dentalcorp Holdings Ltd.

Q2 2024 Earnings Conference Call

8/8/2024

spk08: Good morning and welcome to Dental Corp's second quarter results conference call. Please note that all lines have been placed on mute to prevent any background noise. After the speakers remarks, there will be a question and answer session. If you would like to ask a question during this time, simply press star, then the number one on your telephone keypad. If you would like to withdraw your question, please press star followed by the two. At this time, I would like to turn the call over to Mr. Nate Chapalea, President and Chief Financial Officer of Dental Corp. Please go ahead, sir.
spk03: Thank you, Operator, and good morning, everyone. Welcome to the Dental Corp's second quarter results conference call. I'm joined here by Graham Rosenberg, our CFO. Before we start, we would like to remind you that all amounts discussed on this call are denominated in Canadian dollars unless otherwise indicated. Please note that the statements made during this call may include forward-looking statements and information and future-oriented financial information regarding Dental Corp, its business, and disclosure regarding possible events, conditions, or results that are based on information currently available to management, which indicate management's expectation of future growth, results of operations, business performance, business prospects, and opportunities. Such statements are made at the date hereof, and Dental Corp assumes no obligation to update or revise them to reflect events, disclosures, or circumstance except as required by applicable securities law. Such statements involve significant risk and uncertainties, and are not a guarantee of future performance or results. A number of these risks and uncertainties could cause results to differ materially from the results discussed today. Given these risks and uncertainties, one should not place undue reliance on these statements and information. Please refer to the forward-looking statements and information and future-oriented financial information section of our public filings. Without limitations, our MD&A, our earnings press release, issued today for additional information. For those of you who have dialed into the call, the company has prepared a series of slides to complement our prepared remarks. These slides are available on the investor relations section of our website and the events and presentation section. I will now turn the call over to our Chief Executive Officer, Graham Rosenberg, for his opening remarks. Graham?
spk04: Thanks, Nate, and good morning, everyone. We're pleased to be with you today to review Dental Corp's recent developments, as well as our financial and operating results for the three months ended June 30, 2024. For today's call, I'm going to share a number of those developments with you, and then I will hand the call over to Nate, who will discuss our financial results in detail and provide forward-looking remarks about how our business is trending. As a reminder, Dental Corp operates in a highly recurring essential healthcare industry that is cash-pay, resilient through economic cycles, and insulated from this intermediation by technologies. Importantly, dental expenditures have experienced strong relative growth during periods of higher than average inflation. Accordingly, and in the context of the current macro environment, we believe that Dental our confidence in the business is supported by our second quarter results, which met or exceeded our expectations and provide a constructive outlook for the remainder of the year. Overall, I am pleased with our results this quarter, and as you can see on slide three, our results have been made possible by our network of over 10,000 team members across the country. Our teams continue to deliver the highest standards of care during the reporting period, as we support more than 2.3 million active patients and manage over 5.3 million patient visits annually. You will see that we completed our second quarter end of June 30, 2024, with approximately $1.5 billion of last 12 months' performance revenue and $283 million of performance adjust revenue. As you will see on the next slide, we continued with our balanced approach to growth, driving sustained double-digit growth, and we intend to continue growing our business organically and through a creative M&A, and by driving overall business efficiencies and operating leverage over the medium to long term. This is a program that we have meticulously built over the past decade, and we believe we are able to thrive in any economic climate. With respect to M&A, we acquired nine practices in the quarter for total consideration of $41 million. These practices are expected