December 2015

Dear shareholders and prospective shareholders,

Yesterday morning, CRH Medical announced the acquisition of Johns Creek Anesthesia. This acquisition further solidifies CRH’s footprint in Georgia and begins 2016 with an accretive, value creating transaction for CRH shareholders.

Majority purchase of Macon Gastroenterology Anesthesia Associates

On December 11th, CRH Medical announced the 65% purchase of Macon Gastroenterology Anesthesia Associates (MGAA). The underlying physician sellers remain a 35% partner in the business, and the structure of the transaction is one that is mutually beneficial for both CRH, and our physician partners. The transaction was integrated immediately into our existing operations and is expected to generate total annual revenue of $3.5 million.

Partnering with Scotiabank

On November 25th, CRH announced it had entered into an agreement with Scotiabank for a $33M Senior Secured revolving Credit Facility. The facility replaced $24 million of existing debt and will be used to assist in the financing of potential future acquisitions. CRH has an expected total interest cost of approximately 3.5% per year and approximate financing expense savings for 2016 of $2.5M. In addition to the financial benefits of the Scotiabank partnership, the facility provides a low cost of capital that will further augment our cash flow for future potential acquisitions.

Of key importance to CRH is the fact that our underlying business fundamentals and financial strength have enabled us to partner with one of North America’s premier financial institutions. CRH views this partnership, and the associated low interest rate, as a vote of confidence in our existing business and in our growth strategy moving forward.

US and Canadian Marketing

CRH presented at the Acumen Capital small cap conference in Calgary at the end of November, where we were able to engage with a large audience of institutional investors. Retail branch presentations and ongoing updates continue to keep our retail audience engaged and informed.

In addition to our investor relations program in place in Canada, we are continuing to expand our marketing and investor relations efforts in the US. Management spent a week in the US meeting with investors in November and introduced CRH Medical to several accounts south of the border during the fourth quarter.

GI Conferences

December had us attending two gastroenterology conferences to cap off the year. The first meeting we attended was the ACG Southern Regional Course in Nashville, TN. This two day course proved fruitful for CRH as we were able to generate a substantial number of new leads – many of whom came by our booth after the “hands-on” session which featured the CRH O’Regan System. We then moved on to the New York Society for Gastrointestinal Endoscopy’s Annual Course in New York, NY. Though we have had a presence at this meeting for a number of years, this year we saw a significant increase in interest from physicians in the area, reiterating the need for recurrent messaging to prospective partners both in hemorrhoid treatment and anesthesia services.
I look forward to updating you throughout 2016, and at any time, if you have any questions, or would simply like an update on what we are doing, please don’t hesitate to contact me either by phone or email. Thank you for your continued support.

David Matousek
Director, Investor Relations
CRH Medical Corporation
T: 800.660.2153 x 1030

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