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JP Morgan/Jan 2005 2005HCA Jack O. Bovender, Jr. Chairman and CEO Vic Campbell Senior Vice President
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JP Morgan/Jan 2005 2005HCA 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.
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JP Morgan/Jan 2005 2005HCA 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 2000-2005 Generally 25-40% Market Share 40% of facilities in Texas & Florida Generally 25-40% Market Share 40% of facilities in Texas & Florida
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JP Morgan/Jan 2005 2005HCA 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 $1.2 2001 $1.4 2002 $1.7 2003 $1.8 2004E $1.6 Routine Patient Safety & Infrastructure New Facilities Expansions
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JP Morgan/Jan 2005 2005HCA 5 Capital Regional Medical Center Tallahassee, FL ($100M) 200 beds Opened: August 2003 HCA
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JP Morgan/Jan 2005 2005HCA 6 Stonecrest Medical Center Smyrna, TN ($96M) 75 beds Opened: December 2004 HCA
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JP Morgan/Jan 2005 2005HCA 7 Inpatient Admissions and Outpatient Visits 1980 - 2003 Source: AHA Annual Survey 1980 - 2003 Inpatient Admissions (millions) Outpatient Visits (millions)
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JP Morgan/Jan 2005 2005HCA 8 Socio-Demographics—Age Wave Driving Healthcare Utilization 2000200120022003200420052006200720082009201020112012201320142015 95 100 105 110 115 120 125 Acute Care Utilization Index (2003=100) Baby Boomer Impact Accelerates 1.58% CAGR 2003-2012 121 119 117 115 113 112 110 108 106 105 103 102 100 98 97 96 1.7% 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
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JP Morgan/Jan 2005 2005HCA 9 HCA Admission Trends 2001 to 3Q 2004 Same Facility HCA Market Competitors 15.4% * HCA Growing Medicare Market Share Growth in Medicare Admissions 1998-2001 HCA Growing Medicare Market Share Growth in Medicare Admissions 1998-2001 * 2Q includes same-market admissions
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JP Morgan/Jan 2005 2005HCA 10 Inpatient Surgery Trends Improving 2001 to 3 rd Quarter 2004 - Same Facility 1: Includes Kansas City facilities. 1
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JP Morgan/Jan 2005 2005HCA 11 9.4% 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
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JP Morgan/Jan 2005 2005HCA 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)
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JP Morgan/Jan 2005 2005HCA 13 2004 Managed Care Contracting 2005 Contract Pricing Timeline* 6,844 Facility Level Active Contracts *Anticipated Completion Dates Pre-2004 1Q042Q043Q044Q04 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 04 11.1% 9.9% 3Q 04 6.6% 9.0%
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JP Morgan/Jan 2005 2005HCA 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)
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JP Morgan/Jan 2005 2005HCA 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. Q103 2001 +6.5%+5.1% +4.7% +4.6% Sept YTD Wage Rate Same Facility - % Change from PY 200220032004 1Q 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
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JP Morgan/Jan 2005 2005HCA 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 04 2001 200220032004 7.0% 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
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JP Morgan/Jan 2005 2005HCA 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
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JP Morgan/Jan 2005 2005HCA 18 HCA Reduces Malpractice Reserves by $59 Million in 2Q 2004 HCA Large Claims Declining
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JP Morgan/Jan 2005 2005HCA 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
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JP Morgan/Jan 2005 2005HCA 20 Accounts Receivable Indicators Cash Collections % Adj. Net Revenue / Days in A/R Days in Accounts Receivable Cash Collections % Adjusted Net Revenue
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JP Morgan/Jan 2005 2005HCA 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
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$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 2004 2003 2002 2001 2000 1999 1998 1997 $40.05 $35.76 $45.53 $36.88 $28.65 $24.61 $22.68 $33.59 1 Avg Share Price Share Repurchase Opportunities of Having Strong Cash Flow 22
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JP Morgan/Jan 2005 2005HCA 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….
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