INTELLIMARKER. Ambulatory Surgical Center Financial & Operational Benchmarking Study

Transcription

1 2012 INTELLIMARKER Ambulatory Surgical Center Financial & Operational Benchmarking Study

2 Chateau Plaza 2515 McKinney Ave., Ste Dallas, TX The Pinnacle Building 150 3rd Ave. South, Ste Nashville, TN

3 Ambulatory Surgical Centers Financial & Operational Benchmarking Study 2012 Study based on analysis of over 201 licensed freestanding ASCs and one million cases SEVENTH EDITION Published December 2013

4 MULTI-SPECIALTY ASC INTELLIMARKER 2012 No part of this publication may be reproduced or retransmitted in any form or by any means, in whole or in part, without written permission from VMG Health, LLC. Violators risk criminal penalties and civil damages for each offense. We prosecute copyright violations vigorously.

5 MULTI-SPECIALTY ASC INTELLIMARKER Table of Contents Overview... 1 Data Interpretation - A Report User s Guide... 5 Industry Analysis... 7 Aggregated Statistical Analysis Regional Analysis Facility Size by Operating Rooms Facility Size by Case Volume Facility Size by Net Revenue Facilities with Greater than 50% in Orthopedics VMG Health, LLC Rights Reserved. i

6 MULTI-SPECIALTY ASC INTELLIMARKER Index of Charts Section 4 Aggregated Statistical Analysis...15 Income Statement...16 Common Size Income Statement...17 Balance Sheet...18 Common Size Balance Sheet...19 Liquidity Analysis...20 Accounts Receivable Analysis...21 Case Volume Mix as a percent of Total Cases...22 Case Volume Summary...23 Payor Mix as a percent of Gross Charges...24 Revenue per Case...25 ENT Revenue per Case...26 GI/Endoscopy Revenue per Case...27 General Surgery Revenue per Case...27 OB/GYN Revenue per Case...28 Ophthalmology Revenue per Case...28 Oral Surgery Revenue per Case...29 Orthopedics Revenue per Case...29 Pain Management Revenue per Case...30 Plastic Surgery Revenue per Case...30 Podiatry Revenue per Case...31 Urology Revenue per Case...31 EBITDA Margin Analysis...32 Staffing Summary...33 Hourly Salaries & Wages...34 Staff Hours per Case...35 Operating Expense Analysis...36 Facility Statistics...37 Leverage Ratios...38 Section 5 Regional Analysis...39 Income Statement...40 Common Size Income Statement...41 Balance Sheet...42 Common Size Balance Sheet...43 Liquidity Analysis...44 Accounts Receivable Analysis...45 Case Volume Mix as a percent of Total Cases...46 Case Volume Summary...47 Payor Mix as a percent of Gross Charges...48 Revenue per Case - West...49 Revenue per Case - Southwest...50 Revenue per Case - Midwest...50 ii ii VMG Health, LLC Rights Reserved. VMG Health, LLC 2010 Rights Reserved.

7 MULTI-SPECIALTY ASC INTELLIMARKER 2010 MULTI-SPECIALTY ASC INTELLIMARKER Revenue per Case - Southeast...51 Revenue per Case - Northeast...51 ENT Revenue per Case...52 GI/Endoscopy Revenue per Case...53 General Surgery Revenue per Case...53 OB/GYN Revenue per Case...54 Ophthalmology Revenue per Case...54 Oral Surgery Revenue per Case...55 Orthopedics Revenue per Case...55 Pain Management Revenue per Case...56 Plastic Surgery Revenue per Case...56 Podiatry Revenue per Case...57 Urology Revenue per Case...57 EBITDA Margin Analysis...58 Staffing Summary...59 Hourly Salaries & Wages...60 Staff Hours per Case...61 Operating Expense Analysis...62 Facility Statistics...63 Leverage Ratios...64 Section 6 Facility Size by Operating Rooms...65 Income Statement...66 Common Size Income Statement...67 Balance Sheet...68 Common Size Balance Sheet...69 Liquidity Analysis...70 Accounts Receivable Analysis...71 Case Volume Mix as a percent of Total Cases...72 Case Volume Summary...73 Payor Mix as a percent of Gross Charges...74 Revenue per Case - Facilities with 1-2 ORs...75 Revenue per Case - Facilities with 3-4 ORs...76 Revenue per Case - Facilities with 5 ORs...76 ENT Revenue per Case...77 GI/Endoscopy Revenue per Case...78 General Surgery Revenue per Case...78 OB/GYN Revenue per Case...79 Ophthalmology Revenue per Case...79 Oral Surgery Revenue per Case...80 Orthopedics Revenue per Case...80 Pain Management Revenue per Case...81 Plastic Surgery Revenue per Case...81 Podiatry Revenue per Case...82 Urology Revenue per Case...82 VMG Health, LLC Rights Reserved. iii

8 MULTI-SPECIALTY ASC INTELLIMARKER 2010 MULTI-SPECIALTY ASC INTELLIMARKER EBITDA Margin Analysis...83 Staffing Summary...84 Hourly Salaries & Wages...85 Staff Hours per Case...86 Operating Expense Analysis...87 Facility Statistics...88 Leverage Ratios...89 Section 7 Facility Size by Case Volume...91 Income Statement...92 Common Size Income Statement...93 Balance Sheet...94 Common Size Balance Sheet...95 Liquidity Analysis...96 Accounts Receivable Analysis...97 Case Volume Mix as a percent of Total Cases...98 Case Volume Summary...99 Payor Mix as a percent of Gross Charges Revenue per Case - Facilities with 2,999 Cases Revenue per Case - Facilities with 3,000-5,999 Cases Revenue per Case - Facilities with 6,000 Cases ENT Revenue per Case GI/Endoscopy Revenue per Case General Surgery Revenue per Case OB/GYN Revenue per Case Ophthalmology Revenue per Case Oral Surgery Revenue per Case Orthopedics Revenue per Case Pain Management Revenue per Case Plastic Surgery Revenue per Case Podiatry Revenue per Case Urology Revenue per Case EBITDA Margin Analysis Staffing Summary Hourly Salaries & Wages Staff Hours per Case Operating Expense Analysis Facility Statistics Leverage Ratios Section 8 Facility Size by Net Revenue Income Statement Common Size Income Statement Balance Sheet iv VMG Health, LLC Rights Reserved.

9 MULTI-SPECIALTY ASC INTELLIMARKER Common Size Balance Sheet Liquidity Analysis Accounts Receivable Analysis Case Volume Mix as a percent of Total Cases Case Volume Summary Payor Mix as a percent of Gross Charges Revenue per Case - Facilities with < 4.5 million in Net Revenue Revenue per Case - Facilities with million in Net Revenue Revenue per Case - Facilities with > 7 million in Net Revenue ENT Revenue per Case GI/Endoscopy Revenue per Case General Surgery Revenue per Case OB/GYN Revenue per Case Ophthalmology Revenue per Case Oral Surgery Revenue per Case Orthopedics Revenue per Case Pain Management Revenue per Case Plastic Surgery Revenue per Case Podiatry Revenue per Case Urology Revenue per Case Staffing Summary Hourly Salaries & Wages Staff Hours per Case Operating Expense Analysis Facility Statistics Leverage Ratios Income Statement Common Size Income Statement Balance Sheet Common Size Balance Sheet Liquidity Analysis Accounts Receivable Analysis Case Volume Summary Payor Mix as a percent of Gross Charges Orthopedics Revenue per Case Staffing Summary Hourly Salaries & Wages Staff Hours per Case Operating Expense Analysis Facility Statistics VMG Health, LLC Rights Reserved. vv

10 MULTI-SPECIALTY ASC INTELLIMARKER ASC Financial & Operational Research and Production Team Publisher Research Analysts Design & Production VMG Health Aaron Murski Chance Sherer, CVA Jonathan Tyroch Colin Park David LaMonte Nikolaus Melder Sean Skellenger Marc Sooter The Multi-Specialty ASC Intellimarker for 2012 was developed by Value Management Group, LLC d/b/a VMG Health. If you have comments about how this report or the study methodology could be improved, you can contact VMG Health at (214) or by to vi

