INVESTOR PRESENTATION Winter 2020 FORWARD LOOKING STATEMENTS This - - PowerPoint PPT Presentation
INVESTOR PRESENTATION Winter 2020 FORWARD LOOKING STATEMENTS This - - PowerPoint PPT Presentation
INVESTOR PRESENTATION Winter 2020 FORWARD LOOKING STATEMENTS This presentation contains forwardlooking statements that are subject to risks and uncertainties. All statements other than statements of historical fact included in this
FORWARD LOOKING STATEMENTS
This presentation contains forward‐looking statements that are subject to risks and uncertainties. All statements other than statements of historical fact included in this presentation are forward‐looking statements. Forward‐looking statements give our current expectations and projections relating to our financial condition, results of operations, plans, objectives, future performance and business. You can identify forward‐looking statements by the fact that they do not relate strictly to historical or current facts. These statements may include words such as “believe,” “may,” “will,” “estimate,” “continue,” “anticipate,” “design,” “intend,” “expect” and similar expressions are intended to identify forward‐looking statements. This presentation contains certain forward‐looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, including statements regarding our outlook for revenues, and EBITDA in 2019 and 2020. These forward‐looking statements are based on current expectations, estimates, assumptions and projections that are subject to change and actual results may differ materially from the forward‐looking statements. Factors that could cause actual results to differ materially include, but are not limited to, that the Company may not have sufficient cash flows from
- perations or the availability of funds under its credit agreement to fund ongoing operations and other liquidity needs, that the Company’s
indebtedness could adversely affect its business and financial condition and could reduce the funds available for other purposes and the failure to comply with covenants contained in its credit agreement could result in an event of default that could adversely affect its results of operations, that the Company faces a long period to implement a new contract which may result in the incurrence of expenses before the receipt of revenues from new client relationships, the high level of revenue concentration among the Company's largest customers and any termination in the Company’s relationship with any of our significant clients would result in a material decline in our revenues, that many of the Company's customer contracts are subject to periodic renewal, are not exclusive, do not provide for committed business volumes and may be changed or terminated unilaterally and on short notice that the Company may not be able to manage its potential growth effectively, that the Company faces significant competition in all of its markets, that continuing limitations on the scope of our audit activity under our RAC contracts have significantly reduced our revenue opportunities with this client, that the U.S. federal government accounts for a significant portion of the Company's revenues, that future legislative and regulatory changes may have significant effects on the Company's business, that failure of the Company's or third parties' operating systems and technology infrastructure could disrupt the operation of the Company's business and the threat of breach of the Company's security measures or failure or unauthorized access to confidential data that the Company possesses. More information on potential factors that could affect the Company's financial condition and operating results is included from time to time in the "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" sections of the Company's annual report on Form 10‐K for the year ended December 31, 2018 and subsequently filed reports on Forms 10‐Q and 8‐K. Any forward‐looking statement made by us in this presentation speaks only as of the date on which we make it. We undertake no obligation to publicly update any forward‐looking statement, whether as a result of new information, future developments or
- therwise, except as may be required by law.
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WHO IS PERFORMANT?
- We are a technology‐enabled audit, recovery, outsource
services and related analytics service provider in the United States
- We identify improper payments, and in some markets,
restructure and recover delinquent or defaulted assets and improper payments
- Our clients operate in complex and regulated
environments
- Our technology platform helps our clients improve their
recovery rate and reduce losses on billions of dollars of improper healthcare payments, delinquent state and federal tax and federal treasury, defaulted student loans and other receivables
- We provide complex outsource services for clients across
- ur various markets
Industries Healthcare Government Commercial
PERFORMANT INSIGHT
TMDISRUPTIVE TECHNOLOGY
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Unified platform leverages data assets to create multiple value streams and optimized workflows
Workflow Solutions
- Data is the fuel that powers Performant’s workflow solutions
- Performant Insight™ transforms disparate data assets into the data
solutions that drive business results
- Performant’s proprietary workflow platform is purpose-built to support
product offerings
- User-friendly environment increases efficiency and improves accuracy
Predictive Scoring Peer Group Analysis Payment Trends Line-of-Business Analysis Data Transformation Domain Rules
Workflow Solutions Disparate Data Insight Platform
Registered Nurses Eligibility Specialists Certified Coders
Asset Recovery Workbench Provider Portal for Status Inquiry Specialty- Specific Claim Review Tools Robotics Process Automation
Eligibility Authorizations Healthcare Claims Provider Contracts Medical Records Fee Schedules Coding Rules Data Scientists Data Analysts Business Intelligence
Insight Data Engine
NATIONAL LEADER IN PAYMENT INTEGRITY
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Healthcare
25
MARKETS SERVED:
Government
4,000+ Providers 1,500+ Carriers 3,000+ Group & Non-Group entities
CT, IN, KY, MA, ME, MI, NH, NY, OH, RI, and VT
Region 1 Region 5
National - DME, Home Health & Hospice
CMS RAC CONTRACTOR DATA ASSETS:
Data on over 200 Million Eligible lives
Commercial Repayment Center
National Contractor to recover payments when Medicare should have been secondary.
