Alliance HealthCare Services, Inc. (NYSE:AIQ) (the “Company” or “Alliance”), a leading national provider of outpatient diagnostic imaging and radiation therapy services, reaffirmed full year 2011 guidance and announced financial guidance for full year 2012.

Full Year 2011 Guidance

The Company reaffirms its full year 2011 revenue and Adjusted EBITDA guidance. Adjusted EBITDA is defined below. Full year 2011 revenue is expected to range from $475 million to $495 million and Adjusted EBITDA is expected to range from $140 million to $150 million. Alliance expects to report full year 2011 revenue and Adjusted EBITDA at the higher end of the respective guidance ranges.

Full Year 2012 Guidance

For full year 2012, the Company expects revenue to range from $470 million to $500 million and Adjusted EBITDA is expected to range from $140 million to $160 million.

Paul S. Viviano, Chairman of the Board and Chief Executive Officer, stated, “Alliance is positioned to stabilize its Adjusted EBITDA in the context of the challenging general economic conditions and trends which continue to adversely impact demand and volumes for the healthcare services sector. As previously announced, the Company’s ongoing organizational restructuring initiatives are designed to stabilize and grow imaging services, expand radiation oncology services, increase organizational efficiency and reduce costs. Alliance is implementing a turnaround plan to realize $25 million of annualized cost savings and efforts will continue throughout 2012 to put additional savings in place.”

Included in Alliance’s 2012 full year Adjusted EBITDA guidance range is approximately $18 million to $20 million of cost reductions and increase in organizational efficiencies.

For full year 2012, the Company expects MRI revenue to decrease 4% to 9%. MRI volume is expected to decrease 2% to 4% and MRI pricing is expected to decrease 2% to 5%. PET/CT revenue is expected to decrease 5% to 10%. PET/CT volume is expected to decrease 3% to 5% and PET/CT pricing is expected to decrease 2% to 5%.

For full year 2012, the Company expects radiation oncology revenue to range from $84 million to $92 million, representing an 11% to 21% increase over expected 2011 radiation oncology revenue. Alliance expects that approximately 18% of the Company’s full year 2012 revenue will be generated from radiation oncology, increasing from approximately 15% in full year 2011.

Alliance’s weighted average shares of common stock and common stock equivalents outstanding for 2012 is expected to total approximately 54 million shares.

Alliance expects 2012 cash capital expenditures to total approximately $55 million to $65 million. The Company expects to open 10 to 15 fixed-site imaging centers and expects to open three to five radiation therapy centers in 2012.

Cash income taxes paid for full year 2012 are expected to range from $2 million to $3 million.

In 2012, the Company expects a decrease in long-term debt, net of the change in cash and cash equivalents, of $15 million to $25 million.

Conference Call

Investors and all others are invited to listen to a conference call discussing full year 2012 guidance. The conference call is scheduled for Thursday, December 22, 2011 at 8:30 a.m. Eastern Time. The call will be broadcast live on the Internet and can be accessed by visiting the Company’s website at www.alliancehealthcareservices-us.com. Click on Audio Presentations in the Investors section of the website to access the link.

The conference call can be accessed at (888) 694-4676 (United States) or (973) 582-2737 (International). Interested parties should call at least 5 minutes prior to the call to register. A telephone replay will be available until January 22, 2012. The telephone replay can be accessed by calling (855) 859-2056 (United States) or (404) 537-3406 (International). The conference call identification number is 37189500.

About Alliance HealthCare Services

Alliance HealthCare Services is a leading national provider of advanced outpatient diagnostic imaging and radiation therapy services based upon annual revenue and number of systems deployed. Alliance focuses on MRI, PET/CT and CT through its Imaging division and radiation therapy through its Oncology division. With more than 2,300 team members committed to providing exceptional patient care and exceeding customer expectations, Alliance provides quality clinical services for over 1,000 hospitals and other healthcare partners in 45 states. Alliance operates 570 diagnostic imaging and radiation therapy systems. The Company is the nation’s largest provider of advanced diagnostic mobile imaging services and one of the leading operators of fixed-site imaging centers, with 135 locations across the country. Alliance also operates 37 radiation therapy centers, including 16 dedicated stereotactic radiosurgery facilities, many of which are operated in conjunction with local community hospital partners, providing treatment and care for cancer patients. With 16 stereotactic radiosurgery facilities in operation, Alliance is among the leading providers of stereotactic radiosurgery nationwide.

