US Oncology Reports Financial Results for First Quarter 2004
HOUSTON, April 29 /PRNewswire-FirstCall/ -- US Oncology, Inc. today
reported results for the 2004 first quarter. The company recorded
year-over-year increases in net operating revenue, earnings per
share and net income for the first quarter 2004. The table below
provides a review of first quarter results, along with applicable
comparisons: ($ in millions, except per share amounts) Q1 2004 Q1
2003 % Change Q4 2003 % Change Net Operating Revenue(A) $662.6
$574.1 15.4% $657.3 0.8% Revenue 525.0 447.2 17.4% 518.0 1.3% Net
income 20.1 16.3 23.8% 18.9 6.5% EPS 0.23 0.17 30.8% 0.21 5.6%
EBITDA(B) $56.1 $50.2 11.8% $54.7 2.4% (A) See Key Operating
Statistics for calculations. (B) EBITDA excludes a net gain of $0.1
million for the fourth quarter of 2003. US Oncology highlights for
the first quarter of 2004 are detailed below: -- US Oncology's
EBITDA(C) for the first quarter was $56.1 million, compared to
$54.7 million for the fourth quarter of 2003 and $50.2 million in
the first quarter of 2003. -- The company's percentage of Field
EBITDA(C) for the first quarter was 33 percent, compared to its
percentage of Field EBITDA of 34 percent for both the fourth
quarter and first quarter of 2003. -- The company's affiliated
practices' accounts receivable days outstanding were 47 at the end
of the first quarter, compared to 46 at the end of 2003 and 50 at
the end of the first quarter of 2003. -- 16.3 percent of US
Oncology's first quarter revenue was generated by practices on the
net revenue model as of the end of the first quarter. -- The
company generated operating cash flow for the first quarter of 2004
of $43.5 million compared to $45.5 million for the fourth quarter
of 2003. During the first quarter of 2003, operating cash flow was
a net use of $1.1 million due to advance purchases of
pharmaceuticals during the first quarter of 2003. As of April 26,
2004, US Oncology had approximately $183.0 million in cash and cash
equivalents. -- The company reduced its corporate general and
administrative expenses to $12.7 million for the first quarter of
2004, a decrease of 18.6 percent from the first quarter of 2003, as
a result of a reduction in force during 2003 and other cost
reduction measures. (C) See Reconciliation of Selected Financial
Data for calculations. Medical Oncology Services First quarter
medical oncology services net operating revenue was $562.7 million,
a year-over-year increase of 17.1 percent and a decrease of 0.6
percent from the fourth quarter of 2003. The company's medical
oncology services revenue during the first quarter of 2004 was
$450.9 million, a year- over-year increase of 18.7 percent and an
increase of 0.8 percent from the fourth quarter of 2003. Same
practice medical oncology visits during the first quarter of 2004
increased by 0.6 percent over the same period in the prior year and
decreased by 4.3 percent from the fourth quarter of 2003. The
year-to-year increase is credited to growth in pharmaceutical
revenue and the addition of medical oncologists, partially offset
by the reduction in medical oncology visits from the fourth
quarter. Pharmaceutical expenses as a percentage of net operating
revenue increased to 46.7 percent for the first quarter of 2004, up
from 43.0 percent for the first quarter of 2003. This increase is
mainly attributable to pharmaceutical and service line revenue
increasing as a percentage of total revenue. Medical oncology
services income from operations during the first quarter of 2004
was $47.2 million, a decrease of 11.4 percent from the fourth
quarter of 2003 and 0.2 percent increase over the first quarter of
2003. The decrease in income from operations compared to the fourth
quarter of 2003 is attributable to the decrease in visits, as well
as an increase in pharmaceutical costs as a result of the
recognition by the company in the fourth quarter of certain
performance based rebates. During the first quarter of 2004, the
company affiliated with two practices comprising 3 physicians under
its pharmaceutical service line model. In addition, since March 31,
2004, the company has affiliated with three practices comprising 8
physicians under the pharmaceutical service line model. Included in
these affiliations during 2004 are the company's first market
entries in Montana, Tennessee and Idaho. Cancer Center Services The
Cancer Center Services segment of the company experienced growth in
the first quarter. Net operating revenue for the first quarter of
2004 was $87.8 million, an increase of 10.8 percent over the first
quarter of 2003 and 16.2 percent over the fourth quarter of 2003.
Company revenue in the segment for the first quarter of 2004 was
$61.0 million, an increase of 12.4 percent over the first quarter
of 2003 and 11.2 percent over the fourth quarter of 2003. These
increases were due to four additional cancer centers in operation
at the end of the first quarter of 2003, as well as expansion of
patient-care options, such as intensity modulated radiation therapy
(IMRT), positron emission tomography (PET) and computerized
tomography (CT), at many existing sites. For the first quarter of
2004, cancer center services segment EBITDA was $21.1 million, an
increase of 22.0 percent over the first quarter of 2003 and 32.2
percent over the fourth quarter of 2003. Income from operations in
the segment increased to $13.3 million for the first quarter of
2004, compared to $11.5 million for the first quarter of 2003 and
$8.5 million for the fourth quarter of 2003. The increases in
EBITDA and net income are attributable to increased revenues,
exiting certain markets and increases in same facility treatments.
For the first quarter of 2004, radiation treatments per day
increased to 2,571 from the fourth quarter of 2003 treatments per
day of 2,443, an increase of 5.2 percent. Radiation treatments per
day for the first quarter of 2003 were 2,628. Same facility
radiation treatments per day were 2,470 during the first quarter of
2004, a decrease of 0.8 percent from the first quarter of 2003. PET
scans increased from 4,154 in the first quarter of 2003 to 6,581 in
the first quarter of 2004, an increase of 58.4 percent. The company
currently has 11 cancer centers and four PET systems in various
stages of development for network practices. Update on Merger
Transaction On March 20, 2004, US Oncology Holdings, Inc.
("Holdings") (which was formerly known as Oiler Holding Corp.) and
its wholly owned subsidiary, Oiler Acquisition Corp., entered into
a merger agreement with US Oncology, Inc., pursuant to which Oiler
Acquisition Corp. will be merged with and into US Oncology, Inc.,
with US Oncology, Inc. continuing as the surviving corporation. If
the transaction is consummated, US Oncology, Inc. would become a
private company owned by Holdings. Members of senior management of
the company, including its Chairman and CEO, will continue as
employees of the private entity, participate in the merger by
purchasing equity securities in Holdings and be awarded equity
securities in Holdings. Both Holdings and Oiler Acquisition Corp.
are Delaware corporations that were formed by Welsh, Carson,
Anderson & Stowe IX, L.P. ("Welsh Carson") for the purpose of
completing the merger and related financing transactions.
