Response to Official
Request for Proposal
Citrus County Hospital
Board
PREPARED FOR:
DECEMBER 31, 2012
Partners…Perspective
10 Cadillac Drive, Suite 440
Brentwood, TN 37027
www.ponderco.com
T (615) 690-5540
F (615) 613-0217
300 Park Boulevard, Suite 200
Itasca, IL 60143
www.healthcarefutures.com
T (630) 467-1700
F (630) 467-1701
December 31, 2012
The Citrus County Hospital Board of Trustees
P.O. Box 1030
Inverness, FL 34451
Dear CCHB Trustees:
Ponder & Co. (Ponder) and Health Care Futures (HCF) are pleased to submit our proposal to
assist Citrus Memorial Health System (CMHS) with completing the requirements of Florida
House Bill 711.
We understand that the governing body of a public hospital must undertake a process to
determine whether it is more beneficial to taxpayers and the affected community for the hospital
to be operated by a governmental entity, or whether the hospital can be operated by a not-forprofit or for-profit entity with similar or better cost-efficiencies or measurable outcomes. The
comparison must also determine whether there is a net benefit to the community to operate the
hospital as a not-for profit or for-profit entity and use the proceeds for economic development in
the community.
We have structured our response in the format requested in your November 15, 2012, Request
For Proposal. The numbers in parenthesis throughout the document correspond to the
numbered labeling in your Request For Proposal. Ponder is the primary party responsible for
the contract and its details and will utilize HCF to complete certain components of the study.
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Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 2
Partners…Perspective
Section I – Management Summary (3.3)
General Information
Ponder and Health Care Futures together provide exceptional and seamless service to our
clients. Senior principals in both companies have a more than 30 year history in working
together.
Ponder’s strong strategic options assessment, deep merger, acquisition and divestiture
experience and objectivity in fairness opinions overlaps with the core capabilities of HCF’s in a
way that creates outstanding planning, execution and end/post transaction experiences for our
clients.
Strategic Options
Assessment
M&A Transactions,
Divestitures
Fairness Opinions for
Facilities-Based M&A
Valuation Services
Partnerships/JV’s
Capital Formation
Healthcare Real Estate
Board and
Special Committee
Assignments
PLANNING
EXECUTION
Strategic Planning
M&A Facilitation
Financial Analysis
Business Case
Development
Feasibility Studies
Physician Services
END OR POST
TRANSACTION
Physician Practice
Fairness Opinions
Board and
Special Committee
Assignments
Ponder & Co. Overview
Founded in 1974, Ponder is an independent financial advisory company owned and directed by
its employees who are involved in the day-to-day activities of the company. There is no outside
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Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 3
ownership interest or control of Ponder that might influence our ability to deliver objective advice
to our clients.
Ponder is the nation’s leading financial advisor to the not-for-profit hospital and related
healthcare services industry. We assiduously guard our independence and objectivity by acting
only as financial advisor and remaining free of conflicts of interest. Ponder is a service oriented
firm offering specialized expertise in product lines that serve not-for-profit hospital and
healthcare systems. Ponder’s client base includes over 250 healthcare institutions nationwide.
Ponder has 22 professionals with offices located in eight states: Connecticut, Colorado, Florida,
Illinois, Maryland, New Jersey, Tennessee and Washingston. Memebers of our Chicago, IL and
Nashville, TN offices will be involved in this engagement.
Ponder’s specialized expertise covers three broad areas: Mergers & Acquisitions, Capital
Planning & Advisory, and Capital Markets.
