2012 strategic update book

For additional questions or information regarding this publication, please contact

Mercy Planning Research at 314-628-3611

Our Mission As the Sisters of Mercy before us,

we bring to life

the healing ministry of Jesus

through our compassionate care

and exceptional service.

Our Values Dignity | Justice | Service | Excellence | Stewardship

Our Vision We are the people

of Mercy Health Ministry.

Together, we are pioneering

a new model of care.

We will relentlessly pursue

our goal to get health care right.

Everywhere and every way

that Mercy serves,

we will deliver a

transformative health experience.

Mercy Charism Bias for Action: Practical; anticipating and responding to need; getting things done

Entrepreneurial Spirit: Seeing what needs to be done; having the courage to take risks; innovative; promoting system change

Hospitality: Welcoming and accepting; gracious; forgiving

Right Relationships: Speaking your truth with honesty; resolving differences; holding each other accountable; collaborating

Fullness of Life: Sense of joy; vibrancy for life even amongst suffering; magnanimous; authentic and relevant

Mercy Health WHO WE ARE

Mercy Health WHERE WE SERVE

UTILIZATION (FY11)

4,041 staffed beds

576,947 ED visits

6,646,738 outpatient visits

160,733 inpatient discharges

HOSPITALS

26 acute care hospitals

5 managed hospitals

3 heart hospitals

2 children's hospitals

1 rehab hospital

AMBULATORY SERVICES

271 clinic locations

8 outpatient surgery centers

14 urgent care centers

18 convenient care centers

MEDICAL STAFF & CO-WORKERS

38,000 co-workers

1,691 integrated physicians

618 advanced practitioners

5,276 medical staff * *includes integrated and non-integrated physicians

FINANCIALS (FY11)

$4.0 billion total operating revenue

$4.6 billion total assets

$272 million in community services

Mercy is the 6th largest Catholic Health System in the US (28th overall) based on Net Patient Service Revenue. Source: Modern Healthcare Survey, May 2012

Mercy serves in more than 120 communities across seven states. Nearly 8 million people live in the areas where we serve—3 million of those lives are touched by Mercy annually.

Total population of all Mercy Primary Service Areas including Sponsored Community Ministry areas: Webb County (Laredo, TX); Jefferson, Orleans and St. Tammany Parishes (New Orleans & Mandeville, LA); and Hinds & Rankin Counties (Jackson, MS).

As of July 2012

“When our Founder Catherine McAuley opened the first House of Mercy in Dublin, Ireland, in 1827, the needs were great. The needs today in the communities we serve across the Midwest continue to grow, and we continue to find ways to serve those needs. It’s in our DNA to serve those who are economically poor and to work for change on their behalf.”

– Lynn Britton, President and CEO of Mercy

Springfield 30% St. Louis/

Washington 25%

Oklahoma City/ Ardmore

14% Fort Smith 10%

Joplin 9%

Hot Springs 6%

Rogers 3%

SE KS 3%

Mercy Charity FY11 = $216,941,672 % Distribution by Community

Traditional Charity Care and Medicaid (unreimbursed costs)

Source: Mercy Finance; Mercy Communities, FY11

OUR SERVICES TO THE COMMUNITY

Mercy’s heritage and purpose is focused on the well-being of the communities we serve. Whether it’s much needed funds for domestic violence shelters, teen moms, families in crisis or counseling for those still suffering from the devastating effects of last year’s EF5 tornado in Joplin, Mercy continues to respond to the needs of the communities it serves.

Mercy works closely with several sponsored community partners to improve access to health care resources, provide medical equipment and supplies, advocacy, and spiritual and clinical aid to people in need through subsidized health services, preventive screenings, medical education and outreach ministries.

During FY11, Mercy invested nearly $272 million to help economically disadvantaged members of our communities.

The pie charts to the left depict Mercy Charity and Community Benefits for fiscal year 2011.

Springfield 36%

St. Louis/ Washington

22%

Mercy Ministry Office 12%

Joplin 10%

Laredo 6%

Oklahoma City/ Ardmore

5%

Fort Smith 5%

Hot Springs 3%

Rogers 1%

SE KS 0.3%

Mercy Community Benefits FY11 = $55,163,815 % Distribution by Community or Ministry

Source: Mercy Finance; Mercy Communities, FY11

Mercy Health SERVICES TO THE COMMUNITY

Photo of the 5th Annual Nixa Bike Ride which raises health awareness and funding in the community.

More Providers

Expand Footprint

Underserved Populations

Children

Telemedicine

Specialty Care

Renewal

Tactical Plan

Integrate and Align Providers

Leverage Technology

Broaden Access and Improve Continuity

Build Lifelong Customer Relationships

Influence Health Care Financing

Center for Innovative Care

Core Strategy

Realization

Our vision for delivering a New Model of Care manifested.

We asked our communities to help us define what the new model of care would look like.

From the planning process sprang objectives targeting local, regional and virtual services.

Executing our tactical plan requires focus.

The work of the day is defined by our seven Key Initiatives.

2015 New Model of Care

Mercy Health STRATEGIC DIRECTION

Growth Goals (2x)

Service Definition (Local, Regional. Virtual)

Margin Goals (4%)

Capital Investments

Facilities, Doctors & Philanthropy

Care Model Implementation

Cost Reduction Care Efficiency

Infrastructure & Operational Investments

STRATEGIC DIRECTION

The following pages depict Mercy’s strategic direction beginning in June 2009 with the adoption of a new care model and Mercy’s Core Strategies, growing into a community input-based Tactical Plan, and culminating into our seven Key Initiatives.

Each platform described in this section represents a natural evolution in Mercy’s strategic direction with the ultimate goal of delivering a transformative health experience to our communities by 2015.

Key Initiatives

Managing to Medicare

Performance Reengineering

Palliative Care

Ministry Growth

People Promise

Care Model

Clinical Integration

2009

2010

2011

2012

More Providers

Expand Footprint


Children

Telemedicine

Specialty Care

Renewal

Tactical Plan


Leverage Technology





Core Strategy

Realization








Growth Goals (2x)


Margin Goals (4%)

Capital Investments





Key Initiatives



Palliative Care

Ministry Growth

People Promise

Care Model


2009

2010

2011

2012

• Integrate and align physicians and advanced practitioners The integrated model will create a coordinated system of care that optimizes the roles of primary and specialty physicians as well as advanced practitioners, aligns incentives and supports improved outcomes.

• Leverage technology We will use technology to its fullest potential to improve coordination of care, access to services, clinical outcomes, safety and productivity.

• Broaden access and improve continuity of services By providing access to multiple touchpoints of care and reducing barriers, the redefined model will ease the path our customers take through the care process.

• Build lifelong customer relationships Every customer encounter will be a Mercy brand experience that builds loyalty to Mercy.

• Influence transformation of health care financing We will work with area payers to develop new payment methodologies and advance coordination of care management.

• Develop the Center for Innovative Care To accomplish and sustain the work, we will create a center for coordinating, supporting and constantly advancing all aspects of the care model.


By 2015, Mercy will deliver a new model of care.

Mercy’s Core Strategies

More Providers

Expand Footprint


Children

Telemedicine

Specialty Care

Renewal

Tactical Plan


Leverage Technology





Core Strategy

Realization








Growth Goals (2x)


Margin Goals (4%)

Capital Investments





Key Initiatives



Palliative Care

Ministry Growth

People Promise

Care Model


2009

2010

2011

2012

Mercy Children’s Services

Acute and preventive care

Large pediatric provider base

Pediatric specialists & sub-specialists

School-based health care

HealthTeacher

Outpatient Care

specialty

care

Orthopedics

Oncology

Cardiovascular

Other service lines delivered as an overall patient experience

Virtual radiology

Remote disease management

eICU, telestroke and teleneurology

Direct access to primary care

Pediatric cardiology

High risk pregnancy

Mental health

Post-op follow-up

renewal

Campus expansions and renovations

Improved care

settings

Replacement hospitals in some rural communities

As a result of listening to our communities, we discovered a shared vision for a future where our children will be healthier, technology will bring us closer together and into a more personal environment of care, and access to care will be within reach for more people. This is our continual and relentless pursuit to get health care right.


tele-

medicine

New primary care physicians

New specialty care providers

Nurse practitioners, physician assistants, care managers to coordinate care

more

providers children

under-

served

populations

Medicaid and indigent clinics

Project Access

Mobile services

Retail clinics

New communities

New locations

Align with regional hospitals

New and unique care settings

expanded

footprint

Tactical Plan

More Providers

Expand Footprint


Children

Telemedicine

Specialty Care

Renewal

Tactical Plan


Leverage Technology





Core Strategy

Realization








Growth Goals (2x)


Margin Goals (4%)

Capital Investments





Key Initiatives



Palliative Care

Ministry Growth

People Promise

Care Model


2009

2010

2011

2012

More Providers

Expand Footprint


Children

Telemedicine

Specialty Care

Renewal

Tactical Plan


Leverage Technology





Core Strategy

Realization








VISION We are the people of Mercy Health Ministry. Together, we are pioneering a new model of care. We will relentlessly pursue our goal to get health care right.

Everywhere and every way that Mercy serves, we will deliver a transformative health experience.

Growth Goals (2x)


Margin Goals (4%)

Capital Investments





Key Initiatives



Palliative Care

Ministry Growth

People Promise

Care Model


2009

2010

2011

2012

Mercy Health SPONSORED COMMUNITY MINISTRIES

Mercy Sponsored Community Ministries, located in Texas, Louisiana and Mississippi, provide health care and public support through Mercy Ministries of Laredo, Mercy Family Centers and the Mississippi Health Advocacy Program.


Mercy Ministries of Laredo

Mercy Ministries of Laredo, in the tradition of the Sisters of Mercy, strives to address the needs of all persons—especially those who are economically poor and marginal—by providing primary health care, health education and social services in Laredo, Texas and surrounding communities. The Ministry demonstrates special concern for the needs of women and children while promoting family values and collaborates with other providers and partners who share in Mercy’s mission and values.

Primary Health Care Services

Mercy Clinic in Laredo offers women’s health services, general medicine for women and men, health education, a diabetic center, medication and cancer assistance programs, school physical exams, the Promotoras Program (consisting of five community health workers who help patients navigate the health system and provide health education and follow-up), social services and advocacy. The clinic offers these services at its primary location, in community self-help centers and in underserved areas with its mobile medical van. The health services are provided by nurse practitioners and, when indicated, patients are referred to local physicians who collaborate with Mercy and have agreed to see the patients for specific conditions in their offices at Medicaid rates.

Nearly 100% of the patients who visit Mercy Clinic in Laredo are uninsured and have limited financial resources, making it difficult for them to get health services anywhere else.

Casa de Misericordia (CASA)

CASA is a domestic violence shelter with both residential and outreach components. It serves over 200 women and almost 600 children annually.

While many domestic violence shelters provide a safe haven for victims of physical violence, CASA also addresses their mental, emotional, legal, educational and social needs. An educational center provides classes in language and job skills, exercise and support groups, and after-school tutoring for children. The shelter’s vision statement proclaims the belief “that battered women, despite all they have endured, can reclaim their lives by receiving comprehensive, holistic services and consistent long-term support.” CASA is a founding member of the Webb County Domestic Violence Coalition.


Mississippi Health Advocacy Program (MHAP)

Established in 1992 by a grant from the Sisters of Mercy Health System, the Mississippi Health Advocacy Program (MHAP) is a non-profit, non-partisan public interest health advocacy organization. MHAP combines research, analysis and grass-roots organizing to improve health policies, practices and funding in Mississippi, especially in support of the state's poor and underserved population. MHAP promotes health system change by developing and monitoring implementation of innovative health and human services policies. MHAP works to make health policy and funding patterns more responsive to health needs by providing data and policy information to lawmakers through testimony, position papers and informal discussions throughout the legislative process. The program also provides information and support to front-line workers and communities as they work to address problems at the local level.

Mercy Family Center

Mercy Family Center, founded in 1992, is a multidisciplinary outpatient behavioral health clinic for children, adolescents and their families providing quality assessment and intervention services that are accessible to people of all income levels.

Mercy Family Center has locations in Metairie, Mandeville and the greater New Orleans area in Louisiana. Mercy Family Center is a primary referral site for the identification and treatment of Attention Deficit/Hyperactivity Disorder (AD/HD), Autism Spectrum Disorders, and other childhood disorders. Treatment emphasizes behavior change, problem-solving and promotion of self-esteem for the individual and the family.


Mercy Family Center (continued)

Mercy Learning Center Provides academic support to students identified with learning style differences. The goal of Mercy Learning Center is to help these children acquire the necessary oral and written communication and mathematics skills to be successful in school and eventually in life. In spite of remediation services provided within the schools, these children are not keeping up with the skill acquisition pace of their peers, resulting in their learning gap increasing with age. Without appropriate instruction and support, these children often become discouraged as adolescents and eventually drop out of school causing additional problems for their families and our communities.

Project Fleur-de-lis TM

An intermediate and long-term school-based mental health service model for children who have been exposed to traumatic events as a result of natural and man-made disasters. This collaborative endeavor involving key entities within schools (Catholic, public, public charter, and private), Catholic Healthcare and Catholic Social Services in the greater New Orleans area is currently working with 60 schools encompassing over 29,500 eligible students.

Mercy Community Hope Project

A partnership with Catholic Charities of New Orleans and other community organizations to respond to the stress on children, parents and school staff brought about by exposure to the BP oil disaster. The oil spill in the coastal parishes is yet another traumatic event that has affected all populations living in these areas. The project will make a difference in the lives of participants by introducing the skills necessary to reinforce the resiliency and coping mechanisms needed to reduce or prevent risk behavior due to the traumatic circumstances surrounding the oil spill.

Mercy Health COMMUNITY HEALTH & ACCESS GRANTS

Catherine’s Fund

Beginning in 1991, Catherine’s Fund was established as a means to encourage new and innovative ways of responding to issues that improve community health and quality of life, especially for people who are economically poor. At a funding level of $1 million dollars payable over a three-year period, this fund is intended to have a greater impact on the community in which it is granted than Mercy’s other grant programs.

The Catherine’s Fund award for FY11-FY13 will be utilized to implement Project Access across the Mercy Ministry. Project Access is designed to increase health care access and provide primary prevention strategies for those individuals with unmet health-related needs. The target population for potential participants are those with chronic illness who are using the Emergency Department for their health care needs. These patients are uninsured and without a primary care physician to manage their illness. Key programming strategies include access to primary and preventive care through a medical home, care coordination and education by care managers with 24/7 telephonic access to nurses for self-care advice and triage, and medication assistance. In FY12, hospitals in Mercy communities engaged in a plan to implement Project Access. Funds in FY13 will be dedicated to executing these local plans and expanding the target populations served.

Mercy Caritas Fund

The purpose of Mercy Caritas is to provide funding for community-based programs that improve community health and well-being, with particular concern for people who are economically poor. Annual awards total $500,000 with a maximum award of $50,000 to any single recipient. In FY12, 20 different programs were supported through Mercy Caritas funding. Awards are granted for a twelve-month period. Access to health and social services, quality of life improvements, prevention/wellness activities, and systemic change efforts are areas of focus that receive priority funding consideration. Programs awarded grants in FY12 provide access to health care, wellness education, dental care, mental health services, medication assistance, support for children and new mothers, and various other programs that promote health and assist with the management of chronic illnesses.

Catherine McAuley Area of Greatest Need Fund

The Catherine McAuley Area of Greatest Need Fund (formerly known as the Mercy Make a Difference Fund) is designated annually through a grant process to areas within Mercy demonstrating the greatest need. Each year, co-workers associated with the Ministry Office are invited to participate in a co-worker giving campaign known as Mercy Way. Gifts designated to this fund in the past have been used to support Mercy Ministries of Laredo in purchasing a new mobile health van, provide medical equipment and other furnishings for a community outreach clinic in an underserved area of Southwest Missouri, and in support of medication assistance programs in Springfield, MO and Laredo, TX. Grant amounts vary from $100,000 to $150,000 annually. In FY12, $100,000 was split between two dental clinics, one in Washington, MO and one in Fort Smith, AR.

Saint Louis PRIMARY SERVICE AREA

The St. Louis Primary Service Area (PSA) comprises 194 zip codes in east central

Missouri and west central Illinois

MO

IL

Private 61%

Medicare 14%

Uninsured 13%

Medicaid 12%

DEMOGRAPHICS St. Louis Service Area Missouri 2011

US 2011 2011 2016 % Growth

Total Population 2,738,424 2,789,850 2% 6,015,487 310,650,750

0-17 24% 24% 0% 24% 24%

18-44 Females 18% 17% -2% 18% 18%

18-44 Males 17% 17% -0.4% 18% 19%

45-64 27% 27% 2% 26% 26%

65+ 13% 15% 14% 14% 13%

Median Age 38 - - 38 37

White 75% 74% 1% 81% 64%

Black 18% 19% 3% 11% 12%

American Indian <1% <1% 11% 1% 1%

Asian/Pacific Islander 2% 2% 16% 2% 5%

Multiracial and Other 2% 2% 12% 2% 2%

Hispanic (of any race) 3% 3% 19% 4% 16%

Speak Spanish in Home 2% - - 3% 12%

Total No. of Households 1,087,193 1,106,372 2% 2,393,904 116,862,390

Households with Children 33% - - 33% 34%

HH Income Under $15K 11% - - 14% 13%

HH Income Over $75K 31% - - 25% 30%

Average HH Income $ 67,147 - - $ 58,797 $ 67,529

Some High School 8% - - 9% 9%

High School Graduate/GED 28% - - 33% 29%

Some College 31% - - 29% 28%

Bachelor’s Degree or greater 29% - - 25% 28%

MAJOR EMPLOYERS

Mercy East Communities has over 9,500 co-workers, joining three other health care providers (BJC, SSM and Tenet) in the St. Louis Metro area with workforces exceeding 5,000.

Below are the largest employers (all industries) with employment size of 10,000 or greater:

Hypertension 31%

Arthritis 24%

Asthma 13%

Diabetes 9%

COPD 5%

Coronary Heart Disease 5%

Angina 2%

Congestive Heart Failure 2%

CHRONIC DISEASE

Within the 194-zip code St. Louis Service Area, the following chronic conditions have been identified among the adult (18+) population:

In addition, 3% have had a stroke 4% have had a heart attack, and 5% are living with some type of cancer

Source: Thomson Reuters Continuum of Care, 2011

Saint Louis DEMOGRAPHICS

Note: St. Louis Service Area consists of 194 zip codes in Missouri and Illinois; Education Level based on population age 25+ Source: Thomson Reuters, 2011

Rac

e &

Eth

nic

ity

Age

Gro

up

s H

ou

seh

old

s Ed

uca

tio

n

Health Factor St. Louis County Missouri

National Benchmark

Adult Smoking (% smoking >= 100 cigarettes) 18% 24% 14%

Adult Obesity (% with BMI >= 30) 29% 31% 25%

Physical Inactivity (% of adults age 20+ not active) 25% 28% 21%

Excessive/Binge Drinking 19% 17% 8%

Teen Birth Rate (per 1,000 females age 15-19) 27 44 22

Children in Poverty (% of children under 18 in poverty) 14% 21% 13%

Preventable Hospital Stays (per 1,000 Medicare enrollees) 65 75 49 Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute

COMMUNITY HEALTH MEASURES

Overall Health Ranking: Missouri = 40 (/50 states); St. Louis County = 20 (/115 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.

Below are some of the factors which attribute to community health.

Source: Mercy Human Resources, April 2012; St. Louis Regional Chamber & Growth Association (RCGA), 2011

BJC HealthCare Schnucks (grocer)

Boeing Defense, Space & Security Walmart

Scott Air Force Base Washington University

SSM Health Care

Source: Thomson Reuters Insurance Coverage Estimates, 2011

Private 57% 56% Medicare 16% 14% Medicaid 13% 14% Uninsured 15% 16%

US MO INSURANCE COVERAGE

8.4% 7.4%

8.2%

UNEMPLOYMENT RATE

Change over 12 months

↓0.8% MSA*

↓1.3% Missouri

↓0.7% US

*St. Louis, MO-IL Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics

MARCH 2012

1a

1b

2

12

33

22

31

20

18

25

3

10 28

16 17

8 15

13 6

14 4 7 26

23

30

29

32

9

11

21 1

Saint Louis REGIONAL PROVIDER LANDSCAPE

The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the St. Louis Service Area.

