HCA Financial Analysis

Presenters:Rick LandonDan WingardHouston Hillin

Tony Sidera

August 26. 2015

HCA BackgroundAt its founding in 1968, Nashville-based HCA was one of the nation's first hospital

companies. HCA is the nation's leading provider of healthcare services, a company comprised of locally managed facilities employing approximately 204,000 people. Approximately four to five percent of all inpatient care delivered in the country today is provided by HCA facilities.

HCA is committed to the care and improvement of human life and strives to deliver high quality, cost effective healthcare in the communities we serve. Building on the foundation provided by our Mission & Values, HCA puts patients first and works to constantly improve the care we give them by implementing measures that support our caregivers, help ensure patient safety and provide the highest possible quality.

HCA typically invests about $1.5 billion annually to keep our facilities modern and up-to-date technologically and to expand and add services where needed. Focusing primarily on communities where the company is a leading healthcare provider, HCA selectively adds new facilities in order to better serve our communities.

Two of the HCA founders were physicians, we value highly the strong relationships we've created with local physicians. We endeavor to provide them with a wide array of services and modern facilities in order to help them deliver the best possible care.

HCA BackgroundAt its founding in 1968, Nashville-based HCA was one of the nation's first hospital

companies. HCA is the nation's leading provider of healthcare services, a company comprised of locally managed facilities employing approximately 204,000 people. Approximately four to five percent of all inpatient care delivered in the country today is provided by HCA facilities.

HCA is committed to the care and improvement of human life and strives to deliver high quality, cost effective healthcare in the communities we serve. Building on the foundation provided by our Mission & Values, HCA puts patients first and works to constantly improve the care we give them by implementing measures that support our caregivers, help ensure patient safety and provide the highest possible quality.

HCA typically invests about $1.5 billion annually to keep our facilities modern and up-to-date technologically and to expand and add services where needed. Focusing primarily on communities where the company is a leading healthcare provider, HCA selectively adds new facilities in order to better serve our communities.

Two of the HCA founders were physicians, we value highly the strong relationships we've created with local physicians. We endeavor to provide them with a wide array of services and modern facilities in order to help them deliver the best possible care.

HCA Products & GeographyCORPORATE PROFILE:

HCA owns and operates approximately 166 hospitals and approximately 113 freestanding surgery centers. We are dedicated to providing healthcare services that meet each community's local healthcare needs.

We seek to integrate various services to deliver patient care with maximum quality and efficiency. Our approach includes focusing on quality; streamlining operations; sharing technology, equipment and personnel where appropriate; and using economies of scale when contracting for medical supplies and administrative services.PRODUCTS:

Acute care hospitals provide a full range of services to accommodate such medical specialties as internal medicine, general surgery, cardiology, oncology, neurosurgery, orthopedics and obstetrics, as well as diagnostic and emergency services.

Outpatient and ancillary health care services are provided by our general, acute care hospitals, freestanding surgery centers, freestanding emergency care facilities, diagnostic centers and rehabilitation facilities. Our psychiatric hospitals provide a full range of mental health care services through inpatient, partial hospitalization and outpatient settings.GEOGRAPHY:

Currently HCA operates in 20 states and London, England.

CEO BackgroundR. Milton Johnson Chairman and Chief Executive Officer

R. Milton Johnson is chairman and chief executive officer of Nashville, Tennessee-based HCA. He began his 33-year career in healthcare in 1982, leaving Ernst & Young, where he had practiced as a CPA. After many roles, including head of the company’s Tax Department, senior vice president and controller, then executive vice president and chief financial officer, Johnson became president of HCA in 2011.

He assumed his duties as CEO in January of 2014 and was appointed to HCA’s board of directors in 2009.

In his role, Johnson leads a nearly $36 billion integrated healthcare system that includes approximately 166 hospitals, 113 freestanding surgery centers, and more than 35,000 affiliated physicians in 20 states and the United Kingdom. HCA employs approximately 220,000 people, about 35 percent of whom are registered nurses.

HCA has seen steady advancement in its clinical agenda and 85% of HCA’s hospitals reporting core measure performance data to The Joint Commission for 2013 were included on TJC’s “Top Performers” list, as compared to only slightly more than one-third of all TJC-accredited hospitals reporting 2013 data.

