HCA Investor Day

1
Milton JohnsonSVP and Controller
Mark Kimbrough VP, Investor Relations
Goldman Sachs
2004
HCA
2
This press release contains forward-looking
statements based on current management
expectations. Those forward-looking statements
include all statements regarding our estimated
results of operations in future periods and all
statements other than those made solely with
respect to historical fact. Numerous risks,
uncertainties and other factors may cause actual
results to differ materially from those expressed
in any forward-looking statements. These factors
include, but are not limited to (i) increases in
the amount and risk of collectability of
uninsured accounts and deductibles and co-pay
amounts for insured accounts, (ii) the ability to
achieve operating and financial targets and
achieve expected levels of patient volumes and
control the costs of providing services, (iii)
the highly competitive nature of the health care
business, (iv) the efforts of insurers, health
care providers and others to contain health care
costs, (v) possible changes in the Medicare and
Medicaid programs that may impact reimbursements
to health care providers and insurers, (vi) the
ability to attract and retain qualified
management and personnel, including affiliated
physicians, nurses and medical support personnel,
(vii) potential liabilities and other claims that
may be asserted against the Company, (viii)
fluctuations in the market value of the Companys
common stock, (ix) the impact of the Companys
charity care and self-pay discounting policy
changes, (x) changes in accounting practices,
(xi) changes in general economic conditions,
(xii) future divestitures which may result in
charges, (xiii) changes in revenue mix and the
ability to enter into and renew managed care
provider arrangements on acceptable terms, (xiv)
the availability and terms of capital to fund the
expansion of the Companys business, (xv) changes
in business strategy or development plans, (xvi)
delays in receiving payments for services
provided, (xvii) the possible enactment of
Federal or state health care reform, (xviii) the
outcome of pending and any future tax audits and
litigation associated with the Companys tax
positions, (xix) the outcome of the Companys
continuing efforts to monitor, maintain and
comply with appropriate laws, regulations,
policies and procedures and the Companys
corporate integrity agreement with the
government, (xx) changes in Federal, state or
local regulations affecting the health care
industry, (xxi) the ability to successfully
integrate the operations of Health Midwest,
(xxii) the ability to develop and implement the
payroll and human resources information system
within the expected time and cost projections
and, upon implementation, to realize the expected
benefits and efficiencies, and (xxiii) other risk
factors detailed in the Companys filings with
the SEC. Many of the factors that will determine
the Companys future results are beyond the
ability of the Company to control or predict. In
light of the significant uncertainties inherent
in the forward-looking statements contained
herein, readers should not place undue reliance
on forward-looking statements, which reflect
managements views only as of the date hereof.
The Company undertakes no obligation to revise or
update any forward-looking statements, or to make
any other forward-looking statements, whether as
a result of new information, future events or
otherwise.   All references to Company and
HCA as used throughout this document refer to
HCA Inc. and its affiliates.
Goldman Sachs
2004
HCA
2
3
HCA is located in 16 of 20 Fastest Growing
Large US Cities
Dallas/Ft. Worth 12

• Generally 25-40 Market Share
• 40 of facilities in Texas Florida

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


Palm Beach 11
Percent Growth in Market Population 2000-2005
Tampa Bay 8
Houston 10
Dade 8
Compared to the National Average of 4.5
4
Health Care Market Outlook Strong
National Health Care Spending 1990 2010
U.S. Healthcare Expenditures ( Billions)
12.0
13.4
13.3
14.8
15.4
15.9
16.4
17.1
National Health Care Expenditures as a Share of
Total GDP
Will the U.S. economy shift 2.3 of GDP to health
care services over the next seven years?
Source U.S. Centers for Medicare and Medicaid
ServicesNational Health Expenditure Projections,
2003
5
Inpatient Admissions and Outpatient Visits 1980
- 2002
Inpatient Admissions
Outpatient Visits (millions)
Admissions (millions)
Outpatient Visits
Source AHA Annual Survey, 1980 - 2002
6
HCA Admission Trends 2001 to 1Q 2004Same Facility
15.4
HCA Growing Medicare Market Share Growth in
Medicare Admissions 1998-2001
Market Competitors
HCA
7
Admissions growth rates vary by market
Average Chg. 2.5 1
Admissions Change
Total Admissions Determine Bubble Size
Admissions Change
1 Same Facility 2 Denver is a non-consolidating
JV Market
Volume Variance by Market 1st Quarter Same
Market
8
HCA Capital Expenditures
Billions
2000 1.2
2001 1.4
2002 1.7
2003 1.8
2004E 1.8
Expansions
Open Heart,
Imaging Cardiology, Oncology, etc.
54 Facilities with Surgery and/or ICU/CCU
expansions
1,565 New Beds
Four New Facilities 378 Beds
Distribution of Capital Dollars 2002 and Beyond
9
The Genesis of the Bad Debt/Charity Care Issue
HCA is in 14 of the 20 highest uninsured states,
with 72 of its hospitals in those states
17.0
13.1
13.1
22.2
21.2
15.9
National Average 15.2 1
19.3
19.2
18.1
15.1
15.4
15.4
16.4
23.5
20.3
14.6
23.5
HCA Weighted Average 22.6 2
16.7
19.7
29.7
25.6
22.8
22.2
gt20 Uninsured
15-20 Uninsured
lt15 Uninsured
1 U.S. Census Bureau Health Insurance
Coverage in the United States 2002. 2 Kaiser
Commission Health Ins. Coverage of Nonelderly
Adults 2001-2002.
10
ER has the highest volume of uninsured requires
intervention
ER Visits 1,235,641 ?2.3
ER Visits 1,025,639
Admitted 210,002
17
83
Medicare 103,820
Uninsured 13,313
Managed/ Medicaid 92,869
Medicare 109,235
Uninsured 231,436 95
Managed/ Medicaid 684,968
95
5
Net Change 1Q03-04
Net Change 1Q03-04
?
?
?
?
?
?
?
?
1st Quarter 2004 Eastern Western Groups
10
11
Origination of Bad Debt Expense
How System is Accessed
75-80 Uninsured Patients
20-25 Co-Pay Deductibles