19

24

27

5

Freestanding General Outpatient

Surgery Center

Mercy Health

BJC HealthCare

SSM Health Care

St. Anthony’s Med Ctr

Physician Owned

IndependentSource: Buxton ASC database, 2012

Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation

Mercy Hospital St. Louis* Mercy

Mercy Heart & Vascular Hospital (on campus) Mercy

Mercy Children's Hospital (on campus) Mercy

Mercy Hospital Washington* Mercy

Mercy Rehabilitation Hospital St. Louis Mercy & Centerre Healthcare

Barnes-Jewish Hospital* BJC HealthCare

Missouri Baptist Medical Center* BJC HealthCare

Christian Hospital* BJC HealthCare

St. Louis Children's Hospital* BJC HealthCare

Barnes-Jewish St. Peters* BJC HealthCare

Alton Memorial Hospital* BJC HealthCare

Progress West HealthCare Center* BJC HealthCare

Barnes-Jewish West County* BJC HealthCare

Missouri Baptist Sullivan Hospital* BJC HealthCare

SSM DePaul Health Center* SSM Health Care

SSM St. Mary's Health Center* SSM Health Care

SSM St. Joseph Health Center* (St. Charles, MO) SSM Health Care

SSM St. Joseph Health Center (Wentzville, MO) SSM Health Care

SSM St. Joseph Hospital West* (Lake St. Louis, MO) SSM Health Care

SSM St. Clare Health Center SSM Health Care

SSM Cardinal Glennon Children's Medical Center* SSM Health Care


St. Anthony's Medical Center* St. Anthony's

St. Luke's Hospital* St. Luke's

St. Elizabeth's Hospital* Hospital Sisters Health System

Touchette Regional Hospital* Southern IL Health Care Foundation

St. Alexius Hospital* Success Healthcare

Des Peres Hospital* Tenet Healthcare

St. Louis University Hospital* Tenet Healthcare

Gateway Regional Medical Center* Community Health Systems

CenterPointe Hospital Independent

Jefferson Regional Medical Center Independent

Anderson Hospital* Independent

Memorial Hospital* Independent

Saint Anthony's Health Center* Independent

Lincoln County Medical Center* Independent

20

21

22

23

24

25

26

Saint Louis REGIONAL PROVIDER LANDSCAPE

1

1a

1b

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

29

30

27

31

32

33

35

28

INPATIENT MARKET SHARE 12%

TOTAL ASSETS $718M

NET PATIENT REVENUE $892M

OPER. PROFIT MARGIN 2.4%

• Non-profit, owned by BJC HealthCare

• Eight general acute care hospitals in the region, a pediatric specialty hospital, a network of outpatient health centers offering physician and urgent care services, home health agencies, fitness rehabilitation center, long-term care facilities, and onsite wellness programs

• BJC Medical Group, affiliated with Washington University School of Medicine, consists of 300 physicians and advanced practice providers in 80 locations

• Rehabilitation Institute of St. Louis, a 96-bed freestanding acute rehab hospital with 1,500 inpatient discharges in FY11, is a joint venture with HealthSouth


TOTAL ASSETS $4.6B

NET PATIENT REVENUE $2.9B

OPER. PROFIT MARGIN 0.5% www.bjc.org

Hospital FTEs Staffed

Beds Service Area IP Discharges

Total Hospital IP Discharges

Total Births

Barnes-Jewish Hospital 9,292 1,279 41,530 56,641 3,434

Missouri Baptist Medical Center 2,331 448 20,539 24,556 3,956

Christian Hospital 1,708 262 15,266 15,839 0

St. Louis Children’s Hospital 2,716 250 7,515 11,579 0

Barnes-Jewish St. Peters 697 113 6,428 6,630 564

Alton Memorial Hospital 755 252 5,773 6,489 535

Progress West HealthCare Center 297 42 3,120 3,231 527

Barnes-Jewish West County 465 84 2,163 2,961 0

Missouri Baptist Sullivan Hospital 335 56 1,198 2,454 276

TOTAL 18,596 2,786 103,532 130,380 9,292

• Non-profit, member of Mercy

• Two general acute care hospitals, heart hospital, children’s hospital, rehabilitation hospital, cancer center, home health, urgent care centers, outreach ministries and skilled nursing facilities

• As of July 1, 2012, Patients First, based in Washington, MO will join Mercy. As a part of Mercy, Patients First includes 77 primary care and specialty physicians, 30 advanced practice providers and over 500 co-workers. Patients First supports 20 specialties in 20 locations across the region and has specialty treatment centers focusing on diabetes & nutrition, diagnostics, heart & vascular, sleep, cancer and outpatient surgery, as well as two urgent care sites

• Mercy Clinic East Communities includes 463 primary care, specialty and hospital-based physicians, 101 advanced practice providers and 979 clinic co-workers supporting over 978,000 outpatient visits to patients in 61 clinics and four urgent/convenient care sites within the St. Louis and Washington areas (physician counts as of April 2012; does not include addition of Patients First providers)

Source: IP Discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

Source: IP Discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012; Mercy Rehab FTEs, beds – Mercy Rehab Hospital, FY11

www.mercy.net Note: Hospitals only

Note: Hospitals only

Saint Louis REGIONAL PROVIDER STATISTICS




Total Births

Total ED Visits

Mercy Hospital St. Louis 4,588 979 37,585 40,374 7,830 81,163

Mercy Hospital Washington 533 179 5,050 5,383 872 31,902

Mercy Rehabilitation Hospital 229 90 1,070 1,237 0 0

TOTAL 5,350 1,248 43,705 46,994 8,702 113,065

Service Area IP Discharges represent inpatient discharges within a

specified service area, typically where 85%-95% of Mercy’s patients reside. Market share is calculated based on discharges within the service area. Total Hospital IP Discharges account for all discharges from a facility regardless of where patients reside.


TOTAL ASSETS $601M


OPER. PROFIT MARGIN -3.2%




Total Births

St. Anthony’s Medical Center 3,599 602 25,623 27,495 1,538 Source: IP Discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

• For-profit, independently owned • General acute care hospital, 53-member primary and specialty physician organization in 11 locations, four urgent care facilities

www.stanthonysmedcenter.com

Hospital

Health System FTEs

Staffed Beds

Service Area IP Discharges


Total Births

St. Luke’s Hospital (Chesterfield, MO) Independent 2,995 568 15,808 17,064 2,049

Memorial Hospital (Belleville, IL) Independent 1,870 345 15,436 16,232 1,554

St. Louis University Hospital (St. Louis, MO) Tenet Healthcare 1,381 332 12,352 15,318 0

St. Elizabeth’s Hospital (Belleville, IL) Hospital Sisters Health System 1,231 260 10,701 11,911 1,061

Jefferson Regional Medical Center (Festus, MO) Independent 1,203 196 8,184 11,921 529

Anderson Hospital (Maryville, IL) Independent 798 151 7,513 8,138 1,874

Gateway Regional Medical Center (Granite City, IL) Community Health Systems 608 337 NA 8,133 270

Des Peres Hospital (St. Louis, MO) Tenet Healthcare 723 142 5,657 6,945 0

St. Alexius Hospital (St. Louis, MO) Success Healthcare 748 189 4,984 5,660 0

Saint Anthony’s Health Center (Alton, IL) Independent 755 253 3,247 3,635 535

Touchette Regional Hospital (Centerville, IL) Southern IL Healthcare Foundation 593 89 2,962 3,143 418

CenterPointe Hospital (St. Charles, MO) Independent 311 84 2,326 2,881 0

Lincoln County Medical Center (Troy, MO) Independent 274 25 1,100 1,175 0 Source: IP Discharges (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; Includes providers between 1% and 5% market share

Note: Hospital only

Saint Louis REGIONAL PROVIDER STATISTICS

Other Health Care Providers in the St. Louis Service Area

In June 2012, Mercy and Jefferson Regional Medical Center entered into exclusive negotiations to transition Jefferson Regional to Mercy. Negotiations are expected to conclude by the end of 2012.

• Non-profit, sponsored by SSM Health Care

• Five general acute care hospitals, a pediatric specialty hospital and an inpatient rehabilitation hospital

• SSM Medical Group has over 250 primary care and specialty physicians in 40 locations


TOTAL ASSETS $1.4B

NET PATIENT REVENUE $1.6B

OPER. PROFIT MARGIN 1.5% www.ssmhc.com




Total Births

SSM DePaul Health Center 1,836 476 22,532 23,705 1,229

SSM St. Mary’s Health Center 1,768 374 20,239 21,164 2,925

SSM St. Joseph Health Center (St. Charles, MO) (includes SSM St. Joseph – Wentzville, MO)

1,255 331 14,751 15,903 630

SSM St. Clare Health Center 985 178 12,289 13,305 1,260

SSM St. Joseph Hospital West 666 126 8,885 9,610 1,170

SSM Cardinal Glennon Children’s Med Ctr 1,502 176 5,444 7,354 2

TOTAL 8,012 1,661 84,140 91,041 7,216


Source: IP Discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); FTEs, beds, births – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

http://www.stanthonysmedcenter.com/index.asp

Advanced Practice

18%

Hospital-based 25%

Specialists 21%

Primary Care 36%

Saint Louis PATIENT CARE

INPATIENT PHYSICIANS OUTPATIENT

20%

9%

7%

11%

22%

0 5,000 10,000

Neonate

Pulm

Cardio

Behav Hlth

OB

FFY11 Discharges

Ranks 1st in market share

Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011

Mercy Clinic Physicians 52%

West County Surgical Specialists 3%

Mercy Hospitalists Group 3%

Pediatrics Medical Group 2%

Mid County Orthopedic Surg. & Sports Med. 2%

Midwest Maternal Fetal Medicine 2%

OB-GYN Physicians, Inc. 2%

L. Peter Zhang, MD (Psychiatrist) 1%

Ophthalmology Consultants 1%

Allied Assoc. in OB/Gyn, Inc. 1%

Martin, Merenda and Galakatos (Ortho Surg) 1%

Other 30%

St. Louis MO US

Primary Care 141 121 116

Specialty 103 83 81

Total 244 204 197

Mercy Hospital St. Louis

Note: Mercy service lines used; based on volume within the PSA Source: HIDI, FFY11

Note: Total (n) = 491 integrated Mercy physicians and advanced practitioners serving the St. Louis community Source: Mercy Regional Business Development, April 2012

Of the region’s 10M hospital-based outpatient visits, 3% occurred outside the St. Louis PSA (0.01% at Mercy hospitals)

Medical Facility 2010

Physician's Offices* 46%

Independent Labs* 21%

St. Luke’s Hospital-Chesterfield, MO 3%

Mercy Hospital St. Louis-MO 2%

Barnes-Jewish Hospital-St. Louis, MO 2%

St. Anthony's Medical Center-St. Louis, MO 2%

Missouri Baptist Medical Center-St. Louis, MO 2%

Memorial Hospital-Belleville, IL 2%

SSM St. Joseph's Health Center-St. Charles, MO 2%

Christian Hospital-St. Louis, MO 1%

Barnes-Jewish St. Peters Hospital-St. Peters, MO 1%

St. Elizabeth Hospital-Belleville, IL 1%

Other Mercy hospitals 1%

Other (incl. hospitals and freestanding facilities) 15%

In FFY11, only 1% of patients received inpatient care at hospitals located outside the St. Louis PSA, including 0.02% at Mercy hospitals

Source: HIDI, FFY10-FFY11 (does not include Normal Newborns)

Hospital FFY10 FFY11

Barnes-Jewish Hospital-St. Louis, MO 12% 12%

Mercy Hospital St. Louis-MO 10% 11%

St. Anthony's Medical Center-St. Louis, MO 7% 7%

SSM DePaul Health Center-Bridgeton, MO 7% 6%

Missouri Baptist Medical Center-St. Louis, MO 6% 6%

SSM St. Mary's Health Ctr.-Richmond Hts., MO 5% 6%

St. Luke's Hospital-Chesterfield, MO 5% 4%

Memorial Hospital-Belleville, IL 4% 4%

Christian Hospital-St. Louis, MO 4% 4%

SSM St. Joseph Health Center-St. Charles, MO 4% 4%

St. Louis University Hospital-MO 3% 3%

SSM St. Clare Health Center-Fenton, MO 3% 3%

St. Elizabeth's Hospital-Belleville, IL 3% 3%

SSM St. Joseph Hosp. West-Lake St. Louis, MO 2% 3%

Jefferson Regional Medical Center-Festus, MO 2% 2%

Other Mercy hospitals 2% 2%

Other facilities 24% 19%

Source: Epic data, FY11 inpatient discharges; Buxton physician database, April 2012

Mercy Hospital Volume and Market Share

INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION

INPATIENT DISCHARGES BY PHYSICIAN GROUP

MERCY INTEGRATED MEDICAL STAFF

TOP INPATIENT SERVICE LINES

OUTPATIENT MARKET SHARE (Hospital-based)

OUTPATIENT UTILIZATION – MARKET ESTIMATES

% Change

Select Clinical Service Categories

2011 Procedures

Adjusted and Trended*

5 Yr 10 Yr

Physical and Occ. Therapy 6,552,453 30% 42%

Cardiology 1,154,304 16% 24%

Hematology/Oncology 1,110,125 21% 31%

Nephrology 705,536 44% 70%

Orthopedics 454,256 25% 37%

Neurology 445,241 19% 29%

OB/Gyn 424,197 37% 38%

General Surgery 192,018 20% 29%

Gastroenterology 186,801 24% 31%

*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010

Note: Data is available for additional clinical service categories *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence Source: Thomson Reuters Outpatient Estimates, 2011

Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each facility with an average response rate of 40%.

Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.

Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals. Percentage of patients who gave the hospital

the highest rankings Percentage of patients who gave the hospital

the lowest rankings

Mercy Hospital

Barnes Jewish

MO Baptist

MO US Mercy

Hospital Barnes Jewish

MO Baptist

MO US

78% 73% 74% 77% 76% 4% 6% 7% 5% 5%

80% 80% 82% 81% 80% 5% 5% 3% 4% 4%

63% 52% 60% 65% 64% 9% 16% 13% 10% 10%

70% 67% 72% 69% 70% 6% 7% 8% 7% 7%

58% 62% 54% 60% 61% 23% 20% 24% 21% 21%

72% 65% 68% 72% 72% 8% 14% 13% 9% 9%

59% 54% 54% 57% 58% 10% 15% 14% 11% 11%

79% 88% 83% 84% 82% 21% 12% 17% 16% 18%

76% 67% 69% 68% 68% 6% 9% 11% 9% 9%

80% 73% 75% 68% 70% 3% 4% 7% 5% 5%

Saint Louis PATIENT SATISFACTION

Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”

Scale (Question 8): highest = “yes/did”; lowest = “no/did not”

Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower

Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”

1 How often did nurses communicate well with patients?

2 How often did doctors communicate well with patients?

3 How often did patients receive help quickly from staff?

4 How often was patients’ pain well controlled?

5 How often did staff explain about medicines before giving them to patients?

6 How often were patients’ rooms & bathrooms kept clean?

7 How often was the area around patients’ rooms kept quiet at night?

8 Were patients given information about what to do during their recovery at home?

9 How do patients rate the hospital overall?

10 Would patients recommend the hospital to friends and family?

= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown

33% 32%31% 31%

20% 19% 19% 19%

0%

10%

20%

30%

40%

2008 2009 2010 2011

Barnes-Jewish HospitalMercy Hospital St. LouisMissouri Baptist Medical CenterSt. Luke's HospitalSt. Anthony's Medical Center

40% 39%40%

38%

19% 18% 16% 16%

0%

10%

20%

30%

40%

2008 2009 2010 2011

Barnes-Jewish HospitalMercy Hospital St. LouisSiteman Cancer Center at BJHMissouri Baptist Medical CenterSt. Luke's HospitalSt. Anthony's Medical Center

26% 25% 24% 25%

17% 16% 15%17%

0%

10%

20%

30%

40%

2008 2009 2010 2011

Mercy Hospital St. LouisBarnes-Jewish HospitalMissouri Baptist Medical CenterSt. Luke's HospitalSt. Anthony's Medical CenterSSM St. Mary's Health Center

Saint Louis CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.

When asked about preferred providers for quality, image/reputation and select service lines, participating residents from the surveyed region provided feedback displayed here.

Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); St. Louis 14 Regions

BEST OVERALL QUALITY 2011

Total number of respondents: 3,789 Providers with 2% or less are included in “Other Facilities”; Mercy Hospital Washington, 1%

Average number of respondents (4 yrs trending): 2,521

% r

esp

on

den

ts

Heart Care


% r

esp

on

den

ts

Maternity/OB


% r

esp

on

den

ts

Cancer Treatment


% r

esp

on

den

ts

Pediatric Services

SELECT SERVICE LINE PREFERENCE TRENDS

BEST IMAGE/REPUTATION 2011

Total number of respondents: 3,826 Providers with 2% or less are included in “Other Facilities”; Mercy Hospital Washington, 1%

Last year, 17% of St. Louis consumers who took the survey chose a Mercy Hospital for best overall quality and 16% selected Mercy as having the best image or reputation.

42%

15%5%

5%3%

31%

Barnes-Jewish Hospital Mercy Hospital St. Louis

St. Luke's Hospital Missouri Baptist Medical Center

St. Anthony's Medical Center Other Facilities

34%

16%6%6%

4%3%

3%

28%

Barnes-Jewish Hospital Mercy Hospital St. LouisMissouri Baptist Medical Center St. Luke's HospitalSt. Anthony's Medical Center Barnes-Jewish St. Peters HospitalSSM DePaul Health Center Other Facilities

30%28% 26%

20%

20%22% 21% 15%

0%

10%

20%

30%

40%

2008 2009 2010 2011

St. Louis Children's HospitalSSM Cardinal Glennon Children's HospitalBarnes-Jewish HospitalMercy Hospital St. LouisSt. Luke's HospitalSt. Anthony's Medical CenterMissouri Baptist Medical Center

Washington PRIMARY SERVICE AREA

The Washington Primary Service Area (PSA) comprises 14 zip codes in

west central Missouri

MO

Private 63%

Medicare 17%

Uninsured 10%

Medicaid 10%

DEMOGRAPHICS Washington Service Area Missouri 2011

US 2011 2011 2016 % Growth

Total Population 110,987 114,478 3% 6,015,487 310,650,750

0-17 24% 24% 1% 24% 24%

18-44 Females 16% 16% -0.3% 18% 18%

18-44 Males 17% 17% 1% 18% 19%

45-64 28% 28% 3% 26% 26%

65+ 14% 16% 15% 14% 13%

Median Age 39 - - 38 37

White 95% 95% 3% 81% 64%

Black 2% 2% 14% 11% 12%

American Indian <1% <1% 10% 1% 1%

Asian/Pacific Islander <1% <1% 12% 2% 5%




Total No. of Households 42,196 43,256 3% 2,393,904 116,862,390


HH Income Under $15K 11% - - 14% 13%

HH Income Over $75K 25% - - 25% 30%




Some College 33% - - 29% 28%


MAJOR EMPLOYERS

Largest employers in the Washington area as provided by the community and economic development council:


Hypertension 31%

Arthritis 25%

Asthma 13%

Diabetes 8%

COPD 5%


Angina 3%


CHRONIC DISEASE

Within the 14-zip code Washington Service Area, the following chronic conditions have been identified among the adult (18+) population:




US MO INSURANCE COVERAGE

Washington DEMOGRAPHICS

Note: Washington Service Area consists of 14 zip codes in Missouri; Education Level based on population age 25+ Source: Thomson Reuters, 2011

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Health Factor Franklin County Missouri

National Benchmark









Overall Health Ranking: Missouri = 40 (/50 states); Franklin County = 36 (/115 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.


Source: Washington, MO Community and Economic Development Council, March 2012

Company Industry Type Staff

Parker Hanifin–Sporlan Valve Division Manufacturing 1,087

Mercy Hospital Health care 688

Patients First Health care 580

Washington School District Education 529

CG Power Systems USA, Inc. Transformers 450

9.2%

7.4% 8.2%

UNEMPLOYMENT RATE


↓0.9% Franklin County

↓1.3% Missouri

↓0.7% US

Note: US & State rates are seasonally adjusted; County, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics

MARCH 2012


Mercy Hospital Washington* Mercy

Missouri Baptist Sullivan Hospital* BJC HealthCare

Hermann Area District Hospital Independent

2

3

1

2

4

The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Washington Service Area.

Washington REGIONAL PROVIDER LANDSCAPE

1

3

FreestandingGeneral Outpatient

Surgery Center

Independent

Mercy

Source: Buxton ASC database, 2012

Mercy Hospital Washington

37%

20%

40%

50%

48%

0 200 400 600 800

Gastro

Cardio

Pulm

Ortho

OB

FFY11 Discharges


In FFY11, 61% of patients received inpatient care at hospitals located outside the Washington 14-zip code PSA, including 16% at Mercy hospitals


Patients First (Mercy owned as of July 2012) 32%

SLUCare Washington Medical Group 4%

Cassat Surgery 3%

Martin D. Rudloff, MD (Pediatrics) 3%

Saint Clair Medical Center 2%

Sunil M. Apte, MD (Urology) 1%

Family Healthcare 1%

Andrew A. Zupan, MD (Adolescent Medicine) 1%

Michelle L. Buemer, MD (Pediatrics) 1%

Other 6%

Washington MO US


Specialty 35 83 81

Total 116 204 197



Mercy Hospital Washington-MO 33% 31%

Mercy Hospital St. Louis-MO 15% 16%

SSM St. Clare Health Center-Fenton, MO 11% 13%

Missouri Baptist Sullivan Hospital-MO 7% 7%

Missouri Baptist Medical Ctr.-St. Louis, MO 6% 6%


St. Luke's Hospital-Chesterfield, MO 4% 4%

St. Anthony's Medical Center-St. Louis, MO 3% 3%

St. Louis Children's Hospital-St. Louis, MO 2% 2%

Des Peres Hospital-St. Louis, MO 2% 1%

CenterPointe Hospital-St. Charles, MO 1% 1%

St. Louis University Hospital-MO 1% 1%

Capital Region Med. Ctr.-Jefferson City, MO 1% 1%

SSM DePaul Health Center-Bridgeton, MO 1% 1%

SSM St. Joseph Health Center-St. Charles, MO 1% 1%

Mercy Rehabilitation Hospital-St. Louis, MO 1% 1%

Phelps County Regional Med. Ctr.-Rolla, MO 1% 1%

Other hospitals (including 0.03% Mercy) 7% 6%

Ranks 2nd in market share

Note: Total (n) = 73 integrated Mercy physicians and advanced practitioners serving the Washington community Source: Mercy Hospital Regional Business Development, April 2012

Advanced Practice

19%

Hospital-based 40%

Specialists 15%

Primary Care 26%

Of the region’s 432,813 hospital-based outpatient visits, 31% occurred outside the Washington PSA (7% at Mercy hospitals)




Mercy Hospital Washington-MO 11%

Missouri Baptist Sullivan Hospital-MO 7%

Mercy Hospital St. Louis-MO 2%

St. Luke's Hospital-Chesterfield, MO 1%

Missouri Baptist Medical Center-St. Louis, MO 1%

Barnes Jewish Hospital-St. Louis, MO 1%

SSM St. Clare Health Center-Fenton, MO 1%

St. Anthony's Medical Center-St. Louis, MO 1%

Hermann Area District Hospital-MO 0.5%

SSM St. Joseph Health Center-St. Charles, MO 0.4%




Washington PATIENT CARE

INPATIENT PHYSICIANS OUTPATIENT INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION






Note: Mercy service lines used; based on volume within the PSA Source: HIDI, FFY11


% Change


2011 Procedures


5 Yr 10 Yr

Physical and Occ. Therapy 275,123 27% 41%

Cardiology 60,025 16% 25%

Hematology/Oncology 43,008 21% 33%

Nephrology 24,238 93% 145%

OB/Gyn 16,605 36% 41%


Neurology 15,820 24% 36%









the lowest rankings

Mercy Hospital

SSM St. Clare

MO Bap Sullivan

MO US Mercy

Hospital SSM

St. Clare MO Bap Sullivan

MO US

80% 80% 83% 77% 76% 3% 4% 3% 5% 5%

84% 81% 84% 81% 80% 3% 5% 3% 4% 4%

64% 62% 71% 65% 64% 8% 10% 6% 10% 10%

73% 72% 73% 69% 70% 5% 6% 5% 7% 7%

63% 60% 63% 60% 61% 20% 21% 18% 21% 21%

78% 79% 80% 72% 72% 5% 6% 5% 9% 9%

59% 71% 71% 57% 58% 11% 3% 6% 11% 11%

85% 83% 82% 84% 82% 15% 17% 18% 16% 18%

67% 80% 71% 68% 68% 6% 6% 6% 9% 9%

71% 82% 70% 68% 70% 4% 3% 4% 5% 5%

Washington PATIENT SATISFACTION

















Fort Smith PRIMARY SERVICE AREA

The Fort Smith Primary Service Area (PSA) comprises 13 counties in east central Oklahoma

and west central Arkansas

AROK

Private 42%

Medicare 18%

Uninsured 20%

Medicaid 20%

DEMOGRAPHICS Fort Smith Service Area Arkansas 2011

US 2011 2011 2016 % Growth


0-17 26% 26% 2% 25% 24%

18-44 Females 17% 16% -0.3% 18% 18%

18-44 Males 17% 17% 1% 18% 19%

45-64 26% 25% -1% 25% 26%

65+ 15% 16% 12% 15% 13%

Median Age 38 - - 38 37

White 76% 74% -1% 75% 64%

Black 3% 3% 8% 16% 12%

American Indian 7% 7% 1% 1% 1%







HH Income Under $15K 20% - - 18% 13%

HH Income Over $75K 15% - - 18% 30%




Some College 28% - - 28% 28%


Source: Ft. Smith Chamber of Commerce, 2012

Company Industry Staff

Sparks Health System Health care 2,400

Baldor Electric Company Manufacturing 2,393

O.K. Industries, Inc. Industrial Recycling 1,800

Fort Smith Public Schools Education 1,783

Mercy Hospital Health care 1,487

University of AR-Fort Smith Education 951

Arkansas Best Corporation Trucking 936

MAJOR EMPLOYERS

Largest employers in the greater Fort Smith region as provided by the Chamber of Commerce:


Hypertension 31%

Arthritis 24%

Asthma 12%

Diabetes 9%


COPD 4%

Angina 2%


CHRONIC DISEASE

Within the thirteen-county Fort Smith Service Area, the following chronic conditions have been identified among the adult (18+) population:



INSURANCE COVERAGE

Fort Smith DEMOGRAPHICS

Note: Fort Smith Service Area consists of 13 counties in Arkansas (8) and Oklahoma (5); Education Level based on population age 25+ Source: Thomson Reuters, 2011

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Health Factor Sebastian

County Arkansas National

Benchmark









Overall Health Ranking: Arkansas = 47 (/50 states); Sebastian County = 19 (/75 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.



