Financial Update for 2017 and Budget 2018 JUNE 22, 2017 OPEN – HEALTH AFF – INFO 1 - 1

OPEN – HEALTH AFF – INFO 1 - 2 OPERATING RESULTS MAY 2017 OPEN – HEALTH AFF – INFO 1 - 2

MU HEALTH CARE FINANCIAL PERFORMANCE May 2017 YTD ACTUAL YTD BUDGET MU HEALTH CARE CONSOLIDATED PRIOR YEAR ACTUAL FY17 ANNUAL BUDGET MOODY'S A RATED SUMMARY OF FINANCIAL STATEMENT ($000S) $857,061 $770,491 Net Revenues $762,242 $841,438   (764,999) (737,901) Operating Expenses* (694,741) (804,990) 92,062 32,590 Operating Income 67,501 36,448 (24,647) (9,836) Non-operating Revenues, Net (23,018) (11,380) $67,415 $22,754 Change in Net Assets $44,483 $25,068 *Includes University purchased clinical services annual budget of $44 million. FINANCIAL RATIOS AND BENCHMARKS 7.9% 3.0% Margin Percent 5.8% 6.7% 6.4% 2.2% Annualized Return on Total Assets 4.4% 5.1% 147.5% 140.0% Cash to Total Debt 132.6% 140.9% 125.5% 30.8% 32.0% Debt to Capitalization 33.7% 31.8% 32.8% 5.4 3.3 Maximum Annual Debt Service Coverage 3.6 5.1 218.1 210.2 Days Cash on Hand 222.4 227.5 55.1 48.5 Net Days Revenue in AR 50.1 49.2 48.6 Data to come later. OPEN – HEALTH AFF – INFO 1 - 3

OPEN – HEALTH AFF – INFO 1 - 4 MU HEALTH CARE KEY VOLUME METRICS May 2017 STATISTIC YTD ACTUAL YTD BUDGET VARIANCE % VARIANCE YTD PRIOR YTD ACTUAL % VARIANCE PRIOR YTD DISCHARGES 24,773 24,099 674 2.8% 24,193 2.4% INPATIENT SURGERY 8,759 8,900 (141) -1.6% 8,328 5.2% OUTPATIENT SURGERY 14,600 12,862 1,738 13.5% 12,988 12.4% DELIVERIES 2,115 1,743 372 21.3% 1,857 13.9% NICU DAYS 12,892 11,266 1,626 14.4% 13,204 -2.4% ER VISITS 71,851 70,170 1,681 70,215 2.3% PATIENT DAYS 130,189 121,436 8,753 7.2% 122,750 6.1% CLINIC VISITS 589,448 595,339 (5,891) -1.0% 580,630 1.5% OPEN – HEALTH AFF – INFO 1 - 4

OPEN – HEALTH AFF – INFO 1 - 5 OPERATING BUDGET FY 2018 OPEN – HEALTH AFF – INFO 1 - 5

MU HEALTH CARE CONSOLIDATED Non-operating Revenues, Net OPERATING BUDGET FY2018 & FY2017 COMPARATIVE FY18 ANNUAL BUDGET MU HEALTH CARE CONSOLIDATED FY17 ANNUAL BUDGET FY17 PROJECTED SUMMARY OF FINANCIAL STATEMENT ($000S) $938,486 Net Revenues $841,438 $934,976 (886,446) Operating Expenses (804,990) (834,543)  52,040 Operating Income 36,448 100,433  (17,273) Non-operating Revenues, Net (11,380) (26,889)  $34,767 Change in Net Assets $25,068 $73,544   KEY VOLUME METRICS 27,115 DISCHARGES 26,297 27,025 26,520 SURGERIES 24,616 25,482 77,016 ER VISITS 76,462 78,383 138,509 PATIENT DAYS 132,203 142,024 648,047 CLINIC VISITS 650,175 643,034 OPEN – HEALTH AFF – INFO 1 - 6

