Investment Thesis
- On valuation grounds relative to the current share price, MPL trades fair value.
- MPL is a quality business with a high-quality management team.
- Given Australia’s growing and ageing population, there will be increased demand for health care services. This will add additional pressure on Australia’s public health care system and the Federal budget and an increased dependence on private health care insurers. NHF offers exposure to the business model of providing a funding mechanism for the high-growth health care sector. Healthcare spending is expected to grow at 5-10% per annum, so without significant tax hikes, the government cannot afford for people to shift back to the public healthcare system.
- Given underlying increases in average premium rates of around 5 – 6% p.a., some policyholder growth (especially at the 30-34-year-old segment), estimates that MPL offers close to low double-digit underlying growth in the medium term.
- Potential to improve the company’s expense ratio.
- Room for industry-wide benefits such as losses from risk equalization funds as nonprofitable players are consolidated.
- Incentives and benefits encourage PHI take-up. They include 1. Tax benefits and penalties for Australian residents (via Lifetime Health Cover, Medicare Levy Surcharge and means tested rebate); and 2. Shorter wait times, a choice of specialist doctor/hospital and coverage of ancillary health services support.
Key Risks
- Intensifying competition between top 6 players, putting policy growth targets at risk and any increases in expected marketing spend going forward will no doubt add further strain on earnings growth.
- Policyholders declined unexpectedly, despite the incentives and Australian Government struggling with the rapid increase in healthcare spending and health services demand.
- Registered health insurers cannot increase premium rates without approval from the Government/Minister for Health/PHIAC/APRA. This leaves NHF’s ROE and margins exposed to a political process and pressures if the company is deemed too profitable.
- Regulatory changes especially relating to any changes to tax incentives and benefits which encourage take up of PHI.
- Higher than expected lapse rates and claims inflation as a result of poor insurance policy design, aging population, and costs of new medical equipment, procedures and treatments.
- Poor negotiations with healthcare providers such as private hospital operators leading to unfavourable contractual terms.
- Lower than expected investment returns.
Key Highlights: Relative to the pcp and on a constant currency basis:
- Group operating profit up +12.3% to $286.5m driven by growth in both MPL’s segments – Health Insurance and Medibank Health.
- NPAT was down -2.7% to $220.2m, on lower net investment income relative to the pcp. Underlying NPAT, which normalises for investment market returns, was up +4.4%. Net investment income of $30.9m, was down from $71.8m in 1H21, with income from the growth and defensive portfolios down $14.8m and $24.6m, respectively. Gross margin of 15.4% and operating margin of 8.1%, was a 20bps and 40 bps improvement over the pcp, respectively.
- The Board declared a fully franked interim dividend of 6.1cps, which equates to a 79.1% payout ratio of underlying NPAT which normalises for investment market returns, and within the target payout ratio range of between 75-85% of underlying NPAT. MPL expects the payout ratio to be towards the top end of the target range for the full year.
- Retains a strong capital position with health Insurance capital of $960.8m as at 31 December 2021, which equates to 13.0% of premium revenue after the allowance for the dividend declared with this result and is at the top end of the Board’s stated target range of 11.0-13.0%.
- Health Insurance: Operating profit was up +10.3% to $280.9m driven by growth in premium revenue up +3.8% to $3,452.0m, and a benign claims environment. The segment saw strong resident policyholder growth of +1.5% in the 6 months to 31 December 2021, with policyholder growth of 28,100 comprising 12,100 for Medibank and 16,000 for ahm. Management expense ratio was down 30 bps to 7.2% due to lower management expenses and increasing revenue.
- Medibank Health: Segment profit was up +36.7% to $25.7m driven by strong revenue growth up +6.9% to $155.7m with strong demand in telehealth and health and wellbeing, partially offset by MPL’s travel insurance business (which was impacted by closed borders due to the Covid pandemic).
- Management noted MPL’s healthcare investments including Myhealth Medical Group, East Sydney Private Hospital and JV with Calvary contributed $2.3m to this result.
Company Description
Medibank (MPL) is Australia’s largest private health insurer with ~30% market share. Medibank’s health insurance business (Health Insurance) underwrites private health insurance and the insurer generates revenue from a number of complementary services.
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