en trimegah cf 20151023 silo

October 23, 2015

Siloam Hospitals
Company Focus

Patricia Gabriela
(patricia.gabriela@trimegah.com)

Reaching the Top
Initiate coverage on SILO with BUY
We initiate SILO with a Buy rating as company has been able to deliver
a strong double-digit top line growth. Supported with its network across
Indonesia (20 hospitals and 17 clinics in total), we believe SILO will
have more upside in terms of patient volume that translates to a promising top line growth. The industry is still underpenetrated; and with
MIKA already priced in, we think that SILO might catch up the laggard.
Aggressive hospital development: 4 hospitals per year
SILO managed to add 4-5 hospitals per year in last four years to its
hospital group through greenfield and acquisition. We forecast SILO to
add another 4 hospitals/year (lower than company’s guidance of 8-10
hospitals), but only 1 hospital for 2015F due to delay in permit. We view
that our hospital expansion forecast is still realistic considering the historical data and construction progress of some hospitals.

Positive growth from BPJS program
SILO has recorded robust patient volume growth with 18% CAGR 201214. In 2014, patient from BPJS program contributes 6% to total patient
volume albeit only 7 hospitals registered. Given hospital business’ high
operating leverage and SILO’s currently low occupancy rate, enrolling in
BPJS program makes sense as it should improve asset turnover and
therefore ROE (ROE to rise from 7% in 2015 to 11% in 2017).
Asset-light business model
In order to be able to ramp up its expansion plan, SILO uses light-asset
business model for its greenfield expansion. SILO does not own majority
of land and building of its hospitals. Of 20 hospitals, 12 is rented, 4 is
owned, and 4 is rented from 3rd parties. SILO’s rental expense is ~3%
of net revenue.
Valuation: BUY with TP of Rp 15,500
We recommend SILO at Rp 15,500 using DCF method (WACC of 10%,
LTG of 3%). Our TP implies 2016-17F EV/EBITDA of 28.1x and 23.8x
respectively.

Siloam Hospital Group is the leader of integrated healthcare services in Indonesia. It operates 20 hospitals in total with
more than 3,900 bed capacity.


Buy

Rp 15,500

Company Update
Share Price
Sector
Price Target

Rp 12,300
Healthcare
Rp 15,500 (+26%)

Stock Data
Reuters Code
Bloomberg Code
Issued Shares
Mkt Cap. (Rpbn)
Avg. Value Daily 6
Month (Rpbn)

52-Wk range

SILO.JK
SILO.IJ
1,156
14,220
49.1
17100 / 11275

Major Shareholders
PT Megapratama Karya Persada

60.5%

Public

29.5%

Consensus
Core EPS

Consensus (Rp)
TRIM vs Cons. (%)

16F
138
-4.3

17F
182
-24.3

Companies Data
Year end Dec

2013

2014

2015F


2016F

2017F

Net Sales (Rp bn)
EBITDA (Rp bn)
Net Profit (Rp bn)
EPS (Rp)
EPS Growth (%)
DPS (Rp)

1,847
220
50
48
-6%
-

2,472
455

63
54
14%
-

3,123
528
114
99
82%
5

4,013
630
160
138
40%
10

5,104

746
210
182
31%
21

BVPS (Rp)
EV/EBITDA (x)
P/E (x)

1,565
55.8
255.6

1,430
30.4
225.0

1,515
26.3

123.3

1,644
22.0
87.9

1,805
18.6
67.1

0.0

0.0

0.0

0.1

0.2


Div Yield (%)

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Stock Price
Avg . 5 Day MA Trading Value (RH S )
18,000

P rice (LHS )
( Rpbn )
0.4

16,000

0.3

14,000
0.3

12,000

10,000

0.2

8,000

0.2

6,000

0.1

4,000
0.1

2,000

0.0

O ct-14


De c-14

Feb -15

Ap r-15

Jun-15

Au g -15

COMPANY FOCUS

O ct-15

1

Hospital network across Indonesia
In 1H15, SILO operates 20 hospitals across Indonesia. Management targets to have more than 50 hospitals by
2017F with 8-10 hospital expansion per year. However, we are being realistic as we forecast company to add 4
hospitals per year. In 2015F, we assume SILO to add only 1 hospitals as management confirmed that they’re
lagging in hospital development due to problem in license. Once license has released, company is ready to open
its hospital in Yogyakarta. Aside from hospitals, SILO also operates 17 clinics that serves as a feeder for BPJS
patients.

Figure 1. SILO’s hospital network

Source: TRIM Research

In order to differentiate its hospital from others, SILO established center of excellence in each of its hospitals.
Moreover, SILO acquired BIMC Kuta and BIMC Nusa Dua in 2013 to achieve medical tourism. These hospitals are
well known with Australian tourists, thus can support SILO’s vision. In 1H15, distinct market segment (incl. BIMC
Kuta and BIMC Nusa Dua) contributes 14% to SILO’s total patient volume.
As of now, SILO has the biggest number of operational bed in Indonesia with 29% CAGR 2011-14.