to generate $6.2 million in pro forma adjusted EBITDA after rent. We are also encouraged to see that practice valuations continue to decline, down 3% in the second quarter of 2024 over 2023, as access to financing opportunities tighten for many buyers across the industry. Our acquisition multiple has declined on a -over-year basis for the past seven quarters, and we remain the best positioned and capitalized partner for independent dentists, and will continue to be disciplined about the practices we acquire. On slide five, you can see that our business operates with robust and expanding margins, low capex requirements and capped interest rate exposure on 100% of our existing debt outstanding. We continue to convert a high steady percentage of our EBITDA into free cash flow in any given period and expect this conversion to increase over time. On slide six, and as expected, we completed the quarter at 4.1 times leverage, down 0.3 times from the same time last year as we pursue a medium-term target of under 3.0 times leverage. And on slide seven, you will see that for the fifth consecutive quarter, we self-funded our acquisition program, and we will continue to apply this disciplined approach to growth. By the end of the year, we anticipate realizing a financial benefit from interest savings due to our deleveraging efforts. As per our credit agreements, as we cross below the next leverage threshold, the interest rate on our existing outstanding debt will be reduced by half a percent, bringing up blended cost of debt from .65% to 6.15%. Turning to the next slide, you can see a comparison of valuation in free cash flow yields versus our peers. Since our IPO, we have seen a decline of 9.4 times EBITDA, or 47%, in our EV2LTM EBITDA trading multiple, and we're currently trading at a 34% discount to our total peer group. At the same time, we're trading at an .7% free cash flow yield compared to our peer group of 3.8%. Turning now to slide 9, I'm pleased to report that our business delivered revenue of $309.8 million in the second quarter of 2024, up .6% over the same period in 2023, and adjusted EBITDA margin of $73.9 million, up .3% over the same quarter last year. Our adjusted EBITDA margin came in at 18.5%, an improvement of 30 basis points over Q2 of 2023, and we are encouraged that same practice revenue growth was 2% for the quarter. I would now like to provide an update on the Canadian Dental Care Plan, also known as the CDCP. We began providing care to CDCP patients on May 1. However, in anticipation of that start date, we experienced the deferral of patient visits in April as they awaited their coverage start dates under the program. These patient deferrals combined with gradual provider enrollment resulted in lower than anticipated patient volumes in the quarter. Despite these initial challenges, we are now pleased to report that dental corps participation in the program is generally tracking at or above the current national figures,
spk00: and
spk04: we expect that number to increase over the coming months as the program matures. As participation across our network continues to grow and we continue accepting more CDCP patients, we anticipate that same practice revenue and EBITDA growth will follow suit. Notably, our practices that are seeing CDCP patients are outperforming those that do not, which is an encouraging trend as more practices within our network begin to treat those patients. They have adapted well to the new processes, alleviating initial concerns at the practice level about potential operational challenges. Under the CDCP, we have and will continue to deliver services at rates consistent with our usual and customary fees. This ensures the high quality of care that all of our patients, both new and returning, expect and rely on. Overall, we regard the CDCP as a favorable development for both the Canadian public and dental professionals, and we expect it to be neutral to slightly positive for dental corps. Despite the initial adjustments related to the CDCP rollout, our overall financial performance remained robust. The outcome of our operational efficiency and strategic initiatives was a strong adjusted free cash flow for the quarter of $41 million, enabling us to find the entirety of our acquisition program with free cash flow for the fifth consecutive quarter. As we look to the third quarter of 2024, we anticipate revenues to increase by 8 to 10% over Q3 of 2023, while delivering 3.5 to .5% same-practice revenue growth. We expect adjusted EBITDA margin to be materially consistent with the third quarter of 2023. I will now pass the call over to Nate, who will walk us through the details of our financial results and share some closing remarks before we open the call for questions.
