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Team Health Holdings, Inc. Announces Third Quarter 2014 Financial Results


News provided by

Team Health Holdings, Inc.

Nov 04, 2014, 04:01 ET

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KNOXVILLE, Tenn., Nov. 4, 2014 /PRNewswire/ -- 

2014 Third Quarter Highlights:

  • Net Revenue increased to $712.2 million; 17.5% over the Prior Year
  • Net earnings attributable to Team Health Holdings, Inc. ("Net earnings") were $27.6 million; $43.2 million after adjustments
  • Diluted net earnings per share of $0.38; Adjusted EPS of $0.60
  • Adjusted EBITDA increased 30.8% to $89.0 million
  • Projected growth in net revenue for full year 2014 increased to between 16.0% and 17.0%; Adjusted EBITDA margin to be approximately 11.5%

Team Health Holdings, Inc. ("TeamHealth" or the "Company") (NYSE: TMH), one of the largest providers of outsourced physician staffing solutions for hospitals in the United States, today announced results for its third quarter of 2014.

"We are pleased with our financial results for the third quarter of 2014.  We achieved another quarter of double digit revenue and Adjusted EPS growth and expanded our Adjusted EBITDA margin over the prior year. TeamHealth continues to be an attractive solution for hospitals and physician groups that want to enhance their services in a rapidly changing healthcare environment," said TeamHealth President and Chief Executive Officer, Mike Snow.

"All three of our primary drivers contributed to revenue growth. Our strategy has always been to take a balanced and integrated approach to growth and this continues to be the case going forward.  Over the quarter, we believe that an improving economic environment and the support of healthcare reform led to the strengthening of volume, year over year improvements in payor mix, and an increase in estimated collections per visit.  We continue to be very active on the acquisition front and, since September, we have grown through the addition of eight high quality organizations."

"We believe that we remain well positioned to achieve revenue and earnings growth through the remainder of 2014 and have great momentum going into next year. As a result of our financial performance through the first three quarters of 2014 and our current expectations about operating trends and contributions from recent acquisitions over the remainder of the year, we have increased our estimate for net revenue growth for fiscal year 2014. Our revised net revenue range is now between $2.77 billion and $2.79 billion, reflecting an annual growth rate of between 16.0% and 17.0%, which is an increase from the prior guidance of 13.0% to 14.0%.   We typically experience a seasonal reduction in operating margins in the fourth quarter and we also anticipate some transitional costs on our recently completed acquisitions.  As a result of these expectations, we project Adjusted EBITDA margin for the full year of 2014 to be approximately 11.5%.  We have continued to see growth in Medicaid parity revenue and now anticipate parity revenue will be in the range of $34.0 million to $36.0 million for 2014.  We are engaged in advocacy efforts towards an extension of the Medicaid parity program in its current form into 2015, but at this time, the federal program is scheduled to expire at the end of 2014.  There are a limited number of states that have indicated an intent to continue with a Medicaid parity program into 2015, but we do not believe these state initiatives will be a significant benefit to us," concluded Mr. Snow.

2014 Third Quarter Results

Net revenue increased 17.5% to $712.2 million from $606.1 million in the third quarter of 2013.  Acquisitions contributed 10.1%, same contract revenue contributed 7.1%, and net sales growth contributed 0.3% of the increase in quarter-over-quarter growth in net revenue.  Within the acquisitions category,  new hospital contacting opportunities that were initially developed by our sales and marketing process contributed 2.9% of overall net revenue growth between quarters.      

Same contract revenue increased $43.2 million, or 7.9%, to $589.7 million from $546.5 million in the third quarter of 2013.  An increase of 5.3% in estimated collections on fee for service visits provided a 4.3% increase in same contract revenue growth between quarters while a 5.6% increase in same contract volumes contributed 3.9% to the growth.  Contract and other revenue constrained same contract revenue growth between quarters by 0.3%. Acquisitions contributed $61.1 million of revenue growth and net new contract revenue increased by $1.8 million between quarters.  The benefit from Medicaid parity revenue recognized in the third quarter of 2014 was $10.4 million, of which $8.5 million is same contract revenue.  Because of the deferred recognition of parity revenue in 2013, the third quarter of 2013 reflects a year to date cumulative estimate of Medicaid parity revenue of $12.9 million, of which $12.2 million is same contract.  The decline in total parity revenue between periods of $2.6 million constrained consolidated revenue growth by 0.4% while the decline in same contract Medicaid parity revenue of $3.7 million constrained same contract revenue growth by 0.7% between quarters.

