DALLAS--(BUSINESS WIRE)--Aug 6, 2018--Tenet Healthcare Corporation (NYSE: THC) reported net income from continuing operations available to Tenet common shareholders of $24 million in the second quarter of 2018 compared to a $56 million net loss from continuing operations in the second quarter of 2017. Adjusted EBITDA was $634 million in the second quarter of 2018 compared to $570 million in the second quarter of 2017.

“We are becoming a more agile and decisive organization and are pleased with our strong financial results for the third quarter in a row,” said Ronald A. Rittenmeyer, Executive Chairman and CEO. “We have demonstrated our ability to appropriately minimize costs, which will be an ongoing fundamental part of how we do business. Our top priorities remain strengthening our portfolio, delivering more consistent organic growth and taking additional steps to enhance our margins and free cash flow.”

Hospital Operations and Other Segment

Net operating revenues in the Hospital Operations and other segment were $3.733 billion, down 8.6 percent from the second quarter of 2017, primarily due to hospital divestitures and the wind-down of our health plan business.

On a same-hospital basis, net patient revenues after implicit price concessions were $3.432 billion, up 3.2 percent from the second quarter of 2017. Adjusted admissions were down 0.2 percent in the second quarter of 2018 and would have been up approximately 1.1 percent on a same-hospital basis excluding service line closures and declines in Detroit and Chicago. The Company’s decision to discontinue certain services at selected hospitals lowered same-hospital adjusted admissions by approximately 40 basis points in the second quarter of 2018. In addition, volume declines in Chicago (which the Company is divesting) and Detroit lowered same-hospital adjusted admissions by approximately 90 basis points. Revenue per adjusted admission increased 3.5 percent on a same-hospital basis. Same-hospital revenue included $63 million from the California Provider Fee Program in the second quarter of 2018 compared to no revenue in the second quarter of 2017 since the 2017 program was not approved until December 2017; excluding timing differences related to the California Provider Fee, same-hospital revenue per adjusted admission increased 1.6 percent.

Adjusted EBITDA in Tenet’s hospital segment was $345 million, a decrease of $1 million or 0.3 percent as compared to $346 million in the second quarter of 2017. Key items impacting the year-over-year comparison in Adjusted EBITDA include: (i) a $63 million increase in California Provider Fee revenue, (ii) a $41 million decline in EBITDA due to divestitures; (iii) a $23 million gain in the second quarter of 2017, primarily from the sale of the Company’s home health and hospice assets, which was recorded as a reduction to the Company’s other operating expenses, and (iv) a $6 million decline in electronic health record incentives. After normalizing for these items, Adjusted EBITDA in the hospital segment increased by $6 million, or approximately 2 percent.

Tenet’s health plan business recognized no revenue and $1 million of Adjusted EBITDA in the second quarter of 2018 versus $25 million of revenue and negative $19 million of Adjusted EBITDA in the second quarter of 2017. The revenue and expenses associated with the Company’s health plan operations are included in Tenet’s consolidated statements of operations; however, the results are excluded from Adjusted EBITDA in both periods.

Selected operating expenses in the hospital segment, defined as the sum of salaries, wages and benefits, supplies and other operating expenses, increased 2.2 percent on a per adjusted admission basis in the second quarter of 2018 or just 1.5 percent after normalizing for the aforementioned $23 million gain in the 2017 period.

Exchanges

Tenet’s same-hospital exchange outpatient visits increased 0.6 percent to 51,845 in the second quarter of 2018. Same-hospital exchange admissions were 4,725 in the second quarter of 2018, down 5.6 percent from the second quarter of 2017.

Ambulatory Care Segment

During the second quarter of 2018, the Ambulatory segment produced net operating revenues of $531 million, representing an increase of 12.5 percent as compared to $472 million in the second quarter of 2017. In addition, the Ambulatory segment generated Adjusted EBITDA of $198 million, up 20.7 percent from $164 million in the second quarter of 2017 and Adjusted EBITDA less facility-level noncontrolling interest was $128 million, up 20.8 percent from $106 million in the second quarter of 2017.