Mergers & Acquisition
Capital Planning & Advisory
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December 31, 2012
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Capital Markets
Ponder’s M&A Group was founded in 1999 and is staffed by professionals with combined
experience in excess of 70 years. Since the beginning of 2008, Ponder’s M&A Group has been
engaged by 25 different healthcare clients in 16 states. Our engagements include buy-side and
sell-side work, fairness opinions, valuations, strategic options assessments and real estate
transactions. Our M&A Group solely focuses on health care facilities, including acute care and
specialty care hospitals, senior housing facilities and ambulatory care facilities. We have
provided advisory services in connection with the sales of some of the largest healthcare
systems in the not-for-profit sector of the industry, including Health Midwest (Kansas City),
Hillcrest Healthcare System (Tulsa), and Mercy Health Partners (Knoxville). The combined
purchase price and capital commitments for each of these three transactions ranged from $1.5
billion to $500 million.
The M&A group has extensive valuation experience working with non-for-profit hospitals and
healthcare systems across the country. We have completed two valuations related to HB711.
Further details on our valuation experience and HB711 work are included in Section III B.
Health Care Futures Overview
Founded in 1996 with offices in Itasca, IL and Edina, MN where our 20+ partners and
consultants reside, HCF meets the needs of health care executives and Board members for
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Proposal for Services Related to Florida House Bill 711
December 31, 2012
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innovative business advice. The team for this engagement would be based out of the Itasca
office.
Our clients include elite pace-setters in the industry, as well as other health care organizations
less well known but no less ready to assert themselves in their markets. Our client base
includes integrated delivery systems, academic medical centers, larger free-standing hospitals,
single- and multi-specialty physician group practices and managed care and health insurance
companies.
HCF offers its clients a depth of experience and functional expertise not found within most
health care consulting firms. We view ourselves as expert planners, but also as change agents
within client organizations and the markets within which they compete. We pride ourselves on
helping organizations through difficult decisions and seeing engagements through to full
implementation in the following areas:
Strategic Planning
• Business Strategy
Development/Evaluation
• System Integration/
Realignment
• Service Line and New Product
Development
• Ambulatory Planning/Site
Development
• Managed Care Positioning
Financial Analysis
H ea l t h
Car e
F u t u r es ’
Ser v ic es
Physician Services
• Physician Resource Planning
• Group Practice Formation/
Mergers
• Hospital-Employed Group
Practice Turnaround
• The Next Generation of IPA
Development and
Management
• Development of New Business
Opportunities
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December 31, 2012
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• Analysis of Strategic/Service
Line Initiatives
• Financial Feasibility Studies
• Financial Performance
Improvement
• Physician Compensation/
Practice Valuation
• Incentive-Based Modeling
Consolidation Planning
Mergers/Acquisitions
• Facilitation/Representation
• Business Case Development
• Community Benefit
Assessment
• Governance/Management
Design
• Guidance of Legal Drafting
• Stakeholder Education and
Communication
• Service Rationalization Planning
and Implementation
• Hospital Closure Assistance
• Market/Physician/Capacity
Modeling
• Program Sizing
• Volume/Financial Impact
• Facilitation/Implementation
• Decision Processing
High-Level Approach to the Proposed Action Including an Outline Plan
January
Week of:
7
14 21 28
February
4
11 18 25
March
4
11 18 25
April
1
8
15 22 29
Issue data request
Conduct analyses
Review draft report with management
Finalize report
Issue final report
Conduct two meetings with Board of Trustees
Summary of Services
Ponder and HCF will complete all the steps needed as outlined in the chart above to deliver the
following items:
•
Valuation analysis
•
Operating cost comparison
•
Quality comparison
Fixed Price Cost
The fixed fees associated for completing the work are $185,500, which includes $10,000 to
cover travel and other related expenses.
Section II – Proposed Solution (3.4)
In this section we have identified the methodology, project plan, and key deliverables for each
component, as well as the firm responsible.
