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DVA – DaVita HealthCare Partners


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  • 5 weeks later...

I've been out of DVA for sometime -- however you have a few catalysts at this point... the closing of the sale of Medical Group to UNH for $4.3bn, and possibly reduced noise around Medicaid for All ...  stock is VERY beaten up at this point and VERY cheap on a earnings-yield perspective.  Who knows but i've started to follow it closely ...

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I've been buying a lot of DVA here recently...expecting a nice Q1 once the deal with UNH gets done...seems to me that the market is under-pricing the upside here ...  I think this one quickly trades to the high 60s, low 70s IMHO

I've been out of DVA for sometime -- however you have a few catalysts at this point... the closing of the sale of Medical Group to UNH for $4.3bn, and possibly reduced noise around Medicaid for All ...  stock is VERY beaten up at this point and VERY cheap on a earnings-yield perspective.  Who knows but i've started to follow it closely ...

For the long-term (10, 20 years or longer), I think that the return will gravitate towards 10% per year.

I find it hard to know what will happen to the share price in the next three months.

Can you comment?

 

 

 

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  • 2 weeks later...

https://www.bizjournals.com/denver/news/2019/04/29/davita-kent-thiry-legacy.html?ana=yahoo&yptr=yahoo

 

New CEO at DaVita - I am surprised. Hope it does not signal issues with the United HealthCare deal.

 

perhaps what is more likely is that Thiry is considering becoming a politician?

 

Certainly could be - waiting for this DMG deal to close, with the delays and impairments has been torture.

I'm just paranoid !

 

I'm sure Javier will do a great job.

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  • 2 weeks later...

BAML published a note today suggesting that figures were in-line

 

I thought the numbers were awful and the market seems to have reacted accordingly

 

It doesn't bother me that Thiry wants to step-down, and it's certainly good news if the DMG deal is still on the table, but cash flow doesn't look particularly appealing (resulting from the shutdown and reimbursements?)

 

My feeling is that selling losses and circling in a month can fix a lot of ills... I doubt the sale gets done anytime in the next couple months?  Anyone have any insight on this topic from studying other deals that have been deferred this long? 

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BAML published a note today suggesting that figures were in-line

 

I thought the numbers were awful and the market seems to have reacted accordingly

 

It doesn't bother me that Thiry wants to step-down, and it's certainly good news if the DMG deal is still on the table, but cash flow doesn't look particularly appealing (resulting from the shutdown and reimbursements?)

 

My feeling is that selling losses and circling in a month can fix a lot of ills... I doubt the sale gets done anytime in the next couple months?  Anyone have any insight on this topic from studying other deals that have been deferred this long? 

 

Re: cash flow, CFO said, "This cash flow was adversely impacted by the timing of working capital. There was an increase in accounts receivable as DSOs for the U.S. dialysis and lab business increased sequentially by 4 days to 64 days in Q1 2019 due to some temporary factors that we expect to normalize over the next couple of quarters. We also saw a reduction of accrued compensation due to timing of 401(k) contribution, bonus payments and a reduction in accounts payable."

 

And they maintained full year cash flow guidance so I gave them the benefit of the doubt re: cash flow. They tend to come in close even if they miss (excluding DMG misses which were awful) given the predictability of the business.

 

The unit growth number being 2.4% for Q1 versus guidance of 2.5% to 3.5% was slightly concerning but it's only 1 quarter. But more interestingly they called out slight market share loss from the larger competitors (so I'm guessing Fresenius). I wonder if some of that was home dialysis related - if it was that would be a trend to watch closely.

 

Re: share buybacks they are always coy and have said in the past they are not going to commit themselves to a certain buyback and cause the stock price to go up on that, so there is always some concern that they will just buy something. My guess is that most of it will go towards share buyback.

 

Re: closing DMG, my guess is that it will now be in the coming weeks given the consistent commentary by UNH and DVA.

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  • 3 weeks later...
  • 3 weeks later...

Is this deal ever going to happen

 

::)

 

https://news.bloomberglaw.com/mergers-and-antitrust/davita-gains-on-report-ftc-staff-nearing-approving-unh-unit-deal?utm_source=rss&utm_medium=MANW&utm_campaign=0000016b-32ac-dcbd-ad6b-faecfe8e0000

 

According to Capitol Forum it seems like a vote to approve may happen within the next couple of weeks. Though, I guess the market is saying it doesn't care and / or doesn't believe it.

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Cost pressure are relentless. It seems like costs are raising faster than reimbursements, maybe due to labor market tightness? the smaller players are probably sucking air through a straw. Fresenius on the other hand seems to be doing better, due to being more diversified.

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Cost pressure are relentless. It seems like costs are raising faster than reimbursements, maybe due to labor market tightness? the smaller players are probably sucking air through a straw. Fresenius on the other hand seems to be doing better, due to being more diversified.

 

Part of the slower reimbursement rise has been because the out-of-network commercial amounts are coming down. It's pretty small currently but is a small headwind. Labor market has been affecting them like everyone else, but the cost pressures have always been there and like you're saying they manage better than the smaller guys so at some stage rates catch up a little bit as well. Fresenius is doing better on volumes this past quarter but that's lumpy. DVA has had a lot of "one-off" headwinds for the past 3 years. Assuming that those do not go away and are permanent, I still expect them to start growing EBIT in-line with previous history over the next 3 years. A large opportunity is Medicare Advantage patients which start in 2021 -- that could add up to 20% of EBIT alone. I'm looking forward to their Investor Day later this year and also am looking forward to them buying back up to 1/3 of the market cap over the next 12 to 18 mos.

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The last repurchases in the quarter ended Mar 2018 were poorly timed.

 

4,197,304 shares for @290m = $69 / share.

 

No repurchases since then?

