Jack O Bovender Jr Chairman and CEO Milton
Jack O. Bovender, Jr. Chairman and CEO Milton Johnson Executive Vice President and CFO Vic Campbell Senior Vice President Mark Kimbrough VP, Investor Relations HCA 2004 Merrill Lynch/Dec 04
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. HCA 2004 Merrill Lynch/Dec 04
HCA is located in 16 of 20 Fastest Growing Large US Cities Dallas/Ft. Worth +12% þGenerally 25 -40% Market Share þ 40% of facilities in Texas & Florida Denver +9% Kansas City +5% Las Vegas +22% U. K. Nashville +8% Richmond +8% Austin +18% Southern California +9% Compared to the National Average of 4. 5% HCA Panhandle +10% %% % Percent Growth in Market Population 2000 -2005 Palm Beach +11% % Houston +10% Switzerland Tampa Bay +8% 3 Dade +8% 2004 Merrill Lynch/Dec 04
HCA Capital Expenditures Billions 2000 2001 2002 2003 2004 E $1. 2 $1. 4 $1. 7 $1. 8 $1. 6 Expansions New Denver Facility Patient Safety & Infrastructure New Facilities Expansions 37 37 ER ER Expansions Open Heart, Imaging Cardiology, Oncology, etc. Routine 54 Facilities with Surgery and/or ICU/CCU expansions Distribution of Capital Dollars 1, 565 New Beds Four New Facilities 378 Beds 2002 and Beyond HCA 4 2004 Merrill Lynch/Dec 04
HCA Capital Regional Medical Center Tallahassee, FL ($100 M) 200 beds Opened: August 2003 HCA 2004 Merrill Lynch/Dec 04
HCA Stonecrest Medical Center Smyrna, TN ($96 M) 75 beds Opened: December 2004 HCA 2004 Merrill Lynch/Dec 04
Inpatient Admissions and Outpatient Visits (millions) Inpatient Admissions (millions) 1980 - 2003 Source: AHA Annual Survey 1980 - 2003 HCA 7 2004 Merrill Lynch/Dec 04
Socio-Demographics—Age Wave Driving Healthcare Utilization 1. 56% 3 -Year CAGR Acute Care Utilization Index (2003=100) 125 1. 59% 3 -Year CAGR 1. 62% 3 -Year CAGR 1. 58% 3 -Year CAGR 121 119 120 2 R 2 115 8% 1. 5 110 G CA 106 103 105 102 100 98 100 97 96 HCA 1. 6% 115 1. 6% 113 1. 6% 112 1. 5% 110 1. 6% 108 105 95 01 2 3 00 1. 7% 117 1. 6% Baby Boomer Impact Accelerates 1. 5% 1. 6% 1. 5% 1. 4% 20 2 2 2 2 00 001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 8 2004 Merrill Lynch/Dec 04
HCA Admission Trends 2001 to 3 Q 2004 Same Facility 15. 4% HCA Growing Medicare Market Share Growth in Medicare Admissions 1998 -2001 HCA Market Competitors * *2 Q includes same-market admissions HCA 9 2004 Merrill Lynch/Dec 04
Inpatient Surgery Trends Improving 2001 to 3 rd Quarter 2004 - Same Facility 1 HCA 1: Includes Kansas City facilities. 10 2004 Merrill Lynch/Dec 04
Enhanced Outpatient Services Focus O/P Comprised of Three Business Lines 2003 As a % of Outpatient Surgeries % of HCA Net Revenue 15. 3% Outpatient Surgeries Hospital Based 70% ASC Based 30% 12. 5% Outpatient Diagnostic Services Hospital Based 9. 4% Freestanding ðImaging ðCardiology ðOncology ðOrthopedics ðNeurology Outpatient ER 37. 2% HCA 11 2004 Merrill Lynch/Dec 04
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 HCA Surgery Centers Diversified Radiology (Denver) 4 imaging centers/fifth under construction Austin Radiology Assoc. 2 imaging centers Sarah Cannon Research Institute (Nashville) Thousand Oaks Diagnostic Imaging LAD Imaging Centers (Orange City, Deltona) Millcreek Imaging Center Salt Lake City, UT HCA 12 2004 Merrill Lynch/Dec 04