Currently, Welsh Carson directly owns approximately 14.5% of the
company's outstanding common stock and, together with its
co-investors and the directors and executive officers of US
Oncology that participate in the merger, would own all the capital
stock of Holdings when and if the merger is consummated. If the
merger is completed, each issued and outstanding share of US
Oncology common stock (other than shares owned by Welsh Carson, its
co-investors and directors and executive officers of US Oncology
that participate in the merger) will be converted into the right to
receive $15.05 in cash, subject to the rights of dissenting
stockholders who exercise and perfect their appraisal rights under
Delaware law. Each outstanding option for US Oncology common stock
will be canceled in exchange for (1) the excess, if any, of $15.05
over the per share exercise price of the option multiplied by (2)
the number of shares of common stock subject to the option, net of
any applicable withholding taxes. Outstanding rights to receive
shares of common stock under existing delayed stock delivery
agreements between US Oncology and certain physicians will be
canceled in exchange for an amount in cash equal to (1) $15.05
multiplied by (2) the number of shares of common stock otherwise
issuable under the delayed stock delivery agreements on the
scheduled delivery dates, net of any applicable withholding taxes.
US Oncology's Board of Directors approved the merger following the
unanimous recommendation of a special committee composed of
independent directors Boone Powell, Jr., Burton S. Schwartz, M.D.
and Vicki H. Hitzhusen. The special committee and the Board
received an opinion from Merrill Lynch & Co. as to the
fairness, from a financial point of view, of the consideration to
be received by US Oncology stockholders (other than Welsh Carson,
its affiliates and members of US Oncology's board or management
that participate in the merger) in the merger transaction. The
closing of the merger is subject to various conditions contained in
the merger agreement, including the approval by the holders of a
majority of US Oncology's shares held by stockholders other than
Welsh Carson, its co-investors and members of US Oncology's board
or management that participate in the merger, in addition to
majority stockholder approval statutorily required for a merger.
Additional conditions include the closing of financing arrangements
as set forth in bank commitment letters that have been received by
Holdings, the tender of not less than a majority of the aggregate
principal amount of US Oncology's outstanding 9 5/8% Senior
Subordinated Notes due 2012, the expiration of the applicable
waiting period under the Hart-Scott-Rodino Act and other customary
conditions. As we have previously disclosed, several lawsuits
naming the company and each of its directors as defendants have
been filed in connection with the proposed merger. The company
believes these suits are without merit and intends to vigorously
defend itself. We have filed preliminary proxy materials with the
SEC. Once the SEC has given clearance to these proxy materials,
they will be sent to stockholders in connection with a special
meeting called in connection with the merger. We have also filed
under the Hart-Scott-Rodino Act. Depending on clearance of
regulatory authorities and the satisfaction of other conditions
precedent to the merger, we anticipate holding a meeting of
stockholders to vote on the merger in late June or early July 2004.
Financial Exhibits Exhibits -- including key operating statistics,
financial statements, reconciliation of selected financial data and
financial discussion -- are included in this news release.
Conference Call US Oncology will host a conference call for
investors Thursday, April 29 at 9 a.m., CDT. Investors are invited
to access the call at 1-877-615-1716 and reference password "US
Oncology." The conference call also can be accessed via Web cast.
Details of the Web cast are available at http://www.usoncology.com/
under the Investor Relations link. A replay of the conference call
will be available through May 10 at 1-800-642-1687. The access code
for the replay is 6871394. About US Oncology, Inc. US Oncology,
headquartered in Houston, Texas, is America's premier cancer- care
services company. The company provides comprehensive services to a
network of affiliated practices comprising more than 875 affiliated
physicians in over 470 sites, including 80 integrated cancer
centers, in 32 states. US Oncology's mission is to enhance access
to high-quality cancer care in America. The company's strategies to
accomplish this mission include: (a) helping practices lower their
pharmaceutical and administration costs, (b) providing the capital
and expertise to expand and diversify into radiation oncology and
diagnostic radiology, (c) providing sophisticated management
services to enhance profitability, and (d) providing access to and
managing clinical research trials. In addition, the company assists
practices in negotiations with private payors, in implementing
programs to enhance efficiencies with respect to drugs and in
expanding service offerings such as positron emission tomography
and intensity modulated radiation therapy. This news release
contains forward-looking statements, including statements that
include the words "believes," "expects," "anticipates,"
"estimates," "intends," "plans," "projects," or similar expressions
and statements regarding our prospects. All statements other than
statements of historical fact included in this news release are
forward-looking statements. Although the company believes that the
expectations reflected in such statements are reasonable, it can
give no assurance that such expectations will prove to have been
correct. Such expectations are subject to risks and uncertainties,
including the possibility that the merger may not occur due to the
failure of the parties to satisfy the conditions in the merger
agreement, such as the inability of Holdings to obtain financing,
the failure of US Oncology to obtain stockholder approval or the
occurrence of events that would have a material adverse effect on
US Oncology as described in the merger agreement. Additional risks
and uncertainties relating to the company's operations include
recent legislation relating to prescription drug reimbursement
under Medicare, including the way in which such legislation is
implemented with respect to modifications in practice expense
reimbursement, calculation of average sales price, implementation
of third-party vendor programs and other matters, the impact of the
recent legislation on other aspects of our business (such as
private payor reimbursement, the company's ability to obtain
favorable pharmaceutical pricing, the ability of practices to
continue offering chemotherapy services to Medicare patients or
maintaining existing practice sites, physician response to the
legislation, including with respect to retirement or choice of
practice setting, development activities, and the possibility of
additional impairments of assets, including management services
agreements), reimbursement for pharmaceutical products generally,
our ability to maintain good relationships with existing practices,
expansion into new markets and development of existing markets, our
ability to complete cancer centers and PET facilities currently in
development, our ability to recover the costs of our investments in
cancer centers, our ability to complete negotiations and enter into
agreements with practices currently negotiating with us,
reimbursement for health-care services, continued efforts by payors
to lower their costs, government regulation and enforcement,
continued relationships with pharmaceutical companies and other
vendors, changes in cancer therapy or the manner in which care is
delivered, drug utilization, increases in the cost of providing
cancer treatment services and the operations of the company's
affiliated physician practices. Please refer to the company's
filings with the SEC, including its Annual Report on Form 10-K for
2003, as amended, and subsequent filings, for a more extensive
discussion of factors that could cause actual results to differ
materially from the company's expectations. US ONCOLOGY, INC.