The results of many of the facilities in which the Ambulatory segment has an investment are not consolidated by Tenet. To help analyze the segment’s results of operations, management uses system-wide measures, which include revenues and cases of both consolidated and unconsolidated facilities. On a same-facility system-wide basis, revenue in the Ambulatory segment increased 6.9 percent, with cases increasing 4.3 percent and revenue per case increasing 2.4 percent. In the surgical business, which represents the majority of the revenue in the Ambulatory segment, same-facility system-wide revenue grew 6.6 percent, with cases up 3.4 percent and revenue per case up 3.1 percent, reflecting growth in higher-acuity surgical procedures. In the non-surgical business, same-facility system-wide revenue grew 13.6 percent, with visits up 5.8 percent and revenue per visit up 7.4 percent.

Conifer Segment

During the second quarter of 2018, as a result of divestiture activity at Tenet and other customers, Conifer’s revenue decreased 3.5 percent to $386 million, down from $400 million in the second quarter of 2017. Revenue from third party customers was down 1.2 percent to $242 million. Conifer’s revenue in the second quarter of 2018 included $7 million of contract termination fees from two health systems that acquired hospitals from Tenet and another Conifer customer and subsequently decided to insource revenue cycle management.

Conifer generated $91 million of Adjusted EBITDA in the second quarter of 2018, up 51.7 percent from $60 million in the second quarter of 2017. After normalizing for the aforementioned $7 million of contract termination fee revenue and $3 million of incentive revenue from customers in the second quarter of 2018, Adjusted EBITDA grew by 35 percent, primarily driven by improvements in Conifer’s cost structure.

Net Income and Earnings Per Share

Tenet reported net income from continuing operations available to Tenet common shareholders of $24 million, or $0.23 per diluted share, in the second quarter of 2018 compared to a net loss of $56 million, or $0.56 per diluted share, in the second quarter of 2017.

As shown on Table #2 at the end of this release, net income from continuing operations available to Tenet common shareholders of $24 million included: (i) $30 million of pre-tax impairment and restructuring charges, including $9 million of employee severance, $4 million of impairment charges to write-down assets held for sale in the United Kingdom to their estimated fair value, $4 million of contract and lease termination fees, and $13 million of other items; (ii) $13 million of pre-tax litigation and investigation costs; (iii) $8 million of pre-tax net gains on sales, consolidation and deconsolidation of facilities, primarily related to a $12 million pre-tax gain on the sale of Des Peres Hospital offset by $4 million of other items, and, (iv) other offsetting items. These items collectively lowered pre-tax income by $35 million, after-tax income by $27 million and diluted earnings per share by $0.26.

After adjusting for the items listed above and on Table #2, Tenet produced Adjusted net income from continuing operations available to Tenet common shareholders of $51 million, or $0.49 per diluted share, during the second quarter of 2018, as compared to an Adjusted net loss from continuing operations attributable to Tenet common shareholders of $17 million, or $0.17 per diluted share, in the second quarter of 2017.

A reconciliation of GAAP net income available (loss attributable) to Tenet common shareholders to Adjusted net income available (loss attributable) from continuing operations and Adjusted diluted earnings (loss) per share from continuing operations is contained in Table #2 at the end of this release.

Cash Flow and Liquidity

Cash and cash equivalents were $403 million at June 30, 2018 compared to $974 million at March 31, 2017. The Company had no outstanding borrowings on its $1 billion credit line as of June 30, 2018. Accounts receivable days outstanding from continuing operations were 55.1 at June 30, 2018 compared to 54.3 at March 31, 2018 and 55.8 at December 31, 2017.

Net cash provided by operating activities was $461 in the first half of 2018, representing a $60 million increase compared to $401 million in the first half of 2017. After subtracting $268 million and $348 million of capital expenditures in the first half of 2018 and 2017, respectively, Free Cash Flow was $193 million in the first half of 2018, an increase of $140 million compared to $53 million in the first half of 2017. Adjusted Free Cash Flow was $259 million in the first half of 2018, representing a $142 million increase from $117 million in the first half of 2017.

Net cash provided by investing activities was $225 million in the first half of 2018 compared to $308 million of net cash used in investing activities in the first half of 2017. The 2018 period included $624 million of proceeds from the sales of facilities, long-term investments and other assets, primarily from the sale of the Company’s two hospitals in the Philadelphia area, MacNeal Hospital, Des Peres Hospital, and the Company’s minority interests in four Dallas-area hospitals. The 2018 period also included $126 million of purchases of businesses, joint ventures and equity investments, primarily related to USPI’s acquisition program.