The components of net revenue include revenue from contracts that have been in effect for prior periods (same contracts) and from net, new and acquired contracts during the periods, as set forth in the table below:



Three Months Ended September 30,


2013


2014

% Increase

Contribution to
Overall Revenue
Growth


(in thousands)





Same contracts:










Fee for service revenue

$

399,411



$

444,216


11.2

%

7.4

%

Contract and other revenue

147,056



145,498


(1.1)

%

(0.3)

%

Total same contracts

546,467



589,714


7.9

%

7.1

%

New contracts, net of terminations:










Fee for service revenue

28,410



37,867


33.3

%

1.6

%

Contract and other revenue

24,152



16,507


(31.7)

%

(1.3)

%

Total new contracts, net of terminations

52,562



54,374


3.4

%

0.3

%

Acquired contracts:










Fee for service revenue

6,772



60,527


-


8.9

%

Contract and other revenue

326



7,626


-


1.2

%

Total acquired contracts

7,098



68,153


-


10.1

%

Consolidated:










Fee for service revenue

434,593



542,610


24.9

%

17.8

%

Contract and other revenue

171,534



169,631


(1.1)

%

(0.3)

%

Total net revenue

$

606,127



$

712,241


17.5

%

17.5

%


The following table reflects the visits and procedures included within fee for service revenues described in the table above:



Three Months Ended September 30,


2013


2014

% Increase


(in thousands)



Fee for service visits and procedures:








Same contract

2,430



2,566


5.6

%

New and acquired contracts, net of terminations

251



556


121.5

%

Total fee for service visits and procedures

2,681



3,122


16.4

%


Reported net earnings for the quarter were $27.6 million, or $0.38 diluted net earnings per share, compared to net earnings of $29.4 million, or $0.41 diluted net earnings per share, in the third quarter of 2013.  The financial results for the third quarter of 2014 included $3.1 million of contingent purchase and other acquisition compensation expense ($2.4 million after-tax), non-cash amortization expense of $13.0 million ($8.8 million after tax), and a $7.1 million increase in prior year professional liability loss reserves ($4.4 million million after tax).  Excluding these items, net earnings for the third quarter of 2014 would have been $43.2 million and Adjusted EPS would have been $0.60 per share.  Financial results for the third quarter of 2013 included a credit of $1.6 million of contingent purchase and other acquisition compensation expense ($0.7 million after-tax), and non-cash amortization expense of $8.7 million ($5.8 million after-tax).  Excluding these items, net earnings for the third quarter of 2013 would have been $34.6 million and Adjusted EPS would have been $0.49 per share.

The $7.1 million increase in prior year professional liability loss reserves recorded in the third quarter of 2014 is a result of the settlement of an excess medical malpractice verdict, a decline in the discount factor applied to professional liability reserves due to the lower interest rate environment, and an increase in revised loss estimates for certain older years as reflected in the most recent biannual actuarial report. 

As a result of the recent increased pace of acquisition closings, the Company also incurred an elevated level of transaction costs in the third quarter of 2014 in the amount of $3.1 million, which constrained Adjusted Earnings Per Share by approximately $0.04 per share.  See "Non-GAAP Financial Measures Reconciliations" and "Adjusted Earnings Per Share" below for the definition of Adjusted EPS and its reconciliation to net earnings and diluted earnings per share attributable to Team Health Holdings, Inc.

The following table set forth a reconciliation of diluted earnings per share to Adjusted EPS (note that some totals may not add due to rounding).



Adjusted Earnings Per Share


Three Months Ended September 30,


2013


2014


(in thousands, except for share data)

Diluted weighted average shares outstanding

71,209






72,331





Net earnings and diluted net earnings per share
attributable to Team Health Holdings, Inc., as reported

$

29,427



$

0.41



$

27,586



$

0.38


Adjustments:












Contingent purchase and other acquisition compensation
expense, net of tax of $911 and $(680) for 2013 and 2014,
respectively

(691)



(0.01)



2,406



0.03


Amortization expense, net of tax of $(2,844) and $(4,184)
for 2013 and 2014, respectively

5,821



0.08



8,807



0.12


Professional liability loss reserve adjustments associated
with prior years, net of tax of $(2,729) for 2014

—



—



4,359



0.06


Net earnings and diluted earnings per share attributable to
Team Health Holdings, Inc., as adjusted

$

34,557



$

0.49



$

43,158



$

0.60



Cash flow provided by operations for the quarter was $32.1 million compared to $51.6 million in the third quarter of 2013.  There were $20.7 million of contingent purchase payments made in the third quarter of 2014 and $0.5 million contingent purchase payments in 2013.  Excluding the impact of the contingent purchase payment in 2014 and 2013, operating cash flows increased $0.7 million between quarters. 