Forward-Looking Statements

This press release contains forward-looking statements relating to future events, including statements related to the implementation and potential savings from the Company’s organizational restructure, the Company’s expected 2012 cash capital expenditures, the number of new fixed-site imaging centers and new radiation therapy centers that the Company expects to open in 2012 and the Company’s full year 2011 and 2012 guidance. In this context, forward-looking statements often address the Company’s expected future business and financial results and often contain words such as “expects,” “anticipates,” “intends,” “plans,” “believes,” “seeks” or “will.” Forward-looking statements by their nature address matters that are uncertain and subject to risks. Such uncertainties and risks include: changes in the preliminary financial results and estimates due to the restatement or review of the Company’s financial statements; the nature, timing and amount of any restatement or other adjustments; the Company’s ability to make timely filings of its required periodic reports under the Securities Exchange Act of 1934; issues relating to the Company’s ability to maintain effective internal control over financial reporting and disclosure controls and procedures; the Company’s high degree of leverage and its ability to service its debt; factors affecting the Company’s leverage, including interest rates; the risk that the counterparties to the Company’s interest rate swap agreements fail to satisfy their obligations under these agreements; the Company’s ability to obtain financing; the effect of operating and financial restrictions in the Company’s debt instruments; the accuracy of the Company’s estimates regarding its capital requirements; the effect of intense levels of competition in the Company’s industry; changes in the methods of third party reimbursements for diagnostic imaging and radiation oncology services; fluctuations or unpredictability of the Company’s revenues, including as a result of seasonality; changes in the healthcare regulatory environment; the Company’s ability to keep pace with technological developments within its industry; the growth in the market for MRI and other services; the disruptive effect of hurricanes and other natural disasters; adverse changes in general domestic and worldwide economic conditions and instability and disruption of credit markets; difficulties the Company may face in connection with recent, pending or future acquisitions, including unexpected costs or liabilities resulting from the acquisitions, diversion of management’s attention from the operation of the Company’s business, and risks associated with integration of the acquisitions; and other risks and uncertainties identified in the Risk Factors section of the Company’s Form 10-K for the year ended December 31, 2010, filed with the Securities and Exchange Commission (the “SEC”), as may be modified or supplemented by our subsequent filings with the SEC. These uncertainties may cause actual future results or outcomes to differ materially from those expressed in the Company’s forward-looking statements. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof. The Company does not undertake to update its forward-looking statements except as required under the federal securities laws.

ALLIANCE HEALTHCARE SERVICES, INC. ADJUSTED EBITDA (in millions)

Adjusted EBITDA, as defined by the Company’s management, represents net income (loss) before: interest expense, net of interest income; income taxes; depreciation expense; amortization expense; net income (loss) attributable to noncontrolling interests; non-cash share-based compensation; severance and related costs; restructuring charges; loss on extinguishment of debt; fees and expenses related to acquisitions, costs related to debt financing, non-cash impairment charges, and other non-cash charges included in other (income) expense, net, which includes non-cash losses on sales of equipment. The components used to reconcile net income (loss) to Adjusted EBITDA are consistent with our historical presentation of Adjusted EBITDA. Adjusted EBITDA is not a measure of financial performance under generally accepted accounting principles in the United States, or “GAAP.”

Management uses Adjusted EBITDA, and believes it is a useful measure for investors, for a variety of reasons. Management regularly communicates its Adjusted EBITDA results and management’s interpretation of such results to its board of directors. Management also compares the Company’s Adjusted EBITDA performance against internal targets as a key factor in determining cash incentive compensation for executives and other employees, largely because management feels that this measure is indicative of how our diagnostic imaging and radiation oncology business is performing and is being managed. Management believes that Adjusted EBITDA is a particularly useful comparative measure within the Company’s industry. The diagnostic imaging and radiation oncology industry continues to experience significant consolidation. These activities have led to significant charges to earnings, such as those resulting from acquisition costs, and to significant variations among companies with respect to capital structures and cost of capital (which affect interest expense) and differences in taxation and book depreciation of facilities and equipment (which affect relative depreciation expense), including significant differences in the depreciable lives of similar assets among various companies. In addition, management believes that because of the variety of equity awards used by companies, the varying methodologies for determining non-cash share-based compensation expense among companies and from period to period, and the subjective assumptions involved in that determination, excluding non-cash share-based compensation from Adjusted EBITDA enhances company-to-company comparisons over multiple fiscal periods and enhances the Company’s ability to analyze the performance of its diagnostic imaging and radiation oncology business.

Adjusted EBITDA may not be directly comparable to similarly titled measures reported by other companies. In addition, Adjusted EBITDA has other limitations as an analytical financial measure. These limitations include the fact that Adjusted EBITDA is calculated before recurring cash charges including interest expense, income taxes and severance costs, and is not adjusted for capital expenditures, the replacement cost of assets or other recurring cash requirements of the Company’s business. Adjusted EBITDA also does not reflect any cost for equity awards to employees and does not exclude income attributable to noncontrolling interests. In the future, the Company expects that it may incur expenses similar to the excluded items discussed above. Accordingly, the exclusion of these and other similar items in the Company’s non-GAAP presentation should not be interpreted as implying that these items are non-recurring, infrequent or unusual. Management compensates for the limitations of using Adjusted EBITDA as an analytical measure by relying on the Company’s GAAP results to evaluate its operating performance and by considering independently the economic effects of the items that are or are not reflected in Adjusted EBITDA. Management also compensates for these limitations by providing GAAP-based disclosures concerning the excluded items in the Company’s financial disclosures. As a result of these limitations, however, Adjusted EBITDA should not be considered as an alternative to net income (loss), as calculated in accordance with GAAP, or as an alternative to any other GAAP measure of operating performance.

            2011 Full Year       2012 Full Year
Guidance Range Guidance Range
Net income ($151 )     ($147 ) ($24 )     ($14 )
Income tax expense (benefit) (40 ) (37 ) (18 ) (10 )
Impairment charges 156 156 - -
Depreciation expense; amortization expense; interest
expense and other, net; noncontrolling interest in subsidiaries;
share-based payment and other expenses   175         178     182         184  
Adjusted EBITDA $ 140       $ 150   $ 140       $ 160  

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