Total Indigent Care Geographic Distribution

1. Indigent Care Cost in Dollars Projected FY99 MCVH and MCVP Total Indigent CareGeographic Distribution MCVH and MCVP Total Costs Indigent Care Projected FY99 Entire Commonwealth by County $48,300,000 2,000,001 to 10,000,000 700,001 to 2,000,000 151,001 to 700,000 10,001 to 150,000 1 to 10,000 0 MCV Hospitals & Physicians Indigent Care Information 9/28/99 Page 1

2. Indigent Care Burden - FY99Medical College of Virginia HospitalsandVirginia Commonwealth University School of Medicine • Providing Indigent Care at Significant Loss (No Reimbursement Increase in Four Years) • Previous Ability to Cost Shift Is Exhausted, Insurers Under Managed Care Refuse to Subsidize • $93 Million in Cost of Which Over 1/4 Not Reimbursed Total Reimbursement $ 69.4 Million Costs 93.5 Loss $ (24.1) Million • High Quality/Cost Efficient Operations: - Lowest cost quartile of peer organizations - Top 100 Hospitals in prior year reporting • Without Additional Funding There Will Be No Option But to Limit Indigent Services • Largest Provider of Indigent/Self Pay in State • MCV Campus Major Focal Point of Health Related Education & Research MCVH Payer Mix Indigent Care Services Cost Medicare 25% Richmond $ 48.3 Million Over 700,000 Medicaid 16% Henrico 7.2 Indigent 18% Caroline $.9 Brunswick $1.2 Chesterfield 5.7 King William $.9 Westmoreland $1.1 Self Pay 10% Hanover 2.5 Amelia $.8 New Kent $1.0 Managed Care/Insured 31% Lunenburg $.8 Petersburg 3.9 Mecklenberg $1.0 Spotsylvania $.8 Other > $700,000 10.5 Hopewell $1.0 Newport News $1.0 Other < $700,000 15.4 Total Cost $ 93.5 Million MCV Hospitals & Physicians Indigent Care Information 9/28/99 Page 2

3. Remaining Virginia CountiesIndigent Burden - FY99Note: Less than $700,000. Figures given in millions, therefore some counties with less than $10,000 show $0.00. MCV Hospitals & Physicians Indigent Care Information 9/28/99 Page 3