Methodology - Valuation Analysis – Ponder
Ponder will conduct a valuation analysis (the “Valuation Assignment”) of the business
operations of CMHS to determine its fair market value. The Valuation Assignment will be
subject to the terms of this Agreement and shall consist of the following elements:
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Proposal for Services Related to Florida House Bill 711
December 31, 2012
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1. Data Analysis
Ponder will conduct an analysis of relevant historical, budgeted and projected financial
statements, historical and projected facility utilization data, strategic plans, capital budget
and any other pertinent information relating to the Valuation Assignment. For the Valuation
Assignment, CMHS shall provide a five-year projection of financial and utilization data,
including annual statements of operations and financial position. Such projections and other
information provided by CMHS relating to the CMHS business operations may only be used
by Ponder in connection with this engagement.
2. Industry Analysis
Ponder will conduct an analysis of publicly held healthcare companies to assess the value of
going-concern companies in relation to the cash flow and revenue of those companies, and
apply that information to the cash flow and revenues of the CMHS operations.
3. Comparison of Similar Transactions
Ponder will perform an analysis of sales of healthcare facilities of comparable nature and
situation, if available; based on known sales prices, Ponder will determine the appropriate
multiples of cash flow and revenues of the facilities and apply that information to the CMHS
operations.
4. Discounted Cash Flow Analysis
Ponder will prepare an analysis of the present value of the projected cash flow of the
operations of CMHS based on the financial projections prepared by CMHS management.
Ponder will not provide such analysis of the individual hospitals of CMHS.
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December 31, 2012
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5. Net Proceeds Analysis
Ponder will perform an analysis of the likely cost to satisfy all liabilities of the business
operations being valued, including an estimate of the likely net proceeds to CMHS if the
business operations were to be conveyed at the indicated value.
Methodology - Operating Cost Comparison – HCF
HCF will be responsible for the operating cost comparison component. This is regularly
assessed as part of strategic and financial plans for our clients.
1. HCF will issue a data request for historical audited financial statements, financial projections
and historical community benefit reports.
2. HCF will identify a representative, statewide peer group, including both for-profit and not-forprofit, based on size and overall services and complexity. In addition to a statewide peer
group, we will also identify local competitors for comparison.
3. HCF will then obtain the most recent available data from the Agency for Healthcare
Administration to calculate a CMI-adjusted operating expense per adjusted admission.
4. HCF will also evaluate bad debt and charity care as a percent of gross charges for all of the
hospitals to help frame potential challenges CMHS faces.
5. HCF will obtain historical millage rates and gross tax levies from the local county appraisers
to include as part of the operating comparison.
6. HCF will conduct an analysis that demonstrates community benefit in comparison to net
taxes collected.
7. After the analysis has been completed, HCF will issue a draft report and then conduct a
review session with the appropriate audience prior to any finalization.
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December 31, 2012
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8. Once this review session has been conducted, a final report will be issued and HCF will be
available to the Board of Trustees and the required public hearing of the results of our work.
Methodology - Quality Comparison – HCF
HCF will be responsible for the quality comparison component. Similar to the operating
comparison, we utilize CMS information to help frame the situational assessment portions of our
strategic planning engagements. In addition to CMS data, we regularly compare variation in
length of stays across certain DRGs to help gauge performance. .
1. HCF will compare CMHS to its statewide and local peer groups using information from the
Centers for Medicare and Medicaid Services (CMS) available. The analysis will include the
following example metrics:
a. Process of Care Aggregate Scores:
i. Heart attack or chest pain
ii. Heart failure
iii. Pneumonia
iv. Surgical care improvement
b. Outcomes for Heart Attack, Heart Failure and Pneumonia patients:
i. 30-day mortality rates
ii. 30-day readmission rates
c. Hospital Consumer Assessment of Healthcare Providers & Systems measures for
communication and overall satisfaction
2. In addition to the information available at the CMS website, HCF will issue a data request to
obtain historical quality measures CMHS has recorded. This information will be reviewed to
determine whether CMHS has more to tell in its quality improvement story than the publicly
available information.
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December 31, 2012
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3. After the analysis has been completed, HCF will issue a draft report and then conduct a
review session with the appropriate audience prior to any finalization.
4. Once this review session has been conducted, a final report will be issued and HCF will be
available to the Board of Trustees and the required public hearing of the results of our work.
