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Lehman Brothers Healthcare Conference—March 2004

Vic Campbell. Senior Vice President. Bill Rutherford CFO, Eastern Group Mark Kimbrough VP, Investor Relations. Lehman Brothers Healthcare Conference—March 2004.

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Lehman Brothers Healthcare Conference—March 2004

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  1. Vic Campbell Senior Vice President Bill Rutherford CFO, Eastern Group Mark Kimbrough VP, Investor Relations Lehman Brothers Healthcare Conference—March 2004

  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) the highly competitive nature of the health care business, (ii) the efforts of insurers, health care providers and others to contain health care costs, (iii) possible changes in the Medicare and Medicaid programs that may impact reimbursements to health care providers and insurers, (iv) the ability to achieve operating and financial targets and achieve expected levels of patient volumes and control the costs of providing services, (v) increases in the amount and risk of collectibility of uninsured accounts and deductibles and co-pay amounts for insured accounts, (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 Company’s common stock, (ix) the Company’s ability to complete the share repurchase program, (x) changes in accounting practices, (xi) changes in general economic conditions, (xii) future divestitures which may result in additional 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 Company’s 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 Company’s tax positions, (xix) the outcome of the Company’s continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures and the Company’s corporate integrity agreement with the government, (xx) changes in Federal, state or local regulations affecting the health care industry, (xxi) the impact of charity care and self-pay discounting policy changes, (xxii) the ability to successfully integrate the operations of Health Midwest, (xxiii) the ability to develop and implement the financial enterprise resource planning information system within the expected time and cost projections and, upon implementation, to realize the expected benefits and efficiencies, (xxiv) the ability to obtain court approval of the settlement of the class action securities lawsuits originally filed against the Company in 1997; (xxv) the ability of the Company to continue to fund a cash dividend in the future at the current rate; and (xxvi) other risk factors detailed from time to time in the Company’s filings with the SEC. Many of the factors that will determine the Company’s future results are beyond the ability of the Company to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management’s views only as of the date hereof. The Company undertakes no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise. All references to “Company” and “HCA” as used throughout this document refer to HCA Inc. and its affiliates.

  3. HCA–Hospital Corporation of America • 190 Hospitals—Approximately $22 billion in revenues • Focused upon market leading positions in fast- growing urban and suburban communities • Targeted capital investments to improve quality and availability of care • Use scale/size to improve processes and operate more efficiently

  4. % % % % 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%

  5. Focused on Strengthening Outpatient Services • Outpatient services account for 37% of revenue or $8 billion • Existing outpatient units must operate in a manner consistent with “retail nature” of the business • Increase the accessibility and convenience of the service • Build or buy outpatient outlets that improve our market presence • Develop management structure dedicated to the success of outpatient services

  6. Operations: 2003 Key Observations Payor Composition • Payor class composition is changing. Medicare and self- pay are growing (2.7%, 6.9%). All other Payors have declined (-1.2%) • Self-pay admissions, although representing only 4.4% of total admissions grew 6.9%. • Self-pay admissions via the emergency room grew 14% Pricing • No surprises in pricing (rate, acuity, technology) environment in 2003 (+7.5%), but 2004 will be more difficult due to Medicare Outlier and Charity Care changes.

  7. Operations: 2003 Key Observations Expenses Impact on earnings from volume pressures minimized by efficient expense management: • SW&B % of Net Revenue  50 bps • Contract labor/APD  33% from 1Q 03 • Avg. hourly rate increased 4.7% ( 40 bps from PY) • SW&B/AA declined 260 bps from prior year • Employee Benefit Cost moderating; 2.9% vs.13.7% PY • Supplies/AA costs slowing ( 80 bps vs. 2002) Bad Debt experience in 2003: a. Bad Debt expense was $2.2B, up $574M (sf1), or 36% over 2002 b. Charity care recognition grew dramatically in 2003 to $821M up $230M (sf), or 40% over 2002 c. We are forecasting no relief in Bad Debt/Charity in 2004 • At close of 2003, we had $2.65B reserved as Bad Debt, representing 88.3% of self-pay balances (only $351M on balance sheet not reserved) 1. sf: Same Facility

  8. Operations: 2003 Key Observations Other Operating Highlights • Net Revenue (less Bad Debt) is converting to cash at favorable levels (100.2%) • Successfully integrated Health MidWest • Patient Safety agenda was aggressively deployed • Total employee turnover, 20.1% vs. 22.8% in 2002. RN turnover1, 16.8% vs. 17.0% in 2002. Fourth consecutive year of improving turnover rates. • Enhanced outpatient organization and strategy underway • All patient/employee satisfaction scores remain positive and at record levels 1. Turnover results exclude Midwest Division.

