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Air Methods Corporation (NASDAQ:AIRM)

Q3 2013 Earnings Conference Call

November 07, 2013 4:15 p.m. ET

Executives

Christine Clarke – Investor Relations

Aaron D. Todd – CEO

Trent J. Carman – CFO & Treasurer

Michael Allen – President, Domestic Air Medical Services

Analysts

Ryan Daniels - William Blair

Bob Labick – CJS Securities

Matt Weight – Feltl and Company

Kevin Campbell – Avondale Partners

Operator

Good afternoon, my name is Hope and I’ll be your conference operator today. At this time I would like to welcome everyone to the Air Methods Report 2013 Third Quarter Financial Results. All lines have been placed on mute to prevent any background noise. After the speakers’ remarks, there will be a question-and-answer session. (Operator Instructions).

Thank you. Ms. Christine Clarke, you may begin your conference.

Christine Clarke

Good afternoon and thank you for joining us today to review Air Methods’ third quarter 2013 financial results. My name is Christine Clarke and I’m with Air Methods Corporation. Also on the call today representing the company are Mr. Aaron Todd, Chief Executive Officer; and Mr. Trent Carman, Chief Financial Officer. At the conclusion of today’s prepared remarks, we will open the call for a question-and-answer session.

I would like to remind everyone this conference call includes statements that constitute forward-looking statements within the meanings of the Private Securities Litigation Reform Act of 1995. This conference call includes certain forward-looking statements which are subject to various risks and uncertainties. Actual results could differ materially from those anticipated due to a number of factors, including but not limited to the size, structure and growth of the company’s Air Medical Services and United Rotorcraft Division, the collection rates for patient transports, the continuation, expansion, conversion and/or renewal of Air Medical Services contracts, the acquisition of profitable United Rotorcraft Division contracts and other flight service operations, the final result of preliminary October 2013 flight volumes, weather conditions across the U.S., development and changes in laws and regulations including without limitation, the impact of the patient protection and affordable care act, increased regulation of the health care and aviation industry through legislative action and revised rules and standards and other matters set forth in the company’s public filings.

With that having been said, I would like to turn the call over to Mr. Aaron Todd, Chief Executive Officer of Air Methods Corporation.

Aaron D. Todd

Thanks, Christine, and thank you for joining us this afternoon. In addition to what Trent will highlight in a moment concerning our quarterly and year-to-date 2013 results, I wanted to draw attention to a few notable observations.

As we had anticipated net revenue per transport reflects the full benefit of historical price increases having exceeded the $12,000 per transport discussed in our last conference call. The percentage of patients transported with private insurance lag 90 days to allow for verification was 34.3%. This percentage was 35.5% last year for the quarter after same point in time. As we discuss, we anticipated roughly a 1% reduction associated with increase in Medicare recipients as baby boomers continued to retire.

July 2013 payer mix is now nearly fully verified in this current year at 36.4% privately insured as a percentage of total transports nearly equal with July 2012 insured level. Net cash provided by operating activities during the first nine months of 2013 was $113.4 million. This represents an 18% increase over the prior year period despite reduction in comparative earnings. This is due to the reductions in days sales outstanding realized through strong cash receipts. Although whether adjusted same-based transports continued to show softness as a 3% decline, this reflects improvement over the previous quarter where we experienced the reduction of 6% weather adjusted. Our flight variations year-to-date are in line with what our hospital based customers are experiencing on average.

Maintenance expense did moderate relative to prior year levels during the quarter and were in line with change in flight volumes unlike the first half of 2013. We anticipated this moderation as scheduled inspection and overhauls on particular aircraft models were skewed towards the first half of the year.

Since our last conference call, the following key events have occurred. We have opened four new community-based operations in October with four additional base openings planned between now and the end of the year. We anticipate a total of eight hospital-based conversions with related satellite-based expansions by the end of 2013 for the full year.

In addition, the company has received verbal commitment for addition outsourcing of seven existing hospital-based locations plus two related satellite based expansions involving four of our existing hospital-based programs. These conversions are anticipated to occur sometime during the early part of 2014. In response to weak demand in certain market, the company aggressively address underperforming operations and close seven operating base locations since the beginning of August.

