Off-Site Ambulatory Expansion

1. Off-Site Ambulatory Expansion Siteman Cancer Center – South County Overview for CAC – April 2012

2. Why Expand Off-Campus? Changing Market Dynamics & Improved Payor Mix • The St. Louis metro population is experiencing shift to suburban areas • Patients prefer to receive ambulatory care close to home • Some subspecialty services do not require a hospital setting and are more efficiently delivered in an outpatient paradigm • Preserving and growing our patient base requires us to offer geographically convenient, patient-focused ambulatory services in a highly efficient manner • Improved managed care payor mix, decreased Medicaid

3. Target Market – South Region • Target market population - 561,622 adult population • WUSM and BJC completed a market assessment, looking at the target region shown below, to validate favorability of this market Analysis Market Size & Opportunity Population Trends & Projections Median Household Income WUSM Market Share Inpatient Market Share Referring Physicians Distribution of PCPs Competitor Analysis

4. Overall Vision for South County Short-term – To increase the presence of the Siteman Cancer Center in the South Region by providing state of the art cancer care, in a convenient, comfortable, free-standing ambulatory cancer center. Long-term – To expand BJH and WUSM services beyond cancer to create a broader market presence and capture increased share from South County and Southern Illinois. • Phase I – Cancer Focus: • Medical oncology & chemotherapy • Radiation oncology • Cancer surgical subspecialty consultation • Siteman Support Services • Approx 40,000 SF • Phase II - Other Potential Clinical Programs: • Other WUSM Subspecialty Practices • Expanding Outpatient Imaging Platform • Ambulatory Surgery? • Primary Care? • Up to 40,000+ SF

5. Target Geography Visible Upscale/Professional Growth Area Not immediately adjacent to St. Anthony’s Easy Access/Wayfinding Expandable Pleasant Views Close to some conveniences for family members

6. Aerial View of Site w/Phase I

7. Site Plan – Phase I & Phase II

8. Site Plan – Phase I Close Up

9. SCC – South County Floorplan

10. SCC – South County Building Entrance

11. SCC – South County Highway Visibility

12. SCC – South County Construction Progress – as of April 13, 2012

13. SCC – South County Construction Progress – as of April 13, 2012

14. Next Steps • Plan for Opening of SCC-South County – target Jan 2013 • Space – design detail, furniture, equipment • Operations – staffing, scheduling, supplies, regulatory, clinic flow, IS systems, etc • Marketing – in development of marketing plan/budget • Begin to plan for Phase II – target fall 2015 • What services are at capacity in CAM? • What percent of CAM patients live in South County area? • What scope of ancillary services are needed? • What are projected volumes, resources required, etc.

15. Appendix

16. WUSM Clinics at BJWCH - Payor Mix FY10 WUSM Payor Mix at SLCH1,2 OP Visits, Primary Service Area FY10 WUSM Payor Mix at BJWCH1,2 OP Visits, Primary Service Area Total Unique Patients at BJWCH = 9,135 Total Unique Patients at SLCH = 49,963 1Payor mix based on count of unique patients (0-17) by payor in SLCH’s primary service area. 2 Other includes Commercial, Hospital Contracts, and Other. Source: WUSM Physician Billing Services

17. Target Region for Phase II South County CAM Office Visits1 352,702 (54.8% of total Adult Office Visits) CAM Office Visits from South Region2 47,863 (15%) 1-Based on monthly Adult On-Campus reports from Clin Ops, using sched reports and arrived visits. 2 -Based on PBS query of doctor’s office visits, using patient zip code 17