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  "documentTitle": "NMC Health plc (NMC.LN)",
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  "authorName": "Carson C. Block",
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  "presentationDate": "2019-12-17 00:00:00",
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  "notes": "Includes a sensitivity table modeling EBITDA margin impact based on varying rejection rates.",
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      "text": "A higher-than-stated rejection rate would cast a significant shadow over NMC's financial performance.",
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      "text": "EBITDA margin: 17.6%",
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      "text": "Using a simple model of $1.0 million in invoices on a 25% gross EBITDA margin, the difference in EBITDA margins by rejection rate percentage on the portion of revenue billed to insurers is shown below:",
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      "text": "A higher-than-stated rejection rate would cast a significant shadow over NMC's financial performance. Even if NMC's rejection rates were consistent with those of Mediclinic and Aster—in the neighborhood of 5%, per the lower of two industry expert estimates—, then that shift would seemingly eliminate a material portion of NMC's apparent EBITDA margin advantage over those healthcare groups.",
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      "text": "NMC substantial purchases from related parties that could also boost margins. Notably, there are sizable and increasing purchases from related parties that amounted to $130 million, or 11%, of expenses, in 2018. There is minimal disclosure regarding these purchases, with one footnote that",
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      "text": "Such accumulation of overdue receivables suggests that NMC is having difficulty getting paid by insurers. We understand that payors in the UAE have begun taking a closer look at reimbursement in recent years.",
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      "text": "NMC Unimpaired Receivables Overdue By More Than One Year",
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      "text": "Possible Subsidies from Related Parties",
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