Adjusted EBITDA for the quarter increased 30.8% to $89.0 million from $68.1 million in the third quarter of 2013, and Adjusted EBITDA margin increased to 12.5% compared to 11.2% for the same quarter in 2013. See "Non-GAAP Financial Measures Reconciliations" and "Adjusted EBITDA" below for the definitions of Adjusted EBITDA Margin and Adjusted EBITDA and its reconciliation to net earnings attributable to Team Health Holdings, Inc.

The following table sets forth a reconciliation of net earnings attributable to Team Health Holdings, Inc. to Adjusted EBITDA.



Adjusted EBITDA


Three Months Ended
September 30,


2013


2014


(In thousands)

Net earnings attributable to Team Health Holdings, Inc.

$

29,427



$

27,586


Interest expense, net

3,827



3,921


Provision for income taxes

19,184



20,895


Depreciation

4,281



5,826


Amortization

8,665



12,991


Other (income) expense, net(a)

(1,384)



292


Contingent purchase and other acquisition compensation expense(b)

(1,602)



3,086


Transaction costs(c)

1,017



3,107


Equity based compensation expense(d)

2,906



3,345


Insurance subsidiary interest income

444



503


Professional liability loss reserve adjustments associated with prior years

—



7,088


Severance and other charges

1,293



381


Adjusted EBITDA

$

68,058



$

89,021



a.

Reflects gain or loss on sale or disposal of assets, realized gains on investments, and changes in fair value of investments associated with the Company's non-qualified retirement plan.

b.

Reflects expense recognized for historical and estimated future contingent payments and other compensation expense associated with acquisitions.

c.

Reflects expenses associated with accounting, legal, due diligence and other transaction fees related to acquisition activity.

d.

Reflects costs related to equity awards granted under the Team Health Holdings, Inc. 2009 Amended and Restated Stock Incentive Plan.



As of September 30, 2014, the Company had cash and cash equivalents of approximately $13.6 million and total outstanding debt of $716.8 million.   The outstanding debt as of September 30, 2014 includes borrowings under its revolving credit facility in the amount of $227.4 million incurred to fund the Company's recently completed acquisitions.  In September, the Company expanded its revolving credit facility by $100.0 million to $350.0 million and as of September 30, 2014 had $122.6 million of available borrowings under its revolving credit facilities (without giving effect to $6.7 million of undrawn letters of credit). 

On October 2, 2014, the Company amended and restated its existing credit facility. The First Amendment and Restatement Agreement, among other things, (1) replaced and upsized the existing $275 million Tranche A Term Facility, (2) replaced and upsized the existing $250 million Revolving Credit Facility, (3) extended the maturities of the Tranche A Term Facility and the Revolving Credit Facility from November 1, 2017 to October 2, 2019 and (4) terminated the existing $100 million Interim Revolving Credit Facility. The Company used proceeds from borrowings under the Tranche A Term Facility and the Revolving Credit Facility to repay in full the existing $250 million Tranche B Term Facility , and pay customary fees and expenses associated with the Amendment and Restatement Agreement, with remaining proceeds retained for other future general corporate purposes. After giving effect to the Amendment and Restatement Agreement, the Tranche A Term Facility was increased to $600 million and the Revolving Credit Facility was increased to $650 million.

2014 First Nine Months Results

Net revenue in the nine months ended September 30, 2014 increased 15.2% to $2.03 billion from $1.76 billion for the same period of 2013.  Acquisitions contributed 8.9%, same contract revenue contributed 4.9%,  and net sales growth contributed 1.4% of the increase in year over year growth in net revenue.  Within the acquisitions category, new hospital contracting opportunities that were initially developed by our sales and marketing process contributed 2.1% of overall net revenue growth between years.

Same contract revenue for the nine months ended September 30, 2014 increased  $86.3 million, or 5.8%, to $1.58 billion from $1.49 billion in the same period a year ago.  Increases in estimated collections on fee for service visits of 7.1% provided a 5.2% increase in same contract revenue growth between periods while a 1.5% increase in same contract volumes contributed 1.1% to growth. Contract and other revenue constrained same contract revenue growth 0.5% between periods. Acquisitions contributed $156.7 million of growth between periods and net new contract revenue increased by $24.2 million.  The benefit from Medicaid parity revenue recognized in the nine months ended September 30, 2014 was $27.7 million, of which $22.8 million is same contract revenue compared to $12.9 million in 2013, of which $11.8 million was same contract revenue.  The increase in Medicaid parity revenue contributed 0.8% to consolidated revenue growth and 0.7% to same contract revenue growth between years.

