Merrill Lynch/Dec HCA Jack O. Bovender, Jr. Chairman and CEO Milton Johnson Executive Vice President and CFO Vic Campbell Senior Vice President Mark Kimbrough VP, Investor Relations
Merrill Lynch/Dec HCA 2 This presentation contains forward-looking statements based on current management expectations. Those forward-looking statements include all statements other than those made solely with respect to historical fact. Numerous risks, uncertainties and other factors may cause actual results to differ materially from those expressed in any forward-looking statements. These factors include, but are not limited to (i) the increased leverage resulting from the financing of the tender offer, (ii) increases in the amount and risk of collectability of uninsured accounts and deductibles and co-pay amounts for insured accounts, (iii) the ability to achieve operating and financial targets, achieve expected levels of patient volumes and control the costs of providing services, (iv) the highly competitive nature of the health care business, (v) the efforts of insurers, health care providers and others to contain health care costs, (vi) possible changes in the Medicare and Medicaid programs that may impact reimbursements to health care providers and insurers, (vii) the ability to attract and retain qualified management and other personnel, including affiliated physicians, nurses and medical support personnel, (viii) potential liabilities and other claims that may be asserted against the Company, (ix) fluctuations in the market value of the Company’s common stock, (x) the impact of the Company’s charity care and self-pay discounting policy changes, (xi) changes in accounting practices, (xii) changes in general economic conditions, (xiii) future divestitures which may result in charges, (xiv) changes in revenue mix and the ability to enter into and renew managed care provider arrangements on acceptable terms, (xv) the availability and terms of capital to fund the expansion of the Company’s business, (xvi) changes in business strategy or development plans, (xvii) delays in receiving payments for services provided, (xviii) the possible enactment of Federal or state health care reform, (xix) the outcome of pending and any future tax audits, appeals and litigation associated with the Company’s tax positions, (xx) the outcome of the Company’s continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures and the Company’s corporate integrity agreement with the government, (xxi) changes in Federal, state or local regulations affecting the health care industry, (xxii) the ability to successfully integrate the operations of Health Midwest, (xxiii) the ability to develop and implement the payroll and human resources information systems within the expected time and cost projections and, upon implementation, to realize the expected benefits and efficiencies, (xxiv) the continuing impact of the recent hurricanes on the Company’s Florida facilities and the ability to obtain recoveries under the Company’s insurance policies, and (xxv) other risk factors detailed in the Company’s filings with the SEC. Many of the factors that will determine the Company’s future results are beyond the ability of the Company to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management’s views only as of the date hereof. The Company undertakes no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise. Notwithstanding any statement in this press release, the safe harbor protections of the Private Securities Litigation Reform Act of 1995 do not apply to statements made in connection with a tender offer. All references to “Company” and “HCA” as used throughout this document refer to HCA Inc. and its affiliates.
Merrill Lynch/Dec 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
Merrill Lynch/Dec 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
Merrill Lynch/Dec HCA 5 Capital Regional Medical Center Tallahassee, FL ($100M) 200 beds Opened: August 2003 HCA
Merrill Lynch/Dec HCA 6 Stonecrest Medical Center Smyrna, TN ($96M) 75 beds Opened: December 2004 HCA
Merrill Lynch/Dec HCA 7 Inpatient Admissions and Outpatient Visits Source: AHA Annual Survey Inpatient Admissions (millions) Outpatient Visits (millions)
Merrill Lynch/Dec 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
Merrill Lynch/Dec 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
Merrill Lynch/Dec HCA 10 Inpatient Surgery Trends Improving 2001 to 3 rd Quarter Same Facility 1: Includes Kansas City facilities. 1
Merrill Lynch/Dec 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
Merrill Lynch/Dec 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)
Merrill Lynch/Dec 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%
Merrill Lynch/Dec 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)
Merrill Lynch/Dec 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
Merrill Lynch/Dec 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
Merrill Lynch/Dec HCA 17 HCA Reduces Malpractice Reserves by $59 Million in 2Q 2004 HCA Large Claims Declining
Merrill Lynch/Dec HCA 18 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
Merrill Lynch/Dec HCA 19 Accounts Receivable Indicators Cash Collections % Adj. Net Revenue / Days in A/R Days in Accounts Receivable Cash Collections % Adjusted Net Revenue
Merrill Lynch/Dec HCA 20 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
Merrill Lynch/Dec HCA 21 $7.5 Billion 249 Million Shares 38% of outstanding shares Average Price: $30.20 Opportunities Of Having Strong Cash Flow Share repurchase program $1.3B: 37.9M Shares : 2004 purchases through : 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 $1.3B: 43.5M Shares $28.65/share $706M: 19.2M Shares $36.88/share $1.1B: 31.1M Shares $35.76/share $600M: 14.5M Shares $41.45/share 650M Shares 12/31/96 491M Shares 2 12/31/03 $282M: 6.2M Shares $45.53/share Impact of Tender Offer $10 Billion 311 Million Shares 48% of outstanding shares Average Price: $32.20
Merrill Lynch/Dec HCA 22 Employee Satisfaction at Record Levels Employee Satisfaction (Gallup Score) Employee Turnover Nurse Turnover Turnover Rate Satisfaction Score
Merrill Lynch/Dec 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….