 

The following comes from the Mar 2019 Q1 report & I'm not sure but seem to remember hearing them say that debt reduction would be a priority use of cash from the DMG sale?

 

---

 

We may not be able to use the proceeds from the sale of DMG as planned or we may spend or invest the proceeds in ways that may not improve our results of operations or enhance the value of our common stock.

 

The purchase price for the sale of the DMG business is subject to customary adjustments, both upward and downward, which could be significant. We plan to use the proceeds from the sale of DMG for significant stock repurchases, to repay debt and for general corporate purposes, including growth investments. A number of factors may impact our ability to repurchase stock and the timing of any such stock repurchases, including market conditions, the price of our common stock, our cash flow position, leverage ratios, and legal, regulatory and contractual requirements and restrictions.

 

(page 113)

 

Risk Factors (continued)

 

In addition, we may identify investments or other uses for the proceeds from the sale of DMG that we believe are more attractive than our current intended uses. Further, there can be no assurance that any investment of the proceeds from the sale of DMG will yield a favorable return.

 

Under the terms of the equity purchase agreement, we are subject to certain contractual restrictions while the sale of DMG is pending, and certain post-closing contractual obligations that, in some cases, could have a material adverse effect on our business, results of operations and financial condition.

 

Under the terms of the equity purchase agreement, we are subject to certain restrictions on the conduct of the DMG business prior to completing the sale of DMG, which may adversely affect our ability to execute certain of our business strategies, including the ability in certain cases to enter into or amend contracts, acquire or dispose of assets, incur indebtedness or incur capital expenditures. Such limitations could negatively affect our business and operations prior to the completion of the sale of DMG. Each of these risks may be exacerbated by delays or other adverse developments with respect to the completion of the sale of DMG.

 

In addition, we agreed to retain certain liabilities of the DMG business for which we have certain indemnification rights against the original 2012 HealthCare Partners (“HCP”) sellers. An escrow was established in connection with our acquisition of the DMG business from the HCP sellers as security for these indemnification rights, including with respect to the OIG investigation into certain patient diagnosis coding practices. We have submitted an indemnification claim against the sellers secured by the escrow for any and all liabilities incurred relating to these matters and intend to pursue recovery from the escrow. However, we can make no assurances that the indemnification and escrow will cover the full amount of our potential losses related to these matters, which could have a material adverse effect on our business, results of operations and financial condition.

 

(page 114)

 

---

 

Sounds sufficiently dubious.

 

I'm not smart enough to figure out what the best use of this capital would be, but they list the weighted average interest rate at a hair over 5% for the quarter.

 

It seems like if they put more cash into repurchasing at present levels, they MAY be able to sell into the market IF prices improve & then use proceeds for debt reduction & capex?

 

I'm not saying this would or could happen.

 

-

 

On another note, when looking at the reports, I noticed a line that says "distributions to non-controlling interests" for $44.2m.

 

Does a portion of this go to Berkshire?  ???

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...

-

 

On another note, when looking at the reports, I noticed a line that says "distributions to non-controlling interests" for $44.2m.

 

Does a portion of this go to Berkshire?  ???

Apologies for two reasons:

1-I no longer follow DVA closely, did not check recent disclosures and this is from memory.

2-The following comments may trigger cognitive dissonance. :)

 

Let's say you are a kidney specialist who owns a (or several) dialysis centers and DVA makes an offer that you can't refuse. They set up a joint venture and you keep a minority interest that determines your income allocation and other benefits from the venture.

 

I could not get comfortable with the level of transparency related to these joint ventures. Some suggest that there is a potential for poor (and inapproprate) incentives.

https://catalyst.nejm.org/dialysis-nephrologists-joint-venture/

 

There is an ex-colleague of mine who used to say that there is an often overlooked and so far anatomically unidentified nerve that connects your brain (primitive part) to the pocket where you store your wallet.

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...

-

 

On another note, when looking at the reports, I noticed a line that says "distributions to non-controlling interests" for $44.2m.

 

Does a portion of this go to Berkshire?  ???

Apologies for two reasons:

1-I no longer follow DVA closely, did not check recent disclosures and this is from memory.

2-The following comments may trigger cognitive dissonance. :)

 

Let's say you are a kidney specialist who owns a (or several) dialysis centers and DVA makes an offer that you can't refuse. They set up a joint venture and you keep a minority interest that determines your income allocation and other benefits from the venture.

 

I could not get comfortable with the level of transparency related to these joint ventures. Some suggest that there is a potential for poor (and inapproprate) incentives.

https://catalyst.nejm.org/dialysis-nephrologists-joint-venture/

 

There is an ex-colleague of mine who used to say that there is an often overlooked and so far anatomically unidentified nerve that connects your brain (primitive part) to the pocket where you store your wallet.

 

Aha, I thought that since BRK owns a minority interest, this was partially going to them.

 

I'm sure your explanation is clearly spelled out in the footnotes somewhere.

 

Thanks  ;)

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To answer a few of the questions.

 

The NCI or non-controlling interests is related to the centers where do not have full ownership - the structure is different state by state.

 

Re: the debt paydown, look at the schedule but they have debt maturities in the near-term and part of the provision was from the sale of DMG all proceeds above $750 needed to go to debt paydown. They have said on earnings call, that they will pay it all down, re-lever and then do their share buyback. They might be doing some in small amounts from current FCF.

 

Re: 1/3 of market cap being repurchased, they have guided to 3 to 3.5x leverage and have at times been comfortable being higher. So they have about 1x leverage to get to 3.5x which is $2,200 Ebitda (so $1.1 to $2.2B) and the company generates about $800 million of FCF so that would be $1.2 B over 18 months. So $2.3 to $3.4 B of repurchases. Mkt cap of $8.7 B. Implies 26% - 39% buyback.

 

Can go into more detail.

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