瑞银美股医疗保健行业瑞银2019年Q2医院季度调查资本支出增长成本趋势降低201971551页

GlobalResearch15July2019UBSQuarterlyHospitalSurvey:2Q19UBSEvidenceLabinside:CapexGrowing,CostTrendsExceedinglyLowUBSEvidenceLabQuarterlyAcuteCareHospitalSurvey:Volume4UBSEvidenceLabsurveyed75hospitalexecutiveswithoversightacross159acutecarehospitalstogaugetrendsimpactingcostsandstrategicinitiatives.Accesstheevidencehere(link).Thisquarterlycross-sectornoteprovidesuniqueanddifferentiatedinsightacross90%ofindustry'scoststructure,expectationsforcapitalbudgets,outsourcingtrendsandkeyareasofstrategicfocus.ControllablecostsremainathistoricallylowlevelsWeanalyzeitemscomprising90%ofthehospitalsector'scoststructureandseeexpensegrowthinthe0%-2.5%rangefor2Q19whichcomparestoour2.5%-3.5%forecastandreinforcesourconfidencenotablyforHCA.Forecastedcostitemsareexpectedtofadeespeciallywagesandprofessionalfees.Ambulatory(urgentcare)andorthoremainhighprioritiessupportingTHC'sUSPIsegment.Surveydatasuggestshospitalspendinggrowing;areboundfromwave3Surveyresultsindicatea2.2%increaseinhospitalcapitalbudgetsonaverage,above0.8%fromWave3(3/19),andmodestlybelowthe2.6%and2.7%inWaves2and1,respectively.Mosthospitalsstillexpectbudgetstobeflatorup,withmorepositiveskewthanthepreviousWavesas~29%saidbudgetsaregoingupmorethanusualvs.20%.1Qcapitaltrendswererobustandwecontinuetoexpectstrongtrendsforcap-heavynamesincludingVAR(Buy),HRC(Buy),ISRG(Neutral),SYK(Neutral),MDT(Buy),andBDX(Neutral).WeseecontinuedprioritizationofradiologyasapositiveforPhilips(Buy)andSiemensHealthineers(Neutral-SebastianWalker).HospitalLabOutsourcingmorebalanced,value-basedramppositiveforPINCSurveyresultsindicateamorebalancedpictureofhospitallaboutsourcingvs.theAprilsurveyrun,with23%lookingtoexpanduseofreferencelabsvs.29%lookingtoexpandoutreachoperations(comparedtoa4%/31%outsource/insourceskewintheAprilsurveyandmoreinlinewithpriorsurveywaves).Thedataalsocontinuestosuggestthathospitalsexpecttoseeameaningfulincreaseinnetpatientrevenuestiedtovalue-based/risk-basedcareoverthenextseveralyears(morethandoublingby2025to36%/26%ofnetpatientrevenues),potentiallydrivingdemandforITsolutionsfromHCITvendorslikeBuy-ratedPremier(PINC).EquitiesAmericasHealthcareProvidersWhitMayoAnalystwhit.mayo@ubs.com+1-212-7133842MatthewTaylor,CFAAnalystmatthew-c.taylor@ubs.com+1-212-7136257KevinCaliendoAnalystkevin.caliendo@ubs.com+1-212-7133630YoungLiAnalystyoung.li@ubs.com+1-212-7132078AdamNobleAssociateAnalystadam.noble@ubs.com+1-212-713-9495BrettGasawayAssociateAnalystbrett.gasaway@ubs.com+1-212-7134820UBSQuarterlyHospitalSurvey:2Q1915July20192TableofContentsEXECUTIVESUMMARYINPICTURES...............................................3EXECUTIVESUMMARYINPICTURES...............................................4UBSEvidenceLabSurveyed75CEOsandCFOswithOversightover150Hospitals............................................................................5UBSEvidenceLabSurveyIndicatesHospitalsExpecttoMaintainStrongOperatingCostControls......................................................6CostTrendsandExpectationsbyLineItem..................................................8Costtrendsremainbrightspotforsector...................................................14OutpatientStrategies....................................................................29Urgentcareranksasthetopambulatoryfocusforhospitals......................29Post-AcuteStrategies.................................................................................30SurveyShowsGrowingNumberofActiveEvaluationsforBehavioralHealthJVs.............................................................................................................32PhysicianServicesOutsourcingStrategies...................................................33LabServices....................................................................................35LabOutreachBreakdownbyHospitalSizeandGeography.....................35Value-BasedReimbursement........................................................38ImpactonProviderStrategies.................................................................38Valueandrisk-basedcurrentandfuturepenetration..............................39GPOs................................................................................................42GPOBreakdownbyMarketShareandHospitalSize...............................42UBSEvidenceLabsupportsincreasedServiceUptake.............................43UBSQuarterlyHospitalSurvey:2Q1915July20193EXECUTIVESUMMARYINPICTURESAveragegrowthperadjustedadmissionforallsixoftheoperatingcostlineitemssurveyedhastrendedfromalowof-0.1%(malpractice)toahighof+2.4%(professionalfees).Whilemostcosttrendsareexpectedtoaccelerateonaveragenextyear,increasesremainve