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Alliance HealthCare Services, Inc. (NASDAQ: AIQ) (the “Company,” “Alliance,” “we” or “our”), a leading national provider of outsourced radiology, oncology and interventional services, announced today the results for the quarter and six months ended June 30, 2016.

Second Quarter and Year-to-Date 2016 Highlights

• The Company reported revenue totaling $125.3 million for the second quarter, a $6.8 million or 5.7% increase over the second quarter of last year, and $249.0 million year-to-date, a $21.1 million or 9.3% increase over prior year.
• On a sequential basis vs. first quarter of 2016, revenue increased $1.6 million or 1.3%, and Adjusted EBITDA increased $4.1 million or 13.4%.
• Net income attributable to Alliance was $2.5 million for the quarter, a $4.4 million increase over second quarter of prior year, and $1.3 million year-to-date, a $1.5 million increase over prior year.
• GAAP Net Income per Share was $0.23 for the quarter and Adjusted Net Income per Share (as defined below) was $0.37.
• GAAP Net Income per Share was $0.12 for the first half of 2016 and Adjusted Net Income per Share was $0.42.
• The Company generated $34.4 million of Adjusted EBITDA (as defined below) for the quarter, compared to $34.0 million in the second quarter of prior year, and $64.8 million of Adjusted EBITDA year-to-date, compared to $64.1 million in 2015.
• The Company continued to generate strong cash flow, with $35.2 million of quarterly operating cash flow, compared to $26.9 million in the second quarter prior year, and $57.9 million of year-to-date operating cash flow, compared to $47.7 million last year.
• Alliance Radiology reported strong same-store volume growth of +2.0% for MRI and +5.8% for PET/CT for the quarter.
• Alliance Interventional revenue increased $3.2 million, or 39.0%, to $11.2 million for the quarter.
• Based on our results thus far this year, we are reaffirming full-year 2016 guidance for revenue ranging from $505-$535 million and Adjusted EBITDA of $130-$150 million.

2016 Financial Results

“Our solid results from the second quarter reflect growth, both sequentially and year-over-year, across our core business segments in Radiology and Oncology and positive contributions from Interventional Services. Across each of our businesses, actions we have taken to augment our sales and business development teams, and enhance the value proposition we provide our customers are improving our competitive position and are key elements of our strong performance in retaining existing customers and securing new customers,” stated Tom Tomlinson, Chief Executive Officer and President of Alliance HealthCare Services. “We continued the positive momentum in our Radiology business with another consecutive quarter of net new sales growth driven by strong same-store growth for MRI and PET/CT and improved performance in customer retention and contract renewal. We are proud of our continued progress in Radiology as this marks the ninth consecutive quarter of same-store volume growth for MRI and sixth consecutive quarter of growth for PET/CT. Alliance Oncology continues to seek and build strong partnerships with high profile customers, adding Saint Peter’s University Hospital on June 1, along with the expectations of one or two additional transactions in the coming months. We remain committed to our long-term strategic investment in Alliance Interventional, and we are excited about the growth opportunities to expand our footprint as well as its role in enhancing our value proposition through our integrated value-added business model.”

Tomlinson continued, “The second quarter results also highlight the success we are driving from initiatives focused on balance sheet management. Alliance generated very strong cash flows, allowing us to reduce leverage, strengthen our balance sheet, and make necessary investments to support customer retention and growth. Our strong relationship with Thai Hot, our new majority shareholder, and the other independent Board Members is a solid foundation as we work closely with them to evaluate opportunities to enhance our long-term growth strategy both domestically and in China. Our results and strategic developments for the quarter are a testament to the health of our business, and we look forward to continuing to see revenue and EBITDA growth through the second half of 2016. As a result, we are reaffirming full-year 2016 guidance of revenue ranging from $505-$535 million and Adjusted EBITDA of $130-$150 million.”

Revenue for the second quarter of 2016 increased to $125.3 million, compared to $118.5 million in the second quarter of 2015. This increase was primarily due to an increase in Interventional Services revenue of $3.2 million, in MRI revenue of $3.6 million and in Oncology revenue of $0.5 million, partially offset by a decrease in PET/CT revenue of $0.5 million, when compared to the second quarter of 2015.