AR US

8.0% 7.4% 8.2%

UNEMPLOYMENT RATE


↓0.8% MSA*

↓0.6% Arkansas

↓0.7% US

*Fort Smith, AR-OK Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics

MARCH 2012

The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Fort Smith Service Area.

1

2

4

3 6

5

13

14

12 15

9

10

7

11

Fort Smith REGIONAL PROVIDER LANDSCAPE

8


Surgery Center

Mercy

Physician Owned

Independent



Mercy Hospital Fort Smith* Mercy

Mercy Hospital Waldron Mercy

Mercy Hospital Ozark* Mercy

Mercy Hospital Paris* Mercy

Sparks Regional Medical Center* Health Management Associates

Summit Medical Center Health Management Associates

Haskell County Community Hospital* HMC/CAH Consolidated

Mena Regional Health System* Independent

Booneville Community Hospital* Independent

Chambers Memorial Hospital Independent

Eastern Oklahoma Medical Center* Independent

Johnson Regional Medical Center Independent

Latimer County General Hospital Independent

Memorial Hospital Independent

Sequoyah Memorial Hospital Independent

1

3

4

2

5

6

7

8

9

10

15

11

12

14

13

Fort Smith REGIONAL PROVIDER LANDSCAPE

7


• One general acute care and three critical access hospitals, home health/hospice agency, wellness center, area’s only Level III NICU and home to Arkansas's only Ronald McDonald Family Room

• River Valley Musculoskeletal Center provides orthopedic and neurosurgery care with ambulatory surgery capabilities

• Mercy Clinic includes 108 primary care, specialty and hospital-based physicians, 13 advanced practice providers and 229 clinic co-workers supporting almost 163,000 outpatient visits in 15 clinics and two urgent/convenient care sites (physician counts as of April 2012)

• For-profit, member of Health Management Associates

• One acute care hospital; ambulatory surgery center; a fitness center; nationally recognized stroke program; accredited Chest Pain Center; Sparks Radiation Treatment Center (opened in 2011) provides the area’s only TrueBeam linear accelerator

• Sparks Clinics, a multi-specialty physician group, with approximately 90 physicians and 36 clinics including two urgent care centers

INPATIENT MARKET SHARE *33%

TOTAL ASSETS $171M


OPER. PROFIT MARGIN 19.8% www.sparkshealth.com


Beds Total Hospital

IP Volume Total Births

Sparks Regional Medical Center 1,754 274 16,624 1,205 *Market share reflects FY10 inpatient volume for Mercy and 2010 AHA Guide IP volume for other facilities Source: IP admits (total hospital), market share (total hospital), beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010


Beds Total Hospital


Total ED Visits

Mercy Hospital Fort Smith 1,361 373 13,928 2,228 58,703

Mercy Hospital Ozark 55 25 537 0 5,565

Mercy Hospital Paris 40 16 536 0 2,506

Mercy Hospital Waldron 54 24 523 0 6,538

TOTAL 1,510 438 15,524 2,228 73,312


TOTAL ASSETS $219M



*Market share reflects FY10 inpatient volume for Mercy and 2010 AHA Guide IP volume for other facilities Source: IP discharges (total hospital), market share (total hospital), beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012

• For-profit, member of Health Management Associates

• One acute care hospital, outpatient surgery and home health agency

• Alignment through HMA with Sparks Health System physicians


TOTAL ASSETS $14M



www.summitmedicalcenter.net


Beds Total Hospital


Summit Medical Center 182 103 2,098 0 *Market share reflects FY10 inpatient volume for Mercy and 2010 AHA Guide IP volume for other facilities Source: IP admits (total hospital), beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

www.mercy.net Note: Hospitals only

Note: Hospital only

Note: Hospital only

Fort Smith REGIONAL PROVIDER STATISTICS

Cooper Clinic

• Largest physician-owned multi-specialty medical group in Arkansas

• For-profit, 100 providers (27 primary care – FM, IM, Peds) in 16 locations including three ProMed urgent care sites www.cooperclinic.com

Arkansas Hospitals Health System FTEs

Staffed Beds

Total Hospital IP Volume

Total Births

Johnson Regional Medical Center (Clarksville, AR) Independent 341 80 3,000 513

Chambers Memorial Hospital (Danville, AR) Independent 174 41 2,221 0

Mena Regional Health System (Mena, AR) Independent 259 45 1,574 366

Booneville Community Hospital (Booneville, AR) Independent 125 25 508 0

Other Health Care Providers in the Fort Smith Service Area

HealthSouth Rehabilitation Hospital of Fort Smith

• For-profit, largest provider of outpatient surgery and rehabilitative services in the US

• One inpatient rehabilitation hospital, ambulatory surgery center, home health agency and sleep disorder center

• Ranked in the top 10 percent of 827 rehabilitation hospitals in the nation for exceptional patient outcomes

www.healthsouthfortsmith.com

Oklahoma Hospitals Health System FTEs

Staffed Beds


Total Births

Eastern Oklahoma Medical Center (Poteau, OK) Independent 258 84 2,774 474

Memorial Hospital (Stilwell, OK) Independent 209 34 1,651 63

Sequoyah Memorial Hospital (Sallisaw, OK) Independent 199 26 913 2

Haskell County Community Hospital (Stigler, OK) HMC/CAH Consolidated 163 32 730 0

Latimer County General Hospital (Wilburton, OK) Independent 74 33 556 0

Source: IP admits (total hospital), beds, births, FTEs – AHA Guide, 2010 data; Latimer and Haskell County data – AHA Guide, 2009 data

Fort Smith REGIONAL PROVIDER STATISTICS

http://www.cooperclinic.com/index.html

0 1,000 2,000 3,000

Ortho

Gen Surg

Pulm

OB

Cardio

FY11 Discharges



Cooper Clinic 25%

Eastside OB/Gyn 9%

HealthSouth Rehab Center 5%

Center for Pediatrics & Adolescent Medicine 4%

Pediatric Partners 3%

Advance Care Hospital 2%

Cecil W. Gaby, MD (Pediatrics) 2%

Randall S. Beallis, MD (Family Practice) 2%

John C. Whitaker, MD (Adolescent Medicine) 1%

Other 10%

Fort Smith AR US


Specialty 38 61 81

Total 115 149 197

Mercy Hospital Fort Smith

Note: Mercy service lines used; service line market share not available for AR Source: Trendstar Data, FY2011

Hospitall 2008 2009 2010

Sparks Regional Medical Ctr.-Fort Smith, AR 29% 29% 34%

Mercy Hospital Fort Smith-AR 30% 30% 29%

Johnson Regional Medical Ctr.-Clarksville, AR 7% 7% 6%

Eastern Oklahoma Medical Ctr.-Poteau, OK 7% 7% 6%

Chambers Memorial Hosp.-Danville, AR 5% 5% 5%

Summit Medical Ctr.-Van Buren, AR 5% 5% 4%

Memorial Hosp.-Stilwell, OK 4% 4% 3%

Mena Regional Health System-AR 4% 4% 3%

Sequoyah Memorial Hosp.-Sallisaw, OK 2% 2% 2%

Mercy Hospital Waldron-AR 1% 1% 2%

Haskell County Community Hosp.-Stigler, OK 2% 2% 2%

Latimer County General Hosp.-Wilburton, OK NA 2% 1%

Booneville Community Hosp.-AR 2% 1% 1%

Mercy Hospital Ozark-AR 1% 1% 1%

Mercy Hospital Paris-AR 1% 1% 1%

Note: Total (n) = 121 integrated Mercy physicians and advanced practitioners Serving Fort Smith, Ozark, Paris and Waldron communities Source: Mercy Hospital Fort Smith Medical Staff Services, April 2012

Advanced Practice

11%

Hospital-based 55%

Specialists 21%

Primary Care 13%




Sparks Regional Medical Center-Fort Smith, AR 9%

Mercy Hospital Fort Smith-AR 4%

Mena Regional Health System-AR 2%

Johnson Regional Medical Center-Clarksville, AR 1%

Sequoyah Memorial Hospital-Sallisaw, OK 1%

Summit Medical Center-Van Buren, AR 1%

UAMS Medical Center-Little Rock, AR 1%

Wm. H. Hastings Indian Hospital-Tahlequah, OK 1%

Mercy Hospital Waldron-AR 1%

Eastern Oklahoma Medical Center-Poteau, OK 1%



Note: Includes total inpatient discharges for hospitals located within the Fort Smith 13-county PSA; does not account for outmigration Source: Mercy facilities-Mercy Finance Data, FY08-FY10; All others-AHA Guide, 2008-2010 data (does not include Normal Newborns)

Mercy Hospital Volume

16%

14%

10%

9%

8%

% of Volume

Fort Smith PATIENT CARE








% Change


2011 Procedures


5 Yr 10 Yr


Cardiology 175,109 20% 27%


Nephrology 95,678 70% 103%

Neurology 62,181 32% 42%

OB/Gyn 56,299 52% 54%






Of the region’s 1.6M hospital-based outpatient visits, 20% occurred outside the Fort Smith PSA (0.4% at Mercy hospitals)




Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals.


Percentage of patients who gave the hospital the highest rankings

Percentage of patients who gave the hospital the lowest rankings

Mercy Hospital

Sparks Regional

AR US Mercy

Hospital Sparks

Regional AR US

73% 68% 77% 76% 5% 8% 6% 5%

77% 73% 84% 80% 5% 7% 4% 4%

58% 48% 65% 64% 10% 17% 11% 10%

68% 57% 70% 70% 7% 11% 7% 7%

57% 47% 62% 61% 23% 34% 21% 21%

63% 52% 71% 72% 11% 18% 10% 9%

47% 51% 65% 58% 15% 15% 8% 11%

81% 79% 80% 82% 19% 21% 20% 18%

65% 52% 68% 68% 8% 18% 9% 9%

75% 57% 68% 70% 2% 10% 6% 5%

Fort Smith PATIENT SATISFACTION
















43% 43% 40%

53%

24%28% 28%

25%

4% 2% 5% 3%

0%

15%

30%

45%

60%

2008 2009 2010 2011


Sparks Regional Medical Center

Arkansas Heart Hospital

Average number of respondents (4 yrs trending): 360

% r

esp

on

den

ts

Heart Care

Fort Smith CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.


Last year, 50% of Fort Smith consumers who took the survey chose a Mercy Hospital for best overall quality and 55% selected Mercy as having the best image or reputation.


Total number of respondents: 383 Providers with 1% or less are included in “Other Facilities”; Mercy Hospital Hot Springs, 1%

43% 44% 44%

53%

26% 28% 28% 29%

6% 3% 2% 2%

0%

15%

30%

45%

60%

2008 2009 2010 2011



Eastern Oklahoma Medical Center


% r

esp

on

den

ts

Maternity/OB



Total number of respondents: 380 Providers with 1% or less are included in “Other Facilities”; Mercy Hospital Hot Springs, 1%

49%

26%

4%2%2%

2%

16%

Mercy Hospital Fort Smith Sparks Regional Medical CenterCooper Clinic Central Texas HospitalEastern Oklahoma Medical Center St. Francis HospitalOther Facilities

54%

23%

3%2%

19%

Mercy Hospital Fort Smith Sparks Regional Medical Center

Cooper Clinic Central Texas Hospital

Other Facilities


% r

esp

on

den

ts

Cancer Treatment

36% 38%40%

47%

22%26% 25% 24%

13%7% 5%

10%0%

15%

30%

45%

60%

2008 2009 2010 2011



CTCA at Southwestern Reg Med Ctr

Average number of respondents (4 yrs trending): 326 %

res

po

nd

ents

Pediatric Services

37%40% 38%

47%

26% 28% 27% 28%

7% 7% 10%7%

0%

15%

30%

45%

60%

2008 2009 2010 2011



Arkansas Children's Hospital

Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Fort Smith Community (13-county PSA: Scott County, AR, Haskell and Latimer Counties, OK not surveyed)

% Market Share 2010

OP Volume

45% PHYSICIAN OFFICES 124,185

28% INDEPENDENT LABS 75,890

9% MERCY HOSPITAL OZARK 25,480

4% SPARKS REGIONAL MEDICAL CENTER 10,905

4% MERCY HOSPITAL FORT SMITH 10,232

2% UAMS MEDICAL CENTER-LITTLE ROCK 6,486

1% BOONEVILLE COMMUNITY HOSPITAL 3,623

1% JOHNSON REGIONAL MEDICAL CTR. 3,544

5% OTHER (including 0.4% Mercy) 13,184

Community Snapshot OZARK PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (90%) of Mercy Hospital Ozark’s acute care patients reside in Franklin County in northwest Arkansas. Three in four patients share the same zip code (72949) as the hospital.

HOUSEHOLD ECONOMICS

Total Households: 8,958 Average Income: $43,169 Annual Income <$15K: 20%

INSURANCE COVERAGE

45% Private 19% Medicare 18% Medicaid 18% Uninsured

Race: 93% White; 2% Multiracial Ethnicity: 2% Hispanic (of any race)

Total Area Population: 22,740 5-Yr Growth: 0.1%

Age Cohorts: 24% Children (0-17) 18% Females (15-44) 17% Seniors (65+)

Median Age: 40

POPULATION

SERVICES & PHYSICIANS

In FY11, Mercy Hospital Ozark’s top inpatient service lines were pulmonary (19%), gastroenterology (13%) and cardiovascular (11%).

There are approximately 12 physicians (67% primary care) located in the PSA, of which 42% are integrated with Mercy.

EDUCATION (based on population ages 25+)

12% Some High School 28% Some College 41% High School Diploma 12% Bachelor’s Degree/greater

75% 2%

OUTPATIENT MARKET SHARE (hospital-based only)

Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Market Share – Mercy Finance, FY2010 (does not include Normal Newborns), all others – AHA Guide 2010 data; Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services and Patient Origin – Mercy Hospital Fort Smith, FY2011; Physicians – Buxton, April 2012

Health Factor County AR US



Physical Inactivity (% of 20+ pop. not active) 31% 31% 21%



Children in Poverty (% of children 0-17) 27% 27% 13%

Preventable Hospital Stays (per 1k Medicare) 62 81 49

COUNTY HEALTH RANKINGS

Franklin County Overall Health Rank = 10 (out of 75 counties) The lower the ranking, the healthier the community.

Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.

total outpatient volume in the Ozark PSA 273,529

13%

INPATIENT MARKET SHARE

% Market Share 2010

Discharges


12% BOONEVILLE COMMUNITY HOSPITAL 508

11% MERCY HOSPITAL OZARK 462

6% MERCY HOSPITAL PARIS 252

4,222 total inpatient discharges within a 25-mile radius of Mercy Hospital Ozark

Note: Includes total inpatient discharges for hospitals located within a 25-mile radius of Mercy Hospital Ozark; does not account for outmigration

AR

Mercy Hospital

Mercy Clinic

Mercy Urgent/Convenient Care Clinic

Mercy Freestanding OP Surgery Center

Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)

Other hospital (non-Mercy)

%

Community Snapshot PARIS PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (88%) of Mercy Hospital Paris’s acute care patients reside in Logan County in west central Arkansas. Seven in ten patients share the same zip code (72855) as the hospital.

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE



Total Area Population: 22,761 5-Yr Growth: -2%


Median Age: 41

POPULATION


In FY11, the top inpatient service lines for Mercy Hospital Paris were pulmonary (17%), cardiovascular (16%) and gastroenterology (14%).

There are approximately 13 physicians (62% primary care) located in the PSA, of which none are integrated with Mercy.














Logan County Overall Health Rank = 41 (out of 75 counties) The lower the ranking, the healthier the community.


total outpatient volume in the Paris PSA 299,574

% Market Share 2010

OP Volume



12% BOONEVILLE COMMUNITY HOSPITAL 34,954

5% MERCY HOSPITAL PARIS 15,426






69% 6%

4%

3%

2%


total inpatient discharges within a 25-mile radius of Mercy Hospital Paris

6,443

% Market Share 2010

Discharges


34% CHAMBERS MEMORIAL HOSPITAL 2,221


7% MERCY HOSPITAL OZARK 462

4% MERCY HOSPITAL PARIS 252

AR

Note: Includes total inpatient discharges for hospitals located within a 25-mile radius of Mercy Hospital Paris; does not account for outmigration

Mercy Hospital

Mercy Clinic





%

Community Snapshot WALDRON PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (89%) of Mercy Hospital Waldron’s acute care patients reside in Scott County in west central Arkansas. Three in four patients share the same zip code (72958) as the hospital.

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE


Race: 87% White; 3% Asian/Pacific Isl. Ethnicity: 6% Hispanic (of any race)

Total Area Population: 20,938 5-Yr Growth: -0.4%


Median Age: 39

POPULATION










Scott County Overall Health Rank = 15 (out of 75 counties) The lower the ranking, the healthier the community.



In FY11, Mercy Hospital Waldron’s top inpatient service lines were cardiovascular (20%), pulmonary (15%) and rehabilitation (13%).

There are approximately three primary care physicians located in the Waldron PSA, all of which are integrated with Mercy.





total outpatient volume in the Waldron PSA 151,661

% Market Share 2010

OP Volume


26% MERCY HOSPITAL WALDRON 39,281





1% MENA REGIONAL HEALTH SYSTEM 1,899

0.4% BOONEVILLE COMMUNITY HOSPITAL 576


76%

5%

4%


total inpatient discharges within a 25-mile radius of Mercy Hospital Waldron

2,829

% Market Share 2010

Discharges

56% MENA REGIONAL HEALTH SYSTEM 1,574

26% MERCY HOSPITAL WALDRON 747


AR

Note: Includes total inpatient discharges for hospitals located within a 25-mile radius of Mercy Hospital Waldron; does not account for outmigration

Mercy Hospital

Mercy Clinic





%

Hot Springs PRIMARY SERVICE AREA

The Hot SpringsPrimary Service Area (PSA) comprises six counties in

west central Arkansas

AR

Private 40% Medicare

23%

Uninsured 19%

Medicaid 18%

DEMOGRAPHICS Hot Springs Service Area Arkansas 2011

US 2011 2011 2016 % Growth


0-17 21% 21% 2% 25% 24%

18-44 Females 15% 15% 1% 18% 18%

18-44 Males 16% 16% 1% 18% 19%

45-64 27% 25% -3% 25% 26%

65+ 21% 23% 13% 15% 13%

Median Age 43 - - 38 37

White 82% 81% 1% 75% 64%

Black 11% 11% 4% 16% 12%






Total No. of Households 81,923 82,285 <1% 1,157,580 116,862,390


HH Income Under $15K 19% - - 18% 13%

HH Income Over $75K 16% - - 18% 30%




Some College 30% - - 28% 28%


Source: Hot Springs Chamber of Commerce; Garland County Economic Development Corporation



Oaklawn Park Thoroughbred Racing 1,210

Walmart Retail 1,102

National Park Medical Center Health care 649

City of Hot Springs Government 620

Hot Springs School District Education 610

National Park Community College Higher Education 607

MAJOR EMPLOYERS

Top area employers as listed by The Greater Hot Springs Chamber of Commerce:


INSURANCE COVERAGE

Hot Springs DEMOGRAPHICS

Note: Hot Springs Service Area consists of six counties in Arkansas; Education Level based on population age 25+ Source: Thomson Reuters, 2011

Rac

e &

Eth

nic

ity

Age

Gro

up

s H

ou

seh

old

s Ed

uca

tio

n

Health Factor Garland County Arkansas

National Benchmark









Overall Health Ranking: Arkansas = 47 (/50 states); Garland County = 37 (/75 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.


AR US

Hypertension 34%

Arthritis 28%

Asthma 13%

Diabetes 10%


COPD 5%

Angina 3%


CHRONIC DISEASE

Within the six-county Hot Springs Service Area, the following chronic conditions have been identified among the adult (18+) population:




7.8% 7.4% 8.2%

UNEMPLOYMENT RATE


↓0.8% MSA*

↓0.6% Arkansas

↓0.7% US

*Hot Springs, AR Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics

MARCH 2012

1

3

2

The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Hot Springs Service Area.


