瑞银美股医疗保健行业2019年Q1医院季度调查201951448页

GlobalResearch14May2019QuarterlyHospitalSurvey:1Q19UBSEvidenceLabinside:CostsTrackFavorably,MixedOutsourcingRead,CapexBudgetsGrowingIntroducingtheUBSEvidenceLabQuarterlyHospitalSurveyUBSEvidenceLabsurveyed75hospitalexecutiveswithoversightacross180acutecarehospitals.Thisquarterlycross-sectornoteprovidesuniqueanddifferentiatedinsightacross90%ofindustry'scoststructure,expectationsforcapitalbudgets,outsourcingtrendsandkeyareasofstrategicfocus.CostgrowthexpectedtoremainexceedinglylownextyearControllablecostinflationisexpectedtoremainathistoricallylowlevelswith2020costgrowthexpectedtotrend~0%-2%y/yvsour2%-3.5%assumption.Moderatingcostsenhancesourconfidencearoundour2019hospitalforecasts,mostnotablyHCA.Continuedstronginterestinortho/outpatientcapabilitiesstrikesusasapositiveforTHC(USPI)andSGRY.InterestinpsychJVsremainsfairlyhighoverall,asapositiveforACHCandUHS,thoughthenumberofactiveevaluationisstillsomewhatlow.HospitalSpendingGrowing,AlbeitLessThanIndicatedinPriorSurveyWavesWave3suggestsa0.8%increaseinhospitalcapitalbudgetsonaverage,modestlybelowthe2.6%and2.7%wesawinpriorsurveys.~20%ofhospitalssaidtheirbudgetsaregoingupmorethanusualvs.25%inthelastwave.Whileinteresting,itisunclearwhetherthisisabigenoughchangetohaveconcernsaboutthecapitalenvironment.InQ1results,capitalpurchasesdidnotshowsignsofslowingandwecontinuetoexpectrobustcapitaltrendsforourUSlistedcap-heavynamesincludingVAR,HRC,ISRG,SYK,MDT,andBDX.WeseethecontinuedprioritizationofradiologyasapositiveforPhilips(Buy)andSiemensHealthineers(Neutral),coveredbySebWalker,asitsuggestsrecentstrengthintheUSimagingmarketislikelytocontinue.HospitaloutsourcingmorechallengingforLabs,Value-Basedramp+veforPINCSurveyresultsindicateanegativeshareriskforDGX/LHfromthehospitalmarket(4%lookingtoincreaseoutsourcingvs.31%lookingtoincreaselaboutreachoperations)vs.aslightnetpositivesharegainopportunityintheDecembersurvey.Thedataalsosuggeststhathospitalsexpecttoseeameaningfulincreaseinnetpatientrevenuestiedtovalue-based/risk-basedcareoverthenextseveralyears(doublingby2025to33%/22%ofnetpatientrevenues),potentiallydrivingdemandforITsolutionsfromHCITvendorslikeBuy-ratedPremier(PINC)[e-mail][phone]MatthewTaylor,[e-mail][e-mail][phone]NathanLeiphardt,[e-mail][phone]YiCheng,[e-mail][e-mail][e-mail][e-mail][phone]QuarterlyHospitalSurvey:1Q1914May20192TableofContentsExecutiveSummaryInPictures.......................................................3SurveyOverview..............................................................................5InsightintoCostTrendOutlook.....................................................6CostTrendsandExpectationsbyLineItem..................................................7Costtrendsremainbrightspotforsector...................................................11CapitalBudgetsExpectedtoGrowModestly..............................12CapitalBudgetIncreasesbyServiceLine....................................................14CapitalInvestmentPrioritiesbyServiceLine...............................................16CapitalEquipmentInvestmentPriorities.....................................................26MostProfitableServiceLines......................................................................26StrategicPriorities..........................................................................25Outpatient.................................................................................................25Post-Acute.................................................................................................26BehavioralHealth.......................................................................................28PhysicianServicesOutsourcing...................................................................29LabServices....................................................................................31LabOutreachBreakdownbyHospitalSizeandGeography.....................31DGXandLHwereevenlyselectedaspreferredoutsourcingpartnersforhospitals.................................................................................................35Value-BasedReimbursement........................................................36ImpactonProviderStrategies.................................................................36Valueandrisk-basedcurrentandfuturepen