Terveystalo Oyj
OMXH:TTALO
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Hi. Good morning, everybody, and welcome to Terveystalo's Q3 Results Call and Webcast. As usual, our CEO, Ville Iho; and our CFO, Ilkka Laurila, will present the results in a brief manner, and we'll follow that with a Q&A. We'll take questions from the phone lines, as well as through the webcast after the presentations. Without further ado, I'll give over to Ville on the results.
Thank you, Kati, and good morning from my behalf. It is actually great pleasure today to present our Q3 results. There are a lot of positives and a lot of things that we can take right from inside Terveystalo. We returned to growth, as the headline says, and at the same time, we improved our profitability. Key headlines and takeaways from Q3 presented here. Growth, of course, in this very difficult and changing circumstances, a very good achievement. It's driven by nice sales mix, partly by active COVID testing and our ability to scale up our testing capability and capacity, and margins partly by also very, very strict cost control. Asset. The demand and the market was still highly fluctuating. And agility remains as a key for managing the organization during Q3. Q2 was scale-down exercise with protecting our margins. Q3 was a scale-up exercise in taking the most out of the new opportunities that were presented by market to us. Digital demand still grew, and we are very much in that game. We'll come back to that very, very important topic. And all in all, Terveystalo as an organization and team performed extremely well in these very, very difficult circumstance. If we take a look at the payor group level, where does the growth come from? All in all, the revenue was 240 million due Q3 and revenue grew almost across the board. In corporate segment, almost 5%. In private payer group, almost 10%, which is very, very good progress in that specific group. In public domain, little bit mixed bag. Staffing revenue slightly declined, as well as the outsourcing revenue. But then services were very much high and up from year-on-year. Q3 revenue breakdown here. Asset growth driven by -- very much by private and corporate payor groups and COVID-19 testing, and that was also boosting the service sales inside a public payor group. We have been sort of underlying throughout the COVID-19 season or era or crisis, however you want to call it, our adaptability and ability to react to changing environment. And as I already said, that has been a key point for us during Q3 as well. Q2, as I said, was a good performance from the organization, from the point of view that in a very sort of pressing circumstances and lowering demand, we were able to protect our margins with very strict cost control and adjustment measures. That was well done by the organization. In the last quarter reporting, I sort of used -- referenced a boxing match. Q2 was the first round. We sort of stood up, and we were winning already during the first round. Q3 was the second round, and we are still winning. Different type of round, but very much still winning. Looking forward, the market is very difficult to forecast. Of course, everybody is following the COVID-19 crisis development and how the pandemic is progressing. Finland is, at the moment, doing fine. The society is open. The testing activity is a very big part of that one, and we play a big part in testing activity. We are providing some 10% of our nationwide testing as we speak. And even -- and we are the bulk of corporate testing keeping the Finnish companies active and open. COVID-19 pandemic progress, still difficult to forecast, and agility remains a key for us going forward. But I think we have proved thus far that we can react to demand being down, we can react demand being up and sales mix shifts in very rapid and agile manner. And that's going to be the key going forward as well. We are building sort of assets that we cannot yet book into our balance sheet as we go. Even during the crisis, we are now very proud that we are able to report nice result, higher margins, higher revenue. At the same time, equally important is that customers are trusting us more than ever. So NPS, still record high, very different levels than, for example, last year at the same time, over 80% for -- over 80 for appointments which is a record high level. Equally important, which is not shown here, is that our employee NPS is developing very nicely. I was slightly worried that since we have been pushing very hard and we have been doing adjustments. We have been doing temporary layoffs and