JP摩根美股医疗保健行业全民医疗保险M4A框架2019325页

1NorthAmericaEquityResearchMarch2019HealthcareFacilities&[e-mail]HCAREFACILITIES&MANAGEDCAREAMedicareforAll(M4A)FrameworkDiversifiedHMOs|GovnHMOs|AcuteCare|Sub-Acute|Outpatient|[e-mail]stitutionalClientLunchWednesdayMarch6,2019NoonETContactJPMsalesfordetailsSeetheendpagesofthispresentationforanalystcertificationandimportantdisclosures,includingnon-USanalystdisclosures.J.P.Morgandoesandseekstodobusinesswithcompaniescoveredinitsresearchreports.Asaresult,investorsshouldbeawarethatthefirmmayhaveaconflictofinterestthatcouldaffecttheobjectivityofthisreport.Investorsshouldconsiderthisreportasonlyasinglefactorinmakingtheirinvestmentdecision.OnJanuary3,2018,MIFIDIIcameintoeffect.Therefore,youmayonlybeeligibletoparticipateinthiseventifyouhavetheappropriatelevelofaccesstoJ.P.Morganresearch.Pleasecheckyoureligibilitybeforeparticipating/accessing.”2GaryTaylor|[e-mail],TopPicks,Catalysts&“Out-of-Consensus”HighlightsSource:J.P.MorganandBloomberg.LONG-TERMTHESISOwnpayorsvsproviders.Managedcarerepresentsahigh-ROICplayonthemostsecularinvestmenttrendintheUS;healthcarespendinggrowthGDPgrowth.Providersgenerallyrepresentalower-ROICplayonthatsameseculartrend.Thelong-termshiftfromFFStoValuereducesvolatilityofearningsforpayorswhileincreasingearningsgrowthandvolatilityforproviders.M4Awillultimatelyfail,inourview.NEAR-TERMPOSITIONINGPayors(+):WeseeamodestreboundaftertheworstM4Abullet,Biden’slikelydeclaration&strong1Q19earnings.Providers(--):Weremainonlyselectivelypositive.TheYTDshortralliesdon’tseemsustainableonback-halfloadedguidance,weakvolumes&politicaluncertainty.TOPPICKSWCG–Wellpositionedgovernmentstorywithmarginvisibilityinto2021fromMeridianaccretion,MAmomentum,FLMDCDmargins,AETPDP&CVSPBMrenewal.HUM–Wellpositionedpure-playMAstorywithstrongfundamentals.CATALYSTCALENDARANTMInvestorDayNYCMar7CompetitorHCConferenceBostonMar11-13CompetitorHCConferenceMiamiMar12-14HUMInvestorDayNYCMar19MA2020AdvanceNoticeFinalRuleApr1HHSDrugRebateRuleCommentsDueApr8UNH2Q18EarningsApr16MOHInvestorDayNYCMay30CignaInvestorDayNYCMay312020MA/PDPBidsDueJune3CVSInvestorDayNYCJune4CNCInvestorDayNYCJune14TexasSTAR+Plus,STAR,ChipRFPAward~June/JulyOUT-OF-CONSENSUSIDEAS1)TheSenatelikelyremainsakeybarriertohealthcarereformbeyond2022.2)NeitherpayorsnorproviderstradeddefensivelyvsSPXduringthelasttworecessions.Payorsdooutperformproviders&SPXinratetighteningcycles.3)NFPBlues’commercialgroupmarginsdeterioratingin2018,whichmaymitigate2019pricingpressure,contrarytothe“improvingRBC”thesis.4)MCOparitywithSPXvaluationiswarranted&sustainableasconsolidation&diversificationreducedearningsvolatilityoverthelastdecade–however,weexpectrelativevaluationstobepressuredduringthe2020electioncycle.5)FLhospitalswouldnotexperiencematerialEBITDAgrowthfromMDCDexpansiondueto“crowd-out”ofHIX-subsidizedpopulation133%FPL.6)Despitea3%2019IPPSincrease,netMDCRpricingisamodestheadwindforallexceptHCAduetosharplylowerOPPS(anniversaryof340bbenefit).7)DVAderives60%+ofEPSfromitscontributionstoAKF.OUT-OF-CONSENSUSRATINGSTHC–JPM“Underweight”vsStreet90%“Buy”or“Hold”CNC–JPM“Neutral”vsStreet82%“Buy”DVA–JPM“Neutral”vs.Street62%“Buy”MOH–JPM“Overweight”vs.Street59%“Neutral”or“Sell”UHS–JPM“Neutral”vsStreet55%“Buy”CROWDEDHEDGEFUNDPOSITIONSNetLong:THC(14%),MD(11).NetShort:CYH(-6),ACHC(-5)Controversial:THC(+25/-11%),MOH(+9/-8),ACHC(+12/-17),CYH(+16/-22).ACUTESEASONALITYJan(-1.8%)Feb(0.0%)Mar(-0.2%),1Q19:-0.7%2Q19:-0.3%3GaryTaylor|[e-mail]:J.P.Morgan,BloombergHealthcareFacilities&ManagedCareCoverageUniverse3/4/2019JPMEPSGrowthP/EEV/EBITDACompany/SubsectorTickerPriceTargetMktCapRatingC'18EC'19EC'20EC'18EC'19EC'20EC'18EC'19EC'20EAcuteCareHospitalsCommunityHealthCYH$5.01na$565UW65%3%(17%)------9.0x9.2x8.9xHCAHCA$137.47$151$48,511OW36%7%9%14.8x13.9x12.8x9.8x9.0x8.6xTenetHealthcareTHC$29.34$23$3,032UW142%7%(3%)15.9x14.9x15.4x7.9x7.9x7.7xTotalMarketCap$52,108Median:65%7%(3%)15.4x14.4x14.1x9.0x9.0x8.6xSub-AcuteCareAcadiaHealthcareACHC$30.27$32$2,646N1%(9%)5%13.1x14.4x13.7x10.0x10.0x9.5xUniversalHealthServicesUHS$137.91$147$12,929N27%2%6%14.6x14.3x13.4x9.5x9.3x9.0xTotalMarketCap$15,575Median:14%(4%)6%13.8x14.3x13.6x9.7x9.7x9.3xOutpatientCareDavitaIncDVA$56.00$63$9,323N(0%)38%15%16.6x12.0x10.5x7.7x7.3x7.1xOutsourcedServicesMednaxIncMD$33.14$39$2,925N11%(4%)6%9.4x9.9x9.3x8.7x9.0x8.7xManagedCare-DiversifiedAnthemANTM$302.00$338$79,788OW32%21%18%19.0x15.7x13.4x15.5x14.0x12.4xCignaCI$174.42$250$67,274OW37%15%12%12.1x10.6x9.5x19.5x10.0x9.5xHumanaHUM$281.53$343$38,710OW24%21%14%19.3x16.0x14.0x12.9x11.7x10.4xUnitedHealthUNH$240.89$301$236,554OW28%13%15%18.7x16.5x14.4x14.1x12.8x11.5xTotalMarketCap$422,326Median:30%18%15%18.9x15.9x13.7x14.8x12.2x11.0xManagedCare-MedicaidCenteneCNC$59.98$69$25,206N43%19%14%16.9x14.2x12.4x13.1x10.8x9.8xMolinaMOH$135.56$169$9,028OW725%(7%)16%12.6x13.6x11.6x8.3x9.9x8.8xWellcareWCG$249.99$