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HCAEdge

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Title: HCAEdge


1
Vic Campbell Senior Vice President Mark
Kimbrough Vice President, Investor
Relations Bryan Rogers President, Midwest
Division Clifton Mills CFO, Midwest Division
2
Cautionary Note Regarding Forward-looking
Statements
HCAs management will be making some
forward-looking statements during todays
presentation. Those forward-looking statements
are based on managements 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 HCAs filings
with the Securities and Exchange Commission,
including the companys 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.
3
HCA Hospitals Locatedin Growth Markets
  • 187 Hospitals
  • 94 Surgery Centers
  • Generally 25-40
  • Market Share
  • 40 of facilities in
  • Texas Florida

Kansas City 5
Denver 9
U.K.
Las Vegas 22
Switzerland
Richmond 8
Dallas/Ft. Worth 12
Nashville 8
Southern California 9
Panhandle 10
Palm Beach 11
Houston 10
Dade 8
Percent Growth in Market Population
2000-2005 Compared to the National Average of 4.5
Tampa Bay 8
Austin 18
4
What Will Drive HCAs Future Success
  • Aging Population
  • Located in Large, Growth Markets
  • Capital Investments
  • Enhanced Outpatient Strategy
  • Quality and Patient Safety Initiatives
  • Prudent use of Companys Strong Cash Flows

5
Inpatient Admissions and Outpatient Visits 1980
- 2003
6
Socio-DemographicsAge WaveDriving Healthcare
Utilization
Acute Care Utilization Index (2003100)
Baby Boomer Impact Accelerates
7
HCA Capital Expenditures
Billions
2000 1.2
2001 1.4
2002 1.7
2003 1.8
2004 1.5
2005E 1.5
  • Capital Commitments
  • Houston, TX 517 million
  • Pearland, TX new hospital (2007)
  • Denver, CO 250 million
  • new childrens hospital/ expansion of 3
    hospitals
  • San Antonio, TX 165 million
  • new hospital with JV partner (2007)
  • Atlanta, GA 130 million
  • Emory Johns Creek, new hospital (2007)
  • Salt Lake City, UT 85 million
  • new hospital (2007/ 08)

2.0
1.5
1.0
0.5
0.0
2000
2001
2002
2003
2004
2005E
New and Expanded Services 16/690M
Note Does not include potential new and
replacement facilities.
Outpatient Services/MOBs 11/480M
Replacement Facilities 10/420M
ER Services 8/325
Land Improvements 12/505M
Infrastructure Develop., ITS, Pat. Safety
Midwest Division
Shared Services
3 Facilities 511 Beds
Three Facilities 511 Beds
33 ER Expansions
Open Heart, Cardiology Oncology, etc.
33 ER Expansions
New Replacement Facilities
Open Heart, Cardiology Oncology, etc.
Facility Expansion Projects
Routine Capital
56 Facilities with Surgery and/or ICU/CCU
expansions
Three New Facilities 310 Beds
1611 New Beds
Three New Facilities-310 Beds
Distribution of Capital Dollars 2005 and Beyond
1,611 New Beds
Surgery/Special Units 21/875M
New Facilities 8/340M
Beds 14/590M
8
Outpatient Strategy Progressing
Transactions totaling 130 million
completed 2030 imaging center and 8-10 surgery
center transactions expected to be completed over
the next 12 months
Diversified Radiology (Denver) 4 imaging
centers/fifth under construction
Austin Radiology Assoc. 2 imaging centers
Sarah Cannon Research Institute (Nashville)
Thousand Oaks Diagnostic Imaging
First Health (Jacksonville)
Hope Cancer Centers (Tallahassee) 3 centers
Ultra Open MRI (Tampa) 6 centers
Millcreek Imaging Center Salt Lake City, UT
LAD Imaging Centers (Orange City, Deltona)
Total I Management, LLC (Tampa Bay Area) 5
imaging centers
MDI 7 Centers
9
Volume
1999
2000
2001
2002
2003
2004
2005
2.7
2.8
2.7
0.7
2.5
0.6
Admissions Same Facility Change from PY
1.3
2.5
2.6
2.6
2.6
0.0
Equivalent Admissions Same Facility Change from
PY
10
Operating Expenses
1999
2000
2001
2002
2003
2004
2005
39.2 Sep YTD
38.4
39.3
39.0
39.4
39.2
38.5
SWB1 Same Facility of Net Revenue
17.0 Sep YTD
16.1
16.2
16.7
16.0
15.9
16.0
Supplies Same Facility of Net Revenue
9.6 Sep YTD
11.4
7.6
7.5
7.7
8.0
10.1
Bad Debt As Reported of Net Revenue
12.2
  • Adjusted for uninsured discounts

