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FOCUS RESEARCH
DECEMBER 2012
INITIALPUBLICOFFERING PT SARANA MEDITAMA METROPOLITAN TBK
IPOSTRUCTURE
Noof
Share
Newsharesissued 180,000,000OutstandingsharespostIPO 1,180,000,000
ShareholderspostIPOPTOmniHealthCare 84.53%DidiArmantoKusumanto 0.22%Public 15.25%
IPOScheduleTentativeBookbuildingperiod 1318December2012Effectivedate 28December 2012Offeringperiod 37 January2013Allotmentdate 9January2013Distributiondate 11January2013ListingatIDX 14January2013
TheuseofIPOProceedsTofinancetherepaymentofshareholdersloan 50%TofinancetheadditionofVIPbedsinSMI 28%Workingcapital 22%Source:PreliminaryProspectus
OMNIHOSPITALPULOMAS
Source:Companydata
OMNIHOSPITALALAMSUTERA
Source:Companydata
Theodorus ArielKristian
[email protected](+62-21) 5785 1818 ext. 2050
INVESTMENTHIGHLIGHTS
Leading privately-owned hospital in Indonesia
Omni Hospital is a leading privately-owned hospital company in Greater
J akarta, Indonesia which provides a full range of premier hospital services andthe highest level of patient care. Omni hospitals are operated by PT Sarana
Meditama Metropolitan Tbk (SMM or the company) in Pulomas, East Jakarta
and a lso operated by SMMs subsidiary, PT Sarana Meditama International (SMI)
in Alam Sutera, Tangerang (West of J akarta area). In 2010, Omni hospitals are
accredited by the Ministry of Health for 16 medical services and certified as
Class B hospitals, the highest grade for private hospitals in Indonesia.
Has 77 Premium Beds in Pulomas and Alam Sutera
As of J une 2012, Omni hospitals have 246 beds, in which 77 units are Premium
Beds located in Pulomas (49 units) and Alam Sutera (28 units). The bed
occupancy rate (BOR) of premium beds in SMM was running at 63.3% BOR while
SMIs premium bed was running at 81.5% BOR. The key growth driver for the
company is the addition of Premium Beds, which occupy more space and
generate higher revenue and profits than ordinary beds.
Potential to increase healthcare expenditureCompared with neighbouring Asian countries, Indonesia has one of the lowest
healthcare expenditures per capita. In 2009, Indonesia spent US$ 55 per capita
on healthcare, much lower than the other nearby developing countries, such
as Malaysia (US$ 337), China (US$ 169), Thailand (US$168), Vietnam (US $80) and
the Philippines (US$ 67). However, the country has great potential to increase
healthcare expenditure, given the healthcare expenditure as a % of GDP
remains low compared with other Asia countries.
Healthy and stable margin
SMMs gross margin is expected to remain healthy and stable at the level of
42%-43% during 2012-2015 projec tion periods on the back of 1) the
implementation of more effective medicine prescription policy; 2) expand more
Premium Beds to capture the higher margins segment associated with premier
hospital services; and 3) to consolidate medicine suppliers to achieve lower
average purchase prices for medicine and medical supplies. Meanwhile,
EBITDA is projected to grow by 16.2% p.a . CAG R reach to Rp 110.1 billion in
2015F with stable EBITDA margin at the level of 26%-27%.
Recording net profit, backed by strong operating profile
Given its strong operating profile, SMM will record a net profit of Rp 19.6 billion in
2012F from net loss position in 2009-2011 which was mainly due to the
establishment of SMI in 2007. The companys net profit is projected to jump by
43.8% p.a . CAG R reach to Rp 58.3 billion in 2015F with increases in net margin at
the level of 7%-14%, due to the payment of bank loan instalment until fully
repaid in 2015F.
Backed by highly extensive experienced management team
SMM is headed by Dr. Wartomo Prijosembodo, Sp. KJ - President Commissioner
who has 48 years extensive experience in healthcare industry, and Mr Noersing,
MBA President Direc tor. Noersing has 21 years extensive experience in Senior
Management positions both in the commercial sec tors and in banking. Strong
management team combining highly extensive experience and diversifiedbackground have helped shape SMM effective strategy, differentiating from its
competitors by undertaking operating initiatives to maximize its service level
and financial performance.
Fair Valuation ranging between Rp 523.9 billion to Rp 624.4 billion
We obtain SMMs fair equity value range based on PER comparables and DCF
analysis which is between Rp 523.9 billion to Rp 624.4 billion. SMMs equity value
translate into PER 2013F of 17.75x-21.16x and EV/EBITDA 2013F of 8.95x-10.16x.
Financial SummaryRp billion 2010A 2011A 2012F 2013F 2014F
Revenues 172.7 241.6 270.1 316.2 366.0
Growth 21.5% 39.9% 11.8% 17.1% 15.7%
EBITDA 32.3 63.6 70.2 82.4 97.8
Growth 45.3% 97.0% 10.4% 17.3% 18.7%
Net profit (24.9) (12.2) 19.6 29.5 46.3
Growth -14.9% -51.0% -260.8% 50.6% 57.0%
Net margin -14.4% -5.0% 7.3% 9.3% 12.7%
ROAA -7.7% -3.9% 6.7% 9.9% 15.2%
ROAE -120.8% -595.0% 340.6% 45.2% 33.5%Source: Company data and Lautandhana Research
Plea se see imp ortant d isclosures at the end of this rep ort
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PTSARANA MEDITAMA METROPOLITAN TBK DECEMBER 2012
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VALUATION
Valuation based on PER multiples
PER comparables
To obtain SMMs fair equity value, we use 2013F PER multiples of 22.19x as ourbenchmark which is based on a simple average of 4 Thailand listed companies, 2
Malaysia listed companies and 1 listed company from Singapore, India, Australia
and New Zealand, engages in health care service foc uses on hospital, such as:
Nonthavej Hospital PCL (NTV TB), Bumrungrad Hospital PCL (BH TB), Bangkok Dusit
Medical Services PCL (BGH TB), Bangkok Chain Hospital PCL (BCH TB), KPJ
Healthcare Bhd (KPJ MK), IHH Healthcare Bhd (IHH MK), Raffles Medical Group Ltd
(RFMD SP), Apollo Hospitals Enterprise Ltd (APHS IN), Ramsay Health Care Ltd (RHC
AU) and Acurity Health Group Ltd (AC Y NZ). We took regional listed companies as
PER comparables due to the absence of hospitals consensus in Indonesia. With
applied a discount of 20% of 2013F PER multiple, we generate SMMs equity value
of Rp 523.9 billion which implies PER 2013F of 17.75x and EV/EBITDA 2013F of 8.95x.
