-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, N8pPAPSuJZi5w73U8pp6LwK1v0AE6YfIBzA87N0zTs/tcQQKMa2q2Vdx5qCIZ49R pVHzpudOaTFrYKn8xnfziw== 0001193125-07-106255.txt : 20070508 0001193125-07-106255.hdr.sgml : 20070508 20070508171731 ACCESSION NUMBER: 0001193125-07-106255 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 3 CONFORMED PERIOD OF REPORT: 20070503 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20070508 DATE AS OF CHANGE: 20070508 FILER: COMPANY DATA: COMPANY CONFORMED NAME: US Oncology Holdings, Inc. CENTRAL INDEX KEY: 0001333191 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOSPITALS [8060] IRS NUMBER: 200873619 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-K SEC ACT: 1934 Act SEC FILE NUMBER: 333-126922 FILM NUMBER: 07829126 BUSINESS ADDRESS: STREET 1: 16825 NORTHCHASE DRIVE, SUITE 1300 CITY: HOUSTON STATE: TX ZIP: 77060 BUSINESS PHONE: (832) 601-8766 MAIL ADDRESS: STREET 1: 16825 NORTHCHASE DRIVE, SUITE 1300 CITY: HOUSTON STATE: TX ZIP: 77060 FILER: COMPANY DATA: COMPANY CONFORMED NAME: US ONCOLOGY INC CENTRAL INDEX KEY: 0000943061 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SPECIALTY OUTPATIENT FACILITIES, NEC [8093] IRS NUMBER: 841213501 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-K SEC ACT: 1934 Act SEC FILE NUMBER: 000-26190 FILM NUMBER: 07829127 BUSINESS ADDRESS: STREET 1: 16825 NORTHCHASE DR STREET 2: STE 1300 CITY: HOUSTON STATE: TX ZIP: 77060 BUSINESS PHONE: 2818732674 FORMER COMPANY: FORMER CONFORMED NAME: AMERICAN ONCOLOGY RESOURCES INC /DE/ DATE OF NAME CHANGE: 19950327 8-K 1 d8k.htm FORM 8-K Form 8-K

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

FORM 8-K

 

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): May 3, 2007

 

US Oncology Holdings, Inc.

US Oncology, Inc.

(Exact name of registrant as specified in its charter)

 

 

Delaware   333-126922   20-0873619
Delaware   0-26190   84-1213501

(State or other jurisdiction

of incorporation)

   (Commission File Number)  

(IRS Employer

Identification Number)

16825 Northchase Drive, Suite 1300

Houston, Texas 77060

(Address of principal executive offices including zip code)

(832) 601-8766

(Registrant’s telephone number, including area code)

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrants under any of the following provisions:

 

¨ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

¨ Soliciting material pursuant to Rule 14a-12 under Exchange Act (17 CFR 240-14a-12)

 

¨ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240-14d-2(b))

 

¨ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

 

ITEM 2.02 Results of Operations and Financial Condition.

On May 3, 2007, US Oncology Holdings, Inc., issued a press release regarding earnings for the quarter ended March 31, 2007 for US Oncology Holdings, Inc. and its wholly owned subsidiary US Oncology, Inc. A copy of the press release is furnished herewith as Exhibit 99.1.

The information in this report and the attached exhibit are provided under Item 2.02 of Form 8-K and are furnished to the Securities and Exchange Commission (“SEC”), but shall be not deemed “filed” with the SEC for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, or otherwise subject to the liabilities of that section or of Sections 11 and 12(a)(2) of the Securities Act of 1933, as amended. The information in this report and the attached exhibit shall not be incorporated by reference into any filing of the registrant, whether made before or after the date hereof, regardless of any general incorporation language in such filing.

 

ITEM 9.01 Financial Statements and Exhibits.

The following exhibit is furnished as part of this Current Report on Form 8-K:

(c) Exhibits.

 

Exhibit 99.1    Press Release of US Oncology Holdings, Inc. dated May 3, 2007.

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

Date: May 7, 2007   By:  

/s/ PHILLIP H. WATTS

    Phillip H. Watts
    Vice President and General Counsel
 EX-99.1 2 dex991.htm PRESS RELEASE Press Release

Exhibit 99.1

LOGO

 

Contact:    Rick McCook
   Chief Financial Officer
   832.601.6089
   rick.mccook@usoncology.com

US Oncology Reports First Quarter 2007 Results

HOUSTON, TX, May 3, 2007 – US Oncology Holdings, Inc. (“Holdings” or the “Company”), the parent company of US Oncology, Inc. (“US Oncology”), one of the nation’s largest cancer services companies, reported revenue of $732.0 million, EBITDA of $36.9 million, Adjusted EBITDA of $57.2 million, net loss of $15.6 million and operating cash flow of $23.7 million for the quarter ended March 31, 2007.

The results of Holdings include those of US Oncology, its wholly owned subsidiary, through which all operations are conducted. The results of operations and financial position of Holdings are substantially identical to those of US Oncology, with the exception of nominal administrative expenses and items related to the capitalization of Holdings. For the quarter ended March 31, 2007, US Oncology reported EBITDA of $49.9 million, Adjusted EBITDA of $57.3 million, net income of $2.1 million and operating cash flow of $36.3 million. Differences between the results of Holdings and US Oncology, as well as selected balance sheet data, are reconciled in this press release.