Project Plan
Below is a chart presenting the projected project plan assuming the Citrus Memorial Hospital
Board of Trustees notifies successful bidder the first week in January.
January
Week of:
7
14 21 28
February
4
11 18 25
March
4
11 18 25
April
1
8
15 22 29
Issue data request
Conduct analyses
Review draft report with management
Finalize report
Issue final report
Conduct two meetings with Board of Trustees
Key Deliverables
A final report will be prepared in PowerPoint presenting key findings from analyses. The main
components will be (per section 1.12 of RFP):
•
Citrus Memorial Hospital’s fair market value
•
Operating cost comparison
•
Quality comparison
Time-Scale for Completion
The final report with key deliverables will be completed by March 14, 2013. Furthermore,
Ponder and HCF will be prepared for two meetings with the Citrus County Hospital Board of
Trustees in April 2013 to report all findings.
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 11
Section III – Project Management (3.5)
The Citrus County Hospital Board must nominate two Project Manager(s) with overall
responsibility and authority for this project. Ponder and HCF will report to Citrus County
Hospital Board Project Manager.
The nominated project manager for this proposal will be Eb LeMaster, managing director at
Ponder. CV for Eb is provided at the end of this document.
Section IV – Costs (3.6)
The fixed price costs for this project will be $185,500. The allocation of costs between
professional and other fees (travel and other directs) are shown below. Ponder and HCF do not
charge based on daily rates, so no daily rates are provided.
Fee For Performing Work
$195,000
VHA Preferred Vendor Discount
($19,500)
Travel and Related Expenses
$10,000
Total Fixed Price:
$185,500
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Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 12
Section V – Bidder Information (3.7 – 3.16)
The Contact dealing with the proposal will be Eb LeMaster of Ponder. His general information is
as follows (3.7):
Eb LeMaster
Ponder & Co.
10 Cadillac Drive, Suite 440, Brentwood, TN
(e) elemaster@ponderco.com
(o) 615-690-5540
(f) 615-613-0217
Responsibility for Contract (3.7)
Ponder will be the party who will carry overall responsibility for the contract. HCF be a
subcontractor to Ponder.
Both Ponder and HCF accept the terms and conditions of the tender, as well as overall
responsibility for successful delivery.
Bidder’s Profile (3.8)
Ponder Team
Length of time in existence: 38 years
Number of employees: 28
Brief description of the company’s principal areas of activity:
Ponder is a service oriented firm offering specialized expertise in product
lines that serve not-for-profit hospitals and healthcare systems.
This
expertise has extended to over 250 healthcare institutions across the
United States.
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Proposal for Services Related to Florida House Bill 711
December 31, 2012
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Any additional information in support of this proposal:
Ponder’s M&A group has extensive valuation experience in the state of
Florida, working with clients such as Baptist Health South Florida,
Broward Health, Lee Memorial Health System, Memorial Healthcare
System and Munroe Regional Health system, some of which have been
multiple engagements. We completed the state’s first valuation
presentation related to HB711 for South Broward Hospital District
(Memorial Healthcare System) and delivered the report June 20, 2012.
Ponder also completed a similar valuation engagement for Lee Memorial
Health System and presented its report on December 6, 2012. The M&A
group will be working with at least one more health system for the HB711
valuation.
HCF Team
Length of time in existence: 16 years
Number of employees: 19
Brief description of the company’s principal areas of activity:
HCF focus is to meet the needs of health care executives and board
members with innovative business advice.
Any additional information in support of this proposal:
Once again, HCF offers its clients a depth of experience and functional
expertise not found within most health care consulting firms. We view
ourselves as expert planners, but also as change agents within client
organizations and the markets within which they compete.
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 14
We pride
ourselves on helping organizations through difficult decisions and seeing
engagements through to full implementation. HCF serves many of the
nation's leading community hospitals and regional health systems that are
positioning for success as health care shifts from a profitability to an
affordability paradigm. Health Care Futures enjoys a diverse health care
client base.