PER Comparables 2013FCompany Name Ticker Market Cap* PER (x) EV/EBITDA (x)
Indonesia
Sejahteraraya Anugrahjaya Tbk SRAJ IJ 227.8 n.a. n.a
Regional
Nonthavej Hospital PCL NTV TB 131.7 14.94 9.18
Bumrungrad Hospital PCL BH TB 1,804.4 24.03 14.23
Bangkok Dusit Medical Services PCL BGH TB 5,767.8 25.78 16.27
Bangkok Chain Hospital PCL BCH TB 604.7 19.91 11.68
KPJ Healthcare Bhd KPJ MK 1,246.2 21.62 12.64
IHH Healthcare Bhd IHH MK 8,691.4 35.65 18.00
Raffles Medical Group Ltd RFMD SP 1,146.8 21.97 15.83
Apollo Hospitals Enterprise Ltd APHS IN 2,097.6 29.62 15.10
Ramsay Health Care Ltd RHC AU 5,116.0 17.41 9.15
Acurity Health Group Ltd ACY NZ 70.1 11.00 7.25
Industry simple average 22.19 12.93
SMM Valuation based on PER Comparables
Discount to the market 20%
PER 2013F (x) 17.75
Equity value in Rp billion 523.9
EV/EBITDA 2013F(x) 8.95*) Market capitalization (US$ million)Closing price as of 6 December 2012Source: Bloomberg and Lautandhana Research
DCF Analysis
We also apply the discounted cash flow (DCF) method to obtain SMMs equity
value. We assume a WAC C of 10.8% and a terminal growth of 1%. Our WACCassumption is calculation with 5.5% risk free rate, 7.5% market risk premium and a
beta of 1. Based on DC F analysis, we generate SMMs equity value a t Rp 624.4
billion which translate into 21.16x PER 2013F and 10.16x EV/EBITDA 2013F.
DCF MethodsWACC calculation Valuation (x)
Risk free rate 5.5% Implied PE 2013F 21.16
Market risk premium 7.5% Implied EV/EBITDA 2013F 10.16
Beta 1.0
Cost of equity 13.0%
WACC 10.8%
Equity Value (In Rp billion)
Enterprise value 837.5Net debt (cash) 213.1
Equity value 624.4Source: Lautandhana Research
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Fair equity value range between Rp 523.9 billion Rp 624.4 billionBased on the methodologies as above, we obtain SMMs equity value ranging
between Rp 523.9 billion to Rp 624.4 billion which implies into PER 2013F of 17.75x-
21.16x and EV/EBITDA 2013F of 8.95x-10.16x.
Valuation Comparables Matrix
Company NameBloombergTicker
Market cap(US$ mn)
PER (x) PBV (x) EV/EBITDA (x)
13F 14F 13F 14F 13F 14F
Indonesia
Sejahteraraya Anugrahjaya Tbk SRAJ IJ 227.8 n.a. n.a. n.a. n.a. n.a n.a.
Regional
Nonthavej Hospital PCL NTV TB 131.7 14.94 n.a. 3.11 n.a. 9.18 n.a.
Bumrungrad Hospital PCL BH TB 1,804.4 24.03 21.52 6.14 5.41 14.23 12.60
Bangkok Dusit Medical Services PCL BGH TB 5,767.8 25.78 21.42 4.33 3.90 16.27 14.53
Bangkok Chain Hospital PCL BCH TB 604.7 19.91 17.19 4.48 4.03 11.68 10.29
KPJ Healthcare Bhd KPJ MK 1,246.2 21.62 18.91 3.40 3.04 12.64 11.01
IHH Healthcare Bhd IHH MK 8,691.4 35.65 28.03 1.46 1.40 18.00 14.99
Raffles Medical Group Ltd RFMD SP 1,146.8 21.97 18.62 3.42 3.06 15.83 13.47
Apollo Hospitals Enterprise Ltd APHS IN 2,097.6 29.62 23.41 3.66 3.20 15.10 12.13Ramsay Health Care Ltd RHC AU 5,116.0 17.41 15.55 3.23 2.92 9.15 8.44
Acurity Health Group Ltd ACY NZ 70.1 11.00 9.71 0.91 0.89 7.25 6.43
Industry average 22.19 19.37 3.41 3.09 12.93 11.54
Sarana Meditama Metropolitan 54.6-65.04 17.75-21.16 11.31-13.48 4.55-5.43 3.25-3.87 8.95-10.16 7.53-8.56Closing price as of 6 December 2012Source: Bloomberg and Lautandhana Research
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PTSARANA MEDITAMA METROPOLITAN TBK DECEMBER 2012
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COMPANYPROFILEOVERVIEW
Leading privately-owned hospital in IndonesiaEstablished in 1972, Omni Hospital is a leading privately-owned hospital company
in Greater J akarta, Indonesia which provides a full range of premier hospital
services and the highest level of patient care. Omni hospitals are operated by PTSarana Meditama Metropolitan Tbk (SMM or the company) in Pulomas, East
J akarta and also operated by SMMs subsidiary, namely PT Sarana Meditama
International (SMI) located in Alam Sutera, Tangerang. In 2010, Omni hospitals are
accredited by the Ministry of Health for 16 medical services and certified as Class
B hospitals, the highest grade for private hospitals in Indonesia. Conveniently
located in Pulomas (East Jakarta) and Alam Sutera (West of J akarta Area), the
hospitals are highly accessible to patients located throughout North, Central and
East J akarta, which have a total population of 6.1 million.