The components of net revenue include revenue from contracts that have been in effect for prior periods (same contracts) and from net, new and acquired contracts during the periods, as set forth in the table below:



Nine Months Ended September 30,


2013


2014

% Increase

Contribution
to Overall
Revenue
Growth


(in thousands)





Same contracts:










Fee for service revenue

$

1,078,500



$

1,172,550


8.7

%

5.3

%

Contract and other revenue

412,832



405,044


(1.9)

%

(0.4)

%

Total same contracts

1,491,332



1,577,594


5.8

%

4.9

%

New contracts, net of terminations:










Fee for service revenue

148,640



177,552


19.5

%

1.6

%

Contract and other revenue

91,492



86,760


(5.2)

%

(0.3)

%

Total new contracts, net of terminations

240,132



264,312


10.1

%

1.4

%

Acquired contracts:










Fee for service revenue

29,936



164,023


-


7.6

%

Contract and other revenue

405



23,032


-


1.3

%

Total acquired contracts

30,341



187,055


-


8.9

%

Consolidated:










Fee for service revenue

1,257,076



1,514,125


20.4

%

14.6

%

Contract and other revenue

504,729



514,836


2.0

%

0.6

%

Total net revenue

$

1,761,805



$

2,028,961


15.2

%

15.2

%


The following table reflects the visits and procedures included within fee for service revenues described in the table above:



Nine Months Ended September 30,


2013


2014

% Increase


(in thousands)



Fee for service visits and procedures:








Same contract

6,777



6,878


1.5

%

New and acquired contracts, net of terminations

1,230



1,997


62.4

%

Total fee for service visits and procedures

8,007



8,875


10.8

%


Reported net earnings were $81.6 million in the nine months ended September 30, 2014, or $1.13 diluted net earnings per share, compared to net earnings of $65.9 million, or $0.93 diluted net earnings per share, in the same period of 2013.  The 2014 first nine months financial results included $22.5 million ($15.7 million after-tax) of contingent purchase and other acquisition compensation expense, non-cash amortization expense of $35.2 million ($23.9 million after-tax), and a $7.1 million increase in prior year professional liability loss reserves ($4.4 million after tax).  Excluding these items, net earnings for the first nine months of 2014 would have been $125.6 million and Adjusted EPS would have been $1.75 per share.  Financial results for the same period in 2013 included $18.6 million of contingent purchase and other acquisition compensation expense ($12.5 million after-tax), and non-cash amortization expense of $27.0 million ($17.9 million after-tax).  Excluding these adjustments, net earnings for the same period in 2013 would have been $96.4 million and Adjusted EPS would have been $1.36 per share.  See "Non-GAAP Financial Measures Reconciliations" and "Adjusted Earnings Per Share" below for the definition of Adjusted EPS and its reconciliation to net earnings and diluted earnings per share attributable to Team Health Holdings, Inc.

The following tables set forth a reconciliation of diluted earnings per share to Adjusted EPS (note that some totals may not add due to rounding).



Adjusted Earnings Per Share


Nine Months Ended September 30,


2013


2014


(in thousands, except for share data)

Diluted weighted average shares outstanding

70,841






71,955





Net earnings and diluted net earnings per share
attributable to Team Health Holdings, Inc., as reported

$

65,935



0.93



$

81,634



1.13


Adjustments:












Contingent purchase and other acquisition compensation
expense, net of tax of $(6,049) and $(6,744) for 2013 and
2014, respectively

12,519



0.18



15,739



0.22


Amortization expense, net of tax of $(9,088) and
$(11,345) for 2013 and 2014, respectively

17,945



0.25



23,858



0.33


Professional liability loss reserve adjustments associated
with prior years, net of tax of $(2,729) for 2014

—



—



4,359



0.06


Net earnings and diluted earnings per share attributable to
Team Health Holdings, Inc., as adjusted

$

96,399



$

1.36



$

125,590



$

1.75



Cash flow provided by operations for the nine months ended September 30, 2014 was $106.7 million compared to $106.4 million in 2013.  There were $21.9 million contingent purchase payments in 2014 and $0.5 million contingent purchase payments in 2013.  Excluding the impact of the 2014 and 2013, contingent purchase payments, operating cash flows increased $21.7 million between periods.

