Back on Nasdaq Stockholm June 30, 2015 after 8+ years being privately owned Giving • Long-term corner stone investors • Increased transparency • Financing for expansion With a clear strategy • Modern Medicine giving Rapid Recovery to patients • Modern Management empowering people making change happen • Market Leadership by content – and step by step – by size
Respected as a long-term innovative partner to a sensitive public healthcare sector 2
The European challenge is not going to ease – demographic squeeze is driving need and costs... Women
Men
X%
As the population structure develops towards a larger share being elderly… Population pyramid of EU 1960-2050 Women 80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4
2050 2040 2030 2020 2010 2000 1990 1980 1970 1960
Sweden France
Share of population
Men
Germany United Kingdom
Norway OECD
…the required healthcare expenditures will continue to increase, while there will be fewer people financing the healthcare Total expenditure on health, GDP Percentage Prognosis1 20
29% 27% 25% 21% 19% 18% 16% 15% 15 10 5
http://population pyramid.net/
Source: World Bank
0
1960 70
80
90 2000 10
20 2030
Source: OECD Health data 2014
Year
Pressure to provide “quality healthcare with higher productivity” as fewer people have to pay for an increasingly large share of the population 1 Future development based on extrapolation of historic OECD average CAGR from 2002-12
3
Large gaps and slow implementation create …with large performance gaps between countries opportunities Historic implementation of modern medicine is a slow process… Best-practice proven
Best-practice
AVLOS Days
Knee prosthesis
2
Acute myocardial infarction
2
Inguinal hernia (open surgery)
0
Tonsillect -omy
0
>15 2.4
4.0
4.4
5.3 6.62 8.8
9.8 12.5
>15 ~3 4.0 4.1
6.7 6.8 7.6 8.0 8.4
17 YEARS1
Share of ambulatory surgery %
80 14
43 46
64 66 68
75
Best-practice implemented 90 4 21 30 38
51 57
85
Use Capio’s know-how to transfer knowledge and speed up change Source: AVLOS – Sweden: Socialstyrelsen; Norway: Helsedirektoratet; France: ATIH; Germany: Federal Statistical Office's DRG browser; Finland: Eurostat ; UK: Health and Social Care Information Centre; Spain: Eurostat; Best-practice - knee prosthesis: North Wales knee clinic; Best-practice - AMI: US Healthcare costs and utilization project Ambulatory surgery – All countries excluding Germany: Eurostat; Germany: German association of ambulatory surgery; Best-practice - Inguinal hernia: NHS; Best-practice - Tonsillectomy: US agency for healthcare research and quality 4 1 Goodman et al. 1997; 2 For Norway 2011 data and only reported as aggregated data for knee and hip prosthesis
The Swedish healthcare system has its challenges Sweden has not yet met its target thresholds for waiting times, in particular outside of the Stockholm region Performance on target levels for waiting times (‘vårdgarantiuppfyllelse’); Share of patients who have waited > 90 days Nation-wide
Specialist care - visits 15% 12%
14% 11%
11% 6%
2011
2012
8%
Stockholm
Specialist care – surgeries and procedures 17% 17% 16% 15% 15% 14% 14% 12% 10% 8%
21%
12%
5%
2013
2014
2011
2012
2013
2014
Source: SKL (vantetider.se)
Long waiting times and an experienced lack of resources drive need for increased productivity in the Swedish healthcare system 5
Partly explained by low staff productivity Swedish development of population, patients and resources
• Inpatient growth in line with population growth • Outpatient growing faster • Doctor growth in line with population growth • Help nurses and especially nurses outgrowing population Source: SCB
Estimated annual consultations per doctor (2012)
• Annual consultations per doctor lower than in similar countries
• Clinical staff burdened by non-clinical tasks and old fashioned administration – too little time spent with patients! Source: OECD
A doctor treating more patients becomes a more skilled doctor 6
Private healthcare provision in Capio markets Summary of market outlook, 2013-18E, EUR billions Capio-relevant markets and segments
%
SWEDEN
NORWAY
Private primary and specialist care 1998
FRANCE
Private specialist healthcare (shares also incl. primary care) 2013 13%
MSO private hospital care1 (shares incl. all private hospitals) 2000
2013 23%
23%
Private hospitals (shares by general hospitals) 1995 5%
+~2% p.a. +5-8% p.a. 2.7
3.4-3.9
2013
2018E
+0-1% p.a.
+3-5% p.a 0.9
1.1-1.2
2013
2018E
+1-2% p.a.
2013 ~16%
+6-7% p.a. 2
16
16-17
15
2013
2018E
2013
+0-1% p.a.
20
2018E n/a
Source: Capio market assessments 1 Private and public MSO Hospital care market in France is estimated at EUR 65 billions in 2013 2 Refers to forecast 2012-2018E
Private providers are an important part of the solution 7
More time to focus the business itself – after a prolonged IPO process – and political rhetoric
We want to speed up organic development – and acquisitions 8
The Capio Model – our way of driving the business
Do we really need a complicated model? 9
Healthcare needs to be anchored in strong values
Behaviour
Values
Everything we do, should be defendable on the tabloids front pages 10
A patient is not just a diagnose – quality means different things to each patient group
What is quality to you? 11
Quality corner stones helps us to think in a structured way
The right quality combination best for the patient – speeds up growth 12
The Wheel makes the company move
Empowered managers and co-workers to drive change 13
QPIs (Quality Performance Indicators) Are we proud?
Making quality measurable and tangible 14
There is a link from QPIs to resources KPIs
Quality drives Productivity 15
KPIs transform into money ($)
A reporting package helps!
P&L, BS and CF – a reflection of our daily work to make patients well 16
The basis for improving performance is to understand where we are in all 600 profit centers • Quality - QPI • Productivity - KPI
• Financials – P&L
We only measure what somebody is responsible for! 17
Too obvious?
Not for us being specialists in healthcare! 18
Organic development is the base – acquisitions to give additional leverage Acquisitions in the • Nordics - Proximity care - Specialist care • France - build star networks around existing hubs - establish new hubs • Germany - Specialist clinics - A larger platform
19
Today we want to illustrate how we work in three of our businesses • France – participate in transformation of French healthcare • Capio S:t Göran – the acute hospital shaping the future of healthcare in Stockholm • Proximity care in Sweden – speeding up productivity • To start: What is actually Modern Medicine?