Omni Hospital Location Shareholder Ownership
Source: Company data Source: Company data
History in Brief
Omni hospital commenced operation in September 1972 which was initiallyestablished as a non-profit medical organization in Pulomas that provided
psychiatric diagnosis and therapy to the local community. During its initial 16
years of operation, Omni hospitals grew organically and developed strong
relationships in the surrounding communities and built a loyal patient base.
In 1984, SMM was established and became the owner of Omni hospital. In 1988,
SMM started to strategically transform into a general hospital from a psychiatric
clinic to provide a full range of medical services.
In 2007, the new Omni hospital was founded in Alam Suteras area and operated
by SMI in order to capture the growing medical service demand in western part
of J akarta. In 2008, SMI formally established five c enters of excellence to provide
differentiated premier service.
The Milestone
Source: Company data
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Focused on five centers of excellenceBacked by 193 specialists, Omni hospitals offer a full range of inpatient and
outpatient services which are foc used on five centers of excellence, i.e.:
Neurosurgery, Cardiology, Orthopedics, Urology and Kawasaki Disease. Omni
hospitals also maintain particular strength in the three areas of Internal Medicine,
Pediatrics, and Obstetrics & Gynecology which is aimed to attrac t the majority ofpatient visit to the hospital.
The Services
Source: Company data
The Facilities
Omni hospitals provide a full range of advanced technology and facilities for
diagnostic and therapeutic applications which comprises of 12 Intensive Care
Unit (ICU) beds, 7 operating theaters, 8 delivery rooms, laboratory, pharmacy,
imaging services and other medical equipment.
Specialized imaging services include Magnetic Resonance Imaging (MRI),
Multislice C omputed Tomography 64 Slices (MSCT 64 Slices), X-Ray, PantheroMicroscope, Laparoscopy with HDTV, Endoscopy, Neuron Endoscopy,
Arthroscopy, Bronchoscope, and Cystocopy. Specifically, the MRI machine is
among the most advanced of medical equipment of its kind in the Greater
J akarta area and patients are referred by other hospitals and clinics for MRI
scans.
Supported by other medical equipment, such as: such as a Hyperbaric Chamber,
Extra Shoc k Wave Lithotripsy (ESWL), Bone Mineral Densitometry, Cardiac Cath
Lab, Intra Operative Monitoring (IOM), C avitron Ultrasonic Aspirator (CUSA),
Navigation Stryker, enable Omni hospitals to provide a comprehensive treatments
for complex medical conditions
Currently, Omni hospitals have 246 beds, in which 77 units are Premium Beds. Thekey growth driver for the c ompany is the addition of Premium Beds, which
occupy more space and generate higher revenue and profits than ordinary
beds. In J une 2012, the bed occupancy rate (BOR) of premium beds in SMM was
running at 63.3% BOR while SMIs premium bed was running at 81.5% BOR.
Bed Statistic The BOR
As of June 2012Source: Company data
Source: Company data
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Target the middle and upper-middle segment in Greater Jakarta area
Since it was first established in 1972, Omni hospitals have penetrated its
surrounding communities and developed strong ties with its patient base. As a
premier hospital services provider, Omni hospitals target the middle and upper-
middle c lass market segment in Greater Jakarta area, which is growing rapidly as
Indonesias economy expands and attrac ts investment and J akarta furtherbenefits from the continuing trends in urbanization. In 2007, the new Omnis
hospital (operated by SMI) was designed and equipped with modern facilities in
order to attract customers from a variety of channels. Hence, SMM classifies its
patients into 4 categories, i.e.:
Local Communities
The hospital primarily target patients from c ommunities within 10 kilometres
of SMM and SMI. SMM primarily serves patients from Pulomas, Cempaka
Putih, Kelapa Gading, Kemayoran, and Sunter, while SMI primarily targets
patients from Alam Sutera, Gading Serpong, Graha Raya, Villa Melati Mas,
and Bumi Serpong Damai. Management estimates that the primary service
area has a combined population of 6.1 million residents and nearly 18,000
businesses.
Corporate C ustomers
The hospital has established relationships with large multi-nationalcompanies in Indonesia, such as Petrochina, Asahimas, and PAMA. The
Company offers special packages to these large corporations to
encourage loyalty and capture a high share of their employees hospital
needs.
Insuranc e Companies
The company believes the increase of medical insurance coverage in
Indonesia will be a major trend in the countrys healthcare system. Therefore
the Company targets to acquire patients covered by insurance by building
and expanding relationships with the insuranc e companies.
Special Communities
Special communities are groups of individuals who suffer from common
diseases, such as kidney failure, kawasaki disease, or diabetic. The hospital
provides specific diagnostics and treatments to these patients and providesthem with support as if they comprise their own special communities.
Marketing Initiatives
Omni hospitals have tailored its high-impact marketing initiatives through tactical
promotions for individual customers, as well as incentive programs or packages
for corporate customers and insuranc e companies. Complementary to traditional
advertising and marketing channels, Omni hospitals also utilizes high profile social
events such as doctor seminars and outdoor activities to promote and strengthen
its brand appeal. Omni hospitals have a corporate social responsibility initiative
through which it sponsors community medical check-ups and special events as
part of its patient retention program.
Marketing Initiatives
Source: Company data
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Backed by highly extensive experience management teamSMM is backed by highly experienced and dedicated executive management
team. Dr. Wartomo Prijosembodo, Sp. KJ as President Commissioner has 48 years
extensive experience in healthcare industry, while Mr Noersing, MBA President
Director has 21 years extensive experience in Senior Management positions both
in the commercial sectors and in banking. Others members of the board ofdirectors such as Dr. Raymond Oenleng, MARS and Dr. Maria Theresia Yulita are
experienced doctor which have extensive knowledge in healthcare industry from
their prior working experience; while Mr Hassan Themas - Non Affiliated Finance
Director, has 23 years extensive experience in accounting industry. SMMs strong
management team combining highly extensive experience and diversified
background have helped shape SMM effec tive strategy, differentiating it from its
competitors by undertaking operating initiatives to maximize its service level and
financial performance.