US Oncology Holdings First Quarter Highlights

 

  •  

EBITDA for the first quarter of 2007 was $36.9 million, compared to $61.4 million for the first quarter of 2006 and $59.5 million for the fourth quarter of 2006. The decrease from the first quarter and fourth quarter of 2006 is due primarily to a $12.9 million loss on early extinguishment of $250.0 million floating rate notes of US Oncology Holdings, Inc. and a $7.4 million impairment and restructuring charge relating to two markets. Excluding these charges, Adjusted EBITDA for the first quarter of 2007 was $57.2 million.

 

  •  

Cash provided by operations was $23.7 million in the first quarter of 2007, compared with $128.2 million used in the same period in 2006 and $57.1 million provided in the fourth quarter of 2006.

 

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  •  

In the first quarter of 2007, 26 physicians began practicing as part of the US Oncology network and 16 physicians separated from the network. These departures were due to the retirement of six physicians and separation of six physicians under comprehensive service agreements and four physicians under the oncology pharmaceutical services (“OPS”) model. During the first quarter of 2007, agreements were signed with 69 physicians, consisting of 54 physicians through practice affiliations and 15 individually recruited physicians, to begin practicing in our network under comprehensive management or OPS agreements. Since March 31, 2007, agreements with 47 physicians have become effective and those physicians are now practicing as part of our network.

Key Factors Impacting First Quarter Results

 

  •  

Affiliated practices continued to adopt expanded service offerings for their patients such as image guided radiation therapy (“IGRT”) and brachytherapy, which are reimbursed at higher rates than conventional radiation therapy. At March 31, two integrated cancer centers were under construction and are expected to begin providing patient care in 2007.

 

  •  

Pharmaceutical services revenue and EBITDA continued to increase as a result of the addition of OPS customers since the first quarter of 2006, expanded manufacturer services and increased distribution volume.

 

  •  

As a result of recent studies that have called into question appropriateness of supportive care drugs used to treat cancer induced anemia, we experienced reduced utilization of such drugs as compared to prior periods. We currently expect lower utilization of these drugs to reduce pretax income for fiscal year 2007 by approximately $8 million to $10 million.

 

  •  

Effective January 1, 2007, Medicare discontinued the Medicare Demonstration Project, which provided payments to oncologists for providing certain patient care information, and implemented new rules decreasing diagnostic radiology reimbursement and increasing other non-drug reimbursement. As compared to the first quarter of 2006 and fourth quarter of 2006, these reimbursement changes reduced pretax income by approximately $1.9 million and $2.0 million, respectively.

 

  •  

Results for the first quarter of 2007 include impairment and restructuring charges of $7.4 million relating to affiliated practices in two markets, made up of a total of ten physicians, in which market-specific conditions have prevented effective implementation of our strategies. We also reserved $3.5 million due to uncertainty about collectibility of management fees from those practices.

 

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Dale Ross, Chairman and Chief Executive Officer stated, “During the first quarter, oncologists, particularly medical oncologists, continued to face a challenging environment of downward pressure on reimbursement, rising costs and pressure from payers to contain costs by influencing practice patterns. Operating results of our medical oncology segment reflect this environment. Now more than ever, we believe that to be successful, oncology practices must grow within their local market, diversify beyond medical oncology and focus on efficient management and utilization of assets. US Oncology has a proven track record of helping its affiliated practices accomplish these goals.

“We remain committed to helping our affiliated practices grow and add to their service offerings. At the same time, we continue to support network practices operationally through our practice quality and efficiency initiatives, our electronic medical record and development of our network’s evidence-based medicine initiative. We believe that efficiently operated practices that apply evidence-based treatment protocols offer the best hope of containing the costs of cancer treatment while providing patients the high quality care they deserve. Our recent development successes and strong development pipeline support our value proposition of enabling oncology practices to respond to market pressures more effectively than would be possible if operating outside the US Oncology network.

“Our financial results for the first quarter also include impairment charges relating to two of our markets, representing a total of ten physicians, in which we have not been able to fully implement our strategies. While we are disappointed with the financial impact of these charges, we believe that the challenges in these markets underscore the need for our services. Practices that are not appropriately positioned are feeling the pressures of the marketplace more acutely than ever. We remain committed to these markets and to working with each practice to improve financial performance,” said Ross.

 

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Results of Operations

The Company operates and manages its business through four operating segments. The table below compares the results of the first quarter of 2007 to the results of the corresponding period of the prior year and the preceding quarter (in millions).