Adjusted EBITDA increased 30.4% to $247.1 million from $189.4 million in the nine months ended September 30, 2013, and Adjusted EBITDA margin was 12.2% compared to 10.8% for the same period in 2013. See "Non-GAAP Financial Measures Reconciliations" and "Adjusted EBITDA" below for the definitions of Adjusted EBITDA Margin and Adjusted EBITDA and its reconciliation to net earnings attributable to Team Health Holdings, Inc.

The following table sets forth a reconciliation of net earnings attributable to Team Health Holdings, Inc. to Adjusted EBITDA.



Adjusted EBITDA


Nine Months Ended
September 30,


2013


2014


(in thousands)

Net earnings attributable to Team Health Holdings, Inc.

$

65,935



$

81,634


Interest expense, net

11,363



10,758


Provision for income taxes

44,646



56,542


Depreciation

12,559



15,315


Amortization

27,033



35,203


Other income(a)

(2,848)



(3,457)


Contingent purchase and other acquisition compensation expense(b)

18,568



22,483


Transaction costs(c)

1,590



5,734


Equity based compensation expense(d)

6,988



12,693


Insurance subsidiary interest income

1,308



1,501


Professional liability loss reserve adjustments associated with prior years

—



7,088


Severance and other charges

2,263



1,563


Adjusted EBITDA

$

189,405



$

247,057



a.

Reflects gain or loss on sale or disposal of assets, realized gains on investments, and changes in fair value of investments associated with the Company's non-qualified retirement plan.

b.

Reflects expense recognized for historical and estimated future contingent payments and other compensation expense associated with acquisitions.

c.

Reflects expenses associated with accounting, legal, due diligence and other transaction fees related to acquisition activity.

d.

Reflects costs related to equity awards granted under the Team Health Holdings, Inc. 2009 Amended and Restated Stock Incentive Plan.

Team Health Holdings, Inc.

Consolidated Balance Sheets



December 31,
2013


September 30,
2014


(Unaudited)
(In thousands)

ASSETS






Current assets:






Cash and cash equivalents

$

32,331



$

13,639


Accounts receivable, less allowance for uncollectibles of $377,644 and
$394,027 in 2013 and 2014, respectively

392,430



458,734


Prepaid expenses and other current assets

35,029



42,475


Receivables under insured programs

22,961



16,976


Total current assets

482,751



531,824


Investments of insurance subsidiary

84,081



93,183


Property and equipment, net

53,434



57,171


Other intangibles, net

173,178



307,735


Goodwill

428,311



620,838


Deferred income taxes

44,546



49,963


Receivables under insured programs

39,532



52,923


Other

55,577



52,774



$

1,361,410



$

1,766,411


LIABILITIES AND SHAREHOLDERS' EQUITY






Current liabilities:






Accounts payable

$

27,700



$

35,338


Accrued compensation and physician payable

201,998



228,362


Other accrued liabilities

128,749



119,996


Income tax payable

3,014



4,428


Current maturities of long-term debt

17,969



250,525


Deferred income taxes

39,063



38,013


Total current liabilities

418,493



676,662


Long-term debt, less current maturities

483,594



466,250


Other non-current liabilities

190,842



230,456


Shareholders' equity:






Common stock, ($0.01 par value; 100,000 shares authorized, 70,016 and
70,967 shares issued and outstanding at December 31, 2013 and September 30,
2014, respectively)

700



710


Additional paid-in capital

642,633



683,972


Accumulated deficit

(376,593)



(294,960)


Accumulated other comprehensive earnings

447



1,675


Team Health Holdings, Inc. shareholders' equity

267,187



391,397


Noncontrolling interests

1,294



1,646


Total shareholders' equity including noncontrolling interests

268,481



393,043



$

1,361,410



$

1,766,411


Team Health Holdings, Inc.

Consolidated Statements of Comprehensive Earnings



Three Months Ended September 30,


2013


2014


(Unaudited)
(In thousands, except per share data)

Net revenue before provision for uncollectibles

$

1,115,885



$

1,223,104


Provision for uncollectibles

509,758



510,863


Net revenue

606,127



712,241


Cost of services rendered (exclusive of depreciation and amortization shown separately below)






Professional service expenses

472,027



546,346


Professional liability costs

17,467



29,564


General and administrative expenses (includes contingent purchase and other
acquisition compensation expense of $(1,602) and $3,086 in 2013 and 2014,
respectively)

51,567



61,643


Other (income) expense, net

(1,384)



292


Depreciation

4,281



5,826


Amortization

8,665



12,991


Interest expense, net

3,827



3,921


Transaction costs

1,017



3,107


Earnings before income taxes

48,660



48,551


Provision for income taxes

19,184



20,895


     Net earnings

29,476



27,656


Net earnings attributable to noncontrolling interests

49



70


Net earnings attributable to Team Health Holdings, Inc.

