Omnicell, Inc. (OMCL) Earnings Call Transcript & Summary

All right. Okay. Great. Good afternoon, and welcome to the continuation of day 1 of the Barclays Global Healthcare Conference. I'm Steven Valiquette, the health care services analyst here at Barclays. Our next session will be with Omnicell. And the stock has really been on a tear recently. It's really essentially doubled over the past 6 months or so. So I'm personally looking forward to hearing more about all the good things happening at the company in this session. So with us from the company, we have Randall Lipps, the company's Chairman, President, CEO and Founder; Peter Kuipers, the CFO; and also Kathleen Nemeth from Investor Relations. This will be a formal presentation. Before I turn it to Randall, let me turn it to Kathleen, I think, for a quick safe harbor, and then we'll dive into the presentation.

Thank you, Steve. Good morning, everyone, and thank you again for hosting us. We're delighted to be here. Before we get started, I do want to remind everyone that during the course of today's presentation, we may make forward-looking statements. Please be sure and review our most recent filings with the SEC for a full list of risks associated with those statements. With that, I'll turn the presentation over to Randall.

Thank you, Kathleen. And we're on an adventure. As we know, software and hardware are disrupting many industries right before our eyes. And health care is generally a lag, and the health care pharmacy is ripe for disruption and a model change, not just to change the way workflows work but really transform the industry. And that ultimate aim is to get to the Autonomous Pharmacy, the pharmacy that does all of the industrial backroom, processes and procedures that then frees up pharmacists to do all the clinical stuff. So we're going after all of the workflows and issues that really prevent pharmacists from fully working at the top of their license. And it's not a small amount, but it's a very large amount. Several studies show that 75% of what a big provider pharmacist does is all administrative. Paperwork, administrative, verification, counting, all things that are ripe for automation have already been automated in many industries. And so that really puts us up -- sets us up for this transformational moment in time, particularly over the next 5 years. As we see the light at the end of the tunnel, we see this moment in time when pharmacists won't be behind the counter, they won't be down in the basement, they will be connected, driving with clinicians, hopefully, face-to-face with patients and making the kinds of changes that really improve outcomes on a whole different level. And if this works the way we believe it will work, 200,000 pharmacists will be released from the day-to-day administration. And then the automation of these processes will then be done at near perfection every single time. But we have a lot of problems in pharmacy. And let's just think, an academic pharmacy location like Stanford, near my home. In the Stanford U.S. academic hospital, they've got 1,000 beds, they have 500 employees in the pharmacy. About half of those are pharmacists and half are techs. And a lot of the work that's going on is revolving around workflows that really are antiquated, haven't been automated and require human intervention. Kathleen, if can you go to the next slide or -- can you do that for me? Beautiful. And these intervention are gaps, as we go into these pharmacies, are filled by human beings, usually pharmacists, sometimes techs. And everywhere you have a manual process, you create an issue of errors because humans are not perfect. And those errors then result into other issues of safety, poor outcomes, poor financial outcomes and not meeting regulatory compliance, which is a constant battle, right? The opioid crisis in the last 2 years has created a whole other layer of administration and requirements that fall heavily onto the pharmacy. How are those things going to be met without more people, more intervention in these processes to ensure that those regulations are met. So the opportunity is enormous. And we're going to apply and are applying, obviously, hardware with embedded software to move things around, to verify things, to take over some of these manual tasks. IV robotics is a perfect example. You compound or mix items in an IV bag or a syringe. And if you do that 1,000 times with a human being, about 3 of those will have some kind of error. You do it 1,000 times with a robot, you probably have 0 errors. So those are the kinds of things that people understand and should expect from their health care system. A pharmacy should be running at near perfection. And medication management, of course, is everywhere in health care. You can't practice medicine without medication management. So it's just not in these big providers, which are, of course, in acute care and surgery centers and ambulatory care, but also moving toward the home. You see a lot of these kinds of things that require us to think about how do we make sure -- how do we make absolutely sure that we get the right med to the right person at the right time and it's available. And boy, the pandemic really showed us that we didn't have a good understanding of what meds we had, and we couldn't get them to the people who needed them at that moment, particularly early on in the pandemic. So this creates a huge opportunity, many gaps, many areas for us to automate, to move to the cloud. Of course, the cloud will give us unlimited compute power, unlimited storage power and almost unlimited bandwidth. And that allows us to solve problems that have not even been solvable in the past. And that's where we are as a company and our mindset. And the team at Omnicell are just so excited about getting to this end. In the next 5 to 10 years, we are going to transform pharmacy, and it's just going to be totally different than the way it is. But it's just not our idea. This Autonomous Pharmacy is just not something we made. It's an industry movement. The industry has classified 5 levels of autonomy or automation, if you want. And those 5 levels represent different pieces of workflows that need to be automated, either with robots or with software or some different sorts of technology. And as you move down these different phases, you get higher levels of benefits for each of those. So as we use this as an assessment tool with most big providers that are around Level 2, which is pretty basic automation, if they deploy everything we had today and used all of our advanced service technologies, they could get up to 3, maybe 2.7, not all the way to 3, but pretty close. And that's the excitement that's driving behind the company. That's what we've seen just in the last 6 months since we've come out of the pandemic, that if you're in a virtual world, you need digital tools to drive your processes. And if you're going to use digital tools, you have to have visibility to where the medications are. And so Omnicell has made its -- its historical growth has been on hardware with embedded software that holds these medications. Now we're digitizing those, we are going to different areas in the hospital which traditionally have been manual, putting in more technology to bring to life the actual medication SKUs, and then they get input into the overall picture of the pharmacy. And then this allows us to add on top these additional services, which then helps us to rationalize good decision-making, catch errors before it harms someone, not make a poor judgment on what to order or how much or how expensive or how inexpensive some of these decisions you make can actually end up in. So as we are moving toward this goal, we've built up a platform of hardware. Particularly in 2016, we made a major purchase. That platform is then being integrated into the Omnicell data platform. And on top of that platform, we now offer additional services. And there are different levels of the platform. There's just the operational pieces, but then there's the intelligence layer, and then some of the services actually have to be done with people. But as we've come out of the pandemic, it's really reignited our story in a different way. People are subscribing to the digital tools in order to get better information around how to run these complex pharmacies. So you could have Ohio Health with 25 hospitals and 400 clinics. And so what meds do I have, where are they and where are they needed? These are basic questions in general that can't be answered. But you put in an Omnicell One advanced services, it can actually tell you we've got too much over here, you need to move some over here, you don't need to order anymore. And so we saw some tragic cases in the pandemic, where people had to start substituting less-than-optimal drugs because they thought they were out. But lo and behold, across the street at one of their sister hospitals, they had plenty of the drug, they had too much. Nobody wants to make those mistakes anymore. And that has given us the platform to tell our story. And so these advanced services, over the next 5 years, are growing at 50% CAGR. And these are just the 5 we've deployed so far. So as we go through those levels, we will create -- more value-creation gets done. We are the category leader. We're the only people thinking like this. And as that value gets created, it will create value for our shareholders, so generate revenue and earnings. And of course, the software and the as a Service businesses are growing faster, have higher margins and really contribute to the elegance of the overall Omnicell solution. But really, what gives us this opportunity is the hard work of the last 28 years to make this company. The 145 of the top 300 largest accounts in the provider world have signed strategic long-term accounts with Omnicell, not a product agreement but really a platform agreement, an agreement to stretch out the installs over the next 5 to 10 years of these products to allow these great pharmacies to get to the more higher levels of automation and really transform the whole industry. So it's a unique opportunity. We're well positioned. And I'm going to turn it over to Peter, just to give us some more background on our customers and how it is really generating some new opportunities and great performance for us, particularly at the end of Q4 and last year as we came out of the pandemic.