Mitra Keluarga Kelapa Gading and Siloam Karawaci are the closest competitorOmni hospitals local competition in the Greater J akarta a rea includes 19 full-
service private hospitals. The closest competing hospitals of SMM and SMI are
Mitra Keluarga Kelapa Gading and Siloam Karawaci, respectively. Mitra Keluarga
Kelapa Gading, located North Jakarta, is a member hospital of Mitra Keluarga
Group. Siloam Karawaci, located in Tangerang, is a member hospital of Siloam
Hospital.
Competitor
Source: Company data
Strong market presenceBased on the bed capacity, Omni hospitals ranked at 4thplace which owns 11%
market share, among the key operators. Mitra Keluarga is the leader market share
by 29% which is followed by Ramsay and Siloam with market share of 12%,
respec tively.
Market Share - bed capacity
Source: Company data
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FINANCIALOVERVIEW
Increasing premier services facility to satisfy significant unmet demandAs a premier hospital services provider, Omni hospitals target the middle and
upper-middle class market segment in Greater Jakarta, which is growing rapidly
as Indonesias economy expands and attrac ts investment and J akarta furtherbenefits from the c ontinuing trends in urbanization. Currently, there are
approximately 125 hospitals in the Greater J akarta, however, only 21 hospitals are
commercially owned and managed to fulfil the needs of upper-middle class
market segment.
As of J une 2012, the hospitals have 77 premium beds at its two loc ations with the
average BOR of premium beds are at average 69.9%, much higher than the
average BOR for standard beds, which is 65.1%. In 2013F, the company plans to
add 18 Premium beds in its subsidiary (SMI) which is aimed to satisfy the unmet
needs for premier services. The total investment of its new premium beds are
estimated amount to US$ 1.88 million. This expansion will increase the companys
ability to attrac t and service the growing middle and upper-middle class market
as well as to attract and retain top specialists and medical staff who enjoy theability to work in world c lass facilities.
The company is also focused to continuously develop the five centers of
excellence comprises of Neurosurgery, Cardiology, Orthopedics, Urology and the
Kawasaki Disease. SMM also plans to upgrade its medical equipment, improve
the existing hospital programs and pursue the expansion of new programs.
AssumptionPeriod 2009 2010 2011 Jun-12 2012F 2013F 2014F 2015F CAGR*
Number of Premium Bed
SMM 31.0 30.0 49.0 49.0 49.0 49.0 49.0 49.0 0.0%
Super VIP 9.0 9.0 9.0 9.0 9.0 9.0 9.0 9.0 0.0%
VIP 22.0 21.0 40.0 40.0 40.0 40.0 40.0 40.0 0.0%
.
SMI 28.0 28.0 28.0 28.0 28.0 46.0 46.0 53.0 23.7%
Super VIP 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 0.0%
VIP 26.0 26.0 26.0 26.0 26.0 44.0 44.0 51.0 25.2%
Total Premium Bed 59.0 58.0 77.0 77.0 77.0 95.0 95.0 102.0 9.8%
.
BOR**
SMM
Super VIP 51.5% 63.3% 55.5% 65.0% 52.3% 55.8% 58.8% 62.5%
VIP 65.7% 67.7% 62.7% 62.9% 60.6% 63.6% 66.8% 69.5%.
SMI
Super VIP 48.4% 76.8% 80.8% 81.0% 80.8% 80.8% 80.8% 80.8%
VIP 40.3% 64.6% 76.0% 81.6% 79.1% 61.2% 61.3% 52.0%
Average BOR 51.5% 68.1% 68.8% 69.9% 68.2% 65.4% 66.9% 66.2%*) 2012F-2015F**) The bed occupancy rateSource: Company data & Lautandhana Research
Revenue to increase 16.0% p.a. CAGR
During 2012F-2015F period, SMMs total revenue is expected to increase by 16.0%
p.a. CAG R from Rp 270.1 billion to Rp 421.2 billion on the back of 1) the
favourable market dynamics; 2) the increasing number of premium beds; and 3)
the general migration by consumers to more premier services. During the
projection period, we note that the ancillarys revenue is the higher proportion of
its total revenue which focuses on the five centers of excellence and pharmacy
sales. Revenue from ancillary is projec ted to grow 16.7% p.a. CAGR from Rp 159.3
billion in 2012F to Rp 253.1 billion in 2015F. In addition, the c ompanys total
revenue is mainly driven by its subsidiary performance, SMI, which is in a stage orrapid development while SMM is a more stable and mature business.
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RevenuePeriod 2009 2010 2011 Jun-12 2012F 2013F 2014F 2015F CAGR*
Revenues (Rp billion)
Ancillary 73.1 88.2 130.9 78.0 159.3 187.4 218.9 253.1 16.7%
Inpatient 20.6 30.2 49.0 26.9 62.5 72.8 82.4 93.9 14.5%
Outpatient 11.0 8.4 13.3 6.7 20.1 23.9 28.3 33.2 18.3%Medical Check Up 18.8 22.2 16.6 1.6 4.3 5.1 6.0 7.1 18.5%
Others 21.7 29.6 40.2 21.3 33.2 38.1 43.5 49.3 14.0%
Treatment discount (3.1) (5.8) (8.4) (4.0) (9.3) (11.2) (13.2) (15.4) 18.3%
Total 142.1 172.7 241.6 130.6 270.1 316.2 366.0 421.2 16.0%.