$

29,427



$

27,586








Net earnings per share of Team Health Holdings, Inc.






Basic

$

0.42



$

0.39


Diluted

$

0.41



$

0.38


Weighted average shares outstanding






Basic

69,384



70,627


Diluted

71,209



72,331








Other comprehensive (loss) earnings, net of tax:






Net change in fair value of investments, net of tax of $(34) and $89 for 2013 and 2014, respectively

(63)



165


Comprehensive earnings

29,413



27,821


Comprehensive earnings attributable to noncontrolling interests

49



70


Comprehensive earnings attributable to Team Health Holdings, Inc.

$

29,364



$

27,751


Team Health Holdings, Inc.

Consolidated Statements of Comprehensive Earnings



Nine Months Ended September 30,


2013


2014


(Unaudited)
(In thousands, except per share data)

Net revenue before provision for uncollectibles

$

3,185,040



$

3,493,892


Provision for uncollectibles

1,423,235



1,464,931


Net revenue

1,761,805



2,028,961


Cost of services rendered (exclusive of depreciation and amortization shown separately below)






Professional service expenses

1,379,568



1,557,696


Professional liability costs

55,199



73,482


General and administrative expenses (includes contingent purchase and other acquisition
compensation expense of $18,568 and $22,483 in 2013 and 2014, respectively)

166,617



195,842


Other income

(2,848)



(3,457)


Depreciation

12,559



15,315


Amortization

27,033



35,203


Interest expense, net

11,363



10,758


Transaction costs

1,590



5,734


Earnings before income taxes

110,724



138,388


Provision for income taxes

44,646



56,542


  Net earnings

66,078



81,846


Net earnings attributable to noncontrolling interests

143



212


Net earnings attributable to Team Health Holdings, Inc.

$

65,935



$

81,634








Net earnings per share of Team Health Holdings, Inc.






Basic

$

0.96



$

1.16


Diluted

$

0.93



$

1.13


Weighted average shares outstanding






Basic

68,760



70,209


Diluted

70,841



71,955








Other comprehensive (loss) earnings, net of tax:






Net change in fair value of investments, net of tax of $(637) and $663 for 2013 and
2014, respectively

(1,181)



1,228


Comprehensive earnings

64,897



83,074


Comprehensive earnings attributable to noncontrolling interests

143



212


Comprehensive earnings attributable to Team Health Holdings, Inc.

$

64,754



$

82,862


Team Health Holdings, Inc.

Consolidated Statements of Cash Flows



Three Months Ended September 30,


2013


2014


(Unaudited)
(In thousands)

Operating Activities






Net earnings

$

29,476



$

27,656


Adjustments to reconcile net earnings:






Depreciation

4,281



5,826


Amortization

8,665



12,991


Amortization of deferred financing costs

254



252


Equity based compensation expense

2,906



3,345


Provision for uncollectibles

509,758



510,863


Deferred income taxes

1,619



(12,732)


Equity in joint venture income

(1,037)



(994)


Changes in operating assets and liabilities, net of acquisitions:






Accounts receivable

(509,933)



(529,823)


Prepaids and other assets

(275)



6,993


Income tax accounts

1,350



2,705


Accounts payable

(2,357)



6,685


Accrued compensation and physician payable

10,243



12,710


Contingent purchase liabilities

(3,497)



(17,623)


Other accrued liabilities

(2,665)



(1,062)


Professional liability reserves

2,768



4,294


Net cash provided by operating activities

51,556



32,086


Investing Activities






Purchases of property and equipment

(4,203)



(4,786)


Cash paid for acquisitions, net

(9,847)



(340,637)


Purchases of investments by insurance subsidiary

(28,585)



(37,039)


Proceeds from sale of investments by insurance subsidiary

28,723



36,031


Net cash used in investing activities

(13,912)



(346,431)


Financing Activities






Payments on notes payable

(4,063)



(4,063)


Proceeds from revolving credit facility

—



288,600


Payments on revolving credit facility

—



(61,200)


Stock issuance costs

(12)



—


Payments of financing costs

—



(1,146)


Contribution from noncontrolling interests

600



51


Proceeds from exercise of stock options

2,674



6,832


Tax benefit from exercise of stock options

1,301



5,513


Net cash provided by (used in) financing activities

500



234,587


Net increase (decrease) in cash and cash equivalents

38,144



(79,758)


Cash and cash equivalents, beginning of period

93,864



93,397


Cash and cash equivalents, end of period

$

132,008



$

13,639


Supplemental cash flow information:






Interest paid

$

4,089



$

4,369


Taxes paid

$

14,916



$

25,482


   

Team Health Holdings, Inc.