11 MULTI-SPECIALTY ASC INTELLIMARKER 2012 About the Publisher VMG HEALTH Providing insight. Creating value. The healthcare industry is an intricate web of services, affiliations, and legal mandates that grows increasingly complex every day. For healthcare organizations seeking to grow, maximize profita-bility or form new strategic partnerships, having a relationship with financial experts who thoroughly understand the value drivers in today s healthcare industry is absolutely essential. VMG Health is recognized by leading healthcare systems as one of the most trusted valuation and transaction advisors in the U.S. Unlike most firms, which generally serve a wide variety of indus-tries, healthcare is our only area of focus. Our client list includes virtually every type of healthcare service provider in markets throughout the U.S. and around the world from hospitals and healthcare networks to standalone facilities and ancillary service providers. Our primary practice areas include: Business Valuation Services VMG Health performs more than 250 healthcare valuations each year in support of mergers, ac-quisitions, asset sales, joint ventures, divestitures, reorganizations, and litigation activities. Beyond providing an assessment of the value of the business, our process helps providers gain more in-sight into value and profitability drivers, which ultimately help them enhance their operational and business potential. Transaction Advisory Services Markets evolve, new technologies emerge, relationships change and opportunities arise. VMG Health helps buyers and sellers plan proactively or quickly adapt by providing thorough and objective financial insights at a strategic level, including valuations, financial projections, market and investment analyses, and assistance with financial structures, terms, and documentation. Joint Venture Relationship Development Healthcare is a business based on relationships but the limits and definitions of those relationships can be as varied as the myriad number of specialties in the industry. Whether the joint ven-ture involves a hospital, surgery center, cath lab, or any other facility relationship, VMG Health provides strategic and financial services to help ensure a mutually beneficial outcome, from initial analysis and strategy development to assistance with terms, planning, and documentation. Professional Services Valuations The current healthcare environment is characterized by a diverse array of physician relationships with healthcare organizations. From consulting agreements to call coverage, the relationships are vital to enhancing product and service quality. To ensure compliance with regulatory guidelines, including federal and state anti-kickback statutes, VMG Health values these relationships to ensure that these relationships are established at fair market value. vii

12 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Tangible Asset Appraisals Healthcare transactions are being watched closely in today s environment. To ensure compliance with regulatory guidelines, including federal and state anti-kickback statutes, and to ensure proper tax treatment for all parties, asset purchases must be conducted at the purchased assets fair market value. VMG Health s healthcare and valuation expertise allows us to understand all potential issues when establishing fair market value for assets by any healthcare organization. Real Estate Valuations Real Estate assets have been and continue to be critical assets within the healthcare arena. The certified real estate valuation team within VMG Health has over 50 years of combined experience and was established to provide expert real estate valuation and consulting services to healthcare facility owners, operators, lenders and their advisors. The special nature of healthcare real estate assets requires a firm understanding of the business, financial and legal environment in which our clients work. The professionals at VMG Health are valuation experts who are focused on the unique characteristics of the healthcare field. Notices and Disclaimer The information in the Multi-Specialty ASC Intellimarker is intended to provide readers with information regarding ranges of financial and operating results of ASCs around the country as provided by participants in the study conducted by VMG Health. Improper use of this information, including but not limited to, limiting competition, restricting trade, reducing or stabilizing salary or benefit levels, is expressly prohibited. Such improper use is prohibited by federal and state antitrust laws. Violators risk criminal penalties and civil damages for each offense. The material contained herein is based upon information that we consider to be reliable, but neither VMG Health nor its affiliates warrant its completeness, accuracy or adequacy and it should not be relied upon as such. Any assumptions, opinions or estimates used in connection with the analysis and preparation of the Intellimarker constitute our judgment as of the date of this material and are subject to change without notice. Neither VMG Health nor its affiliates are responsible for any errors or omissions or for results obtained from the use of this information. Past performance is not necessarily indicative of future results. This report contains valuable information of VMG Health which is licensed to purchasers of the study for internal review only. No other use is permitted. Requests for permission to make copies of any part of this publication or to arrange for additional user licenses should be directed to: VMG Health Chateau Plaza 2515 McKinney Avenue Suite 1500 Dallas, TX viii

13 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Confidentiality Information furnished by participants in our research, including but not limited to, information regarding the business, financial condition, customer lists, marketing strategy, names of employees, compensation amounts and formulas, billing amounts, operations, and prospects shall be treated as confidential. VMG Health will not disclose or reveal any of the confidential information to any persons or entities other than to those employees, officers or directors or affiliates who need access to actively and directly participate in the evaluation of the information and the production of such research. No individual facility information is disclosed in our research and all data is used in a form that makes it impossible to determine the identity of an individual facility. information is presented in the aggregate and as summarized statistics. iv

14 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Section 1 - Overview INTRODUCTION The Multi-Specialty ASC Intellimarker (the Intellimarker ) provides detailed financial benchmarking information and analysis on ambulatory surgical centers ( ASCs ) around the United States. The Intellimarker is designed to help you better understand the relative financial and operating performance of ASCs. By comparing an ASC s results to other similar facilities, you can identify areas where a facility might be excelling as well as target areas for improvement. The Intellimarker data can help pinpoint issues and provide a basis for developing actionable strategies for improving financial performance and creating value. The Intellimarker provides detailed information and analysis on all of the significant areas of financial and operational performance. The report includes detailed revenue analyses including gross and net revenues per case by specialty. Benchmarks and analyses are provided on case mix and volume, payor mix, staffing, supplies and other expense items. Balance sheet analysis includes accounts receivable agings, information on assets, working capital and the financing of centers. The study is based on the actual detailed financial and operating performance information from over 200 centers around the country representing an aggregate case volume of over 1.2 million cases. INSIDE THE INTELLIMARKER STUDY METHODOLOGY Data Collection: Experts from VMG Health formed a research oversight committee to set the standards for participation, for information included in the report, and for the analysis and presentation of the information. Our analysts and research team aggregated, compiled and analyzed all of the data provided by participants. Participants in the study were asked to contribute actual financial and operating reports from their facilities. The information included in this study is taken directly from the detailed income statements, balance sheets, accounts receivable aging reports, operating reports, staffing reports, and other information from all of the centers participating in the study. The raw data, provided to our analysts was gathered and immediately reviewed for accuracy and completeness. In the evaluation of each center s information, we identify missing data, inconsistencies and other reporting errors. As a part of our protocol, we contact each center to reconcile errors and secure any omitted data. In an effort to ensure the highest quality data, centers contributing incomplete data or with irreconcilable reporting errors have been excluded from the analysis. The research was conducted using 2010 and 2011 information. Participants in the Multi-Specialty ASC Intellimarker include only in-network, multi-specialty ASCs. Data Compilation and Analysis: The accuracy and reliability of the Intellimarker metrics is a direct function of the quality of the data gathered. As a result, the compilation of accurate and complete information is critical to ensuring the quality of the reported data. 1

15 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Aggregated data on each center is then analyzed and uploaded into our proprietary database. By using the actual detailed data provided by participants in the study, we are able to directly categorize and input data to ensure consistency and comparability. The resulting database is then used in the preparation of the final analysis and reports presented in the report. Throughout the data collection process, the research oversight committee served to refine performance measurements, benchmarking metrics and the other important information specific to the successful operation of ASCs. Data Presentation: In order to use benchmarking data effectively, it is important to use information that is as closely comparable as possible. The information in the Intellimarker has been divided into multiple sections each presenting the ASC data in a different grouping in order to enable users to ensure comparability. Each section in the report is identified by the vertical color tab on each page. Virtually every page is dedicated to a different analysis. The benchmark information and analysis summarizes the relevant data with a table and a chart or graph. The sections include an aggregated statistical analysis, a regional analysis, an analysis of facilities by size by number of ORs, by case volume, and more. Each section provides information and analysis on all of the significant areas of financial performance in a slightly different grouping. There are approximately 35 different analyses and groupings of information in each section showing over 100 different performance indicators. The statistics presented on each page allow report users to evaluate and compare ASC financial and operating performance to the industry. The Aggregated Statistical Analysis section includes data from all of the participants in the study. The statistical breakdown of the data provides additional detail on the reported information. The data is presented as an average, or statistical mean. The standard deviation illustrates the variance of the data around the mean. The quartile and decile information is also provided to show how the data is distributed. Similarly, the other sections, as detailed in the chart above, report the data in a variety of ways to enable user to isolate groupings that might be most comparable. The Regional Analysis section provides a breakdown of the data from participants by region (see Participation for additional detail on each region). Facility Size by Operating Room groups the participant data into centers with one and two OR facilities, three and four OR facilities and greater than five OR facilities, and so on. 2