  9. Adjusted for closed SNF/OB units HCA Admission Trends 2001 to 2003Same Facility

  10. +0.6% +7.5% -2.6% +8.1% +4.7% 2003 Operating Indicators Same Facility vs. Prior Year 2003 Quarterly Trending 2003 vs. 2002 Q1 Q2 Q3 Q4 (same facility) Admissions Net Revenue/ AA SWB/AA Supplies/ AA Labor Cost/ Manhour

  11. Increasing Uninsured Revenues Put Pressure on Bad Debts • Provision for Doubtful Accounts increased to approximately 10% of NR in 2003 • Increasing self-pay receivables combined with a deterioration in collectibility of this A/R contributed to the need to increase the provision for doubtful accounts • Soft economy/unemployment is a major driver of the escalation of uninsured patients • We anticipate no significant moderation in bad debts in 2004

  12. Response to Increasing Bad Debt • Increasing level of intensity around front-end collections •  40% from ‘01-’02 •  30% from ‘02-’03 • Enhance self-pay policy, procedure and process flow • - Hospital self-pay committees • - Review access points—impact on non-emergent access • Aggressively pursue all alternative payment sources, including federal and/or state funding sources (i.e. Medicaid, etc.) • - 15% of uninsured accounts convert to Medicaid • Charity care and financial discount policy

  13. 2001 $1.4 2000 $1.2 2002 $1.7 2003 $1.8 2004E $1.8 Billions Shared Services Infrastructure Develop., IT&S, & Pat. Safety New & Replacement Facilities Facility Expansion Projects Midwest Division Routine Capital Capital Expenditures Dollars ($ in billions)

  14. 37 ER Expansions 37 ER Expansions Imaging, Open Heart, Cardiology Oncology, etc. 54 Facilities with Surgery and/or ICU/CCU expansions Four New Facilities 378 Beds 1,565 New Beds Distribution of Capital Dollars2002-2005 and beyond Ongoing Projects in Capital Plan

  15. 2003 Growth Capital Assets Placed in Service $1,400 $1,200 $1,000 (Dollars in Millions) $800 $600 $400 $200 $0 2000 2001 2002 2003 2004 2005

  16. New Facilities: Denver, CO • Sky Ridge Medical Center • Denver, Colorado • Opened 8/20/03 • 104 Beds • Cost: $147M • 4 Month Update • Admissions: • 2,076 (+47% vs. Budget) • ADC: • 45 (57 in December) • ER Visits: • 9,125 (+56% vs. Budget)

  17. New Facilities: Nashville, TN StoneCrest Medical Center Nashville, Tennessee Opened 11/30/03 75 Beds Cost: $76M One Month of Operations Admissions: 255 ER Visits: 3,449

  18. Replacement Facility:Tallahassee, FL Before Replacement

  19. Replacement Facility Replacement Facility: Tallahassee, FL

  20. Replacement Facility: Tallahassee, FL • Capital Regional • Medical Center • Tallahassee, Florida • Opened 8/26/03 • 180 Beds • Cost: $98M • 4 Month Update • (% change vs. PY) • Admissions: +15.3% • Surgeries: +9% • ER Visits: +28% • Caths: +30% • Admissions growth for 12 months prior to the new facility opening: 5%

  21. Capital Targeted to Growth Opportunities 3.2% Admissions growth rate for facilities with major projects opening in 2002 or 2003—vs. 1.4% for Total Company • Denver: New Facility • 2,076 admissions in the first 4 months of operations • (+47% vs. budget) • Tallahassee: Replacement Facility • 15.3% growth in admissions in the first four months vs. 5% growth rate in the 12 months prior to opening • Nashville: New Facility • 3,449 ER visits in the first month of operations

  22. Capital Targeted to Growth Opportunities • Lewisville, TX: 85 net new beds (1Q) 14.6% growth in admissions (April-December) • Richmond, VA: Major surgery expansions at 2 facilities (2Q) 14.4% inpatient surgery growth (July-December) • Brandon, FL: Open heart program 323 open hearts in first year. • Austin, TX: 66 new beds in North Austin (3Q 02) 2003 admissions growth rate: 12.5% vs. 10.3% PY

  23. HCA Board Approves Dividend IncreaseFrom $0.02 Per Share to $0.13 Per Share • Prudent investment/use of free cash flow • Share Repurchase • Integral component of the Company’s financial policies • Since 1997, repurchased $6.9 billion of HCA stock (average cost $29.51) • Dividend • Cash-flows allow us to pay a significantly increased dividend • Continue to reinvest in our markets, and strengthen our balance sheet

  24. 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

  25. 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

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