Thank you, Randall. So we believe we have the largest installed base of connected devices in medication management automation globally. So what that leads to really here on the left side of this page is really highly feasible revenue and a resilient customer base. You've seen in the financials that our product backlog increased 57% year-over-year from the end of '19 to the end of 2020. Randall already talked about these 145 long-term sole-source partnership agreements which are exclusive, which means that these health systems have signed up for the journey to the Autonomous Pharmacy and have signed up to implementing solutions on the platform. We have a very high customer retention as you can see. And we also are benefiting from several upgrade cycles. So all that together leads to very highly feasible connected device revenue that you can see on the right side, the 63%. In addition, we have recurring revenue from maintenance and technical services. And then Randall earlier talked about these advanced services, recurring Software as a Service, subscription software- and tech-enabled services. And in the larger deals, the vast, vast majority, these are strategically led by these advanced services. So let's go one click down on the next page. So these advanced services are really the spearhead of the growth we see in both in the backlog but also in the pipeline. And we started implementing an increasing scale of these advanced services as well. So this is the EnlivenHealth retail pharmacy platform. It's the Omnicell One performance tool to really drive the feasibility and drive and suggest pharmacy actions to really optimize pharmacy across these large health systems, but also Robotics as a Service and also the 340B software solutions that we also have. So we're very confident in the growth here. It's a 50% CAGR from 2020 for 2021. We believe we've guided to these advanced services making up between 9% and 10% of total revenue. We're very confident in being able to grow that to 20% to 30% of total revenue by 2025 all organically and all based on the current set of advanced services that we offer. Of course, this leads to high unit -- higher-margin unit economics as well. So if we go to the next page. Let's spend a minute also about our growth trajectory and our commitment for the next 5 years. So we have the largest installed base of connected devices. We have a very strong economic hold, a few of these, 145. Long-term sole-source partnership agreements, we've said publicly that we believe that we will be able to sign between 5 million and 10 million additional long-term sole-source agreements in the top 300 U.S. health systems. So we're very uniquely positioned to grow the company from multiple angles on the revenue stream. So first of all, expansion. As these health systems further implement and move up the different levels of automation, the Autonomous Pharmacy, expansion is the biggest growth driver. We have upgrade cycles, like I talked about earlier. And we continue to gain market share gains, specifically in point of care. We gain about 100, 200 basis points of share every single year for the last couple of years, and we believe we'll continue to gain market share at that rate in the coming years as well. And of course, we'll innovate further to provide more solutions to Level 3 and then ultimately Level 4 and 5 as well. And so we're very confident in here, the organic growth rate of a CAGR of 11% to 12%, using '21 as a baseline. And then on top of that, because we now have the scale, we have these long-term sole-source partnerships and the economic moat, we believe that we're very well-positioned to add an average 3% CAGR on top of that via M&A, where we can leverage the scale on the channel to really supercharge acquisitions as well. It could be in the software space. It could be in 340B. It could be specialty pharmacy. It could be additional modules on Omnicell One, et cetera. So very confident there. We have financing at a low cost of capital available, of course, that we're looking to deploy. The pipeline from an M&A perspective is rich. So we're confident in the total CAGR here that we're committing to on a very reasonable basis of 14% to 15% total revenue growth from 2021 to 2025. If we then move to the following page. And also, from a profitability perspective, we've put programs in place. And we're confident -- and to increase both operating -- non-GAAP operating margin and EBITDA by 400 basis points from 2021 to 2025. And there are a number of drivers detailed on the right side of the page. First of all, of course, these advanced services have higher unit economics and higher gross margin that will flow through EBITDA. This longer-term sole-source partnership agreements, these are really platform choices where there are an RFP. So it's a long-term partnership where we have value-add, very strategic. We have economies of scale and specifically volume leverage. We've really architected our supply chain in a way where the fixed cost increase in these spread out over higher volume, and that drives into scale. And we have very specific manufacturing cost-saving programs in place that are paying dividends every single year. And then we're also simplifying, of course, and further automating also our own internal processes that are driving internal efficiencies. Good. If we go to the following page. So just in summary, so Randall talked about it earlier, we believe we have created a category of medication management automation, and we're changing the pharmacy care delivery model in a large market. And we're doing this together with the industry. We are the strategic partner for large health systems in the medication management automation space. Again, we have highly feasible and a high component of recurring revenue. We've demonstrated, of course, a track record of executing, and we're confident in the long-term growth that we've guided to and also the expansion of margin as well. So with that, thank you.

