-26页.pdf
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DISCLOSURE APPENDIX AT THE BACK OF THIS REPORT CONTAINS IMPORTANT DISCLOSURES, ANALYST
CERTIFICATIONS, LEGAL ENTITY DISCLOSURE AND THE STATUS OF NON-US ANALYSTS. US Disclosure: Credit
Suisse does and seeks to do business with companies covered in its research reports. As a result, investors should be aware
that the Firm may have a conflict of interest that could affect the objectivity of this report. Investors should consider this report
as only a single factor in making their investment decision.
10 May 2019
Americas/United States
Equity Research
Healthcare Facilities
Healthcare Facilities
QUARTERLY
Research Analysts
A.J. Rice
212 325 8134
Caleb Harris, CPA
212 325 7458
Jailendra Singh
212 325 8121
Eduardo Ron
212 325 7491
Q1 Hospital Recap: Solid Vols Despite Tough
Flu Comp, Still Overall Results Mixed
■ Overall Results Mixed: Two of the four public hospital companies that we
cover reported EBITDA ahead of consensus expectations. HCA beat the
Street by a wide margin ($262 mln ahead, including an $86 mln payor
settlement award), while THC was ahead of the Street by $9 mln. UHS and
CYH both missed consensus expectations modestly.
■ Q1 Volumes Generally Strong Despite the Flu Comp: For the first
quarter of 2019, the hospital group reported SS inpatient admissions
growth of 1.5%, on average. This represents an increase in the Y/Y growth
rate of 110 bps sequentially and an increase of 130 bps Y/Y. UHS had the
strongest growth in SS admissions at 5.2%, followed by HCA at 0.9%. CYH
and THC both SS admissions down just 0.1%, a significant improvement
for both companies relative to the recent past. SS adjusted admissions
grew 2% for the group, on average, a sequential improvement of 110 bps
and a Y/Y improvement of 190 bps in the growth rate. UHS was strongest
on this metric as well at 4.9%, followed by HCA at 1.8%, CYH at 0.8%, and
THC at 0.6%. Each of the four companies said that a tough flu comp was a
headwind to volume growth on a Y/Y basis.
■ Q1 Pricing Metrics: On pricing, the group reported a Y/Y increase in net
revenue per adjusted admission of 1.9%, on average, in the first quarter of
2019. This represents a decrease in the Y/Y growth rate of 60 bps
sequentially and 200 bps relative to 1Q18. HCA had the strongest pricing
growth at 4.4% (3.6% ex- the settlement award), while UHS had a pricing
decline of 0.4%. UHS attributed the pricing weakness to a lower mix of
surgical services and a higher mix of medical cases.
■ Outlook for Remainder of Year: CYH, THC, and UHS maintained the key
figures in their 2019 guidance. HCA modestly increased its EBITDA
guidance to account for the $86 mln settlement award, which was not in
original guidance. HCA is tracking well ahead of expectations after Q1, so
we could see a positive guidance revision when the company reports Q2
results. For THC, operating trends are looking somewhat better. Conifer
profitability has improved, but focus remains on the company’s plan to
conduct a strategic transaction with respect to Conifer. We’ll look for UHS’
SS pricing to bounce back in Q2, and focus will stay on potential
improvement in the psych segment (which looked a bit better in 1Q19).
While CYH’s volumes have picked up, the main focus there continues to be
on the capital structure challenges and the divestiture program.
■ Updating Models: With this note, we are updating our CYH, THC, and
UHS models. Our THC target price is now $25 (prev $33), and our UHS
target price is now $150 (prev $152). Risks to our ratings and target prices
for all hospital companies include volume and pricing trends.
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