Revenue Portion
Ancillary 51.4% 51.1% 54.2% 59.7% 59.0% 59.3% 59.8% 60.1%
Inpatient 14.5% 17.5% 20.3% 20.6% 23.2% 23.0% 22.5% 22.3%
Outpatient 7.8% 4.8% 5.5% 5.1% 7.4% 7.6% 7.7% 7.9%
Medical Check Up 13.2% 12.8% 6.9% 1.2% 1.6% 1.6% 1.6% 1.7%
Others 15.3% 17.1% 16.6% 16.3% 12.3% 12.1% 11.9% 11.7%
Treatment discount -2.2% -3.4% -3.5% -3.0% -3.4% -3.5% -3.6% -3.7%
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
*) 2012F-2015F**) The bed occupancy rateSource: Company data & Lautandhana Research
Healthy gross margin
We expec t that SMMs gross profit will grow by 16.8% p.a. CAGR over the next
three years which attains to Rp 182.0 billion by end of 2015F. Meanwhile, SMMs
gross margin is expected to remain healthy and stable at the level of 42%-43%
during 2012-2015 projec tion periods due to the following cost efficiencys initiative
programs:
the implementation of Formularium (more effective medicine prescription
policy through reducing the number, type and c entralizing its medicine
sourcing);
to add more Premium Beds to capture the higher margins segment
assoc iated with premier hospital services;to consolidate medicine suppliers (focused on 7 biggest suppliers from
approximately 100 suppliers) in order to achieve lower average purchase
prices for medicine and medical supplies.
Gross Margin
Source: Company data and Lautandhana Research
EBITDA grow 16.2% p.a. CAGRAs a result of the companys proposed expansion, EBITDA is projected to grow by
16.2% p.a CAGR reach to Rp 110.1 billion in 2015F with stable EBITDA margin at
the level of 26%-27%. Meanwhile, operating profit is also expected to advance
by 22.7% p.a. CAGR from Rp 43.7 billion in 2012F to Rp 80.9 billion in 2015F, backed
by operating cost efficiency through better utilization of marketing efforts andother operational resources which generates higher operating margin between
16%-19%.
40.8
56.9
103.3
114.3
134.6
159.0
182.0
28.7
32.9
42.8 42.3 42.643.4 43.2
15.0
20.0
25.0
30.0
35.0
40.0
45.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
180.0
200.0
2 00 9 2 01 0 2 01 1 2 0 12 F 2 01 3F 2 0 14 F 2 01 5F
%
Rpbillion
Grossprofit Grossmargin RHS
CAGR=16.8%p.a.
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PTSARANA MEDITAMA METROPOLITAN TBK DECEMBER 2012
10
Operating margin EBITDA margin
Source: Company data and Lautandhana Research Source: Company data and Lautandhana Research
Recording net profit, backed by strong operating profile
Given its strong operating profile, we forecast that SMM will record a net profit of
Rp 19.6 billion in 2012F from its net loss position during 2009-2011 which wasprimarily due to the establishment of SMI in 2007. The companys net profit is
projected to jump by 43.8% p.a. CAGR reach to Rp 58.3 billion in 2015F with
increases in net margin at the level of 7%-14%, due to the payment of bank loan
instalment until fully repaid in 2015F.
Net margin
Source: Company data and Lautandhana Research
Healthier balance sheet
In 2009 and 2010, SMMs debt equity ratio (DER) was at higher level between 7.6x-
32.9x due to the establishment of SMI in 2007. It was reasonable since SMI needed
more funding source, primarily from banking loan (Rp 201.8 billion in 2009 and Rp
194.3 billion in 2010) to operate the new Omni hospital located in Alam Suterastarted in 2008, in our view. With the proposed IPO, the companys equity will
improve this year which will further improve its balance sheet, i.e.: lower DER and
net DER. SMMs DER is projected to dec rease gradually become 14.17x in 2012F,
1.29x in 2013F, 0.54x in 2014F and 0.18x in 2015F.
Balance Sheet (Rp billion)Period 2009 2010 2011 Jun-12 2012F 2013F 2014F 2015F CAGR*
Interest bearing debt 249.2 267.7 253.6 230.7 220.4 148.0 86.5 37.4 -44.6%
Equity 33.0 8.1 (4.0) 8.7 15.6 115.1 161.4 212.7 139.1%
Cash and cash equivalent 8.5 9.4 8.8 7.4 5.9 18.1 22.6 15.9 39.3%
Debt to equity (x) 7.55 32.88 (62.69) 26.45 14.17 1.29 0.54 0.18
Net debt to equity (x) 7.29 31.72 (60.51) 25.60 13.79 1.13 0.40 0.10*) 2012F-2015FSource: Company data and Lautandhana Research
(3.3)
6.0
36.1
43.7
54.6
70.4
80.9
(2.3)
3.5
14.916.2
17.3
19.2 19.2
(5.0)
5.0
10.0
15.0
20.0
25.0
(10.0)
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
2 00 9 2 01 0 2 01 1 2 01 2F 2 01 3F 2 01 4F 2 01 5F
%
Rpbillion
Operatingprofi t Ope rati ngmarginRHS
CAGR=22.7%p.a.
22.2
32.3
63.670.2
82.4
97.8
110.1
15.6
18.7
26.3 26.0 26.126.7
26.1
5.0
10.0
15.0
20.0
25.0
30.0
20.0
40.0
60.0
80.0
100.0
120.0
2 00 9 2 0 10 2 01 1 2 01 2F 2 0 1 3F 2 0 1 4F 2 0 1 5F
%
Rpbillion
EBITDA EBITDAmargin RHS
CAGR=16.2%p.a.
(29.2)(24.9)
(12.2)
19.6
29.5
46.3
58.3
7.3
9.3
12.7
13.8
(10.0)
(7.5)
(5.0)
(2.5)
2.5
5.0
7.5
10.0
12.5
15.0
(40.0)
(30.0)
(20.0)
(10.0)
10.0
20.0
30.0
40.0
50.0
60.0
70.0
2 00 9 2 01 0 2 01 1 2 01 2F 2 01 3F 2 01 4F 2 01 5F
%
Rp
billion
Netprofit (loss) NetmarginRHS
CAGR=43.8%p.a.
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INDUSTRYOVERVIEW
Indonesia Market OverviewIndonesia is one of the fastest growing countries in Southeast Asia with a total
population of 238 million in 2010. As the countrys capital city and economic
centre, J akarta is the most populous city in Indonesia and Southeast Asia, andranks as the 13th largest in the world. In 2010, population of the Greater Jakarta
area , which includes J akarta, Tangerang, Depok, Bogor and Bekasi, reached 27.9
million, representing a 10-year CAGR of 3.6% p.a..