Exhibit 1 Key Operating Statistics ($ in millions) (unaudited) Q1
2004 Q1 2003 % Change Net operating revenue $662.6 $574.1 15.4%
Amounts retained by affiliated practices (137.6) (126.9) 8.5%
Revenue $525.0 $447.2 17.4% Physician Summary: PPM physicians 801
817 (2.0)% Service Line physicians 96 68 41.2% Total physicians 897
885 1.4% Medical Oncology/Hematology: Medical oncologists 738 693
6.5% Medical oncology visits (A) 578,708 585,686 (1.2)% Other
oncologists 37 39 (5.1)% Radiation Oncology: Radiation oncologists
122 115 6.1% Radiation treatments per day 2,571 2,628 (2.2)% Total
cancer centers 80 76 5.3% Imaging/Diagnostics: Diagnostic
radiologists 0 38 N/A PET installations 3 1 N/A Total PET
installations 24 17 41.2% PET scans 6,581 4,154 58.4% New patients
enrolled in research studies 743 874 (15.0)% Days sales outstanding
47 50 (6.0)% (A) Visits only include information for practices
affiliated under the practice management model and do not include
results of service line practices. US ONCOLOGY, INC. Exhibit 2
Consolidated Income Statement (in thousands, except per share data)
(unaudited) Three Months Ended March 31, 2004 2003 Revenue $524,996
$447,210 Operating expenses: Pharmaceuticals and supplies 309,549
246,628 Field compensation and benefits 94,566 87,893 Other field
costs 52,145 46,958 General and administrative 12,684 15,576
Depreciation and amortization 18,954 18,813 487,898 415,868 Income
from operations 37,098 31,342 Other income (expense): Interest
expense, net (4,382) (5,132) Income before income taxes 32,716
26,210 Income taxes (12,596) (9,960) Net income $20,120 $16,250 Net
income per share - basic $0.23 $0.17 Net income per share - diluted
$0.23 $0.17 Shares used in per share calculations - basic 85,988
92,972 Shares used in per share calculations - diluted 89,276
94,632 US ONCOLOGY, INC. Exhibit 3 Condensed Consolidated Statement
of Cash Flows ($ in thousands) (unaudited) Three Months Ended March
31, 2004 2003 Net cash provided (used) by operating activities
$43,530 $(1,123) Cash flows from investing activities: Acquisition
of property and equipment (21,546) (16,878) Net cash used in
investing activities (21,546) (16,878) Cash flows from financing
activities: Repayment of other indebtedness (7,816) (9,536)
Purchase of treasury shares (4,247) (3,482) Proceeds from exercise
of stock options 17,586 339 Net cash provided (used) by financing
activities 5,523 (12,679) Increase (decrease) in cash and
equivalents 27,507 (30,680) Cash and equivalents: Beginning of
period 124,514 105,564 End of period $152,021 $74,884 US ONCOLOGY,
INC. Exhibit 4 Condensed Consolidated Balance Sheet ($ in
thousands) (unaudited) March 31, December 31, 2004 2003 ASSETS
Current assets: Cash and equivalents $152,021 $124,514 Accounts
receivable 317,589 304,507 Other receivables 44,590 47,738 Prepaids
and other current assets 18,498 18,451 Inventories 2,065 7,481 Due
from affiliates 39,696 43,629 Total current assets 574,459 546,320
Property and equipment, net 362,524 356,125 Service agreements, net
235,817 239,108 Deferred income taxes 8,915 10,915 Other assets
22,011 22,551 Total assets $1,203,726 $1,175,019 LIABILITIES AND
STOCKHOLDERS' EQUITY Current liabilities: Current maturities of
long-term debt $74,849 $79,748 Accounts payable 159,466 160,628 Due
to affiliates 71,985 64,052 Accrued compensation costs 19,324
26,316 Income taxes payable 30,463 19,810 Other accrued liabilities
33,539 41,847 Total current liabilities 389,626 392,401 Deferred
revenue 6,387 5,349 Long-term indebtedness 185,495 188,412 Total
liabilities 581,508 586,162 Minority interests 10,391 10,497
Stockholders' equity 611,827 578,360 Total liabilities and
stockholders' equity $1,203,726 $1,175,019 US ONCOLOGY, INC.
Exhibit 5 Reconciliation of Selected Financial Data (in thousands,
except per share data) (unaudited) Three Months Ended March 31,
2004 2003 Net Income / EPS Income before income taxes $32,716
$26,210 Tax rate 38.5% 38.0% Net income $20,120 $16,250 Weighted
average shares outstanding - diluted 89,276 94,632 EPS $0.23 $0.17
EBITDA / Field EBITDA Income before income taxes $32,716 $26,210
Depreciation 14,858 14,410 Amortization 4,096 4,403 Interest
expense, net 4,382 5,132 EBITDA 56,052 50,155 General &
administrative 12,684 15,576 Amounts retained by affiliated
practices 137,652 126,918 Field EBITDA $206,388 $192,649 Discussion
of Non-GAAP Information In this release, we use certain
measurements of our performance that are not calculated in
accordance with generally accepted accounting principles of the
United States ("GAAP"). These non-GAAP measures are derived from
relevant items in our GAAP financials. A reconciliation of each
non-GAAP measure to our income statement is included in this
report. Management believes that the non-GAAP measures we use are
useful to investors, since they can provide investors with
additional information that is not directly available in a GAAP
presentation. In all events, these non- GAAP measures are not
intended to be a substitute for GAAP measures, and investors are
advised to review such non-GAAP measures in conjunction with GAAP
information provided by us. The following is a discussion of these
non GAAP measures. "Net operating revenue" is our revenue, plus
amounts retained by our affiliated physicians. We believe net
operating revenue is useful to investors as an indicator of the
overall performance of our network, since it includes the total
revenue of all of our PPM practices and other business lines,
without a reduction to reflect the portion retained as physician
compensation. In addition, by comparing trends in net operating
revenue to trends in our revenue, investors are able to assess the
impact of trends in physician compensation on our overall
performance. "Net patient revenue" is the net revenue of our
affiliated practices under the PPM model for services rendered to
patients by those affiliated practices and revenue from sales of
pharmaceuticals directly to patients by retail pharmacies owned by
us. Net patient revenue is the largest component (91.1% for the
three months ended March 31, 2004) of net operating revenue. It is
a useful measure because it gives investors a sense of the overall
operations of our PPM network because we are responsible for
billing and collecting such amounts. "EBITDA" is earnings before
taxes, interest, depreciation and amortization. We believe EBITDA
is a commonly applied measurement of financial performance. We
believe EBITDA is useful to investors because it gives a measure of
operational performance without taking into account items that we
do not believe relate directly to operations -- such as
depreciation and amortization, which are typically based on
predetermined asset lives, and thus not indicative of operational
performance, or that are subject to variations that are not caused
by operational performance -- such as tax rates or interest rates.
EBITDA is a key tool used by management in assessing our business
performance both as a whole and with respect to individual sites or
product lines. "Field EBITDA" is EBITDA plus physician compensation
and corporate general and administrative expenses. Like net
operating revenue, Field EBITDA provides an indication of our
overall network operational performance, without taking into
account the effect of physician compensation and corporate general
and administrative expense. "EBITDA Margin" is EBITDA divided by
net operating revenue. Like EBITDA and Field EBITDA, EBITDA margin
provides an indication of our overall operational performance,
without taking into account the effect of physician compensation
and corporate general and administrative expense. Financial
Discussion Introduction The following discussion should be read in
conjunction with financial information appearing elsewhere in this
release. In addition, see "Forward- Looking Statements and Risk
Factors" included in our Annual Report on Form 10-K for 2003 filed
with the Securities and Exchange Commission (SEC). General We
provide comprehensive services to our network of affiliated
practices, made up of more than 875 affiliated physicians in over
470 sites, with the mission of expanding access to and improving
the quality of cancer care in local communities. The services we
offer include: -- Medical Oncology Services. We purchase and manage
specialty oncology pharmaceuticals for our affiliated practices.