System size, geographical origin (nearly all 50 states),
ownership status and business perspectives of our clients are widely
varied.
Brief Profile of Key Personnel (3.8)
Ponder Team
Eb LeMaster:
•
Responsible for delivery of the final valuation report.
•
Has over 17 years of healthcare finance and investment banking experience.
•
Holds Bachelors and MBA degrees from Vanderbilt University
Duane Waugh:
•
Will lead analytical aspects of the engagement and deliver the final valuation report with
Eb LeMaster.
•
Has over 30 years of experience, focusing on valuation analysis for all of Ponder’s
engagements.
•
Holds a Bachelor’s degree from the University of Wisconsin and a MBA degree from the
University of Chicago.
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Proposal for Services Related to Florida House Bill 711
December 31, 2012
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HCF Team
Ed McGrath:
•
Responsible for delivery of the operating and quality comparison components.
•
Brings more than 25 years of health care consulting experience and leads HCF financial
planning assignments.
•
Holds a Bachelor’s degree in both Accounting and Business Administration from
Augustana College and a Master’s degree in Health Administration from St. Louis
University.
Lanny Lautenschlager:
•
Will lead the operating and quality comparison aspects of the assignment
•
Specializes in strategic planning, medical group operations, hospital-physician
integration models, and facility capacity planning.
•
Holds a Bachelor of Arts in Education degree with Business and Economics
endorsements from the University of Nebraska at Kearney and a Master of Health
Administration degree from Ohio State University.
Customer Base (3.9)
Ponder Team
Ponder generates over 95% of its revenues from advisory services to healthcare related entities.
In terms of our M&A group, over the past three years, over 25% of our assignments have been
either valuations or fairness opinions. In addition, approximately 20% of our engagements
during this period were strategic options assessments, which all include valuations.
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 16
Ponder provides valuation services as part of virtually all of our engagements: it is a cornerstone
of our work. Past clients in terms of fairness opinions and/or formal valuation include:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Multi-state Catholic Health System (PA)
Multi-state Catholic Health System (MI)
South Broward Hospital District (FL)
Lee Memorial Health System (FL)
SSM Healthcare (OK)
El Camino Hospital (CA)
Hospital Sisters Health System (IL)
Sentara Healthcare (VA)
Saline County Medical Center (AR)
Greater Baltimore Medical Center (MD)
Munroe Regional Health System (FL)
Saint Vincent Health System (PA)
Victory Health Services (IL)
Hillcrest Healthcare System (OK)
Montgomery General Hospital (MD)
•
•
•
•
•
•
•
•
•
•
•
•
•
•
RML Specialty Hospital (IL)
ProMedica Health System (OH)
Mercy Medical Center (IA)
Eastern Health System (AL)
Wythe County Community Hospital (VA)
Providence Health System (CA)
Baptist Health South Florida (FL)
Presbyterian Healthcare Services (NM)
Jewish Hospital of Cincinnati (OH)
Upper Chesapeake Health System (MD)
Sisters of St Francis Health Services (IN)
Carilion Health System (VA)
Orangeburg Regional Medical Center (SC)
DeKalb Regional Health System (GA)
HCF Team
Health Care Futures generates 100 percent of its revenues through consultative services to
health care-related clients (95 percent are non-profit hospitals and 5 percent are insurance
companies).
Below is a representative list of clients for which HCF has completed a relevant engagement for
in the past 3 years. In addition, HCF will begin a strategic planning engagement with a not-forprofit client in the greater Palm Beach County area at the beginning of 2013.