Revenue for the first half of 2016 increased to $249.0 million, compared to $227.9 million in 2015. This increase was primarily due to an increase in Interventional Services revenue of $11.0 million, in MRI revenue of $8.2 million and in Oncology revenue of $2.4 million, partially offset by a decrease of $0.3 million in PET/CT revenue. Other revenues remained consistent with the first half of 2015.

Alliance’s net income, computed in accordance with GAAP, totaled $2.5 million in the second quarter of 2016 compared to a net loss of $2.0 million in the second quarter of 2015. Net income, computed in accordance with GAAP, totaled $1.3 million for the first half of 2016, compared to a net loss of $0.2 million in 2015.

Alliance’s Adjusted EBITDA for the second quarter of 2016 increased 1.3% to $34.4 million from $34.0 million in the second quarter of 2015 and increased 1.1% for the first half of 2016 to $64.8 million from $64.1 million in 2015. The increases were primarily driven by our expansion into the Interventional Services line of business and increased total volume of MRI scans, partially offset by planned MRI and PET/CT price reductions.

Net income per share on a diluted basis, computed in accordance with GAAP, was $0.23 per share in the second quarter of 2016 compared to net loss of $(0.18) per share for same quarter of 2015. Net income (loss) per share on a diluted basis was impacted by $0.14 in the second quarter of 2016 and $0.52 in the second quarter of 2015 due to restructuring charges, severance and related costs, transaction and shareholder transaction costs, legal matter expenses and differences in the GAAP income tax rate from our historical income tax rate of 42.5%. Excluding these charges, adjusted net income per diluted share – non-GAAP was $0.37 for the second quarter 2016 and $0.34 for the same quarter of 2015.

Net income per share on a diluted basis, computed in accordance with GAAP, was $0.12 per share for the first half of 2016 compared to net loss of $(0.02) per share in 2015. Net income (loss) per share on a diluted basis was impacted by $0.30 in the first half of 2016 and $0.66 in 2015 due to restructuring charges, severance and related costs, transaction and shareholder transaction costs, legal matter expenses and differences in the GAAP income tax rate from our historical income tax rate of 42.5%. Excluding these charges, adjusted net income per diluted share – non-GAAP was $0.42 for the first half of 2016 and $0.64 for the same period in 2015.

Cash flows provided by operating activities totaled $35.2 million in the second quarter of 2016, compared to $26.9 million in the second quarter of 2015. In the second quarter of 2016, total capital expenditures, including cash and financed capital expenditures, capital leases and deposits on equipment, were $27.2 million compared to $26.9 million in the second quarter of 2015.

Cash flows provided by operating activities totaled $57.9 million in the first half of 2016, compared to $47.7 million in 2015. During the six months ended June 30, 2016, total capital expenditures, including cash and financed capital expenditures, capital leases and deposits on equipment, were $49.3 million compared to $37.6 million in 2015.

Alliance’s gross debt, defined as total long-term debt (including current maturities but excluding the impact of deferred financing costs), decreased $5.6 million to $572.1 million at June 30, 2016 from $577.7 million at December 31, 2015. Alliance’s net debt, defined as total long-term debt (including current maturities but excluding the impact of deferred financing costs) less cash and cash equivalents, increased $8.2 million to $547.8 million at June 30, 2016 from $539.6 million at December 31, 2015. Cash and cash equivalents were $24.3 million at June 30, 2016 and $38.1 million at December 31, 2015.

Alliance’s total debt, as defined above, divided by the last twelve months Consolidated Adjusted EBITDA was 4.15x for the twelve month period ended June 30, 2016, compared to 4.10x for the year ended December 31, 2015. Alliance’s net debt, as defined above, divided by the last twelve months Consolidated Adjusted EBITDA was 3.97x for the twelve month period ended June 30, 2016, compared to 3.83x for the year ended December 31, 2015.