Indonesias population of persons over 60 years old was 8.2% of the total
population in 2010, up from 6.1% in 1990. This segment is estimated to grow to
15.7% by 2030 and the growth of this older segment is expected to drive a
significant increase in hea lthcare expenditure over the long-term.
The rapid growth of the Indonesian economy in the past few years has improved
the income of all segments of the population. The average income per capita
rose to US$ 2,607 in 2010 from less than US$ 1,410 five years ago. Middle c lass in
Indonesia, defined as people with disposable household income of US$ 5,000 toUS$ 15,000 per annum, is expected to grow from 36% of the total population in
2010 to over 58% by 2020, representing an annual increase in the middle c lass of
seven million people. As the largest and most developed city in Indonesia,
Greater J akarta has the largest proportion of the middle class population and
therefore has a higher demand for premier hospital services. J akartas regional
GDP per capita has grown at 5-year CAGR of 13.2% p.a. to US$ 10,520 in 2010.
Historical and Projected Age Distribution in Indonesia
Source: Company data and World Population Prospects: The 2010 Revision, United Nations
Potential to increase healthcare expenditureDespite the strong economic growth, when compared with neighbouring Asian
countries, Indonesia has one of the lowest healthcare expenditures per capita. In
2009, Indonesia spent US$ 55 per capita on healthcare, much lower than the
world average of US$ 854. As compared with other nearby developing countries,
Indonesia hea lthcare expenditure is significantly less than Malaysia (US$ 337),
China (US$ 169), Thailand (US$ 168), Vietnam (US$ 80) and the Philippines (US$ 67).
However, the country has great potential to increase healthcare expenditure,given the healthcare expenditure as a % of GDP remains low compared with
other Asia countries.
Per Capita Total Health Expenditure by Country Total Health Expenditure - % of GDP by Country
Source: Company data and World Health Organization Source: Company data and World Health Organization
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Divided into public hospital and private hospital
The number of hospital in Indonesia has grown in the past five years from 1,245 in
2005 to 1,330 in 2010, representing a 6.8% increase over the period. Indonesian
hospitals can be divided into two categories: public hospitals and private
hospitals. Public hospitals are managed by the Indonesian government which
aims to provide basic hospital service primarily to the lower income population.Private hospitals are comprised of:
i) Social community hospitals which are owned by religious groups, non-government organizations and other non-profit groups, serving the middle
to low market segment;
ii) Commercial hospitals like Omni hospital that typically offer a wide range ofcomprehensive, high quality and more expensive hospital services primarily
to the middle c lass population.
Indonesia Hospital Breakdown by Ownership
Source: Company data
Facing various challenges in hospital industry
Despite the growth dynamics, the current Indonesia hospital industry is facing
various challenges as follows:
Limited Middle to High End Hospital Services
According to the Ministry of Health, more than 100,000 Indonesians go
abroad every year to seek medical assistance due to the lack of reliableand high quality domestic hospital service. Primarily consisting of the middle
to upper-class population, these patients have contributed approximately
US$600 million annua lly to the foreign hospital service market since 2003. This
represents a significant market opportunity for middle to high level hospital
service providers in the Greater J akarta area.
Inadequate Medical Facilities and Equipment
Indonesia has one of the lowest beds to population ratio among Asian
countries. With six beds per 10,000 inhabitants, most hospitals are generally
overcrowded. Additionally, most non-profit organizations, public hospitals
and social community hospitals in Indonesia do not have the capital
necessary to upgrade their facilities and equipment. Many hospitals are
short of specialized medical equipment, presenting problems for both
pa tients and physicians. As a result, many clinics and hospitals refer pa tients
with complex conditions to better equipped medical centers for diagnostics
and treatment.
Bed to Population Ratio by Country
Source: Company data and World Health Organization
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Shortage of Medical StaffDensity of medical staff in Indonesia is also low compared with other
developing Asian countries. Physician density of 2.88 per 10,000 inhabitants
is much lower than the world average of 14 physicians per 10,000
inhabitants, putting great pressure on the healthcare system.
Healthcare Workforce Density
Source: Company data and World Health Organization
High Turnover of Specialists
In Indonesia, most spec ialists work as pa rtners rather than employees of
hospitals. With SIPs (Prac tice Licenc es) issued by the Ministry of Hea lth, a
spec ialist may simultaneously work for a maximum of three hospitals. This
unique dynamic coupled with limited supply of specialists result in the high
specialist turnover and therefore increases the competition among hospitals
to retain leading specialists.
Management Structure
Based on the regulation of Health Ministry, Indonesian hospitals are
managed directly by authorized doctors. This regulation excludes
professional commercial management from most care facilities and can
result in inefficiency.