people have been working their butt out in our network in scaling up, for example, testing capability and reacting to new demand profile. Still our eNPS, employee satisfaction is up from spring. It's up from last year's level. It's developing nicely, and that's great. That's a very, very good sort of proof of the trust inside the company that we are doing right things and the team is dedicated together to perform. Another thing -- another indicator that service during Q3 is that our brand preference is record high. It's developing nicely. We are the most preferred brand in this branch, in this industry. And the gap against our competitors is growing nicely. So even that one, because that's typically the best forecast for future market share, that's very important that we are doing nice progress in that field as well. So very, very many positive things. Digital, we'll discuss in detail in just a while. In our internal webcast, I used a lot of time to thank the organization, to thank the Terveystalo team. Q2 and Q3, they have been both proof of our capabilities, our sort of commitment to serve customers in whatever circumstances, through whatever channel is needed. Three examples here, starting from the right-hand side. Finnair, Terveystalo cooperation, just 1 example of our capability of serving our customers in sort of very retail -- detailed and dedicated manner. We have built our testing platform inside Finnair's booking cycle, making the digital booking flow convenient and as smooth for customers -- for traveling customers, just 1 example. We were able to build that very fast and in very, very agile and responsive manner to Finnair. Then overall response times in our services and smoothness of our services. I can share a personal example because I first tested the COVID-19 sort of processes 2 days ago. I got slight sort of symptoms of flu. I thought that this is going to be a very important week for us, so it's better to take COVID-19 test right away. It was 20 past 5, I started getting a doctor's referral to COVID-19 tests. 10 to 6, I was already out from the test. Two hours after that one, I got the result from rapid test, 12 hours after that when I got the final PCR test result. Of course, negative, and that's why I'm here presenting today, but very smooth digital flow and very quick response time. Excellent service during the process as well. Then my favorite part in this slide and sort of proof of Terveystalo team perseverance or [Foreign Language], as we call it in Finland. I -- 2 weeks ago, I visited [indiscernible]. This is from Seinäjoki, one of our units. When we say that we need to build testing capabilities, for example, in this case, driving lanes for our customers, our people in the units, they don't wait. They don't wait for sort of nice signs or attempts or whatnot. They start doing, they start building, they go to local hardware store, they buy tents, they have nails and hammers. They build it, and in a matter of hours, we have the testing capabilities built up in our regions. And that's one of the great strengths. We talked a lot about digital and our capabilities in that front, but equally important is sort of Terveystalo's spirit and ability nationwide, to react very fast. When there's a get-go, people, they perform and they deliver. Talking about digital. As we discussed in our CMD earlier, this is a trend. It's not going to go anywhere in the future. Digital appointments are here to stay. We have now clocked 0.5 million visits during the year, during October, and it's growing rapidly. Already 15% of our corporate appointments are digital. And that's -- I would say it's a proof of the sort of durability of that service mode. And this has been COVID-19, with all the sort of burden on the organization. It has been a great sort of test and exercise for the company like Terveystalo to go truly into the omnichannel world and omnichannel processes. And I think we are doing fine. We are leading back here, as I said, in CMD earlier. We have emphasized throughout the crisis, the importance of agility. That remains a key topic going forward. Of course, we are doing our plans for next year. We are planning, we are budgeting. We are building our must-win battles based on our strategy, but we need to be conscious of the fact that nobody can still predict and forecast COVID-19 pandemic progress. And hence, we need to be ready to make moves. We were ready to make moves during Q2. We were able to make moves during Q3, and we will be ready to make moves going forward as well. And with that one, over to CFO, Ilkka Laurila.
