dentalcorp Holdings Ltd.

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 speaker's 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 redraw 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.

Thank you, operator, and good morning, everyone. Welcome to the Dental Corp 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 as 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 risks 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 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 presentations section. I will now turn the call over to our Chief Executive Officer, Graham Rosenberg, for his opening remarks. Graham?

Thanks, Nate, and good morning, everyone. We're pleased to be with you today to review General Corp's recent developments, as well as our financial and operating results for the three months ended June 30th, 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, DentalCorp operates in a highly recurring essential healthcare industry that is cash pay, resilient through economic cycles, and insulated from disintermediation 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 DentalCorp's favorable cost structure, high margins, low commodity risk, and negligible capital expenditures provide support for the company's continued delivery of balanced double-digit growth in the $22 billion Canadian dental industry. 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 30th, 2024 with approximately $1.5 billion of last 12 months pro forma revenue and $283 million of pro forma adjusted EBITDA. As you'll 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 accretive 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 2024 over 2023, as access to financing opportunities tighten for many buyers across the industry. Our acquisition multiple has declined on a year-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 discipline to post-year 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 our blended cost of debt from 6.65% to 6.15%. Turning to the next slide, you can see a comparison of valuation and free cash flow yields versus our peers. Since our IPO, we have seen a decline of 9.4 times EBITDA, or 47%. in our EV to LTM 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 8.7% free cash flow yield compared to our peer group of 3.8%. Turning now to slide nine, I'm pleased to report that our business delivered revenue of $399.8 million in the second quarter of 2024, up 8.6% over the same period in 2023. an adjusted EBITDA margin of $73.9 million, up 10.3% 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 the 1st. However, in anticipation of that start date, we experienced the deferral of patient visits in April as they awaited their coverage start date under the program. These patient deferrals combined with gradual provider enrollment resulted in lower than anticipated patient volumes in a 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 and 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 health. 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 fund 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 4.5% 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.

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 slide 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 slower-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 0.3% of margin expansion year over year, as we begin to realize operating leverage following the significant investments in our corporate infrastructure throughout 2022 and 2023. Looking forward, we continue to be confident about our ability to grow the business both acquisitively as well as organically. Turning to the next slide, you can see our net leverage and liquidity as of June 30, 2024. On a net debt basis, we are approximately 4.1 times levered at the end of the second quarter, deleveraging by 0.2 times over Q1 2024. As Graham alluded to earlier, we anticipate crossing the next leverage threshold as per our credit agreement. This will result in an interest rate reduction of 0.5%, bringing our blended cost of debt down from 6.65% today to 6.15%. We ended the second quarter 2024 with liquidity of $426 million comprised of $72 million in cash and $353 million in undrawn debt capacity under our senior debt facilities. Our second quarter and last 12 months adjusted free cash flow was $41 and $136 million respectively, which supports our strong balance sheet position. In addition, we continue to see strong interest rate coverage as defined by our LTM pro forma adjusted EBITDA after rent divided by our net interest expense of 3.3 times in Q2 2024. Overall, we are pleased with our second quarter 2024 results. We increased organic growth in part through our insourcing efforts, created ongoing operating efficiencies, closed accretive acquisitions, and continued to develop our pipeline. Turning to slide 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 free 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 rent of approximately $20 million in 2024. This aligns with our balanced approach to strategic growth. Additionally, we expect further deleveraging 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?

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.

Hi, this is Noor Roble 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? And then as a follow-up, is there anything to note on the seasonality of the business given the historical strength in Q4?

Thanks for the question. It's a good one. And 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 so 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 so what we are seeing is a return to normal in Q3 or close our path to a return to normal where the volumes are coming back to our expectations. 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. So 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. But I want to reiterate our confidence in the 4% plus growth through the balance of the year.

Great. And then I'm 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 valuations of dental practices. Just curious if that might change the pace or cadence of M&A in the near term.

Yeah, so 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 a release 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 will provide us with an opportunity to potentially increase our pacing. 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.

All right. Thank you.

Your next question comes from the line of Scott Fletcher with CIBC Capital Markets. Scott, your line is now open.

Hi. Good morning. Thanks for taking the question. I just wanted to ask on some of the puts and takes on the quarter-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 year on year. If you could sort of just give us some color on the puts and takes there. Thanks.

Yeah, absolutely. I would say the only difference, and if we get back in the time machine and go back to Q3 2023, we discussed 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 would be consistent. However, margins are consistent to Q3 23, 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.