Consolidated Statements of Cash Flows



Nine Months Ended September 30,


2013


2014


(Unaudited)
(In thousands)

Operating Activities






Net earnings

$

66,078



$

81,846


Adjustments to reconcile net earnings:






Depreciation

12,559



15,315


Amortization

27,033



35,203


Amortization of deferred financing costs

764



758


Equity based compensation expense

6,988



12,693


Provision for uncollectibles

1,423,235



1,464,931


Deferred income taxes

(8,101)



(21,367)


Loss (gain) on disposal or sale of equipment

79



(2,349)


Equity in joint venture income

(2,723)



(3,124)


Changes in operating assets and liabilities, net of acquisitions:






Accounts receivable

(1,434,125)



(1,515,378)


Prepaids and other assets

(4,209)



(1,467)


Income tax accounts

959



1,414


Accounts payable

(4,934)



7,831


Accrued compensation and physician payable

2,031



13,694


Contingent purchase liabilities

13,934



(1,283)


Other accrued liabilities

(5,774)



712


Professional liability reserves

12,654



17,287


Net cash provided by operating activities

106,448



106,716


Investing Activities






Purchases of property and equipment

(11,563)



(16,783)


Sale of property and equipment

125



2,776


Cash paid for acquisitions, net

(22,432)



(347,154)


Purchases of investments by insurance subsidiary

(68,612)



(68,527)


Proceeds from sale of investments by insurance subsidiary

59,082



61,314


Net cash used in investing activities

(43,400)



(368,374)


Financing Activities






Payments on notes payable

(12,188)



(12,188)


Proceeds from revolving credit facility

—



316,100


Payments on revolving credit facility

—



(88,700)


Stock issuance costs

(519)



—


Payments of financing costs

(1)



(1,146)


Contribution from noncontrolling interests

600



262


Distributions to noncontrolling interests

—



(122)


Proceeds from the issuance of common stock under stock purchase plans

1,443



1,903


Proceeds from exercise of stock options

26,363



15,510


Tax benefit from exercise of stock options

12,022



11,347


Net cash provided by financing activities

27,720



242,966


Net increase (decrease) in cash and cash equivalents

90,768



(18,692)


Cash and cash equivalents, beginning of period

41,240



32,331


Cash and cash equivalents, end of period

$

132,008



$

13,639


Supplemental cash flow information:






Interest paid

$

11,669



$

11,708


Taxes paid

$

39,899



$

65,525










Forward Looking Statements
Statements and information contained herein that are not historical facts and that reflect the current view of the Company about future events and financial performance are hereby identified as "forward looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995.  Some of these statements can be identified by terms and phrases such as "anticipate," "believe," "intend," "estimate," "expect," "continue," "could," "should," "may," "plan," "project," "predict" and similar expressions.  The Company cautions  that such "forward looking statements," including without limitation, those relating to the Company's future business prospects, revenue, working capital, professional liability expense, liquidity, capital needs, interest costs and income, wherever they occur in this or in other statements attributable to the Company, are necessarily estimates reflecting the judgment of the Company's senior management and involve a number of risks and uncertainties that could cause actual results to differ materially from those suggested by the "forward looking statements."  Factors that could cause our actual results to differ materially from those expressed or implied in such forward-looking statements include but are not limited to current or future government regulation of the healthcare industry, exposure to professional liability lawsuits and governmental agency investigations, the adequacy of insurance coverage and insurance reserves, as well as those factors detailed under the caption "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" in the Company's most recent annual report on Form 10-K and the most recent quarterly report on Form 10-Q filed with the Securities and Exchange Commission.  The Company's "forward looking statements" speak only as of the date hereof and the Company disclaims any intent or obligation to update "forward looking statements" herein to reflect changed assumptions, the occurrence of unanticipated events, or changes to future operating results over time.