16 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Participation: The study includes the analysis Multi-Specialty of over 201 ASC freestanding Intellimarker ASCs 2011 across the United States, representing over one million surgical cases across specialties. The information received from participants Participation: in the study included financial and operating information from calendar years 2010 and The study includes the analysis of over 240 freestanding ASCs across the United States, representing over one million surgical cases across specialties. The information received from partici The study is based on twelve months of operations using the detailed financial and operatinpants performance in the study reports included of these financial facilities. and operating information from calendar year 2009 and The study is based on twelve months of operations using the detailed financial and operating performance of the reports facilities of these submitting facilities. data were excluded from the study based on incomplete or Certain otherwise questionable data. The charts, tables and analysis included in Sections 4-9 in this report Certain are of based the facilities on a final submitting count of data 201 were freestanding excluded from ASCs, the representing study based on a incomplete total case or volume otherwise questionable cases. A detailed data. The breakdown charts, tables of centers and analysis and case included volume in included Sections in 4 - the 9 in study this report is below. of 1,241,348 are based on a final count of 243 freestanding ASCs, representing a total case volume of 1,676,688 cases. A detailed breakdown of centers and case volume included in the study is below. West 36 Midwest 40 Northeast 26 Southwest 63 Southeast 36 VMG Health, LLC 2011 Rights Reserved 7 3

17 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Multi-Specialty ASC Intellimarker 2012 Ophthalmology Orthopedics Oral Surgery 14,216 27, , ,131 6,218 81,983 80,581 4,223 Pain Orthopedics Management 50,220 22, , ,642 65,334 65,638 Plastic Pain Management 44,462 4, ,195 26,785 54,207 23,624 Podiatry Plastic 4,704 3,955 26,371 17,883 22,340 17,520 Urology Podiatry 4,890 3,800 41,631 20,040 13,068 24,914 Other Urology 3, ,455 6,600 18,226 10,650 Total Cases 234, , , , , ,962 Multi-Specialty ASC Intellimarker 2012 Multi-Specialty ASC Intellimarker 2011 The following The table following details the table details the case volume by specialty Multi-Specialty case volume by ASC specialty Intellimarker included 2011 in the The study. following The chart following illustrates the chart participation illustrates the participation in the Formatted: Font: in Arial, the Not study Highlight by facility size by case volume. included in the study. study by facility size by case volume. The following table details the case volume by specialty included in the study. Formatted: Font: Font: Arial, Arial, Not Not Highlight Highlight Aggregated Statistical Analysis Facility Size by Case Volume Formatted: Font: Arial, Not Highlight < 3,000 3,000-5,999 > 5,999 Number Aggregated of ASCs Statistical Analysis Number Cases by of Specialty ASCs Cases by Specialty Cases ENT by Specialty 8,724 41,037 61,471 ENT Number of ASCs 111, , ENT GI 6,059 8,024 27,081 73, , ,808 GI Cases by Specialty 236, ,219 GI General Surgery 8,597 7,596 46,070 24, ,552 55,831 General ENT Surgery 133, , ,994 87,591 General OB/GYNSurgery 5,245 3,742 22,405 15,534 28,309 84,344 OB/GYN GI 375, ,713 47,585 61,343 OB/GYN Ophthalmology 10,336 3,756 13,983 54, ,291 43,604 Ophthalmology General Surgery 111, , ,173 87,591 Ophthalmology Oral Surgery 6,682 1,478 61,035 6, ,456 3,395 Oral OB/GYN Surgery 61,343 47,585 10,914 13,130 Oral Orthopedics Surgery 21, ,142 4, ,345 8,688 Orthopedics Ophthalmology 247, , , ,949 Orthopedics Pain Management 24,134 16,936 69,093 56, , ,722 Pain Oral Management Surgery 200, ,779 13,130 10, ,949 Pain Plastic Management 17,846 5,567 57,624 14, ,309 24,261 Plastic Orthopedics 217,976 44,421 56, ,779 Plastic Podiatry 6,820 5,016 12,185 13,937 17,955 37,426 Podiatry Pain Management 200,316 36,908 47,988 56,431 Podiatry Urology 3,261 2,650 15,456 16,582 33,026 29,271 Urology Plastic 44,421 52,258 73,614 47,988 Urology Total Cases 91,558 1, ,587 12, ,815 59,823 Other Podiatry 36,908 14,388 18,120 1,676,688 73,614 Other 1,417 2,140 14,563 Total Urology Cases 1,241,348 52,258 Other 18,120 14,388 Total Cases 85, ,684 1,247,566 Total Cases 1,676,688 1,241,348 Multi-Specialty ASC Intellimarker 2012 Multi-Specialty ASC Intellimarker 2011 The following chart illustrates the participation in the study by regional location. Formatted: Font: Arial The following chart illustrates the participation in the The following chart Formatted: illustrates Font: Arialthe participation in the The following chart illustrates the participation in the study by regional location. The following chart illustrates the Formatted: participation Font: Arial in study by facility size by revenue. study by regional location. study by facility size Formatted: by revenue. Font: Arial Regional Analysis Regional Analysis W SW MW SE NE Cases Number by of Specialty ASCs W SW MW SE NE ENT Cases by Specialty 19,701 31,463 26,787 21,641 11,640 Cases Number by of Specialty ASCs GI ENT 19,502 41,497 35,187 24,115 13,647 Cases by Specialty 34,814 83,863 39,506 45,353 33,177 ENT 19,701 31,463 26,787 21,641 11,640 General GI ENT Surgery 12,179 36,250 19, ,511 31,834 41,497 35,187 15,941 50,401 24,115 14,752 98,650 13,647 12,885 49,407 GI 34,814 83,863 39,506 45,353 33,177 OB/GYN General Surgery 10,482 43,412 18,536 24,950 14,614 General GI Surgery 12,179 36,250 4, ,511 17,182 31,834 50,401 15,941 11,264 98,650 14,752 6,845 49,407 12,885 8,225 Ophthalmology OB/GYN OB/GYN General Surgery 24,072 10,482 4,050 4,069 75,054 43,412 17,182 23,617 18,536 11,264 23,973 14,026 24,950 32,988 11,677 6,845 14,614 24,959 8,225 7,973 Oral Ophthalmology Ophthalmology OB/GYN Surgery 45,448 24,072 2,595 4,050 23,617 75,054 78,091 6,107 14,026 23,973 33, ,677 32,988 59, ,959 7,973 31, Orthopedics Oral Oral Ophthalmology Surgery Surgery 43,904 45,448 4,318 2,595 48,353 78,091 6,107 7,103 33,043 57, ,137 33, ,454 35, Pain Orthopedics Oral Management Surgery 33,941 52,275 43,904 4,318 42,729 48,353 62,310 7,103 57,703 43,344 73, ,002 51,071 42, ,014 29,231 38, Plastic Pain Pain Orthopedics Management 10,789 55,489 33,941 52,275 10,816 42,729 62,310 58,750 73,904 43,344 13,150 63,192 42,476 51,071 60,925 8,068 38,984 29,231 29,423 1,598 Podiatry Plastic Pain Management 10,401 10,789 55,489 4,705 11,234 10,816 58,750 13,265 63,192 13,150 19,044 8,956 60,925 10,592 8,068 4,893 29,423 1,598 7,120 3,129 Urology Podiatry Plastic 10,401 6,043 5,300 4,705 13,547 11,234 13,265 13,520 19,044 13,227 8,956 8,052 10,592 10,155 4,893 7,320 14,461 3,129 7,120 8,621 Total Urology Podiatry Cases 196,812 9,936 6,043 5, ,182 13,547 13,520 18, ,543 13,227 8,052 9, ,403 10,155 11,784 7, ,020 14,461 23,259 8,621 Other Total Urology Cases 196,812 3,702 9, ,182 18,774 6, ,543 9,861 6, ,403 11,784 1, ,020 23,259 1,082 Total Other Cases 257,153 3, ,031 6, ,781 6, ,325 1, ,398 1,082 Total Cases 257, , , ,325 Multi-Specialty ASC Intellimarker ,398 Formatted: Font: Arial Formatted: Font: Arial Formatted: Font: Arial Facility Size by Net VMG Revenue Formatted: Health, LLC Font: Arial Rights Reserved < $4.5 M $4.5 M - $6.9 M > $6.9 M Cases Number by of Specialty ASCs ENT Cases by Specialty GI ENT 18,606 46,298 23,079 27,230 68,409 40,407 65, ,006 83,130 General GI Surgery 12,889 84, ,051 14, ,033 60,213 OB/GYN General Surgery 17,954 6,444 18,526 6,695 34,445 77,428 Ophthalmology OB/GYN 28,760 7,407 26,822 9, ,464 47,099 Oral Ophthalmology Surgery 49,034 2,477 77,327 4, ,233 4,425 Orthopedics Oral Surgery 29,942 3,863 45,388 1, ,647 7,610 Pain Orthopedics Management 44,015 37,384 55,492 65, , ,962 Plastic Pain Management 46,992 6,755 10,069 67, ,000 27,597 Podiatry Plastic 10,079 5,868 15,704 7,690 23,351 33,117 Urology Podiatry 7,999 9,030 7,886 9,657 36,373 32,510 Total Urology Cases 210,053 7, ,182 10, ,725 56,759 Other 1,259 3,601 13,701 Total Cases 298, ,077 1,017, Multi-Specialty ASC Intellimarker 2011 The following The chart following illustrates chart the participation illustrates in the study participation by facility size in by the number of operating rooms. study by facility VMG size Health, by number LLC 2012 of operating Rights Reserved rooms. VMG Health, LLC 2012 Rights Reserved 7 7 Facility Size by Number Operating VMG Health, of Room Operating LLC 2011 Rooms Rights Reserved VMG Health, LLC 2011 Rights Reserved ORs 3-4 ORs > 4 ORs 8 Number Cases by of Specialty ASCs Cases ENT by Specialty ENT GI 7,671 43,682 8,132 52, ,829 64,706 50,671 64,774 54,344 GI General Surgery 94,152 5, ,140 44, ,087 38,277 General OB/GYNSurgery 6,423 3,714 54,094 23,174 19,643 46,973 OB/GYN Ophthalmology 14,216 1,981 31,979 81,254 81,983 25,611 Ophthalmology Oral Surgery 30, ,682 6, ,320 4,223 Oral Orthopedics Surgery 22, ,642 7,660 65,334 4,700 Orthopedics Pain Management 27,134 44, , ,195 54,207 80,581 Pain Plastic Management 50,220 3, ,028 17,883 22,340 65,638 Plastic Podiatry 4,814 3,800 26,785 20,040 13,068 23,624 Podiatry Urology 4,704 3,577 26,371 30,455 18,226 17,520 Urology Total Cases 152,784 4, ,660 41, ,746 24,914 Other 193 6,600 10,650 Total Cases 234, , ,962 The following chart illustrates the participation in the study by facility size by case volume. Formatted: Font: Arial Formatted: Font: Arial Formatted: Font: Arial The following chart illustrates the participation in the study by facility size by case volume. Facility Size by Case Volume 4 Facility Size by Case Volume < 3,000 3,000-5,999 > 5,999 Cases by Specialty ENT < 3,000 8,724 3,000-41,037 5,999 > 5,999 61,471 Number GI of ASCs 8, , , Cases General by Surgery Specialty ENT OB/GYN 7,596 6,059 3,742 24,164 15,534 27,081 55, ,808 28,309 GI Ophthalmology 10,336 8,597 54,419 46, , ,552 General Oral Surgery Surgery 5,245 1,478 22,405 6,041 84,344 3,395 Formatted: Font: Arial VMG Health, LLC 2012 Rights Reserved VMG Health, LLC 2011 Rights Reserved 9 10