So good morning on my behalf as well. And like usually, then we will take a closer look on the numbers. Starting from the top line and profitability development. Like Ville already mentioned, the development in Q3 was very good. Actually, we actually made a record high on Q3 sales-wise as well as in EBITDA profitability. As you can see, the EBIT -- absolute EBITDA, it was close to EUR 31 million and the relative EBITDA margin, 12.9%, which is clearly higher than during the period that we have been listed so far. So on a quarter -- on a comparable quarter-to-quarter basis, we have, all years since 2017, been able to increase both the relative margin and the absolute amount of the EBITDA. And in the following slides, we will take a closer look on that, where it actually derives from during this quarter. So if you take a closer look on the cost structure, again, you can see that if the top line has increased at 3.6%, pointing that the private was up at close to 9% and the corporate, up by 0.5% in which we have that operating leverage working and the scalability. And for the public business, we had a slight decline in those areas which are not operated within our network, so in staffing and in outsourcing. The public business, which is operated in the network, the occupational health care and the service sales that was also up, sort of emphasizing the operating leverage of the business. But on the cost structure, you can see that the purchase of the materials has increased at 8.3%. Obviously, the reason for that is the PPE procurement. The situation, the global situation and the sourcing capabilities when it comes to the face mask has more or less normalized and the prices have came down, but there's -- in these kind of situations, you have to be cautious with those gearings and you always have some kind of bottlenecks and [indiscernible]. And in the future, if you consider that globally, we would have to give vaccination for millions of people, it might sort of have some disturbances for the sourcing, and therefore, we need to be cautious and careful when purchasing materials for the operations. But so far, we have been successful and we have been -- prepared carefully, and we haven't had any sort of scarce resources when it comes to any productive gearing for any other sort of health care supplies. Employee benefit expenses also declined slightly. Reasons for that, that we still had those temporary layoffs during July and at the beginning of August. The second reason for that is that we are having here in Finland, the temporary pension cost reduction up until end of this year. The impact for this quarter is EUR 1.5 million roughly relating to that. And the third reason is that as we have been very cautious and trying to be agile and trying to be tight when it comes to the costs, we have been also postponed some of the recruitments both within the network as well as here within the group functions. Then if we take a look at the IT expenses, still continue to increase like-for-like during earlier quarters. An obvious reason for that is that as the digital -- sort of digital network increases, the number of the laptops and the PCs increases, the remote working increases, and we are developing all the time, new kinds of applications, et cetera, et cetera. That will also have -- obviously, will also have an impact for the IT expenses, which continue increase also in the times like this. Other operating expenses declined by almost 20% as an evidence of our tight sort of cost control. We have been able to decline some of the expenses. But most of those, we have been sort of cut the budgets and postponed some of the cost line items, not making any sort of permanent cost reductions. From the balance sheet perspective, highlighting the -- sort of the key takeaway, this slide, I would say, is that our cash and cash equivalent is that close to EUR 65 million. So our liquidity is on a good level, and no worries related to that. From the balance sheet perspective, our net debt ratio -- leverage ratio is still below our target, 3.4 during this quarter, developed quite stable, as you can see. So still another reason related to that, and we are quite sort of positive that we will -- we are able to keep it in a good level also in the near future. Working capital level slightly increased. A couple of reasoning for that, obviously. Since the Q2 the sales has increased which also, obviously, have impact for the accounts receivable side. Also, the inventory has increased because we are -- like mentioned earlier, we sort of are cautious when it comes to health care supplies and keep -- try to keep higher inventory levels that we usually do. And that's why the inventory levels are also increasing. Thirdly, within the other payables, we are in Finland having sort of been able to postpone some of the pension-related payments in Q2 and during the Q1 already. And now we are sort of paying those postponed pension payments back. And that's why the other payables have also declined during this quarter. CapEx-wise, like-for-like, mentioned earlier, during the earlier quarters, we have said that we are considering some of the investments again. And we have been postponing some of the investments, the LTM impact you can see here so that if you take a look at the digital development, the intangible assets that has remained actually rather stable. So we continue to invest in those. But what we have sort of been postponing during the crisis is the machinery and equipment investments. And -- but we have also now when the situation has been better, we have sort of opening the investments again on that area as well and continue to invest in those as well in the future. Improvement for the premises has remained rather stable. Those are obviously quite sort of lengthy projects and that's why in the short term -- you are not able to see in a short-term impact in those. Relative to top line, you can see that we have also -- the total CapEx level has slightly declined from 4.5 to 3.9 as we have freezed some of the investments. Finally, that closes my section. And here, you can see our financial calendar for the next year and our AGM for this financial year, which have been also published today. And then I think that we are ready for the Q&A.
Thanks, Ilkka. Do we have any questions from the phone lines?
Yes. We do have a question from Alex Gibson from Morgan Stanley.
I have 2 quick questions. And the first one is just on cost savings, and I'm not I caught it. What was the contribution in the quarter from subsidies and temporary layoffs to employees in absolute euro amounts? Just trying to figure out what will and will not recur as we move into 2021. And then on the testing or the COVID testing opportunity, could you be a bit more precise in saying how much was the revenue contribution? And probably more importantly, how much was the EBITDA contribution to your business in the quarter from COVID-19 testing?
