HCA Investor Update

Forward Looking Statements andNon‐GAAP Financial Measures

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This presentation may contain certain forward‐looking statements provided by Company management. These statements are intended to be covered by the safe‐harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward‐looking statements include all statements that do not relate solely to historical or current facts, including statements regarding future operations, financial results, cash flows, costs and cost management initiatives, capital structure management, growth rates, and operational and strategic initiatives, and can also be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “intend,” “plan,” “initiative,” “continue” or words or phrases of similar meaning.  These forward‐looking statements speak only as of the date hereof and are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control. These risks and uncertainties are described under headings such as “Risk Factors” in our annual report on Form 10‐K for the year ended December 31, 2015 and other reports filed with the Securities and Exchange Commission. As a consequence, current plans, anticipated actions and future financial position and results of operations may differ significantly from those expressed in any forward‐looking statements in today’s presentation. You are cautioned not to unduly rely on such forward‐looking statements when evaluating the information presented and we do not intend to update any of these forward‐looking statements.

The presentation may contain certain non‐GAAP measures, including Adjusted EBITDA.  The Company’s earnings releases for the yearended December 31, 2015 and quarter and six months ended June 30, 2016 located on the Company’s investor relations page at www.hcahealthcare.com, include a reconciliation of the difference between certain non‐GAAP financial measures with the most directly comparable financial measure calculated in accordance with GAAP. These non‐GAAP financial measures should not be considered alternatives to the GAAP financial measures.

References to “Company” used herein refer to HCA Holdings, Inc. and its affiliates, unless otherwise stated or indicated by context.

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Our strategy:

Industry leading quality and service

Profitable growth through distinctive physician & patient relationships

A well‐informed response to the market environment

Industry leading efficiency

Unparalleled development of future leaders

To leverage the scale and capabilities of HCA in the local markets to create competitive advantage and be the provider system of choice for patients and physicians

Shareholders• Earnings growth

• Return oncapital

• Future growth

• Management

• Governance

Payers• Comprehensive network of access points and service lines

• Competitively priced

• Physician network

• Clinical Outcomes

Patients• Safe

• High quality

• Compassionate

• Convenient

• User friendly

• Cost‐effective

Physicians• Clinical capabilities

• Efficient placeto practice

• Voice

• Growth

Employees• Compensation and benefits

• Training and development

• Resources

• Advancement

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Driving value for key stakeholders

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Today’s site specific care delivery

FreeStanding ERsUrgent Care

SpecialistsPrimary Care

Surgery Centers

Hospitals

Behavioral Health

Imaging Centers

“We believe the future will reward comprehensive integrated delivery networks”

Sustaining top line growth

Admissions 3.8%

4.8%Equivalent Admissions

ER Visits

Surgeries

7.1%

2.5%

Revenue 7.2%

1.9M

3.1M

8.1M

1.4M

$39.7B

Values represent 2015 resultsPercentages  represent 5  year CAGR:  2010 – 2015 5

23.8%

24.0%

24.2%

24.4%

24.6%

24.8%

25.0%

25.2%

25.4%

2012 2013 2014 2015

Sustaining market share growth

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24.7%

25.2%

Share gains over PY in 22 of 38 Markets

HCA Growth in 10 of 19 Service Lines 

Note: Percentages represent current market share1Market Share Notes: Source = State data via Stratasan

London

Strengthening a diversified portfolio

7Note: Percentages represent current market share1

Nashville34%

Tampa/ St. Pete30%

Denver32%

Dallas/Fort Worth

18%Austin39%

Houston19%

Kansas City23%

Miami/Fort Lauderdale

22%

Las Vegas32%

Western Idaho

Idaho Falls

Wichita

OklahomaCity

Las Vegas

El Paso

BrownsvilleMcAllen

Corpus Christi

New Orleans

Central Louisiana

LafayettePanhandle

Tallahassee Jacksonville

North Central FloridaOrlando

Treasure Coast

Charleston

Myrtle Beach

New Hampshire

Augusta

Middle GA

Chattanooga

NWGAAtlanta

TerreHaute

Frankfort

NOVA

SWVA

Anchorage

London

Richmond37%

San Jose17%

Salt Lake 20%

San Antonio35%

Growing diversification in mix of revenue

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Acute Care

Shared Services

Access Centers

169

44K

Ambulatory Services

Hospitals

Licensed Beds

116

15

GI Centers

Urgent  Care  Centers

69

57

Freestanding ERs

Physicians

Physician  Clinics

~830

35K

Active Medical Staff 

ASCs

Enterprise Services

Quality agenda is yielding results

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Delivering clinical excellence Continuing strong performance on external reporting 

Reducing complications and mortality through clinical excellence program

Maximizing meaningful use incentives

Piloting front‐end EHR strategies

Leveraging the clinical data warehouse for clinical and operational insights

Developing a national reputation for improving clinical outcomes 

Making progress on patient experience,but room exists for improvement

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39Free Standing ERs 

214ER Beds452FSER Beds

2,258Hospital Beds

3,965BedsHospitals   17

Making significant investments in our markets

$14+ billion since the IPO

Acquisitions

Capacity

EBITDA growth up 34% and margins at industry leading levels

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5‐year Adjusted EBITDA CAGR: 6.2%