18 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Section 2 - DATA INTERPRETATION A REPORT USER S GUIDE HOW TO USE THE INTELLIMARKER Selecting appropriate comparables: facilities are different. They each have unique case mixes, different volumes and negotiated reimbursement schedules. They are sized differently, some with more operating rooms, others with larger medical staffs. While there are no perfect comparables for any facility, comparing a single center to a meaningfully sized group of peers eliminates the impact any one facility might have on the aggregated financial performance information. In order to compare a facility to as close a group of peers as possible, it is best to look at several different groupings of centers. For example, a two OR facility in Arkansas, with approximately 3,400 cases annually would be best served by looking at more than one subset of the benchmark data. Compare the facility to the aggregated information, but also look at data provided in the regional grouping, the facility size by OR grouping, and the facility size by case volume grouping. The data from multiple groups will provide a range to compare performance to and also provide a higher degree of certainty that the results are accurate and truly comparable. Additionally, since all centers are unique, it might also be necessary to make adjustments to arrive at the most comparable information. Determining where in the range a particular center should fall depends on the details of the particular ASC. For example, an ASC with a case mix more heavily weighted to high volume pain management procedures, might be staffed differently than the industry averages. Identifying factors like these can help narrow the range even further, providing a more accurate measure against which to compare. Identifying and understanding the variances: Compare a center s performance data and identify the variances. Use each of the metrics contained in this study for a clear understanding of performance. The charts, tables and graphs have been selected to include the most meaningful performance information and designed to provide the most relevant information. The easy-to-read graphs and charts provide additional support to the detail provided in the tables. Significant discrepancies from the benchmarks are the first places to look to understanding operating strengths and areas for improvement. While variances identify the places to look, they rarely provide an adequate explanation of how a center is different. When variances are located, it is crucial to dig deeper to understand the cause for the discrepancies. For example, variances in revenue from comparable centers are related to either the amount of revenue collected per case or the volume of cases performed in a center. Further detailed analysis of charges, a coding review or a review of the reimbursements from each payor would provide more insight into the causes for any variances in collected revenue. Understanding the detail be-hind case mix and the numbers of cases per day or per operating room will help shed light on vol-ume differences from other centers. 5

19 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Using the results to effect change and improve performance: There may be perfectly valid reasons for variances from the benchmark, and it does not necessarily signal under performance in that area. Not every variance is a call for change. In those in-stances where the variance from the benchmark results in actionable steps to improve operations, it is important to implement the change and continue to monitor the results. Start by identifying and changing the most obvious and the easiest to implement and move on from there. Plan change initiatives and measure the outcomes. This is when benchmark data is more important than ever. Using the data is not a one-time event. Use it as a resource to mark and measure pro gress on an ongoing basis. Limitations of the Data: Participants in the study may not be representative of all ASCs. The study is based on a statistical sampling of ASCs around the country. Participation in the study is voluntary, and as such, the dis-tribution of centers is not uniform across each area of analysis. For example, certain regions have greater participation than others, and facilities of a particular size might be under or over repre-sented. In these instances, the data might contain bias. Comparisons to specific operating charac-teristics should be made with caution and the understanding that the data might, or might not be directly comparable. Individual management decisions or other decisions related to strategy, per-sonnel, or other business practices should take into account the all of the relevant attributes of the specific facility. 6

20 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Section 3 - INDUSTRY ANALYSIS General Healthcare Overview Healthcare Spending in the United States Over the last fifty years, health care spending as a percent of GDP has grown from approximately 4% to approximately 17%. This steady rise in health care spending is illustrated in the graph below. Healthcare spending in the United States grew 3.9% in 2010 following a 3.8% increase in Total health expenditures reached $2.6 trillion in 2010, which translates to $8,402 per person or 17.9% of the nation s GDP. 20.0% Na onal Healthcare Spending as a % of GDP 18.0% 16.0% 14.0% 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% Ambulatory Surgery Center ( ASC ) Industry Overview Ambulatory surgery refers to lower-acuity, planned, surgical procedures that can be performed on an outpatient basis and typically require less than a 24-hour stay. These surgeries can be performed in either a hospital outpatient surgery unit or in a non-hospital site such as a freestanding ambulatory surgery center ( ASC ). ASCs provide a more productive environment than traditional acute care hospitals since the doctor can maintain his or her schedule without the interruption of emergencies that can delay scheduled surgeries in the hospital setting. Likewise, patients may prefer the less institutionalized environment of an ASC. ASCs also provide a setting for surgical procedures to be performed at a considerable discount, in terms of cost, compared to a hospital setting. ASCs provide the surgical equipment and supplies, personnel, and other supporting services that enable their surgeon-users to perform surgery cases. The physicians typically do not pay for these services, but instead, the ASC bills a technical fee to the patient and/or payor for these technical, or non-physician services provided to the patient. Separately, the physician bills his or her professional fees to the patient or payor. The ASC neither employs nor pays compensation to the surgeon-users. Consequently, the success or failure of an ASC is directly related to its ability to provide the necessary technical services to enable its surgeon-users to perform their surgical cases. 7