 

     Q1     Q1     %     Q4     %  
     2007     2006     Change     2006     Change  

Revenue

           

Medical oncology services

    $ 521.9     $ 528.3     (1.2 )   $ 524.5     (0.5 )

Cancer center services

      84.3       79.0     6.7       81.8     3.1  

Pharmaceutical services(2)

      541.4       481.8     12.4       520.0     4.1  

Research and other

      13.0       12.6     3.2       12.5     4.0  

Eliminations(1),(2)

      (428.6 )     (400.0 )   7.1       (417.2 )   2.7  
                            

Total

    $ 732.0     $ 701.7     4.3     $ 721.6     1.4  
                            
          

Operating income (loss)

           

Medical oncology services

    $ 24.8     $ 31.8     (22.0 )   $ 25.2     (1.6 )

Cancer center services

      20.0       19.1     4.7       19.2     4.2  

Pharmaceutical services

      21.1       20.4     3.4       20.2     4.5  

Research and other

      0.3       (0.9 )   nm  (5)     0.4     (25.0 )

Corporate costs(3)

      (30.3 )     (29.4 )   (3.1 )     (27.9 )   (8.6 )

Impairment and restructuring charges(4)

      (7.4 )     —       nm  (5)     —       nm  (5)
                            

Total

    $ 28.5     $ 41.0     (30.5 )   $ 37.1     (23.2 )
                            
          

EBITDA

           

Medical oncology services

    $ 24.8     $ 31.8     (22.0 )   $ 25.2     (1.6 )

Cancer center services

      29.5       28.5     3.5       28.9     2.1  

Pharmaceutical services

      22.4       20.5     9.3       21.5     4.2  

Research and other

      0.5       (0.9 )   nm  (5)     0.6     nm  (5)

Corporate costs(3)

      (20.0 )     (18.5 )   (8.1 )     (16.7 )   (19.8 )

Loss on debt extinguishment(4)

      (12.9 )     —       nm  (5)     —       nm  (5)

Impairment and restructuring charges(4)

      (7.4 )     —       nm  (5)     —       nm  (5)
                            

Total

    $ 36.9     $ 61.4     (39.9 )   $ 59.5     (38.0 )
                            
          

Adjusted EBITDA(4)

   $ 57.2     $ 61.4     (6.8 )   $ 59.5     (3.9 )

Net income (loss)

    $ (15.6 )   $ 7.6     nm  (5)   $ 3.3     nm  (5)

Operating cash flow

    $ 23.7     $ (128.2 )   nm  (5)   $ 57.1     (58.5 )
(1) Eliminations represent the sale of pharmaceuticals from our distribution center (pharmaceutical services segment) to our practices affiliated under comprehensive service agreements (medical oncology segment).
(2) The distribution center began operations on a limited basis in September 2005, and achieved normal operating levels in the second quarter of 2006.
(3) Corporate costs relate primarily to general and administrative expenses in support of our network.
(4) Loss on early extinguishment of debt of $12.9 million and impairment and restructuring charges of $7.4 million (of which $3.1 million relates to the cancer center services segment and the remainder is included as a corporate cost) in the first quarter of 2007 are excluded from Adjusted EBITDA for the first quarter of 2007.
(5) Not meaningful.

 

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Medical Oncology Services

In the first quarter of 2007, medical oncology services revenue decreased $6.4 million, or 1.2 percent and EBITDA decreased $7.0 million, or 22.0 percent, compared to the first quarter of 2006. Medical oncology services revenue was consistent with the fourth quarter of 2006 and EBITDA decreased $0.4 million, or 1.6 percent, from the prior quarter. These decreases were due to a reduction of the management fees paid by affiliated practices (as discussed below), financial support provided to two affiliated practices experiencing operational challenges, and the elimination of payments by Medicare to oncologists for providing certain patient care information (the “Medicare Demonstration Project”) effective January 1, 2007. These reductions were partially offset by lower drug costs resulting from the renegotiation of certain manufacturer discounts and rebates.

The involvement of affiliated practices in our medical oncology services segment is important to the success of our pharmaceutical services segment. Effective July 1, 2006, to promote continued support of initiatives in this area, we began a program to reduce management fees paid by affiliated practices based upon compliance with distribution efficiency guidelines established by the Company and the profitability of the pharmaceutical services segment. For the first quarter of 2007 and the fourth quarter of 2006, the management fee reduction amounted to $4.2 million and $4.6 million, respectively. This program was not in effect during the first quarter of 2006 and, as such, no management fee reductions were recognized in that period.

During the first quarter, the U.S. Food and Drug Administration (the “FDA”) issued a public health advisory outlining new safety information, including revised product labeling, about erythropoiesis-stimulating agents (“ESAs”), widely-used drugs for the treatment of anemia. ESAs have historically been used by oncologists to treat anemia caused by chemotherapy, as well as anemia in cancer patients who are not currently receiving chemotherapy. In particular, the FDA highlighted studies that concluded an increased risk of death may occur in cancer patients who are not receiving chemotherapy who are treated with ESAs. Partly in response to such warnings, certain Medicare intermediaries have ceased reimbursement for ESAs administered to patients who are not current or recent chemotherapy recipients at the time of administration. In addition, intermediaries have revised usage guidelines for ESAs in other circumstances. The Centers for Medicare and Medicaid Services (“CMS”) is currently developing standard national usage and reimbursement policies for ESAs which are expected to be issued in December 2007. We remain engaged in that process and expect further clarity to result. In addition, the Company expects continued payer scrutiny of the side effects of supportive care products and other drugs that represent significant costs to payers. In its evidence-based medicine initiative, our network also continually reviews emerging scientific information to develop clinical pathways for use in oncology and we remain engaged with payers in determining optimal usage for pharmaceuticals.