In addition, the company received notification from three of its hospital-based customers that they would not be renewing their contract with us involving four locations on November 1, and one location in February of 2014. Competitive conflicts were deemed primarily factors in our ability to reach renewal agreements which should allow for greater ability to meet our surviving customer expectations in these markets. Our preferred provider relationship implementation with community health is essentially complete. During the current year third quarter we completed 623 community-based patient transports on their behalf. This compares with 544 during the second quarter of 2013 and 453 during the prior year third quarter.

Well, our United Rotorcraft division has experienced difficult financial results year-to-date, its current external backlog is now over $50 million. The external revenue during the fourth quarter is anticipated to accelerate significantly as a result of delayed government contracts that were secured in late September.

Well, it is always difficult to predict quarter results in our operations; certain factors are in place to support optimism during the next few quarters. First outsourcing activity demand from our hospital-based relationship is expected to be at historical highs over the next few quarters. If payer mix continues to maintain its recent stability, current reimbursement allow should reflect strong growth over prior year and first half 2013 levels. The prior year winter and spring season was very severe and decreases the likelihood of a repeat at the same level of severity. Greenfield community based expansions have generally shown good performance and we continue to develop these expansion opportunities. And improvement in the United Rotorcraft earnings compared with 2013 quarter year-to-date should also begin contributing once again to overall corporate fiscal performance.

So with that summary, I will turn the call over to Trent to give more specific details on the third quarter financial results.

Trent J. Carman

Thank you, Aaron. I’ll start by offering some details on our operating expenses for the most recent quarter. Flight center expenses for the third quarter of 2013 were $89.4 million. Aircraft operating expenses were $35.6 million, cost of sales for United Rotorcraft were $5.3 million. Tourism operating expenses were $9.2 million.

For the third quarter of 2012 these expenses were $81.3 million, $37.8 million, $5.9 million and zero respectively. Maintenance expense was $24.6 million and $26.4 million for the third quarters of 2013 and 2012 respectively and fuel expense was $6.7 million and $6.4 million respectively for these two periods. These numbers were for the Air Medical Services division only.

Earnings before interest, income taxes, depreciation and amortization or EBITDA were $82.8 million and $73.6 million for the third quarters of 2013 and 2012 respectively. EBITDA for the trailing 12 months ended September 30, 2013 was $215.2 million. You can reconcile EBITDA by adding interest expense, depreciation and amortization, and adding a loss on disposition of assets to income before income tax expense.

On a three-month lag basis, the company’s payer mix for the three months ended June 30, 2013 was 34% insurance, 32% Medicare, 21% Medicaid and 13% uninsured. This compares to 32% for insurance, 34% Medicare, 21% Medicaid and 13% uninsured for the three months ended March 31, 2013. For the 12 months ended June 30, 2013 the payer mix was 34% insurance, 32% Medicare, 21% Medicaid and 13% uninsured.

For the 12 months ended March 31, 2013, cash collections as a percentage of our gross charge for insured payers was 76%, cash payments as a percentage of gross charge for Medicaid and Medicare were 20% and 8%, respectively for the same period.

Year-to-date the company has entered into 44 aircraft promissory notes totaling $120 million. The company has acquired seven aircraft approximately $28 million and bought up 43 leases for approximately $93 million. Flying out aircraft leases has helped to reduce our depreciation expense due to the different useful life and solid value assumptions associated with owned versus leased aircraft and has reduce our interest expense as the interest rate and new promissory notes and on our revolving line of credit is lower than the incremental borrowing rate on the aircraft leases.

Additionally, aircraft has provided with the very favorable tax depreciation deduction. The company intends to exercise the early buyout options on 7 aircraft for the remainder of 2013. The total cost of the buyouts will be approximately $15 million and we expect approximately $10 million of this to be financed with new promissory notes.

For 2014, we intend to exercise the early buyout on 19 aircraft or approximately $37 million. At September 30, 2013 as Aaron previously mentioned our day sales outstanding on an annualized three months basis were 92 days. This compares to 106 days at December 31 and 108 days at the prior year period. At September 30, the company operated approximately 400 aircraft in its aircraft operations and 25 aircraft in its Tourism operations. The company operated 173 bases that generated patient transport revenue and 112 bases that generated Air Medical Services contract revenue.

With that, I’ll turn it over to Aaron for his closing remarks and then question.