5 year Adj. EPS CAGR: 13.7%*

* Adj. EPS excludes the impact of items such as, but not limited to, gains or losses on sales of facilities, losses on retirement of debt, legal claim costs, impairments of long‐lived assets

Balanced approach to capital deployment

12Use  of  Cash  Flows  from March  2011  IPO  through  2Q  2016

Acquisitions

Cash Flows from Operations

Capital Expenditures

Special Dividends

Share Repurchases

$22.8B

$10.9B

$3.9B

$3.2B

$8.0B

Strategy is strengthening the sourcesof differentiation

Deep andexperiencedleadership

Scale

Diversifiedportfolio

Financialstrength

Strongoperatingculture 

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Market demand for healthcare isstill growing

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CMS projects health spending for U.S. to grow 5.8% annually for 2014 –20242:

Key Drivers: Population growth Aging population Chronic conditions Clinical innovation ACA coverage expansion

3 & 5 Year Forecasts of Inpatient Admit Growth Rates by Service Line ‐ 2015–2020

National health expenditure projectionsforecast accelerating growth

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1% overall population growth annually through ‘24 

Over 64 population to grow 3.4%annually during same time period

Health spending outpacing GDP growth by 1.1% per year 

Health share of GDP to rise to 19.6% by ‘24, up 220 bps since ‘13

3,197

3,351

3,522

3,731

3,959

4,198

4,457

4,733

5,022

5,322

5,631

 $2,500

 $3,000

 $3,500

 $4,000

 $4,500

 $5,000

 $5,500

 $6,000

'15 '16 '17 '18 '19 '20 '21 '22 '23 '24 '25

National Health Expenditure Projections 2015‐20253

Billions

HCA markets are more favorable than U.S.

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5‐year Population CAGR4

5‐year Demand CAGR5

GDP Growth6

Unemployment Rate7

2.4%

U.S.HCA

3.0%

4.6%

0.7%

1.6%2.2%

1.2%

4.8%

Sources:  ESRI  – 5  year  CAGR,  2015 ‐2020  population  project ion;  Sg2  – 5  year  CAGR,  2015 ‐2020   inpatient  admissions;  U.S.  Dept.  of  Commerce,  Bureau  of  Economic  Analysis,    2014%  Real  GDP  Growth;   U.S.  Dept.  of  Labor,  Bureau  of  Labor  Statist ics   ‐ November  2015P  Unemployment  Rate,  Not  Seasonal ly  Adjusted.

Pricing environment is stable

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Reimbursement tied to value is still modest

While Shared Saving Program has not proven effective, Medicare has migrated to bundled payment pilots

No significant commercial payer migration to risk or into provider space

Payer consolidation should have a marginal impact, if allowed to move forward

Employers: • Continued movement to high‐deductible health plans • Slow to adopt defined contribution plans • Not “moving” employees into exchanges

Alternative payment models are evolving

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Revenue Model

Fee for Service

Fee for Value‐P4P

Full Risk

Strengthening our delivery capability

Low“Fragmented delivery”

High“Integrated delivery”

Balancing the risk & pace of integration investment vs the changing revenue model

Management Challenge

Investment Risk

Business Risk

Fast Moving?

Slow Moving

Bundled Payment

Corridor risk

Competitor dynamics are mostly unchanged

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Healthcare is still a local business

Industry remains largely fragmented with few scaled players

Pace of change across the industry is slow

No new entrants are materially disrupting the markets

Vertical integration (employment) has slowed on the physician side and in the payer space

Rational pricing environment remains

Capital spending is increasing in some markets

Growth opportunities still existin HCA markets

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Local Sustainable Growth

Coordination Across 

Continuum 

Access and Convenience

Operational Excellence

Strong Physician 

Relationships

Comprehensive Service Lines

Capacity expansion

New facilities

Intra‐network retention

Medical staff development

Rural outreach

Complementary acquisitions

Leveraging our scale to create local marketcompetitive advantage

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Economies

Innovation

Capital

Make our business better

Drive more growth 

Get to market faster 

Support even better execution

Capacity coming online continues to accelerate

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808901

975

202

355 347

0

200

400

600

800

1,000

1,200

2012‐2013 2014‐2015 2016‐2017  Proj

IP Beds

ER + FSER Beds

Advancing the patient experience

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Patient Experience

Big Data/Best 

Practices

Partnering with 

Physicians

Competent Employees

Technology

Adding corporate talent Implementing standards 

on best practices Focusing efforts at 

certain facilities Leveraging nursing 

agenda  Leadership training Incentives  More granular reporting 

and analytics

Investing in our people

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Implementing OneHRplatform 

Expanding Executive Development Program

Focusing on nurse retention and nurse directors

Leveraging ParallonWorkforce Solutions (StaRN)