 

- 5 -

Cancer Center Services

Cancer center services revenue was $84.3 million and EBITDA was $29.5 million for the first quarter of 2007, representing increases of 6.7 percent and 3.5 percent, respectively, over the first quarter of 2006. These increases reflect a 1.4 percent increase in radiation treatments and diagnostic radiology procedures per day over the same period in the prior year, which were partially offset by the reduced Medicare reimbursement for diagnostic radiology services effective January 1, 2007. Both revenue and EBITDA increased at a rate in excess of treatment volumes as a result of expanding services in advanced targeted radiation therapies, such as image guided radiation therapy (“IGRT”) and brachytherapy by network practices, which are reimbursed at higher rates than conventional radiation therapy.

Cancer center services revenue increased 3.1 percent and EBITDA increased 2.1 percent from the fourth quarter of 2006 reflecting a 2.6 percent increase in daily technology-based treatments over the prior quarter, partially offset by the reduced Medicare imaging reimbursement.

Pharmaceutical Services

Pharmaceutical services revenue was $541.4 million, an increase of $59.6 million over the first quarter of 2006. The revenue increase is primarily due to the fact that our distribution center operations did not achieve normal operating levels until the second quarter of 2006. Also contributing to revenue growth was the addition of 62 net physicians affiliated through oncology pharmaceutical services (“OPS”) agreements since the first quarter of 2006. Pharmaceutical services EBITDA was $22.4 million for the first quarter of 2007, an increase of $1.9 million over the comparable prior year period, as a result of the increase in revenue, which was partially offset by start-up losses associated with our recently launched oral oncology specialty pharmacy business and other services targeted to payers and manufacturers.

Pharmaceutical services revenue in the first quarter of 2007 increased 4.1 percent and EBITDA increased 4.2 percent over the preceding quarter due to the addition of 44 net physicians affiliated under OPS agreements during the fourth quarter of 2006 and first quarter of 2007.

Corporate Costs

Corporate costs, which represent general and administrative expenses, excluding stock-based compensation, were $20.0 million in the first quarter of 2007, compared to $18.5 million in the first quarter of 2006 and $16.7 million in the fourth quarter of 2006. Corporate costs in the first quarter of 2007 were $1.5 million higher than the comparable period in 2006 due primarily to personnel and professional costs incurred in the first quarter of 2007 in furtherance of strategic initiatives.

During the first quarter, corporate costs increased $3.3 million over the fourth quarter of 2006, due primarily to a reduction in incentive compensation recognized during the fourth quarter of 2006 to reflect actual results for the fiscal year.

 

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Net Income (Loss)

Net loss for the first quarter of 2007 was $15.6 million which represents a decrease of $23.2 million compared to the first quarter of 2006 and a decrease of $18.8 million compared to the fourth quarter of 2006. These decreases reflect reductions in income before income taxes of $29.2 million and $23.1 million compared to the first and fourth quarters of 2006, respectively, due principally to the loss on debt extinguishment of $12.9 million and impairment and restructuring charges of $7.4 million incurred in the first quarter of 2007. Additionally, compared to both periods, the loss before income taxes in the first quarter of 2007 reflects lower operating income, which is consistent with the results of operations discussed above, and higher interest expense. The income tax benefit associated with the loss before income taxes was partially offset by a margin tax in the state of Texas which became effective January 1, 2007.

The Company has reduced its Adjusted EBITDA expectation for fiscal year 2007 to between $250 million to $260 million. Adjusted EBITDA excludes $20.3 million related to charges in the first quarter of 2007 for the loss on extinguishment of debt and impairment and restructuring costs in two markets. For fiscal year 2007, EBITDA is expected to be between $230 million and $240 million. This estimate is a forward-looking statement and is subject to uncertainty. The reader should refer to the Company’s cautionary advice regarding forward-looking statements appearing elsewhere in this news release and in the Company’s filings with the Securities and Exchange Commission.

Cash Flow

During the first quarter of 2007, cash provided by operations was $23.7 million, compared to $128.2 million used in the first quarter of 2006 reflecting working capital investments for inventory and accounts payable to support the Company’s distribution initiative in the first quarter of 2006. During the first quarter of 2006, inventory increased by $61.3 million and accounts payable decreased by $51.7 million as the Company became the primary pharmaceutical distributor for the network.

During the fourth quarter of 2006, cash provided by operations was $57.1 million. The decrease in operating cash flow in the first quarter of 2007 reflects higher scheduled interest payments in the first quarter.

As of May 1, 2007, the Company had $95.8 million of cash and investments, and availability under its revolving credit facility of $136.7 million.

Note Offering

In March 2007, US Oncology Holdings, Inc. completed a $425.0 million senior floating rate PIK toggle note offering (“the Notes”). Proceeds from the Notes were used to repay existing $250.0 million floating

 

- 7 -

rate notes and, after payment of transaction fees and expenses, a $158.5 million dividend to common and preferred shareholders. The $425.0 million notes bear interest at LIBOR plus 4.50 percent. The Company has entered into an interest rate swap agreement effectively fixing the LIBOR base rate at 4.97% through maturity. Prior to a scheduled 0.50 percent spread increase in both 2009 and 2010 (as called for under the loan agreement) the fixed interest rate will be 9.47%.