Starting from the cost side, the total impact of the subsidies during this quarter is close to that EUR 1.5 million, and that relates that pension payment reductions. The temporary -- the impact from the temporary labels we have not published. But you can see in our report, we have published a number of the working days and a number of the people that we have been laid off. So you can do some sort of estimate on that. But bigger impact, actually, number-wise, is that we have been freezed recruitment during this year. And obviously, when the business grows, we continue investing in people and continue recruiting new people as well. Then when it comes to the top line, also we haven't published the explicit number what comes from the COVID-19 testing, but the average or the prices -- we have done that 75,000 tests and the price for the private individuals is EUR 235. And for the corporate customers, the list price is EUR 195. So through that, you can do sort of estimate of the total impact from the COVID-19 testing. A clear majority of the testing volumes relates to corporates. So that EUR 195 is a sort of list price for the corporates. And that's clearly the biggest part of the COVID-19 testing. From the margin contributions-wise, we have said earlier that it's a sort of solid business. At the beginning, you'll have a quite high sort of costs related to that, you have to recruit resources, you have the PPP expenses -- PPE expenses, you have different kind of investments related to that testing. And -- but if you are able to keep your volumes up and people's sort of -- the utilization rate of the facilities and the capacity is high, then it comes with sort of higher than the average margin. But if the utilization rate gets lower, obviously, the high level of fixed costs will have a negative impact for the total profitability on that.
Okay. That's helpful. Maybe just following up on the utilization, how many tests per month or per quarter do you need to deliver to really make this a margin-accretive business rather than a margin-dilutive business?
It's not -- unfortunately, it's not that straightforward. Like we did actually in -- during Q1, when the testing volumes were slow and when we were -- we actually down the capacity and we closed some of the testing facilities. So that comes back to that agility, which Ville mentioned, so that if we are seeing a decrease in testing volumes, we are also acting really fast to scale down the capacity. In a matter of weeks, I would say, we are able to take down the capacity. And in that sense, we don't have a big -- we are not afraid of having a sort of negative impact from the testing because we are always able to scale down the capacity. But obviously, the positive impact is then sort of diminishing.
Yes, maybe shortly continue on that one. Just underlying the sort of capability of Terveystalo to scale up and scale down once again. In this testing context, we are #1 nationwide provider for the testing. We have the vastest nationwide network. And I think I gave quite nice example how we are able, in a physical manner, scale up very rapidly throughout the network of 350 units, if we so wish. Earlier in Q3, when the demand for testing was increasing, the public side, they were contemplating around doubling the capacity in 5 weeks. We were contemplating around 5, folding the capacity in 2 weeks. And that's what we did. And that's what we can do going forward as well. We are highly, highly agile. We are highly adaptable. And during the crisis, what has improved quite nicely is the logistics. We have a central lab now in Helsinki. And the logistics, it has become faster and leaner and to a certain extent, also more cost efficient. And that's sort of a sustainable improvement for the process going forward.
And just continuing that still, not to mention the digital capabilities that we are able to do when it comes to testing. So only physical piece when it comes to the testing now is the sample taking. Everything else has been digitalized. So you can book the time online or through your mobile. You can have the referral through online, you can sort of make an appointment online, and you can get the results online. Only piece that we are not able to digitalize is the sample taking, unfortunately. The world is not ready for that yet.
Not yet. And in my sort of individual -- in my individual experience, exactly, as Ilkka said, the physical experience was 5 minutes. All the rest was digital.
Yes. And so I'm getting it right -- if I was to exclude testing, is like a decline of minus 5% in the quarter, ballpark around, where you think the underlying growth of the business is?
Sorry, sorry. Can you repeat?
So just doing the simple calculation and you have given us numbers, but it seems like your growth if you didn't have testing, would have been maybe minus 5%.
You mean the -- you're referring to underlying -- yes, underlying volume.
Yes, yes.
