The Healthy Muse
The Healthy Muse hooks you up with all of the latest first quarter earnings reports in the healthcare sector.



Q1 2019 Earnings Highlights:




Healthcare’s performance in the first quarter of 2019 was above expectations from a financial standpoint, but that didn’t stop the market sell-off.

Overall, the S&P 500 Healthcare Sector returned -2.6% in the month of April, which was….the worst performing sector over the month. Notable outperformers included Cerner (+16.2%), Quest Diagnostics (+7.8%), CVS (+1.8%), McKession (+1.9%), and LabCorp (+4.5%). Notable decliners included Anthem (-8.3%), Eli Lilly (-9.8%), and Intuitive Surgical (-10.5%).

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Here’s the latest healthcare earnings news from the first quarter’s releases:




Aetna helps out CVS.

CVS‘ acquisition of Aetna helped offset struggling retail margins this quarter. The company raised its full-year guidance based on Aetna’s solid performance.


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Walgreens Slips.

Walgreens Boot Alliance shares didn’t fare well as the company issued warnings throughout its statements, including significant reimbursement pressure and addressing weaknesses in its business model.

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Express Scripts lifts Cigna.

Similarly, Cigna bragged big time about its Express Scripts acquisition during the firm’s first quarter earnings parade, touting the innovative programs the combined companies can now create given the merger.

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Teladoc’s visits surpass a milli.

Teladoc passed the 1 million quarterly visits milestone during the first quarter, but shares slid in trading due to the company’s high valuation and growth expectations. On a positive note, the company expects to be cash-flow positive soon.

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Community Health Systems struggles.

A still-struggling hospital operator, Community Health Systems surprised no one by continuing its divestiture strategy and losing $118 million. Still, the company produced more operating cash flow than expected.

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U.S. Physical Therapy expands its gross margin.

U.S. Physical Therapy grew revenues 7.3% quarter over quarter, attributable to its increase in total patient visits and positive operational performance in its industrial injury prevention business. As a result, the company improved its gross margin to 23.0%, up from 21.4% a quarter ago.

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HCA’s machine rolls on.

HCA Healthcare’s same facility equivalent admissions grew 1.8%, while revenues totaled $12.5 billion in the first quarter of 2019. The efficient hospital operator re-issued its guidance based on its recent acquisition of Mission Health, a 6-hospital rural health system in west North Carolina. Compared to Q1 2018, its adjusted EBITDA grew over 150 bps to 20.3%.

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Tenet beats expectations

Tenet Healthcare beat the market consensus in Q1, but struggled with declining revenues, visit volume, and adjusted EBITDA.

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Humana gets downgraded.

Humana reported better than expected results for both revenue and earnings and upped its guidance for 2019, but shares dipped after the insurance giant received several analyst downgrades.

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Acadia’s divestiture plans.

Amid buy-out rumors for its London operation for $1.3 billion, Acadia Healthcare reported a slight earnings beat. The potential sale would comprise between one third and one half of the behavioral health company’s existing annual revenues.

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Fresenius up to par.

Fresenius Medical finished above the consensus for the quarter, with both its products and services segments contributing to the revenue increase.

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Amedisys details PDGM changes.

Amedysis reported a strong 6.0% same-store sales growth figure, but the company’s shares sold off almost 6% shortly afterwards. A notable development: the home health and hospice firm is working with members of Congress to pass the Home Health Innovation Act, which would make reimbursement modifications to the PDGM legislation going into effect in 2020.

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MedNax’s comeback.

MedNax came up short in both the revenue and earnings category, but investors must have liked something – the stock finished up on the day after starting more than 5.0% down at the open.

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Molina Healthcare’s Medicaid margins.

Molina Healthcare reported a 16% margin for its managed Medicaid business, and 7.5% margins for its managed Medicare operations. The firm increased its guidance for the rest of 2019.

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Encompass’ growth and Alacare acquisition.