•
•
•
•
•
•
•
•
•
•
•
DeKalb Regional Health System (GA)
Elmhurst Memorial Healthcare (IL)
Mercy (MO)
OSF HealthCare (IL)
Christus Health (TX)
Franciscan Alliance (IL/IN)
Deaconess Health System (IN)
Edward Health System (IL)
HealthPartners (MN)
Southwestern Vermont Health Care (VT)
Memorial Health System (IL)
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 17
Financial Details (3.10)
Ponder & Co. is a small, privately held financial advisory company that has been in existence for
over 35 years. Our financial statements are not made publicly available. As mentioned later in
this document, we have provided similar work for other hospital districts in the state this year.
We are happy to respond to specific questions if needed.
Technical Capability & Tenderer Qualifications (3.11 & 3.14)
Ponder’s M&A group completed the state’s first valuation presentation related to HB711 for
South Broward Hospital District (Memorial Healthcare System) and delivered the report June 20,
2012. Ponder also completed a similar valuation engagement for Lee Memorial Health System
and presented its report on December 6, 2012. The M&A group will be working with at least one
more health system for the HB711 valuation.
HCF has provided relevant engagements to 10+ clients in the past three years. Additionally,
HCF will begin a strategic planning engagement with a not-for-profit client in the greater Palm
Beach County area at the beginning of 2013.
Quality Certification (3.12)
Our expertise and quality of services is addressed throughout this response. There are no
further details we need to provide in this section 3.12
Industry Standards (3.13)
Our expertise and quality of services is addressed throughout this response. There are no
further details we need to provide in this section 3.13
Tenderer Qualifications (3.14)
Competence and experience in providing similar services are discussed in sections 3.15 and
3.16.
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 18
Relevant Services (3.15)
Name of Organization
Services Provided
Value of Contract
Memorial Healthcare System
HB 711 Valuation
$50,000
Lee Memorial Health System
HB 711 Valuation
$75,000
Over the past three years, over 25% of Ponder’s M&A assignments have been either valuations
or fairness opinions. In addition, approximately 20% of our engagements during this period
were strategic options assessments, which all include valuations.
Specific Skills and Experience (3.16)
Ponder and HCF offer a combined 50 plus years of experience working in the health care
industry sector including specific engagements regarding to valuation analyses and operational
cost and quality comparisons. Furthermore, both Ponder and HCF have previously worked with
Palm Beach County area clients relative to HB711.
As mentioned in section 3.11 and 3.14 Ponder’s M&A group completed the state’s first valuation
presentation related to HB711 for South Broward Hospital District (Memorial Healthcare
System) and delivered the report June 20, 2012. Ponder also completed a similar valuation
engagement for Lee Memorial Health System and presented its report on December 6, 2012.
HCF has provided relevant engagements to 10+ clients in the past three years. Additionally,
HCF will begin a strategic planning engagement with a not-for-profit client in the greater Palm
Beach County area at the beginning of 2013.
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 19
Section VI – Key Personnel (3.17)
Both the Ponder and HCF teams have committed senior partners to this engagement. The
experience of the team members provided will be beneficial in the completion of the analyses
but also in the communication with the public, as required by HB 711.
Ponder Team
The proposed Ponder team includes:
•
Eb LeMaster, a managing director with Ponder, will be responsible for delivery of the
final valuation report, along with Duane Waugh. Eb has over 17 years of healthcare
finance and investment banking experience. He will coordinate and co-lead all internal
review sessions with management as well as lead external communications.
•
Duane Waugh, a managing director, will lead the analytical aspects of the engagement
and deliver the final valuation report with Eb LeMaster. Duane has over 30 years of
experience, focusing on valuation analysis in all of our engagements. He specializes in
the analytics behind looking at a hospital or health system’s financial performance, credit
characteristics, valuation, market situation and debt capacity.
In addition to the above individuals, we bring access to our full complement of staff and
valuation expertise for this engagement. CV’s with qualifications, employee backgrounds, and
key accomplishments for the above and other team members are provided at the end of this
document.