spk03: Nate? Thank you, Graham. Our quarterly results, which met or exceeded expectations in all respects, demonstrate the strength and predictability of our business. If we turn to slides 10, you'll see that revenue for the three-month period ended June 30, 2024, as Graham mentioned, was approximately $400 million compared to $368 million for the corresponding period last year, representing an increase of approximately 9%. The increase is attributable to our continued acquisitive and organic growth, offset by a -than-expected ramp of CDCP enrollment throughout the quarter. As you can see, we reported second quarter adjusted EBITDA of approximately $74 million compared to $67 million in the same quarter last year, and reported second quarter adjusted EBITDA margins of 18.5%, representing .3% of margin expansion -over-year. As we begin to realize operating leverage following the significant investments in our business, we are now at a net debt of $1.2 million compared to the previous quarter, which was $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and $1.2 million in June, and we see that it is providers create their own gateway, driving that By 12, we remain highly confident about our future opportunities. As we look ahead to the remainder of 2024, we remain optimistic on our same practice revenue growth returning to the 4% plus range in the second half of the year, along with our previous 2024 guidance of 15 to 20% of adjusted pre-cash flow growth per share and adjusted EBITDA margin expansion of 20 plus basis points. We also anticipate completing acquisitions representing pro forma adjusted EBITDA after the current balance sheet of approximately 20 million in 2024. This aligns with our balance approach to strategic growth. Additionally, we expect further de-leveraging of our balance sheet as the company continues to self-fund acquisitive growth. Thank you all for joining our call today. This concludes the formal part of the presentation and I would now like to open the line to any questions. Operator?
spk08: Thank you. We will now begin the question and answer session. If you have dialed in and would like to ask a question, please press star one on your telephone keypad to raise your hand and join the queue. If you would like to withdraw your question, again simply press star followed by the two. Your first question comes from the line of Brian Tanquilla with Jefferies. Brian, your line is now open.
spk05: Hi, this is Noor Roblay in for Brian. Thank you for taking my question. Looking at the Q3 same practice revenue guide, I'm just curious to provide some color on how much that's being driven by deferrals of CDCP patient volumes versus underlying patient demand. Then as a follow-up, is there anything to note on the seasonality of the business given the historical strength in Q4?
spk03: Thanks for the question. It's a good one. Really, since the CDCP rollout which began in May and ultimately the impact it had on patient volumes really on the uninsured base of Canadians that we're expecting to qualify for coverage under the plan. Now as we look to, the government actually put out a press release yesterday and had an open call with the media. 2.3 million Canadians have now been approved to receive coverage under the Canadian dental care plan and 450,000 Canadians have already received treatment under that plan. What we are seeing is the friction in the system as people were getting educated as well as qualifying under the plan and the dentists were now signing up both through the initial enrollment as well as the alternative pathway that opened up in July 8th which saw a significant number of clinics and clinicians join the program. That's really opened up that opportunity to begin seeing those patients. What we are seeing is a return to normal in Q3 or a closer path to a return to normal where the volumes are coming back to our expectations. We are optimistic as we continue to end the year that that will continue to improve albeit not all age cohorts are eligible yet. Really we're talking about the 65 plus and the 18 and under. Remaining age cohorts are going to continue to become eligible through 2025. I'd say we're still expecting a limited amount of friction as we exit 2024 and are very optimistic at the volumes coming back to full normalcy in 2025 and forward. Want to reiterate our confidence in the 4% plus growth through the balance of the year.
spk05: Great. Then curious if we could talk about the seasonality of the business and then also just to follow up on Graham's remarks on the press evaluations of dental practices. Just curious if that might change the pace or cadence of M&A in the near term.
spk03: Yeah. As far as seasonality goes, Q2 and Q4 are slightly stronger quarters. Q1 and Q3 are slightly slower quarters just given the months of operations. We expect the performance to be consistent with what you would have seen in 2023 as far as the seasonality impact. As it relates to acquisitions, Graham? Yeah, morning. As
spk04: it relates to acquisitions, we're going to continue to focus on self-funding our acquisition program. And so as we move into next year, you know, with free cash flows increasing, we'll provide a certain opportunity to potentially increase our pricing. But most importantly to note for this quarter and the last few quarters is that valuations are coming down which allow us to drive more creative deal flow and grow our free cash flow per share which is a core focus of the business across the board.
spk05: All
spk09: right. Thank you. Your next
spk08: question comes from the line of Scott Fletcher with CIBC Capital Markets. Scott, your line is now open.