Non-GAAP Financial Measures Reconciliations
In this release we refer to Adjusted EBITDA, Adjusted EBITDA margin and Adjusted Earnings per Share ("Adjusted EPS") which are financial measures that are calculated and presented on the basis of methodologies other than in accordance with generally accepted accounting principles in the United States of America ("GAAP").   Adjusted EBITDA is defined as net earnings attributable to Team Health Holdings, Inc. before interest expense, taxes, depreciation and amortization, as further adjusted to exclude the non-cash items and the other adjustments shown in the table under "Adjusted EBITDA" in the release.  Adjusted EBITDA margin represents Adjusted EBITDA divided by net revenue.  Adjusted EPS is defined as diluted earnings per share attributable to Team Health Holdings, Inc. excluding non-cash and other adjustments, including the impact of contingent purchase and other acquisition compensation expense and amortization expense relating to purchase accounting for historical acquisitions and the other adjustments shown in the table under "Adjusted Earnings Per Share" in the release.  For a reconciliation of each of Adjusted EBITDA and Adjusted EPS to the most directly comparable GAAP measure, we refer you to the tables under "Adjusted EBITDA" and "Adjusted Earnings Per Share," respectively, contained in the release.

Adjusted EBITDA
We present Adjusted EBITDA as a supplemental measure of our performance.  We present Adjusted EBITDA because we believe it assists investors and analysts in comparing our performance across reporting periods on a consistent basis by excluding items that we do not believe are indicative of our core operating performance.

Adjusted EBITDA is not a measurement of financial performance or liquidity under generally accepted accounting principles.  In evaluating our performance as measured by Adjusted EBITDA, management recognizes and considers the limitations of this measure.  Adjusted EBITDA does not reflect certain cash expenses that we are obligated to make, and although depreciation and amortization are non-cash charges, assets being depreciated and amortized will often have to be replaced in the future, and Adjusted EBITDA does not reflect any cash requirements for such replacements.  In addition, other companies in our industry may calculate Adjusted EBITDA differently than we do or may not calculate it at all, limiting its usefulness as a comparative measure.  Because of these limitations, Adjusted EBITDA should not be considered in isolation or as a substitute for net earnings, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles.

Adjusted Earnings Per Share
We present Adjusted earnings per share attributable to Team Health Holdings, Inc. ("Adjusted EPS") as a supplemental measure of our performance.  We present Adjusted EPS because we believe that it assists investors in understanding the impact of acquisition-related costs on our earnings per share and comparing our performance across operating periods on a consistent basis and provides additional insight into our core earnings performance.  Adjusted EPS is not a measurement of financial performance or liquidity under generally accepted accounting principles.  In evaluating our performance as measured by Adjusted EPS, management recognizes and considers the limitations of this measure.  Adjusted EPS does not reflect certain cash expenses that we are obligated to make, and although contingent purchase and other acquisition compensation expense and amortization expense are non-cash charges in the period reported, such charges reflect historical or future cash payments in conjunction with our acquisition transactions.  In addition, other companies in our industry may calculate Adjusted EPS differently than we do or may not calculate it at all, limiting its usefulness as a comparative measure.  Because of these limitations, Adjusted EPS should not be considered in isolation or as a substitute for net earnings, operating income, basic and diluted earnings per share, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles.

Conference Call
As previously announced, TeamHealth will hold a conference call tomorrow, November 5, 2014, to discuss its third quarter 2014 results at 8:30 a.m. (Eastern Time).  The conference call can be accessed live over the phone by dialing 1-877-407-0784, or for international callers, 1-201-689-8560.  A replay will be available two hours after the call and can be accessed by dialing 1-877-870-5176, or for international callers, 1-858-384-5517.  The passcode for the live call and the replay is 13593856. The replay will be available until November 12, 2014.

Interested investors and other parties may also listen to a simultaneous webcast of the conference call by logging onto the Investor Relations section of the Company's website at www.teamhealth.com.  The on-line replay will remain available for a limited time beginning immediately following the call.

To learn more about TeamHealth, please visit the company's Web site at www.teamhealth.com.  TeamHealth uses its Web site as a channel of distribution for material Company information.  Financial and other material information regarding TeamHealth is routinely posted on the Company's Web site and is readily accessible.

About TeamHealth
TeamHealth (Knoxville, Tenn.) (NYSE: TMH) is one of the largest providers of outsourced physician staffing solutions for hospitals in the United States.  Through its 21 regional locations and multiple service lines, TeamHealth's approximately 11,000 affiliated healthcare professionals provide emergency medicine, hospital medicine, anesthesia, urgent care, and pediatric staffing and management services to approximately 980 civilian and military hospitals, clinics, and physician groups in 47 states.

SOURCE Team Health Holdings, Inc.

Related Links

http://www.teamhealth.com

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