Annually, we are responsible for purchasing, delivering and
managing more than $1.2 billion of pharmaceuticals through a
network of 45 licensed pharmacies, 145 pharmacists and 278 pharmacy
technicians. Under our physician practice management arrangements,
we act as the exclusive manager and administrator of all day-to-day
non-medical business functions connected with our affiliated
practices. As such, we are responsible for billing and collecting
for medical oncology services, physician recruiting, data
management, accounting, systems and capital allocation to
facilitate growth in practice operations. -- Cancer Center
Services. We develop and manage comprehensive, community-based
cancer centers, which integrate all aspects of outpatient cancer
care, from laboratory and radiology diagnostic capabilities to
chemotherapy and radiation therapy. We have developed and operate
80 integrated community-based cancer centers and manage over one
million square feet of medical office space. We also have installed
and manage 24 Positron Emission Tomography Systems (PET). -- Cancer
Research Services. We facilitate a broad range of cancer research
and development activities throughout our network. We contract with
pharmaceutical and biotechnology firms to provide a comprehensive
range of services relating to clinical trials. We currently
supervise 222 clinical trials, supported by our network of
approximately 620 participating physicians in more than 170
research locations. We provide these services through two business
models: the physician practice management (PPM) model, under which
we provide all of the above services under a single contract with
one fee based on overall performance; and the service line model,
under which practices contract with the company to purchase only
the pharmaceutical aspects of medical oncology services and/or
cancer research services, each under a separate contract, with a
separate fee methodology for each service. Most of our revenue
(90.2% during the first quarter 2004) was derived under the PPM
model. Our Strategy Our mission is to increase access to and
advance the delivery of high- quality cancer care in America. We do
this by offering physicians services to enable them to provide
cancer patients with a full continuum of care, including
professional medical services, chemotherapy infusion, radiation
oncology, diagnostic services, access to clinical trials, patient
education and other services, primarily in a community setting. We
aim to enhance efficiency and lower cost structures at our
affiliated practices, while enabling them to continue to deliver
quality patient care. We believe that in today's marketplace,
particularly in light of recent reductions in Medicare
reimbursement and continued pressures on overall reimbursement, the
most successful oncology practices will be those that have a
preeminent position in their local market, that are diversified
beyond medical oncology and that have implemented efficient
management. We believe that our services best position practices to
attain these characteristics. We intend to continue to offer
practices and physicians the opportunity to take advantage of our
services through a comprehensive strategic alliance, encompassing
all of the management services we offer. We also continue to offer
medical oncology practices who do not wish to obtain comprehensive
services our less comprehensive, lower cost "service line" option.
During the last several years, we have worked to enhance the
platform upon which we hope to build. Our model conversions and
disaffiliations have stabilized our network by aligning our
incentives with those of our affiliated practices, better ensuring
that our economic arrangements are sustainable and eliminating the
distraction of underperforming practices and assets. Economic
Models Most of our revenue is derived under the PPM model. Under
the PPM model, we provide all of our services to a physician
practice under a single management agreement under which we are
appointed exclusive business manager, responsible for all of the
non-clinical aspects of the physicians' practice. Our PPM
agreements are long-term agreements (generally with initial terms
of 25 to 40 years) and cannot be terminated unilaterally without
cause. Physicians joining the PPM practices are required to enter
into employment or non-competition agreements with the practice.
Prior to 2002, we generally paid consideration to physicians in
physician groups in exchange for the group's selling us operating
assets and entering into such long-term contracts or joining an
already affiliated group. Historically, we also have helped
affiliated groups expand by recruiting individual physicians
without buying assets or paying consideration for service
agreements. We intend to continue to expand our business, both by
recruiting new physicians and by affiliating with new groups. We
will pay consideration for operating assets of groups and may,
under some circumstances, pay other consideration. Under most of
our PPM agreements, we are compensated under the "earnings model."
Under that model, we are reimbursed for all expenses we incur in
connection with managing a practice, and are paid an additional fee
based upon a percentage of the practice's earnings before income
taxes, subject to certain adjustments. During the first quarter of
2004, 73.9% of our revenue was derived from affiliated practices
managed under agreements on the earnings model. PPM agreements
accounting for 16.3% of our revenue are under the net revenue model
described below. In some states, our agreements provide for a fixed
management fee. Of our first quarter 2004 revenue, 8.2% was derived
under the service line model. Under our service line agreements,
fees include payment for pharmaceuticals and supplies used by the
group, reimbursement for certain pharmacy related expenses and
payment for the other services we provide. Rates for our services
typically are based on the level of services required by the
practice. Realignment of Net Revenue Model Practices Under the net
revenue model, our fee consists of a fixed amount, plus a
percentage of net revenues, plus, if certain performance criteria
are met, a performance fee. Under these agreements, once we have
been reimbursed for expenses, the practice is entitled to retain a
fixed portion of revenues before any additional service fee is paid
to us. The effect of this priority of payments is that we bear a
disproportionate share of increasing practice costs, since if there
are insufficient funds to pay both our fee and the fixed amount to
be retained by the practice, the entire amount of the shortfall
reduces our management fee. Rapidly increasing pharmaceutical costs
have increased practice revenues and thus the amounts retained by
physicians. At the same time rising costs have eroded margins,
leaving less available to pay our management fees. The net revenue
model does not appropriately align our economic incentives with
those of our affiliated practices, since the parties do not have
similar motivation to control costs or efficiently utilize capital.
For this reason, we have been seeking to convert net revenue model
practices to the earnings model since the beginning of 2001. In
some cases, net revenue model practices have converted instead to
the service line model or disaffiliated entirely. Of our 2000
revenue, 56.3% was derived from net revenue model practices, while
only 16.3% of our first quarter 2004 revenue was derived from
practices under the net revenue model as of March 31, 2004. We no
longer enter into new affiliations under the net revenue model.
Conversions and disaffiliations have helped to stabilize our
operating platform. The percentage of Field EBITDA that we retained
as management fees (not including reimbursement for practice
expenses) declined from 42% in 1999 to 38% in 2000 and 35% in 2001.