21 MULTI-SPECIALTY ASC INTELLIMARKER 2012 The idea of performing surgery on an outpatient basis was first explored and brought into a public forum in 1966 by the Journal of the American Medical Association ( JAMA ). JAMA suggested that it is possible to conduct a program of Anesthesia for outpatient surgery without compromising patient safety. Shortly thereafter, the health insurance industry began exploring alternatives to the high costs associated with procedures in hospitals and the United States National Advisory Commission on Health Facilities began experimenting with lowering healthcare costs. In 1970, the first ASC was opened and within one year a second facility was opened. In 1971, the American Medical Association ( AMA ) endorsed ASCs under general and local anesthesia for selected procedures and patients. By 1976, there were 67 ASCs in the country. Although Medicare began to collaborate with six ASCs in 1974, it was not until 1982 that the Medicare program approved payment for 200 selected procedures performed in ASCs. As a result of this approval and increased demand by physician users and patients, the number of Medicare licensed ASCs has grown to about 5,900 centers. The expanded acceptance by Medicare and other payors has led to large growth in both total and types of procedures performed in the ambulatory setting. ASC Industry Trends Percentage Share of Inpatient vs. Outpatient Surgeries 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Source: American Hospital Association Outpa ent Surgeries Inpa ent Surgeries Of all the surgery cases performed in the United States in 2010, approximately 63.0% were performed in the outpatient setting. Outpatient surgery as a percentage of total surgery has increased significantly from 1980 to The increase in surgical procedures performed in outpatient settings is primarily linked to both the rise of ASCs as well as technological and surgical procedure innovation which has expanded the types of procedures suitable for an outpatient setting. Beginning in the early to mid-1990s, the shift in surgical volume from inpatient to outpatient began to flatten. Since 2000, the percentage of surgeries performed in the outpatient setting has remained steady at approximately 63.0% of total surgeries. The lack of growth in outpatient surgery versus inpatient surgery suggests a maturing of the ASC industry. 1 1 Trendwatch Chartbook 2011 as provided by the American Hospital Association and Avelere Health 8

22 MULTI-SPECIALTY ASC INTELLIMARKER 2012 As the chart below illustrates, total Medicare payments for ASC services more than doubled between 2000 and Payments increased approximately 8.7% compounded annually from approximately $1.4 billion in 2000 to $3.5 billion in During the same time period, the number of Medicare-certified ASCs grew approximately 5.3% compounded annually from 3,028 in 2000 to 5,344 centers in The growth in Medicare payments to ASCs far outpaced the growth in Medicare certified ASCs during the period prior to Since 2005, this trend slowed significantly, coinciding with the freeze in Medicare grouper payments to ASCs which became effective in Growth in Medicare payments to ASCs have fallen from a high of 16.7% in 2000 to 2.9% in The reduction in growth in Medicare payments reflects slower annual growth in the number of Medicare certified ASCs, which has fallen from 9.0% in 2001 to 1.8% in Medicare ASC Trends Medicare ASC payments (in $1.4 $1.6 $1.9 $2.2 $2.5 $2.7 $2.8 $2.9 $3.1 $3.2 $3.4 $3.5 billions) Growth (Es mated) 16.7% 14.3% 18.8% 15.8% 13.6% 8.0% 3.7% 3.6% 6.9% 3.2% 6.3% 2.9% Number of Medicare Cer fied 3,028 3,302 3,545 3,848 4,140 4,362 4,879 5,095 5,217 5,316 5,344 ASCs 4,608 Growth (Es mated) 8.7% 9.0% 7.4% 8.5% 6.7% 7.3% 5.5% 5.9% 4.3% 2.2% 1.8% 1.8% Medicare Payments per Facility $462 $485 $536 $572 $604 $619 $608 $594 $608 $613 $640 $655 (in thousands) Growth (Es mated) 7.3% 4.8% 10.6% 6.7% 5.6% 2.5% -1.8% -2.2% 2.4% 0.8% 4.3% 2.3% 2 A Data Book: Health Care Spending and the Medicare Program (Medpac June 2012) 9

23 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Illustrated below is a representation of those states that require a Certificate of Need ( CON ), states that do not require a CON, and the number of Medicare certified ASCs located within each state in 2007 (last year of reported data). A CON is a state regulatory review process that requires an application to the Department of Public Health for, and receipt of, a CON prior to the offering or development of a new or changed institutional health service. In an effort to control the rapidly escalating costs of healthcare through planning and regulation, CON programs have been designed to evaluate whether a proposed service or facility is actually needed. As supported by the accompanying graph, ASCs are more prevalent in non-con states. Current estimates show that there are approximately 5,900 freestanding ambulatory surgery cen-ters located in the United States. Since 1996, the industry has added on average more than 200 new ASCs per year. Although there are still a number of new ASC projects under development in many areas, the market for ASCs has become increasingly saturated. As evidenced by current market trends, there is also significant opportunity for consolidation within the ASC market. The industry is highly fragmented, composed of several large, publicly and privately owned companies and many smaller, independent operators. Of the 5,900 freestanding ASCs operating in the United States, approximately 1,325 facilities, or 22.4%, are owned or managed by multi-facility chains. ASC Regulatory Environment ASCs are some of the most regulated healthcare facilities in the nation. Each ASC must comply with a host of laws and regulations on both the state and federal level. There are specific items of legislation and CMS guidelines that pertain directly to ASCs. We have outlined and discussed certain of these items and guidelines on the following pages. 3 3 FASA Update Magazine, Nov/Dec 2007 edition; AmSurg 10k; ASC Focus Magazine, November/December 2008 Vol 1 No 6 10

24 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Medicare Conditions for ASC Coverage Update On November 18, 2008, CMS modified the conditions for coverage of ASCs. This was the first time that CMS significantly revised the conditions for coverage of ASCs since the inception of the Medicare ASC benefit in The new regulations changed the definition of an ASC to modify the rules regarding overnight care, added three new conditions and 19 standards, and revised four existing conditions. Now to become and remain a Medicare-certified ASC, a surgery center must comply with 13 conditions and 35 standards. These new regulations, called Conditions for Coverage, became effective on May 19, CMS excludes from ASC payment any procedure for which standard medical practice dictates that the beneficiary who undergoes the procedure would typically be expected to require active medical monitoring and care at midnight following the procedure (overnight stay) as well as all surgical procedures that medical advisors determine may be expected to pose a significant safety risk to Medicare beneficiaries. The criteria used under the revised ASC payment system to identify procedures that would be expected to pose a significant safety risk when performed in an ASC include, but are not limited to, those procedures that: generally result in extensive blood loss; require major or prolonged invasion of body cavities; directly involve major blood vessels; are emergent or life-threatening in nature; or commonly require systemic thrombolytic therapy. Outpatient Prospective Payment System Approved in November of 2007 and commenced on January 1, 2008, CMS implemented a new system for payments to ambulatory surgery centers for the provision of medical services to Medicare beneficiaries. The new payment system is similar to the previous Medicare payment system in that CMS pays ASCs a facility fee intended to cover the non-professional costs associated with providing a surgical procedure. Instead of categorizing payments into one of nine groupers, the new payment is based on ambulatory payment classifications ( APCs ). Medicare will use the same APCs for ASCs as are used for hospital out-patient departments ( HOPDs ). Each CPT code is assigned to an APC, and each APC has a specific payment rate. Although CMS uses APCs to determine the rates that will be paid, ASCs submit for payment using CPT codes. Therefore, ASCs will continue to bill and collect from Medicare using CPT codes. The rate paid to HOPDs for each APC is based upon the APC s relative weight, which is a measure that CMS uses to rank the costs of performing procedures in one APC as compared to those in other APCs, and a uniform conversion factor that applies to all APCs. CMS determines the relative weight for each APC using hospital cost reports. As the cost of performing a procedure increases as compared to other outpatient procedures, its relative weight increases. Conversely, as a procedure s cost goes down as compared to other outpatient procedures, its relative weight decreases. The final step in determining HOPD relative weights is to adjust the new weights to preserve budget neutrality in the HOPD payment system. In 2007, CMS established a four-year transition to the new payment methodology for procedures, a process that gives individual ASCs more time to adjust to the new payment system than an immediate transition to the full system would have provided. As of 2011, ASCs have been fully transitioned to the new payment system. 11

25 MULTI-SPECIALTY ASC INTELLIMARKER 2012 ASC Reimbursement On November 1, 2012, CMS released the final ruling for 2013 ASC payments. CMS will apply a 0.6% increase to ASC payments for CY The ASC payment system is updated annually by the consumer price index for all urban consumers, which CMS estimates to be 1.4% for CY Beginning in CY 2011, the Patient Protection and Affordable Care Act ( PPACA ) requires any annual update under the ASC payment system to be reduced by a productivity adjustment, which is 0.8% for CY CMS estimates that payments to ambulatory surgery centers will be approximately $4.07 billion in CY According to the final rule, the final CY 2013 ASC payment weight scaler is CMS updates the ASC relative payment weights each year using the national OPPS relative payment weights [and Medicare Physician Fee Schedule (MPFS) non-facility practice expense relative value unit (PE RVU)-based amounts, as applicable] for that same calendar year and uniformly scales the ASC relative payment weights for each update year to make them budget neutral. CMS will apply its established methodology for determining the final CY 2013 ASC conversion factor. The final ASC conversion factor of $ is the product of the CY 2012 conversion factor of $ multiplied by the wage index budget neutrality adjustment of and the MFP-adjusted CPI-U payment update of 1.3%. 12