Aaron D. Todd

Thanks Trent. I think what we will do at this time is open it up to questions from our various analysts.

Question-and-Answer Session

Operator

(Operator Instructions) Your first question comes from the line of Ryan Daniels with William Blair.

Ryan Daniels - William Blair

Yes, good evening guys. Thanks for taking my questions. Just the first one I guess to you Aaron. You mentioned record momentum in each HBS to CBS conversions. I know that’s very favorable for the company in the revenue and profits standpoint. So curious if there is anything in particular that is driving that suddenly this quarter next quarter and kind of looking forward?

Aaron D. Todd

You know lot of these opportunities have been, discussions that have been gone going for several months some have been the byproduct of various consolidations going on within the hospital community, and it was interesting. Those four systems communicated verbally their intent within about 48 hour period even though the reasons were diverse and the conversations had varied from lengthy to short. So it was – it can be very unpredictable but I would say broadly speaking, there is great momentum associated with the affordable care act to focus on core services. There is certainly some byproduct of consolidations. There is an interest in utilizing the outsourcing options to allow not only for risk sharing or risk shifting but also to expand capacity and scope of operation. So there are a myriad of reasons and advantages why many of our partners are choosing this path but as we remind our hospital partners those specifically that do not have this as one of their objectives we are happy to be there aviation partners for as long as they will have us as well.

Ryan Daniels - William Blair

Okay, very helpful. And then couple of more quick ones. Just the United Rotor backlog, I think that’s probably as big as it's ever been. I am curious how long that backlog typically takes to come into the revenue stream?

Aaron D. Todd

Well, we picked up $9 million contract involving the backlog what we refer to as the IMS interior in like September and it was – we were worried that that money might get lost to the fiscal year end and then of course with the government shutdown, it was a little bit nip and tuck but credit to our team. They got the contract fully secured and we will have some significant flow of revenue because we had already had some inventory that had been produced and manufactured even in anticipation of that eventuality and we were grateful to secure the contract in the end.

Ryan Daniels - William Blair

Okay, and then the last one I will hop off. Just any color you might have on your new EVP business development. I don’t know if that was a replacement of an open role or new position but any color specifically if you are focusing more on M&A activity and then if so any color on domestic, international air ambulance ground other kind of any color you can give what we should read into that higher?

Aaron D. Todd

You bet and we have been very open in a myriad of needs. We continued to look at opportunities to grow this company both organically and inorganically. Some of the present inorganic pursuits include international opportunities. We are very interested in additional opportunities to expand our tourism and certainly within our Air Medical space whether it be within rotor wing or potentially vertical integration. And we were just finding that the drain on our resources of not having a kind of head to that process was becoming the challenge and we wanted to bring greater focus and discipline around that. So we are very pleased to have David Doerr with us, bring his great talent, but his background is very health care focused and so certainly his primary focus will be in helping us if you are heading up our M&A efforts but also to assist us in many of our business development initiatives within our core services as well and so this is an organization that has to some extent more opportunities than we can manage and develop within the scope of our senior leadership and right now we believe building a little bit of depth at the senior levels is going to pay significant returns and we are very grateful to have him on board.

Ryan Daniels - William Blair

Okay. Very helpful color and congrats on all the strengths for this quarter.

Aaron D. Todd

Thank you.

Operator

Your next question comes from the line of Bob Labick with CJS Securities.

Bob Labick – CJS Securities

Good after noon.

Aaron D. Todd

Hi Bob!

Bob Labick – CJS Securities

Hi! I wanted to start with the payer mix. Obviously it's good to see it continues to increase and normalize. You had some more time to go back and analysis this what happened in the past and just wanted to get your latest thoughts and take on what cause the depth if you will and short patients, are we fully back, where do you expect that to go overtime and what you have learned about the changes that we have seen?

Aaron D. Todd

Bob, you know if you go with the most up-to-date, most recent information that would be the month it is 90 days lagged in next July and July if you looked at where July was verified a year ago for July 2012 and where July is verified to-date, it's almost identical at a very strong 36.4% which is the highest percentage verification month that we have had in either year.