With the implementation of our realignment strategy, the percentage
of Field EBITDA has been steady, at 34% in both 2003 and 2004. For
the three months ended March 31, 2004 the percentage of Field
EBITDA was 33%. Since announcing our initiative to convert
practices away from the net revenue model in November 2000, we have
recorded charges of $251.3 million relating to impairment of net
revenue model practices resulting either from termination of those
agreements or the determination that their carrying values were not
recoverable. As of March 31, 2004, only one net revenue model
service agreement, with a carrying value of $22.2 million, was
reflected on our balance sheet. Forward-looking Statements and Risk
Factors The following statements are or may constitute
forward-looking statements within the meaning of the Private
Securities Litigation Reform Act of 1995: (i) certain statements,
including possible or assumed future results of operations
contained in "Management's Discussion and Analysis of Financial
Condition and Results of Operations," (ii) any statements contained
herein regarding the prospects for any of our business or services
and our development activities relating to the service line model,
cancer centers and PET installations; (iii) any statements preceded
by, followed by or that include the words "believes", "expects",
"anticipates", "intends", "estimates", "plans" or similar
expressions; and (iv) other statements contained herein regarding
matters that are not historical facts. Our business and results of
operations are subject to risks and uncertainties, many of which
are beyond our ability to control or predict. Because of these
risks and uncertainties, actual results may differ materially from
those expressed or implied by such forward-looking statements, and
investors are cautioned not to place undue reliance on such
statements, which speak only as of the date thereof. The merger
transaction discussed above is subject to numerous risks and
uncertainties, including the possibility that the merger may not
occur due to the failure of the parties to satisfy the conditions
in the merger agreement, such as the inability of Holdings to
obtain financing, our failure to obtain stockholder approval or the
occurrence of events that would have a material adverse effect on
us as described in the merger agreement. Additional risks and
uncertainties relating to our operations include recent legislation
relating to prescription drug reimbursement under Medicare,
including the way in which such legislation is implemented with
respect to modifications in practice expense reimbursement,
calculation of average sales price, implementation of third-party
vendor programs and other matters, the impact of the recent
legislation on other aspects of our business (such as private payor
reimbursement, our ability to obtain favorable pharmaceutical
pricing, the ability of practices to continue offering chemotherapy
services to Medicare patients or maintaining existing practice
sites, physician response to the legislation, including with
respect to retirement or choice of practice setting, development
activities, and the possibility of additional impairments of
assets, including management services agreements), reimbursement
for pharmaceutical products generally, our ability to maintain good
relationships with existing practices, expansion into new markets
and development of existing markets, our ability to complete cancer
centers and PET facilities currently in development, our ability to
recover the costs of our investments in cancer centers, our ability
to complete negotiations and enter into agreements with practices
currently negotiating with us, reimbursement for health-care
services, continued efforts by payors to lower their costs,
government regulation and enforcement, continued relationships with
pharmaceutical companies and other vendors, changes in cancer
therapy or the manner in which care is delivered, drug utilization,
increases in the cost of providing cancer treatment services and
the operations of our affiliated physician practices. Please refer
to our filings with the SEC, including our Annual Report on Form
10-K for 2003, as amended, for a more extensive discussion of
factors that could cause actual results to differ materially from
our expectations. The cautionary statements contained or referred
to herein should be considered in connection with any written or
oral forward-looking statements that may be issued by us or persons
acting on our behalf. We do not undertake any obligation to release
any revisions to or to update publicly any forward- looking
statements to reflect events or circumstances after the date
thereof or to reflect the occurrence of unanticipated events.
Critical Accounting Policies and Estimates Our discussion and
analysis of our financial condition and results of operations are
based upon our consolidated financial statements, which have been
prepared in accordance with accounting principles generally
accepted in the United States (GAAP). The preparation of these
financial statements requires management to make estimates and
judgments that affect the reported amounts of assets, liabilities,
revenues and expenses, and related disclosure of contingent assets
and liabilities. On an ongoing basis, we evaluate these estimates,
including those related to service agreements, accounts receivable,
intangible assets, income taxes, and contingencies and litigation.
We base our estimates on historical experience and on various other
assumptions that we believe to be reasonable under the
circumstances. These estimates form the basis for making judgments
about the carrying values of assets and liabilities that are not
readily apparent from other sources. Actual results may differ from
those estimates under different assumptions or conditions. In
addition, as circumstances change, we may revise the basis of our
estimates accordingly. For example, in the past we have recorded
charges to reflect revisions in our valuations of accounts
receivable as a result of actual collections patterns or a sale of
accounts receivable. We maintain decentralized billing systems and
continue to upgrade and modify those systems. We take this into
account as we continue to evaluate receivables and record
appropriate reserves, based upon the risks of collection inherent
in such a structure. In the event subsequent collections are higher
or lower than our estimates, results of operations in subsequent
periods could be either positively or negatively impacted as a
result of such prior estimates. This risk is particularly relevant
for periods in which there is a significant shift in reimbursement
from large payors, such as the recent changes in Medicare
reimbursement. Please refer to the "Critical Accounting Policies"
section of our Annual Report on Form 10-K for the year ended
December 31, 2003 for a discussion of our critical accounting
policies. Management believes such critical accounting policies
affect its more significant judgments and estimates used in the
preparation of our consolidated condensed financial statements.
These critical accounting policies include our policy of
non-consolidation of the results of affiliated practices, revenue
recognition (including calculation of physician compensation),
general estimates of accruals, including accruals relating to
accounts receivable, and intangible asset amortization and
impairment. Recent Pronouncements In January 2003, the Financial
Accounting Standards Board ("FASB") issued Interpretation No. 46
(FIN 46), Consolidation of Variable Interest Entities. It requires
that the assets, liabilities and results of the activity of
variable interest entities be consolidated into the financial
statements for the company that has controlling financial interest.
It also provides the framework for determining whether a variable
interest entity should be consolidated based on voting interest or
significant financial support provided to it. Additionally, in
December 2003, the FASB released a revised version of FIN 46 (FIN
46R) clarifying certain aspects of FIN 46 and providing certain
entities with exemptions from the requirements of FIN 46. The
adoption of FIN 46R in January 2004 had no impact on the Company's
financial position, results of operations or cash flows for the
three months ended March 31, 2004. From time to time, the FASB, the
SEC and other regulatory bodies seek to change accounting rules,
including rules applicable to our business and financial
statements. We cannot assure you that future changes in accounting
rules would not require us to make restatements. Discussion of
Non-GAAP Information In this report, we use certain measurements of
our performance that are not calculated in accordance with GAAP.
These non-GAAP measures are derived from relevant items in our GAAP
financials. A reconciliation of each non-GAAP measure to our income
statement is included in this report. Management believes that the
non-GAAP measures we use are useful to investors, since they can
provide investors with additional information that is not directly
available in a GAAP presentation. In all events, these non- GAAP
measures are not intended to be a substitute for GAAP measures, and
investors are advised to review such non-GAAP measures in
conjunction with GAAP information provided by us. The following is
a discussion of these non- GAAP measures. "Net operating revenue"
is our revenue, plus amounts retained by our affiliated physicians.
We believe net operating revenue is useful to investors as an
indicator of the overall performance of our network, since it
includes the total revenue of all of our PPM practices and other
business lines, without a reduction to reflect the portion retained
as physician compensation. In addition, by comparing trends in net
operating revenue to trends in our revenue, investors are able to
assess the impact of trends in physician compensation on our
overall performance. "Net patient revenue" is the net revenue of
our affiliated practices under the PPM model for services rendered
to patients by those affiliated practices and revenue from sales of
pharmaceuticals directly to patients by retail pharmacies owned by
us. Net patient revenue is the largest component (91.1% for the
three months ended March 31, 2004) of net operating revenue. It is
a useful measure because it gives investors a sense of the overall
operations of our PPM network and the amounts for which we are
responsible for billing and collecting. "EBITDA" is earnings before
taxes, interest, depreciation and amortization. We believe EBITDA
is a commonly applied measurement of financial performance. We
believe EBITDA is useful to investors because it gives a measure of
operational performance without taking into account items that we
do not believe relate directly to operations -- such as
depreciation and amortization, which are typically based on
predetermined asset lives, and thus not indicative of operational
performance, or that are subject to variations that are not caused
by operational performance -- such as tax rates or interest rates.