Mercy Hospital Hot Springs* Mercy

National Park Medical Center* Capella Healthcare

Baptist Health Medical Center-Arkadelphia* Baptist Health

HSC Medical Center* Independent

Howard Memorial Hospital* Independent

4

3

1

2

4

Hot Springs REGIONAL PROVIDER LANDSCAPE

5

5

ARKANSAS


Surgery Center

Mercy

Independent



• General acute care hospital, ambulatory surgery center, a network of physician clinics, hospice and home health agency

• Offers the only Level II trauma center in southwest Arkansas, the region’s only da Vinci Surgical system and a newly established telestroke program

• Mercy Clinic includes 106 primary care, specialty and hospital-based physicians, 41 advanced practice providers and 455 clinic co-workers supporting more than 367,000 outpatient visits in 21 clinics and three urgent/convenient care sites (physician counts as of April 2012)


TOTAL ASSETS $126M


OPER. PROFIT MARGIN 2.4% *Market share reflects FY10 inpatient volume for Mercy and 2010 AHA Guide IP volume for National Park Source: IP discharges (total hospital), market share (total hospital), beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012

www.nationalparkmedical.com


Beds Total Hospital


National Park Medical Center 600 181 5,102 689

• For-profit, owned by Capella Healthcare

• One acute care hospital, heart and vascular center, The Family Maternity Center, home health, a skilled nursing facility and medical offices in Hot Springs Village and Hot Springs, AR

• The hospital’s adult inpatient rehab department has earned five consecutive accreditations from the Commission on Accreditation of Rehabilitation Facilities, one of only six such programs in Arkansas to achieve this accreditation


TOTAL ASSETS $108M


OPER. PROFIT MARGIN 10.9% *Market share reflects FY10 inpatient volume for Mercy and 2010 AHA Guide IP volume for National Park Source: IP admits (total hospital), market share (total hospital), beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

Hospital Health System FTEs Staffed

Beds Total Hospital


HSC Medical Center (Malvern, AR) Independent 306 72 2,449 0

Baptist Health Medical Center-Arkadelphia Baptist Health 167 25 1,039 264

Howard Memorial Hospital (Nashville, AR) Independent 120 20 809 0

Source: IP admits (total hospital), beds, births, FTEs – AHA Guide, 2010 data

Other Health Care Providers in the Hot Springs Service Area


Beds Total Hospital


Total ED Visits

Mercy Hospital Hot Springs 1,125 270 11,910 1,028 39,085 www.mercy.net

Note: Hospital only

Note: Hospital only

In May 2012, Mercy signed an Agreement in Principle with Capella Healthcare, the parent organization of National Park Medical Center, to explore a transfer of ownership of Mercy in Hot Springs to Capella by late 2012.

Hot Springs REGIONAL PROVIDER STATISTICS

0 500 1,000 1,500 2,000

OB

Pulm

Ortho

Neuro

Cardio

FY11 Discharges



Richard Wyderski, MD (Geriatrics) 6%

Hot Springs Neurosurgery Clinic 4%

Family Medicine Clinic 3%

Hot Springs Bone & Joint Clinic 3%

Genesis Cancer Center 2%

Hot Springs Diagnostic Associates 2%

Psychiatric Clinic Hot Springs 2%

Pioneer Health Services 2%

Levi Hospital Physicians 2%

Hot Springs Pediatric Clinic 1%

Other 5%

Hot Springs AR US


Specialty 52 61 81

Total 130 149 197

Mercy Hospital Hot Springs

Note: Includes total inpatient discharges for hospitals located within the Hot Springs six-county PSA; does not account for outmigration Source: Mercy Finance Data, FY08-FY10; All others-AHA Guide, 2008-2010 Data (does not include Normal Newborns)

Hospital 2008 2009 2010

Mercy Hospital Hot Springs-AR 50% 51% 56%

National Park Medical Center-Hot Springs, AR 20% 19% 24%

HSC Medical Center-Malvern, AR 10% 10% 11%

HealthPark Hospital-Hot Springs, AR* 5% 5% NA

Baptist Health Medical Center-Arkadelphia, AR 4% 4% 5%

Howard Memorial Hospital-Nashville, AR 3% 2% 4%

Note: Total (n) = 147 integrated Mercy physicians and advanced practitioners serving the Hot Springs community Source: Mercy Hospital Hot Springs Medical Staff Coordinator, April 2012

Advanced Practice

28% Hospital-

based 21%

Specialists 22%

Primary Care 29%


Physician Offices* 61%


Mercy Hospital Hot Springs-AR 7%

UAMS Medical Center-Little Rock, AR 3%

National Park Medical Center-Hot Springs, AR 2%

Howard Memorial Hospital-Nashville, AR 2%

HealthPark Hospital-Hot Springs, AR** 2%

HSC Medical Center-Malvern, AR 2%

Baptist Health Medical Center-Arkadelphia, AR 1%

Levi National Arthritis Hospital-Hot Springs, AR 1%

Other Mercy hospitals <1%


Note: Mercy service lines used; service line market share data not available for AR Source: Trendstar Data, FY11


*As of January 2011, HealthPark Hospital (Mercy facility) converted to an Ambulatory Surgery Center

13%

11%

10%

10%

9%

% of Volume

Hot Springs PATIENT CARE







% Change


2011 Procedures


5 Yr 10 Yr



Cardiology 135,486 19% 25%


Nephrology 33,657 113% 135%

Neurology 29,176 28% 38%

OB/Gyn 25,402 52% 56%



*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system **As of January 2011, HealthPark Hospital (Mercy facility) converted to an Ambulatory Surgery Center Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010


Of the region’s 737,430 hospital-based outpatient visits, 23% occurred outside the Hot Springs PSA (15% at Little Rock, AR facilities)






the lowest rankings

Mercy Hospital

National Park

HSC Med Ctr (Malvern)

AR US Mercy

Hospital National

Park HSC Med Ctr

(Malvern) AR US

75% 74% 71% 77% 76% 4% 8% 7% 6% 5%

79% 81% 88% 84% 80% 4% 4% 2% 4% 4%

59% 59% 61% 65% 64% 11% 11% 13% 11% 10%

72% 69% 62% 70% 70% 5% 6% 10% 7% 7%

58% 60% 62% 62% 61% 22% 21% 19% 21% 21%

69% 66% 69% 71% 72% 8% 12% 8% 10% 9%

53% 64% 56% 65% 58% 13% 8% 9% 8% 11%

78% 79% 77% 80% 82% 22% 21% 23% 20% 18%

68% 70% 58% 68% 68% 8% 8% 13% 9% 9%

70% 74% 58% 68% 70% 4% 5% 6% 6% 5%

Hot Springs PATIENT SATISFACTION















Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each facility. Average response rate was 33%.


Hot Springs CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.



Total number of respondents: 283 Providers with 1% or less are included in “Other Facilities”


Total number of respondents: 287 Providers with 1% or less are included in “Other Facilities”

50%46%

50%

44%

0%

15%

30%

45%

60%

2008 2009 2010 2011

Mercy Hospital Hot SpringsNational Park Medical CenterBaptist Health Medical Center-Little RockArkansas Heart HospitalUAMS-University Hospital of Arkansas


% r

esp

on

den

ts

Heart Care

51%

45%

53%

46%

17%23% 23% 22%

0%

15%

30%

45%

60%

2008 2009 2010 2011

Mercy Hospital Hot SpringsNational Park Medical CenterUAMS-University Hospital of ArkansasBaptist Health Medical Center-Little Rock


% r

esp

on

den

ts

Maternity/OB

52% 53% 51%

42%

0%

15%

30%

45%

60%

2008 2009 2010 2011

Mercy Hospital Hot SpringsUAMS-University Hospital of ArkansasNational Park Medical CenterBaptist Health Medical Center-Little Rock


% r

esp

on

den

ts

Cancer Treatment


res

po

nd

ents

Pediatric Services


Last year, 44% of Hot Springs consumers who took the survey chose a Mercy Hospital for best overall quality; 44% also selected Mercy as having the best image or reputation.

Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Hot Springs Community (6-county PSA: Clark and Montgomery Counties not surveyed)

44%

19%12%

9%

3%

12%

Mercy Hospital Hot SpringsNational Park Medical CenterUAMS-University Hospital of ArkansasBaptist Health Medical Center-Little RockCHRISTUS St. Michael Health SystemOther Facilities

44%

20%13%

8%

2%

13%

Mercy Hospital Hot SpringsNational Park Medical CenterUAMS-University Hospital of ArkansasBaptist Health Medical Center-Little RockCHRISTUS St. Michael Health SystemOther Facilities

(Texarkana, TX)

(Texarkana, TX)

41%

31%

39%36%

29% 31%

14%

22%

0%

15%

30%

45%

60%

2008 2009 2010 2011

Mercy Hospital Hot SpringsArkansas Children's HospitalNational Park Medical CenterUAMS-University Hospital of ArkansasBaptist Health Medical Center-Little Rock

Northwest Arkansas PRIMARY SERVICE AREA

The Northwest ArkansasPrimary Service Area (PSA) comprises

six counties in southwest Missouri and northwest Arkansas

AR

MO


Rogers Public Schools Education 1,926


Pinnacle Healthcare Nursing Home 1,100

Tyson Chick-N-Quick Plant Poultry/food products 1,033

Walmart Claims Center Claims Administration 875

Crossland Construction General Contractor 700

Rogers Tool Works Cutting Tools 700

Private 56%

Medicare 14%

Uninsured 16%

Medicaid 15%

DEMOGRAPHICS Northwest AR Service Area Arkansas 2011

US 2011 2011 2016 % Growth


0-17 26% 27% 12% 25% 24%

18-44 Females 19% 18% 6% 18% 18%

18-44 Males 19% 19% 5% 18% 19%

45-64 23% 23% 11% 25% 26%

65+ 12% 13% 21% 15% 13%

Median Age 35 - - 38 37

White 78% 73% 4% 75% 64%

Black 2% 3% 38% 16% 12%








HH Income Under $15K 14% - - 18% 13%

HH Income Over $75K 21% - - 18% 30%




Some College 26% - - 28% 28%


Source: Rogers-Lowell Chamber of Commerce, 2011

MAJOR EMPLOYERS

Largest employers in Rogers as listed with the Rogers-Lowell Area Chamber of Commerce:


Hypertension 28%

Arthritis 22%

Asthma 13%

Diabetes 8%

COPD 4%


Angina 2%


CHRONIC DISEASE

Within the six-county Northwest Arkansas Service Area, the following chronic conditions have been identified among the adult (18+) population:



INSURANCE COVERAGE

Northwest Arkansas DEMOGRAPHICS

Note: Northwest Arkansas Service Area consists of six counties in Arkansas (4) and Missouri (2); Education Level based on population age 25+ Source: Thomson Reuters, 2011

Rac

e &

Eth

nic

ity

Age

Gro

up

s H

ou

seh

old

s Ed

uca

tio

n

Health Factor Benton County Arkansas

National Benchmark









Overall Health Ranking: Arkansas = 47 (/50 states); Benton County = 1 (/75 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.


AR US

Private 45% 56% Medicare 17% 14% Medicaid 19% 14% Uninsured 19% 16% 5.7%

7.4% 8.2%

UNEMPLOYMENT RATE


↓0.6% MSA*

↓0.6% Arkansas

↓0.7% US

*Fayetteville-Springdale-Rogers, AR-MO Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics

MARCH 2012

5 The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Northwest Arkansas Service Area.

2

4

3

1

5

6

7 8

9

11

10

Northwest Arkansas REGIONAL PROVIDER LANDSCAPE


Surgery Center

Mercy

Community Health Systems

Washington Regional

Independent


12

1

3

4

2

5

10

11

8

6

7


Mercy Hospital Northwest Arkansas Mercy

Mercy Hospital Berryville* Mercy

Mercy Hospital Cassville* Mercy

Cox Monett Hospital* CoxHealth

Northwest Medical Center-Springdale* Northwest Health System (Community Health Systems)

Northwest Medical Center-Bentonville* Northwest Health System (Community Health Systems)

Willow Creek Women's Hospital* Northwest Health System (Community Health Systems)

Siloam Springs Memorial Hospital* Community Health Systems

Washington Regional Medical Center* Washington Regional

Physicians’ Specialty Hospital* Physician Owned

Eureka Springs Hospital* Independent

Ozarks Community Hospital of Gravette Independent

9

Northwest Arkansas REGIONAL PROVIDER LANDSCAPE

12

Hospital

FTEs

Staffed Beds


Total Births

Total ED Visits

Mercy Hospital Northwest Arkansas 698 147 8,395 1,266 40,237


• One general acute care hospital, ambulatory surgery center, heart and vascular center, home health/hospice agency, imaging center and other specialty centers

• Mercy Clinic includes 92 primary care and specialty physicians, 30 advanced practice providers and 433 clinic co-workers providing 345,000 outpatient visits in 15 clinics and one urgent/convenient care site (physician counts as of April 2012)


TOTAL ASSETS $190M



www.wregional.com

Hospital

FTEs

Staffed Beds


Total Births

Washington Regional Medical Center 1,661 248 12,077 881

• Non-profit, community-owned

• One general acute care hospital in Fayetteville, surgery center, long-term care facility, rehabilitation hospital (joint venture with HealthSouth), two cancer support homes, three dialysis centers and 15 primary care and specialty clinics

• Home to Johnelle Hunt Women’s Center and the Walker Heart Institute


TOTAL ASSETS $293M


OPER. PROFIT MARGIN 1.2% Source: IP admits, market share (total facility), beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

www.northwesthealth.com

Hospital

FTEs

Staffed Beds


Total Births

Northwest Medical Center-Springdale 993 183 8,886 0

Northwest Medical Center-Bentonville 362 99 6,005 1,093

Willow Creek Women’s Hospital (Johnson, AR) 220 64 3,520 2,905

TOTAL 1,575 346 18,411 3,998

• For-profit, member of Community Health Systems

• Two general acute care hospitals, a women’s hospital, home health agency

• Northwest Physicians Clinics includes approximately 50 physicians and advanced practitioners in 36 primary care and specialty clinics


TOTAL ASSETS $181M



Source: IP admits, market share (total facility), beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

www.mercy.net

Note: Mercy Hospital Northwest Arkansas only

Note: Northwest Health System Hospitals only

Note: Hospital only

Source: IP discharges, market share (total facility), beds, births, FTEs, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012

Hospital

FTEs

Staffed Beds


Total Births

Total ED Visits

Mercy Hospital Berryville 136 25 797 100 9,380

Mercy Hospital Cassville 95 18 300 0 10,163 Source: IP discharges (for Berryville), beds, ED visits - Mercy Finance, FY11; Berryville births – AHD, 2010; IP discharges (Cassville) – HIDI, FFY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012

Other Mercy Facilities in the NWA Service Area (part of Mercy Springfield)

Northwest Arkansas REGIONAL PROVIDER STATISTICS

Hospital

FTEs

Staffed Beds


Total Births

Siloam Springs Regional Hospital 246 43 2,873 571

Source: IP admits (total facility), beds, births, FTEs – AHA Guide, 2010 data • For-profit, member of Community Health Systems

• One general acute care hospital; affiliated but not integrated part of Northwest Health System

www.ssrh.net

Other CHS Facilities in the NWA Service Area

Northwest Health System Hospitals


TOTAL ASSETS $11M


OPER. PROFIT MARGIN 8.2% Note: Hospital only

www.chs.net

http://www.ssrh.net/default.aspx

Hospital Health System

FTEs Staffed

Beds Total Hospital


Physicians’ Specialty Hospital (Fayetteville, AR) Physician-owned 151 20 886 0

Cox Monett Hospital (Missouri) CoxHealth 235 25 812 286

Ozarks Community Hospital of Gravette Independent 170 25 750 3

Eureka Springs Hospital Independent 79 15 488 0

Source: Physicians’ Specialty Hospital – AHD, 2010; Cox Monett IP discharges (total facility) – HIDI, FFY11; All others – IP admits (total facility), beds, births, FTEs – AHA Guide, 2010 data

Other Health Care Providers in the Northwest Arkansas Service Area

HealthSouth Rehabilitation Hospital of Fayetteville

• For-profit, joint venture between HealthSouth and Washington Regional Medical Center

• 60-bed facility offering inpatient and outpatient rehabilitation services www.healthsouthfayetteville.com

Northwest Arkansas REGIONAL PROVIDER STATISTICS

Advanced Practice

25%

Hospital-based 9%

Specialists 23%

Primary Care 43%

0 500 1,000 1,500 2,000

Gastro

Pulm

Gen Surg

OB

Cardio

FY11 Discharges



Ozarks Ortho & Sports Medicine Clinic 5%

Highlands Oncology Group 2%

Urology Assoc. of Northwest Arkansas 1%

Benton County Urology 1%

Lowell Medical Center 1%

Randelon Smith, MD (Gastroenterology) 1%

Other 6%

NWA AR US


Specialty 47 61 81

Total 124 149 197

Mercy Hospital Northwest Arkansas

Note: Mercy service lines used; service line market share not available for AR Source: Trendstar Data, FY2011

Hospital 2008 2009 2010

Washington Reg. Med. Ctr.-Fayetteville, AR 31% 24% 26%

Northwest Medical Ctr.-Springdale-AR 16% 17% 19%

Mercy Hospital NW Arkansas-Rogers, AR 18% 19% 19%

Northwest Medical Ctr.-Bentonville-AR 12% 12% 13%

Willow Creek Women's Hosp.-Johnson, AR 8% 13% 8%

Siloam Springs Memorial Hosp.-AR 7% 6% 6%

Mercy Hospital Berryville-AR 3% 3% 2%

Cox Monett Hosp.-MO 2% 2% 2%

Physicians’ Specialty Hosp.-Fayetteville, AR NA 2% 2%

Ozarks Community Hosp. of Gravette-AR NA 1% 2%

Eureka Springs Hosp.-AR 1% 1% 1%

Mercy Hospital Cassville-MO 1% 1% 1%

Note: Total (n) = 122 integrated Mercy physicians and advanced practitioners serving the Northwest Arkansas community Source: Mercy Hospital Northwest Arkansas Medical Staff Services, April 2012




NW Medical Centers-Bentonville & Springdale, AR 6%

Washington Regional Medical Ctr.-Fayetteville, AR 5%

Mercy Hospital NW Arkansas-Rogers, AR 3%

Cox Monett Hospital-MO 1%

Mercy Hospital Berryville-AR 1%

Mercy Hospital Cassville-MO 1%

Freeman Neosho Hospital-MO 1%

UAMS Medical Center-Little Rock, MO 1%

Eureka Springs Hospital-AR 1%



Note: Includes total inpatient discharges for hospitals located within the Northwest Arkansas six-county PSA; does not account for outmigration Source: Mercy Finance Data, FY08-FY10; All others-AHA Guide, 2008-2010 Data (does not include Normal Newborns)


19%

16%

11%

8%

8%

% of Volume

Northwest Arkansas PATIENT CARE







% Change


2011 Procedures


5 Yr 10 Yr



Cardiology 198,699 28% 47%

Neurology 76,625 33% 54%

OB/Gyn 74,220 55% 65%


Nephrology 52,406 113% 188%





Of the region’s 1.4M hospital-based outpatient visits, 18% occurred outside the Northwest Arkansas PSA (4% at Mercy hospitals)






the lowest rankings

Mercy Hospital

NWMC* Washington

Regional AR US

Mercy Hospital

NWMC* Washington

Regional AR US

73% 73% 76% 77% 76% 5% 6% 4% 6% 5%

79% 79% 80% 84% 80% 4% 4% 4% 4% 4%

58% 59% 64% 65% 64% 11% 12% 10% 11% 10%

67% 70% 69% 70% 70% 8% 7% 6% 7% 7%

60% 58% 59% 62% 61% 21% 23% 20% 21% 21%

79% 69% 69% 71% 72% 6% 10% 10% 10% 9%

54% 62% 65% 65% 58% 10% 9% 7% 8% 11%

85% 85% 81% 80% 82% 15% 15% 19% 20% 18%

72% 69% 68% 68% 68% 7% 8% 7% 9% 9%

77% 72% 77% 68% 70% 3% 5% 3% 6% 5%

Northwest Arkansas PATIENT SATISFACTION















*NWMC represents Northwest Arkansas Hospitals, LLC reporting as a combined 3-hospital system including Northwest Medical Centers Springdale and Bentonville, and Willow Creek Women’s Hospital in Johnson, AR Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each hospitals. Average response rate was 33%.


Northwest Arkansas CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.


49%

35%

40% 38%

12% 15% 15% 15%

0%

10%

20%

30%

40%

50%

2008 2009 2010 2011

Washington Regional Medical CenterMercy Hospital Northwest ArkansasNorthwest Medical Center-SpringdaleMercy Hospital Springfield


% r

esp

on

den

ts

Heart Care


% r

esp

on

den

ts

Maternity/OB

38%

27%

34%31%

6%11%

15% 13%

0%

10%

20%

30%

40%

50%

2008 2009 2010 2011

Washington Regional Medical Center

Mercy Hospital Northwest Arkansas

CTCA at Southwestern Regional Medical Center

Mercy Hospital Springfield

Northwest Medical Center-Springdale


% r

esp

on

den

ts

Cancer Treatment


res

po

nd

ents

Pediatric Services


Last year, 27% of Northwest Arkansas consumers surveyed chose a Mercy Hospital for best overall quality and 25% selected Mercy as having the best image or reputation.

Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Northwest Arkansas Community (6-county PSA: Madison County not surveyed)


Total number of respondents: 379 Providers with 1% or less are included in “Other Facilities”; Mercy Hospitals Berryville, Cassville and Fort Smith, <1% each


Total number of respondents: 377 Providers with 1% or less are included in “Other Facilities”; Mercy Hospitals Berryville, Cassville and Fort Smith, <1% each

26%25%

29% 27%

13% 17% 18%15%

0%

10%

20%

30%

40%

50%

2008 2009 2010 2011

Washington Regional Medical CenterMercy Hospital Northwest ArkansasWillow Creek Women's HospitalNorthwest Medical Center-SpringdaleMercy Hospital Springfield

33%

31% 31% 31%

13% 13% 16%12%

0%

10%

20%

30%

40%

50%

2008 2009 2010 2011

Washington Regional Medical CenterMercy Hospital Northwest ArkansasArkansas Children's HospitalNorthwest Medical Center-SpringdaleMercy Hospital Springfield

34%

16%

10%

7%

4%

3%

2%

2%

2%2%

2%2%

2%11%

Washington Regional Medical Center Mercy Hospital Northwest ArkansasNorthwest Medical Center-Bentonville Northwest Medical Center-SpringdaleMercy Hospital Springfield Arkansas Children's HospitalMercy Hospital Aurora Cox SouthVeterans Affairs Medical Center Mercy Hospital JoplinSiloam Springs Memorial Hospital Willow Creek Women's HospitalFreeman Hospital West Other Facilities

36%

16%11%

6%

3%

3%

3%

2%2%

2%2%

13%

Washington Regional Medical Center Mercy Hospital Northwest ArkansasNorthwest Medical Center - Bentonville Northwest Medical Center-SpringdaleMercy Hospital Springfield Arkansas Children's HospitalVeterans Affairs Medical Center Freeman Hospital WestCox South Mercy Hospital JoplinSiloam Springs Memorial Hospital Other Facilities

Fort Scott PRIMARY SERVICE AREA

The Fort Scott Primary Service Area (PSA) comprises three counties in

southeast Kansas

KS



Cigna Medical Insurance 410

Ward/Kraft Manufacturing 330

Unified School District #234 Public Schools 320

Peerless Products, Inc. Manufacturing 260

Valu Merchandisers Wholesale Grocers 250

DEMOGRAPHICS Fort Scott Service Area Kansas 2011

US 2011 2011 2016 % Growth

Total Population 64,521 63,998 -1% 2,864,235 310,650,750

0-17 23% 24% -0.1% 25% 24%

18-44 Females 18% 18% -1% 17% 18%

18-44 Males 19% 19% -1% 18% 19%

45-64 24% 23% -6% 26% 26%

65+ 16% 17% 6% 13% 13%

Median Age 36 - - 37 37

White 91% 90% -2% 79% 64%

Black 2% 2% 6% 6% 12%






Total No. of Households 25,998 25,806 -1% 1,115,065 116,862,390


HH Income Under $15K 20% - - 12% 13%

HH Income Over $75K 16% - - 28% 30%




Some College 33% - - 31% 28%


Source: Fort Scott Area Chamber of Commerce, 2012

MAJOR EMPLOYERS

Largest employers as listed by the Fort Scott Area Chamber of Commerce:

Fort Scott DEMOGRAPHICS

Note: Fort Scott Service Area consists of three counties in Kansas; Education Level based on population age 25+ Source: Thomson Reuters, 2011

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Health Factor Bourbon County Kansas

National Benchmark









Overall Health Ranking: Kansas = 26 (/50 states); Bourbon County = 92 (/100 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.



