2019 Financing Investor Presentation Michael J. Dowling President & CEO Mark J. Solazzo Executive Vice President & Chief Operating Officer Michele L. Cusack Senior Vice President & Chief Financial Officer September 13, 2019
Disclaimer The Investor Presentation you are about to view is provided as of September 13, 2019, for a proposed offering of Dormitory Authority of the State of New York, Northwell Health Obligated Group, Series 2019A&B Tax-Exempt Bonds, and Northwell Health, Series 2019A Taxable Bonds (the “Bonds”). Market prices, financial data, and other information provided herein are not warranted as to completeness or accuracy and are subject to change without notice. This Investor Presentation is provided for your information and convenience only. By receiving this presentation, you agree not to duplicate, copy, download, screen capture, electronically store or record this Investor Presentation, or to produce, publish or distribute this Investor Presentation in any form whatsoever. This Investor Presentation does not constitute an offer to sell or the solicitation of an offer to buy any security or other financial instrument, including the Bonds, or to adopt any investment strategy. Any offer or solicitation with respect to the Bonds will be made solely by means of the Preliminary Official Statement, Official Statement, Preliminary Offering Memorandum or Offering Memorandum, which describe the actual terms of such Bonds. The underwriters make no representations as to the legal, tax, credit or accounting treatment of any transactions mentioned herein, or any other effects such transactions may have on you and your affiliates or any other parties to such transactions and their respective affiliates. In no event shall the underwriters or the Issuer be liable for any use by any party of, for any decision made or action taken by any party in reliance upon, or for any inaccuracies or errors in, or omissions from, the information contained herein and such information may not be relied upon by you in evaluating the merits of participating in any transaction mentioned herein. Nothing in these materials constitutes a commitment by the underwriters or any of their affiliates to enter into any transaction. No assurance can be given that any transaction mentioned herein could in fact be executed. Any investment decision regarding the Bonds should only be made after a careful review of the complete Preliminary Official Statement or Preliminary Offering Memorandum. You will be responsible for consulting with your own advisors and making your own independent investigation and appraisal of the risks, benefits, appropriateness and suitability of the proposed transaction and any other transactions contemplated by this presentation and neither the Issuer nor the underwriter is making any recommendation (personal or otherwise) or giving any investment advice and will have no liability with respect thereto. Transactions involving the Bonds may not be suitable for all investors. You should consult with your own advisors as to the suitability of the Bonds for your particular circumstances. Past performance is not indicative of future returns, which will vary. This Investor Presentation may contain “forward-looking” statements that involve risks, uncertainties and assumptions. If the risks or uncertainties ever materialize or the assumptions prove incorrect, the results may differ materially from those expressed or implied by such forward-looking statements. We caution you not to place undue reliance on these statements. All statements other than the statements of historical fact could be deemed forward-looking. All opinions, estimates, projections, forecasts and valuations are preliminary, indicative and are subject to change without notice. Prospective investors should contact their salesperson at, and execute transactions through an underwriter for the Bonds qualified in their home jurisdiction unless governing law permits otherwise. 2
Investment Highlights • Large scale , covering broad geographic area – more than 8 million people • Stable financial profile • #1 in market, with continued market share gains • 29.9% inpatient market share, more than 2x that of any other provider in the greater metro NY area • Largest market share growth in last 6 years compared to top 5 systems in service area • Demonstrated track-record of successful integration of acquired hospitals, physician practices, and other assets • Experienced, stable management team • Centralized governance & strategic decision-making 3
• A proud history of achievement; innovation and growth. − Consistency of strategy and purpose − Stability of performance • A recognition of how much has changed. − Role of the hospital − Creation of a distributed network − New programs; new business A progressive culture. • The Northwell − Collaborative and team-based Perspective − Optimistic, integrated and adaptive • An understanding of the responsibility and obligation of leadership. − An agent of continuous change and practical disruption − Responsibility to the community at large A commitment to the promotion and advancement of • overall health. − More than the delivery of excellent medical care − Long-term view; multi-year perspective 4
Key Facts … The largest integrated health system in New York State 19 $11.6 hospitals billion 750+ operating revenue ambulatory facilities 1,800 2,500 5.5 million 29.9% 1,800 residents clinical patient encounters inpatient share residents 4,000 and fellows in research of market and fellows in 120 programs studies conducted 120 programs researchers 4,300+ employed physicians nearly 70,000 12,600+ employees affiliated physicians 5
Northwell Health Major Components 6
We Have Been Busy This Past Year 7
Key Focus Areas Current Operations Growth Diversification 8
Current Operations – Enhanced Effectiveness Cumulative Beds Created Through Efficiency 800 700 660 600 612 571 500 506 469 436 400 402 339 300 280 227 200 120 100 53 - 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 9
Current Operations – Enhancing Our P&L: Revenue & Expense Focus 10
Growth – 19 Hospitals and 750+ Ambulatory Locations 11
Growth – Ambulatory Network Referral Funnel Credentialed Voluntary Physicians………. 13,600 Voluntary Premium IPA…………………………….. 2,446 Employed Physicians………………………………………. 4,380 Ambulatory Practices…………………………………………... 636 750+ (2) Urgent Care Centers………………………………………………….. 52 Ambulatory Locations Ambulatory Surgery Centers………………………………………… 15 (1) Hospitals & Post Acute Services The referral funnel has caused many of our Hospitals to be at or above full capacity (1) Includes majority and minority-owned joint ventures as well as hospital-based ASCs. 12 (2) Total also includes non-physician practice ambulatory locations, such as imaging centers.
Growth – Expanding Operating Revenue ($ in Billions) $12.0B $11.6B $10.0B $10.0B $9.3B $8.5B $8.0B $7.4B $7.0B $6.6B $6.2B $6.0B $5.5B $4.8B $4.2B $4.4B $3.4B $3.6B $3.8B $3.9B $4.0B $2.5B $2.6B $2.8B $2.9B $3.1B $2.0B $1.7B $1.7B $1.0B - 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 13 Note: Excludes Health Insurance companies
Growth – Expanding Market Share Source: SPARCS data as of 2018 YTD September based on discharges and patient origin; excludes normal newborns (DRG 795). Market includes Staten Island, Queens, Manhattan, Nassau, Suffolk, and Westchester residents. 14 * Includes all Northwell hospitals in both years, including Peconic Bay, which joined Northwell on January 1, 2018, and all competitor hospitals for both years.
Diversification – Shifting to Ambulatory 15 Note: Excludes Health Insurance companies
Growth – Telehealth Initiatives Telehealth Services enable the highest quality of specialist care in both inpatient and outpatient settings • An interdisciplinary team from across the enterprise • Interconnecting our backend systems to provide a digitally- powered, patient-centric experience 16
Diversification – Clinical Joint Ventures Leveraging investments & partnership expertise to enter new markets and expand clinical capabilities 13 Joint Venture Surgery Centers 52 Urgent Care Centers 7 centers operational 7-10 more within the next 2 years (1) 150,000 treatments annually Additional centers in Development (1) 17 (1) Subject to receipt of regulatory approvals.
Diversification – Expanding Opportunities Moving to For-Profit 18
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