Accretive Health - Revenue Cycle - Revenue Cycle Management

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Proprietary & Confidential

Credit Suisse 2012 Healthcare Conference November 14, 2012

Phoenix

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Safe Harbor Statement

Certain statements contained in this presentation may be considered forward-looking as defined by the Private

Securities Litigation Reform Act of 1995. In particular, any statements made about Accretive Health’s expectations for

future financial and operational performance, expected growth, new services, profitability or business outlook, the

effects of the ongoing investigations of our operating practices being conducted by various parties, our responses to

these investigations and the impact of the Company’s settlement allegations with the Minnesota Attorney General,

securities-related class action and derivative lawsuits filed against us and certain of our officers and directors, follow-on

investigations and inquiries by government authorities, and other litigation matters, all of which involve risks and

uncertainties, are forward-looking statements. Investors are cautioned not to place undue reliance on such forward-

looking statements. There is no assurance that the matters contained in such statements will occur since these

statements involve various risks and uncertainties that could cause actual results to differ materially from those

expressed in such forward-looking statements. These risks and uncertainties include those listed under the heading

Risk Factors in the company’s Quarterly Report on Form 10-Q for the period ended September 30, 2012, which is

available on the SEC’s website as well as in the investor relations portion of Accretive Health’s website at

Accretivehealth.com. The forward-looking statements made in this presentation are based on the company’s beliefs and

expectations as of November 14, 2012 only and should not be relied upon as representing the company’s views as of

any subsequent date. While the company may elect to update these forward-looking statements at some point in the

future, Accretive Health specifically disclaims any obligation to do so, even if its views change.

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Three Distinct Offerings

Revenue Cycle Management

Physician Advisory

Services

Quality and Total

Cost of Care

Assist hospitals maximize compliant revenue for inpatient stays

Complete infrastructure for population health management and episodic care

First of its kind end-to-end comprehensive revenue cycle management

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Our Mission

Our Mission: To help our healthcare clients strengthen their financial stability and

deliver better care to communities they serve increasing healthcare access for all

We leverage our people, processes, and technology to achieve our mission:

Our success is defined by Measured Value we deliver to our clients, enabling

them to meet the goal of improving the health of the communities they serve

People

Processes

Technology Comprehensive tools to measure and improve

efficiency for clinical and financial outcomes

Market leading processes and best practices to produce seamless workflow management

Outstanding professionals who work tirelessly to achieve exceptional results

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Healthcare Industry Facing Multiple Pressures

In an Increasingly Complex Healthcare Landscape,

Accretive Health Delivers Compelling Solutions

Quality and Total

Cost of Care and

Intra-Stay Quality

Pressures Solutions

Quality Pressures

Lack of Technology Infrastructure

Compliance Pressures

Insufficient Internal Resources

Financial Pressures

Revenue Cycle

Management

Physician

Advisory Services

New Regulations

Obama Care / ICD-10

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Market Opportunity

$50 billion market opportunity

Revenue Cycle Management

AccretivePAS® Quality and Total Cost of Care

$100 billion domestic market opportunity

Nearly $1 billion market opportunity

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Highly Diversified Prestigious Client Base

Community Health Systems/ Integrated Delivery Network

Partnering with Market Leaders Across Multiple Operating Environments

http://www.beaumont.edu/

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Compelling Revenue Cycle Value Proposition

Revenue Cycle Value Proposition

No upfront costs to implement

400-600 basis point typical improvement in operating margin at contract maturity

Customers engage with Accretive Health as a critical operating partner

$30 million in additional value created annually for a typical hospital with $1billion in NPSR

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End-to-End Solution Provides Competitive Advantages

SaaS /

Technology- Supported

RCM BPO

Consulting

IT

Outsourcing / Non-HC BPO

Payor

Follow-Up

Patient

Advocacy

Patient

Share

Lost

Charges Compliance

4-6% (Measured)

Value Proposition

(% revenue lift)

Est. 0.5 -1% (Not Measured)

Est. 0.5 -1% (Measured)

Est. 0.5 -1.5% (Not Measured)

Note: Based on Management’s estimates

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1%

1%

2%

1%

5%

0%

1%

2%

3%

4%

5%

Self-Pay Conv.