spk02: Hi. Good morning. Thanks for taking the question. I just wanted to ask on some of the puts and takes on the -over-quarter margins. You sort of had a nice quarter here where there were slightly above expectations and then next quarter you're sort of back down to flat -on-year. You could sort of just give us some colour on the puts and takes there.
spk03: Yeah, absolutely. I would say the only difference and if we get back in the time machine and go back to Q3 2023, we discuss the partner conference. So we have our annual meeting of all of our partners that takes place in Q3. That is obviously a cost to the business which is incurred in that period. If we remove that cost margins, margins would be consistent. However, margins are consistent to Q3 2023 just given the investment in that annual partner conference that does take place. I do want to reiterate that we are confident in the 20 basis points of margins expansion for the full year period as we exit 2024.
spk02: Okay, great. That's helpful. And then it looks like it's just in the casual statement you disposed again of some practices. Can you give us an idea of what's qualified practices for disposal and is that still potential going forward?
spk03: Absolutely. They're all in line with our historical disposals. They're all part of the standalone specialty that was all pre-2014 acquisitions. We do still have a few left that we may see a couple of disposals in the future. Again, our business today is predominantly general practitioners, family dentistry. We have a small group of specialty that continues to remain. But it's de minimis as it relates to our overall performance. So no change in strategy as it relates to what our disposals have been as it relates to these two disposals that happen in the quarter. Great. That makes sense.
spk02: Thank
spk08: you. Your next question comes from the line of Darrell Young with Stiffle. Darrell, your line is now open.
spk07: Yeah, just one quick one for me related to the supplier environment for equipment and consumables. It seems like there's been some competitive shifts there and the environment seems to be quite competitive. I'm just curious if that's opening the door at all for you to maybe negotiate better pricing or new support agreements or just anything there that might further benefit margins in the future?
spk03: That's a great question, Darrell. We have a systematic approach to continue to review all of our material supply arrangements and continue to ensure that we are managing relationships both for our practices as well as vendors to set our providers and ultimately our patients for success. With that, from a pricing strategy, we do continue to evaluate year on year and enter into long-term fixed pricing agreements with those vendors. That's allowed us even through the period of inflation in 2022 and 2023 to maintain the strong margins that we have. And what you're seeing now is the ability for us to continue to expand on that through the margin expansion that we're experiencing through 2024.
spk07: Got it. That's good color. Thanks, guys, and congrats on a good quarter.
spk08: Thanks, Darrell. Your next question comes from the line of Stephen McLeod with BMO Capital Markets. Stephen, your line is now open.
spk10: Thank you. Good morning, guys. I just wanted to ask about the CDCP. Can you talk a little bit about, like, I've been trying to get a sense of how should we think about that program impacting your business over the long term? Is there a way to quantify what your penetration is through your practices of CDCP patients and what it could potentially be? Or is it more just existing patients that are now accessing their health care coverage through the government as opposed to funding it themselves previously?
spk03: Yeah, I'd say that's a great question, Stephen. So I think if we look to the figures that the government is putting out, what we've always thought about our business is that it's highly representative of the Canadian industry as a whole. Being the only national platform coast to coast in every province, what we are seeing is the enrollment, the patient figures in our business are really consistent and proportional to that what we're seeing across Canada. With that, what that means is as more patients do come online, both patients that have previously been seeking dental care as those that otherwise couldn't access it and now will, it will be a slight positive tailwind to our practices from a volume perspective once it's all through the system. Again, in 2023, we're only seeing a small portion of the Canadian population that is able to actually qualify for the program. In 2025, we'll see a significant increase in those total volumes. What we are also seeing is November is really the next main date where increased, call it access to care with more comprehensive treatments will open up in the country coast to coast under the CDCP. So we will see higher value work begin to be provided. What we are seeing is really our practices that have been enrolled in the program and the early adopters in the program are outperforming the practices over those same periods that were not enrolled. And that's primarily coming from a volume perspective. So what we were seeing is patients ultimately on the sidelines waiting for their clinicians to enroll and get acclimated with the program as well as receive their own accreditation to participate. So as we see month over month, both throughout the quarter as well as through the early part of Q3, we're seeing consistent increases in penetration and ultimately consistent increase in our same practice revenue growth driven by the correction in volume from the CDCP penetration.