Hypertension 30%

Arthritis 25%

Asthma 13%

Diabetes 8%

COPD 5%


Angina 3%


CHRONIC DISEASE

Within the three-county Fort Scott Service Area, the following chronic conditions have been identified among the adult (18+) population:




KS US

INSURANCE COVERAGE


18%

Uninsured 20%

Medicaid 9%

8.2%

6.2%

8.2%

UNEMPLOYMENT RATE


↓0.6% Service Area

↓0.6% Kansas

↓0.7% US

*Fort Scott Service Area 3-county aggregate (Bourbon, Crawford & Linn Counties) Note: US & State rates are seasonally adjusted; County data, non-seasonally adjusted Source: KS Labor Information Center (KLIC); US Dept. of Labor – Bureau of Labor Statistics

MARCH 2012

1

2

1


Mercy Hospital Fort Scott* Mercy

Via Christi Hospital* Via Christi Health

Girard Medical Center* Independent

2

3

3

Fort Scott REGIONAL PROVIDER LANDSCAPE

The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Fort Scott Service Area.


Surgery Center

Mercy

Independent





Total Births

Total ED Visits

Mercy Hospital Fort Scott 253 69 1,374 1,666 231 6,688


• General acute care hospital, rural outreach clinics and home health agencies

• Mercy Clinic includes 14 physicians, 9 advanced practice providers and 57 clinic co-workers supporting 52,000 outpatient visits to patients in four clinics including two urgent/convenient care sites (physician counts as of April 2012)


TOTAL ASSETS $40M


OPER. PROFIT MARGIN 3.3% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012




Total Births

Via Christi Hospital (Pittsburg, KS) 645 114 3,260 4,022 575

• Non-profit, sponsored by Via Christi Health System

• General acute care hospital, primary care clinic in Iola, KS, senior assisted living and nursing care facility


TOTAL ASSETS $82M


OPER. PROFIT MARGIN 0.7% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010




Total Births

Girard Medical Center 189 35 862 1,021 0

• Government-owned

• Critical access hospital with five clinics


TOTAL ASSETS $25M


OPER. PROFIT MARGIN 0.5% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); FTEs, beds, births – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010




Total Births

Freeman Health System (Joplin, MO) Freeman Health System 2,810 348 485 18,745 2,489

Mercy Hospital Joplin* (Joplin, MO) Mercy Health 1,139 150 477 9,973 532

Olathe Medical Center (Olathe, KS) Olathe Health System 1,402 227 427 10,971 1,329

University of Kansas Hospital (Kansas City, KS) University of Kansas 4,661 606 357 24,408 1,536

Other Health Care Providers outside the Fort Scott Service Area

*Note: Mercy Hospital in Joplin was destroyed by an E5 tornado in May 2011; currently Mercy operates a 150-bed component hospital until 2015 when the replacement facility will be complete. Source: IP discharges – HIDI, FFY11 (does not include Normal Newborns); beds, FTEs – AHA Guide, 2010 data; Mercy Joplin data – Mercy Finance, FY11

www.via-christi.org

www.girardmedicalcenter.com

www.mercy.net

Note: Hospital only

Note: Hospital only

Note: Hospital only

Fort Scott REGIONAL PROVIDER STATISTICS

Service Area IP Discharges represent inpatient discharges within a specified service area, typically where 85%-95% of Mercy’s patients reside. Market share is calculated based on discharges within the service area. Total Hospital IP Discharges account for all discharges from a facility regardless of where patients reside.

http://www.via-christi.org/default.cfm

17%

9%

24%

24%

21%

0 50 100 150 200 250

Gen Surg

Cardio

Gastro

OB

Pulm

FFY11 Discharges

Advanced Practice

39%

Hospital-based

9%

Specialists 13%

Primary Care 39%


Fort Scott KS US


Specialty 44 69 81

Total 119 180 197

Mercy Hospital Fort Scott





Mercy Hospital Fort Scott-KS 14%

Via Christi Hospital-Pittsburg, KS 13%

Girard Medical Center-KS 7%

Miami County Medical Center-Paola, KS 2%

Mercy Hospital Joplin-MO 1%

University of Kansas Hospital-Kansas City, KS 1%

Olathe Medical Center-KS 1%

Freeman Health System-Joplin, MO 1%

Other Mercy hospitals < 1%


Note: Total (n) = 23 integrated Mercy physicians and advanced practitioners serving the Fort Scott community Source: Mercy Hospital Administration, April 2012

In FFY11, 35% of patients received inpatient care at hospitals located outside the Fort Scott three-county PSA, including 7% at Mercy hospitals



Via Christi Hospital-Pittsburg, KS 42% 38%

Mercy Hospital Fort Scott-KS 16% 16%

Girard Medical Center-KS 8% 10%

Freeman Health System-Joplin, MO 5% 6%

Mercy Hospital Joplin-MO 7% 6%

Olathe Medical Center-KS 4% 5%

University of Kansas Hospital-Kansas City, KS 4% 4%

Shawnee Mission Medical Center-KS 1% 2%

Children's Mercy Hosp & Clinics-Kansas City, MO 1% 1%

Miami County Medical Center Inc.-Paola, KS 1% 1%

Labette Health-Parsons, KS 1% 1%

Saint Luke's Hospital-Kansas City, MO 1% 1%

Overland Park Regional Medical Center-KS 1% 1%


Other hospitals 8% 7%


John G. Yost, Jr., MD (Orthopedic Surgery) < 1%

Roxanna S. Jones, MD (Family Practice) < 1%

Talaat E. Yaghmour, MD (Urology) < 1%

11 Other physicians with 1 discharge each < 1%


Fort Scott PATIENT CARE








% Change


2011 Procedures


5 Yr 10 Yr




Nephrology 10,311 89% 128%


Neurology 8,677 27% 33%

OB/Gyn 7,744 60% 59%



Note: Mercy service lines used; based on volumes within the PSA Source: HIDI, FFY11

Of the region’s 397,101 hospital-based outpatient visits, 21% occurred outside the Fort Scott PSA (3% at Mercy hospitals)








the lowest rankings

Mercy Hospital

Via Christi

Girard Med Ctr

KS US Mercy

Hospital Via

Christi Girard

Med Ctr KS US

81% 79% 71% 79% 76% 1% 3% 4% 3% 5%

86% 86% 84% 84% 80% 2% 1% 4% 3% 4%

73% 65% 77% 70% 64% 3% 7% 8% 7% 10%

70% 68% 70% 71% 70% 4% 5% 8% 5% 7%

63% 65% 64% 63% 61% 15% 18% 17% 17% 21%

80% 70% 83% 75% 72% 5% 9% 3% 7% 9%

63% 60% 62% 63% 58% 5% 9% 12% 8% 11%

86% 84% 85% 84% 82% 14% 16% 15% 16% 18%

73% 70% 75% 74% 68% 6% 6% 7% 6% 9%

67% 67% 80% 75% 70% 2% 3% 5% 3% 5%

Fort Scott PATIENT SATISFACTION















Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for Mercy and Via Christi hospitals and between 100 and 299 surveys were received for Girard Medical Center. Average response rate was 28%.


Independence PRIMARY SERVICE AREA

The IndependencePrimary Service Area (PSA) comprises four counties in

southeast Kansas

KS


22%

Uninsured 15%

Medicaid 9%


Cessna (Aircraft) Assembly plant 650

Standard Motor Products Auto Parts 367

Unified School District #446 Education 362

Four County Mental Health Health care 329

Walmart Retail 280


DEMOGRAPHICS Independence Service Area Kansas 2011

US 2011 2011 2016 % Growth

Total Population 50,803 48,925 -4% 2,864,235 310,650,750

0-17 23% 24% -3% 25% 24%

18-44 Females 15% 15% -5% 17% 18%

18-44 Males 15% 16% -2% 18% 19%

45-64 27% 25% -10% 26% 26%

65+ 19% 21% 4% 13% 13%

Median Age 42 - - 37 37

White 86% 85% -5% 79% 64%

Black 4% 4% -2% 6% 12%

American Indian 3% 3% -3% 1% 1%





Total No. of Households 21,042 20,276 -4% 1,115,065 116,862,390


HH Income Under $15K 18% - - 12% 13%

HH Income Over $75K 15% - - 28% 30%




Some College 35% - - 31% 28%


Source: Montgomery County Action Council (MCAC), 2012

MAJOR EMPLOYERS

As listed by the Montgomery County Action Council:

Independence DEMOGRAPHICS

Note: Independence Service Area consists of four counties in Kansas; Education Level based on population age 25+ Source: Thomson Reuters, 2011

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Health Factor Montgomery

County Kansas National

Benchmark









Overall Health Ranking: Kansas = 26 (/50 states); Montgomery County = 99 (/100 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.



Hypertension 34%

Arthritis 28%

Asthma 13%

Diabetes 9%


COPD 5%

Angina 3%


CHRONIC DISEASE

Within the four-county Independence Service Area, the following chronic conditions have been identified among the adult (18+) population:




KS US

INSURANCE COVERAGE

9.0%

6.2%

8.2%

UNEMPLOYMENT RATE


↓1.6% Service Area*

↓0.6% Kansas

↓0.7% US

*Independence Service Area 4-county aggregate (Chautauqua, Elk, Montgomery and Wilson Counties) Note: US & State rates are seasonally adjusted; County data, non-seasonally adjusted Source: KS Labor Information Center (KLIC); US Dept. of Labor – Bureau of Labor Statistics

MARCH 2012


Mercy Hospital Independence* Mercy

Coffeyville Regional Medical Center* Quorum Health Resources

Fredonia Regional Hospital* Great Plains Health Alliance

Wilson Medical Center* Independent

Sedan City Hospital Independent

1

4

5

2

The map below depicts all inpatient hospitals in the Independence Service Area.

denotes hospital outside the service area

Independence REGIONAL PROVIDER LANDSCAPE

3

4

5

2

1

3




Total Births

Total ED Visits

Mercy Hospital Independence 157 40 1,027 1,092 229 8,276


TOTAL ASSETS $32M


OPER. PROFIT MARGIN 8.5% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012




Total Births

Coffeyville Regional Medical Center 344 88 1,929 2,255 224

• Non-profit, city-owned; managed by Quorum Health Resources

• General acute care facility; opened The Jerry Marquette Radiation Oncology Center in November 2011


TOTAL ASSETS $50M


OPER. PROFIT MARGIN -6.1% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

www.crmcinc.com




Total Births

Wilson Medical Center (Neodesha, KS) Independent 110 15 242 276 0

Sedan City Hospital (Sedan, KS) Independent 31 25 239 240 NA

Other Health Care Providers within the Independence Service Area

Source: IP discharges – HIDI, FFY11 (does not include Normal Newborns); beds, FTEs – AHA Guide, 2010 data

www.mercy.net


• General acute care hospital, rural outreach clinics and home health agencies

• Mercy Clinic includes 7 physicians, 7 advanced practice providers and 33 clinic co-workers supporting almost 27,000 outpatient visits to patients in four clinics including one urgent/convenient care site (physician counts as of April 2012)

Note: Hospital only

Note: Hospital only




Total Births

Fredonia Regional Hospital 107 25 675 842 0

• Government-owned, critical access; managed by Great Plains Health Alliance

• Includes a nine-bed geriatric psych unit


TOTAL ASSETS $20M


OPER. PROFIT MARGIN -15.7% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

www.fredoniaregionalhospital.org Note: Hospital only

FREDONIA REGIONAL HOSPITAL




Total Births

Labette Health (Parsons, KS) Independent 447 67 483 2,814 211

Via Christi Hospital (Wichita, KS) Via Christi Health 3,861 759 327 33,961 2,823

Wesley Medical Center (Wichita, KS) HCA 2,069 524 268 24,292 6,403

Key Providers outside the Independence Service Area

Independence REGIONAL PROVIDER STATISTICS


Advanced Practice

50%

Specialists 14%

Primary Care 36%

13%

16%

19%

14%

38%

0 100 200 300

Cardio

Ortho

Gastro

Pulm

OB

FFY11 Discharges


Independence KS US


Specialty 24 69 81

Total 95 180 197





Coffeyville Regional Medical Center-KS 10%

Mercy Hospital Independence-KS 10%

Fredonia Regional Hospital-KS 4%

Wilson Medical Center-Neodesha, KS 3%

Labette Health-Parsons, KS 2%

Sedan City Hospital-KS 2%

William Newton Hospital-Winfield, KS 2%

Jane Phillips Medical Center-Bartlesville, OK 2%

Greenwood County Hospital-Eureka, KS 1%

Other Mercy hospitals <1%


Note: Total (n) = 14 integrated Mercy physicians and advanced practitioners serving the Independence community Source: Mercy Hospital Medical Staff Coordinator, April 2012

In FFY11, 32% of patients received inpatient care at hospitals located outside the Independence four-county PSA, including 1% at Mercy hospitals



Coffeyville Regional Medical Center-KS 34% 32%

Mercy Hospital Independence-KS 18% 17%

Fredonia Regional Hospital-KS 12% 11%

Labette Health-Parsons, KS 6% 8%

Via Christi Hospital-Wichita, KS 5% 5%

Wesley Medical Center-Wichita, KS 5% 4%

Wilson Medical Center-Neodesha, KS 3% 4%

Sedan City Hospital-KS 3% 4%

Neosho Memorial Reg. Medical Ctr.-Chanute, KS 3% 3%

University of Kansas Hospital-Kansas City, KS 2% 2%

Mercy Hospital Joplin-MO 1% 1%

Greenwood County Hospital-Eureka, KS 1% 1%

Other Mercy hospitals < 1% < 1%


Mercy Hospital Independence



Casana R. Brunton, MD (Family Practice) 19%

Joseph Spurlock, MD (Family Practice) 16%

Jason P. Brunton, MD (Family Practice) 13%

Gregory H. Mears, MD (Family Practice) 11%

Larry C. Atwood, MD (Family Practice) 9%

Virenda C. Patel, MD (Sports Medicine) 6%

Charles L. Empson, MD (Emergency Medicine) 3%

Other (8 physicians combined) 1%


Independence PATIENT CARE








% Change


2011 Procedures


5 Yr 10 Yr




Nephrology 12,740 61% 82%


OB/Gyn 5,140 43% 39%

Neurology 4,936 22% 25%


Gastroenterology 2,951 4% -0.2%


Of the region’s 297,593 hospital-based outpatient visits, 8% occurred outside the Independence PSA (0.2% at Mercy hospitals)






Mercy Hospital

Coffeyville Regional

KS US Mercy

Hospital Coffeyville Regional

KS US

80% 76% 79% 76% 3% 5% 3% 5%

86% 81% 84% 80% 2% 5% 3% 4%

69% 61% 70% 64% 6% 11% 7% 10%

71% 68% 71% 70% 6% 8% 5% 7%

66% 54% 63% 61% 14% 26% 17% 21%

72% 68% 75% 72% 5% 10% 7% 9%

61% 50% 63% 58% 6% 14% 8% 11%

86% 73% 84% 82% 14% 27% 16% 18%

70% 62% 74% 68% 9% 11% 6% 9%

64% 58% 75% 70% 4% 7% 3% 5%

Independence PATIENT SATISFACTION



















Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for Coffeyville Regional Medical Center and between 100 and 299 surveys were received for Mercy Hospital. Average response rate was 26%.

Joplin PRIMARY SERVICE AREA

The Joplin Primary Service Area (PSA) comprises nine counties in southeast

Kansas, northeast Oklahoma and southwest Missouri

KS MO

OK

Private 48%

Medicare 18%

Uninsured 19%

Medicaid 16%

DEMOGRAPHICS Joplin Service Area Missouri 2011

US 2011 2011 2016 % Growth


0-17 25% 25% 3% 24% 24%

18-44 Females 17% 17% 0% 18% 18%

18-44 Males 18% 17% 1% 18% 19%

45-64 25% 24% -2% 26% 26%

65+ 15% 17% 11% 14% 13%

Median Age 37 - - 38 37

White 84% 83% <1% 81% 64%

Black 1% 1% 15% 11% 12%

American Indian 5% 5% -1% 1% 1%







HH Income Under $15K 18% - - 14% 13%

HH Income Over $75K 15% - - 25% 30%




Some College 30% - - 29% 28%


Source: Joplin Area Chamber of Commerce, 2011


Freeman Health System Health care 2,897

Con-way Truckload Transportation 2,677


Joplin School District Education 1,200

Downstream Casino Resort Entertainment 1,083

EaglePicher Technologies, LLC Battery Manufacturing 1,022

Walmart Retail 920

MAJOR EMPLOYERS

Largest employers provided by the Joplin Area Chamber of Commerce:


Hypertension 30%

Arthritis 25%

Asthma 13%

Diabetes 8%

COPD 5%


Angina 3%


CHRONIC DISEASE

Within the nine-county Joplin Service Area, the following chronic conditions have been identified among the adult (18+) population:




US MO

INSURANCE COVERAGE

Joplin DEMOGRAPHICS

Note: Joplin Service Area consists of nine counties in Missouri (5), Kansas (2) and Oklahoma (2); Education Level based on population age 25+ Source: Thomson Reuters, 2011

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Health Factor Jasper County Missouri

National Benchmark









Overall Health Ranking: Missouri = 40 (/50 states); Jasper County = 41 (/115 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.


6.8% 7.4% 8.2%

UNEMPLOYMENT RATE


↓1.2% MSA*

↓1.3% Missouri

↓0.7% US

*Joplin, MO Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics

MARCH 2012

The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Joplin Service Area.

Joplin REGIONAL PROVIDER LANDSCAPE

1

3 2

4

5

6

7

8

10

9

11


Surgery Center

Physician Owned

Freeman Health Sys.


12


Mercy Hospital Joplin* (new facility to open early 2015) Mercy

Mercy McCune-Brooks Hospital Mercy

Mercy Maude Norton Hospital Mercy

Freeman Hospital West Freeman Health System

Freeman Neosho Hospital Freeman Health System

Via Christi Hospital* Via Christi Health

Integris Baptist Regional Health Center* Integris Health

Integris Grove General Hospital* Integris Health

Nevada Regional Medical Center* Independent

Barton County Memorial Hospital Independent

Girard Medical Center* Independent

Stateline Specialty Hospital (new facility to open December 2012) Physician Owned

Joplin REGIONAL PROVIDER LANDSCAPE

6

7

8

10

9

11

1

3

2

4

5

12


• On May 22, 2011, Mercy Hospital in Joplin was destroyed by an EF5 tornado; currently Mercy operates a 110-bed component hospital until 2015 when the replacement facility will be complete

• One general acute care in Joplin, and two critical access hospitals: Mercy McCune-Brooks (acquired January 2012) in Carthage, MO and Mercy Maude Norton in Columbus, KS

• Landmark Hospital of Joplin, a 30-bed long-term care facility, is a joint venture between Mercy, Freeman Health System and four Joplin physicians

• Mercy Clinic consists of 111 primary care, specialty and hospital-based physicians, 42 advanced practice providers and 227 clinic co-workers supporting over 167,000 outpatient visits to patients in 18 clinics including one urgent/convenient care site (physician counts as of April 2012)

www.freemanhealth.com




Total Births

Freeman Hospital West 2,810 348 16,918 18,745 2,489

Freeman Neosho Hospital 188 25 1,607 1,675 0

TOTAL 2,998 373 18,525 20,420 2,489

• Non-profit, community-owned

• One general acute care hospital and one critical access hospital, home health, DME, cancer, heart and vascular, rehab, orthopedic and sports medicine, women’s centers and urgent care services

• Landmark Hospital of Joplin, a 30-bed long-term care facility, is a joint venture with Mercy, Freeman Health System and four Joplin physicians

• Freeman Physician Group includes approximately 180 physicians with clinics located in Joplin, Neosho and Anderson, MO, and Baxter Springs and Pittsburg, KS


TOTAL ASSETS $367M



www.mercy.net



Joplin REGIONAL PROVIDER STATISTICS




Total Births

Via Christi Hospital (Pittsburg, KS) 645 114 3,716 4,022 575

• Non-profit, sponsored by Via Christi Health

• General acute care hospital, primary care clinic in Iola, KS, senior assisted living and nursing care facility


TOTAL ASSETS $82M


OPER. PROFIT MARGIN 0.7% www.via-christi.org Note: Hospital only

Service Area IP Discharges represent inpatient discharges within the specified service area, typically where 85%-95% of Mercy’s patients reside. Market share is calculated based on discharges within the service area. Total Hospital IP Discharges account for all discharges from a facility regardless of where patients reside.

Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010




Total Births

Total ED Visits

Mercy Hospital Joplin* 1,066 110 8,639 9,973 532 35,994

Mercy McCune-Brooks Hospital 365 35 1,968 2,115 155 NA

Mercy Maude Norton Hospital 34 25 110 111 0 2,060

TOTAL 1,465 170 10,717 12,199 687 38,054


TOTAL ASSETS $118M



*Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only)– HIDI, FFY11 (does not include Normal Newborns); beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, as of April 2012; Mercy McCune-Brooks beds and births – AHA Guide, 2010 data

Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

http://www.via-christi.org/default.cfm




Total Births

Barton County Memorial Hospital 181 25 1,284 1,411 0

www.nrmchealth.com




Total Births

Nevada Regional Medical Center 326 63 1,360 2,228 336

• Non-profit, community-owned in Nevada, MO; managed by Quorum Health Resources

• Operates the NowCare Clinic in Nevada, MO, rural health clinics in Rich Hill and Sheldon, MO, and a home health agency; owns a 40-bed Alzheimer’s unit and 108-bed nursing home


TOTAL ASSETS $48M



• Non-profit, sponsored by Integris Health

• Integris Baptist Regional in Miami, OK, provides critical care and surgical services, rehabilitation, geriatric behavioral health, diabetes management, hospice, home health care and home medical equipment; 40+ physicians and advanced practice providers on staff

• Integris Grove General Hospital in Grove, OK, includes a women’s health center, cardiac catheterization lab and four new operating rooms; 37 physicians and advanced practice providers on staff

INPATIENT MARKET SHARE NA

TOTAL ASSETS $149M



Note: Hospital only


www.integrisok.com




Total Births

Integris Baptist Regional Health Center 362 94 3,106* 3,607 300

Integris Grove General Hospital 290 48 2,666* 3,033 268

TOTAL 652 142 5,772 6,640 568

Joplin REGIONAL PROVIDER STATISTICS

www.bcmh.net

• For-profit, government-owned critical access facility in Lamar, MO

• New facility in 2007; clinics located in Lamar, Lockwood and Golden City, MO


TOTAL ASSETS $24M


OPER. PROFIT MARGIN -3.5% Note: Hospital only

• For-profit, government-owned in Girard, KS

• Critical access hospital with five clinics


TOTAL ASSETS $25M


OPER. PROFIT MARGIN 0.5% Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only)– HIDI, FFY11 (does not include Normal Newborns); FTEs, beds, births – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

www.girardmedicalcenter.com Note: Hospital only

Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only)– HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only)– HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

*Represents discharges from residents in Delaware and Ottawa, OK counties only Source: IP discharges (for PSA) – OK State data 2010 (does not include Normal Newborns); beds, births, FTEs, total assets, NPR, OPM – AHA Guide, 2009 data/AHD, 2010




Total Births

Girard Medical Center 189 35 869 1,021 0


Mercy Hospital Joplin (non-integrated) 31%

Bazzano Clinic 3%

Orthopedic Specialists of the Four States 2%

Pediatric Associates Southwest MO 2%

American Diagnostics 1%

Neurological Associates 1%

Joplin Urology Associates 1%

Other 25%

Advanced Practice

27%

Hospital-based 30%

Specialists 25%

Primary Care 18%

24%

29%

20%

28%

24%

0 500 1,000 1,500 2,000

Neuro

Gen Med

Pulm

Behav Hlth

Cardio

FFY11 Discharges



Joplin MO US


Specialty 51 83 81

Total 129 204 197

Mercy Hospital Joplin


Note: Total (n) = 153 integrated Mercy physicians and advanced practitioners serving Joplin and Columbus communities Source: Mercy Hospital Joplin Medical Affairs Department, April 2012




Freeman Health System-Joplin, MO 9%

Mercy Hospital Joplin-MO 9%

Integris Grove General Hospital-OK 3%

Via Christi Hospital-Pittsburg, KS 3%

Freeman Neosho Hospital-MO 2%

Integris Baptist Reg. Health Center-Miami, OK 2%

Mercy McCune-Brooks Hospital-Carthage, MO 2%

Barton County Memorial Hospital-Lamar, MO 2%

Girard Medical Center-MO 1%

Nevada Regional Medical Center-MO 1%

Mercy Maude Norton Hospital-Columbus, KS 1%


Other (incl. hospitals located outside the Joplin PSA) 6%

Prior to the May 2011 tornado, 9% of patients received inpatient care at hospitals located outside the Joplin PSA (1% at Mercy hospitals), compared to 16% leaving the area after the tornado (4% at Mercy hospitals)

Note: Market share includes discharges for Missouri and Kansas hospitals only Source: HIDI, FFY10-FFY11 (does not include Normal Newborns)

Hospital FFY 10

FFY 11

FFY11 Pre-

storm

FFY11 Post-storm

Freeman Health System-Joplin, MO 36% 40% 37% 47%

Mercy Hospital Joplin-MO 29% 20% 28% 5%

Via Christi Hospital-Pittsburg, KS 10% 9% 8% 10%

Mercy McCune-Brooks Hosp.-Carthage, MO 4% 5% 3% 8%

Freeman Neosho Hospital-MO 3% 4% 4% 4%

Nevada Regional Medical Center-MO 3% 3% 3% 4%

Barton County Memorial Hosp.-Lamar, MO 2% 3% 3% 3%

Girard Medical Center-KS 2% 2% 2% 2%

Mercy Hospital Springfield-MO 1% 2% 1% 3%

Missouri Residents/Arkansas Hospitals 1% 1% 1% 2%

Cox South-Springfield, MO 1% 1% 1% 2%

University of Kansas Hosp.-Kansas City, KS 1% 1% 1% 1%

Other Mercy hospitals 1% 1% 1% 1%

Other hospitals 6% 8% 7% 9%


Joplin PATIENT CARE







% Change


2011 Procedures


5 Yr 10 Yr


Cardiology 185,658 15% 20%


Nephrology 65,925 87% 128%


Neurology 50,885 34% 46%

OB/Gyn 45,267 53% 55%




Of the region’s 1.8M hospital-based outpatient visits, 10% occurred outside the Joplin PSA (2% at Mercy hospitals)


Source: Mercy Hospital Joplin, July 1, 2010 – April 30, 2011; Buxton physician database, April 2012





Mercy Hospital

Freeman West

MO US Mercy

Hospital Freeman

West MO US

75% 77% 77% 76% 5% 4% 5% 5%

79% 77% 81% 80% 6% 5% 4% 4%

61% 60% 65% 64% 10% 10% 10% 10%

69% 68% 69% 70% 6% 7% 7% 7%

54% 56% 60% 61% 25% 25% 21% 21%

71% 68% 72% 72% 7% 11% 9% 9%

53% 58% 57% 58% 12% 10% 11% 11%

78% 85% 84% 82% 22% 15% 16% 18%

69% 69% 68% 68% 9% 7% 9% 9%

72% 73% 68% 70% 5% 4% 5% 5%

Joplin PATIENT SATISFACTION



















39%43%

47%

42%

29% 28%

32%

27%

0%

15%

30%

45%

60%

2008 2009 2010 2011

Freeman Hospital WestMercy Hospital JoplinMercy Hospital SpringfieldVia Christi Hospital

42%

48% 48%51%

31% 33%

38%

28%

0%

15%

30%

45%

60%

2008 2009 2010 2011


Joplin CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.


Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Joplin Community (counties not surveyed: Barton, MO; Cherokee, KS; Ottawa and Delaware, OK)


Total number of respondents: 366


Total number of respondents: 363


% r

esp

on

den

ts

Heart Care


% r

esp

on

den

ts

Maternity/OB


% r

esp

on

den

ts

Cancer Treatment


% r

esp

on

den

ts

Pediatric Services


Last year, 39% of Joplin consumers who took the survey chose a Mercy Hospital for best overall quality and 35% selected Mercy as having the best image or reputation.

45%

28%6%

5%

3%

3%

2%

1%

6%

Freeman Hospital West Mercy Hospital JoplinMercy McCune-Brooks Hospital Mercy Hospital SpringfieldVia Christi Hospital The University of Kansas HospitalCox South Nevada Regional Medical CenterOther Facilities

49%

26%6%

3%3%

4%

2%

1%

6%

Freeman Hospital West Mercy Hospital JoplinMercy Hospital Springfield Mercy McCune-Brooks HospitalVia Christi Hospital The University of Kansas HospitalNevada Regional Medical Center Cox SouthOther Facilities

47%

54%

64%

55%

22%

25% 25%

20%

0%

25%

50%

75%

2008 2009 2010 2011


44%

51% 51% 50%

21% 25%

29%

22%

0%

15%

30%

45%

60%

2008 2009 2010 2011

Freeman Hospital WestMercy Hospital JoplinMercy Hospital SpringfieldChildren's Mercy Hospital (Kansas City)Freeman Neosho HospitalVia Christi Hospital

Mercy Hospital

Mercy Clinic




%

% Market Share 2010

OP Volume

46% PHYSICIAN OFFICES 1,036,718

15% FREEMAN HEALTH SYSTEM 327,628


13% MERCY HOSPITAL JOPLIN 300,394

4% MERCY MCCUNE-BROOKS HOSPITAL 97,847

3% FREEMAN NEOSHO HOSPITAL 77,927

0.2% BARTON COUNTY MEM. HOSPITAL 5,057

0.2% COX SOUTH 4,691


Community Snapshot CARTHAGE PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (80%) of Mercy McCune-Brooks Hospital’s acute care patients reside in Jasper and Newton Counties in southwest Missouri. Four in ten patients share the same zip code (64836) as the hospital.

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE


Race:88% White; 2% Multiracial Ethnicity: 6% Hispanic (of any race)

Total Area Population: 175,621 5-Yr Growth: +4%


Median Age: 36

POPULATION

Health Factor County MO US









Jasper County Overall Health Rank = 41 (out of 115 counties) The lower the ranking, the healthier the community.


SERVICES & PHYSICIANS In FFY11, Mercy McCune-Brooks Hospital’s top inpatient service lines were orthopedics (19%) and pulmonary and neurology both at 13%.

The 13% of residents leaving the Carthage area for inpatient services primarily go to Mercy Hospital Springfield for neurology and orthopedic services.




44%

7%

3%

total outpatient volume in the Carthage PSA 2.3M


Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – HIDI, FFY11 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – HIDI, FFY11; Physicians – Buxton, April 2012

% Market Share FFY11

Discharges



7% MERCY MCCUNE-BROOKS HOSPITAL 1,700

5% FREEMAN NEOSHO HOSPITAL 1,161

2% MERCY HOSPITAL SPRINGFIELD 486

1% COX SOUTH 355

1% CHILDREN’S MERCY HOSP. & CLINICS 276


total inpatient discharges in the Carthage PSA

24,290

5%

3%

2%

2%

2%

3%

5%


MO

% Market Share 2010

OP Volume





9% MERCY MAUDE NORTON HOSPITAL 24,655

4% VIA CHRISTI HOSPITAL-PITTSBURG, KS 9,126

1% GIRARD MEDICAL CENTER 2,705

1% INTEGRIS BAPTIST-MIAMI, OK 1,854


Community Snapshot COLUMBUS

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE


Race: 90% White; 4% American Indian Ethnicity: 2% Hispanic (of any race)

Total Area Population: 20,162 5-Yr Growth: -4%


Median Age: 40

POPULATION

Health Factor County KS US









Cherokee County Overall Health Rank = 96 (out of 100 counties) The lower the ranking, the healthier the community.



In FFY11, Mercy Maude Norton Hospital’s top inpatient service lines were pulmonary (31%) and cardiovascular (18%).

The 96% of residents leaving the Columbus area for inpatient services primarily go to Freeman Health System for cardiovascular and OB services, and to Mercy Hospital Joplin for cardiovascular services.





total outpatient volume in the Columbus PSA 260,664


PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (95%) of Mercy Hospital Columbus’s acute care patients reside in Cherokee County in southeast Kansas. Eight in ten patients share the same zip code (66725) as the hospital.

80%

6%

5%

2%

Mercy Hospital

Mercy Clinic




%

total inpatient discharges in the Columbus PSA 2,796


Discharges


30% MERCY HOSPITAL JOPLIN 837

13% VIA CHRISTI HOSPITAL-PITTSBURG, KS 360

4% MERCY MAUDE NORTON HOSPITAL 105

2% MERCY MCCUNE-BROOKS HOSPITAL 60

2% UNIVERSITY OF KANSAS HOSPITAL 57


8% OTHER (including 0.4% Mercy) 210


KS

Springfield PRIMARY SERVICE AREA

The Springfield Primary Service Area (PSA)

comprises 13 counties in southwest Missouri

MO

DEMOGRAPHICS Springfield Service Area Missouri 2011

US 2011 2011 2016 % Growth


0-17 24% 24% 6% 24% 24%

18-44 Females 18% 17% 3% 18% 18%

18-44 Males 18% 17% 4% 18% 19%

45-64 25% 25% 2% 26% 26%

65+ 16% 17% 14% 14% 13%

Median Age 38 - - 38 37

White 92% 91% 4% 81% 64%

Black 2% 2% 22% 11% 12%








HH Income Under $15K 16% - - 14% 13%

HH Income Over $75K 17% - - 25% 30%




Some College 30% - - 29% 28%


Source: Springfield Business Development Corporation; Springfield, Missouri MSA – Greene, Christian, Webster, Polk and Dallas Counties Full Time Equivalent Employees as of summer 2011


Mercy Health Health care 9,036

CoxHealth Systems Health care 7,560

Walmart Retail 4,000

Springfield Public Schools Education 2,911

US Government Government 2,500

Bass Pro Shops/Tracker Marine Retail 2,363

MAJOR EMPLOYERS

Largest employers in the greater Springfield area as listed by the Springfield Business Development Corporation:


Hypertension 30%

Arthritis 25%

Asthma 13%

Diabetes 8%


COPD 5%

Angina 3%


CHRONIC DISEASE

Within the thirteen-county Springfield Service Area, the following chronic conditions have been identified among the adult (18+) population:

In addition, 4% have had a heart attack 3% have had a stroke, and 7% are living with some type of cancer


US MO

INSURANCE COVERAGE

Springfield DEMOGRAPHICS

Note: Springfield Service Area consists of 13 counties in Missouri; Education Level based on population age 25+ Source: Thomson Reuters, 2011

Rac

e &

Eth

nic

ity

Age

Gro

up

s H

ou

seh

old

s Ed

uca

tio

n

Health Factor Greene County Missouri

National Benchmark









Overall Health Ranking: Missouri = 40 (/50 states); Greene County = 38 (/115 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.


Private 51%

Medicare 18%

Uninsured 17%

Medicaid 14%


7.0% 7.4% 8.2%

UNEMPLOYMENT RATE

Change over 12 months:

↓1.2% MSA*

↓1.3% Missouri

↓0.7% US

*Springfield, MO Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics

MARCH 2012

Springfield REGIONAL PROVIDER LANDSCAPE

The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Springfield Service Area.

1 7

12

2

3

4

5

6

8

9

11

10

KANSAS

OKLAHOMA

MISSOURI

ARKANSAS


Surgery Center

Mercy

CoxHealth

Independent


1a

1b


Mercy Hospital Springfield* Mercy

Mercy Children’s Hospital Springfield (renovations to be completed by spring 2013) Mercy

Mercy Orthopedic Hospital Springfield (new facility to open summer 2013) Mercy

Mercy Hospital Lebanon* Mercy

Mercy Hospital Aurora* Mercy

Mercy Hospital Berryville* Mercy

Mercy St. Francis Hospital Mercy

Mercy Hospital Cassville* Mercy

Cox South* CoxHealth

Cox Monett Hospital* CoxHealth

Skaggs Regional Medical Center* Independent

Ozarks Medical Center* Independent

Citizens Memorial Hospital* Independent

Ozarks Community Hospital Independent

1

3

2

5

4

6

8

9

10

11

12

7

Springfield REGIONAL PROVIDER LANDSCAPE

1a

1b

• Non-profit, private

• Two general acute care hospitals, a bone and joint center (Meyer Orthopedic Center), newly expanded Neuro Trauma ICU, a large multi-specialty physician group, 60 regional physician clinics and five Walmart clinic locations

• Integrated physician group consists of 250+ physicians and the Ferrell-Duncan Clinic which is a managed multi-specialty clinic with 100+ physicians


TOTAL ASSETS $1.0B


OPER. PROFIT MARGIN -3.2% www.coxhealth.com




Total Births

Cox South (includes North & Walnut Lawn) 6,256 626 28,067 31,480 3,373

Cox Monett 235 25 743 812 286

TOTAL 6,491 651 28,810 32,292 3,659

Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

www.mercy.net




Total Births

Total ED Visits

Mercy Hospital Springfield 4,816 774 26,740 31,988 2,957 92,322

Mercy Hospital Lebanon 490 62 1,890 2,467 420 27,370

Mercy Hospital Berryville* 136 25 797 797 100 9,380

Mercy Hospital Aurora 148 25 755 770 236 14,086

Mercy Hospital Cassville 95 18 289 300 0 10,163

Mercy St. Francis Hospital 113 25 239 523 0 8,338

TOTAL 5,798 929 30,710 36,845 3,713 161,659


• Two general acute and four critical access hospitals, a dedicated children’s hospital; Heart Institute; region’s only Level 1 trauma and burn center; nationally-certified stroke center; and 48-bed orthopedic specialty hospital to open in summer 2013

• Mercy Clinic includes 511 primary care, specialty and hospital-based physicians, 279 advanced practice providers and 1,945 co-workers. The clinic provides more than 1.5 million outpatient visits in over 70 specialty, multi-specialty clinics and eight urgent/convenient care sites in Southwest Missouri and Northwest Arkansas (physician counts as of April 2012)


TOTAL ASSETS $487M



*Berryville not included in market share; Berryville Service Area IP Discharges are total hospital discharges from Mercy Finance, FY11; Berryville births – AHD, 2010 Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, as of April 2012




Total Births

Skaggs Regional Medical Center (Branson, MO) Independent 1,050 132 5,879 7,076 674

Ozarks Medical Center (West Plains, MO) Independent 1,092 114 4,174 6,228 686

Citizens Memorial Hospital (Bolivar, MO) Independent 829 62 2,316 3,263 537

Ozarks Community Hospital (Springfield, MO) Independent 586 35 1,020 1,099 0

Source: IP discharges – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data

Other Health Care Providers in the Springfield Service Area



Springfield REGIONAL PROVIDER STATISTICS


In June 2012, Skaggs Regional Medical Center and CoxHealth signed a letter of intent to form a financial partnership. The two health systems will enter into a period of due diligence and should have a definitive agreement by fall 2012. As a part of the agreement, Skaggs would function as a subsidiary of CoxHealth but would keep its name, board, current employees, management and medical staff.

% Change


2011 Procedures


5 Yr 10 Yr


Cardiology 321,369 19% 29%


Nephrology 140,096 85% 132%


OB/Gyn 95,536 54% 61%

Neurology 91,671 36% 50%



Advanced Practice

35%

Hospital-based 18%

Specialists 22% Primary Care

25%

36%

30%

41%

33%

36%

0 1,000 2,000 3,000 4,000

Pulm

Ortho

Neuro

OB

Cardio

FFY11 Discharges



Springfield Nephrology Assoc. 2%

CMH Surgical Services 1%

Pediatrics Medical Group-Springfield 1%

Springfield OB/Gyn 1%

Cardiovascular Surgeons 1%

Andy J. Wright, MD (Rheumatology) 1%

Other Physicians 6%

Springfield MO US


Specialty 57 83 81

Total 156 204 197

Mercy Hospital Springfield



Note: Total (n) = 790 integrated Mercy physicians and advanced practitioners serving the 13-county Springfield PSA Source: Mercy Hospital Medical Staff Services, April 2012

Of the region’s 3M hospital-based outpatient visits, 5% occurred outside the Springfield PSA (1% at Mercy hospitals)




Cox South-Springfield, MO 9%


Mercy Hospital Springfield-MO 8%

Skaggs Regional Medical Center-Branson, MO 4%

Ozarks Community Hospital-Springfield, MO 2%

Citizens Memorial Hospital-Bolivar, MO 2%

Ozarks Medical Center-West Plains, MO 1%

Mercy Hospital Lebanon-MO 1%

Cox Monett Hospital-MO 1%

Mercy Hospital Aurora-MO 0.6%

Mercy Hospital Cassville-MO 0.4%

Mercy St. Francis Hospital-Mountain View, MO 0.3%

Other Mercy hospitals 0.3%


In FFY11, 10% of patients received inpatient care at hospitals located outside the Springfield 13-county PSA, including 1% at Mercy hospitals



Cox South-Springfield, MO 35% 35%

Mercy Hospital Springfield-MO 33% 33%

Skaggs Regional Medical Center-Branson, MO 7% 7%

Ozarks Medical Center-West Plains, MO 5% 5%

Citizens Memorial Hospital-Bolivar, MO 3% 3%

Mercy Hospital Lebanon-MO 2% 2%

Ozarks Community Hospital-Springfield, MO 1% 1%

Missouri Residents/Arkansas Hospitals 1% 1%


Mercy Hospital Aurora-MO 1% 1%

Cox Monett Hospital-MO 1% 1%







Springfield PATIENT CARE











Mercy Hospital

Cox South

MO US Mercy

Hospital Cox

South MO US

79% 73% 77% 76% 3% 5% 5% 5%

83% 79% 81% 80% 3% 4% 4% 4%

63% 59% 65% 64% 8% 12% 10% 10%

70% 67% 69% 70% 4% 7% 7% 7%

60% 56% 60% 61% 21% 24% 21% 21%

77% 68% 72% 72% 5% 10% 9% 9%

56% 51% 57% 58% 11% 13% 11% 11%

86% 83% 84% 82% 14% 17% 16% 18%

78% 65% 68% 68% 5% 9% 9% 9%

83% 70% 68% 70% 1% 5% 5% 5%

Springfield PATIENT SATISFACTION



















Springfield CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.


Last year, 50% of Springfield consumers who took the survey chose a Mercy Hospital for best overall quality and 52% selected Mercy as having the best image or reputation.

Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Springfield Community (13-county PSA: Dallas and Douglas Counties not surveyed)


Total number of respondents: 609 Mercy Hospitals Cassville, Lebanon and St. Louis received less than 1% each

52% 50% 51% 48%

31% 32%35%

31%

0%

25%

50%

75%

2008 2009 2010 2011

Mercy Hospital Springfield Cox South


re

spo

nd

en

ts

Heart Care


% r

esp

on

de

nts

46%

38%

45% 42%

32%38% 37%

34%

0%

25%

50%

75%

2008 2009 2010 2011


Maternity/OB


% r

esp

on

de

nts

44%40%

44% 42%

31% 31% 33% 32%

0%

25%

50%

75%

2008 2009 2010 2011


Cancer Treatment


% r

esp

on

de

nts

45%39%

46% 43%

30%35% 34% 35%

0%

25%

50%

75%

2008 2009 2010 2011


Pediatric Services


47%

35%

4%4%

1%1%

1% 1% 7%

Mercy Hospital Springfield Cox SouthCox North Skaggs Regional Medical CenterMercy Hospital Aurora Ozarks Community HospitalMercy Hospital Joplin Cox Monett HospitalOther Facilities

Total number of respondents: 613 Mercy Hospitals Cassville, Lebanon and St. Louis received less than 1% each


49%

32%

4%

4%

1%1%

1% 1% 7%

Mercy Hospital Springfield Cox SouthCox North Skaggs Regional Medical CenterOzarks Community Hospital Mercy Hospital AuroraMercy Hospital Joplin Cox Walnut LawnOther Facilities


Discharges

29% COX SOUTH 2,462

27% MERCY HOSPITAL SPRINGFIELD 2,237

9% COX MONETT 722

8% MERCY HOSPITAL AURORA 703

5% MO RESIDENTS/AR HOSPITALS 459

5% FREEMAN HOSPITAL WEST 379

3% MERCY HOSPITAL CASSVILLE 276

4% OTHER MERCY 292

10% OTHER 829

9%

38%

12%

2%

7%

8%

Community Snapshot AURORA

total outpatient volume in the Aurora PSA 967,710

INPATIENT MARKET SHARE OUTPATIENT MARKET SHARE (hospital-based only)

total inpatient discharges in the Aurora PSA

% Market Share 2010

OP Volume


9% COX MONETT 90,292


6% COX SOUTH 58,959

6% MERCY HOSPITAL AURORA 53,265

4% MERCY HOSPITAL CASSVILLE 41,371


2% OTHER MERCY 22,481

13% OTHER 128,686

8,359

PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (91%) of Mercy Hospital Aurora’s acute care patients reside in Barry and Lawrence Counties in southwest Missouri. Four in ten patients share the same zip code (65605) as the hospital.