Figure 2. SILO’s operational beds
6,000
4,978

5,000
3,928

4,000

3,078

3,000
1,533

2,000
1,000

1,985

2,397

857

2011

2012

2013

2014

2015F

2016F

2017F

Source: TRIM Research

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COMPANY FOCUS

2

Figure 3. SILO’s hospital group
Hospitals

Centre of Excellence

Mature:
Lippo Village

Cardiology, Neuroscience, Orthopedics, Emergency

Kebon Jeruk

Urology, Orthopaedic, Cardiology, Emergency

Surabaya

Fertility treatment, Cardiology, Emergency

Cikarang

Occupational health, Emergency

Balikpapan

Orthopedics, Emergency

MRCCC Semanggi

Cancer, Liver, Emergency

Developing:
Jambi

Emergency

Manado

Emergency

Makassar

Cardiology, Endocrinology, Emergency

Palembang

Gastroenterology, Emergency

Bali

Treatment for tourists, Orthopedics, Cardiology, Emergency

TB Simatupang

Cardiology, Oncology, Neuroscience, Emergency

New hospitals:
Purwakarta

Emergency

Medan

Trauma, Emergency

Kupang

Emergency

Distinct market segment hospitals:
RSUS

Emergency

Cinere

Cardiology

BIMC Kuta

Treatment for tourists, Emergency

BIMC Nusa Dua

Cosmetic surgery, Emergency

Asri

Urology

Source: TRIM Research

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COMPANY FOCUS

3

Figure 4. Number of operational beds comparison
Ramsay Sime Darby Health Care
Sari Asih Group
Awal Bros Group
MIKA
SILO
-

500

1,000

1,500

2,000

2,500

3,000

Source: TRIM Research

One stop care for primary, secondary, tertiary, and quaternary levels
By primary, means SILO provides clinics for corporate clients and gateway to Indonesia’s “Universal Healthcare
Coverage” as well as Government Health Insurance Program. As in 1H15, 11 of SILO’s hospitals participates in
BPJS program. SILO eagers to be best in class through rapid expansion of hospital network, attracting and retaining best doctors, and equip hospitals with latest technology. On top of that, SILO also develops integrated
centers of excellence and Digital Tele-Medicine.
As SILO serves all class levels, SILO has a higher revenue per patient compared to MIKA. We expect SILO to
hike its price by 2% CAGR 2015-20F (vs historical 2-6% CAGR 2012-14). The price increase is expected from a
more complex services. In 2011-12, SILO opened comprehensive cancer center and Indonesia’s first Gamma
Knife.
Regarding BPJS program, management stated that there is no problem in terms of payment. Once BPJS patient
has checked out from hospital, the documents related are collected and checked by verifiers. Management confirmed that the money can be received ~15 days after the document is verified.

Figure 5. SILO’s revenue per inpatient day
5.0

4.8

4.8

4.7
4.5

4.6

4.4

4.4
4.2

4.1

4.2

4.1

4.0
3.8
2011

2012

2013

2014

2015F

2016F

2017F

Source: TRIM Research

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COMPANY FOCUS

4

Figure 6. SILO’s revenue per outpatient
1.0
0.8

0.7

0.8

0.7

0.8

0.9

0.9

0.9

2014

2015F

2016F

2017F

0.6
0.4
0.2
2011

2012

2013

Source: TRIM Research

Lower occupancy rate due to new and developing hospitals
SILO has a slight lower occupancy rate at 53.9%, compared to MIKA at 63.6% in FY14. Need to remind that SILO has 4 mature hospitals, 12 developing, and 4 new; while majority of MIKA’s hospitals are considered as mature hospitals. (We base our mature assumption with >3 years of commencing).
A mature hospital tends to have higher occupancy rate; hence, better efficiency. We expect SILO to be able to
raise its occupancy rate overtime and a robust patient volume growth of 22% CAGR 2015-20F on the back of
more mature hospitals.

