JP Morgan/Jan HCA Jack O. Bovender, Jr. Chairman and CEO Vic Campbell Senior Vice President
JP Morgan/Jan HCA 2 Cautionary Note Regarding Forward-looking Statements HCA’s management will be making some forward-looking statements during today’s presentation. Those forward-looking statements are based on management’s current expectations and are subject to risks and uncertainties that may cause those forward looking statements to be materially incorrect. Certain of those risks and uncertainties are discussed in HCA’s filings with the Securities and Exchange Commission, including the company’s report on Form 10-K and its quarterly reports on form 10-Q, to which you are referred. Management cautions you not to rely on, and makes no promises to update any of the forward looking statements.
JP Morgan/Jan HCA 3 HCA is located in 16 of 20 Fastest Growing Large US Cities Switzerland U.K. % % % % % % Compared to the National Average of 4.5% Las Vegas +22% Las Vegas +22% Southern California +9% Southern California +9% Denver +9% Denver +9% Dade +8% Dade +8% Nashville +8% Nashville +8% Panhandle +10% Panhandle +10% Tampa Bay +8% Tampa Bay +8% Dallas/Ft. Worth +12% Dallas/Ft. Worth +12% Austin +18% Austin +18% Richmond +8% Richmond +8% Palm Beach +11% Palm Beach +11% Houston +10% Houston +10% Kansas City +5% Kansas City +5% Percent Growth in Market Population Generally 25-40% Market Share 40% of facilities in Texas & Florida Generally 25-40% Market Share 40% of facilities in Texas & Florida
JP Morgan/Jan HCA 4 HCA Capital Expenditures 1,565 New Beds 54 Facilities with Surgery and/or ICU/CCU expansions Four New Facilities 378 Beds Open Heart, Imaging Cardiology, Oncology, etc. 37 ER Expansions 37 ER Expansions Distribution of Capital Dollars 2002 and Beyond Distribution of Capital Dollars 2002 and Beyond New Denver Facility Expansions Billions 2000 $ $ $ $ E $1.6 Routine Patient Safety & Infrastructure New Facilities Expansions
JP Morgan/Jan HCA 5 Capital Regional Medical Center Tallahassee, FL ($100M) 200 beds Opened: August 2003 HCA
JP Morgan/Jan HCA 6 Stonecrest Medical Center Smyrna, TN ($96M) 75 beds Opened: December 2004 HCA
JP Morgan/Jan HCA 7 Inpatient Admissions and Outpatient Visits Source: AHA Annual Survey Inpatient Admissions (millions) Outpatient Visits (millions)
JP Morgan/Jan HCA 8 Socio-Demographics—Age Wave Driving Healthcare Utilization Acute Care Utilization Index (2003=100) Baby Boomer Impact Accelerates 1.58% CAGR % 1.6% 1.5% 1.6% 1.5% 1.6% 1.5% 1.4% 1.56% 3-Year CAGR 1.59% 3-Year CAGR 1.58% 3-Year CAGR 1.62% 3-Year CAGR
JP Morgan/Jan HCA 9 HCA Admission Trends 2001 to 3Q 2004 Same Facility HCA Market Competitors 15.4% * HCA Growing Medicare Market Share Growth in Medicare Admissions HCA Growing Medicare Market Share Growth in Medicare Admissions * 2Q includes same-market admissions
JP Morgan/Jan HCA 10 Inpatient Surgery Trends Improving 2001 to 3 rd Quarter Same Facility 1: Includes Kansas City facilities. 1
JP Morgan/Jan HCA % 37.2% OutpatientEROutpatientER Enhanced Outpatient Services Focus 12.5% Hospital Based FreestandingFreestanding Outpatient Diagnostic Services Outpatient Imaging Cardiology Oncology Orthopedics Neurology Imaging Cardiology Oncology Orthopedics Neurology Hospital Based Outpatient Surgeries 15.3% ASC Based 70% 30% 2003 % of HCA Net Revenue As a % of Outpatient Surgeries O/P Comprised of Three Business Lines
JP Morgan/Jan HCA 12 Outpatient Strategy Processing Transactions totaling $41 million completed 20–30 imaging center and 8-10 surgery center transactions expected to be completed over the next 12 months Sarah Cannon Research Institute (Nashville) Austin Radiology Assoc. 2 imaging centers Austin Radiology Assoc. 2 imaging centers Diversified Radiology (Denver) 4 imaging centers/fifth under construction Diversified Radiology (Denver) 4 imaging centers/fifth under construction Thousand Oaks Diagnostic Imaging Thousand Oaks Diagnostic Imaging Millcreek Imaging Center Salt Lake City, UT Millcreek Imaging Center Salt Lake City, UT HCA Surgery Centers LAD Imaging Centers (Orange City, Deltona) LAD Imaging Centers (Orange City, Deltona)