spk10: Okay. That's helpful, Nate. Thank you. And then is that expectation for accelerated patient growth in 2025, is that embedded in your 4% same-practice revenue growth medium-term target?
spk03: Yeah. So what I'll say is the 4% medium-term target, that's under the assumption of normal patient behavior without taking into consideration any increased, call it patient volume that previously were not seeking dental care. So there's upside in that 4% figure to put it simply.
spk10: Okay. That's great. Thanks, guys. Appreciate it.
spk08: Your next question comes from the line of Chi-Li with HOD insecurities. Chi, your line is now open.
spk01: Hi. Good morning. Thank you for taking the question. So on the CDCP, can you remind us if there is any difference in the economics between the patients that are uninsured versus the one that you typically treat?
spk03: Thanks for the question, Chi. There is no change or difference in the economics. The process under which the patients are billed and treated as far as the actual submission of claim and repayment, those are the standard pipelines that exist with all the major insurers. As you may know, Sun Life is administering the plan and it really would be no different than any other employer-sponsored insurance plan that Sun Life would support. As it relates to the reimbursement, depending on the household income of that patient, there's going to be different levels of coverage, but ultimately to the practice and the economics to the practice, it would be the same for all patients as the practice would balance bill to the provincial fee guidelines.
spk01: Got it. Thank you. And just on leverage, it's good to see that leverage has improved to 4.1 times in a quarter. So where do you see this metric moving to by the end of the year?
spk03: Yeah, so we're going to continue to deliver at the pace of roughly 0.1 per quarter. Expect by the end of the year to be at 4 times or below. What I would like to also reiterate is under our bank covenants and bank leverage, as you may have heard over the call, as we get to below 4 times leverage, which we are very close to, we're going to have a 50 basis point pickup on our old bank accounts. Our bank account is not going to be able to pay our overall interest costs, which will result in an increase of $5 million to our free cash flow, which will continue to both accelerate our leveraging as well as allow for additional free cash flow to accelerate our program.
spk01: Thank you.
spk08: Your next question comes from the line of David Kwon with TD Cohen. David, your line is now open.
spk00: Hey guys,
spk06: just on that leverage question, so when it drops below four times the interest rate, the base rate is going to decline by 50 basis points. Does it decline every, when it gets below say three and a half and then three times?
spk03: Bingo, yes it does get below. Every half turn we pick up 50 basis points of interest cost savings on our spread. As you know, we are hedged fully on the SOFR rate, the base rate up until May of 2026, so we'll have continued upside overall in our interest costs as we continue to deliver and May 2026 as we look at the forward yield curve and we see continued easing there, are very confident at again our strong balance sheet position and continued ability to grow our free cash flow.
spk06: Thanks for the clarification there, Nate. And on the CDCP, you commented how the practices that had signed up for it are outperforming ones that aren't enrolled to student of the higher volumes. Can you quantify, you know, how much that's been? I know you kind of talked about the overall, I think 20,000 patients or so that have been treated, but like how material has that bumped in so far?
spk03: It's a significant difference I would say, where the practices that are seeing those patients are performing at a significantly higher rate. What I would say is as we look through the quarter and where we ended at 2%, I think you could see the significant improvement in our estimate for Q3 being in the .5% to .5% range. That growth is predominantly now driven by the increase in penetration of CDCP practices across our network. As you know, July 8th, the alternative pathway did open up and what you are seeing even from what the government put forward is prior to that, it was called roughly 50% in June. Post July, you are now seeing 75% plus penetration and participation in the dental industry under the CDCP. Again, we are highly representative of that, which is showing that increase of call it .5% to 2% on same practice growth from where we are in Q2.