Okay. Actually, I do have 1 or 2 questions. I think we have maybe 1 or 2 minutes here. I can sneak in a couple. So you did reference these -- the sole-source agreements. That seems to be a big part of the revenue growth. And it's also for a full suite of products or what it looks like. So I guess I'm curious on the competitive landscape. Yes, I don't know if Pyxis would still be a primary competitor. It was owned by Cardinal a long time ago, spun off into like CareFusion. Now it's part of Becton, Dickinson. Is that a primary competitor? And also, as we think about the target customer being the acute care hospital versus other channels, whether it's SNFs, maybe just talk a bit more about the competitive landscape. And because of your full suite of offerings, is that what allows all these sole-source agreements that the competitors can't really capture, just to kind of tie all that together?

Sure. Well, we certainly have competitors, but they're mostly on certain products, single products at a time. We don't have a platform competitor that has anywhere near the breadth or depth of the product lines. And most of the product categories we do have, we are the market leader already. So IV robotics, significant shareholder -- market leader in the point-of-care system, so 50-50 or close to it. So I think that it's when you put the suite together and you approach it as a platform, and that's really what health care systems want to do. They want to invest in large platform plays that they can leverage over time and digitize all of the processes. Now the EnlivenHealth group as well, not only is focused on some of the things that providers can take care of, but they're mainly focused on the retail arena, where you're trying to get patients engaged in taking their medications at home or making sure they get their medication. So I think that the providers are not just the acute care, obviously, anymore. They're these big platforms and big players. And pharmacy has to change. It has to change such that it gets more connected directly with patients and on a more ongoing basis. And certainly, there are 20 ways to do that, and certainly vaccinations with patients and getting testing is the first scheduled event that retail pharmacy has taken on. It's changed the industry forever and now is a great avenue for us to move forward as we have already integrated into most of the major pharmacy platforms.

Okay. Great. With that, I think we're out of time. I think we're over time by a little bit too much here. So I appreciate the extra time. Thanks for the presentation, and enjoy the rest of the conference.

Cheers.

All right. Thank you.

Thanks for having us.