HCF Team
The proposed Health Care Futures team is included on the following page:
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 20
•
Ed McGrath, a founding Partner of Health Care Futures will be responsible for delivery of
the operating and quality comparison components. Ed brings more than 25 years of
health care consulting experience and leads Health Care Futures’ financial planning
assignments. Ed will lead all internal review sessions with management, as well as play
an active role in external communications.
•
Lanny Lautenschlager, a senior consultant in the firm since 2011, will lead the operating
and quality comparison aspects of the assignment, and be responsible for the day-today management of our staff resources. He will attend and participate in all internal
review sessions with management, as well as external communications.
CV’s with qualifications, employee backgrounds, and key accomplishments for the above HCF
team members are located at the end of this document.
Ponder will be the primary party responsible to manage this contract and details within. HCF
will be subcontracted by Ponder.
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 21
Section VII – Reference Projects (3.19)
Reference Project 1:
Reference 1 – Valuation for HB 711
Bill Wheatley, Treasurer, Memorial Healthcare
Name
System
3501 Johnson Street
Address
Hollywood, Florida 33021
www.mhs.net
Website
BWheatley@mhs.net
Telephone Number
(954) 265-5829
Sort Code
Reference 2 – Valuation for HB 711
Mike German, Executive Director - Finance, Lee
Name
Memorial Health System
PO Box 2218
Address
Fort Myers, Florida 33902
www.leememorial.org
Website
mike.german@leememorial.org
Telephone Number
Sort Code
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 22
(239) 242-6202

Thank you for the opportunity to be considered on this important assignment.
Very best regards,
Ponder & Co.
Edward B. (“Eb”) LeMaster III
Managing Director
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 23
Edward B. (“Eb”) LeMaster III, Managing Director
10 Cadillac Drive, Suite 440
Brentwood, TN 37027
Tel: (615) 690-5540
Fax: (615) 613-0217
Electronic Mail: elemaster@ponderco.com
Mr. LeMaster has over 15 years of investment banking and corporate development
experience. His corporate finance experience includes over 50 merger and
acquisition transactions, public equity and debt offerings, and private placements.
Background
Prior to joining Ponder & Co., he was Vice President of Development for Ardent
Health Services, a hospital management company with 12 acute care hospitals
and over 2,100 beds. Ardent was also one of the largest providers of inpatient
behavioral services with 20 hospitals and approximately 2,000 beds prior to the
sale of the division in July 2005. At Ardent, he focused on acute care and
behavioral acquisitions and worked extensively on the development of a physician
joint venture hospital, the consolidation of two hospitals, and the purchase, sale
and development of medical office buildings. Before joining Ardent, he spent eight
years in investment banking most recently as director with Robert W. Baird & Co.
He focused on M&A transactions, public equity and debt offerings and private
placements.
Mr. LeMaster holds Bachelors and MBA degrees from Vanderbilt University.
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 24
Duane W. Waugh, Managing Director
180 North Stetson Avenue, Suite 750
Chicago, IL 60601
Tel: (312) 377-2185
Fax: (312) 377-4943
Electronic Mail: dwaugh@ponderco.com
Mr. Waugh provides merger and acquisition advisory services to the healthcare
services industry. With 30 years of experience in analytical, research, advisory
and transaction services, he has served multi-hospital systems and individual
hospitals through his investment banking advisory work. Mr. Waugh focuses on
the financial performance, credit characteristics, market situation, debt capacity,
and market valuations of firms in the healthcare services industry.
Background
Prior to joining Ponder & Co. in 2000, Mr. Waugh was a vice president in the
healthcare investment banking group of US Bancorp Piper Jaffray and prior to that
with John Nuveen & Co. He holds a Bachelor’s degree from the University of
Wisconsin and a MBA degree from the University of Chicago.
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 25
EDWARD J. McGRATH, Partner
Health Care FUTURES L.P.