Encompass Health had a strong quarter. The post-acute behemoth achieved higher volume in its home health operations, and investors received a bit more insight on its recent $218 million purchase of Alacare Home Health & Hospice.

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LabCorp delivers despite negative effect of PAMA.

Despite the impact of PAMA – price reductions in the laboratory industry – LabCorp beat expectations and is one of the best healthcare performers year to date on the market.

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UHS’ Miss.

Universal Health Services‘ earnings missed by a wide margin in Q1.

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Select Medical’s JV plans.

Finally, Select Medical, which reported at the end of March, reported in-line with expectations. This week, the company announced a joint venture with Norton Healthcare for outpatient services in Kentucky and Indiana.

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Surgery Partners Highlights.

Surgery Partners saw same store revenues increase 5% in the first quarter. Other highlights from the press release:

  • Revenues increased 1.3% over the prior year period to $416.8 million
  • Same-facility revenues increased 5.0% over the prior year period; adjusted for business days operated in the first quarter of 2019, same-facility revenues increased by 6.7%
  • Net loss attributable to common stockholders of $28.6 million
  • Adjusted net loss attributable to common stockholders of $20.3 million
  • Adjusted EBITDA increased 7.6% over the prior year period to $50.7 million
  • Diluted net loss per share of $0.60
  • Diluted adjusted net loss per share of $0.42

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Cardinal Health Ups its Guidance, Shares Sell off.

Cardinal Health upped the lower end of its guidance and renewed its agreement with CVS through 2023 in its latest earnings report. Other highlights from the press release:

  • Revenue increased 5 percent to $35.2 billion
  • GAAP operating earnings decreased 21 percent to $432 million, and non-GAAP operating earnings decreased 15 percent to $667 million
  • GAAP diluted earnings per share increased 22 percent to $0.99, and non-GAAP diluted earnings per share increased 14 percent to $1.59
  • Raised lower end of FY19 guidance
  • Extended distribution agreements with CVS Health through June 30, 2023

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Quorum Health.

As a struggling hospital operator, Quorum Health performed about as expected. The company also recently announced its intention to use R1 RCM for its revenue cycle management.

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Anthem Raises Guidance.

Anthem beat earnings and raised its guidance for the year, but the stock dropped in trading.

Highlights from the press release:

  • First quarter net income was $5.91 per share, including net negative adjustment items of $0.12 per share. Adjusted net income was $6.03 per share.
  • Operating revenue grew by 9.2% over the prior year quarter to $24.4 billion.
  • Medical enrollment increased by 905 thousand members sequentially to 40.8 million members.
  • The operating gain was $1.9 billion, an increase of 3.9% over the prior-year quarter.
  • Second quarter 2019 dividend of $0.80 per share declared to shareholders.

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UnitedHealth Beats. Per Usual.

UnitedHealth beat on both top and bottom line estimates in addition to offering some ominous warnings about the disruptive power of any Medicare for All proposals. Other highlights from the press release included the following:

  • Revenues of $60.3 Billion Grew 9% Year-Over-Year
  • Earnings from Operations Increased 19% to $4.8 Billion,
  • Net Earnings of $3.56 Per Share Grew 24% Year-Over-Year
  • Adjusted Net Earnings of $3.73 Per Share Grew 23% Year-Over-Year

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Centene Corporation.

Centene‘s earnings results were perhaps overshadowed by its recent WellCare acquisition announcement and Humana buyout interest.

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LHC Group.

LHC Group grew its net service revenue by 72.7% in the first quarter. Other highlights from the press release include:

  • Net service revenue increased by 72.7% to $502.6 million.
  • Net income attributable to LHC Group’s common stockholders increased 277.5% to $18.9 million. Earnings per diluted share attributable to LHC Group’s common stockholders increased 114.3% to $0.60 which includes a 72.9% increase in weighted average diluted shares outstanding and the effect of costs and expenses described within the adjusted results below.
  • Adjusted net income attributable to LHC Group’s common stockholders increased 171.5% to $30.7 million. Adjusted earnings per diluted share attributable to LHC Group’s common stockholders increased 55.6% to $0.98.
  • Adjusted results for the first quarter of 2019 exclude transaction and other transition-related costs, expenses related to certain closures and relocations and a license change related impairment in the aggregate amount of $11.8 million after tax, or $0.38 per diluted share.
  • Total growth in home health admissions was 76.3%; organic growth was 5.7%.
  • Total growth in home health revenue was 77.4%; organic growth was 7.0%.
  • Total growth in hospice admissions was 13.1%; organic growth was 6.2%.