2004 Managed Care Contracting 6, 844 Facility Level Active Contracts 2005 Contract Pricing Timeline* 35% 42% 55% 75% 95% Pre-2004 1 Q 04 2 Q 04 3 Q 04 4 Q 04 *Anticipated Completion Dates 100% 2005 Cumulative Net Revenue per Adjusted Admission 16% Managed Care & Other Discounted 11. 1% 10. 5% 11. 4% 13. 0% 9. 9% 15. 0% 13. 3% 11. 1% 9. 6% 7. 0% 7. 3% 3 Q 03 4 Q 03 9. 2% 6. 6% 0% 1 Q 02 2 Q 02 3 Q 02 4 Q 02 1 Q 03 2 Q 03 1 Q 04 2 Q 04 3 Q 04 75% of 2005 and 35% of 2006 contracts completed HCA 2004 Merrill Lynch/Dec 04
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) HCA 14 2004 Merrill Lynch/Dec 04
Labor Cost Wage Rate Same Facility - % Change from PY 2001 2002 2003 2004 1 +6. 5% 1 Q 01 2 Q 01 4 Q 01 3 Q 01 2 Q 02 1 Q 02 3 Q 02 +4. 6% +4. 7% +5. 1% 4 Q 02 1 Q 03 2 Q 03 3 Q 03 Sept YTD 4 Q 03 3 Q 04 2 Q 04 1: Includes Kansas City facilities. Contract Labor Reduction $/Adj. Patient Day 15% vs. Q 103 25% vs. Q 103 Total Operations* Nursing 29% vs. Q 103 33% vs. Q 103 29% vs. Q 103 * Eastern and Western Consolidated Operations HCA 2004 Merrill Lynch/Dec 04
Bad Debt Impact on Operating Expenses/AA – Percent Change from Prior Year per Adjusted Admission 15% 2001 2002 2003 2004 7. 0% 7. 4% 9. 4% 8. 5% 10. 2% 10% 8. 0% 5. 4% 5% 4. 7% 7. 8% 5. 5% 5. 2% 8. 9% 8. 5% 8. 8% 7. 4% Sept. YTD 10. 4% 10. 8% 8. 0% 8. 1% 6. 0% 5. 6% 7. 6% 9. 3% 7. 0% 5. 5% 6. 6% 7. 0%1 7. 5% 6. 2% 6. 0% 5. 3% 5. 5% 5. 8% 5. 1%1 3. 8% 6. 5% 0% 6. 7% 6. 0% 6. 4% Sept. YTD 1 Q 01 2 Q 01 3 Q 01 4 Q 01 1 Q 02 2 Q 02 3 Q 02 4 Q 02 1 Q 03 2 Q 03 3 Q 03 4 Q 03 1 Q 04 2 Q 04 3 Q 04 Same Facility – Percent Change from Prior Year Operating Expense/AA (Adj. For Bad Debt) 1: Adjusted for $26 M in net hurricane operating expense impact during the 3 rd quarter HCA 2004 Merrill Lynch/Dec 04
HCA Reduces Malpractice Reserves by $59 Million in 2 Q 2004 HCA Large Claims Declining HCA 2004 Merrill Lynch/Dec 04
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 HCA 18 2004 Merrill Lynch/Dec 04
Accounts Receivable Indicators Cash Collections % Adj. Net Revenue / Days in A/R Days in Accounts Receivable Cash Collections % Adjusted Net Revenue HCA 19 2004 Merrill Lynch/Dec 04
Strong Cash Flow Trends Provide Opportunities Net Cash Provided by Operating Activities Dollars in Millions Capital Reinvestment $1. 6 B in 2004 Share Repurchase Program $10. 0 B in 8 years $2. 5 B “Dutch Auction” completed at $39. 75 in November ‘ 04 New Dividend Policy $250 mm annually Excluding settlements with government agencies and investigation related costs. HCA 20 2004 Merrill Lynch/Dec 04
Opportunities Of Having Strong Cash Flow Share repurchase program e ar h s a h s 6/ / 45. 1 20041 $600 M: 14. 5 M Shares 2003 $1. 1 B: 31. 1 M Shares 2002 $282 M: 6. 2 M Shares re $4 . 7 are 5 3 sh $ re a h / 53 5. $4 /s 8 8 6. 3 $ re 2001 $706 M: 19. 2 M Shares a /sh 5 8. 6 2 2000 $1. 3 B: 43. 5 M Shares $ re ha s / 1 . 6 4 2 HCA 1: 2004 purchases through 3 -12 -04 38% of outstanding shares Average Price: $30. 20 650 M Shares 12/31/96 491 M Shares 12/31/03 2 Impact of Tender Offer e ar h /s 311 Million Shares e 8 1997 $1. 3 B: 37. 9 M Shares 249 Million Shares ar h /s 1999 $1. 4 B: 55. 6 M Shares $ 1998 $930 M: 41 M Shares $7. 5 Billion . 6 22 $ 9 5. 3 $3 21 $10 Billion 48% of outstanding shares Average Price: $32. 20 2004 Merrill Lynch/Dec 04 2: Includes other activities affecting share balance (stock option exercises, restricted grants, and ESPP activity. )
Employee Satisfaction at Record Levels Employee Satisfaction Employee Turnover Satisfaction Score Turnover Rate (Gallup Score) Nurse Turnover HCA 2004 Merrill Lynch/Dec 04
In Summary We Have…. 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 HCA 23 2004 Merrill Lynch/Dec 04
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