Jack O. Bovender, Jr.Chairman and CEO

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Jack O. Bovender, Jr.Chairman and CEO

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c. We are forecasting no relief in Bad Debt/Charity in 2004 ... Net Revenue (less Bad Debt) is converting to cash at favorable levels (100.2%) ... – PowerPoint PPT presentation

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Title: Jack O. Bovender, Jr.Chairman and CEO


1
UBS Global Healthcare Services Conference
Jack O. Bovender, Jr. Chairman and CEO Vic
Campbell Senior Vice President Mark
Kimbrough VP, Investor Relations
February 2004
2
HCA
This press release contains forward-looking
statements based on current management
expectations. Those forward-looking statements
include all statements regarding our estimated
results of operations in future periods and 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 highly
competitive nature of the health care business,
(ii) the efforts of insurers, health care
providers and others to contain health care
costs, (iii) possible changes in the Medicare and
Medicaid programs that may impact reimbursements
to health care providers and insurers, (iv) the
ability to achieve operating and financial
targets and achieve expected levels of patient
volumes and control the costs of providing
services, (v) increases in the amount and risk of
collectibility of uninsured accounts and
deductibles and co-pay amounts for insured
accounts, (vi) the ability to attract and retain
qualified management and personnel, including
affiliated physicians, nurses and medical support
personnel, (vii) potential liabilities and other
claims that may be asserted against the Company,
(viii) fluctuations in the market value of the
Companys common stock, (ix) the Companys
ability to complete the share repurchase program,
(x) changes in accounting practices, (xi) changes
in general economic conditions, (xii) future
divestitures which may result in additional
charges, (xiii) changes in revenue mix and the
ability to enter into and renew managed care
provider arrangements on acceptable terms, (xiv)
the availability and terms of capital to fund the
expansion of the Companys business, (xv) changes
in business strategy or development plans, (xvi)
delays in receiving payments for services
provided, (xvii) the possible enactment of
Federal or state health care reform, (xviii) the
outcome of pending and any future tax audits and
litigation associated with the Companys tax
positions, (xix) the outcome of the Companys
continuing efforts to monitor, maintain and
comply with appropriate laws, regulations,
policies and procedures and the Companys
corporate integrity agreement with the
government, (xx) changes in Federal, state or
local regulations affecting the health care
industry, (xxi) the impact of charity care and
self-pay discounting policy changes, (xxii) the
ability to successfully integrate the operations
of Health Midwest, (xxiii) the ability to develop
and implement the financial enterprise resource
planning information system within the expected
time and cost projections and, upon
implementation, to realize the expected benefits
and efficiencies, (xxiv) the ability to obtain
court approval of the settlement of the class
action securities lawsuits originally filed
against the Company in 1997 (xxv) the ability of
the Company to continue to fund a cash dividend
in the future at the current rate and (xxvi)
other risk factors detailed from time to time in
the Companys filings with the SEC. Many of the
factors that will determine the Companys 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 managements 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.   All references to Company and
HCA as used throughout this document refer to
HCA Inc. and its affiliates.
2
3
HCA is located in 16 of 20 Fastest Growing
Large US Cities
  • Generally 25-40 Market Share
  • 40 of facilities in Texas Florida

Dallas/Ft. Worth 12
Denver 9
Kansas City 5
U.K.
Las Vegas 22
Nashville 8
Switzerland
Richmond 8
Austin 18
Southern California 9
Panhandle 10


Palm Beach 11
Percent Growth in Market Population 2000-2005
Tampa Bay 8
Houston 10
Dade 8
Compared to the National Average of 4.5
4
Operations 2003 Key Observations
Patient volume remains soft from earlier levels -
we do see some strength in selected markets
Growth rate varies significantly by month and by
market
ER Visit growth was strong (4.2) half the
growth coming from uninsured
  • ASCs experiencing favorable growth (2.1)

5
Operations 2003 Key Observations
  • Impact on earnings from volume pressures
    minimized by efficient expense management
  • SWB of Net Revenue ? 50 bps
  • Contract labor/APD ? 33 from 1Q 03
  • Avg. hourly rate increased 4.7 (? 40 bps from
    PY)
  • SWB/AA declined 260 bps from prior year
  • Employee Benefit Cost moderating 2.9 vs.13.7
    PY
  • Supplies/AA costs slowing (? 80 bps vs. 2002)
  • Bad Debt experience in 2003
  • a. Bad Debt expense was 2.2B, up 574M (sf1),
    or 36 over 2002
  • b. Charity care recognition grew dramatically in
    2003 to 821M up 230M (sf), or 40 over 2002
  • c. We are forecasting no relief in Bad
    Debt/Charity in 2004
  • At close of 2003, we had 2.65B reserved as Bad
    Debt, representing 88.3 of self-pay balances
    (only 351M on balance sheet not reserved)