Figure 7. SILO’s hospital breakdown
Mature
35
30
25
20
15
10
5
-

Developing

New

4
2

4

4

10

4

10

8
4

12
4

2013

2014

13
7

12

16

2015F

2016F

2017F

Source: TRIM Research

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COMPANY FOCUS

5

Financials

Figure 8. Income statement
Income estimate (Rp bn)
Total patient volume:

2013

2014

2015F

2016F

2017F

1,383,973

1,726,217

2,086,936

2,584,345

3,156,313

369,409

471,775

580,469

731,391

914,239

1,014,564

1,254,442

1,506,467

1,852,954

2,242,074

Per inpatient days

4.1

4.4

4.5

4.7

4.8

Per outpatient visits

0.8

0.8

0.9

0.9

0.9

Gross sales:

2,504

3,341

4,209

5,404

6,864

Inpatient

1,541

2,060

2,638

3,424

4,409

963

1,280

1,570

1,980

2,455

(1,845)

(2,389)

(3,054)

(3,909)

(4,946)

Doctors fee, salary and employee benefits

(848)

(1,107)

(1,439)

(1,842)

(2,358)

Drugs and medical supplies

(621)

(786)

(1,009)

(1,296)

(1,646)

Depreciation charges

(150)

(186)

(201)

(219)

(241)

Clinic supplies

(75)

(90)

(99)

(108)

(119)

Food and beverage

(45)

(53)

(57)

(88)

(124)

Outchecking expense

(36)

(55)

(69)

(86)

(108)

(9)

-

-

-

-

(61)

(112)

(180)

(270)

(351)

1,847

2,472

3,123

4,013

5,104

659

952

1,224

1,581

2,026

79

134

184

255

333

220

455

528

630

746

50

63

114

160

210

Inpatient days
Outpatient visits

Revenue (in mn Rp):

Outpatient

COGS:

Repairs and maintenance
Others

Net sales

Gross profit

EBIT

EBITDA

Net profit
Source: TRIM Research

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COMPANY FOCUS

6

We forecast SILO to post 25% net profit CAGR in 2015-18F as the group’s hospitals maturing. Note that we assume BPJS business will not hurt SILO’s margin (BPJS business is 8% of revenue). Company has assigned a case
manager to keep track of BPJS patient in order to manage their ALoS (Average Length of Stay) low. Management
stated that they will suffer no loss as long as ALoS for BPJS patient under 4 days.

Figure 9. Margin outlook (%)
2013
Gross profit

2014

2015F

2016F

2017F

35.7%

38.5%

39.2%

39.4%

39.7%

4.1%

6.8%

7.0%

7.2%

7.2%

11.9%

18.4%

16.9%

15.7%

14.6%

Pretax profit

3.9%

3.8%

5.6%

6.1%

6.4%

Net profit

2.7%

2.5%

3.7%

4.0%

4.1%

Operating profit
EBITDA

Source: TRIM Research

Figure 10. Balance sheet
Rp bn

2013

2014

2015F

2016F

2017F

Cash

515

280

243

256

248

Receivables

271

393

419

539

685

Inventories

95

106

125

161

203

1,402

1,589

1,717

1,960

2,290

317

476

467

467

467

2,601

2,844

2,971

3,382

3,893

Loan

447

462

462

662

912

Payables

164

193

221

283

359

Others

351

535

535

535

535

Total liability

962

1,190

1,219

1,481

1,806

1,639

1,654

1,752

1,901

2,087

Fixed assets
Others
Total assets

Total equity
Source: TRIM Research

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COMPANY FOCUS

7

Valuation
We initiate SILO with a BUY rating at target price of Rp 15,500, +26% upside from current price. We like SILO as
company managed to deliver double digit top line growth and continue to serve a strong growth on the back of
its aggressive hospital development and participation in BPJS program. We derive our target price using DCF
method assuming a WACC of 10% and LT growth rate of 3%.
Our TP implies 2016-17F EV/EBITDA of 28.1x and 23.8x. This is a 38% discount to MIKA (SILO’s only actively
traded peer in JCI), respectively. We view the discount should narrow as SILO delivers on its growth promise.

Figure 11. DCF calculations
2017F

2018F

2019F

2020F

2021F

2022F

2023F

2024F

2025F

EBIT

333

441

557

837

1,084

1,506

1,871

2,306

2,821

EBIT (1-T)

213

282

356

534

692

961

1,195

1,472

1,802

Depreciation

412

457

510

574

651

744

855

987

1,147

Net working capital

306

455

642

887

1,111

1,389

1,711

2,096

2,557

Capex

(742)

(891) (1,069) (1,282)

(1,539) (1,847) (2,216)

(2,659) (3,191)

FCFF (Rp bn)

190

303

440

713

916

1,248

1,545

1,897

2,315

Discounted FCFF

190

275

361

530

617

761

854

950

1,050

Terminal value

32,277

PV of terminal value

13,263

Total company value

18,850

Net debt

728

NAV

18,122

NAV / share

15,675

Source: TRIM Research

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COMPANY FOCUS

8

Income Statement (Rpbn)

Balance Sheet (Rpbn)