EBITDA is a key tool used by management in assessing our business
performance both as a whole and with respect to individual sites or
product lines. "Field EBITDA" is EBITDA plus physician compensation
and corporate general and administrative expenses. Like net
operating revenue, Field EBITDA provides an indication of our
overall network operational performance, without taking into
account the effect of physician compensation and corporate general
and administrative expense. "EBITDA Margin" is EBITDA divided by
net operating revenue. Like EBITDA and Field EBITDA, EBITDA margin
provides an indication of our overall operational performance,
without taking into account the effect of physician compensation
and corporate general and administrative expense. Results of
Operations The company was affiliated (including under the service
line) with the following number of physicians, by specialty: March
31, 2004 2003 Medical oncologists/hematologists 738 693 Radiation
oncologists 122 115 Other oncologists 37 39 Total
oncologists/hematologists 897 847 Diagnostic radiologists --- 38
Total physicians 897 885 The following table sets forth the sources
for growth in the number of physicians affiliated with the company:
Three Months Ended March 31, 2004 2003 Affiliated physicians,
beginning of period 897 884 Physician practice affiliations 3 13
Recruited physicians 13 9 Physician practice separations (13) (10)
Retiring/Other (3) (11) Affiliated physicians, end of period 897
885 The following table sets forth the number of cancer centers and
PET units managed by the company: Three Months Ended March 31, 2004
2003 Cancer Centers, beginning of period 78 79 Cancer Centers
opened 3 --- Cancer Centers closed (1) --- Cancer Centers
disaffiliated --- (3) Cancer Centers, end of period 80 76 PET
Systems 24 17 The following table sets forth the key operating
statistics as a measure of the volume of services provided by our
PPM practices: Three Months Ended March 31, 2004 2003 Medical
oncology visits (A) 578,708 585,686 Radiation treatments 164,557
165,542 PET scans 6,581 4,154 CT scans 23,082 16,090 New patients
enrolled in research studies 743 874 (A) Medical oncology visits
include consults by medical oncologists under our PPM model only
and do not include service line results. The following table sets
forth the percentages of revenue represented by certain items
reflected in the Company's Condensed Consolidated Statement of
Operations and Comprehensive Income. The following information
should be read in conjunction with our unaudited condensed
consolidated financial statements and notes thereto included
elsewhere herein. Three Months Ended March 31, 2004 2003 Revenue
100.0% 100.0% Operating expenses: Pharmaceuticals and supplies 59.0
55.1 Field compensation and benefits 18.0 19.7 Other field costs
9.9 10.5 General and administrative 2.4 3.5 Depreciation and
amortization 3.6 4.2 Income from operations 7.1 7.0 Interest
expense, net (0.9) (1.2) Income before income taxes 6.2 5.8 Income
tax provision (2.4) (2.2) Net income 3.8% 3.6% Net Operating
Revenue. Net operating revenue includes two components -- net
patient revenue and our other revenue: The following table shows
the components of our net operating revenue for the three months
ended March 31, 2004 and 2003 (in thousands): Three Months Ended
March 31, 2004 2003 Net patient revenue $603,426 $541,142 Other
revenue 59,222 32,986 Net operating revenue $662,648 $574,128 Net
Patient Revenue. Under our PPM model, we are responsible for
billing and collecting all practice revenues. We disclose "net
patient revenue" to give you a sense of the size and operating
trends of the business which we manage. Net patient revenue
comprises all of the revenues for which we bill and collect for
affiliated practices under the PPM model. We collect all of the
receivables, control cash management functions and are responsible
for paying all expenses at our PPM practices. We retain all the
amounts we collect in respect of practice receivables. On a monthly
basis, we calculate what portion of revenues our practices are
entitled to retain by subtracting our accrued fees and accrued
practice expenses from accrued revenues. We pay practices this
remainder in cash, which they use primarily for physician
compensation. These amounts we remit to physician groups are
excluded from our revenue, since they are not part of our fees. By
paying physicians on a cash basis for accrued amounts, we finance
their working capital. Net patient revenue is recorded when
services are rendered based on established or negotiated charges
reduced by contractual adjustments and allowances for doubtful
accounts. Differences between estimated contractual adjustments and
final settlements are reported in the period when final settlements
are determined. Other Revenue. Our other revenues are primarily
derived in three areas: -- Service line fees. In the medical
oncology services area under our service line agreements, we bill
practices on a monthly basis for services rendered. These revenues
include payment from the practices for all of the pharmaceutical
agents used by the practice for which we are obligated to pay the
pharmaceutical manufacturers, and a service fee for the pharmacy
related services we provide. -- GPO and data fees. We receive fees
from pharmaceutical companies for acting as a group purchasing
organization (GPO) for our affiliated practices, as well as for
providing informational and other services to pharmaceutical
companies. GPO fees are typically based upon the volume of drugs
purchased by the practices. Fees for other services include amounts
paid for data we collect and compile. -- Research fees. We receive
fees for research services from pharmaceutical and biotechnology
companies. These fees are separately negotiated for each study and
typically include some management fee, as well as per patient
accrual fees and fees for achieving various study milestones. Net
patient revenue is recorded when services are rendered based on
established or negotiated charges reduced by contractual
adjustments and allowances for doubtful accounts. Differences
between estimated contractual adjustments and final settlements are
reported in the period when final settlements are determined. Net
operating revenue is reduced by amounts retained by the practices
under our services agreement to arrive at the amount we report as
revenue in our financial statements. Net operating revenue
increased from $574.1 million in the first quarter of 2003 to
$662.6 million in the first quarter of 2004, an increase of $88.5
million, or 15.4%. Same practice net operating revenue (which
excludes the results of practices with which we disaffiliated since
January 1, 2003) increased from $561.2 million for the first
quarter of 2003 to $662.3 million for the first quarter of 2004, an
increase of $101.1 million, or 18.0%. Revenue growth was
attributable to increases in medical oncology revenue and cancer
center revenue. Other revenue increased from $33.0 million in the
first quarter of 2003 to $59.2 million in the first quarter of
2004, an increase of $26.2 million, or 79%. This increase was
attributable to $27.1 million of operating revenue under the
service line agreements, as well as an increase in group purchasing
organization revenues, offset by a decline in research revenues.
The following table shows our net operating revenue by segment for
the three months ended March 31, 2004 and 2003 (in thousands):
Three Months Ended March 31, 2004 2003 Medical oncology services
$562,704 $480,668 Cancer center services 87,836 79,292 Other
services 12,108 14,168 $662,648 $574,128 Medical oncology services
net operating revenue increased from $480.7 million in the first
quarter of 2003 to $562.7 million for the first quarter of 2004, an
increase of $82.0 million or 17.1%. $27.1 million of such increase
is attributed to growth in the service line model, including $7.8
million attributable to new markets, $8.2 million attributable to a
conversion from the PPM model during the second quarter of 2003 and
$11.1 million attributable to growth in the service line business
existing during the first quarter of 2003. The remainder of the
growth in medical oncology services revenue is attributable to
increased fees for drug administration and use of more expensive
chemotherapy agents and additional supportive care drugs. Growth of
medical oncology services revenue during the first quarter of 2004
was partially offset by a 1.2% decline in medical oncology visits
compared to the same period during 2003, as a result of PPM
practice disaffiliations and conversions to the service line model.