3%

3%

2%

2%

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE







Median Age: 39

POPULATION


In FFY11, Mercy Hospital Aurora’s top inpatient service lines were OB (32%) and pulmonary (21%).

The 80% of patients leaving the Aurora area for inpatient services primarily go to Mercy Springfield for cardiovascular and orthopedic services, and to Cox South for cardiovascular, general surgery and neurology services.









Preventable Hospital Stays (per 1,000 Medicare) 55 75 49


Lawrence County Overall Health Rank = 57 (out of 115 counties) The lower the ranking, the healthier the community.


3%

Mercy Hospital

Mercy Clinic





%

MO

Community Snapshot BERRYVILLE


Sources: Map – Mercy Locations Directory, AHD (other locations); Inpatient Discharges Mercy Finance, FY10 (does not include Normal Newborns), Eureka Springs – AHA Guide 2010 data; Inpatient Patient Origin – Mercy Finance (Springfield Region), FY11; Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Physicians – Buxton, April 2012

total outpatient volume in the Berryville PSA 402,236

% Market Share 2010

OP Volume



9% MERCY HOSPITAL BERRYVILLE 36,815

6% EUREKA SPRINGS HOSPITAL 25,684

1% WASHINGTON REG. MED. CTR. 5,302

1% NORTH AR REG. MED. CTR. 5,039


10% OTHER 40,332


PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (74%) of Mercy Hospital Berryville’s acute care patients reside in Carroll County in northwest Arkansas. Four in ten patients share the same zip code (72616) as the hospital.

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE





Median Age: 42

POPULATION

PHYSICIANS











Carroll County Overall Health Rank = 16 (out of 75 counties) The lower the ranking, the healthier the community.




AR

Mercy Hospital

Mercy Clinic





%

% Market Share 2010

Discharges

70% MERCY HOSPITAL BERRYVILLE 1,149

30% EUREKA SPRINGS HOSPITAL 488

1,637 total inpatient discharges within a 25-mile radius of Mercy Hospital Berryville

Note: Includes total inpatient discharges for hospitals located within a 25-mile radius of Mercy Hospital Berryville; does not account for outmigration

3%

4%

20% 42%

5%


Discharges

27% COX SOUTH 1,173


11% COX MONETT 483


6% MERCY HOSPITAL CASSVILLE 269

5% FREEMAN HOSPITAL WEST 215

8% OTHER MERCY 338

10% OTHER 435

PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (90%) of Mercy Hospital Cassville’s acute care patients reside in Barry County in southwest Missouri. Approximately five in ten patients share the same zip code (65625) as the hospital.

Community Snapshot CASSVILLE

Sources: Map – Mercy Locations Directory, AHD (other locations); Inpatient Patient Origin & Market Share – HIDI, FFY11 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – HIDI, FFY11; Physicians – Buxton, April 2012


total outpatient volume in the Cassville PSA 531,932

% Market Share 2010

OP Volume


13% COX MONETT 68,225

8% MERCY HOSPITAL CASSVILLE 40,755


5% COX SOUTH 26,153



13% OTHER 70,400


48%

total inpatient discharges in the Cassville PSA 4,275

3%

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE


Race:86% White; 1% Multiracial Ethnicity: 11% Hispanic (of any race)

Total Area Population: 44,147 5-Yr Growth: +2


Median Age: 40

POPULATION

4%

9%

8% 9% 2% 3%

6%


In FFY11, Mercy Hospital Cassville’s top IP service lines were pulmonary (35%), cardiovascular (11%) and gastroenterology (11%).

The 82% of patients leaving the Cassville area for inpatient services primarily go to Mercy Springfield for cardiovascular and orthopedic services, and to Cox South for cardiovascular, general surgery and neurology services; 10% are leaving for Arkansas hospitals.











Barry County Overall Health Rank = 96 (out of 115 counties) The lower the ranking, the healthier the community.




Mercy Hospital

Mercy Clinic





%

MO

65584 St. Robert

Community Snapshot LEBANON



% Market Share 2010

OP Volume


17% MERCY HOSPITAL LEBANON 147,580


5% PHELPS CO. REG. MEDICAL CTR. 44,601


2% LAKE REGIONAL HEALTH SYSTEM 21,919

2% COX SOUTH 16,224

10% OTHER (incl. 0.03% Mercy) 89,385

total outpatient volume in the Lebanon PSA 880,865


PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (87%) of Mercy Hospital Lebanon’s acute care patients reside in Laclede and Pulaski Counties in central Missouri. Six in ten patients share the same zip code (65536) as the hospital.

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE


Race: 84% White; 6% Black Ethnicity: 6% Hispanic (of any race)



Median Age: 34

POPULATION


Discharges

25% MERCY HOSPITAL LEBANON 2,144


15% PHELPS CO. REG. MEDICAL CTR. 1,314

9% UNIVERSTY HOSPITALS & CLINICS 728

7% LAKE REGIONAL HEALTH SYSTEM 638

7% COX SOUTH 576

0.7% OTHER MERCY 62

16% OTHER 1,353

total inpatient discharges in the Lebanon PSA 8,552

60%

6% 6%

3%

2%

2%

2%

2%

2%


In FFY11, Mercy Hospital Lebanon’s top inpatient service lines were pulmonary and OB, both at 18%.

The 75% of patients leaving the Lebanon area for inpatient services primarily go to Mercy Springfield for cardiovascular and neurology services, and to Phelps County Regional Medical Center in Rolla, MO, for behavioral health and OB services.











Laclede County Overall Health Rank = 68 (out of 115 counties) The lower the ranking, the healthier the community.




MO

Mercy Hospital

Mercy Clinic




%

Community Snapshot MOUNTAIN VIEW



total outpatient volume in the Mountain View PSA 670,677

% Market Share 2010

OP Volume


19% OZARKS MEDICAL CENTER 130,038


8% MERCY ST. FRANCIS HOSPITAL 53,671

2% COX SOUTH 16,264


1% TEXAS COUNTY MEMORIAL 4,361

14% OTHER (incl. 0.01% Mercy) 93,930


PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (83%) of Mercy St. Francis Hospital’s acute care patients reside in Howell and Shannon Counties in southeast Missouri. Three in ten patients share the same zip code (65548) as the hospital.


Discharges

59% OZARKS MEDICAL CENTER 3,918


8% COX SOUTH 524

7% MERCY ST. FRANCIS HOSPITAL 437


2% BARNES-JEWISH HOSPITAL 116

2% POPLAR BLUFF REG. MEDICAL CTR. 108

8% OTHER (incl. 0.3% Mercy) 582

total inpatient discharges in the Mountain View PSA 6,671

34%

17%

10%

9%

9%

6%

2%

2%

2%

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE





Median Age: 40

POPULATION

34%

2%

9%

2%

6%

9%

2%

10%

Mercy Hospital

Mercy Clinic



%


In FFY11, Mercy St. Francis Hospital’s top inpatient service lines were pulmonary (43%) and gastroenterology (14%).

The 35% of patients leaving the Mountain View area for inpatient services primarily go to Mercy Hospital Springfield for cardiovascular and general surgery services.

There are approximately 82 physicians (41% primary care) located in the PSA area, of which 7% are integrated with Mercy.










Howell County Overall Health Rank = 98 (out of 115 counties) The lower the ranking, the healthier the community.


17%



MO

Oklahoma City PRIMARY SERVICE AREA

OK

The Oklahoma City Primary Service Area (PSA) comprises

six counties in central Oklahoma

Sayre, OK, Beckham County,

121 miles west of Oklahoma City

Private 56%

Medicare 13%

Uninsured 17% Medicaid

14%

DEMOGRAPHICS Oklahoma City Service Area Oklahoma 2011

US 2011 2011 2016 % Growth

Total Population 1,191,068 1,250,099 5% 3,771,943 310,650,750

0-17 25% 26% 7% 25% 24%

18-44 Females 19% 18% 1% 18% 18%

18-44 Males 19% 19% 2% 19% 19%

45-64 24% 24% 3% 25% 26%

65+ 12% 14% 16% 14% 13%

Median Age 35 - - 36 37

White 68% 66% 2% 70% 64%

Black 11% 11% 6% 8% 12%








HH Income Under $15K 14% - - 16% 13%

HH Income Over $75K 25% - - 21% 30%




Some College 32% - - 30% 28%



State of Oklahoma Government 42,100

Tinker Air Force Base Military 27,000

OU – Norman Campus Education 11,650

FAA Mike Monroney Aeronautical Center Aerospace 7,500

Integris Health Health care 6,025

City of Oklahoma City Government 5,040

MAJOR EMPLOYERS

Largest employers in the greater Oklahoma City area provided by the Economic Development Division of the Greater Oklahoma City Chamber—Mercy is listed as ninth largest with 3,450 staff:

Oklahoma City DEMOGRAPHICS R

ace

& E

thn

icit

y A

ge G

rou

ps

Ho

use

ho

lds

Edu

cati

on

Health Factor Oklahoma

County Oklahoma National

Benchmark






Children in Poverty (% of children age 0-17 in poverty) 28% 24% 13%

Preventable Hospital Stays (per 1,000 Medicare enrollees) 62 82 49

Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute


Overall Health Ranking: Oklahoma = 48 (/50 states); Oklahoma County = 32 (/77 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.


Note: Oklahoma City Service Area consists of six counties in Oklahoma; Education Level based on population age 25+ Source: Thomson Reuters, 2011

Source: Greater Oklahoma City Economic Development, March 2012

CHRONIC DISEASE

Within the six-county Oklahoma City Service Area, the following chronic conditions have been identified among the adult (18+) population:




OK US

INSURANCE COVERAGE

Hypertension 29%

Arthritis 22%

Asthma 13%

Diabetes 8%

COPD 4%


Angina 2%



4.4% 5.4%

8.2%

UNEMPLOYMENT RATE


↓0.9% MSA*

↓0.5% Oklahoma

↓0.7% US

*Oklahoma City, OK Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics

MARCH 2012

24

1

4

11

12 14

5 7 6

9

19

20

18

26

25

10

21 17 15

16 3 13

2 22

The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Oklahoma City Service Area.

Oklahoma City REGIONAL PROVIDER LANDSCAPE

OKLAHOMA

Sayre, OK, Beckham County, 121 miles west of Oklahoma City 8

23

Integris Health

SSM Health Care of OK

HCA

HealthSouth

Physician Owned

Independent

Universal Health Svcs

Freestanding General Outpatient Surgery Center


Oklahoma City REGIONAL PROVIDER LANDSCAPE

8

16

2 3

4

1

5

6

7

9

10

11

12

14

13

15

18

16

17

19

20

21

22

24


Mercy Hospital Oklahoma City* Mercy

Oklahoma Heart Hospital Mercy

Oklahoma Heart Hospital South Mercy

Mercy Hospital El Reno Mercy

Mercy Hospital Logan County Mercy

Mercy Hospital Watonga (Mercy-owned as of July 1, 2012) Mercy

Kingfisher Regional Hospital (managed facility) Mercy

Sayre Memorial Hospital (managed facility as of June 1, 2012) Mercy

Integris Baptist Medical Center* Integris Health

Integris Southwest Medical Center* Integris Health

Integris Canadian Valley Hospital Integris Health

Integris Edmond Integris Health

OU Medical Center* HCA

OU Medical Center Edmond* HCA

St. Anthony Hospital* SSM Health Care

Bone & Joint Hospital* SSM Health Care

Midwest Regional Medical Center* HMA

Norman Regional Hospital* Norman Regional Health System

Moore Medical Center* Norman Regional Health System

Healthplex* Norman Regional Health System

Deaconess Hospital* Community Health Systems

Oklahoma Spine Hospital Medical Facilities Corporation

Summit Medical Center* Physician Owned

Lakeside Women’s Hospital* Independent

McBride Clinic Orthopedic Hospital* Independent

Community Hospital* Independent

8

23

25

26


• Three general acute care hospitals: Mercy Hospital Oklahoma City, Mercy Hospital El Reno and Mercy Hospital Watonga (July 2012); one critical access facility - Mercy Hospital Logan County; two managed hospitals - Kingfisher Regional and Sayre Memorial

• Mercy broke ground on an $88 million medical complex in Edmond, OK to include a walk-in clinic, wellness and women’s centers, sports rehab , outpatient surgery and offices for 30 physicians

• Mercy, in partnership with Centerre Healthcare Corporation, broke ground on the $14 million, 50,000-sq.ft. Mercy Rehabilitation Hospital to be completed in fall 2012

• Oklahoma Heart Hospital; two campuses – North, a joint venture between Mercy and Oklahoma Heart Hospital Physicians; South, a joint venture between Mercy, Norman Regional and Oklahoma Heart Hospital Physicians

• Mercy Clinic includes 162 primary care, specialty and hospital-based physicians, 66 advanced practice providers and 534 clinic co-workers supporting over 475,000 outpatient visits to patients in 34 clinics and seven urgent/convenient care sites (physician counts as of April 2012)




Total Births

Total ED Visits

Mercy Hospital Oklahoma City 1,671 366 12,568 15,593 3,060 47,179

Oklahoma Heart Hospitals 1,523 145 6,164 11,933 0 19,524

Mercy Hospital Logan County 137 25 999 1,055 0 NA

Mercy Hospital El Reno 106 58 662 804 78 9,833

Mercy Hospital Watonga 70 25 12 381 0 NA

Managed Facilities

Kingfisher Regional Hospital 109 25 814 984 68 NA

Sayre Memorial Hospital 85 25 2 756 0 NA

TOTAL 3,701 669 21,221 31,506 3,206 76,536

INPATIENT MARKET SHARE (All except OHH)

13%

TOTAL ASSETS $208M



Note: Market share reflects a 6-county service area and includes all Mercy facilities except OHH; OHH market share uses a 24-county service area; OHH’s 24-county region represents 85% of their total discharges; OHH market share uses Mercy’s cardiology service line definition Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); OKC, El Reno – total assets, NPR, OPM, beds, births, ED visits – Mercy Finance, FY11; all other facilities: beds, births, ED visits, FTEs, total assets, NPR, OPM – AHA Guide/AHD, 2010; OHH statistics – OHH Finance, FY11; outpatient office-based clinic visits and clinic co-workers – Mercy MPO Office, FY12; Mercy FTEs – Mercy Pension & Comp, April 2012

• Non-profit, sponsored by Integris Health

• Four general acute care hospitals, an inpatient rehab hospital, a multi-specialty physician group operating 34 clinics


TOTAL ASSETS $1.2B


OPER. PROFIT MARGIN 3.9% www.integrisok.com

www.okheart.net


TOTAL ASSETS $310M






Total Births

Integris Baptist Medical Center 3,219 584 16,054 22,176 2,481

Integris Southwest Medical Center 1,229 358 11,273 13,301 1,173

Integris Canadian Valley Hospital 302 44 2,708 3,141 902

Integris Health Edmond (Oct. 2011) NA 40 NA NA NA

TOTAL 4,750 1,026 30,035 38,618 4,556

Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

www.mercy.net

• For-profit, owned by Hospital Corporation of America (HCA) • Academic medical center affiliated with University of Oklahoma College

of Medicine, the only MD program in the state • One general acute care hospital, a children’s hospital and primary care physician clinics; more than 500 physicians (150 OU Children’s Physicians)


TOTAL ASSETS $332M


OPER. PROFIT MARGIN 1.9% www.hcahealthcare.com www.oumedicine.com




Total Births

OU Medical Center (includes OU Medical Center Edmond & Children’s Hospital of OK)

2,658 554 18,826 28,140 4,280

Note: In 2010, OU Medical Center Edmond began reporting under OU Medical Center Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010


Note: Hospitals only; Financials incl. owned facilities only


Note: Oklahoma Heart Hospital North and South

Oklahoma City REGIONAL PROVIDER STATISTICS

• For-profit, community-owned

• Two general acute care hospitals, six primary care clinics and The Healthplex, a state-of-the-art specialty hospital focusing on cardiology, orthopedic/spine and women’s/children’s services

• Affiliated in partnership with Mercy and Oklahoma Heart Hospital Physicians in Oklahoma Heart Hospital’s new south campus


TOTAL ASSETS $449M






Total Births

Norman Regional Health System - includes Norman Regional, Moore Medical

Center and The Healthplex

2,118 358 12,825 17,764 2,927 www.normanregional.com




Total Births

Deaconess Hospital Community Health Systems 1,076 313 9,508 10,771 1,200

McBride Clinic Orthopedic Hospital Independent 286 78 1,343 2,678 0

Lakeside Women’s Hospital Independent 141 23 1,333 1,563 1,374

Oklahoma Spine Hospital Medical Facilities Corporation 192 23 1,047 2,176 0

Community Hospital Independent 315 37 1,027 1,769 0

Summit Medical Center Physician-owned 60 15 147 284 0

Source: IP discharges (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide/AHD, 2010 data

Other Health Care Providers in the Oklahoma City Service Area

• Non-profit, sponsored by SSM Health Care of Oklahoma

• A general acute care hospital, orthopedic specialty hospital, network of primary care physician clinics, ambulatory sports medicine/rehabilitation facility, ambulatory surgery center, and home health agencies

• Saints Medical Group includes 60 primary and specialty physicians serving 30 locations


TOTAL ASSETS $240M


OPER. PROFIT MARGIN -2.6% www.ssmhc.com




Total Births

St. Anthony Hospital 1,873 463 14,035 18,758 1,303

Bone & Joint Hospital 168 33 Included above Included above 0

TOTAL 2,041 496 14,035 18,758 1,303 Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs, total assets, NPR, OPM – AHD, 2010



Oklahoma City REGIONAL PROVIDER STATISTICS



• For-profit, owned and operated by Health Management Associates (HMA)

• General acute care hospital, Renaissance Women’s Center of Midwest City on campus


TOTAL ASSETS $99M






Total Births

Midwest Regional Medical Center 1,059 255 12,648 14,303 947 www.midwestregional.com

Note: Hospital only


http://www.normanregional.com/en/index.html

Advanced Practice

29% Hospital-based

9%

Specialists 22%

Primary Care 40%


Center for Women’s Health 5%

Oklahoma Spine & Sports Rehab 5%

Goff & Shanbour MDs & Assoc. (OB/Gyn) 5%

Mark G. Miles, MD (Internal Medicine) 3%

Neuroscience Specialists 3%

Parrington & Freeman (Pediatrics) 3%

Perinatal Center Oklahoma 2%

Funnell, Strebel and Hager, MDs (OB/Gyn) 2%

Northwest Pediatrics of Oklahoma City 1%

Pediatrics Medical Group 1%

Other 31%

0 1,000 2,000 3,000

Gastro

Pulm

Gen Surg

Neuro

OB

2010 Discharges


In 2010, only 2% of patients received inpatient care at hospitals located outside the Oklahoma City PSA, including 0.1% at Mercy hospitals

Oklahoma City OK US


Specialty 100 63 81

Total 222 167 197

Mercy Hospital Oklahoma City

Note: Mercy service lines used; based on volumes within the PSA Source: Oklahoma State Data, 2010

Source: Oklahoma State Data, 2009-2010 (does not include Normal Newborns)

Hospital 2009 2010

OU Medical Center-Oklahoma City, OK 13% 14%

Integris Baptist Medical Center-Oklahoma City, OK 12% 12%

St. Anthony Hosp. (incl. Bone & Joint)-Oklahoma City, OK 11% 11%

Norman Regional Hospital-OK 10% 10%

Midwest Regional Medical Center-OK 10% 10%

Mercy Hospital Oklahoma City-OK 10% 10%

Integris Southwest Medical Center-Oklahoma City, OK 9% 9%

Deaconess Hospital-Oklahoma City, OK 7% 7%

Oklahoma Heart Hospital-Oklahoma City, OK 3% 4%

Integris Canadian Valley Regional Hospital-Yukon, OK 2% 2%

McBride Clinic Orthopedic Hospital-Oklahoma City, OK 1% 1%

Lakeside Women's Hospital-Oklahoma City, OK 1% 1%

Oklahoma Heart Hospital South-Oklahoma City, OK NA 1%

Oklahoma Spine Hospital-Oklahoma City, OK 1% 1%

Community Hospital-Oklahoma City, OK 1% 1%

Mercy Hospital Logan County-Guthrie, OK 1% 1%

Mercy Hospital Tishomingo-OK 1% 1%

Unity Health Center-Shawnee, OK 1% 1%

Mercy Hospital El Reno-OK 1% 1%

Other Mercy hospitals (owned and managed) 0.1% 0.1%

Other hospitals 5% 6% Note: Total (n) = 228 integrated Mercy physicians and advanced practitioners serving Oklahoma City and El Reno communities Source: Mercy Hospital Medical Staff Services, April 2012

Of the region’s 4M hospital-based outpatient visits, 4% occurred outside the Oklahoma City PSA (includes 0.1% Mercy hospitals)




Norman Regional Hospital-OK 4%

Mercy Hospital Oklahoma City-OK 4%

Integris Baptist Medical Center-Oklahoma City, OK 2%

Integris SW Medical Center-Oklahoma City, OK 2%

OU Medical Center-Oklahoma City, OK 2%

St. Anthony Hospital-Oklahoma City, OK 2%

Midwest Regional Medical Center-OK 2%

Deaconess Hospital-Oklahoma City, OK 1%

Oklahoma Heart Hospital-Oklahoma City, OK 1%

OU Medical Center Edmond-OK 1%

Mercy Hospital Logan County-Guthrie, OK 1%

Integris Canadian Valley Hospital-Yukon, OK 1%

Other Mercy hospitals (owned and managed) 1%


OHH ranks 1st in cardio

market share


Oklahoma City PATIENT CARE








% Change


2011 Procedures


5 Yr 10 Yr



Cardiology 433,770 23% 34%


OB/Gyn 174,123 45% 48%

Neurology 167,818 28% 41%

Nephrology 153,502 102% 160%



Note: Data is available for additional clinical service categories. *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence. Source: Thomson Reuters Outpatient Estimates, 2011



14%

12%

11%

8%

11%

% Market Share





the lowest rankings

Mercy Hospital

Integris Baptist

OU Med. Ctr.