Full Year 2016 Guidance

Alliance’s full year 2016 guidance ranges are as follows:

  Ranges (dollars in millions) Revenue $505 - $535 Adjusted EBITDA $130 - $150 Capital expenditures $75 - $90 Maintenance $45 - $55 Growth $30 - $35

Decrease/(Increase) in long-term debt, net of the change in cash and cash equivalents (before investments in acquisitions), before growth capital expenditures or "free cash flow before growth capital expenditures"

$20 - $40

Decrease/(Increase) in long-term debt, net of the change in cash and cash equivalents (before investments in acquisitions), after growth capital expenditures or "free cash flow after growth capital expenditures"

($15) - ($25)

Second Quarter 2016 Earnings Conference Call

Investors and all others are invited to listen to a conference call discussing second quarter 2016 results. The conference call is scheduled for Thursday, August 4, 2016 at 5 p.m. Eastern Time. Additionally, a live webcast of the call will be available on the Company’s website at www.alliancehealthcareservices-us.com. Click on “About Us,” then, “Investor Relations.” You will find the Audio Presentation in the “News & Events” section. A replay of the webcast will be available on the Company’s website until September 4, 2016.

The conference call can be accessed at 877.638.4550 (International callers can dial 973.582.2737). Interested parties should call at least five minutes prior to the call to register. A telephone replay will be available until September 4, 2016. The telephone replay can be accessed by calling 800.585.8367. The conference call identification number is 54025886.

Definition of Non-GAAP Measures

Adjusted EBITDA and Adjusted Net Income Per Share are not measures of financial performance under generally accepted accounting principles in the United States (“GAAP”).

For a more detailed discussion of these non-GAAP financial measures and a reconciliation to the most directly comparable GAAP financial measure, see the section entitled “Non-GAAP Measures” included in the tables following this release.

About Alliance HealthCare Services

Alliance HealthCare Services (NASDAQ: AIQ) is a leading national provider of outsourced healthcare services to hospitals and providers. We also operate freestanding outpatient radiology, oncology and interventional services clinics, and Ambulatory Surgical Centers (“ASC”) that are not owned by hospitals or providers. Diagnostic radiology services are delivered through the Radiology Division (Alliance HealthCare Radiology), radiation oncology services are delivered through the Oncology Division (Alliance Oncology), and interventional and pain management services are delivered through the Interventional Services Division (Alliance Interventional). Alliance is the nation’s largest provider of advanced diagnostic mobile imaging services, an industry-leading operator of fixed-site imaging centers, and a leading provider of stereotactic radiosurgery nationwide. As of June 30, 2016, Alliance operated 621 diagnostic radiology and radiation therapy systems, including 112 fixed-site radiology centers across the country, and 34 radiation therapy centers and SRS facilities. With a strategy of partnering with hospitals, health systems and physician practices, Alliance provides quality clinical services for over 1,000 hospitals and other healthcare partners in 45 states, where approximately 2,400 Alliance Team Members are committed to providing exceptional patient care and exceeding customer expectations. For more information, visit www.alliancehealthcareservices-us.com.

Forward-Looking Statements

This press release contains forward-looking statements relating to future events, including statements related to the Company’s long-term growth strategy and efforts to diversify its business model, the Company’s plans to expand its new Interventional Services Division, both organically and through one or more acquisitions, the Company’s expectations regarding growth across the Company’s divisions, the expansion of its service footprint and revenue growth, maximizing shareholder value, and the Company’s Full Year 2016 Guidance, including its forecasts of revenue, Adjusted EBITDA, capital expenditures, and increase in long-term debt. 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; our ability to comply with reporting obligations and other covenants under our debt instruments, the failure of which could cause the debt to become due; the accuracy of the Company’s estimates regarding its capital requirements; the effect of intense levels of competition and overcapacity 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 or lack thereof in the market for radiology, oncology, interventional 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 and equity 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, costs, delays and impediments to completing the acquisitions, 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, 2015, 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. CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (LOSS) (in thousands, except per share amounts)     Quarter Ended June 30,   Six Months Ended June 30, (unaudited) (unaudited)   2016       2015     2016       2015   Revenues $ 125,317 $ 118,504 $ 249,041 $ 227,933 Costs and expenses: Cost of revenues, excluding depreciation and amortization 69,939 67,485 140,853 129,371 Selling, general and administrative expenses 23,175 20,800 48,440 41,755 Transaction costs 431 1,113 848 1,532 Shareholder transaction costs 1,498 — 2,507 — Severance and related costs 708 195 2,424 454 Impairment charges — 6,670 — 6,746 Depreciation expense 13,730 12,072 26,778 23,705 Amortization expense 2,494 2,495 4,937 4,530 Interest expense and other, net 8,872 6,904 16,367 12,922 Other (income) and expense, net   (3,546 )   486     (4,334 )   127   Total costs and expenses   117,301     118,220     238,820     221,142  