26 MULTI-SPECIALTY ASC INTELLIMARKER 2012 ASC Quality Measure Reporting In the CY 2012 final rule, CMS adopted five quality measures to be reported by ASCs beginning Oct. 1, 2012, for CY 2014 payment determination. These measures include four outcome and one surgical infection control measure to be reported by ASCs on Medicare claims using quality data codes. In CMS CY 2012 final rule for ASC payments, CMS added two structural measures safe surgical checklist use and ASC facility volume data on selected ASC surgical procedures, beginning with reporting in CY 2013 for the CY 2015 payment determination as well as one National Healthcare Safety Network (NHSN) infectioin control measure influenza vaccination coverage among health-care personnel, beginning with reporting in CY 2014 for the CY 2016 payment determinatiions. The following table outlines the meausres finalized for purposes of the CY payment determinations. Though the CY 2013 final rule did not add new measures to the 22 measures finalized for CY 2014, CMS finalized revisions to the ASC Quality Reporting ( ASCQR ) Program. The revisions included specific considerations for data completeness, submission dates, and a methodology for reducing payments to ASCs that do not meet the program s reporting requirements. These measures are set to take effect Cy 2014 through CY

27 MULTI-SPECIALTY ASC INTELLIMARKER

28 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER 2012 SECTION 4 Financial Statements Income Statement 4.1 Common Size Income Statement 4.2 Balance Sheet 4.3 Common Size Balance Sheet 4.4 Revenue Cycle Analysis Liquidity Analysis 4.5 Accounts Receivable Analysis 4.6 Revenue Analysis Case Volume Mix as a percent of Total Cases 4.7 Case Volume Summary 4.8 Payor Mix as a percent of Gross Charges 4.9 Revenue per Case 4.10 ENT Revenue per Case 4.11 GI/Endoscopy Revenue per Case 4.12 General Surgery Revenue per Case 4.13 OB/GYN Revenue per Case 4.14 Ophthalmology Revenue per Case 4.15 Oral Surgery Revenue per Case 4.16 Orthopedics Revenue per Case 4.17 Pain Management Revenue per Case Podiatry Revenue per Case 4.20 Urology Revenue per Case 4.21 EBITDA Margin Analysis 4.22 Sta ysis Sta ry 4.23 Hourly Salaries & Wages 4.24 Sta rs per Case 4.25 Expense Analysis Expense Analysis 4.26 Asset Analysis Liability Detail Aggregated Statistical Analysis VMG Health, LLC 2012 Rights Reserved

29 MULTI-SPECIALTY ASC INTELLIMARKER Aggregated Statistical Analysis 4.1 Income Statement $'s in thousands Patient Revenues Standard Median Mean Dev. 25% 50% 75% 90% Gross Charges $30,988 $18,737 $17,517 $27,071 $41,987 $57,290 Adjustments ($22,987) ($15,520) ($12,575) ($18,441) ($33,139) ($43,505) Net Revenue $7,983 $4,621 $4,450 $7,164 $10,179 $15,133 Operating Expenses Employee Salary and Wages $1,643 $829 $1,081 $1,507 $2,052 $2,521 Taxes and Benefits $393 $245 $226 $349 $503 $644 Occupancy Costs $490 $308 $277 $438 $617 $863 Medical and Surgical $1,644 $1,075 $936 $1,435 $2,139 $2,818 Other Medical Costs $91 $124 $23 $52 $106 $189 Insurance $55 $39 $29 $45 $74 $110 Depreciation and Amortization $352 $287 $175 $264 $448 $717 General & Administrative Bad Debt $156 $152 $69 $117 $199 $316 Management Fees $374 $257 $201 $320 $458 $671 Other G & A $710 $441 $455 $622 $850 $1,235 Total G & A $1,175 $692 $738 $930 $1,441 $1,995 Total Operating Expenses $5,523 $2,699 $3,549 $5,521 $6,792 $8,725 Operating Income $2,107 $2,398 $528 $1,571 $2,933 $5,698 Other Income (Expense) $22 $48 $2 $5 $20 $58 Net Interest Expense $100 $129 $12 $50 $122 $273 Earnings Before Taxes $2,018 $2,397 $463 $1,457 $2,822 $5,696 EBITDA $2,460 $2,455 $745 $1,886 $3,438 $6,370 16

30 MULTI-SPECIALTY ASC INTELLIMARKER Common Size Income Statement Standard Median Mean Dev. 25% 50% 75% 90% Gross Charges % % % % % % Adjustments % % % % % % Net Revenue % % % % % Employee Salary and Wages 23.5 % 8.9 % 18.0 % 23.0 % 28.4 % 32.7 % Taxes and Benefits 5.5 % 3.3 % 4.0 % 5.1 % 6.5 % 8.3 % Occupancy Costs 7.5 % 5.4 % 4.2 % 6.7 % 9.2 % 12.5 % Medical and Surgical 21.6 % 8.0 % 17.3 % 21.4 % 26.1 % 29.8 % Other Medical Costs 1.3 % 1.7 % 0.4 % 0.7 % 1.4 % 2.4 % Insurance 0.8 % 0.6 % 0.4 % 0.7 % 1.0 % 1.4 % 5.8 % 9.6 % 2.4 % 3.7 % 6.1 % 10.6 % Aggregated Statistical Analysis Bad Debt 1.9 % 1.4 % 1.0 % 1.5 % 2.7 % 3.4 % Management Fees 4.9 % 2.6 % 3.7 % 5.0 % 5.9 % 6.8 % Other G & A 10.4 % 6.8 % 6.9 % 8.9 % 12.1 % 16.0 % Total G & A 16.0 % 8.8 % 12.1 % 14.3 % 18.1 % 22.0 % 75.5 % 27.9 % 63.8 % 75.0 % 83.9 % 94.4 % 18.9 % 35.8 % 10.7 % 20.0 % 32.5 % 44.2 % Other Income (Expense) 0.4 % 1.1 % 0.0 % 0.1 % 0.3 % 1.1 % Net Interest Expense 1.8 % 3.3 % 0.2 % 0.7 % 2.0 % 4.3 % Earnings Before Taxes 17.3 % 37.9 % 8.7 % 18.9 % 31.8 % 43.6 % EBITDA 24.5 % 27.9 % 16.1 % 25.5 % 36.2 % 47.6 % 17

31 MULTI-SPECIALTY ASC ASC INTELLIMARKER Aggregated Statistical Sta s cal Analysis 4.3 Balance S eet $'s in thousands ASSETS Standard Median Mean Dev. 25% 50% 75% 90% Cash and Equivalents $702 $708 $283 $510 $923 $1,381 Net Accounts Receivable $769 $505 $427 $628 $965 $1,380 Other Current Assets $238 $211 $105 $174 $292 $468 Current Assets $1,650 $1,171 $878 $1,296 $2,200 $2,893 Gross PP&E $4,023 $2,503 $2,419 $3,389 $5,330 $7,446 ated e e a n ($2,614) $1,498 ($3,516) ($2,273) ($1,561) ($952) Net PP&E $1,510 $1,482 $556 $972 $1,827 $3,654 Other Assets $1,351 $2,620 $24 $158 $1,830 $4,076 Total Assets $3,879 $3,020 $1,782 $2,886 $5,331 $7,921 LIABILITIES ent a es $479 $393 $256 $373 $574 $820 ent n T $272 $273 $68 $169 $396 $676 T ta ent a es $605 $528 $291 $449 $725 $1,224 T ta n Te e t $1,133 $1,489 $89 $417 $1,718 $3,331 t e T a es $330 $798 $6 $47 $307 $918 T ta a es $1,618 $1,802 $414 $949 $2,052 $3,621 EQUITY Shareholders' Equity $2,282 $2,406 $838 $1,570 $2,954 $4,549 Total Lia ili es E uity $3,879 $3,020 $1,782 $2,885 $5,331 $7, VMG Health, LLC 2012 Rights Reserved