So basically, the -- especially when it comes to the private business, like we said in the outlook as well, we saw positive development in the private. And private is already going also to underlying volumes. The -- for the corporate segment, the sort of -- it's a bit mixed picture. The preventive and legally required services have bounced back. So it has normalized and it's slightly increasing but sort of the sickness care-related services, when it comes to the corporate segment. And if you would exclude the COVID-19 testing, there we are not -- situation has not yet fully normalized and that relates to a couple of factors, I would say. The first thing is, obviously, the -- some of the corporates are not using so much occupational health care, sickness care-related services and are cost-cautious. Some of that relates to the fact that, that -- especially when it comes to the work-related injuries and other sort of accidents, the estimate at the moment is that the volume of that -- or the number of those incidents have declined nationwide from 10% to 15%. So that will obviously have impact for the corporate sickness care. And the third element is that as people are working remotely and having social distance, of course, all kinds of other infections than the COVID-19 are also sort of being avoided. And we can see the clear decline nationwide as well, when it comes to the other infections, be it any ear-, nose-, throat- or stomach-related infections. And obviously, post-COVID-19 situation that -- like as well, the injury -- work-related injuries would and should sort of normalize.
We have another question on the telephone from Panu Laitinmäki from Danske Bank.
Yes. I have 3 questions. So firstly, continuing on the testing topic, what's the outlook for the volume of the tests in the coming months? I think you made an agreement with the Helsinki Hospital District and to be a partner with them. So how much will be this growth volume of the testing going forward?
Do you want to take it or...
The Helsinki Hospital District, the Helsinki, Uusima Hospital, that is -- that only relates to sample taking, first of all. So it's not COVID-19 testing, it's only the sample taking. So it's a bit different sort of type of business. When it comes to the COVID-19 testing, our -- we have to refer to our best medical experts in this case, and they are estimating that during the following 6 months, like our outlook, is that the testing volumes nationwide and within our operations as well are going to remain on a high level. We will see, like you can see, if you are taking -- if you are looking at our open reporting through the Internet where we publish every day, the testing volumes. You can see the weekly fluctuations, but our medical experts still continue estimating that volumes will remain rather high-level during the following 6 months at least.
Yes. Commenting on that one, still coming back to the network strength that Terveystalo has the strongest network in Finland. As the COVID-19 pandemic or epidemic progresses, we will see sort of shifts and changes in different districts as we have seen lately. For Terveystalo, that doesn't mean instability because we are in every corner of Finland. So basically, wherever this COVID-19 pops up, we are there and we will capture the testing volumes.
Okay. The second question is more broadly on demand from the public sector. I think we had discussed earlier that there is a backlog of services in the public sector, and they might need help with that. What have you seen related to that recently? Or is there any progress with that? Or is it the opposite so that things would be frozen with the kind of traditional services now as the public sector is again, preparing for COVID-19?
There has been like this. The 1 example is, of course, the sample taking agreement that we have done with the Helsinki, Uusima Hospital District. And there's other similar kind of smaller agreements and negotiations ongoing. But in a sort of bigger scale, I would argue that part of the positive development in sickness care and in specialty care within the private business, that's partly driven by people opting out the public queues. It's difficult to sort of quantify the number because we don't ask every patient why you have visited our facilities, but I think that what -- that 1 element is that. And the THL, the Finnish -- I don't know what that is in English, but the Finnish -- sort of the health...
Authority.
Authority, published the survey related to public use. If the situation typically, historically, at the end of August has been that people waiting in queues for more than 6 months, the number of those have been, on average, roughly 2,000 people nationwide. This year, The situation at the end of August was close to 18,000 that have waited more than 6 months for their operations. And some of those customers most likely, will opt out the public queue and pay out of pocket. Then the following question obviously is -- and the best and the good question is that how much the public sector will sort of try to close down that queue with their own operations and how much they are outsourcing to private partners. I think it's pretty clear that they are not able to do it on their own. They need private sector for that, but the quantity remains open because the queues have already, since the end of August, at least based on the Finnish newspapers, have been increasing from that 18,000 still. So the jury is out still, that how big of the opportunity that is for the private sector.
Yes, municipalities and public sector in general, they have been given a lot of leeway in this one, not sort of acting according to guarantees, care guarantees, access to care. And that's due to COVID-19. That has been sort of the explanation why they have been given so much leeway. But at 1 point, as Ilkka said, this -- they need to dismantle these queues. And as said many times before, the capacity available, only capacity available for solving that developing crisis is private segment -- private sector.