Service line model visits are not included in our patient volume
statistics. Cancer center services net operating revenue increased
from $79.3 million in the first quarter of 2003 to $87.8 million
for the first quarter of 2004, an increase of $8.5 million, or
10.8%. This increase is attributable to the addition of IMRT, an
increase in radiology revenue from CT and PET scans and additional
cancer centers. PET scans increased from 4,154 in the first quarter
of 2003 to 6,581 in the first quarter of 2004, an increase of
58.4%. This growth was attributable to an increase in same-facility
PET scans per day of 20.6% and the addition of 8 PET systems during
2003 and the first quarter of 2004. Radiation treatments decreased
slightly from 165,542 in the first quarter of 2003 to 164,557 in
the first quarter of 2004, or 0.6%. Same practice radiation
treatments increased from 156,827 in the first quarter of 2003 to
158,102 in the first quarter of 2004, or 0.8%. In addition, since
the first quarter of 2003 we have added a net total of 4 cancer
centers (taking into account closures and disaffiliations). We
currently have 11 cancer centers and 4 PET systems in various
stages of development. Other services net operating revenue
decreased from $14.2 million in the first quarter of 2003 to $12.1
million for the first quarter of 2004, a decrease of $2.1 million,
or 14.5%. The decrease is attributable to a decrease in research
revenue. Patients enrolled in research trials decreased from 874 in
the first quarter of 2003 to 743 in the first quarter of 2004.
Revenue. Our revenue is net operating revenue less the amount of
net operating revenue retained by our affiliated physician
practices under PPM service agreements. The following presents the
amounts included in determination of our revenue (in thousands):
Three Months Ended March 31, 2004 2003 Net operating revenue
$662,648 $574,128 Amounts retained by affiliated practices
(137,652) (126,918) Revenue $524,996 $447,210 Amounts retained by
practices increased from $126.9 million in the first quarter of
2003 to $137.7 million in the first quarter of 2004, an increase of
$10.7 million, or 8.5%. Such increase in amounts retained by
practices is directly attributable to the growth in net patient
revenue combined with the increase in profitability of affiliated
practices. Amounts retained by affiliated practices as a percentage
of net operating revenue decreased from 22.1% to 20.8% for the
first quarters of 2003 and 2004, respectively, primarily as a
result of increases in service line model revenues. Under the
service line model, net operating revenue does not include amounts
retained by practices. Revenue increased from $447.2 million for
the first quarter of 2003 to $525.0 million for the first quarter
of 2004, an increase of $77.8 million, or 17.4%. Revenue growth was
caused by increases in net operating revenues. The following table
shows our revenue by segment for the three months ended March 31,
2004 and 2003 (in thousands): Three Months Ended March 31, 2004
2003 Medical oncology services $450,928 $379,824 Cancer center
services 61,064 54,305 Other services 13,004 13,081 $524,996
$447,210 Medicare and Medicaid are the practices' largest payors.
For the three months ended March 31, 2004 and 2003, the affiliated
practices derived approximately 42% and 41% respectively, of their
net patient revenue from services provided under the Medicare
program and approximately 3% and 2% respectively, of their net
patient revenue from services provided under the state Medicaid
programs. Capitation revenues were less than 1% of total net
patient revenue in 2004 and 2003. Changes in the payor
reimbursement rates, particularly Medicare and Medicaid due to its
concentration, or affiliated practices' payor mix can materially
and adversely affect the Company's revenues. Pharmaceuticals and
Supplies. Pharmaceuticals and supplies expense, which includes
drugs, medications and other supplies used by the practices,
increased from $246.6 million in the first quarter of 2003 to
$309.5 million in the same period of 2004, an increase of $62.9
million, or 25.5%. As a percentage of revenue, pharmaceuticals and
supplies increased from 55.1% in the first quarter of 2003 to 59.0%
in the same period in 2004, primarily because of an increase in our
service line business and an increase in pharmaceutical revenue as
a percentage of total revenue. Field Compensation and Benefits.
Field compensation and benefits, which includes salaries and wages
of our field-level employees and the practices' employees (other
than physicians), increased from $87.9 million in the first quarter
of 2003 to $94.6 million in the first quarter of 2004, an increase
of $6.7 million, or 7.6%. As a percentage of revenue, field
compensation and benefits decreased from 19.7% in the first quarter
of 2003 to 18.0% in the first quarter of 2004. The decrease as a
percentage of revenue is primarily attributable to economies of
scale resulting from the increase in pharmaceutical revenues and
diagnostic and radiation revenue. Other Field Costs. Other field
costs, which consist of rent, utilities, repairs and maintenance,
insurance and other direct field costs, increased from $47.0
million in the first quarter of 2003 to $52.1 million in the first
quarter of 2004, an increase of $5.2 million, or 11.0%. As a
percentage of revenue, other field costs decreased from 10.5% in
the first quarter of 2003 to 9.9% in the first quarter of 2004 as a
result of growth in pharmaceutical, diagnostic and radiation
revenue. General and Administrative. General and administrative
expenses decreased from $15.6 million in the first quarter of 2003
to $12.7 million in the first quarter of 2004, a decrease of $2.9
million, or 18.6% due to reductions in personnel and other costs
during 2003, as well as expenses for strategic planning and
lobbying costs incurred during the first quarter of 2003. As a
percentage of revenue, general and administrative costs decreased
from 3.5% in the first quarter 2003 to 2.4% in the first quarter
2004. Overall, we experienced a decline in operating margins with
earnings before taxes, interest, depreciation and amortization,
EBITDA, as a percentage of revenue, decreasing from 11.2% in the
first quarter of 2003 to 10.7% in the first quarter of 2004. The
following is the EBITDA of our operations by operating segment for
the three months ended March 31, 2004 and 2003 (in thousands):
Three Months Ended March 31, 2004: Medical Cancer Unallocated
Oncology Center Corporate Services Services Other Expenses Total
Net operating revenue $562,704 $87,836 $12,108 $--- $662,648
Amounts retained by affiliated practices (111,776) (26,772) 896 ---
(137,652) Revenue 450,928 61,064 13,004 --- 524,996 Operating
expenses (403,729) (47,750) (12,897) (23,522) (487,898) Income
(loss) from operations 47,199 13,314 107 (23,522) 37,098
Depreciation and amortization 10 7,865 241 10,838 18,954 EBITDA
$47,209 $21,179 $348 $(12,684) $56,052 Three Months Ended March 31,
2003: Medical Cancer Unallocated Oncology Center Corporate Services
Services Other Expenses Total Net operating revenue $480,668
$79,292 $14,168 $--- $574,128 Amounts retained by affiliated
practices (100,844) (24,987) (1,087) --- (126,918) Revenue 379,824
54,305 13,081 --- 447,210 Operating expenses (332,728) (42,782)
(12,033) (28,324) (415,868) Income (loss) from operations 47,096
11,523 1,048 (28,324) 31,342 Depreciation and amortization 20 5,836
209 12,748 18,813 EBITDA $47,116 $17,359 $1,257 $(15,576) $50,155
Medical oncology services EBITDA margin decreased from 9.8% in the
first quarter of 2003 to 8.4% in the first quarter of 2004. This
decrease is attributable to an increase in lower margin
pharmaceuticals and increase in service line revenues. Cancer
center services EBITDA margin increased from 21.9% in the first
quarter of 2003 to 24.1% in the first quarter of 2004. This
increase is attributable to exiting from unprofitable sites,
investment in technology such as intensity modulated radiation
therapy (IMRT), CT and PET, and growth in same practice treatments.