32 MULTI-SPECIALTY ASC INTELLIMARKER Common Si e Balance S eet Standard Median Mean Dev. 25% 50% 75% 90% ASSETS Cash and Equivalents 19.7 % 12.4 % 11.0 % 17.0% 29.5 % 40.4 % Net Accounts Receivable 23.6 % 12.8 % 13.9 % 22.1 % 29.2 % 39.9 % Other Current Assets 6.2 % 7.0 % 6.0 % 6.0 % 5.5 % 5.9 % Current Assets 42.6 % 38.8 % 49.3 % 44.9 % 41.3 % 36.5 % Gross PP&E % 82.9 % % % % 94.0 % ated e e a n % 49.6 % % % % % Net PP&E 38.9 % 49.1 % 31.2 % 33.7 % 34.3 % 46.1 % Other Assets 34.8 % 86.8 % 1.4 % 5.5 % 34.3 % 51.5 % Total Assets % % % % % % Aggregated Statistical Sta s cal Analysis LIABILITIES ent a es 12.4 % 13.0 % 14.4 % 13.0 % 10.8 % 10.4 % ent n T 7.0 % 9.1 % 3.9 % 5.9 % 7.4 % 8.5 % T ta ent a es 15.6 % 17.5 % 16.3 % 15.6 % 13.6 % 15.5 % Total Long-Term Debt 29.2 % 49.3 % 5.0 % 14.5 % 32.2 % 42.1 % t e T a es 8.5 % 26.4 % 0.4 % 1.6 % 5.8 % 11.6 % T ta a es 41.7 % 59.7 % 23.2 % 32.9 % 38.5 % 45.7 % EQUITY Shareholders' Equity 58.8 % 79.7 % 47.0 % 54.4 % 55.4 % 57.4 % Total Lia ili es E uity % % % % % % 19 VMG Health, LLC 2012 Rights Reserved 4

33 MULTI-SPECIALTY ASC INTELLIMARKER Aggregated Statistical Analysis 4.5 Liquidity Analysis $'s in thousands Standard Median Mean Dev. 25% 50% 75% 90% Cash $716 $708 $283 $510 $923 $1,381 % of Total Assets 19.7% 12.4 % 11.0% 17.0 % 29.5 % 40.4 % Net A/R $769 $505 $427 $628 $965 $1,380 % of Total Assets 23.6 % 12.8 % 13.9 % 22.1 % 29.2 % 39.9 % Working Capital $1,213 $983 $582 $881 $1,522 $2,363 % of Net Revenue 15.0 % 7.5 % 10.1 % 13.7 % 19.1 % 23.4 % $100 $600 $1,100 $1,600 $2,100 $2,600 > $2,600 Working Capital 20

34 MULTI-SPECIALTY ASC INTELLIMARKER Accounts Receivable Analysis $'s in thousands Standard Median Mean Dev. 25% 50% 75% 90% Accounts Receivable - Gross $1,430 $1,236 $569 $1,004 $1,689 $3,459 Accounts Receivable - Net $769 $505 $427 $628 $965 $1,380 A/R Turnover - Net A/R Days Outstanding - Net A/R Aging 0 to 30 days 55.5 % 13.6 % 47.4 % 55.8 % 63.4 % 71.0 % 31 to 60 days 16.5 % 4.8 % 12.9 % 16.5 % 19.6 % 22.7 % 61 to 90 days 8.0 % 3.6 % 6.1 % 7.5 % 9.9 % 12.1 % 91 to 120 days 5.4 % 2.8 % 3.5 % 5.1 % 7.1 % 8.3 % Over 120 days 14.7 % 10.0 % 8.1 % 12.7 % 19.3 % 26.8 % Aggregated Statistical Analysis Median Accounts Receivable 50% 40% 30% 20% 10% 0% 0 to 30 days 31 to 60 days 61 to 90 days 91 to 120 days Over 210 Days 21

35 MULTI-SPECIALTY ASC ASC INTELLIMARKER Aggregated Statistical Sta s cal Analysis 4.7 Case olume Mix as a percent of Total Cases Specialty acili es ENT 9 % GI / Endoscopy 27 % General Surgery 7 % OB/GYN 3 % Ophthalmology 17 % Oral Surgery 1 % Orthopedics 17 % Pain Management 13 % as 4 % Podiatry 3 % Urology 2 % Other 1 % Ophthalmology Orthopedics GI / Endoscopy OB/GYN ENT General Surgery Pain Management 22 7 VMG Health, LLC 2012 Rights Reserved

36 MULTI-SPECIALTY ASC INTELLIMARKER Case olume Summary Total Cases per Center Cases per Day a ases e e a n per Year per Day n a ases e ed e per Year per Day ases e ed Top 2 Physicians Top 5 Physicians Top 10 Physicians Standard Median Mean Dev. 25% 50% 75% 90% 4,629 2,382 2,958 4,204 5,854 7, , ,083 1, ,398 2, % 28 % 21 % 28 % 35 % 45 % 53 % 16 % 43 % 52 % 61 % 73 % 71 % 17 % 63 % 73 % 83 % 91 % Aggregated Statistical s Analysis Top Producing P ysicians % of Case Volume 60% 40% 20% 0% Top 2 Physicians Top 5 Physicians Top 10 Physicians 23 VMG Health, LLC 2012 Rights Reserved 8

37 MULTI-SPECIALTY ASC INTELLIMARKER Aggregated Sta s cal Statistical Analysis 4.9 Payor Mix as a Percent of ross C arges Standard Median Mean Dev. 25% 50% 75% 90% Medicare 24 % 13 % 14 % 24 % 34 % 40 % Medicaid 6 % 7 % 1 % 3 % 7 % 15 % Commercial 57 % 15 % 48 % 58 % 67 % 76 % Worker's Comp 5 % 6 % 1 % 4 % 7 % 11 % Self Pay 3 % 5 % 1 % 2 % 4 % 9 % Other Pay 8 % 11 % 1 % 4 % 10 % 22 % 60% Average Payor Mix 40% 20% 0% Medicare Medicaid Commercial Workers's Comp Self Pay Other Pay Mean Standard Dev VMG Health, LLC 2012 Rights Reserved

38 MULTI-SPECIALTY ASC ASC INTELLIMARKER Revenue per Case Specialty ross C arges Net Revenue ENT $7,847 $1,849 GI / Endoscopy $3,610 $788 General Surgery $6,152 $1,795 OB/GYN $7,001 $2,081 Ophthalmology $6,097 $1,273 Oral Surgery $3,194 $1,026 Orthopedics $9,874 $2,618 Pain Management $4,106 $840 as $7,419 $1,696 Podiatry $7,969 $1,893 Urology $7,498 $1,788 Other $5,853 $1,582 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH $0 $2,000 $4,000 $6,000 $8,000 Aggregated Statistical Sta s cal Analysis Net Revenue Gross Charges 25 VMG Health, LLC 2012 Rights Reserved 10

39 MULTI-SPECIALTY ASC INTELLIMARKER Aggregated Sta s cal Statistical Analysis 4.11 ENT Revenue per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 111,232 Gross Charges per Case $9,113 $5,773 $5,852 $7,847 $10,587 $15,164 Net Revenue per Case $2,026 $1,011 $1,282 $1,849 $2,451 $3,291 Discount To Charges 74.0 % 12.5 % 69.6 % 76.2 % 81.8 % 86.4 % ENT re uency Distri u on 0 $600 $1,200 $1,800 $2,400 $3,000 > $3,000 Net Revenue per Case VMG Health, LLC 2012 Rights Reserved

40 MULTI-SPECIALTY ASC ASC INTELLIMARKER I Endoscopy Revenue per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 236,713 Gross Charges per Case $3,673 $1,507 $2,687 $3,610 $4,594 $5,497 Net Revenue per Case $937 $707 $651 $788 $1,090 $1,331 Discount To Charges 71.2 % 16.5 % 65.9 % 75.1 % 80.8 % 86.0 % I re uency Distri u on Aggregated Statistical Sta s cal Analysis 0 $400 $600 $800 $1,100 $1,300 $1,500 Net Revenue per Case 4.13 eneral Surgery per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 87,591 Gross Charges per Case $6,758 $3,926 $4,357 $6,152 $7,903 $10,344 Net Revenue per Case $1,919 $940 $1,301 $1,795 $2,434 $2,979 Discount To Charges 68.0 % 13.0 % 60.6 % 69.4 % 76.1 % 84.3 % 60 eneral Surgery re uency Distri u on $800 $1,200 $1,600 $2,000 $2,400 > $2,400 Net Revenue per Case 27 VMG Health, LLC 2012 Rights Reserved 12