6
Operations 2003 Key Observations
Payor class composition is changing. Medicare
and Self-pay are growing (2.7, 6.9). All Other
Payors have declined (-1.2)
Self-pay admissions, although representing only
4.4 of total admissions, grew 6.9
Self-pay admissions via the emergency room grew
14
No surprises in pricing (rate, acuity,
technology) environment in 2003 (7.5), but 2004
will be more difficult due to Medicare Outlier
and Charity Care changes
7
Operations 2003 Key Observations
Net Revenue (less Bad Debt) is converting to cash
at favorable levels (100.2)
Successfully integrated Health MidWest
Patient Safety agenda was aggressively deployed
Total employee turnover1 20.1 vs. 22.8 in 2002.
RN turnover1 16.8 vs. 17.0 in 2002. Fourth
consecutive year of improving turnover rates.
Enhanced outpatient organization and strategy
underway
All patient/employee satisfaction scores remain
positive and at record levels
1. Turnover results exclude Midwest Division.
8
2003 Operating IndicatorsSame Facility vs. prior
year
2003 Quarterly Trending
2003 vs. 2002
Q1
Q2
Q3
Q4
(same facility)
Admissions
Net
Revenue/ AA
SWB/AA
Supplies/ AA
Labor Cost/
Manhour
9
Increasing Uninsured Revenues Put Pressure on Bad
Debts
HCA
  • Provision for Doubtful Accounts increased to
    approximately 10 of NR
  • Increasing self-pay receivables combined with a
    deterioration in collectibility of this A/R
    contributed to the need to increase the provision
    for doubtful accounts
  • Soft economy/unemployment is a major driver of
    the escalation of uninsured patients
  • We anticipate no significant moderation in bad
    debts in 2004

9
10
Capital ExpendituresDollars in Billions
11
Distribution of Capital Dollars2002-2005 and
beyond
Ongoing Projects in Capital Plan
12
Growth CapitalAssets Placed in Service
1,400
1,200
1,000
(Dollars in Millions)
800
600
400
200
0
2000
2001
2002
2003
2004
2005
249
249
Total HCA 549 373 676 1,223 896 678
427
427
Eastern
Eastern
896
678
678
676
676
373
373
Total HCA
Total HCA
13
New Facilities Denver, CO
Sky Ridge Medical Center Denver, Colorado
Opened 8/20/03 104 Beds Cost 147M 4 Month
Update Admissions 2,076 (47 vs.
Budget) ADC 45 (57 in December) ER
Visits 9,125 (56 vs. Budget)
14
New Facilities Nashville, TN
StoneCrest Medical Center Nashville,
Tennessee Opened 11/30/03 75 Beds Cost
76M One Month of Operations Admissions
255 ER Visits 3,449
15
Replacement Facility Tallahassee, FL
Before Replacement
16
Replacement Facility Tallahassee, FL
17
Replacement Facility Tallahassee, FL
  • Capital Regional
  • Medical Center
  • Tallahassee, Florida
  • Opened 8/26/03
  • 180 Beds
  • Cost 98M
  • 4 Month Update
  • ( change vs. PY)
  • Admissions 15.3
  • Surgeries 9
  • ER Visits 28
  • Caths 30
  • Admissions growth for 12 months prior to the new
    facility opening 5

18
Recent Capital Results
3.2 Admissions growth rate for facilities with
major projects opening in 2002 or 2003 vs. 1.4
for Total Company
19
HCA Board Approves Dividend IncreaseFrom 0.02
Per Share to 0.13 Per Share
  • Prudent investment/use of free cash flow
  • Share Repurchase
  • Integral component of the Companys financial
    policies
  • Since 1997, repurchased 6.9 billion of HCA stock
    (average cost 29.51)
  • Dividend
  • Cash-flows allow us to pay a significantly
    increased dividend
  • Continue to reinvest in our markets, and
    strengthen our balance sheet

20
HCA
HCA is Investing Significantly in Programs
forPatient 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
21
Great Assets
Excellent Investment Opportunities
Strong Cash Flows
Excellent Long-Term Earnings Growth Outlook
A prudent financial strategy that provides for a
strong balance sheet and return of cash to
shareholders through share repurchase and/or
dividends
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