34th Annual J.P. Morgan Healthcare Conference
San Francisco, CA January 11, 2016
Milton Johnson Chairman of the Board & Chief Executive Officer Sam Hazen Chief Operating Officer Vic Campbell Senior Vice President Mark Kimbrough Vice President, Investor Relations
Forward Looking Statements and Non-GAAP Financial Measures
This presentation may contain certain forward-looking statements provided by Company management. These statements are intended to be covered by the safe-harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include all statements that do not relate solely to historical or current facts, including statements regarding future operations, financial results, cash flows, costs and cost management initiatives, capital structure management, growth rates, and operational and strategic initiatives, and can also be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “intend,” “plan,” “initiative,” “continue” or words or phrases of similar meaning. These forward-looking statements speak only as of the date hereof and are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control. These risks and uncertainties are described under headings such as “Risk Factors” in our annual report on Form 10-K for the year ended December 31, 2014 and other reports filed with the Securities and Exchange Commission. As a consequence, current plans, anticipated actions and future financial position and results of operations may differ significantly from those expressed in any forward-looking statements in today’s presentation. You are cautioned not to unduly rely on such forward-looking statements when evaluating the information presented and we do not intend to update any of these forward-looking statements.
The presentation may contain certain non-GAAP measures, including Adjusted EBITDA. The Company’s earnings releases for the year ended December 31, 2014, and quarter and nine months ended September 30, 2015, located on the Company’s investor relations page at www.hcahealthcare.com, include reconciliations of the difference between certain non-GAAP financial measures with the most directly comparable financial measure calculated in accordance with GAAP. These non-GAAP financial measures should not be considered alternatives to the GAAP financial measures.
References to “Company” used herein refer to HCA Holdings, Inc. and its affiliates, unless otherwise stated or indicated by context.
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Positioned to succeed
Healthcare industry overview
Who we are
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Who we are
Pearland Medical Center Pearland, Texas Opened February 2015
Sources of differentiation
Deep and experienced leadership
Scale
Diversified portfolio
Financial strength
Strong
operating culture
5
Nashville 34%
Tampa/ St. Pete
29%
Denver 32%
Dallas/ Fort Worth
18% Austin
41%
Houston 19%
Kansas City 23%
Miami/Fort Lauderdale
22%
Las Vegas 32%
Western Idaho
Idaho Falls
Wichita
Oklahoma City
Las Vegas
El Paso
Brownsville
McAllen
Corpus Christi
New Orleans
Central Louisiana
Lafayette
Panhandle
Tallahassee Jacksonville
North Central Florida
Orlando
Treasure Coast
Charleston
Myrtle Beach
New Hampshire
Augusta
Middle GA
Chattanooga
NWGA Atlanta
Terre Haute
Frankfort
NOVA
SWVA
Anchorage
London
Richmond 37%
San Jose 17%
Salt Lake 20%
Diversified portfolio in growing markets
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Note: Percentages represent current market share1
San Antonio
36%
Diversified mix of facilities and services
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Acute Care
Shared Services
Access Centers
167
44K
Ambulatory Services
Hospitals
Licensed Beds
113
15
GI Centers
Urgent Care Centers
66
55
Freestanding ERs
Physicians
Physician Clinics
~830
35K
Active Medical Staff
ASCs
Enterprise Services
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Delivering strong topline growth
Admissions 3.7%
4.6% Equivalent Admissions
ER Visits
Surgeries
6.9%
2.4%
Values represent LTM September 2015 Percentages represent 5 year CAGR: 2010 – LTM September 2015
Revenue 6.9%
1.9M
3.1M
8.0M
1.4M
$39.1B
Converting to solid EBITDA growth
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5-year Adjusted EBITDA CAGR: 5.7%
5 year adjusted EBITDA CAGR: 2010 – LTM September 2015
In B
illi
on
s
$5.9
$7.7
$5.0
$5.5
$6.0
$6.5
$7.0
$7.5
$8.0
2010 2011 2012 2013 2014 Sept 2015-LTM
Deploying a balanced capital allocation
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Use of Cash Flows from March 2011 IPO through 3Q 2015
Acquisitions
Cash Flows from Operations
Capital Expenditures
Special Dividends
Share Repurchases
$18.5B
$8.9B
$3.3B
$3.2B
$5.1B
Advancing the patient experience
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Patient Experience
Big Data/ Best
Practices
Partnering with
Physicians
Competent Employees
Technology
106 Hospitals 2015 Top Performers by the Joint Commission
Values: • Safe • High quality • Efficient • Compassionate
Healthcare industry overview
StoneSprings Hospital Center Dulles, Virginia Opened December 2015
Positive industry outlook
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U.S. health spending projected to grow 5.8% annually from 2014-20242