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APPENDIXI.SARANAMEDITAMAMETROPOLITANFINANCIALHIGHLIGHTS
PROFIT AND LOSS
Period (Rp bln) 2010 2011 2012F 2013F 2014F 2015F
Revenues 172.7 241.6 270.1 316.2 366.0 421.2Direct cost 115.8 138.3 155.8 181.6 207.0 239.2
Gross profit 56.9 103.3 114.3 134.6 159.0 182.0
Operating expenses 50.9 67.2 70.6 79.9 88.6 101.1
Operating profit 6.0 36.1 43.7 54.6 70.4 80.9
EBITDA 32.3 63.6 70.2 82.4 97.8 110.1
Other Income / (Expenses) (34.9) (29.1) (17.6) (15.3) (8.7) (3.2)
Interest expenses (34.3) (30.7) (18.0) (15.9) (9.7) (4.1)
Interest income & others (0.5) 1.6 0.4 0.6 1.0 1.0
Pre-tax profit (loss) (28.9) 7.0 26.1 39.3 61.8 77.7
Tax income (expenses) 4.0 (19.2) (6.5) (9.8) (15.4) (19.4)
Non-controlling interest - 0.0 0.0 0.0 0.0 0.0
Net profit (loss) (24.9) (12.2) 19.6 29.5 46.3 58.3Source: Company data and Lautandhana Research
BALANCE SHEET
Period (Rp bln) 2010 2011 2012F 2013F 2014F 2015F
ASSETS 320.4 302.9 282.9 310.3 301.1 309.7
Current Assets
Cash and cash equivalents 9.4 8.8 5.9 18.1 22.6 15.9
Trade receivables 20.1 21.4 20.3 30.3 35.3 40.8
Inventories 6.5 8.5 11.9 19.0 22.2 25.7
Other current assets 2.2 4.2 4.8 5.1 6.3 7.2
Total Current Assets 38.2 43.0 42.9 72.5 86.4 89.6
1.0
Non-Current Assets
Fixed assets 267.6 257.3 234.3 230.7 207.6 213.0Others non-current assets 14.6 2.6 5.7 7.1 7.1 7.1
Total Non-Current Assets 282.2 259.9 240.0 237.8 214.7 220.1
1.0
LIABILITIES AND EQUITY 320.4 302.9 282.9 310.3 301.1 309.7
Current Liabilities
Short term bank loan 12.4 - - - - -
Trade payables 22.7 24.2 16.1 14.7 17.2 19.9
Current maturities of LT bank loan 14.8 29.2 37.4 37.4 37.4 37.4
Shareholder loan 61.0 74.7 70.6 35.6 11.6 -
Other current liabilities 12.4 17.4 20.5 22.0 25.1 29.0
Total Current Liabilities 123.3 145.4 144.7 109.8 91.4 86.4
1.0
Non-Current Liabilities
Long term Loan - net 179.5 149.8 112.3 74.9 37.4 -
Other non-current liabilities 9.5 11.8 10.4 10.5 10.9 10.6
Total Non-Current Liabilities 188.9 161.5 122.7 85.4 48.3 10.6
1.0
Equity
Capital Stock & PIC 100.0 100.0 100.0 170.0 170.0 170.0
Others (34.4) (34.4) (34.4) (34.4) (34.4) (34.4)
Retained earnings (57.5) (69.7) (50.1) (20.6) 25.7 77.1
Total Equity 8.1 (4.0) 15.6 115.1 161.4 212.7
1.0
Non-controlling interest - (0.0) (0.0) (0.0) (0.0) (0.0)
Source: Company data and Lautandhana Research
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APPENDIX I Contd
CASH FLOWPeriod (Rp bln) 2010 2011 2012F 2013F 2014F 2015F
Net profit (loss) (24.9) (12.2) 19.6 29.5 46.3 58.3Depreciation & Amortization 26.3 27.5 26.5 27.8 27.4 29.3
Change in WC (2.0) (1.9) (10.3) (18.5) (5.7) (6.3)
Others 0.4 3.0 2.6 1.3 1.8 3.1
Net Operating Cash Flow (0.2) 16.4 38.3 40.0 69.9 84.3
Change in fixed assets - net (11.5) (17.2) (3.5) (24.1) (4.4) (34.7)
Others (5.5) 12.0 (3.2) (1.4) - -
Net Investing Cash Flow (17.0) (5.2) (6.6) (25.5) (4.4) (34.7)
Change in borrowings - net 18.5 (14.1) (33.2) (72.4) (61.4) (49.1)
Change in equity - - - 70.0 - -
Dividend payment - - - - - (6.9)
Others (0.4) 2.3 (1.4) 0.2 0.4 (0.3)
Net Financing Cash Flow 18.1 (11.8) (34.6) (2.3) (61.1) (56.3)
Change in cash 0.9 (0.6) (2.9) 12.3 4.5 (6.7)
Cash at the beginning period 8.5 9.4 8.8 5.9 18.1 22.6
Cash at the ending period 9.4 8.8 5.9 18.1 22.6 15.9Source: Company data and Lautandhana Research
KEY FINANCIAL RATIOPeriod 2010 2011 2012F 2013F 2014F 2015F
Growth (%)
Revenues 21.50 39.89 11.82 17.06 15.74 15.09
Gross profit 39.32 81.60 10.67 17.73 18.15 14.45
Operating Profit (283.28) 500.12 21.13 24.92 28.89 14.80
EBITDA 45.34 97.04 10.37 17.32 18.75 12.56
Net profit (loss) (14.92) (50.97) (260.82) 50.56 56.96 25.81
Profitability (%)
Gross margin 32.94 42.76 42.32 42.56 43.45 43.21
Operating margin 3.48 14.95 16.19 17.28 19.24 19.20
EBITDA margin 18.70 26.34 26.00 26.06 26.74 26.15
Net profit margin (14.40) (5.05) 7.26 9.33 12.66 13.83
ROAA (7.71) (3.91) 6.69 9.95 15.15 19.08
ROAE (120.84) (594.99) 340.60 45.18 33.51 31.15
Solvency (x)
Current ratio 0.31 0.30 0.30 0.66 0.95 1.04
Quick ratio 0.26 0.24 0.21 0.49 0.70 0.74DER 32.88 (62.69) 14.17 1.29 0.54 0.18
Interest coverage 0.18 1.18 2.43 3.44 7.27 19.63
EBITDA coverage 0.94 2.07 3.91 5.18 10.10 26.74
Net debt to equity 31.72 (60.51) 13.79 1.13 0.40 0.10Source: Company data and Lautandhana Research
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APPENDIX II
II.1 The Board of Commissioners and Direc tors
A Brief Biography of NELY Commissioners and Director
Name Position RemarksDr. Wartomo Prijosembodo,Sp. KJ
PresidentCommissioner
An Indonesian citizen, appointed as President Commissioner since October 2012. Currently, he also serves asTreasurer of Kesehatan Jiwa Dharmawangsa Foundation since 1964, Psychiatry Doctor at Omni HospitalPulomas since 1972, and as Commissioner of PT Sarana Meditama International since 2010. Previously, heserved as Deputy Director of Sanatorium Dharmawangsa (1964 - 1968), Director of Sanatorium Dharmawangsa(1968 - 1973), Deputy Director of Sanatorium Dharmawangsa (1974 1998); FK Psychiatry at University ofIndonesia (1966 1994), Director of Majalah Jiwa (1970 1973), President Director of Omni Hospital Pulomas(1974 2005), President Director of PT Sarana Meditama Metropolitan Jakarta (September 1996 - February2003), Commissioner of PT Sarana Meditama International (May 2005 March 2006), Commissioner of PTSarana Meditama Metropolitan (December 2005 September 2012). He holds General Practitioner Degreefrom University of Indonesia in 1962, Psychiatry degree from University of Indonesia in 1966 andPsychotheraphy from West Berlin Hospital in 1974.