In connection with refinancing the existing notes, the Company recognized a $12.9 million extinguishment loss related to payment of a 2.0 percent call premium, interest expense during a 30 day call period, and the write off of unamortized issuance costs related to the retired debt.

Development

One of the Company’s ongoing objectives is to expand our network by affiliating with practices in new or existing markets, recruiting physicians into existing affiliated practices and entering into joint ventures. In the first quarter of 2007, our network grew by 10 net physicians. As of March 31, 2007, 60 physicians had executed contracts to join our network under new or existing comprehensive services agreements expected to become effective in the second and third quarters of 2007. Since March 31, 2007, 14 of these physicians have commenced practicing under comprehensive service agreements, including three new practices, consisting of 13 physicians, that joined the US Oncology network effective May 1, 2007. Two of these practices represent new markets in Ohio and New York and the third practice is joining with an existing affiliated practice in South Carolina.

At March 31, 2007, 36 physicians had executed agreements under the OPS model that will become effective in the current year. Since March 31, 2007, 33 of these physicians have started purchasing pharmaceutical products and services from the Company.

In addition, a joint venture with a major healthcare system in Indiana commenced operations in March, 2007, and a second joint venture is expected to begin providing patient care in June, 2007 in North Texas.

Ross continued, “The Company’s value proposition continues to be validated by the results of our increased development activity, particularly considering the more recent difficult operating environment. We are excited to welcome thirteen new affiliated physicians with over 70 employees to our network this week. Growth, such as these three new affiliations, will continue to permit us to expand our capabilities and resources, thereby increasing the Company’s competitive advantage and further strengthening the clinical care offered by our affiliated practices.”

Impairment and Restructuring Charges

In the large majority of our markets, we believe our strategies of practice consolidation, diversification and process improvement continue to be effective. However in a small number of markets, specific local

 

- 8 -

factors have prevented effective implementation of our strategies and practice performance has suffered. Specifically, in two markets in which an aggregate of ten physicians are affiliated with us, these market-specific conditions caused us to recognize impairment and restructuring charges totaling $7.4 million during the first quarter. The components of the charge are as follows (in thousands):

 

Management Services Agreement    $4,325
Equipment    2,512
Lease Obligations and Leasehold Improvements    558
    
Total    $7,395
    

In one of the markets, state regulators reversed a prior determination and ruled that, under the state’s certificate of need law, our affiliated practice was required to cease providing radiation therapy services to patients at a newly constructed cancer center. We are appealing this determination and are exploring other options that would make the treatment facility available to patients. However, such efforts did not advance sufficiently during the first quarter of 2007 and, therefore, the resumption of radiation services or other recovery of our investment is not considered likely.

In the other market, financial performance has deteriorated as a result of an excessive cost structure relative to practice revenue. We are working with the practice involved to restructure this market and establish a base for future growth to otherwise improve financial performance. During the first quarter we incurred impairment and restructuring charges because, based on currently anticipated operating results, we do not expect that practice performance will be sufficient to recover the value of certain assets and our intangible asset associated with the management service agreement in this market.

We remain committed to the markets in which we have recognized impairment charges. In each of them, we are taking actions to improve performance, including consolidation of facilities, possible transfers of assets, and other actions, such as recruiting physicians, designed to better align the practices with our strategic direction. As we work to restructure operations in these markets, we expect that they will continue to underperform relative to the network and during this period we may recognize additional costs.

Contingencies and Risks

On April 18, 2006, the Company terminated its net revenue model comprehensive service agreement with a 35-physician practice in Oklahoma, as a result of alleged breaches of that agreement by the practice. The practice accounted for 4.6 percent and 2.3 percent of the Company’s revenue and EBITDA, respectively, for the first quarter of 2006. The Company remains in litigation with this practice regarding termination of its service agreement. As a result of the practice’s alleged breaches of that agreement and the litigation, the Company was unable to collect payments on receivables owned by us and other amounts owed by the practice on a timely basis. At March 31, 2007, the total amount owed to us for

 

- 9 -

those receivables of $22.5 million is reflected on our balance sheet as other assets. We intend to pursue our claims, including claims for those amounts owed to us, as well as unpaid management fees and any other damages, fees and expenses that we incurred as a result of terminating this service agreement. We also intend to defend against the practice’s allegations that we breached the agreement and that the agreement is unenforceable. As with any complex litigation, the process necessary to resolve this claim may take as long as one to two years.

During the fourth quarter of 2005, we received a subpoena from the United States Department of Justice’s Civil Litigation Division (“DOJ”) requesting a broad range of information about us and our business, generally in relation to our contracts and relationships with pharmaceutical manufacturers. We are in the process of responding to the subpoena and are cooperating fully with the DOJ.