Income before income taxes, earnings from unconsolidated investees, and noncontrolling interest

8,016 284 10,221 6,791 Income tax expense (benefit) 2,221 (1,366 ) 1,275 206 Earnings from unconsolidated investees   (393 )   (1,292 )   (645 )   (2,455 ) Net income 6,188 2,942 9,591 9,040 Less: Net income attributable to noncontrolling interest   (3,729 )   (4,903 )   (8,322 )   (9,250 )

Net income (loss) attributable to Alliance HealthCare Services, Inc.

$ 2,459   $ (1,961 ) $ 1,269   $ (210 ) Comprehensive income (loss), net of taxes

Net income (loss) attributable to Alliance HealthCare Services, Inc.

$ 2,459 $ (1,961 ) $ 1,269 $ (210 ) Unrealized gain (loss) on hedging transactions, net of taxes   84     (13 )   46     (141 ) Comprehensive income (loss), net of taxes: $ 2,543   $ (1,974 ) $ 1,315   $ (351 )

Income (loss) per common share attributable to Alliance HealthCare Services, Inc.:

Basic $ 0.23   $ (0.18 ) $ 0.12   $ (0.02 ) Diluted $ 0.23   $ (0.18 ) $ 0.12   $ (0.02 )

Weighted average number of shares of common stock and common stock equivalents:

Basic 10,882 10,715 10,771 10,714 Diluted 10,893 10,836 10,796 10,839   ALLIANCE HEALTHCARE SERVICES, INC. CONDENSED CONSOLIDATED BALANCE SHEETS (in thousands)     June 30,   December 31, (unaudited) (audited)   2016     2015   ASSETS Current assets: Cash and cash equivalents $ 24,319 $ 38,070 Accounts receivable, net of allowance for doubtful accounts 73,514 73,208 Prepaid expenses 13,191 13,463 Other receivables   2,532     3,206   Total current assets 113,556 127,947 Plant, property and equipment, net 204,447 177,188 Goodwill 106,129 102,782 Other intangible assets, net 164,587 162,923 Other assets   25,858     32,820   Total assets $ 614,577   $ 603,660   LIABILITIES AND STOCKHOLDERS’ EQUITY Current liabilities: Accounts payable $ 24,973 $ 20,796 Accrued compensation and related expenses 22,753 19,933 Accrued interest payable 3,253 3,323 Current portion of long-term debt 19,174 17,732 Current portion of obligations under capital leases 2,606 2,674 Other accrued liabilities   34,783     36,453   Total current liabilities 107,542 100,911 Long-term debt, net of current portion and deferred financing costs 509,800 540,353 Obligations under capital leases, net of current portion 11,524 10,332 Deferred income taxes 23,960 23,020 Other liabilities   7,149     6,664   Total liabilities 659,975 681,280   Stockholders’ deficit: Common stock 109 108 Treasury stock (3,138 ) (3,138 ) Additional paid-in capital 60,635 29,297 Accumulated comprehensive loss (465 ) (511 ) Accumulated deficit   (197,124 )   (198,393 ) Total stockholders’ deficit attributable to Alliance HealthCare Services, Inc. (139,983 ) (172,637 ) Noncontrolling interest   94,585     95,017   Total stockholders’ deficit   (45,398 )   (77,620 ) Total liabilities and stockholders’ deficit $ 614,577   $ 603,660     ALLIANCE HEALTHCARE SERVICES, INC. CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) (in thousands)     Six Months Ended June 30,   2016       2015   Operating activities: Net income $ 9,591 $ 9,040 Adjustments to reconcile net income to net cash provided by operating activities: Provision for doubtful accounts 1,356 1,054 Share-based payment 1,780 819 Depreciation and amortization 31,715 28,235 Amortization of deferred financing costs 3,312 2,098 Accretion of discount on long-term debt 254 232 Adjustment of derivatives to fair value (45 ) 98 Distributions more than undistributed earnings from investees 107 189 Deferred income taxes 940 (697 ) Gain on sale of assets (169 ) (406 ) Changes in fair value of contingent consideration related to acquisitions (3,640 ) — Impairment charges — 6,746 Excess tax benefit from share-based payment arrangements 436 5 Changes in operating assets and liabilities, net of the effects of acquisitions: Accounts receivable (1,389 ) (577 ) Prepaid expenses (119 ) (1,499 ) Other receivables 674 (242 ) Other assets 4,240 534 Accounts payable 2,578 627 Accrued compensation and related expenses 2,820 340 Accrued interest payable (70 ) (31 ) Income taxes payable (36 ) 131 Other accrued liabilities   3,614     964   Net cash provided by operating activities   57,949     47,660     Investing activities: Equipment purchases (33,975 ) (26,382 ) Increase in deposits on equipment (13,847 ) (9,935 ) Acquisitions, net of cash received (6,659 ) (24,061 ) Proceeds from sale of assets   370     520   Net cash used in investing activities   (54,111 )   (59,858 )   ALLIANCE HEALTHCARE SERVICES, INC. CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (continued) (Unaudited) (in thousands)     Six Months Ended June 30,   2016       2015   Financing activities: Principal payments on equipment debt and capital lease obligations (8,035 ) (4,639 ) Proceeds from equipment debt 4,809 15,691 Principal payments on term loan facility (2,600 ) (7,351 ) Proceeds from term loan facility — 29,850 Principal payments on revolving loan facility (24,000 ) (28,000 ) Proceeds from revolving loan facility 21,000 26,000 Payments of debt issuance costs and deferred financing costs (25,059 ) (654 ) Noncontrolling interest in subsidiaries (11,703 ) (8,353 ) Excess tax benefit from share-based payment arrangements (436 ) (5 ) Issuance of common stock 1 — Proceeds from exercise of stock options 614 25 Settlement of contingent consideration related to acquisitions (810 ) — Proceeds from shareholder transaction   28,630     —   Net cash (used in) provided by financing activities   (17,589 )   22,564   Net (decrease) increase in cash and cash equivalents   (13,751 )   10,366   Cash and cash equivalents, beginning of period   38,070     33,033   Cash and cash equivalents, end of period $ 24,319   $ 43,399   Supplemental disclosure of cash flow information: Interest paid $ 12,957 $ 11,110 Income taxes refunded, net of payments (92 ) (146 )   Supplemental disclosure of non-cash investing and financing activities: Capital lease obligations related to the purchase of equipment $ 1,499 $ 1,294 Equipment purchases in accounts payable and accrued equipment 352 2,477 Noncontrolling interest assumed in connection with acquisitions 2,948 20,598 Fair value of contingent consideration related to acquisitions 420 — Extinguishment of note receivable — 3,071

ALLIANCE HEALTHCARE SERVICES, INC.NON-GAAP MEASURES(in thousands)

Adjusted EBITDA and Adjusted Net Income Per Share (the “Non-GAAP Measures”) are not measures of financial performance under generally accepted accounting principles in the United States, or “GAAP.”

Adjusted EBITDA, as defined by the Company’s management, is consistent with the definition in the Company’s Credit agreement and represents net income (loss) before: interest expense, net of income tax (benefit) expense, interest income, depreciation expense, amortization expense, non-cash share-based payment, severance and related costs, net income attributable to noncontrolling interest, restructuring charges, fees and expenses related to acquisitions, costs related to debt financing, non-cash impairment charges, legal matter expenses, 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 Net Income Per Share, as defined by the Company’s management, represents net income (loss) before: restructuring charges, severance and related charges, fees and expenses related to acquisitions, impairment charges, legal matter expenses, and differences in the GAAP income tax rate compared to our historical income tax rate. The components used to reconcile net income (loss) per share to Adjusted Net Income Per Share are consistent with our historical presentation of Adjusted Net Income Per Share.