11
Uninsured
HCA Financial History 2005.ppt
2000
2001
2002
2003
2004
2005
5.0 Sep YTD
Uninsured Admissions Same Facility of Total
Admissions
N/A
7.7 Sep YTD
2004 9.7
15.0 vs. PY
13.7 vs. PY
Uninsured Admissions Same Facility Chg from
Prior Year
2.4 vs. PY
11.5 vs. PY
7.1 vs. PY
5.1 vs. PY
7.2 vs. PY
7.5 vs. PY
15.2 vs. PY
3.7 vs. PY
3.3 vs. PY
20.2 Sep YTD
Uninsured ER Visits Same Facility of Total ER
Visits
N/A
12
Cash flow in 2005 Remains Positive
Net Cash Provided by Operating Activities1 Dollars
in Millions
Uses of Cash
(1) Capital Reinvestment 1.5B in 2005 in
existing markets and 1.8B in 2006
(2) Share Repurchase Program 11.5B in 8
years 1.44B Dutch Auction complete 28.8
million shares 1B open-market authorization
(3) Dividend Policy Approx. 250mm annually
(4) Acquisitions opportunistic 1B Health
Midwest - April 2003 Austin, TX- pending
acquisition
2
Excluding settlements with government agencies
and investigation related costs.
(5) Debt Repayment
1 1999-2003 are non-GAAP numbers 2 YTD 2005-
9/30/05
13
In Summary We Have.
Great Assets
Strong Cash Flows
Prudent Financial Strategy Focused on Shareholder
Value
14
Bryan Rogers, President
Midwest Division
15
Midwest Division Hospitals
  • The Big Six Hospitals
  • Research Medical Center
  • Baptist-Lutheran Medical Center
  • Overland Park Regional Medical Center
  • Menorah Medical Center
  • Independence Regional Health Center
  • Medical Center of Independence
  • Suburban /Rural/Specialty Hospitals

16
Kansas City Marketplace
  • Kansas City Profile
  • 26 Full Service Acute Hospitals
  • 6,507 Licensed / 5,254 Staffed Beds
  • 3,343 ADC
  • 64 Occupancy (staffed)
  • 1.87M Residents in MSA - 2004
  • 5.9 Population Growth 2004-09
  • CON
  • Provider owned MCOs / dueling systems
  • Available bed capacity
  • Irrational capital spending by stand alone single
    hospital franchises
  • Low commodity pricing
  • PRO
  • No dominant system
  • High use rate for service utilization
  • Lack of inpatient niche traction
  • Missouri Certificate of Need state
  • Low of uninsured population

17
2004 Kansas City Market Share
11 County Service Area
18
Characteristics of Health Midwest
  • System Developed through Acquisition (13)
  • Poor Management Control Systems
  • Centralized Decision Making
  • Declining Market Share
  • Lack of Leadership
  • Attempted Vertical Integration
  • Low Employee Morale
  • Lack of Capital Spending

19
Key Accomplishments - Growth
  • Recruited 54 New Physicians to Market
  • Managed Care Pricing 9 2004 9 2005
  • ASC Development Projects Approved
    (Independence, MMC, OPRMC)
  • New Service Development
  • Pancreas / Transplant Services (RMC)
  • Gyn Oncology (OPRMC / RMC)
  • Trauma (OPRMC/Independence)
  • Open Heart Services (OPRMC / BLMC)
  • Cyberknife JV (MMC)
  • Chest Pain Accreditation
  • The Cancer Institute Unwind (Health Midwest/St.
    Lukes Oncology JV)
  • CON Approval Independence Lees Summit

Growth 2003-2005 62- MRI 38 - CT
  • Imaging

20
Key Accomplishments Cost /Efficiency
  • Labor Reductions
  • Closed Unprofitable Services (Skilled Nursing,
    Rehabilitation Units)
  • Shed Non-core Businesses (EHS, Trinity Manor,
    Fitness Center)
  • Built Flexible Workforce (implemented All
    About Staffing)
  • Case Management Avoidable Day Reduction
  • Supply Chain Warehouse
  • PAS Implementation

21
Capital Investment
  • Major Capital Initiatives
  • 281 Million New Independence Hospital (196M)
    New Lees Summit Hospital (85M)
  • 92 Million Research Medical Center (ER,
    Patient Rooms, Cancer, Imaging)
  • 25 Million Overland Park Regional Health
    Center (Womens Services ICU)
  • 15 Million Outpatient Strategy Development
    (ASC, JVs, etc.)
  • 32 Million Financial Clinical Information
    System
  • 16 Million Imaging Investment

22
New Replacement Hospitals
Lees Summit
Independence
  • Site Summary
  • 89 acres purchased for 15M
  • Bed Profile Proposed
  • Medical / Surgical 156
  • Intensive Care Unit 28
  • NICU (Level II III) 12
  • GYN/Antepartum 9
  • Post Partum 16
  • TOTAL 221
  • Site Summary
  • 39 acres purchased for 8M
  • Bed Profile Proposed
  • Medical / Surgical 48
  • Intensive Care Unit 10
  • Womens Services 6
  • TOTAL 64
  • ER Bays 14 treatment bays
  • Surgical OR 4
  • PACU 8
    positions
  • Prep Recovery 12
    positions
  • ER Bays 32 treatment bays
  • Surgical OR 10
  • PACU 15 positions
  • Prep Recovery 30 positions

23
Stabilized Run Rate
Admissions
24
Long Run Strategy
  • 1 Growth Increase Market Share in High
    Margin Services
  • 2 Execute Capital Investment Strategy
  • 3 Upgrade Quality / Satisfaction
  • 4 HCA Goodwill / Communication Efforts
  • 5 Execute Revenue Plan to Address Provider
    Reimbursement
  • 6 Bed Consolidation
  • 7 Shared Service Initiatives / Continued
    Reduction in Fixed Costs
  • 8 Geographical Expansion into New Markets
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