24 things to know about AmSurg

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Here are 24 things to know about AmSurg, a leader in the ASC management and development industry.

2015 Acquisitions
1. AmSurg acquired Sheridan Healthcare in May 2014 in a stock and cash transaction valued at nearly $2.35 billion. Since its acquisition of the anesthesia and physician services company, AmSurg has continued to diversify and expand its services into anesthesiology, radiology and emergency medicine.

"AmSurg has undergone a dramatic transformation as a company. Once focused on GI and ophthalmology centers, it is now as much a professional and physician services company as an ASC firm," said Scott Becker, JD, CPA, publisher of Becker's Hospital Review. "It has been fascinating to watch."

2. AmSurg acquired its first radiology group in January 2015 – Radisphere, which has offices in Ohio and Connecticut. Radisphere is comprised of more than 100 radiologists. The terms of the transaction were not disclosed. The company then acquired its second radiology group, Radiology Associates of Hollywood (Fla.), in March.

3. Sheridan, AmSurg's anesthesia services provider acquired last year, acquired Daytona Beach, Fla.-based Halifax Anesthesiology Associates in April. The anesthesiology practice is comprised of eight physicians and 23 certified registered nurse anesthetists.

4. In July, Sheridan acquired Coastal Anesthesia Consultant, which includes 25 physicians, certified nurse anesthetists and anesthesiologist assistants. The partnership expanded Sheridan's anesthesiology services business and strengthened its presence in Florida.

5. Sheridan acquired Bay Area Anesthesia in Tampa, Fla., in August. Bay Area Anesthesia has three locations and two ASCs. The anesthesia group's locations are affiliated with BayCare Health System, based in Clear Water, Fla., and AmSurg and Baycare jointly own the ASCs. The financial terms of the transactions were not disclosed.

6. In November, Sheridan acquired Valley Anesthesiology & Pain Consultants in Phoenix, which bolstered its anesthesiology services business. Prior to the acquisition, Valley Anesthesiology & Pain Consultants was one of the largest independent anesthesiology practices in the United States, and provided anesthesiology and pain management services through more than 240 physicians and 38 allied health providers to 21 hospitals.

7. Sheridan acquired Premier Emergency Medical Specialists on Dec. 8. The acquisition marks Sheridan's first entry into the emergency medicine specialty in the Phoenix market. AmSurg's three specialty practices serve more than 50 Arizona hospitals and ASCs.

8. On Dec. 16, Sheridan acquired Northside Anesthesiology Consultants marking Sheridan's entry into the anesthesia specialty in Atlanta. Northside Anesthesiology Consultants is comprised of 60 physicians and is the sole provider of anesthesiology for Atlanta's Northside Hospital Healthcare System.

Robert Coward, president of Sheridan and chief development officer, AmSurg, said, "We are appreciative of NAC's vote of confidence and selection of Sheridan as its partner. In an increasingly complex and demanding healthcare environment, we believe Sheridan can provide NAC with vital delivery platform components, expertise and resources, all backed by a shared, physician-centric culture."

Financial report for Q3
9. AmSurg operated 253 ASCs and one surgical hospital at the end of the third quarter. The company had five additional ASCs under the letter of intent and one center under development expected to open in 2016.

10. AmSurg reported 29 percent net revenue growth to $650.2 million. Ambulatory Services net revenue growth was up 12 percent to $309 million. Physician Services net revenue reached $341.2 million.

11. Ambulatory Services produced 6.6 percent same-center revenue growth primarily because of improved reimbursement, increased volume and improved case mix. The company experienced a 2.7 increase in procedures and 3.9 percent rise in net revenue per procedure.

12. Physician Services reported 10.1 percent same contract revenue growth, driven by increased volume, improved reimbursement and higher acuity. Same-contract growth was 7.6 percent of the total revenue growth; 2.9 percent was from net new contract revenues; and 15.4 percent was from acquisition revenues.

13. The company's Ambulatory Services purchased two ambulatory surgery centers during the quarter and opened one de novo ASC. The division entered into a joint venture with a California health system that contributed two ASCs and a surgical hospital. The division acquired two ASCs. Physician Services purchased two anesthesia practices in the third quarter.

14. AmSurg's Physician Services reported a 5 percent increase in patient encounters and a 5.1 percent increase in net revenue per patient encounter. AmSurg reported $187.4 million cash and cash equivalents for the quarter. Net cash flows from operations, less distributions to non-controlling interests, were $118.7 million in the third quarter.

15. The company increased revenue guidance for the full year to $2.52 billion to $2.54 billion.

16. AmSurg's same-center revenue is expected to increase 4 percent to 5 percent for Ambulatory Services. Same-contract revenue growth was affirmed at 8 percent to 10 percent for Physician Services for the full year.

17. AmSurg expects adjusted EBITDA at $486 million to $490 million, up from previous guidance of $474 million to $480 million.

"AmSurg continued to perform meaningfully better than we expected during the third quarter of 2015, resulting in our raising our financial guidance for the third consecutive quarter," said President and CEO Christopher A. Holden. "Our strong results reflected outstanding organic growth for the quarter, with an acceleration in our Ambulatory Services same-center revenue for the third consecutive quarter and double-digit growth in Physician Services same-contract revenue growth for the second consecutive quarter."

Senior leadership
18. Christopher A. Holden serves as the president, CEO and director of AmSurg. He joined the company in October 2007. With more than 21 years of experience in the healthcare industry, Mr. Holden has spent most of his career involved in multi-facility and multi-market management. He was senior vice president and a division president of Triad Hospitals before joining AmSurg.

19. In March 2009, Phillip A. Clendenin joined AmSurg as senior vice president of corporate services. He now serves as president of ambulatory services. He became executive vice president of operations in February 2013. He has held management positions with Hospital Corporation of American, Triad Hospitals, Community Health Systems and National Medical Enterprises.

20. Robert J. Coward is the president of Sheridan Healthcare. He joined Sheridan Healthcare in 1994 and was the company's CEO, executive vice president for operations and chief operating officer. Before joining Sheridan Healthcare, Mr. Coward worked in the audit department for Price Waterhouse Coopers and served as the director of account for a regional dialysis provider.

21. Claire M. Gulmi is AmSurg's executive vice president, chief financial officer, secretary and director. She joined the company in 1994.

22. Joining AmSurg in March 1997, Kevin D. Eastridge is currently the senior vice president, finance and chief accounting officer. He was an assurance senior manager at KPMG before joining AmSurg.

Recent news
23. On Nov. 30, AmSurg proposed an underwritten public offering of 5.5 million shares of its common stock. The company plans to use the net proceeds from the offering to repay outstanding debt under its revolving credit facility borrowed to fund its recent acquisition. AmSurg also intends to use the net proceeds to fund a portion of the nearly $500 million of acquisition opportunities in its pipeline.

24. In October, AmSurg offered TeamHealth $7.8 billion to acquire the company, but TeamHealth rejected the offer.

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