• ?1Q 01 vs. 1Q 04 front-
• end collections ?93,
• percent collected ?53,
• co-pays/deductibles
• ? 25
• ? Intensify collections at
• discharge and post
• discharge
• Minimum front-end
• deposit requirements

11
12
Bad Debt Action Plan

• ? Patient Financial
• Management Committee
• ? In-house case management
• ? Concurrent financial
• counseling
• ? Standard discharge
• process

• Follow-up care
• criteria established.

• Screen all potential
• non-emergent
• patients by
• qualified medical
• personnel
• Once stabilized or
• deemed
• non-emergent,
• proceed
• with collection effort
• ? Mandatory ER case
• management

• Executive
• Management
• approval must be
• obtained
• ? Minimum deposit
• standards
• ? Enhanced front-end
• collection goals

12
13
Enhanced Outpatient Services Focus
O/P Comprised of Three Business Lines
2003 of HCA Net Revenue
As a of Outpatient Surgeries
70
Hospital Based
Outpatient Surgeries
15.3
ASC Based
30
14
2004 Managed Care Contracting
6,844 Facility Level Active Contracts
2005 Contract Pricing Timeline
1Q04
2Q04
3Q04
4Q04
Pre-2004
2005 Cumulative
Anticipated Completion Dates
Net Revenue per Adjusted Admission Managed Care
Other Discounted
11.1
9.9
83 of 2004 and 42 of 2005 contracts completed.
14
15
Operating Expenses per Adjusted Admission
Managed Effectively

2001
2002
2003
2004
Operating Expenses/AA Percent Change from Prior
Year
Same Facility Percent Change from Prior Year
15
16
Employee Satisfaction at Record Levels
Turnover Rate
Satisfaction Score
16
17
Strong Cash Flow Trends Provide Opportunities
Net Cash Provided by Operating Activities Dollars
in Millions
Capital Reinvestment
Balance Sheet
Share Repurchase Program
New Dividend Policy
Excluding settlements with government agencies
and investigation related costs.
18
Opportunities Of Having Strong Cash Flow
Share repurchase program
42.19/share
35.76/share
YTD 20041
7.3 Billion 244 Million Shares 38 of
outstanding shares Average Price 30.03
422M 10.0M Shares
45.53/share
2003
1.1B 31.1M Shares
2002
36.88/share
282M 6.2M Shares
706M 19.2M Shares
2001
28.65/share
2000
1.3B 43.5M Shares
24.61/share
1.4B 55.6M Shares
1999
22.68/share
930M 41M Shares
1998
33.59/share
1997
1.3B 37.9M Shares
1 2004 purchases through 5-6-04
2 Includes other activities affecting share
balance (stock option exercises, restricted
grants, and ESPP activity).
19
HCA is Investing Significantly in Programs for
Patient Safety and Improved Patient Outcomes
? E MAR Medication Error Prevention ? E POM
Physician Order Entry ? 100 Participation in
CMS Quality Reporting Initiative ? Member of NQF
and Leapfrog ? Cardiovascular, OB and Emergency
Department Initiatives
20
In Summary We Have.
Great Assets
Excellent Investment Opportunities
Strong Cash Flows
Excellent Long-Term Earnings Growth Outlook
A prudent financial strategy that provides for a
strong balance sheet and return of cash to
shareholders through share repurchase and/or
dividends