2. Key Messages
• Attractive markets
• Physician employment
• Expanding the outpatient footprint
• Increasing case mix intensity or patient severity
3. Missouri and Tennessee
Hospitals
St. Louis
Des Peres, 2
St. Louis University
Total Beds 523
Hospitals
Memphis
St. Francis, 2
St. Francis-Bartlett
Total Beds 619
• Certificate of Need Regulations
4. Texas
Hospitals
El Paso
Providence, Sierra, Eastside 3
Dallas
Centennial, Doctors 3
at White Rock, Lake Pointe
Houston
Cypress Fairbanks, 3
Houston Northwest,
Park Plaza
East Texas
1
Nacogdoches
Total Beds 2,644
• Dallas-Fort Worth currently adding more residents than any other metro area nationwide
and projected to be 3rd largest in the country by 2030
• Houston 4th largest city in the nation
• El Paso’s Ft. Bliss BRAC (base realignment and closure) is in the process of adding
65,000 soldiers and their families through 2013
5. High Population Growth Service Areas
2000 - 2007 2007 - 2012
Dallas MSA 16.4% 9.7%
Centennial 85.9% 30.6%
Lake Pointe 37.2% 17.9%
Houston MSA 16.4% 8.7%
Cypress Fairbanks 39.9% 17.0%
Houston Northwest 17.8% 9.0%
El Paso MSA 8.2% 5.3%
Sierra Providence East 17.8% 9.0%
Source: Thomson Medstat – 2007 Claritas Data
6. Central Region TGI Actions
• Physician employment in primary care specialties
• Expansion of the outpatient footprint
• Growth of service intensity
7. Central Region Markets
HealthGrades 2007 statistics
• 3.7 million searches for a physician
• 780,000 physician reports opened
• Consumers clicked on “appointment request”
button over 208,000 times
• HealthGrades results show consumers are 33%
more likely to contact the physician when they have
more information about the practice
10. Primary Care Physician Productivity
Annual admissions per productive physician average
• Family Practice 70
• Internal Medicine 120
• OB/GYN 185
• Pediatrics 65
Source: Tenet – McKinsey analysis
16. Ease of Access a Priority
• Ease of access to results for physician
– PACS
– Physician Portal
• Ease of access in scheduling for physicians and patients
– Evening and Saturday appointments
– Centralized scheduling
– Online scheduling and precertification
• Ease of access in registration for patients
– Online
– Kiosk
– SmartCard
18. Growing Intensity
Acute Case Mix Index
Total Medicare
2006 1.326 1.519
2007 1.330 1.520
2008 YTD 1.369 1.539
• 8 of 13 hospitals increased both Medicare and total CMI from
2006 to 2007
• 12 hospitals have increased in total CMI and 5 have increased in
Medicare CMI from 2007 into 2008
19. Service Lines Growing Intensity
• Neonatal ICUs
• Vascular Programs
• Neurosciences/Stroke
• Spine & Orthopedic Surgery
• Oncology Programs
• Cardiac Programs
• ER Trauma Designations
20. Growing Intensity
2006 2007
Medicare LOS 6.13 6.02
Medicare CMI 1.519 1.520
• Every .01 increase in CMI change across the Region
creates an estimated $5.6 million in net revenue
21. Central Region Summary
• Attractive growing markets
• Continued TGI focus from 2005
• Physician employment
• Expanding outpatient access points
• Growing intensity