So and typically you would have expected to see that down about eight tenths of a percent associated with the Medicare shifting which we haven’t seen and so I would argue that it reflects even a little bit better than expected or anticipated outcome relative but that’s just one month. If you look at it on the most recent quarter-over-quarter, then it's kind of more in line with what we have expected as a very stable profile reflecting the migration of retires in the Medicare. What the volatility if you recall, we experienced a 4.5% shift from what we experienced in the kind of second and third quarters versus what ended up getting verified in the fourth quarter of 2012 and therefore trued up in the first quarter of 2013 which we had never seen before. And when we went back and looked at all of the variations of seasonality we have never seen more than a 1.5%.

So there is nothing as we have tried to wet this out that would indicate that we should somehow build in a predictive seasonality factor to payer mix but certainly we will be very open with you as these percentages began to convey themselves but I personally believe that the severity of the winter not only affected demand but also had a more pronounced effect on the payer mix last year and that seems to be bearing out as the payer mix is returning to a more historical level going into the summer months compared to the prior year summer months.

So I don’t think it's reflective of any macro changes in either the markets where we are serving or broader things going on within the economy or the insured status of the patients for transporting.

Bob Labick – CJS Securities

Okay, great, thanks. Good color there. And then just on DSOs obviously very low number there which is great, part of it obviously mathematical with the strong revenues but are you doing anything different in collections? You are seeing anything differently out there or the trends have been good for the last few quarters?

Aaron D. Todd

No, we haven’t done anything different Bob than we have done for several years now. Just to give you a point of reference you know when you have a high revenue quarter or a low revenue quarter that can impact the DSO which is by the sheer math of the daily sales. So when you look the DSOs using a six month revenue number for September of 2013 it was 100 days, for December of 2012 it was 106 and September of last year it was 106. So just to put in a perspective obviously there was a good revenue quarter that did help bring that down but there has been no change in the collection methodologies or anything of that nature.

Trent J. Carman

Yes, one of the things we tried to say the reason why the numbers spiked up much at March 31 was because if we using annualized 90 day revenue measure to compete your DSO as you are going to see the effect of seasonality true up to the reserves, etcetera have a more distorted effect on the DSO computation. So in the SEC filings we have begun to show comparative numbers using both six and three months annualized revenue methodology so that if you want to have a number that is more recent and reflective then you can use the 90 day but I would say that the six month annualized numbers probably more indicative of what the real longer term trend profile is.

Bob Labick – CJS Securities

Okay. Great.

Trent J. Carman

Take some of that seasonality out of it.

Bob Labick – CJS Securities

Right, absolutely. And then looking at obviously net revenue for transport is very strong and we had anticipated from last call and the trends but also I mean pricing has been -- taken halt there. What are your thoughts on kind of go forward basis? I think previously you said probably you did, your price increases for 2013 but how do you look at either the rest of this year, next year or what do you think on that pricing?

Aaron D. Todd

We talked a lot about this and as you know we have not really, all we really did was accelerate our pricing into May 1 to kind of compensate for what we lost with the weather headwinds in the first half of the year but have not felt the need to do any supplemental increases for the remainder of this year and I think we have got more than enough fire power from the pricing to-date to drive our growth objectives through the end of the year and then one of the changes that we believe would be appropriate as we have kind of experienced the effects of that and have kind of validated in our strategic plan is we think it maybe more to our advantage to do a single price increase for the full year on January 1 and that would be indicative of what we might have spread out over the four quarters and then have that be in front of what is traditionally our weakest quarter that gives us a little push and if we do see any real effects from severity of winter or any seasonality in the payer mix although we hope that it won’t be as severe as it was last year. We are not expecting it to be.

But we found that when we did the acceleration in May, that it really didn’t have any major effect on volume or push back from payers and therefore maybe instead of always bombarding the marketplace with a quarterly increases that it might be easier just to do a single increase at the beginning of the year and then only worry about having to do any supplemental increases if indeed other factors materialize that we haven’t anticipated such as shift in payer mix or volume changes that we are not short term in nature. So that is the current plan and what will be built into our 2014 strategic planning and it shouldn’t overly change what the outlook for the year will be other than it will give us a little bit of front end of advantage that should offset some of the seasonality that would have otherwise been there.

Bob Labick – CJS Securities

Okay, great that sounds terrific. Thank you very much.

Aaron D. Todd

You bet.