Net cash used in financing activities was $894 million in the first half of 2018 compared to $334 million of net cash used in financing activities in the first half of 2017. The 2018 period included $642 million in purchases of noncontrolling interests, including approximately $630 million in the second quarter of 2018 to increase Tenet’s ownership in USPI to 95 percent, and $78 million of debt retirement through open market purchases.

Reconciliations of net cash provided by operating activities to both Free Cash Flow and Adjusted Free Cash Flow are contained in Table #3 at the end of this release.

Outlook

The Company’s Outlook for 2018 includes:

Revenue of $17.9 billion to $18.3 billion, Net income from continuing operations available to Tenet common shareholders of $115 million to $186 million, Adjusted EBITDA of $2.550 billion to $2.650 billion, Net cash provided by operating activities of $1.220 billion to $1.525 billion, Adjusted Free Cash Flow of $725 million to $925 million, Diluted earnings per share from continuing operations of $1.11 to $1.79, and Adjusted diluted earnings per share from continuing operations of $1.54 to $1.88.

The Outlook for 2018 assumes equity in earnings of unconsolidated affiliates of $160 million to $170 million, net income available to noncontrolling interests of $390 million to $410 million and an average diluted share count of 104 million.

The Company’s Outlook for the third quarter of 2018 includes:

Revenue of $4.300 billion to $4.500 billion, Net income available (loss attributable) from continuing operations to Tenet common shareholders ranging from a loss of $10 million to income of $5 million, Adjusted EBITDA of $575 million to $625 million, Diluted earnings per share from continuing operations ranging from a loss of $0.10 to earnings of $0.05, and Adjusted diluted earnings per share from continuing operations ranging from $0.10 to $0.24.

The Outlook for the third quarter assumes equity in earnings of unconsolidated affiliates of $40 million to $45 million, net income available to noncontrolling interests of $90 million to $100 million, and an average diluted share count of 104 million.

Additional details on Tenet’s Outlook for both the third quarter and calendar year 2018 are available in Tables #4, #5 and #6 at the end of this press release and in an accompanying slide presentation that is accessible through the Company’s website at www.tenethealth.com/investors.

Management’s Webcast Discussion of Second Quarter Results

Tenet management will discuss the Company’s second quarter 2018 results on a webcast scheduled for 10:00 a.m. Eastern Time (9:00 a.m. Central Time) on August 7, 2018. Investors can access the webcast through the Company’s website at www.tenethealth.com/investors. A set of slides, which will be referred to on the conference call, is available on the Quarterly Results section of the Company’s website.

Additional information regarding Tenet’s quarterly results of operations is contained in its Form 10-Q report for the period ended June 30, 2018, which will be filed with the Securities and Exchange Commission and posted on the Company’s website.

This press release includes certain non-GAAP measures, such as Adjusted EBITDA, Adjusted net income available (loss attributable) from continuing operations to Tenet common shareholders, Adjusted diluted earnings (loss) per share from continuing operations, Free Cash Flow and Adjusted Free Cash Flow. Reconciliations of these measures to the most comparable GAAP measures are contained in the tables at the end of this release.

Tenet Healthcare Corporation is a diversified healthcare services company with approximately 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities in the United States and the United Kingdom. Tenet’s Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans. For more information, please visit www.tenethealth.com.

The terms “THC,” “Tenet Healthcare Corporation,” “the Company,” “we,” “us” or “our” refer to Tenet Healthcare Corporation or one or more of its subsidiaries or affiliates as applicable.

This release contains “forward-looking statements” - that is, statements that relate to future, not past, events. In this context, forward-looking statements often address our expected future business and financial performance and financial condition, and often contain words such as “expect,” “assume,” “anticipate,” “estimate,” “intend,” “plan,” “project” “believe,” “seek,” “see,” or “will.” Forward-looking statements by their nature address matters that are, to different degrees, uncertain. Particular uncertainties that could cause our actual results to be materially different than those expressed in our forward-looking statements include, but are not limited to, the factors disclosed under “Forward-Looking Statements” and “Risk Factors” in our Form 10-K for the year ended December 31, 2017, and subsequent Form 10-Q filings and other filings with the Securities and Exchange Commission.

Tenet uses its Company website to provide important information to investors about the Company including the posting of important announcements regarding financial performance and corporate developments.

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