spk06: That's awful. Thanks for the color, Nate. One last question. On the response on the talk about when you sign these kind of long-term contracts, can you talk about when they come up? Because it sounded like you said that you benefited from them in the last couple of years in the higher inflationary environment, but I assume once those contracts come up, you will renew that, there's going to be some catch up there.
spk03: We just signed really at the end of last year. So we continue to be opportunistic in evaluation of all of our supplier partners. Again, we don't have any sole source relationships. We have multiple relationships for ultimately the goods that we do source in our practice and ensure that we are maintaining our leadership position in the Canadian market as it relates to both access as well as pricing.
spk06: Okay. So I think it's fair to say then that those increases likely, increases with these new contracts wouldn't bake into your margin of guidance, right? Absolutely. Perfect.
spk08: Thanks. Your next question comes from the line of Alan Lutz with Bank of America. Alan, your line is now open.
spk09: Hey, it's Devon for Alan Lutz. I just want to touch quickly on the gross margin and how to think about this for the rest of the year and into 2025. Good expansion at 2Q here, but it looks like there could be potentially flat, 82H. Nate, could you just consider in the CDCP any pricing impact there and how we should think about it for the second half of the year and into 2025?
spk03: I heard the first part. I'm just going to repeat the question because you've cut out for the second part. So the first part is just some color on gross margin interview on a go forward on gross margin. What was the second part of the question?
spk09: Yeah, that's pretty much it.
spk03: Okay. So as it relates to gross margin, just as a reminder for everyone really what goes into it, it's our dental draw compensation, which is a fixed percentage. So ultimately all dentists get paid on a commission rate. So that is our number one cost to the business, which ensures that variability. Two is our cost to our hygienists, which as well on an hourly basis maintains variability. Our consumable costs to our practices, which we discussed, which were on fixed rates, as well as there's additional incentive payments to our dentists as part of our structure on acquisition. When a practice ultimately continues to perform significantly well, there is a participation and alignment payment to the dental partner, which ultimately given the strong performance that we are having in the business, the expansion of margins and the growth, that would be included in the gross margin line as well. So as you look at it, that is purely from a financial statement classification perspective, whether it just sits in gross margin as opposed to call it in an SG&A area, all costs as it relates to the inputs into the dental services. Our gross margins, frankly, are consistent and are expanding. The one difference would be the alignment payments that our partners are receiving, given the strong EBITDA performance and EBITDA growth at the practice level that we are experiencing.
spk09: Okay, that's helpful. And then just on the valuations, it's good to know that those are coming down, but I'm just trying to that the CDCP is benefiting essentially the operating performance. It seems like not just of dental core, but potentially the market. How do you see the CDCP impacting valuations moving forward? I'm just curious on any thoughts there.
spk03: Yeah, so I think what just to summarize here, the CDCP rollout, which began really in December of 2023, disrupted the dental industry through the first half of 2024, just given the patient flow was disrupted by their patients for qualification and receipt of the CDCP plan. And ultimately, there was a slow adoption rate from clinicians in seeing those patients. So ultimately, patients that they would have other seen in the normal course, there was deferral of volume, as well as call it some disruption as it relates to an administrative perspective of getting up to speed. As Graham mentioned from an administration progress process, that's all been really implemented nicely. And the teams have done a really nice job there. So no, no concern on that front. So what we're seeing in call it Q3, Q4 and forward is a return to normal, not so much a significant increase from where we were beforehand. Albeit, as we do see new cohorts of patients begin to qualify for the plan in 2025 and beyond, we are optimistic on the upside that is available to our 4% same practice revenue growth target.
spk09: Okay, thank you.
spk08: There are no further questions at this time. That concludes our question and answer session and also today's conference call. Thank you all for joining. You may now disconnect.
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