JP Morgan/Jan HCA Managed Care Contracting 2005 Contract Pricing Timeline* 6,844 Facility Level Active Contracts *Anticipated Completion Dates Pre Q042Q043Q044Q04 75% of 2005 and 35% of 2006 contracts completed 2005 Cumulative42%55%75%95%35%100% Net Revenue per Adjusted Admission Managed Care & Other Discounted 15.0% 10.5% 11.4% 13.0% 13.3% 9.6% 7.0% 7.3% 11.1% 9.2% 0% 16% 1Q 022Q 023Q 024Q 021Q 032Q 033Q 034Q 031Q 042Q % 9.9% 3Q % 9.0%
JP Morgan/Jan HCA 14 Medicare Reimbursement Improves Oct. 1, 2004 with Outlier Threshold Change and Full Market Basket Update Hospitals receive full market basket update 3.3% beginning October 1, 2004 Medicare outlier threshold reduced from $30,150 (Oct ’03), to $25,800 (Oct ’04)
JP Morgan/Jan HCA 15 Labor Cost * Eastern and Western Consolidated Operations 15% vs. Q103 15% vs. Q103 25% vs. Q103 25% vs. Q103 33% vs. Q103 33% vs. Q103 29% vs. Q103 29% vs. Q103 29% vs. Q103 29% vs. Q %+5.1% +4.7% +4.6% Sept YTD Wage Rate Same Facility - % Change from PY Q 01 2Q 01 3Q 01 4Q 01 1Q 02 2Q 02 3Q 02 4Q 02 1Q 03 2Q 03 3Q 03 4Q 03 1Q 04 2Q 04 Total Operations* Nursing 1: Includes Kansas City facilities. 1 3Q 04 Contract Labor Reduction $/Adj. Patient Day 33% vs. Q103 33% vs. Q103
JP Morgan/Jan HCA 16 Bad Debt Impact on Operating Expenses per Adjusted Admission Operating Expenses/AA – Percent Change from Prior Year Operating Expense/AA Operating Expense/AA (Adj. For Bad Debt) Same Facility – Percent Change from Prior Year 4.7% 8.1% 5.4% 5.6% 5.5% 5.8% 5.3% 3.8% 6.0% 6.2% 7.5% 9.3% 7.4% 7.8% 5.5% 7.6% 6.6% 10.4% 7.6% 8.9% 10.8% 10.2% 8.0% 6.0% 7.0% 8.8% 8.5% 8.0% 5.2% 0% 5% 10% 15% 1Q 012Q 013Q 014Q 011Q 022Q 023Q 024Q 021Q 032Q 033Q 034Q 031Q 042Q 043Q % 9.4%7.4% 6.4% 6.7% 6.5% 6.0% 8.5% Sept. YTD 7.0% 1 5.1% 1 1: Adjusted for $26M in net hurricane operating expense impact during the 3 rd quarter
JP Morgan/Jan HCA 17 Revisions Made to the Uninsured Policy Provide a discount to all uninsured non-elective patients similar to managed care rates Continue to attempt to qualify uninsured patients for Medicaid and other state and federal programs Charity care will continue to be provided for those uninsured patients with income levels at or below 200 percent of the Federal Poverty Level The Company estimates that there will be no material impact on earnings
JP Morgan/Jan HCA 18 HCA Reduces Malpractice Reserves by $59 Million in 2Q 2004 HCA Large Claims Declining
JP Morgan/Jan HCA 19 HCA is Investing Significantly in Programs for Patient Safety and Improved Patient Outcomes E MAR: Medication Error Prevention E POM: Physician Order Entry 100% Participation in CMS Quality Reporting Initiative Member of NQF and Leapfrog Cardiovascular, OB and Emergency Department Initiatives
JP Morgan/Jan HCA 20 Accounts Receivable Indicators Cash Collections % Adj. Net Revenue / Days in A/R Days in Accounts Receivable Cash Collections % Adjusted Net Revenue
JP Morgan/Jan HCA 21 Strong Cash Flow Trends Provide Opportunities Net Cash Provided by Operating Activities Dollars in Millions Excluding settlements with government agencies and investigation related costs. New Dividend Policy $250mm annually ShareRepurchaseProgram $10.0B in 8 years $2.5B “Dutch Auction” completed at $39.75 in November ‘04 Capital Reinvestment $1.6B in 2004
$7.5 Billion 249 Million Shares 38% of outstanding shares Average Price: $30.20 $1.3B: 37.9M Shares 1: 2004 purchases through 12/31/04 2: Includes other activities affecting share balance (stock option exercises, restricted grants, and ESPP activity). $33.59/share $22.68/share $930M: 41M Shares $1.4B: 55.6M Shares $24.61/share 650M Shares 12/31/96 422M Shares 2 12/31/04 Impact of Tender Offer $10 Billion 312 Million Shares 48% of outstanding shares Average Price: $32.20 $3.1B: 77.4 Shares $1.1B: 31.1M Shares $282M: 6.2M Shares $706M: 19.2M Shares $1.3B: 43.5M Shares $1.4B: 55.6M Shares $1.3B: 37.9M Shares $930M: 41M Shares $40.05 $35.76 $45.53 $36.88 $28.65 $24.61 $22.68 $ Avg Share Price Share Repurchase Opportunities of Having Strong Cash Flow 22
JP Morgan/Jan HCA 23 A prudent financial strategy that provides for a strong balance sheet and return of cash to shareholders through share repurchase and/or dividends Excellent Investment Opportunities Strong Cash Flows Excellent Long-Term Earnings Growth Outlook Great Assets In Summary We Have….