CMS MSP CONTRACTOR
3 of the 5 largest national health plans and multiple Blues and Regional insurers 110 Million Commercial covered lives
COMMERCIAL HEALTH PLANS
Over 100 audit programs in all 50 states 50 Managed Medicaid Plans in 40 states 35,000+ audits per month
SOLUTION SCALE:
300 employees 6 offices across the nation
FOOTPRINT: ESTABLISHED NETWORKS:
Commercial Health Plans
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HEALTHCARE PAYMENT INTEGRITY MARKET SIZING
Commercial Medicaid Medicare Employer Sponsored Managed Medicaid Medicare Advantage Fee-For- Service Fee-For- Service
Performant’s market opportunity is between 10 and 15% of the total amount of inaccurate payments
Expected 2019 Spend Inaccurate Payments % Inaccurate $1,086B ~$65B 6.0% $357B ~$29B 8.2% $390B ~$32B 8.2% $307B ~$44B 14.4% $282B ~$41B 14.4%
Source: 2018 Medicare FFS Supplemental Report, Dept. of HHS, CMS CERT/PERM Note: Market-rate fee for comprehensive pre- and post-pay
- Total U.S. Healthcare Expenditures
expected to exceed $4 trillion by 2020
- Performant’s addressable market is
approximately $200 billion that continues to grow annually
- Some of the largest commercial and
government entities that are potential
- pportunities include:
- Centene
- UHC
- Blues Network
- Centers for Medicare and
Medicaid (CMS)
- Anthem
HEALTHCARE REVENUE GROWTH
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8.1% 7.6% 17.7% ~ 50.0% $141.4 $132.0 $155.7 > $200.0
0.0 20.0 40.0 60.0 80.0 100.0 120.0 140.0 160.0 180.0 200.0 2016 2017 2018 2021
Revenue ($ millions)
Healthcare Recovery / All Other
Performant Healthcare Revenue anticipated to be a majority of total company revenues by 2021 driven by big data analytics
- Disruptive technology is allowing us to
capture significant market share from legacy players while driving revenue growth
- Master service agreements with all
national payers and significant penetration into the Blues network
- Successful land and expand strategy as
- ur share of claims continues to rise
- Multiple contracts are still in the
investment stage – transition to profitability coming in 12 – 18 months
- On track to achieve our strategic goal of
$200+ million in total revenues with margins in excess of 20% by 2021
- Performant was hired by Client A, one of the nation’s largest MCOs,
as a 2nd seat (come behind) vendor to conduct Medicaid Reclamation (Asset Recovery) and to expand Identification of new savings.
- Performant’s results returned a 50% lift for Client A over the
incumbent vendor, previously a sole powerhouse in the market and who had been entrenched with Client A for more than a decade.
- Client A moved Performant into the 1st position for 5 test states
(covering about 1M lives). Performant continued to return impressive results, providing 75% gains over the incumbent.
- In 2019, for the first time in over a decade, Client A cancelled services
with the incumbent vendor and shifted all 25 states (covering over 6M lives) to Performant.
- Performant anticipates driving savings of over $60M annually for
Client A
CASE STUDY (COMMERCIAL HEALTHCARE CLIENT)
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Fresh solutions, even in mature markets – driving significant value for clients
- One of four contractors to recover
- utstanding inactive tax receivables on the
first contract of its kind on behalf of the IRS
- One of six contractors on the most recent
Treasury contract that includes receivables subrogated to it by numerous different federal agencies
- The only PCA that has had every Treasury
contract since 1997
- CRM BPO market is expected to reach $85
billion by 2020 with customer service and sales service accounting for over $40 billion
- Focused on less commoditized, non‐
collection BPO services.
- Develop strategic partnerships with
companies to expand existing service
- fferings
- Premiere acquisition diversified our
existing Student Loan / Government recovery streams while expanding the commercial footprint
RECOVERY AND CUSTOMER CARE SERVICES
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STUDENT LOANS CMS RAC HEALTHCARE PROVIDERS CMS MSP TREASURY/ IRS COMMERCIAL AUDIT & COB TPL SERVICES COMMERCIAL GOVERNMENT (STATE & FEDERAL) DEFAULT PREVENTION BACK-OFFICE PROCESSS OUTSOURCING (BPO) CALL CENTER OMNICHANNEL CRM STUDENT LOANS CMS RAC HEALTHCARE PROVIDERS CMS MSP TREASURY/ IRS COMMERCIAL AUDIT & COB TPL SERVICES COMMERCIAL GOVERNMENT (STATE & FEDERAL) DEFAULT PREVENTION BACK-OFFICE PROCESSS OUTSOURCIN G (BPO) CALL CENTER OMNICHANNE L CRM
RETURN TO PROFITABILITY
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- As Performant’s investment in major contracts enter steady state, overall movements
across all markets are driving a return to profitability in 2020
- 2018 and 2019 have been investment years, as we are still in year one or the early
stages of year two in many of our contracts
- Growth is being achieved through recurring revenue contracts with marquee
customers (e.g., United Healthcare, Humana, Blues Network Participants, CMS)
- Incremental growth continues to add onto a stable fixed cost base
- Profitability highlights of 2019 → 2020 include:
- Healthcare margin expansion through major contracts in year two and three from
implementation
- Healthcare margin expansion from continued mix shift and growth in TPL reclamation
- Expected returns on $2MM+ investment in headcount in recovery and sustained
growth in newer contracts
- Conversion of Premiere acquisition to profitability
- Ongoing reduction in corporate overhead via migrations off legacy platforms
- Actively pursue additional opportunities to
service the private healthcare market.
- Find and eliminate losses prior to
payment for healthcare services,
- Detection of fraud, waste and abuse in
the public and private healthcare markets
- Federal and state tax recoveries have grown
meaningfully year‐over‐year, and the recovery of delinquent state taxes is seen as a growing source of revenue
- According to the Center on Budget and
Policy Priorities, an independent think tank, 31 U.S. states faced a total budget shortfall of approximately $46 billion in 2017 and 2018
GROWTH BEYOND 2021
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