Patient Yield Payor Yield Incr. to net revenue

Total Revenue Lift

Payroll60%

Third-Party Spend30%

Technology10%

Indicative Revenue Lift(1)

Cost Components

Indicative Hospital

$1 Billion NPR

Potential Value Created

$50 Million

$9 Million

Cost Conversion

(1) Net revenue improvement as measured against hospital base year NPR

Clerical Expense Converted to High Impact Investment

(Typically 80% of lift is included in gain-share calculation)

(% of baseline NPR)

Accretive’s Base Fee

$43 Million

RCM Spend

$9M in savings from

automation and efficiency of low-end clerical labor redeployed in technology,

analytics and higher end human talent

Revenue Lift and Cost Takeout Drive Significant Benefits

Majority of $ Goes to Client

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Incremental Benefits Delivered Through Shared Services

Expanding network of centers -

domestic and blended shore

offering

Delivering broad array of functions

– Pre-registration, financial clearance, billing, follow-up,

transcription, pre-collections,

collections, customer contact

52% of our revenue cycle

management customers are in shared services

Enhanced Benefits:

– Greater cost savings than under managed services model

– Ability to generate more revenue lift

– Greater economies of knowledge

Accretive Health’s Network of Shared Services Centers

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Highly Differentiated Technology

Full visibility into the factors influencing

revenue yield loss

Technology within and across processes to

drive bottom-line results

– Technology suite different from clinical healthcare systems and from patient

accounting systems

– State of the art technology

Focus on continuous learning

– Extensive hospital operations experience

– Data mining and analysis

– Business operator expertise

Our Technology is Different Because Our Organization is Different

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End-to-end Infrastructure

Sophisticated Business and

Payor Contracting Model

Proprietary Data and

Technology Platform

Physician Performance and

Change Management

Patient Engagement /

Coordination of Providers’

Care Management

Continuous R&D and

Predictive Performance

Population-Based Management: The Future of Healthcare Delivery

Quality and Total Cost of Care

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Accretive works with primary care

physicians when addressing large diverse

populations and with specialists in high-

variability and high-cost specialties (i.e.

oncology)

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Population-Based Management: The Future of Healthcare Delivery

Sickest

and most

responsive

patients

Patient-specific

care plans and

care

coordination

workflow

Real-time

clinical

pathway

adjustment

R&D Platform

Continuous care

assessment and

patient population

management system

that allows

physicians to focus

on the sickest

patients with the

optimal clinical path

to improve quality

and cost outcomes

Access Point

Algorithms

Providing an End-to-End Infrastructure

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1. Develop a first-of-its kind, end-to-end oncology care management offering which

includes:

a) Best practice protocols and processes to improve quality, standardize care and eliminate

waste

b) New payment model to incent highest quality of care at most appropriate cost (i.e. cancer

benefit management)

c) Highly interactive technology and workflow tools to engage physicians and patients

d) On-the-ground resources to provide data, analytics, and research

2. Co-Develop and Go-to-Market with Cancer Centers of Excellence with access to 224

oncologists practicing evidence-based medicine across 15 states

CCE – Accretive Health Partnership

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Physician Advisory Services

Offering to assist hospitals

maximize compliant revenue for

inpatient stays

Direct physician contact with

Accretive Health physicians to

determine proper classification for

billing purposes

Pre-emptive chart reviews

to identify inappropriately classified

cases for billing purposes

Team of highly trained clinicians to

help customers respond to denials

Continuous improvement

through analytics

AccretivePAS® Solution Growing Portfolio of Clients

0

50

100

150

200

250

2010 Q1 2010 Q2 2010 Q3 2010 Q4 2011 Q1 2011 Q2 2011 Q3 2011 Q4 2012 Q1

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Accretive Health’s Platform for Innovation

Sophisticated and proven change management engine

Strategic partner to CEOs, CFOs and operating leadership who welcome innovative value proposition ideas, and serve as customer references

Leading provider of Revenue Cycle – “we see it all”

Comprehensive knowledge of existing and evolving healthcare payment systems

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End-to-end Infrastructure

Physician Engagement and

Change Management

Proprietary Workflow

Technology Platform

Standard Procedures /

Assisting Providers with

Patient Care Coordination

Effective Transition

Management

Intra-Stay Quality

Intra-Stay Quality

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Historical Financial Performance (dollars in millions)