A native of Nashville, Johnson received his bachelor’s degree in business administration from Belmont University.

Financial Analysis 2014 2013 Metric

Cash

Cash and Cash Equivalent $566 $414 Cash

Net Cash Provided by Operating Activities $4,448 $3,680 Cash Flow

Profit

Total Revenues $36,918 $34,182 Total Revenue

Income before income Taxes $3,481 $2,946 Operating Profit

Income before income TaxesTotal Revenue 9.43% 8.62%

Operating Profit Margin

Share Holder Net Income $1,875 $1,556 Net Profit

Share Holder Net IncomeTotal Revenue 5.08% 4.55% Net Profit Margin

SH Net inc Per Share- Diluted EPS -$6,498 -$6,928 Earnings per Share

Assets ShareHolder Net IncomeTotal Shareholder Equity -29.00% -22.00% Return on Equity

Growth

Total Revenues 8.00% 3.50% Revenue Growth

Shareholder Net Income20.00% -3.10% Net Income Growth

SH Net inc Per Share- Diluted EPS 23.40% -3.40%Earnings per Share Growth

Stock Performance

Payees

Physicians / Medical Professionals

Competition

Investors

Risk Landscape

Competition

Risk Landscape

Our substantial leverage could adversely affect our ability to raise additional capital to fund our operations, limit our ability to react to changes in the economy or our industry, expose us to interest rate risk to the extent of our variable rate debt and prevent us from meeting our obligations.

We may not be able to generate sufficient cash to service all of our indebtedness and may not be able to refinance our indebtedness on favorable terms. If we are unable to do so, we may be forced to take other actions to satisfy our obligations under our indebtedness, which may not be successful.

Our facilities are heavily concentrated in Florida and Texas, which makes us sensitive to regulatory, economic, environmental and competitive conditions and changes in those states.

Emerging Competition: in recent years the number of freestanding specialty hospitals, surgery centers, emergency departments, urgent care centers and diagnostic and imaging centers in the geographic areas in which we operate has increased significantly.

PayeesRisk Landscape

Government:• New / unpredictable regulations

• Penalties? • Compliance costs?

• Inability to predict ACA adoption

Private:• While HCA expects contracted annual average increases cted to yield 4% to 5% from

managed care payers during 2014, there can be no assurance that we will continue to receive increases in the future.

• The trend toward consolidation among non-government payers tends to increase their bargaining power over fee structures.

Physicians / Medical Professionals

Risk Landscape

Our performance depends on our ability to recruit and retain quality physicians. Our hospitals face competition for staffing, which may increase labor costs and reduce profitability.

Investors

Risk Landscape

On November 17, 2006, HCA Inc. was acquired by a private investor group, including affiliates of or funds sponsored by Bain Capital Partners, LLC, Kohlberg Kravis Roberts & Co., BAML Capital Partners and HCA founder, Dr. Thomas F. Frist, Jr.

The Investors may continue to have influence over us and may have conflicts of interest with us in the future.

Leveraged

Common Stock Repurchase

Income Statement

Balance Sheet

Statement of Cash Flows

Sales Revenue

Insight:Approximately 54% Revenue comes via Managed Care Insurers (e.g. Cigna)Approximately 43% Revenue comes via Medicaid / Medicare Insurers (e.g. Healthspring)

Hospital Utilization

Insight:Hospital utilization has increased 2% over the last 5 years

Competition:Generally, other hospitals in the communities we serve provide services similar to those offered by our hospitals. Additionally, in recent years the number of freestanding specialty hospitals, surgery centers, emergency departments, urgent care centers and diagnostic and imaging centers in the geographicareas in which we operate has increased significantly. As a result, most of our hospitals operate in a highly competitive environment. In some cases, competing hospitals are more established than our hospitals. Some competing facilities are physician-owned or are owned by tax-supported government agencies and many others are owned by not-for-profit entities that may be supported by endowments, charitable contributions and/or tax revenues and are exempt from sales, property and income taxes. Such exemptions and support are not available to our hospitals.