Year end Dec

2013

2014

2015F

2016F

2017F

Net Revenue
Revenue Growth

1,847
45.0%

2,472
33.9%

3,123
26.3%

4,013
28.5%

5,104
27.2%

659

952

1,224

1,581

2,026

76

168

218

289

367

220

455
106.2%

528
16.1%

630
19.3%

746
18.3%

(7)

(40)

(9)

(9)

(9)

Gross Profit
Opr. Profit
EBITDA
EBITDA Growth (%)
Net Int Inc/(Exp)

Year end Dec

2013

2014

2015F

2016F

2017F

Cash and equivalents

515

280

243

256

248

Other curr asset

392

561

607

761

951

1,402

1,589

1,717

1,960

2,290

291

414

404

404

404

2,601

2,844

2,971

3,382

3,893

Net fixed asset
Other asset
Total asset
ST debt

17

16

16

16

16

Other curr liab

279

462

491

553

628

Gain/(loss) Forex

-

-

-

-

-

Other Inc/(Exp)

3

(34)

(34)

(34)

(34)

LT debt

430

446

446

646

896

72

94

174

246

324

Other LT Liab

236

266

266

266

266

(22)
0

(34)
(3)

(63)
(3)

(89)
(3)

(117)
(3)

28

5

(4)

(4)

(4)

962

1,190

1,219

1,481

1,806

Extra. Items
Reported Net Profit

50

60

111

157

207

1,639

1,654

1,752

1,901

2,087

Core Net Profit

50

63

114

160

210

(69)

182

219

406

664

2,305

2,366

2,464

2,813

3,249

Pre-tax Profit
Tax
Minority Int.

Minority interest
Total Liabilities
Shareholders Equity
Net debt / (cash)

-1.2%

25.5%

82.4%

40.3%

31.1%

Total cap employed

Dividend per share

-

-

5

10

21

Net Working capital

612

363

343

449

555

growth (%)

-

-

-

82.4%

110.4%

Debt

447

462

462

662

912

Dividend payout

-

-

10%

10%

15%

2013

2014

2015F

2016F

2017F

35.7%

38.5%

39.2%

39.4%

39.7%

4.1%

6.8%

7.0%

7.2%

7.2%

11.9%

18.4%

16.9%

15.7%

14.6%

Core Net Margin (%)

2.7%

2.5%

3.7%

4.0%

4.1%

ROAE (%)

5.3%

3.8%

6.7%

8.8%

10.5%

ROAA (%)

2.4%

2.3%

3.9%

5.0%

5.8%

Growth (%)

Cash Flow (Rpbn)
Year end Dec
Net Profit
Depr / Amort
Chg in Working Cap
Others
CF's from oprs
Capex

Key Ratio Analysis

2013

2014

2015F

2016F

2017F

50

63

114

160

210

Profitability

142

321

344

375

412

Gross Margin (%)

(2)

(100)

(17)

(93)

(114)

43

(157)

-

-

-

189

284

441

443

508

(386)

(331)

(472)

(618)

(742)

-

-

(6)

(11)

(24)

Others

(375)

(179)

-

(0)

-

CF’s from investing

(761)

(511)

(478)

(630)

(766)

CF’s from financing

904

(8)

-

200

Net cash flow

333

(234)

(37)

Cash at BoY

169

515

515
(479)

Dividend

Cash at EoY
Free Cashflow

Year end Dec

Opr Margin (%)
EBITDA Margin (%)

Stability
3.1

1.8

1.7

1.8

1.9

Net Debt to Equity (x)

(0.0)

0.1

0.1

0.2

0.3

250

Net Debt to EBITDA (x)

(0.3)

0.4

0.4

0.6

0.9

13

(8)

Interest Coverage (x)

4.0

3.0

9.1

12.1

15.3

280

243

256

Efficiency

280

243

256

248

A/P (days)

48

43

39

37

38

(19)

90

112

190

A/R (days)

45

49

47

44

44

Inventory (days)

26

24

22

21

22

Interim Result (Rpbn)

Current ratio (x)

Capital History

2Q14

3Q14

4Q14

1Q15

2Q15

Sales

602

624

926

732

746

Gross Profit

218

236

285

307

259

EBITDA

100

147

106

145

140

Opr. Profit

33

34

55

75

62

Net profit

20

7

8

34

28

Core profit

19

8

8

35

28

Gross Margins (%)

36.3%

37.7%

30.8%

41.9%

34.8%

EBITDA Margins (%)

16.6%

23.5%

11.5%

19.8%

18.8%

Opr Margins (%)

5.4%

5.4%

5.9%

10.2%

8.3%

Net Margins (%)

3.3%

1.1%

0.9%

4.6%

3.8%

Core Margins (%)

3.2%

1.3%

0.9%

4.7%

3.7%

PT Trimegah Securities Tbk - www.trimegah.com

Date
12-Sept-13

IPO@Rp9,000

COMPANY FOCUS

9

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