During March 2007, the Company became aware that it and one of its affiliated practices are the subject of allegations that the practice may have engaged in activities that violate the Federal False Claims Act. These allegations are contained in a qui tam complaint, commonly referred to as a “whistle-blower” lawsuit. The details of this suit are not publicly available or disclosable at the current time since qui tam complaints are filed on a confidential basis with a United States federal court. The Department is in the early stages of its investigation, and as such, has not made a decision on the merits of the whistle-blower’s claim. The Company intends to continue to investigate and vigorously defend itself against any and all such claims, and the Company continues to believe that it conducts its operations in compliance with law. Based upon its present understanding of the nature and scope of the claim and investigation, the Company does not expect this claim to have a material adverse effect on its operations or financial condition.

The Company and US Oncology will broadcast the 2007 first quarter financial results by conference call on Thursday, May 3, 2007 at 9:00 A.M. Central Daylight Time. The archived replay of the event will be available through the news center on the Company’s Web site (www.usoncology.com).

 

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About US Oncology, Inc.

US Oncology, headquartered in Houston, Texas, is one of the nation’s largest cancer treatment and research networks. US Oncology provides extensive services and support to its affiliated cancer care sites nationwide to help them expand their offering of the most advanced treatments and technologies, build integrated community-based cancer care centers, improve their therapeutic drug management programs and participate in many of the new cancer-related clinical research studies. US Oncology is affiliated with 1,077 physicians operating in 433 locations, including 90 radiation oncology facilities in 38 states.

This news release contains forward-looking statements, including statements that include the words “believes,” “expects,” “anticipates,” “estimates,” “intends,” “plans,” “projects,” or similar expressions and statements regarding our prospects. All statements other than statements of historical fact included in this news release are forward-looking statements. Although the Company believes that the expectations reflected in such statements are reasonable, it can give no assurance that such expectations will prove to have been correct. Such expectations are subject to risks and uncertainties, including the Company’s reliance on pharmaceuticals for the majority of its revenues, the Company’s ability to maintain favorable pharmaceutical pricing and favorable relationships with pharmaceutical manufacturers and other vendors, concentration of pharmaceutical purchasing and favorable pricing with a limited number of vendors, prescription drug reimbursement and other reimbursement under Medicare (including reimbursement for radiation and diagnostic services), reimbursement for medical services by non-governmental payers and cost-containment efforts by such payers, other changes in the manner patient care is reimbursed or administered, the Company’s ability to service its substantial indebtedness and comply with related covenants in debt agreements, the Company’s ability to fund its operations through operating cash flow or utilization of its existing credit facility or its ability to obtain additional financing on acceptable terms, the Company’s ability to implement strategic initiatives, the Company’s ability to maintain good relationships with existing practices and expand into new markets and development of existing markets, modifications to, and renegotiation of, existing economic arrangements, the Company’s ability to complete cancer centers and PET facilities currently in development and its ability to recover investments in cancer centers, government regulation and enforcement, increases in the cost of providing cancer treatment services and the operations of the Company’s affiliated physician practices. Please refer to the US Oncology Holdings, Inc. filings with the Securities and Exchange Commission, including its Annual Report on Form 10-K for the year ended December 31, 2006, and subsequent filings, for a more extensive discussion of factors that could cause actual results to differ materially from the Company’s expectations.

Discussion of Non-GAAP Information

In this release, the Company uses the term “EBITDA” and “Adjusted EBITDA”. EBITDA is earnings before interest, taxes, depreciation and amortization (including amortization of stock compensation) and minority interest expense. EBITDA is not calculated in accordance with accounting principles generally accepted in the United States of America (“GAAP”). Adjusted EBITDA is EBITDA before loss on early extinguishment of debt and impairment and restructuring charges. These measures are derived from relevant items in the Company’s GAAP financials. A reconciliation of EBITDA to net income (loss) and operating cash flow is included in this release.

The Company believes EBITDA is useful to investors in evaluating the value of companies in general, and in evaluating the liquidity of companies with debt service obligations and their ability to service their indebtedness. Management uses EBITDA as a key indicator to evaluate liquidity and financial condition, both with respect to the business as a whole and with respect to individual sites in the US Oncology network. Adjusted EBITDA is useful to investors as it eliminates certain amounts that are unusual in nature and not currently expected to be part of the Company’s ongoing operational performance. The Company’s senior secured credit facility also requires that it comply on a quarterly basis with certain financial covenants that include Adjusted EBITDA as a financial measure. Management believes that EBITDA and Adjusted EBITDA are useful to investors, since they provide investors with additional information that is not directly available in a GAAP presentation.

As a non-GAAP measure, EBITDA and Adjusted EBITDA should not be viewed as alternatives to the Company’s GAAP financial statements, but should be read as a supplement to, and in conjunction with, the Company’s GAAP financial statements.

 

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US ONCOLOGY HOLDINGS, INC.