Ongoing HCA summits for service line networking and leadership training

Investing in better analytics and management systems

Partnering with physicians

PhysicianEngagement

Voice

GrowthTime

25Clinical Capabilities 

Corporate Support Areas:

Practice Operations Provider Relations Chief Medical Officers Hospital Based  GME Recruitment Urgent Care Leadership Development Credentialing Branding Program Engagement Surveys

15.3M eligible enrollees remain across HCA’s 20 states, including 30%, or 4.5M, who are tax credit eligible8

Healthcare reform potential remains

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Texas1.0M*

HCA Medicaid Expansion State9Florida

825K*

<15% of HCA beds in Medicaid expansion states 

* Tax credit eligible enrollees

Shareholders• Earnings growth

• Return oncapital

• Future growth

• Management

• Governance

Payers• Comprehensive network: access and service lines

• Competitively priced

• Physician network

• Clinical Outcomes

Patients• Safe

• High quality

• Compassionate

• Convenient

• User friendly

• Cost‐effective

Physicians• Clinical capabilities

• Efficient place to practice

• Voice

• Growth

Employees• Compensation and benefits

• Training and development

• Resources

• Advancement

27CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.

Continue to drive for value  

Capitalize further on our sourcesof differentiation and maintain agility

Deep andexperiencedleadership

Scale

Diversifiedportfolio

Financialstrength

Strongoperatingculture 

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Notes and Sources

1  Market  Share  Notes:• Same  Store.  Composit ion  Market  ( In  Market  +   In  Migrat ion)• Stat ist ics  are  based  on   inpat ient  discharge  data  for  the  most  recent ly  avai lable  48  month  period  for  30  def ined  markets.• Analys is   inc ludes  data  for  30  markets  with  data  through  4Q’15• Source  =  State  data  via  Stratasan

2  Aggregate   forecast  for  32  HCA  markets,  excluding  normal  newborns.  Sources:   Impact  of  Change®v15.0;  HCUP  National   Inpat ient  Sample  (NIS) .  Healthcare  Cost  and  Uti l izat ion  Project  (HCUP).  2012.  Agency   for  Healthcare  Research  and  Qual i ty,  Rockvi l le ,  MD;  The  Nielsen  Company,  LLC,  2015;  The  Nielsen  Company,  LLC,  2015;  Sg2  Analys is ,  2016.

3  CMS  Off ice  of  the  Actuary   in  the  Centers  for  Medicare  &  Medicaid  Services,   July  2016.  NHE  Project ions  2015 ‐2025  Forecast  Summary:  https://www.cms.gov/Research ‐Stat ist ics ‐Data ‐and ‐Systems/Stat ist ics ‐Trends ‐and ‐Reports/NationalHealthExpendData/Downloads/proj2015.pdf

4  ESRI  – 5  year  CAGR,  2015 ‐2020  populat ion  project ion5  Sg2  – 5  year  CAGR,  2015 ‐2020   inpat ient  admiss ions  Demand  based  on  epidemiology  and  populat ion  forecasts ,  2014  base  year.    Excludes  normal  newborns.

6  U.S.  Dept.  of  Commerce,  Bureau  of  Economic  Analys is   ‐ 2014%  Real  GDP Growth  over  2013:  U.S.  Bureau  of  Economic  Analys is ,  National  Real  GDP  (mi l l ions  of  chained  2009  dol lars ,  http://  www.bea.gov/newsreleases/nat ional/gdp/  gdpnewsrelease.htm.  EMBARGOED  UNTIL  RELEASE  AT  8:30  A.M.  EST,  Nov  24,  2015

7  U.S.  Dept.  of  Labor,  Bureau  of  Labor  Stat ist ics   ‐ November  2015P  Unemployment  Rate,  Not  Seasonal ly  Adjusted.  Table  1.  Civ i l ian  labor  force  and  unemployment  by  state  and  metropol i tan  area.  http://www.bls .gov/news.release/metro.t01.htm.    As  of  December  31,  2015.    

8  Potentia l  enrol lment  el ig ible  populat ion  def ined  as  people  who  were  uninsured  or  buying  their  own   insurance  before  the  ACA  went   into  effect ,  who  are  not  el ig ible  for  Medicaid  or  employer  coverage,   inc luding  Tax  Credit  El ig ible,   Inel ig ible  for  Financia l  Assistance  due  to   Income,  ESI  Offer  or  Cit izenship,  and   In  the  coverage  gap  who  are  cit izens  or  authorized   immigrants.    Source:  KFF   ‐ Distr ibution  of  El ig ibi l i ty  for  ACA  Health  Coverage  Among  those  Remaining  Uninsured  as  of 2015.    Timeframe:  January  12,  2016.  http://kff .org/health0reform/state0indicator/distr ibut ion0of0el ig ibi l i ty0for0aca0coverage0among0the0remaining0uninsured/  for  notes  and  sources

9  Kaiser  Family  Foundation.  Status  of  State  Action  on  the  Medicaid  Expansion Decis ion  as  July  7,  2016.