Dr. Henry Naland, Sp. B(K)Onk
Commissioner An Indonesian citizen, appointed as Commissioner since October 2012. Currently, he also serves as SpecialistsSurgical Oncology at Omni Medical Center since 1988 and Specialist Physician Surgical Oncology in PremierHospital Jatinegara since 1988. He previously served as a General Practitioner in HKBP Hospital - Balige (1971- 1976) and at RSUP in Dili, East Timor (1985 - 1986), Physicians Surgeons Oncology in Persahabatan Hospital(1988-1994). He holds General Practitioner degree from University of Indonesia in 1972, Education SpecialistSurgery of Arztekammer Nordrhein, West Germany in 1983 and the Medicine Department of Surgery Tumofrom University of Indonesia in 1988.
Drs. Herbudianto, Ak IndependentCommissioner
An Indonesian citizen, appointed as Independent Commissioner since October 2012. He previously servedamong others as Head of Accounting Standards and Inspection Service Business Bureau Rating of CorporateFinancial Services Sector Capital Market Supervisory Agency (Bapepam) - the Ministry of Finance of theRepublic of Indonesia (1991-1997), Head of the Community Development Bureau Accountants AccountingStandards and Disclosure, Supervisory Board Capital Markets (Securities and Exchange Commission), Ministryof Finance of the Republic of Indonesia (1997-2000), Head of Development and Formulation of AccountingStandards Accounting Standards Bureau and the openness of the Capital market Supervisory Agency(Bapepam) - the Ministry of Finance of the Republic of Indonesia (2000-2002), Head of Business Servicestrade, Transportation, and Tourism Bureau of Assessment Services Sector Corporate Finance, Capital MarketSupervisory Agency (Bapepam) - the Ministry of Finance of the Republic of Indonesia (2002-2006), Head ofCorporate Valuation Services Bureau of Non-Financial Services Sector Assessment Corporate Finance, CapitalMarket Supervisory Board & Financial Institution (Bapepam-LK) - Ministry of Finance Republic of Indonesia(2006 - September 2012). He graduated from Gajah Mada University, Jogjakarta in 1984 with Economicdegree major in Accounting.
Noersing, MBA PresidentDirector
An Indonesian citizen, appointed as President Director since 2010. He graduated from TarumanagaraUniversity in 1991 with Economic degree majoring Accounting, Management Magister from IPMI GraduateBusiness School in 2000 and Master of Business Administration from Monash University, Melbourne Australia, in 2000. Previously, he served as Associate Manager in Arthur Andersen & Co. (1991 - 1995), GroupFinancial Controller of The Lion Group Indonesia Region (1995 1999), Chief Financial Officer in KIA CeramicsGroup of Companies (2000 2003), Chief Financial Officer PT Bank Commonwealth (2003 2005); Director ofSales and Services PT Bank Commonwealth (2006 2007) and as President Director of PT Bank Commonwealth(2008 2009).
Dr. Raymond Oenleng, MARS Director An Indonesian citizen. He graduated from University of Christian Indonesia in 1989 with General Practitionerdegree, Management Magister majoring in Hospital Administration from University of Indonesia in 2009.Appointed as Director since August 2012. Currently, he also serves as Director of Omni Hospital Pulomas since
August 2012. Previously, he served as Medical Staff Coordinator at Hospital Pantai Indah Kapuk (1998 -2008), Assistant Manager Clinic at Hospital Pantai Indah Kapuk (2009 - 2011) and Deputy Director of MedicalPulomas OMNI Hospital (2011 - July 2012).
Dr. Maria Theresia Yulita Director An Indonesian citizen, appointed as Director since October 2012. She holds General Practitioner degree fromTarumanagara University in 1993, Medical Professional Education from Airlangga University, Surabaya in 1994.Currently, she also serves as Director of Omni Hospital Alam Sutera, Tangerang since 2011 and as Director ofPT Sarana Meditama International, Tangerang since September 2011. Previously, she served as Doctor ClinicHotel Aston Atrium (1994 - 1996), Manager Medical Support at Mitra Kemayoran Hospital, Jakarta (1997 -1998), Doctor of Physician Health Center (Puskesmas) in PKM West Kedaung, Tangerang (1998 - 2001),Director of PT Cipta Publika Home (November 2002 - April 2009), Director of Omni Hospital Pulomas (2007 -2011) and as Director of PT Sarana Meditama Metropolitan (2009-2011).
Hassan Themas Non AffiliatedDirector
An Indonesian citizen, appointed as Non Affiliated Director since 2012. He studied at TarumanagaraUniversity, Jakarta majoring Accounting (1985 - 1989). Previously, he served as an Assistant in the Office ofPublic Accountants Drs. Johan Malonda & Partners (1989 - 1990), Public Accountant Prasetio Utomo & Co.
(1991-1995), Group Corporate Finance Manager of Surya Dumai Group (1995 - 1997), Director Uniseraya Group(1998 - 2002), Country Financial Controller Phillips Foods Asia Inc (2003 - 2007), Director of PT
Keramika Indonesia Assosiasi Tbk (2008 - 2011).
Source: Company data
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17
APPENDIX II Contd
II.2 Facility and Equipments
SMM SMI
Source: Company data Source: Company data
II.3 Five Centers of Excellent
Orthopedics Center Kawasaki Center
Source: Company data Source: Company data
Neurosurgery Center
Source: Company data
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18
APPENDIX II Contd
II.3 Five Centers of Excellent Contd
Cardiology Center Urology Center
Source: Company data Source: Company data
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PT Lautandhana SecurindoWisma KEIAI 15thFloor
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Tel : +6221 5785 1818Fax : +6221 5785 1717
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