Management uses the Non-GAAP Measures, and believes they are useful measures for investors, for a variety of reasons. Management regularly communicates the results of its Non-GAAP Measures and management’s interpretation of such results to its board of directors. Management also compares the Company’s results of its Non-GAAP Measures against internal targets as a key factor in determining cash incentive compensation for executives and other employees, largely because management feels that these measures are indicative of how our radiology, oncology and interventional services businesses are performing and are being managed. 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 radiology, oncology and interventional services businesses.

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. The Non-GAAP Measures have certain limitations as analytical financial measures, which management compensates for 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 the Non-GAAP Measures. 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 and because the Non-GAAP Measures may not be directly comparable to similarly titled measures reported by other companies, however, the Non-GAAP Measures should not be considered as an alternative to the most directly comparable GAAP measure, or as an alternative to any other GAAP measure of operating performance.

The calculation of Adjusted EBITDA is shown below:

      Twelve Months Ended June Quarter Ended June 30, Six Months Ended June 30,   30,     2016       2015     2016       2015     2016   Net income (loss) attributable to Alliance HealthCare Services, Inc. $ 2,459 $ (1,961 ) $ 1,269 $ (210 ) $ 8,221 Income tax expense (benefit) 2,221 (1,366 ) 1,275 206 7,605 Interest expense and other, net 8,872 6,904 16,367 12,922 29,686 Amortization expense 2,494 2,495 4,937 4,530 9,507 Depreciation expense 13,730 12,072 26,778 23,705 51,668 Share-based payment (included in selling, general and administrative expenses) 379 430 2,243 819 3,125 Severance and related costs 708 195 2,424 454 3,290 Net income attributable to noncontrolling interest 3,729 4,903 8,322 9,250 19,445 Restructuring charges 1,120 236 1,351 491 2,187 Transaction costs 431 1,113 848 1,532 2,612 Shareholder transaction costs 1,498 — 2,507 — 4,360 Impairment charges — 6,670 — 6,746 71 Legal matter expenses (included in selling, general and administrative expenses) 39 1,543 194 2,903 4,206 Non-cash gain on step acquisition (included in other (income) and expense, net) — — — — (10,672 ) Other non-cash charges (included in other (income) and expenses, net)   (3,238 )   781     (3,701 )   783     (3,367 ) Adjusted EBITDA $ 34,442   $ 34,015   $ 64,814   $ 64,131   $ 131,944  

The leverage ratio calculations as of June 30, 2016, are shown below:

  Consolidated Total debt $ 572,122 Less: Cash and cash equivalents   (24,319 ) Net debt 547,803 Last 12 months Adjusted EBITDA 131,944 Pro-forma acquisitions in the last 12 month period (1)   5,925   Last 12 months Consolidated Adjusted EBITDA 137,869 Total leverage ratio

4.15

x

Net leverage ratio

3.97

x

__________

(1) Gives pro-forma effect to acquisitions occurring during the last twelve months pursuant to the terms of the Credit Agreement.

The reconciliation of income (loss) per diluted share – GAAP to adjusted net income per diluted share – non-GAAP is shown below:

  Quarter Ended June 30,   Six Months Ended June 30,   2016       2015     2016       2015   Income (loss) per diluted share- GAAP $ 0.23 $ (0.18 ) $ 0.12 $ (0.02 ) Reconciling charges (benefits) to arrive at Adjusted net income per diluted share-non-GAAP: Severance and related charges, net of taxes 0.04 0.01 0.13 0.02 Restructuring charges, net of taxes 0.06 0.01 0.07 0.03 Transaction costs, net of taxes 0.02 0.06 0.05 0.08 Shareholder transaction costs, net of taxes 0.08 — 0.13 — Deferred financing costs in connection with shareholder transaction, net of taxes 0.10 — 0.10 — Impairment charges, net of taxes — 0.36 — 0.36 Legal matter expenses, net of taxes — 0.08 0.01 0.15 Other non-cash gains, net of taxes (0.17 ) — (0.21 ) — GAAP income tax rate compared to our historical income tax rate   0.01     —     0.02     0.02   Total reconciling charges (benefits)   0.14     0.52     0.30     0.66   Adjusted net income per diluted share- non-GAAP $ 0.37   $ 0.34   $ 0.42   $ 0.64  