Okay, great. That's helpful. And then it looks like it's just in the cash flow statement, you disposed again of some practices. Can you just sort of give us an idea of what qualifies practices for disposal and if that's still a potential going forward?

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, uh we have a small group of specialty that continues to remain uh but it's de minimis as as it relates to our overall overall performance so no no no change in strategy as it relates to what our disposals uh have been uh as it relates to these uh these two disposals that happen in the quarter great that makes sense thank you your next question comes from the line of daryl young with stifle daryl your line is now open

Yeah, just one quick one for me related to the supplier environment for equipment and consumables. 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.

That's a great question, Daryl. 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.

Got it. That's good color. Thanks, guys, and congrats on a good quarter.

Thanks, Daryl. Your next question comes from the line of Stephen McLeod with BMO Capital Markets. Stephen, your line is now open.

Thank you. Good morning, guys. Just wanted to ask about the CDCP. Can you talk a little bit about, like, I'm just trying to get a sense of how should we think about that program impacting your business over the long term? Like, is there a way to quantify kind of what, what, 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 healthcare coverage through the government as opposed to funding it themselves previously?

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.

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 tax revenue growth, medium term target.

Yeah. So, so what I'll say is the four, the 4% medium term target, uh, that's under the assumption of normal, normal patient, uh, patient behavior, uh, without taking into consider consideration any increased, uh, call it patient volume, uh, that previously were not seeking dental care. So there's, there's upside in that 4% figure, uh, to put it, uh, to put it simply.

Okay. Okay, that's great. Thanks, guys. Appreciate it.

Your next question comes from the line of Chile with HR and Securities. Chi, your line is now open.

Hi, good morning. Thank you for taking that 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?

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 insurance. ensures 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.

Got it, thank you. And just on leverage, it's good to see that leverage has improved to 4.1 pounds in a quarter. So where do you see this metric moving to by the end of the year?

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 four 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 four times leverage, which we are very close to, we're going to have a 50 basis point pickup on 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 due leveraging as well as allow for additional free cash flow to accelerate our acquisitor program.

Thank you, Alcázar.

Your next question comes from the line of David Cohen with TD Cohen. David, your line is now open.

Hey, guys. Just on that leverage question, so when it drops below four times, the base rate is going to decline by 50 basis points. Does it decline every, you know, when it gets below, say, three and a half and then three times?

Bingo. Yes, it does. 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 in 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.

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 just due to 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 been so far?

It's a significant difference, I would say, where the practices that are outperforming 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 3.5% to 4.5% 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% participation in June. Post July you're now seeing 75% plus penetration and participation in the dental industry under the CDCP. Again we're highly representative of that.

uh which is showing called that increase of call it one and a half to two percent on same practice growth from where we are uh in q2 that's awful thanks for the color nate and there's one last question on on the comment uh the the response on the consumables side i think it was to daryl's question um so you talked about when you signed you signed a long-term contract can you talk about when they come up because it sounded like you said that they You benefited from them the last couple of years in the higher inflationary environment. But I assume once those contracts come up, you renew that there's going to be some catch up there.

So 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.

Okay, so I think it's fair to say then that those likely increases with these new contracts wouldn't bake into your margin guidance, right? Absolutely.

Perfect. Thanks. Your next question comes from the line of Alan Lutz with Bank of America. Alan, your line is now open.

Hey, it's Devon for Alan Lutz. I just want to touch quickly on the gross margin and how to think about this in the rest of the year and into 2025. You know, a bit of, you know, good expansion at 2Q here, but it looks like there could be potentially, you know, flat into 2H. Nate, could you just consider in the CDCT any pricing impact there and how we should think about it for the second half of the year and into 2025? Thanks.

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 and our view on a go forward on gross margin. What was the second part of the question?

Yeah, that's pretty much it.

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, call it 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 delivery of dental services. Our gross margins, frankly, are consistent and or 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.

Okay, that's helpful. And then just on the valuations, you know, it's good to know that those are coming down, but I'm just trying to square that with the fact that you also mentioned that, you know, the CDCP is benefiting essentially the operating performance. It seems like not just of Dental Corps, but potentially the market. How do you see the CDCP, you know, impacting valuations moving forward? Just curious on any thoughts there.

Yeah, so I think 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 either seen in their 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 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 have we're optimistic on the upside that is available to our four percent same practice revenue growth target okay thank you 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