• Improving economic conditions
• Aging population
• Clinical innovation
• ACA coverage expansion
Stable pricing environment
No significant change in competitive dynamics
5-year Population CAGR3
5-year Demand CAGR4
GDP Growth5
Unemployment Rate6
HCA markets are more favorable
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2.4%
U.S. HCA
3.0%
4.6%
0.7%
1.6% 2.2%
1.2%
4.8%
3.9M* remaining eligible enrollees7, 8, 9
Healthcare reform potential remains
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Texas 1.5M*
HCA Medicaid Expansion State10 Florida
840K*
<15% of HCA beds in Medicaid expansion states
*Remaining eligible enrollees within HCA markets only7, 8, 9
Positioned to succeed
Citrus Park Emergency Room Tampa, Florida Opened June 2015
Be the provider system of choice
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Local Sustainable
Growth
Coordination Across
Continuum
Access and Convenience
Operational Excellence
Strong Physician
Relationships
Comprehensive Service Lines
Leveraging our scale locally
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Economies
Innovation
Capital
Make our business better
Drive more growth
Get to market faster
Support even better execution
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37 Free Standing ERs
181 ER Beds
430 FSER Beds
1,950 Hospital Beds
3,911 Beds
Hospitals 16
Making significant investments in our markets
$12+ billion since the IPO
Acquisitions
Capacity
Nashville market overview
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5
3
3
5
7
2 14 Minute Clinics
12 Hospital Campuses 1 Children’s Campus 1 Behavioral Campus 2,000 Beds 1 Trauma Center
10 CareSpot Urgent Care Centers
17 Imaging Centers
6 Ambulatory Surgery Centers
66 TriStar Medical Group Locations
3 Freestanding ERs
1 Transfer Center
7 Health Parks
2
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Dallas/Fort Worth market overview
HOSPITAL CAMPUSES (12) Children’s Hospital (1) Behavioral Hospital (1) Beds (3,000) Trauma Centers (3)
Freestanding ERs (6)
Pedi Urgent Care (6)
CareNow (25)
Women’s Imaging (12)
ASCs (11)
Physician Offices (11)
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22.8%
23.0%
23.2%
23.4%
23.6%
23.8%
24.0%
24.2%
24.4%
Prior Year (3) Prior Year (2) Prior Year Current Year
Sustaining market share growth
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23.4%
24.3%
Share gains over PY
30 of 38 Markets
14 of 19 Service Lines
Note: Percentages represent current market share1
Market Share Notes: Source = State data via Stratasan
Sources of differentiation
Deep and experienced leadership
Scale
Diversified portfolio
Financial strength
Strong
operating culture
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Notes and Sources
1 Market Share Notes: • Same Store. Composition Market ( In Market + In Migration) • Statistics are based on data for the most recently avai lable 48 month period for 38 defined markets. • Analysis includes data for 32 markets through 1Q‘15, 2 markets through 4Q‘14 (Kansas City & Wichita) , & 4 markets through
4Q’13 (CA) • Source = State data via Stratasan
2 CMS Off ice of the Actuary in the Centers for Medicare & Medicaid Services, July 2015. NHE Projections 2014 -2024 Forecast Summary: https://www.cms.gov/Research-Statistics -Data-and-Systems/Stat istics -Trends-and-Reports/NationalHealthExpendData/Downloads/proj2014.pdf
3 ESRI – 5 year CAGR, 2015-2020 population projection
4 Sg2 – 5 year CAGR, 2015 -2020 inpatient admissions Demand based on epidemiology and population forecasts, 2014 base year. Excludes normal newborns.
5 U.S. Dept. of Commerce, Bureau of Economic Analysis - 2014% Real GDP Growth over 2013: U.S. Bureau of Economic Analysis, National Real GDP (mil l ions of chained 2009 dollars, http:// www.bea.gov/newsreleases/national/gdp/ gdpnewsrelease.htm. EMBARGOED UNTIL RELEASE AT 8:30 A.M. EST, Nov 24, 2015
6 U.S. Dept. of Labor, Bureau of Labor Statistics - November 2015P Unemployment Rate, Not Seasonally Adjusted. Table 1. Civi l ian labor force and unemployment by state and metropolitan area. http://www.bls.gov/news.release/metro.t01.htm . As of December 31, 2015.
7 HHS, Off ice of the Assistant Secretary For Planning and Evaluation (ASPE), 2015 Plan Selections by ZIP Code in the Health Insurance Market Place. Published Apri l 2015. Kaiser Family Foundation
8 Potential enrol lment el igible population defined as people who were uninsured or buying their own insurance before the ACA went into effect, who are not el igible for Medicaid or employer coverage, who are not in the coverage gap, and who are cit ize ns or authorized immigrants.
9 HCA market ZIP codes were mapped to Public Use Microdata Areas (PUMA) uti l ized by Kaiser Family Foundation for its enrollment penetration estimates .
10 Kaiser Family Foundation. Status of State Action on the Medicaid Expansion Decision as December 17, 2015.
34th Annual J.P. Morgan Healthcare Conference
San Francisco, CA January 11, 2016
Milton Johnson Chairman of the Board & Chief Executive Officer Sam Hazen Chief Operating Officer Vic Campbell Senior Vice President Mark Kimbrough Vice President, Investor Relations