OK US Mercy

Hospital Integris Baptist

OU Med. Ctr.

OK US

74% 75% 72% 77% 76% 4% 4% 7% 5% 5%

80% 82% 76% 83% 80% 5% 3% 5% 4% 4%

55% 64% 57% 68% 64% 12% 10% 13% 9% 10%

70% 69% 67% 71% 70% 5% 7% 8% 7% 7%

58% 56% 56% 63% 61% 25% 24% 25% 19% 21%

65% 72% 61% 73% 72% 10% 8% 15% 9% 9%

57% 61% 55% 65% 58% 11% 9% 13% 8% 11%

79% 83% 83% 82% 82% 21% 17% 17% 18% 18%

71% 74% 67% 69% 68% 6% 7% 9% 9% 9%

81% 77% 69% 69% 70% 3% 4% 6% 5% 5%

Oklahoma City PATIENT SATISFACTION

















Oklahoma City CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.


Last year, 25% of Oklahoma City consumers who took the survey chose a Mercy facility for best overall quality as well as best image or reputation.

Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Oklahoma City, OK CBSA


Total number of respondents: 1,069 Providers with 1% or less are included in “Other Facilities”; Mercy Hospital El Reno, 1%

27%

23%

11%

7%

7%

6%

3%2%2%

2%2% 8%

Integris Baptist Medical Center Mercy Hospital Oklahoma CityOU Medical Center Norman Regional HospitalSt. Anthony Hospital Deaconess HospitalIntegris Southwest Medical Center Midwest Regional Medical CenterOklahoma Heart Hospital Integris Canadian Valley Reg HospChildrens Hospital at OU Medical Center Other Facilities


Total number of respondents: 1,062 Providers with 1% or less are included in “Other Facilities”; Mercy Hospital El Reno, 1%

31%

22%11%

7%

6%

4%

3%2%2%

2% 10%

Integris Baptist Medical Center Mercy Hospital Oklahoma CityOU Medical Center Norman Regional HospitalSt. Anthony Hospital Deaconess HospitalIntegris Southwest Medical Center Oklahoma Heart HospitalIntegris Canadian Valley Reg Hosp OU Medical Center EdmondOther Facilities

33%28% 29% 29%

21% 20% 20% 20%

13% 15%17% 17%

0%

10%

20%

30%

40%

2008 2009 2010 2011

Integris Baptist Medical CenterMercy Hospital Oklahoma CityOklahoma Heart HospitalOU Medical CenterNorman Regional HospitalSt. Anthony Hospital


% r

esp

on

den

ts

Heart Care

21%

17% 18%

20%

17%

19% 19%

20%

0%

10%

20%

30%

2008 2009 2010 2011

Integris Baptist Medical CenterMercy Hospital Oklahoma CityNorman Regional HospitalDeaconess HospitalOU Medical CenterSt. Anthony Hospital


% r

esp

on

den

ts

Maternity/OB

36%

28%31%

35%

0%

10%

20%

30%

40%

2008 2009 2010 2011

Integris Baptist Medical CenterOU Medical CenterMercy Hospital Oklahoma CityCTCA at Southwestern Regional Med CtrNorman Regional HospitalSt. Anthony Hospital


% r

esp

on

den

ts

Cancer Treatment

23%

15% 16% 16%

15% 14% 14%14%

22%

27%

21%

11%

0%

10%

20%

30%

2008 2009 2010 2011

Integris Baptist Medical CenterMercy Hospital Oklahoma CityOU Medical CenterNorman Regional HospitalDeaconess HospitalSt. Anthony Hospital


res

po

nd

ents

Pediatric Services


Community Snapshot EL RENO


Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – Oklahoma State Data, 2010 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – Oklahoma State Data, 2010; Physicians – Buxton, April 2012


total outpatient volume in the El Reno PSA 2.2M

% Market Share 2010

OP Volume

53% PHYSICIAN OFFICES 1,134,689


4% MERCY HOSPITAL OKLAHOMA CITY 77,403

4% INTEGRIS CANADIAN VALLEY 77,210

2% MERCY HOSPITAL EL RENO 43,318

2% INTEGRIS BAPTIST MEDICAL CTR. 41,716

1% OKEENE MUNICIPAL HOSPITAL 27,937

2% OTHER MERCY (owned and managed) 51,959

15% OTHER 332,208

PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (88%) of Mercy Hospital El Reno’s acute care patients reside in Canadian, Blaine & Caddo Counties near central Oklahoma. Two out of every three patients share the same zip code (73036) as the hospital.

67%

5%

% Market Share 2010

Discharges

15% INTEGRIS CANADIAN VALLEY 2,443

14% INTEGRIS BAPTIST MEDICAL CTR. 2,348


9% OU MEDICAL CENTER 1,444

6% DEACONESS HOSPITAL 1,039

6% ST. ANTHONY HOSPITAL 914

4% MERCY HOSPITAL EL RENO 707


26% OTHER 4,266

16,212 total inpatient discharges in the El Reno PSA

5%

3%

3%

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE







Median Age: 37

POPULATION

Mercy Hospital

Mercy Clinic



Managed hospital


%Health Factor County OK US









Canadian County Overall Health Rank = 3 (out of 77 counties) The lower the ranking, the healthier the community.



In 2010, Mercy Hospital El Reno’s top inpatient service lines were pulmonary (25%) and OB (14%).

The 74% of residents leaving the El Reno area for inpatient services primarily go to Integris Baptist for cardiovascular and general surgery services, and to Mercy Hospital Oklahoma City for OB and neurology services.


OK

Kingfisher

Community Snapshot GUTHRIE




total outpatient volume in the Guthrie PSA 330,477

% Market Share 2010

OP Volume


28% MERCY HOSPITAL LOGAN COUNTY 92,788



2% OU MEDICAL CENTER EDMOND 8,187

2% OKLAHOMA HEART HOSPITAL 6,104

2% STILLWATER MEDICAL CENTER 5,312


14% OTHER 45,526

PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (91%) of Mercy Hospital Logan County’s acute care patients reside in Logan County in north central Oklahoma. Three in four patients share the same zip code (73044) as the hospital.

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE





Median Age: 36

POPULATION

Mercy Hospital

Mercy Clinic



Managed hospital


%

Health Factor County OK US









Logan County Overall Health Rank = 12 (out of 77 counties) The lower the ranking, the healthier the community.



In 2010, Mercy Hospital Logan County’s top inpatient service lines were rehabilitation (28%) and pulmonary (16%).

The 77% of residents leaving the Guthrie area for inpatient services primarily go to Mercy Hospital Oklahoma City for OB services and to OU Medical Center for general surgery, OB and cardiovascular services.




OK

total inpatient discharges in the Guthrie PSA 4,255

% Market Share 2010

Discharges

23% MERCY HOSPITAL LOGAN COUNTY 960

20% MERCY HOSPITAL OKLAHOMA CITY 850

14% OU MEDICAL CENTER 589

10% OKLAHOMA HEART HOSPITAL 407

8% INTEGRIS BAPTIST MEDICAL CTR. 347


19% OTHER (incl. 0.01% Mercy) 844

9%

3%

74%

Community Snapshot WATONGA PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (94%) of Mercy Hospital Watonga’s acute care patients reside in Blaine, Custer & Dewey Counties near central Oklahoma. Nearly two in three patients share the same zip code (73772) as the hospital.

64% 6%

2%

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE







Median Age: 33

POPULATION

Mercy Hospital

Mercy Clinic



Managed hospital


%










Blaine County Overall Health Rank = 36 (out of 77 counties) The lower the ranking, the healthier the community.





total outpatient volume in the Watonga PSA 577,997

% Market Share 2010

OP Volume



10% WEATHERFORD REG HOSPITAL 55,213

7% INTEGRIS CLINTON REG HOSPITAL 40,639

5% OKEENE MUNICIPAL HOSPITAL 29,136

4% MERCY HOSPITAL WATONGA 23,579

1% SEILING COMMUNITY HOSPITAL 7,818


15% OTHER 83,988


In 2010, Mercy Hospital Watonga’s top inpatient service lines were pulmonary (20%) and cardiovascular and gastroenterology (16% each).

The 54% of residents leaving the Watonga PSA for inpatient services primarily go to Integris Baptist Medical Center for cardiovascular and general surgery services and to OU Medical Center for OB and neurology services.


total inpatient discharges in the Watonga PSA 5,863

% Market Share 2010

Discharges

21% INTEGRIS CLINTON REG HOSPITAL 1,208

11% WEATHERFORD REG HOSPITAL 651

8% INTEGRIS BAPTIST MEDICAL CENTER 484

8% MERCY HOSPITAL WATONGA 451



9% OTHER MERCY (owned and managed) 550

34% OTHER 1,972

11%

2%

4%

OK

Ardmore PRIMARY SERVICE AREA

The Ardmore Primary Service Area (PSA) comprises six counties in south central Oklahoma

OK

Private 42%

Medicare 20%

Uninsured 20%

Medicaid 19%

DEMOGRAPHICS Ardmore Service Area Oklahoma 2011

US 2011 2011 2016 % Growth


0-17 25% 25% 3% 25% 24%

18-44 Females 16% 15% 0% 18% 18%

18-44 Males 16% 16% 2% 19% 19%

45-64 26% 25% -3% 25% 26%

65+ 17% 18% 10% 14% 13%

Median Age 39 - - 36 37

White 74% 72% -0.2% 70% 64%

Black 5% 5% 5% 8% 12%








HH Income Under $15K 20% - - 16% 13%

HH Income Over $75K 17% - - 21% 30%




Some College 26% - - 30% 28%



Michelin North America Manufacturing 1,700


Dollar General Distribution 750

Walmart Retail 570

Ardmore City Schools Education 450

MAJOR EMPLOYERS

Largest employers in Ardmore as listed by the Ardmore Development Authority:

Ardmore DEMOGRAPHICS R

ace

& E

thn

icit

y A

ge G

rou

ps

Ho

use

ho

lds

Edu

cati

on

Health Factor Carter County Oklahoma

National Benchmark






Children in Poverty (% of children age 0-17 in poverty) 27% 24% 13%



Overall Health Ranking: Oklahoma = 48 (/50 states); Carter County = 59 (/77 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.


Note: Ardmore Service Area consists of six counties in Oklahoma; Education Level based on population age 25+ Source: Thomson Reuters, 2011

Source: Ardmore Development Authority, 2012

CHRONIC DISEASE

Within the six-county Ardmore Service Area, the following chronic conditions have been identified among the adult (18+) population:




OK US

INSURANCE COVERAGE


Hypertension 32%

Arthritis 25%

Asthma 12%

Diabetes 9%


COPD 5%

Angina 3%


3.8% 5.4%

8.2%

UNEMPLOYMENT RATE


↓1.0% MSA*

↓0.5% Oklahoma

↓0.7% US

*Ardmore, OK Micropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics

MARCH 2012

The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Ardmore Service Area.


Mercy Hospital Ardmore* Mercy

Mercy Hospital Healdton* Mercy

Mercy Hospital Tishomingo Mercy

Mercy Health Love County* (managed facility) Mercy

Arbuckle Memorial Hospital (managed facility) Mercy

Valley View Regional Hospital (managed facility) Mercy

Integris Marshall County Medical Center* (joint venture with HMA) Integris Health

Medical Center of Southeastern Oklahoma* Health Management Associates (HMA)

Duncan Regional Hospital* Independent

Jefferson County Hospital Independent

Ardmore REGIONAL PROVIDER LANDSCAPE

10

2

6

5

1 3

7

4 8

1

2

3

4

5

6

7

8

9

10

9


Surgery Center

Physician Owned


OKLAHOMA

• OU Medical Center – 4% market share, 552 acute discharges

• Oklahoma Heart Hospital – 4%, 502

• Integris Baptist Medical Center – 2%, 310

• Norman Regional Hospital – 2%, 267

• Mercy Hospital OKC – 2%, 247




Total Births

Total ED Visits

Mercy Hospital Ardmore 666 151 6,977 7,667 918 34,720

Mercy Hospital Tishomingo 34 25 325 359 0 1,354

Mercy Hospital Healdton 35 22 174 185 0 3,485

Managed Facilities

Arbuckle Memorial Hospital 101 25 516 565 0 NA

Mercy Health Love County 123 25 420 454 0 NA

Valley View Regional Hospital 518 110 230 4,429 500 NA

TOTAL 1,477 358 8,642 13,659 1,418 39,559


• Three general acute care hospitals; new cancer treatment center opened in partnership with the Ardmore Chamber of Commerce Foundation

• Managed facilities include one general acute care (Valley View in Ada) and two critical access hospitals (Arbuckle Memorial in Sulphur and Mercy Health Love County in Marietta)

• Mercy Clinic consists of 35 primary care, specialty and hospital-based physicians, 15 advanced practice providers and 145 clinic co-workers supporting over 56,000 outpatient visits to patients in five clinics and one urgent/convenient care site (physician counts as of April 2012)

INPATIENT MARKET SHARE (all facilities)

62%

TOTAL ASSETS $111M



Note: Market share includes all facilities above; total assets, NPR and OPM are for Mercy owned facilities only Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, ED visits – Mercy Finance, FY11; managed facilities beds, births, FTEs – AHD, 2010; outpatient office-based clinic visits and clinic co-workers – Mercy MPO Office, FY12; Mercy FTEs – Mercy Pension & Comp, April 2012

www.mymcso.com




Total Births

Medical Center of Southeastern Oklahoma 524 148 1,000 8,408 1,148

• For-profit, owned and operated by Health Management Associates (HMA)

• One general acute care hospital located in Durant, OK approximately 45 miles east of Ardmore


TOTAL ASSETS $42M


OPER. PROFIT MARGIN NA Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010

www.mercy.net

Note: Hospital only

www.integrisok.com




Total Births

Integris Marshall County Medical Center 93 21 695 750 0

• Non-profit, joint venture between Integris Health and Health Management Associates (HMA)

• Critical access hospital located in Madill, OK approximately 26 miles east of Ardmore


TOTAL ASSETS $1M


OPER. PROFIT MARGIN -5.4% Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010 Note: Hospital only




Total Births

Duncan Regional Hospital 730 124 285 4,920 506

Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data

Additionally, these Oklahoma City providers account for a portion of market share from Ardmore Region residents:

Note: Hospitals only; financials include only Mercy owned facilities

• Non-profit, independent hospital located in Duncan, OK approximately 70 miles from Ardmore

• One acute care hospital, eight physician clinics and 70 physicians on staff

www.duncanregional.com

Ardmore REGIONAL PROVIDER STATISTICS

Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns)


http://integrismarshallcounty.com/

http://www.duncanregional.com/default.cfm

Advanced Practice

30%

Hospital-based 28%

Specialists 18%

Primary Care 24%

54%

62%

71%

48%

48%

0 500 1,000 1,500

Gastro

Ortho

OB

Pulm

Cardio

2010 Discharges


In 2010, 33% of patients received inpatient care at hospitals located outside the Ardmore PSA, including 8% at Mercy hospitals


Nedley Clinic 5%

Bone and Joint Clinic of Oklahoma 5%

OSU Center for Health Sciences 5%

David Dean Rose, MD (Internal Medicine) 5%

Family Health Center of Ardmore 5%

Southern Oklahoma Women’s Health 4%

Life Cycle Women’s Care 4%

Pulmonary Medical Clinic 4%

Shockey Internal Medicine 3%

Doctors Clinic 2%

Cornerstone Family Healthcare 2%

Other 23%

Ardmore OK US


Specialty 33 63 81

Total 94 167 197

Mercy Hospital Ardmore

Hospital 2009 2010

Mercy Hospital Ardmore-OK 50% 50%

Medical Center of SE Oklahoma-Durant, OK 8% 7%

Integris Marshall County Med. Ctr.-Madill, OK 5% 5%

OU Medical Center-Oklahoma City, OK 4% 4%

Arbuckle Memorial Hospital-Sulphur, OK 3% 4%

Oklahoma Heart Hospitals-Oklahoma City, OK 3% 4%

Mercy Health Love County-Marietta, OK 3% 3%

Mercy Hospital Tishomingo-OK 2% 2%

Integris Baptist Med. Ctr.-Oklahoma City, OK 2% 2%

Duncan Regional Hospital-OK 2% 2%

Norman Regional Hospital-OK 2% 2%

Mercy Hospital Oklahoma City-OK 2% 2%

Valley View Regional Hospital-Ada, OK 2% 2%

Jefferson County Hospital-Waurika, OK 2% 2%

St. Anthony Hospital-Oklahoma City, OK 1% 1%

Mercy Hospital Healdton-OK 2% 1%




Physician’s Offices* 54%

Mercy Hospital Ardmore-OK 12%


Arbuckle Memorial Hospital-Sulphur, OK 3%

Mercy Health Love County-Marietta, OK 2%

Integris Marshall County Med. Center-Madill, OK 2%

Carl Albert Indian Hospital-Ada, OK 1%

Duncan Regional Hospital-OK 1%

Medical Center of SE Oklahoma-Durant, OK 1%

Mercy Hospital Tishomingo-OK 1%

Jefferson County Hospital-Waurika, OK 1%

Mercy Hospital Healdton-OK 1%

Other Mercy hospitals (owned and managed) 1%


Note: Total (n) = 50 integrated Mercy physicians and advanced practitioners serving Ardmore and Healdton communities Source: Mercy Hospital Medical Staff Services, April 2012

Of the region’s 408,161 hospital-based outpatient visits, 23% occurred outside the Ardmore PSA (1% at Mercy hospitals)


Ardmore PATIENT CARE








% Change


2011 Procedures


5 Yr 10 Yr



Nephrology 31,371 63% 92%



Neurology 12,483 31% 40%

OB/Gyn 11,800 54% 57%



Note: Data is available for additional clinical service categories. *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence. Source: Thomson Reuters Outpatient Estimates, 2011



Note: Mercy service lines used; based on volumes within the PSA Source: Oklahoma State Data, 2010

Source: Oklahoma State Data, 2009-2010 (does not include Normal Newborns)





the lowest rankings

Mercy Hospital

Med Ctr of SE OK

Integris Marshall Co

OK US Mercy

Hospital Med Ctr of SE OK

Integris Marshall Co

OK US

75% 71% 86% 77% 76% 6% 9% 3% 5% 5%

81% 80% 92% 83% 80% 4% 7% 2% 4% 4%

63% 55% 83% 68% 64% 12% 18% 5% 9% 10%

71% 63% 75% 71% 70% 7% 11% 10% 7% 7%

56% 59% 75% 63% 61% 23% 26% 17% 19% 21%

75% 67% 82% 73% 72% 7% 12% 7% 9% 9%

60% 57% 71% 65% 58% 13% 14% 8% 8% 11%

81% 78% 83% 82% 82% 19% 22% 17% 18% 18%

65% 59% 70% 69% 68% 10% 14% 7% 9% 9%

62% 60% 71% 69% 70% 5% 10% 7% 5% 5%

Ardmore PATIENT SATISFACTION

















Community Snapshot HEALDTON


Sources: Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – Oklahoma State Data, 2010 (does not include Normal Newborns); Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – Oklahoma State Data, 2010; Physicians – Buxton, April 2012


total outpatient volume in the Healdton PSA 725,635

% Market Share 2010

OP Volume


17% MERCY HOSPITAL ARDMORE 121,946


2% DUNCAN REGIONAL HOSPITAL 14,597

2% MERCY HOSPITAL HEALDTON 10,677

1% JEFFERSON COUNTY HOSPITAL 10,249

1% CARL ALBERT INDIAN HOSPITAL 10,041


7% OTHER 48,188

PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (94%) of Mercy Hospital Healdton’s acute care patients reside in Carter and Jefferson Counties in south central Oklahoma. About four in ten patients share the same zip code (73438) as the hospital.

% Market Share 2010

Discharges



4% DUNCAN REGIONAL HOSPITAL 278

4% OKLAHOMA HEART HOSPITAL 269

3% JEFFERSON COUNTY HOSPITAL 230

2% MERCY HOSPITAL HEALDTON 173


12% OTHER 915

7,555 total inpatient discharges in the Healdton PSA

39% 9%

22%

16%

3%

2%

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE





Median Age: 38

POPULATION










Carter County Overall Health Rank = 59 (out of 77 counties) The lower the ranking, the healthier the community.



In 2010, Mercy Hospital Healdton’s top inpatient service lines were rehabilitation (31%) and pulmonary (25%).

The 27% of residents leaving the Healdton area for inpatient services primarily go to OU Medical Center for neurology and general surgery services, and to Duncan Regional for OB and orthopedic services.


Mercy Hospital

Mercy Clinic



Managed hospital


%



OK

Community Snapshot TISHOMINGO


Sources: Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – Oklahoma State Data, 20010 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – Oklahoma State Data, 2010; Physicians – Buxton, April 2012


total outpatient volume in the Tishomingo PSA 327,148

% Market Share 2010

OP Volume



8% INTEGRIS MARSHALL COUNTY 26,183


3% MEDICAL CTR. OF SE OKLAHOMA 10,962

3% MERCY HOSPITAL TISHOMINGO 10,739

2% TEXOMA MEDICAL CENTER 7,170


11% OTHER 35,224

PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (87%) of Mercy Hospital Tishomingo’s acute care patients reside in Johnston and Marshall Counties in south central Oklahoma. Two of every three patients share the same zip code (73460) as the hospital.

% Market Share 2010

Discharges

27% MEDICAL CTR. OF SE OKLAHOMA 964

23% MERCY HOSPITAL ARDMORE 820

19% INTEGRIS MARSHALL COUNTY 672

9% MERCY HOSPITAL TISHOMINGO 312



11% OTHER 373

total inpatient discharges in the Tishomingo PSA 3,545

67% 6%

4%

4%

2%

HOUSEHOLD ECONOMICS


INSURANCE COVERAGE





Median Age: 40

POPULATION










Johnston County Overall Health Rank = 67 (out of 77 counties) The lower the ranking, the healthier the community.



In 2010, Mercy Hospital Tishomingo’s top inpatient service lines were pulmonary (33%) and cardiovascular (16%).

The 72% of residents leaving the Tishomingo area for inpatient services primarily go to the Medical Ctr. Of SE OK for OB and cardiovascular services, and to Mercy Hospital Ardmore for orthopedic and cardiovascular services.


Mercy Hospital

Mercy Clinic



Managed hospital


%



OK

2012 strategic update book

Documents