KEY OPERATING STATISTICS

(unaudited)

 

     Q1    Q1 (5)    %     Q4    %  
     2007    2006    Change     2006    Change  

Physician Summary:

              

Medical oncologists

    685    690    (0.7 )%   686    (0.1 )%

Radiation oncologists

    148    140    5.7     146    1.4  

Other oncologists

    44    44    —       47    (6.4 )
                   

Total CSA physicians

    877    874    0.3     879    (0.2 )
                   

OPS physicians

    200    138    44.9     188    6.4  
                   

Total physicians

    1,077    1,012    6.4     1,067    0.9  
                   

Daily Operating Statistics:

              

Medical oncology visits (1)

    9,806    10,051    (2.4 )   9,918    (1.1 )

Radiation treatments/diagnostic scans (2)(4)

    3,614    3,564    1.4     3,522    2.6  

Daily Same Store Statistics:

              

Medical oncology visits (1)

    9,806    9,552    2.7     9,918    (1.1 )

Radiation treatments/diagnostic scans (2)(4)

    3,443    3,377    2.0     3,358    2.5  

Other Statistics:

              

Radiation oncology facilities(3)(4)(5)

    90    93    (3.2 )   91    (1.1 )

PET systems

    34    30    13.3     33    3.0  

New patients enrolled in research

    761    646    17.8     790    (3.7 )

studies during the period

              

Accounts receivable days outstanding

    37    44    (15.9 )   38    (2.6 )

Notes to Key Operating Statistics:

(1) Medical oncology visits include information for practices affiliated under comprehensive service agreements only, and do not include the results of OPS practices.
(2) Represents technology-based treatments, including IMRT treatments and diagnostic scans, provided through our integrated cancer centers and radiation-only facilities.
(3) The first quarter of 2007 includes 79 integrated cancer centers and 11 radiation-only facilities. The fourth quarter of 2006 includes 80 integrated cancer centers and 11 radiation-only facilities while the first quarter of 2006 includes 82 integrated cancer centers and 11 radiation-only facilities.
(4) Radiation treatments/diagnostic scans and facilities do not include cancer centers operated by unconsolidated joint ventures in which the Company or an affiliated practice has a financial interest.
(5) Radiation oncology facilities at March 31, 2006 include 4 cancer centers operated by a 35-physician net revenue model practice whose management service agreement was terminated in April, 2006. These 4 centers were sold to the disaffiliated practice in October, 2006.

 

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US ONCOLOGY HOLDINGS, INC.

CONDENSED CONSOLIDATED STATEMENT OF OPERATIONS

(in thousands)

(unaudited)

 

    

Three Months Ended

March 31,

    

Three Months
Ended

December 31,

2006

  
     2007     2006    

Product revenue

    $ 481,615     $ 457,741     $ 462,184  

Service revenue

      250,426       244,002       259,400  
                        

Total revenue

      732,041       701,743       721,584  

Cost of products

      464,665       438,313       460,725  

Cost of services:

       

Operating compensation and benefits

      117,349       116,682       114,341  

Other operating costs

      72,794       66,800       70,256  

Depreciation and amortization

      17,729       16,034       17,854  
                        

Total cost of services

      207,872       199,516       202,451  

Total cost of products and services

      672,537       637,829       663,176  

General and administrative expense

      20,276       19,078       17,488  

Impairment and restructuring charges

      7,395       —         —    

Depreciation and amortization

      3,364       3,800       3,806  
                        
     703,572       660,707       684,470  

Income from operations

      28,469       41,036       37,114  

Other income (expense):

       

Interest expense, net

      (31,025 )     (27,458 )     (29,547 )

Minority interests

      (722 )     (525 )     (660 )

Loss on extinguishment of debt

      (12,917 )     —         —    
                        

Income (loss) before income taxes

      (16,195 )     13,053       6,907  

Income tax benefit (provision)

      609       (5,482 )     (3,654 )
                        

Net income (loss)

    $ (15,586 )   $ 7,571     $ 3,253  
                        

 

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US ONCOLOGY HOLDINGS, INC.

CONDENSED CONSOLIDATED STATEMENT OF CASH FLOWS

(in thousands)

(unaudited)

 

    

Three Months Ended

March 31,

  
     2007     2006  

Cash flows from operating activities:

     

Net cash provided by (used in) operating activities

    $ 23,730     $ (128,193 )
                

Cash flows from investing activities:

     

Acquisition of property and equipment

      (17,427 )     (11,768 )

Payments in practice affiliation transactions

      —         (3,281 )

Net proceeds from sale of assets

      750       —    
                

Net cash used in investing activities

      (16,677 )     (15,049 )
                

Cash flows from financing activities:

     

Proceeds from senior floating rate PIK toggle notes

      425,000       —    

Proceeds from other indebtedness

      665       —    

Net borrowings under revolving facility

      —         20,000  

Payment of dividends on preferred stock

      (25,000 )     —    

Payment of dividends on common stock

      (323,580 )     —    

Repayment of senior floating rate notes

      (256,766 )     —    

Debt financing costs

      (11,700 )     —    

Repayment of term loan

      (3,791 )     (1,000 )

Repayment of other indebtedness

      (369 )     (2,076 )

Distributions to minority interests

      (1,420 )     —    

Contributions from minority interests

      426       482  

Proceeds from exercise of options

      517       18  
                

Net cash provided by (used in) financing activities

      (196,018 )     17,424  
                

Decrease in cash and equivalents

      (188,965 )     (125,818 )

Cash and equivalents:

     

Beginning of period

      281,768       125,838  
                

End of period

    $ 92,803     $ 20  
                

 

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US ONCOLOGY HOLDINGS, INC.