Interest. Net interest expense decreased from $5.1 million in the
first quarter of 2003 to $4.4 million in the first quarter of 2004,
a decrease of $0.8 million, or 14.6%, because of a reduction in
outstanding indebtedness. As a percentage of revenue, net interest
expense decreased from 1.2% for the first quarter of 2003 to 0.9%
for the first quarter of 2004. Income Taxes. We recognized an
effective tax rate of 38.5% for the first quarter of 2004 and 38.0%
for the first quarter of 2003. Net Income. Net income increased
from $16.3 million, or $0.17 per diluted share, in the first
quarter of 2003 to $20.1 million, or $0.23 per share, in the first
quarter 2004, an increase of $3.9 million or 23.8%. Net income as a
percentage of revenue increased from 3.6% in the first quarter of
2003 to 3.8% in the first quarter of 2004. Liquidity and Capital
Resources As of March 31, 2004, we had net working capital of
$184.8 million, including cash and cash equivalents of $152.0
million. We had current liabilities of $389.6 million, including
$74.8 million in current maturities of long-term debt, and $185.5
million of long-term indebtedness. During the first quarter of
2004, we provided $43.5 million in net operating cash flow,
invested $21.5 million, and provided cash from financing activities
in the amount of $5.5 million. As of April 26, 2004, we had cash
and cash equivalents of approximately $183.0 million. Cash Flows
from Operating Activities During the first quarter of 2004, we
provided $43.5 million in cash flows from operating activities as
compared to using $1.1 million in the comparable prior year period.
The increase in cash flow is primarily due to advance purchases of
certain pharmaceutical products paid for during 2003, and timing of
certain working capital payments. Cash Flows from Investing
Activities During the first quarter of 2004 and 2003, we had $21.5
million and $16.9 million in capital expenditures, including $19.4
million and $13.1 million on the development and construction of
cancer centers, respectively. Maintenance capital expenditures were
$2.1 million and $3.8 million in the first quarters of 2004 and
2003, respectively. For all of 2004, we anticipate expending a
total of approximately $30-$35 million on maintenance capital
expenditures and approximately $55-$60 million on development of
new cancer centers and PET installations, which may be acquired
pursuant to operating leases or purchased. Cash Flows from
Financing Activities During the first quarter of 2004, we provided
cash from financing activities of $5.5 million as compared to cash
used of $12.7 million in the first quarter of 2003. On February 1,
2002, we entered into a five-year $100 million syndicated revolving
credit facility and terminated our existing syndicated revolving
credit facility. Proceeds under that credit facility may be used to
finance the development of cancer centers and new PET systems, to
provide working capital or for other general business purposes. No
amounts have been borrowed under that facility. Our credit facility
bears interest at a variable rate that floats with a referenced
interest rate. Therefore, to the extent we have amounts outstanding
under the credit facility in the future, we would be exposed to
interest rate risk under our revolving credit facility. On February
1, 2002, we issued $175 million in 9.625% Senior Subordinated Notes
due 2012 to various institutional investors in a private offering
under Rule 144A under the Securities Act of 1933. The notes were
subsequently exchanged for substantially identical notes in an
offering registered under the Securities Act of 1933. The notes are
unsecured, bear interest at 9.625% annually and mature in February
2012. Payments under those notes are subordinated in substantially
all respects to payments under our revolving credit facility and
certain other debt. We entered into a leasing facility in December
1997, which we have used to finance the acquisition and development
of cancer centers. Since December 31, 2002, the lease has been
classified as indebtedness on our financial statements since we
have guaranteed 100% of the residual value of the properties in the
lease since that date. As of March 31, 2004, we had $67.3 million
outstanding under the facility and no further amounts are available
under that facility. The annual cost of the lease is approximately
$2.9 million, based on interest rates in effect as of March 31,
2004. The lease matures in June 2004. We anticipate refinancing
substantially all of our indebtedness in connection with the merger
transaction described above. We intend to extend the maturity of
the lease to allow such a refinancing in the event the merger
transaction does not close prior to its maturity. In the event the
merger is not consummated or if we do not extend the term, we would
pay the lease in full at its maturity and anticipate having
sufficient cash available to make such payment. Because the lease
payment floats with a referenced interest rate, we are also exposed
to interest rate risk under the leasing facility. An increase of
one percent in the referenced rate would result in an increase in
lease payments of approximately $0.7 million annually. Borrowings
under the revolving credit facility and advances under the leasing
facility bear interest at a rate equal to a rate based on prime
rate or the London Interbank Offered Rate, based on a defined
formula. The revolving credit facility, leasing facility and Senior
Subordinated Notes contain affirmative and negative covenants,
including the maintenance of certain financial ratios, restrictions
on sales, leases or other dispositions of property, restrictions on
other indebtedness and prohibitions on the payment of dividends.
Events of default under our revolving credit facility, leasing
facility and Senior Subordinated Notes include cross-defaults to
all material indebtedness, including each of those financings.
Substantially all of our assets, including certain real property,
are pledged as security under the revolving credit facility and the
guarantee obligations of our leasing facility. We are currently in
compliance with covenants under our leasing facility, revolving
credit facility and Senior Subordinated Notes, with no borrowings
currently outstanding under the revolving credit facility. We have
relied primarily on cash flows from our operations to fund working
capital and capital expenditures for our fixed assets. We currently
expect that our principal use of funds in the near future will be
in connection with the purchase of medical equipment, investment in
information systems and the acquisition or lease of real estate for
the development of integrated cancer centers and PET centers. It is
likely that our capital needs in the next several years will exceed
the cash generated from operations. Thus, we may incur additional
debt or issue additional debt or equity securities from time to
time. Capital available for health care companies, whether raised
through the issuance of debt or equity securities, is quite
limited. As a result, we may be unable to obtain sufficient
financing on terms satisfactory to management or at all.
DATASOURCE: US Oncology, Inc. CONTACT: Bruce Broussard, Investor
Relations, +1-832-601-6103, or , or Steve Sievert, Public
Relations, +1-832-601-6193, or , both of US Oncology, Inc. Web
site: http://www.usoncology.com/
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