瑞信美股医疗保健行业一季度医疗设施行业总结尽管流感比较严重但总体结果仍喜忧参半201951026页

DISCLOSUREAPPENDIXATTHEBACKOFTHISREPORTCONTAINSIMPORTANTDISCLOSURES,ANALYSTCERTIFICATIONS,LEGALENTITYDISCLOSUREANDTHESTATUSOFNON-USANALYSTS.USDisclosure:CreditSuissedoesandseekstodobusinesswithcompaniescoveredinitsresearchreports.Asaresult,investorsshouldbeawarethattheFirmmayhaveaconflictofinterestthatcouldaffecttheobjectivityofthisreport.Investorsshouldconsiderthisreportasonlyasinglefactorinmakingtheirinvestmentdecision.10May2019Americas/UnitedStatesEquityResearchHealthcareFacilitiesHealth[e-mail],[e-mail]@[e-mail]1HospitalRecap:SolidVolsDespiteToughFluComp,StillOverallResultsMixed■OverallResultsMixed:TwoofthefourpublichospitalcompaniesthatwecoverreportedEBITDAaheadofconsensusexpectations.HCAbeattheStreetbyawidemargin($262mlnahead,includingan$86mlnpayorsettlementaward),whileTHCwasaheadoftheStreetby$9mln.UHSandCYHbothmissedconsensusexpectationsmodestly.■Q1VolumesGenerallyStrongDespitetheFluComp:Forthefirstquarterof2019,thehospitalgroupreportedSSinpatientadmissionsgrowthof1.5%,onaverage.ThisrepresentsanincreaseintheY/Ygrowthrateof110bpssequentiallyandanincreaseof130bpsY/Y.UHShadthestrongestgrowthinSSadmissionsat5.2%,followedbyHCAat0.9%.CYHandTHCbothSSadmissionsdownjust0.1%,asignificantimprovementforbothcompaniesrelativetotherecentpast.SSadjustedadmissionsgrew2%forthegroup,onaverage,asequentialimprovementof110bpsandaY/Yimprovementof190bpsinthegrowthrate.UHSwasstrongestonthismetricaswellat4.9%,followedbyHCAat1.8%,CYHat0.8%,andTHCat0.6%.EachofthefourcompaniessaidthatatoughflucompwasaheadwindtovolumegrowthonaY/Ybasis.■Q1PricingMetrics:Onpricing,thegroupreportedaY/Yincreaseinnetrevenueperadjustedadmissionof1.9%,onaverage,inthefirstquarterof2019.ThisrepresentsadecreaseintheY/Ygrowthrateof60bpssequentiallyand200bpsrelativeto1Q18.HCAhadthestrongestpricinggrowthat4.4%(3.6%ex-thesettlementaward),whileUHShadapricingdeclineof0.4%.UHSattributedthepricingweaknesstoalowermixofsurgicalservicesandahighermixofmedicalcases.■OutlookforRemainderofYear:CYH,THC,andUHSmaintainedthekeyfiguresintheir2019guidance.HCAmodestlyincreaseditsEBITDAguidancetoaccountforthe$86mlnsettlementaward,whichwasnotinoriginalguidance.HCAistrackingwellaheadofexpectationsafterQ1,sowecouldseeapositiveguidancerevisionwhenthecompanyreportsQ2results.ForTHC,operatingtrendsarelookingsomewhatbetter.Coniferprofitabilityhasimproved,butfocusremainsonthecompany’splantoconductastrategictransactionwithrespecttoConifer.We’lllookforUHS’SSpricingtobouncebackinQ2,andfocuswillstayonpotentialimprovementinthepsychsegment(whichlookedabitbetterin1Q19).WhileCYH’svolumeshavepickedup,themainfocustherecontinuestobeonthecapitalstructurechallengesandthedivestitureprogram.■UpdatingModels:Withthisnote,weareupdatingourCYH,THC,andUHSmodels.OurTHCtargetpriceisnow$25(prev$33),andourUHStargetpriceisnow$150(prev$152).Riskstoourratingsandtargetpricesforallhospitalcompaniesincludevolumeandpricingtrends.10May2019HealthcareFacilities2TableofcontentsSummaryof1Q19Results3Company-by-Company1Q19Recap4CommunityHealthSystems.....................................................................................4HCAHoldings...........................................................................................................5TenetHealthcare......................................................................................................7Ambul7UniversalHealthServices........................................................................................8PricePerformance&Valuation10Industry–KeyOperatingStatistics12SameFacilityAdmissions......................................................................................12SameFacilityAdjustedAdmissions.......................................................................12SameFacilityPricing..............................................................................................13MarginAnalysis......................................................................................................13ExpenseAnalysis...................................................................................................13FinancialStrength/Leverage..................................................................................14CommunityHealthSystems(CYH)16TenetHealthcareCorporation(THC)18UniversalHealthServices(UHS)2010May2019HealthcareFacilities3Summaryof1Q19ResultsTwoofthefourhospitalscompaniesunderourcoveragepostedEBITDAaheadofconsensusexpectations.ThemajorhospitalcompaniesreportedSSinpatientadmissionsgrowthof+1.5%Y/Y(110bpsbetterthan4Q18).ThiswasdrivenprimarilybyUHS,whoreported5.2%SSadmitsgrowth.HCAandUHS(urbanproviders)continuetooutperformtheirpeersonthismetric.Thehospitalgroupreportedanincreaseof2.0%Y/YinSSadjustedadmissions(110bpsbetterthan4Q18).UHSwasstrongestinthiscategoryaswellat4.9%growth.HCAreported1.8%growthinSSadjustedadmiss