OPEN – HEALTH AFF – INFO 1 - 7 CAPITAL BUDGET FY 2016 - 2018 OPEN – HEALTH AFF – INFO 1 - 7

CAPITAL EQUIPMENT & PROJECTS MU HEALTH CARE CAPITAL SPENDING FY 16-18 CAPITAL EQUIPMENT & PROJECTS FY16 BUDGET FY17 BUDGET FY18 BUDGET In-house Design & Construction Projects $2,500 Plant Operations 13,591 6,806 20,031 Facility Renovations 17,519 27,292 13,186 Information Technology Systems 6,310 8,000 7,000 Major Medical Equipment 23,826 18,493 24,283 New Construction 23,893 3,100   TOTAL $87,639 $66,191 $67,000 $s in 000s SOURCES OF FUNDS FY16 BUDGET FY17 BUDGET FY18 BUDGET Cash Reserves $65,846 $66,191 $67,000 Bonds 21,793   TOTAL $87,639 MAJOR RENOVATIONS PLANNED OR COMPLETED: Hospital Visitor Garage 4th, 5th and 7th Floor Renovation Patient Care Tower 3rd and 4th Floor Renovation NEW CONSTRUCTION PLANNED OR COMPLETED: South Providence Medical Building MOI Expansion ED Expansion MAJOR MEDICAL EQUIPMENT 3 T MRI CT Automated Dispensing Cabinets Da Vinci XI Robot OPEN – HEALTH AFF – INFO 1 - 8

SUPPORT TO THE UNIVERSITY FY2012 - FY2017 PROJECTED OPEN – HEALTH AFF – INFO 1 - 9

SUPPORT ANALYSIS OPEN – HEALTH AFF – INFO 1 - 10 $ in 000s FY2012 CARTS Payments to School of Medicine Payments to School of Medicine Above CARTS Performance Based Support to School of Medicine Columbia Campus Budget Support Payments to School of Nursing Payments to School of Health Professions Payments to UM System Payments to Columbia Campus Costs for Space Owned by MUHC and Utilized by Others Commercial Billings Total $ in 000s FY2012 $ 34,000 $ 4,878 $ - $ 438 $ 562 $ 11,700 $ 20,773 $ 5,832 $ 4,606 $ 82,789 FY2013 33,800 2,616 8,450 - 433 562 12,524 20,860 5,804 4,920 89,969 FY2014 36,000 3,739 4,740 444 582 11,238 20,164 7,335 5,270 89,512 FY2015 40,000 2,272 15,110 464 584 12,697 25,917 7,226 5,483 109,753 FY2016 42,600 4,750 15,250 446 590 13,330 23,481 4,229 5,921 110,597 FY2017 Projected 44,000 3,955 15,000 3,000 1,090 13,040 25,001 6,316 116,075 OPEN – HEALTH AFF – INFO 1 - 10

OPEN – HEALTH AFF – INFO 1 - 11 MUHC SUPPORT TO UNIVERSITY OF MISSOURI OPEN – HEALTH AFF – INFO 1 - 11

INDUSTRY BENCHMARK Funds Flow to Schools of Medicine OPEN – HEALTH AFF – INFO 1 - 12

OPEN – HEALTH AFF – INFO 1 - 13 VIZIENT STUDY Funds Flow Initiative March 24, 2016 OPEN – HEALTH AFF – INFO 1 - 13

Participation 55 Participants Since FY 2010 VIZIENT STUDY PARTICIPANTS Participation 55 Participants Since FY 2010 Arizona Barnes Jewish Bayview Brigham Case Cedars Sinai Chicago Cincinnati Colorado Duke ECU Fairview Fletcher Allen Froedtert Iowa JHMI Kansas Louisville Maryland Memorial Hermann Michigan Missouri MUSC Northwestern OHSU OSU Penn RIH Rush RWJUH Stony Brook SUNY TJUH Truman Tufts UAB UAMS UCI UCLA UCSD UCSF UK UMass UMDNJ UNC UNM U of R Utah UTMB UVA VCU Washington Wisconsin WVU Yale OPEN – HEALTH AFF – INFO 1 - 14

OPEN – HEALTH AFF – INFO 1 - 15 VIZIENT STUDY FUNDS FLOW COMPARISON 16% 14% 12% 10% 8% 6% 4% 2% 0% Participants Vizient Range: 2.2% to 14.2% Vizient Average: 8.9% Average = 8.9% School of Medicine Support as a % of 2014 Net Patient Revenue MU Health Care 2015: 13.2% MU Health Care 2016: 12.9% MU Health Care OPEN – HEALTH AFF – INFO 1 - 15