Operator

Your next question comes from the line of Matt Weight with Feltl and Company.

Matt Weight – Feltl and Company

Good afternoon. Aaron I wonder if you can comment so July mix sounds like it was 36.4% what would that imply for an October net revenue for transport number?

Aaron D. Todd

Well as you know July is essentially going to be updating the estimate that we had put in for when we booked July would have been the April estimate. The April estimate would have been based upon I don’t know what was initially put but it was 33.4%. So it will come in stronger than what was initially booked. So it will be a favorable true up in October. So it's certainly going to be equal to or better than what our average was for the quarter but I think you want to be – but – there is nothing to suggest that our payer mix for the fourth quarter which is based on the third quarter is going to be materially different than what it ended up being in the third quarter based upon the payer mix of the second quarter because that I mean there is – you got to be very careful about strap in single month.

And again, if somebody were to ask me as they did on the last conference call what's your best estimate for net revenue for transport for the quarter I would say the same thing; something north of 12,000 to transport which is basically where we came in at here and I would give you the same guidance for the fourth quarter even though we typically aren’t very good about hitting out quarterly guidance that would be my best estimate based upon what I am seeing today.

Matt Weight – Feltl and Company

Okay. And can you talk a little bit the four openings that you had here in October and the four that you plan on before your end? Are those and overlapping markets, new markets? Can you give any details there?

Aaron D. Todd

You know they are spread out because some of them haven’t been opened yet. We need to keep our competitive advantage there. So I can't go into those but I have got Michael Allen, our President of the division. The four that just opened Mike, you want to speak to those at all.

Michael Allen

Well, we just opened a couple in Oregon, Eastern Oregon as a result of our change in relationship there. Those are on the books. We would hope to open those little bit earlier in the year but licensing requirement slowed this down a bit. And the other two are anticipated to be good productive basis opening down in the southern part of the country during the going into the fair season there.

Aaron D. Todd

Yes, we’ve got in some of those areas where they tend to be lower reimbursement environments we you know one case we have some subsidization there and so each situations all are bit different, but no we don’t none of these locations as I recall are in close proximity where cannibalization is a major concern?

Matt Weight – Feltl and Company

Okay, okay. Very good. And then just for the quarter your comp is down 6% I think for the month of July it was down 10%, so do you have any comments must have been a pretty back half of the quarter?

Aaron D. Todd

I think we’ve seen general positive trending I think on a weather adjusted where we were only down 3% for the quarter if you adjusted for weathering you are right July was far worse and although it was much of it attributed to weather and if you look at October on a weather adjusted basis it’s down just fractionally and it’s up overall on a just a total number. And so I think that if you look at just kind of trying to show little bit of productiveness, I would characterize that the month of October in 2012 was kind of an average month, November was a mild month relative to weather and December was a horrific month relative to weather, so I say if you kind of through it all on the blender you would say we got a kind of an average quarter to compare against for weather comps, but certainly at least October is in the bag and the volume has been fairly reasonable considering some of the softness it’s generally been experienced within hospital admissions and certainly with what we had experienced last winter. December is going to be a very easy comp and November is going to be a more difficult comp, but I would say the December is a more easy comp than is November a tough comp.

Matt Weight – Feltl and Company

Okay and just last question here thinking about next year and fermentation of ACA presumably you’ll see some sort of improved payer mix, but are there any concerns that you have that we should be kind of think it about? Thanks.

Aaron D. Todd

Well, I think just the general concerns everyone has I mean there’s such an uncertainty as to the ability for individuals to get signed up on the exchanges and as I indicated we are not building anything into our 2014 budget model relative to improved payer mix and if it comes, it comes, but in my kind of large range forecast or five year forecast I kind of shift everything kind of a year to the right to basically allow websites and regulations and deferments and all of those things to kind of you built in and I think that has been -- I think that’s proving prudent so that we don’t let our in our cost structure or expansion or CapEx or any of those things be reliant upon things that invariably are going to benefit us.

But could arrive six months a year later and be maybe less than we have anticipated there are various numbers out there that indicate what it could ultimately mean, but then trying to put that in the context of what the volume trends are makes it also difficult, but certainly we are very bullish as to what it’s going to mean relative to reimbursement in payer mix. But when and how quickly is difficult to predict and to what extent it breeds further appetite for expansion of capacity and whether that creates a utilization offset, I think it’s something that you still have to be sensitize to.