CONDENSED CONSOLIDATED BALANCE SHEET

(in thousands)

(unaudited)

 

     March 31,     December 31,  
     2007     2006  

ASSETS

     

Current assets:

     

Cash and equivalents

    $ 92,803     $ 281,768  

Accounts receivable

      351,067       341,306  

Other receivables

      111,482       105,544  

Prepaid expenses and other current assets

      25,670       21,139  

Inventories

      87,299       78,381  

Deferred income taxes

      4,365       4,268  

Due from affiliates

      62,770       66,674  
                

Total current assets

      735,456       899,080  

Property and equipment, net

      390,310       393,318  

Service agreements, net

      231,911       240,100  

Goodwill

      757,870       757,870  

Other assets

      79,345       76,126  
                
   $ 2,194,892     $ 2,366,494  
                

LIABILITIES AND STOCKHOLDERS’ EQUITY

     

Current liabilities:

     

Current maturities of long-term indebtedness

    $ 10,701     $ 9,397  

Accounts payable

      225,393       198,978  

Dividends payable

      —         190,000  

Due to affiliates

      165,396       146,683  

Accrued compensation cost

      26,273       26,854  

Accrued interest payable

      12,409       30,965  

Income taxes payable

      2,705       1,842  

Other accrued liabilities

      30,007       32,565  
                

Total current liabilities

      472,884       637,284  

Deferred revenue

      7,983       8,337  

Deferred income taxes

      30,359       33,520  

Long-term indebtedness

      1,489,911       1,319,664  

Other long-term liabilities

      8,594       8,032  
                

Total liabilities

      2,009,731       2,006,837  

Minority interests

      13,857       14,148  

Preferred stock Series A, 15,000 shares authorized, 13,939 shares issued and outstanding

      293,186       312,749  

Preferred stock Series A-1, 2,000 shares authorized, 1,948 shares issued and outstanding

      51,165       50,797  
                

Preferred stock

      344,351       363,546  

Stockholders’ deficit

     

Common stock, $0.001 par value, 300,000 shares authorized, 141,495 shares issued and outstanding

      141       141  

Accumulated other comprehensive income (loss), net of tax

      (582 )     951  

Retained deficit

      (172,606 )     (19,129 )
                

Stockholders’ deficit

      (173,047 )     (18,037 )
                
   $ 2,194,892     $ 2,366,494  
                

 

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US ONCOLOGY HOLDINGS, INC.

RECONCILIATION OF NET INCOME AND SELECTED BALANCE SHEET DATA

(in thousands)

(unaudited)

Reconciliation of Holdings Net Income to US Oncology Net Income:

 

         Three Months Ended  
              March 31, 2007        

Holdings Net Loss

       $ (15,586 )  

Add back:

   General and administrative expense         41    
 

Loss on extinguishment of debt

         12,917    
 

Interest expense

         7,218    
 

Effective tax rate differential

         (2,540 )  
               

US Oncology Net Income

       $ 2,050    
               

Reconciliation of Selected Balance Sheet Data:

 

     As of March 31, 2007  
     US Oncology   

Holdings
combining

entries and
eliminations

     Holdings  

Total assets

    $ 2,168,582    $ 26,310     $ 2,194,892  

Total liabilities

      1,585,035      424,696       2,009,731  

Preferred stock

      —        344,351       344,351  

Stockholders’ equity (deficit)

      569,690      (742,737 )     (173,047 )

 

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US ONCOLOGY HOLDINGS, INC.

RECONCILIATION OF NET INCOME (LOSS) TO EBITDA AND ADJUSTED EBITDA

(in thousands)

(unaudited)

 

    

Three Months Ended

March 31,

     Three Months Ended
December 31,		  
     2007     2006     2006  

Net income (loss)

    $ (15,586 )   $ 7,571     $ 3,253  

Add back:

       

Interest expense, net

      31,025       27,458       29,547  

Income tax (benefit) provision

      (609 )     5,482       3,654  

Depreciation and amortization

      21,093       19,834       21,660  

Amortization of stock compensation

      260       545       746  

Minority interest expense

      722       525       660  
                        

EBITDA

      36,905  (1)     61,415 (1)     59,520  (1)

Plus:

       

Loss on extinguishment of debt

      12,917       —         —    

Impairment and restructuring charges

      7,395       —         —    
                        

Adjusted EBITDA

      57,217       61,415       59,520  

Changes in assets and liabilities

      (835 )     (158,047 )     29,394  

Deferred income tax provision

      (2,236 )     1,379       1,414  

Interest expense, net

      (31,025 )     (27,458 )     (29,547 )

Income tax benefit (provision)

      609       (5,482 )     (3,654 )
                        

Net cash provided by (used in) operating activities

    $ 23,730     $ (128,193 )   $ 57,127  
                        

(1)

US Oncology Holdings incurs certain general and administrative costs that are incremental to the amounts incurred by US Oncology. During the quarters ended March 31, 2007 and 2006 and the quarter ended December 31, 2006, these expenses were $12.9 million (including $41 thousand of general and administrative costs and $12.9 million loss on extinguishment of debt), $126 thousand and $39 thousand, respectively, and are not included in the determination of US Oncology EBITDA of $49.9 million, $61.5 million and $59.6 million, respectively, for these periods.

 

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