The reconciliation from net income to Adjusted EBITDA for the 2016 guidance range is shown below (in millions):

  2016 Full Year Guidance Range Net income $ 7     $ 12 Income tax expense 5 9

Interest expense and other, net; depreciation expense; amortization expense; share-based payment and other expenses; noncontrolling interest in subsidiaries

  118   129 Adjusted EBITDA $ 130 $ 150   ALLIANCE HEALTHCARE SERVICES, INC. SELECTED STATISTICAL INFORMATION     Quarter Ended June 30, 2016   2015 MRI Average number of total systems 274.5 251.1 Average number of scan-based systems 216.5 200.6 Scans per system per day (scan-based systems) 9.36 8.99 Total number of scan-based MRI scans 136,251 123,461 Price per scan $ 307.39 $ 316.84 Scan-based MRI revenue (in millions) $ 41.9 $ 39.1 Non-scan based MRI revenue (in millions)   6.9   6.1 Total MRI revenue (in millions) $ 48.8 $ 45.2 PET/CT Average number of total systems 120.5 115.1 Average number of scan-based systems 110.7 108.3 Scans per system per day 5.51 5.38 Total number of PET/CT scans 34,863 35,569 Price per scan $ 885.34 $ 890.59 Total PET and PET/CT revenue (in millions) $ 32.1 $ 32.6 Oncology Linear accelerator treatments 22,421 23,069 Stereotactic radiosurgery patients 900 849 Total oncology revenue (in millions) $ 25.8 $ 25.3 Interventional Visits 57,825 38,070 Total interventional revenue (in millions) $ 11.4 $ 8.2 Revenue breakdown (in millions) Total MRI revenue $ 48.8 $ 45.2 PET/CT revenue 32.1 32.6 Oncology revenue 25.8 25.3 Interventional revenue 11.4 8.2 Other revenue   7.2   7.2 Total revenues $ 125.3 $ 118.5   Total fixed-site revenue (in millions) $ 27.5 $ 28.1

ALLIANCE HEALTHCARE SERVICES, INC.SELECTED STATISTICAL INFORMATIONRADIOLOGY AND ONCOLOGY DIVISION SAME-STORE VOLUME

The Company utilizes same-store volume growth as a historical statistical measure of the MRI and PET/CT imaging procedure, linear accelerator (“Linac”) treatment and stereotactic radiosurgery (“SRS”) case growth at its customers in a specified period on a year-over-year basis. Same-store volume growth is calculated by comparing the cumulative scan, treatment or case volume at all locations in the current year quarter to the same quarter in the prior year. The group of customers whose volume is included in the scan, treatment case volume totals includes only those that received service from Alliance for the full quarter in each of the comparison periods. A positive percentage represents growth over the prior year quarter and a negative percentage represents a decline over the prior year period. Alliance measures each of its major radiology and oncology modalities, MRI, PET/CT, Linac and SRS, separately.

The Radiology Division same-store volume growth for the last four calendar quarters ended June 30, 2016, is as follows:

  Same-Store Volume MRI   PET/CT

2016

Second Quarter 2.0% 5.8% First Quarter 6.6% 9.3%

 

2015

Fourth Quarter 3.6% 8.6% Third Quarter 4.7% 5.7%

The Oncology Division same-store volume growth/(decline) for the last four calendar quarters ended June 30, 2016, is as follows:

  Same-Store Volume Linac   SRS

2016

Second Quarter (1.1 %) (0.2 %) First Quarter 5.6 % 9.0 %  

2015

Fourth Quarter (6.4 %) 3.9 % Third Quarter (5.5 %) 10.8 %

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Alliance HealthCare Services, Inc.Rhonda Longmore-GrundExecutive Vice PresidentChief Financial Officer949.242.5300