2. Proprietary & Confidential
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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3. Proprietary & Confidential
Three Distinct Offerings
First of its kind end-to-end
Revenue Cycle comprehensive revenue
Management cycle management
Complete infrastructure for
Quality and Total
population health management
Cost of Care and episodic care
Assist hospitals maximize
Physician Advisory compliant revenue for
Services inpatient stays
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4. Proprietary & Confidential
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:
Outstanding professionals who work tirelessly to
People achieve exceptional results
Market leading processes and best practices
Processes to produce seamless workflow management
Comprehensive tools to measure and improve
Technology efficiency for clinical and financial outcomes
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
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5. Proprietary & Confidential
Healthcare Industry Facing Multiple Pressures
In an Increasingly Complex Healthcare Landscape,
Accretive Health Delivers Compelling Solutions
Pressures Solutions
Financial Pressures
New Regulations
Obama Care / ICD-10
Compliance Pressures
Quality Pressures
Revenue Cycle Quality and Total Physician
Lack of Technology Infrastructure Management Cost of Care and Advisory Services
Intra-Stay Quality
Insufficient Internal Resources
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6. Proprietary & Confidential
Market Opportunity
Revenue Cycle
Management Quality and Total Cost of Care AccretivePAS®
$50 billion market $100 billion domestic Nearly $1 billion
opportunity market opportunity market opportunity
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7. Proprietary & Confidential
Highly Diversified Prestigious Client Base
Partnering with Market Leaders Across Multiple Operating Environments
Community Health Systems/ Integrated Delivery Network
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8. Proprietary & Confidential
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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9. Proprietary & Confidential
End-to-End Solution Provides Competitive Advantages
Patient Patient Lost Payor Value Proposition
Compliance
Advocacy Share Charges Follow-Up (% revenue lift)
4-6%
(Measured)
SaaS /
Technology- Est. 0.5 -1%
Supported
RCM BPO
(Not Measured)
Est. 0.5 -1%
Consulting (Measured)
IT Est. 0.5 -1.5%
Outsourcing / (Not Measured)
Non-HC BPO
Note: Based on Management’s estimates 9
10. Proprietary & Confidential
Revenue Lift and Cost Takeout Drive Significant Benefits
Indicative Revenue Lift(1) Indicative Hospital Potential Value Created
(% of baseline NPR)
5% Majority of $ Goes
4%
1% to Client
3% 2%
2%
5% $1 Billion NPR $50 Million
1%
1%
1%
0% (Typically 80% of lift is included
Self-Pay Patient Yield Payor Yield Incr. to net Total
Conv. revenue Revenue Lift in gain-share calculation)
Cost Components
$43 Million
RCM Spend
Technology
10%
Accretive’s Base Fee
$9 Million
Third-Party Spend $9M in savings from Cost Conversion
30% Payroll automation and efficiency of
60% Clerical Expense
low-end clerical labor Converted to High
redeployed in technology, Impact Investment
analytics and higher end
human talent
(1) Net revenue improvement as measured against hospital base year NPR
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11. Proprietary & Confidential
Incremental Benefits Delivered Through Shared Services
Accretive Health’s Network of Shared Services Centers
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 Enhanced Benefits:
shared services – Greater cost savings than under managed
services model
– Ability to generate more revenue lift
– Greater economies of knowledge
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12. Proprietary & Confidential
Highly Differentiated Technology
Our Technology is Different Because Our Organization is Different
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
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13. Proprietary & Confidential
Population-Based Management: The Future of Healthcare Delivery
Quality and Total Cost End-to-end Infrastructure
of Care
Sophisticated Business and
Payor Contracting Model
Proprietary Data and
Technology Platform
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Care Management
Accretive works with primary care
physicians when addressing large diverse Continuous R&D and
populations and with specialists in high- Predictive Performance
variability and high-cost specialties (i.e.
oncology)
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14. Proprietary & Confidential
Population-Based Management: The Future of Healthcare Delivery
Providing an End-to-End Infrastructure
Sickest
and most
responsive Continuous care
patients assessment and
patient population
management system
that allows
physicians to focus
on the sickest
patients with the
Real-time Patient-specific
optimal clinical path
clinical care plans and to improve quality
pathway care and cost outcomes
adjustment coordination
workflow
Access Point
Algorithms
R&D Platform
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15. Proprietary & Confidential
CCE – Accretive Health Partnership
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
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16. Proprietary & Confidential
Physician Advisory Services
AccretivePAS® Solution Growing Portfolio of Clients
Offering to assist hospitals 250
maximize compliant revenue for
inpatient stays 200
Direct physician contact with
Accretive Health physicians to
150
determine proper classification for
billing purposes
100
Pre-emptive chart reviews
to identify inappropriately classified
cases for billing purposes 50
Team of highly trained clinicians to
help customers respond to denials 0
2010 Q1 2010 Q2 2010 Q3 2010 Q4 2011 Q1 2011 Q2 2011 Q3 2011 Q4 2012 Q1
Continuous improvement
through analytics
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17. Proprietary & Confidential
Accretive Health’s Platform for Innovation
Leading provider of Revenue Cycle – “we see it all”
Comprehensive knowledge of existing and evolving healthcare
payment systems
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
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18. Proprietary & Confidential
Intra-Stay Quality
Intra-Stay Quality
End-to-end Infrastructure
Physician Engagement and
Change Management
Proprietary Workflow
Technology Platform
Standard Procedures /
Assisting Providers with
Patient Care Coordination
Effective Transition
Management
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19. Proprietary & Confidential
Historical Financial Performance
(dollars in millions)
Net Services Revenue Non-GAAP Adj. EBITDA / EBITDA Margin
826 82
36% 86%
CAGR 606 CAGR 9.9%
510
398 45
33 7.4%
241
12 6.5%
7
2.8% 3.1%
2007 2008 2009 2010 2011 2007 2008 2009 2010 2011
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 19
20. Proprietary & Confidential
2012 Outlook
PCARR $930M - $960M
Net Services Revenue Low end of
$948M - $980M
Adjusted EBITDA $50M - $55M
Includes $30 to $33 million of non-recurring items
Adjusted EPS $0.23-$0.27
As provided on November 7, 2012 20
21. Proprietary & Confidential
2013 Growth Priorities and Strategic Initiatives
Invest in
Priority Areas
Scale
Physician
Advisory
Accelerate Services
Quality and Total
Cost of Care and Long-Term Targets
Extend
Intra-Stay Quality
Leadership
In Revenue Net Services
Cycle Revenue Growth:
Management 20 – 25% CAGR
Adj. EBITDA Margin:
14% - 18%
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22. Proprietary & Confidential
Appendix – Use of Non-GAAP Financial Measures
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.
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This information can be accessed for free in the Investor Relations section of the Company’s website at www.accretivehealth.c om
23. Proprietary & Confidential
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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