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Addus HomeCare

Addus HomeCare’s revenues increased 27.2% to $139 million. Other highlights from their first quarter report included:

  • Net Income of $4.9 Million or $0.36 per Diluted Share, and Adjusted Diluted Earnings per Share of $0.52
  • Adjusted EBITDA Increased by 23.1% to $10.8 Million
  • Same-Store Sales Increased 5.6%

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Civitas Solutions – Nothing to See Here.

Civitas‘ first-quarter earnings reported that net revenue increased by 2.8% to $406.6 million. The company didn’t have too much to report considering the fact that it’s about to be officially taken private.




Chemed’s Margins Contract.

Highlights from Chemed’s first quarter earnings report included:

  • Revenue increased 5.2% to $462 million
  • GAAP Diluted Earnings-per-Share (EPS) of $2.70
  • Adjusted Diluted EPS of $2.92, an increase of 7.4%
    • VITAS segment operating results:
      • Net Patient Revenue of $307 million, an increase of 5.1%
      • Average Daily Census (ADC) of 18,345, an increase of 6.6%
      • Admissions of 17,758, a decline of 2.9%
      • Net Income, excluding certain discrete items, of $34.6 million, an increase of 7.3%
      • Adjusted EBITDA, excluding cap, of $49.7 million, an increase of 16.0%
    • Roto-Rooter segment operating results:
      • Revenue of $155 million, an increase of 5.5%
      • Net Income, excluding certain discrete items, of $23.3 million, an increase of 1.8%
      • Adjusted EBITDA of $33.5 million, a slight decline of 1.1%
      • Adjusted EBITDA margin of 21.6%, a decrease of 145-basis points

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RadNet Re-Affirms Guidance, But Higher Interest Payment Expected.

  • RadNet increased its revenues by 17.4% to $271.5 million in the first quarter of 2019 from $231.4 million in the first quarter of 2018. The firm reiterated its guidance but expects a $5 million higher cash interest payment this year. Other highlights:
    • Adjusted EBITDA(1) increased 57.3% to $33.1 million in the first quarter of 2019 from $21.0 million in the first quarter of 2018
    • Diluted loss per share was $(0.08) per share in the first quarter of 2019 as compared with diluted loss per share of $(0.15) from the prior year’s first quarter
    • Aggregate procedural volumes increased by 7.6%; Same-center procedural volumes increased 2.3% from the first quarter of 2018
    • Began operating its second Dignity Health joint Venture in Ventura County, CA and, subsequent to quarter end, completed $120 million incremental credit facility to provide additional financial and operating flexibility for future growth
    • RadNet affirms full-year 2019 guidance levels for Revenue, Adjusted EBITDA(1), Free Cash Flow and Capital Expenditures

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Quest Outperforms in April.

  • Quest‘s First quarter revenues increased by 0.4%, or $1.89 billion. More from its report:
    • First quarter reported diluted EPS of $1.20, down 5.4% from 2018; and adjusted diluted EPS of $1.40, down 7.9% from 2018
    • Cash provided by operations was $275 million, up 53.4% from 2018
    • Outlook for full-year 2019 remains unchanged.

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DaVita Healthcare

DaVita reported consolidated revenue of $2,743 million and income of $341 million in the first quarter of 2019.

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American Renal Associates Delays its Filing.

Due to faulty revenue recognition practices, American Renal Associates was forced to delay its quarterly filing. Uh oh…

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