241

398 510

606

826

2007 2008 2009 2010 2011

7 12

33 45

82

2007 2008 2009 2010 2011

2.8% 3.1%

6.5%

7.4%

36%

CAGR

86%

CAGR

Net Services Revenue Non-GAAP Adj. EBITDA / EBITDA Margin

Adjusted EBITDA adds back stock-based compensation expense and other non-recurring charges to EBITDA

See appendix for discussion of the use of Non GAAP measures

9.9%

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2012 Outlook

PCARR

Net Services Revenue

Adjusted EBITDA

Adjusted EPS

$930M - $960M

Low end of

$948M - $980M

$50M - $55M

$0.23-$0.27

As provided on November 7, 2012

Includes $30 to $33 million of non-recurring items

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2013 Growth Priorities and Strategic Initiatives

Extend

Leadership

In Revenue

Cycle

Management

Accelerate

Quality and Total

Cost of Care and

Intra-Stay Quality

Scale

Physician

Advisory

Services

Invest in Priority Areas

Long-Term Targets

Net Services

Revenue Growth:

20 – 25% CAGR

Adj. EBITDA Margin:

14% - 18%

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In order to provide stockholders with greater insight and to allow for better understanding of how our management and board

of directors analyze our financial performance and make operational decisions, we supplement our condensed consolidated financial statements presented on a GAAP basis with the adjusted EBITDA and adjusted net income measures *.

Adjusted EBITDA measure has limitations, as noted below, and should not be considered in isolation or in substitute for

analysis of our results as reported under GAAP.

Our management uses adjusted EBITDA:

• as a measure of operating performance, because it does not include the impact of items that we do not consider indicative of our core operating performance;

• for planning purposes, including the preparation of our annual operating budget;

• to allocate resources to enhance the financial performance of our business;

• to evaluate the effectiveness of our business strategies; and

• in communications with our board of directors and investors concerning our financial performance.

We believe adjusted EBITDA is useful to stockholders in evaluating our operating performance for the following reasons:

• these and similar non-GAAP measures are widely used by investors to measure a company’s operating performance without regard to items that can vary substantially from company to company depending upon financing and

accounting methods, book values of assets, capital structures and the methods by which assets were acquired;

• securities analysts often use adjusted EBITDA and similar non-GAAP measures as supplemental measures to evaluate the overall operating performance of companies; and

• by comparing our adjusted EBITDA in different historical periods, our stockholders can evaluate our operating results without the additional variations of interest income (expense), income tax expense (benefit), depreciation and

amortization expense and share-based compensation expense.

We understand that, although measures similar to adjusted EBITDA are frequently used by investors and securities analysts in their evaluation of companies, these measures have limitations as analytical tools, and you should not consider it in

isolation or as a substitute for analysis of our results of operations as reported under GAAP. To properly and prudently evaluate our business, we encourage you to review the GAAP financial statements included elsewhere in our regulatory

filings, including the Preliminary Prospectus, Form 8-K, and Form 10-K, and not to rely on any single financial measure to

evaluate our business.

* Reconciliations of non-GAAP measures to their most directly comparable GAAP measures are presented, where possible in the Appendix,

as well as in the Company’s financial press releases and related Form 8-K filings with the Securities and Exchange Commission.

This information can be accessed for free in the Investor Relations section of the Company’s website at www.accretivehealth.c om

Appendix – Use of Non-GAAP Financial Measures

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Appendix - Reconciliation of Non-GAAP Financial Measures

The following table presents a reconciliation of adjusted EBITDA to net income, the most comparable GAAP measure

in millions 2007 2008 2009 2010 2011

Net Income $0.8 $1.2 $14.6 $12.6 $29.2

Net Interest Expense (Income) (1.7) (0.7) 0.0 (0.0) (0.0)

Provision for Taxes 0.5 2.3 3.0 9.7 18.9

Depreciation & Amortization Expense 1.3 2.5 3.9 6.2 8.3

EBITDA $0.8 $5.3 $21.5 $28.5 $56.4

Stock Compensation Expense 6.0 6.9 11.4 16.5 25.2

Adjusted EBITDA* $6.8 $12.2 $32.9 $45.0 $81.6

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Accretive Health - Revenue Cycle - Revenue Cycle Management