300 Park Boulevard, Suite 200
Itasca, IL 60143
Tel: (630) 467-1700 ext. 102
Fax: (630) 467-1701
Electronic Mail: e.mcgrath@healthcarefutures.com
Edward J. McGrath is a partner and founding principal of Health Care Futures
L.P., a strategy consulting company dedicated to superior strategic and
implementation support for leading regional health systems, academic medical
centers, physician practices, and health care associations. Health Care Futures
focuses on long-term relationships with a core group of clients, working as
partners in a successful team.
Ed specializes in physician relationships/partnerships strategic planning, mergers
and acquisitions, strategic direction of cardiology and oncology, service-line
strategy, clinical co-management, and financial analyses. Ed’s client base
includes, but is not limited to, integrated delivery systems; academic medical
centers; single- and multi-specialty physician group practices; and, managed care
and contracting organizations. His background includes 13 years with KPMG
where he spent the last 16 months of his KPMG career as a partner in the National
Health Care Strategy Practice.
Mr. McGrath has a Bachelor’s degree in both Accounting and Business
Administration from Augustana College. He earned his Master’s degree in Health
Administration from St. Louis University. He is an active speaker at various health
forums on topics such as strategic planning, mergers and acquisitions, physician
integration and managed care. He is a member of various fund raising
committees and boards including the Foundation Board of St. Joseph Hospital and
Health Centers. He is a member of the American College of Healthcare
Executives, the American Hospital Association, and the Healthcare Financial
Management Association among other health related organizations.
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 26
Key Accomplishments
•
Facilitated the affiliation of a
40-member physician clinic
and a community hospital;
•
Conducted valuations for
more than 30 physician
practices;
•
Performed strategic
planning for IPA
organizations;
•
Developed hospitalsponsored primary care
groups in various models
(employed, MSO, etc);
•
Assessed potential buyers
for various physician groups;
•
Directed strategic planning
for numerous health care
systems;
•
Conducted acquisition
analyses for cancer care
centers and ambulatory
surgery centers;
•
Led numerous acquisition
analyses for a major forprofit health system;
•
Performed numerous
financial and capital
planning studies for various
health providers; and
•
Facilitated more than 40
mergers, affiliations, and
acquisitions.
LANNY D. LAUTENSCHLAGER, Consultant
Health Care FUTURES L.P.
300 Park Boulevard, Suite 200
Key Accomplishments
Itasca, IL 60143
• Assisted in the development
Tel: (630) 467-1700 ext. 104
of a system-wide medical
Fax: (630) 467-1701
group that transitioned 350+
Electronic Mail: l.lautenschlager@healthcarefutures.com employed physicians from six
different groups into one
group with a unified board,
management structure, and
compensation plan.
Lanny Lautenschlager is a consultant at Health Care Futures L.P. He specializes
in strategic planning, medical group operations, hospital-physician integration
models, and facility capacity planning. During his career, Lanny has worked with a
variety of clients including both national and regional integrated health systems,
multi-specialty physician groups, and independent community hospitals. Lanny
joined Health Care Futures in 2011.
•
Facilitated accountable care
organization discussions
between an integrated health
system and an independent
multi-specialty medical group.
Background
•
Designed a methodology to
determine market
compensation for a 400physician multispecialty
group in support of
acquisition by a public safety
net hospital.
•
Developed a clinical capacity
and distribution model for a
multi-hospital system to
inform a $500 M capital
allocation process.
•
Completed market
assessments in support of
new hospital planning and
major facility expansions
•
Evaluated adjacent
geographies for a large
health system in order to
prioritize market expansion
initiatives.
Prior to joining Health Care Futures, Lanny worked at two different major national
health care consulting firms. He also worked at a large health system in
Columbus, Ohio and developed medical staff development plans and provided
analytical support to business development initiatives.
Lanny received a Bachelor of Arts in Education degree with Business and
Economics endorsements from the University of Nebraska at Kearney. Lanny also
earned a Master of Health Administration degree from Ohio State University.
CCHB Trustees
Proposal for Services Related to Florida House Bill 711
December 31, 2012
Page 27