My final question is on the very kind of near-term outlook. You already described what's happening in the corporate and private segments in general. But have you seen any change to people's behavior in the, let's say, past couple of weeks when we have seen more restrictions on Finland? So any kind of indications that Q4 would be more negative than what we have seen in Q3?
What we can see also from the open credit card data, which some of the Nordic banks are publishing, the usage of the health care services has remained rather stable during the recent weeks, even though that the usage of some other service sector services have already declined because of the worsening COVID-19 situation. But so far, so good. So we haven't seen any major deviations when it comes to our operations.
Yes, after Q2 and during Q2, we were discussing a lot about this fear factor, which was impacting demand especially in capital region. But clearly, the atmosphere, it has shifted so that we are sort of a trusted partner in this crisis. Obviously, we'll see some sporadic changes in demand, for example, Vaasa, a good example. When the COVID-19 spikes in certain areas, it might temporarily impact our demand. But overall, in our network, we haven't seen any negative development in sort of customers' willingness to use our services.
There are no further audio questions registered.
Thank you. We have some questions from the webcast. I think some of the questions were already discussed earlier, but question from Anssi Raussi, OP. How much do you estimate our COVID testing capacity to increase in Q4 compared to Q3?
So the question was our testing capacity...
Our testing capacity quarter-to-quarter compared to this quarter to...
Well, at the moment, we don't see a need to increase our overall testing capacity. We have what it takes, so to speak. But obviously, as I said many times before, we are ready to ramp up regionally where needed. So the capacity will be -- will not be a bottleneck for us.
Then another question from Pauli Lohi, Nordea. You're guiding for significant fall in revenue from outsourcing contracts. Does this have anything to do with the new health care reform? And are the new outsourcing contracts postponed by municipalities once the new health care reform is in place and uncertainty disappears in that regard?
No, it has nothing to do with the social and health care reform. It's discontinuing some of the old Attendo outsourcing contracts. And we haven't lost any contracts, but the municipalities are in-sourcing the operations.
And maybe still on that note. As we commented, I think during last quarter report, the activity from the municipalities and from the public sector when it comes to outsourcing, it's still active. So the market is there.
Yes. Then a question from Iiris Theman, Carnegie. Can you comment how has the sales of corporate and private customers developed so far in October? And how do you expect the current employment situation, down 1% year-on-year in September, to impact your corporate customer sales?
So like I mentioned earlier, the credit card data that has been published openly by the Nordic banks, that refers to situation that the private health care spend has remained rather stable. Overall, when it comes to corporate segment, like mentioned earlier, the situation is such that the preventive services are developing quite positively. And the sickness care is still sort of uncertain and behind -- the underlying demand is behind the normal situation like explained earlier. Of course, if the unemployment situations is worsening significantly, that will have an impact to our business as well. But in the short term and currently, there's other drivers that are sort of having bigger impact for the corporate sales than the unemployment situation related to COVID-19.
Then a question on the cost line items. Should we expect any temporary government cost subsidy for Q4 this year still?
That pension-related subsidy of which impacted during this quarter was that EUR 1.5 million. That is still continuing during the Q4, and that's the only sort of subsidy that we are seeing during the Q4.
Then a follow-up question on the queues in the public sector from Pauli Lohi, Nordea. Aren't the largest cues in the secondary health care side in the public sector? And how much can we help on the secondary health care to dissolve those lines?
The number that I was referring to relates exactly to secondary care. So it's the number that is collected from the Finnish hospital districts, which operates the secondary care in Finland. So the increase from that 2,000 to 18,000 relates to secondary care and mostly operations and namely eye operations and surgeries.
Yes, which we do operate, so we can take part in dismantling those queues. Then a follow-up question on the ending outsourcing contracts. Can you quantify the impact of these terminating contracts and when will these end?
Most of those will end at the end of this year. So some -- in some occasions, we might have 1 or 2 months impact also for the next year, but most of those will end at the end of this year. We are still negotiating with some of the outsourcing contracts, and therefore, it's not sort of -- we're not able to quantify the actual impact post the year-end at the moment.
Yes, and there are still some new contracts also up in negotiations. So the net impact is not clear yet. Unless we have any new questions from the phone lines, I think we've covered all the questions from the webcast.
There are no further questions registered.
Thank you.
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