Matt Weight – Feltl and Company

Thank you.

Operator

Your next question comes from the line of Kevin Campbell with Avondale Partners.

Kevin Campbell – Avondale Partners

Good afternoon. Thanks for taking my questions Trent also maybe you could start by talking about G&A it was up about million and half sequentially and so I’m curious what sort of drove that and how we should think about that going forward especially in light of your new hire?

Trent J. Carman

Well, it is part of G&A have a couple of things there Kevin just you should see we are aware obviously there is year-over-year if we’re looking at year-over-year you have the tourism division that’s in there, sequentially of course you don’t have that, but that is one impact there, the second thing is we have just we’ve discussed the transfer center operations which relate to our Air Medical Services Apps and they have out of the significant number of new employees there to help support the increased volume that they have there were some of the contractual relationships.

So that’s the majority of the increase is obviously some other stuff that will be disclosed in the 10-Q that you can see I think it’s tomorrow, but that’s a majority of the increase going forward I would expect it to be comparable, I don’t expect that to come down significantly for the quarter.

Aaron D. Todd

Kevin one of the things we’ve talked about at the transfer center that trends referring to, they’ve got 50 more FTEs and these are revenue generating positions even though they function in an administrative capacity it’s really an SG&A kind of role, but they really functioning in a kind of a revenue generating capacity. So we may, as that function becomes more material to the overall operation, we may look to create a separate line item so that it doesn’t create or distorted, now these things are disclosed in the MD&A for transparency, but it can make it look like the G&A is creeping at a heavier pace.

The other thing that creates this dynamic is hospital based operations have a lower overhead or G&A burden then community based operations because community based operations have to have dispatch billing services, program administration, clinical training, marketing expenses that safe within that general and administrative line item and as we migrate more into the as you see the mix of basis migrate away from hospital based and into community based and Trent gave you that mix that you could look at that also going to increase the general administrative burden because you’ve got those added functions that now have to be supporting those operations that we are not relevant in the hospital based operations.

So we are going to think about as that migration occurs as the transfer center grows, how to perhaps maybe breakout some of those line items without creating too complex income statement, so that you can see that, but for the time being you get a lot of more detail in the MD&A they help you see that that’s not associated with a lot of corporate administration expansion.

Kevin Campbell – Avondale Partners

Yes, okay. And I missed the answer to Ryan’s question about backlog and sort of timing on how quickly you can realize that $50 million in revenue is that sort of 12 months period or 24 months period how should we think about?

Trent J. Carman

There’s a little of that, that extends beyond ’14 because some of the Blackhawk is a multiyear, but I would say a great percentage of majority certainly is going to be over the next 15 months?

Kevin Campbell – Avondale Partners

Okay and then last question, Trent I’m curious on the DSO front you have, one of the reasons why it increased last year in the third and fourth quarter was also a relationship you had with one of your commercial payers that kind of extended that and I’m curious now 12 months later, sort of how that has gone, did you end up resulting benefit of the firm or detriment and if a detriment did you cancel the relationship and is part of the -- some idea --?

Trent J. Carman

The relationship is still ongoing Kevin, so what you are seeing now is a cycle of the whole period or all of the periods that are presented in the financials, so nothing has changed in that regard and yes we are happy with the relationship.

Kevin Campbell – Avondale Partners

Okay, great. That’s all I have thank you very much.

Aaron D. Todd

Thank you.

Operator

(Operator Instructions) And there are no further questions at this time.

Aaron D. Todd

Very good. I just wanted to mentioned Trent and I were attending our boarding meeting this week out of town and are going to be heading to the airport to catch a flight, so we apologize if we’re not available until the morning to answer your any individual questions you might have, but we’ll be back in the office in the morning and certainly if you want to leave us messages we might have time to respond to your calls while we are waiting to catch our flight. We try to get those returned as quickly as we can and appreciate your participation on the call and we’ll be in touch as soon as we can with any individual questions you have. Trent you know when the Q is going to be filed? I think its tomorrow, so you will have access to that and that might generate a few more questions and would refer you to that document as well. Thanks again for your participation.

Operator

Thank you, this does conclude today’s conference call. You may now disconnect.

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