41 MULTI-SPECIALTY ASC INTELLIMARKER Aggregated Sta s cal Statistical Analysis 4.14 OB YN Revenue per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 47,585 Gross Charges per Case $7,293 $3,159 $5,053 $7,001 $9,118 $11,094 Net Revenue per Case $2,199 $969 $1,447 $2,081 $2,802 $3,493 Discount To Charges 67.2 % 13.6 % 61.1 % 68.7 % 75.8 % 81.3 % OB YN re uency Distri u on 0 $800 $1,200 $1,800 $2,400 $3,000 > $3,000 Net Revenue per Case 4.15 Op t almology Revenue per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 181,046 Gross Charges per Case $6,488 $3,851 $4,270 $6,097 $7,371 $9,352 Net Revenue per Case $1,363 $426 $1,103 $1,273 $1,507 $1,889 Discount To Charges 75.7 % 9.4 % 71.5 % 77.5 % 82.1 % 85.2 % Opt almology re uency Distri u on $800 $1,000 $1,200 $1,400 $1,600 > $1,600 Net Revenue per Case VMG Health, LLC 2012 Rights Reserved

42 MULTI-SPECIALTY ASC ASC INTELLIMARKER Oral Surgery Revenue per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 10,914 Gross Charges per Case $4,339 $2,961 $2,384 $3,194 $5,628 $8,291 Net Revenue per Case $1,276 $829 $742 $1,026 $1,579 $2,383 Discount To Charges 66.1 % 16.6 % 60.2 % 68.6 % 77.6 % 82.6 % 30 Oral Surgery re uency Distri u on Aggregated Statistical Sta s cal Analysis $800 $1,000 $1,500 $2,000 $3,500 > $3,500 Net Revenue per Case 4.17 Ort opedics Revenue per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 217,976 Gross Charges per Case $10,206 $4,543 $6,843 $9,874 $12,514 $15,776 Net Revenue per Case $2,807 $1,217 $1,974 $2,618 $3,463 $4,260 Discount To Charges 69.9 % 12.0 % 63.7 % 71.2 % 78.3 % 82.9 % 80 Ort opedics re uency Distri u on $1,000 $1,800 $2,600 $3,400 $4,200 $5,000 Net Revenue per Case 29 VMG Health, LLC 2012 Rights Reserved 14

43 MULTI-SPECIALTY ASC ASC INTELLIMARKER Aggregated Statistical Sta s cal Analysis 4.18 Pain Management Revenue per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 200,316 Gross Charges per Case $5,424 $5,493 $2,459 $4,106 $6,239 $9,884 Net Revenue per Case $1,302 $1,610 $632 $840 $1,370 $2,839 Discount To Charges 72.0 % 27.5 % 66.9 % 76.2 % 82.3 % 86.2 % Pain Management re uency Distri u on 0 $450 $800 $1,150 $1,500 > $1,500 Net Revenue per Case 4.19 Plas c Surgery Revenue per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 44,421 Gross Charges per Case $8,952 $6,915 $5,294 $7,419 $11,938 $14,198 Net Revenue per Case $2,008 $1,342 $1,231 $1,696 $2,408 $3,250 Discount To Charges 70.7 % 21.1 % 66.9 % 77.6 % 83.0 % 88.0 % 60 Plas c Surgery re uency Distri u on $800 $1,200 $1,600 $2,000 $2,400 Net Revenue per Case VMG Health, LLC 2012 Rights Reserved

44 MULTI-SPECIALTY ASC ASC INTELLIMARKER Podiatry Revenue per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 36,908 Gross Charges per Case $8,665 $4,287 $5,975 $7,969 $10,749 $13,298 Net Revenue per Case $2,171 $1,066 $1,451 $1,893 $2,600 $3,436 Discount To Charges 72.1 % 11.7 % 65.7 % 74.3 % 81.1 % 85.7 % Podiatry re uency Distri u on Aggregated Statistical Sta s cal Analysis 0 $800 $1,200 $1,600 $2,000 $2,400 Net Revenue per Case 4.21 Urology Revenue per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 52,258 Gross Charges per Case $7,388 $3,850 $4,228 $7,498 $9,848 $11,747 Net Revenue per Case $2,143 $1,312 $1,260 $1,788 $2,823 $3,948 Discount To Charges 67.3 % 17.0 % 59.3 % 70.7 % 78.5 % 84.6 % 40 Oral Surgery re uency Distri u on $700 $1,100 $1,500 $1,900 $2,300 > $2,700 Net Revenue per Case 31 VMG Health, LLC 2012 Rights Reserved 16

45 MULTI-SPECIALTY ASC INTELLIMARKER Aggregated Sta s cal Statistical Analysis 4.22 EBITDA Margin Analysis Net Revenue Standard Median Mean Dev. 25% 50% 75% 90% Less than $3 mm 11.0 % NMF -0.5 % 12.8 % 28.7 % NMF $3 mm to $4.9 mm 16.3 % 15.8 % 7.9 % 16.2 % 19.5 % 25.6 % $5 mm to $6.9 mm 26.2 % 18.2 % 17.4 % 24.5 % 35.5 % 45.9 % $7 mm to $8.9 mm 31.1 % 17.9 % 21.7 % 28.6 % 35.1 % 48.1 % Greater than $9 mm 36.8 % 12.0 % 27.2 % 37.3 % 46.5 % 52.8 % 80% 60% 40% 20% 0% Mean Standard 25% 50% 75% 90% $5 mm to $6.9 mm Less than $3 mm $3 mm to $4.9 mm $7 mm to $8.9 mm Greater than 9 mm 32

46 MULTI-SPECIALTY ASC INTELLIMARKER Sta ng Summary Standard Median Mean Dev. 25% 50% 75% 90% Nurse FTE Tech FTE d n st a e T Administrator FTE Total FTE Aggregated Sta s cal Statistical Analysis VMG Health, LLC 2012 Rights Reserved 1

47 MULTI-SPECIALTY ASC INTELLIMARKER Aggregated Sta s cal Statistical Analysis 4.24 ourly Salaries ages Standard Median Mean Dev. 25% 50% 75% 90% se ta $33.24 $15.99 $29.02 $32.10 $35.69 $39.57 Te ta $21.03 $4.23 $18.02 $21.18 $23.68 $26.48 d n st a e ta $22.91 $5.19 $19.84 $22.70 $25.34 $28.82 Total Hourly $27.05 $4.51 $24.36 $27.00 $29.28 $32.21 Administrator - Salary $108,014 $21,829 $96,500 $105,996 $124,595 $135,844 Administrator Salary re uency Dis u on $60,000 $80,000 $100,000 $120,000 $140,000 $140,000 Annual Salary 34

48 MULTI-SPECIALTY ASC INTELLIMARKER Sta ours per Case Standard Median Mean Dev. 25% 50% 75% 90% Nurse HPC Tech HPC d n st a e Administrator HPC Total HPC Aggregated Sta s cal Statistical Analysis VMG Health, LLC 2012 Rights Reserved 1

49 MULTI-SPECIALTY ASC INTELLIMARKER Aggregated Statistical Analysis 4.26 Operating Expense Analysis Standard Median as a % of Net Revenue Mean Dev. 25% 50% 75% 90% Employee Salary and Wages 23.5 % 8.9 % 18.0 % 23.0 % 28.4 % 32.7 % Taxes and Benefits 5.5 % 3.3 % 4.0 % 5.1 % 6.5 % 8.3 % Occupancy Costs 7.5 % 5.4 % 4.2 % 6.7 % 9.2 % 12.5 % Medical and Surgical 21.6 % 8.0 % 17.3 % 21.4 % 26.1 % 29.8 % Other Medical Costs 1.3 % 1.7 % 0.4 % 0.8 % 1.4 % 2.4 % Insurance 0.8 % 0.6 % 0.4 % 0.7 % 1.0 % 1.4 % General & Administrative 16.0 % 8.8 % 12.1 % 14.3 % 18.1 % 22.0 % Total Operating Expenses 75.5 % 27.9 % 63.8 % 75.0 % 83.9 % 94.4 % per Square Foot Employee Salary and Wages $ $47.84 $81.03 $ $ $ Taxes and Benefits $27.42 $12.59 $18.25 $25.69 $34.56 $45.65 Occupancy Costs $34.23 $12.94 $26.68 $34.54 $41.12 $49.01 Medical and Surgical $ $60.26 $73.23 $ $ $ Other Medical Costs $5.56 $6.70 $1.54 $3.62 $6.11 $11.18 Insurance $4.19 $3.48 $1.85 $3.22 $5.32 $8.15 General & Administrative $89.82 $68.43 $53.49 $75.90 $ $ Total Operating Expenses $ $ $ $ $ $ per OR ($'s in thousands) Employee Salary and Wages $ $ $ $ $ $ Taxes and Benefits $ $53.19 $66.93 $92.98 $ $ Occupancy Costs $ $67.84 $88.95 $ $ $ Medical and Surgical $ $ $ $ $ $ Other Medical Costs $23.91 $31.67 $6.63 $12.92 $29.07 $58.19 Insurance $14.58 $10.95 $7.10 $12.10 $18.31 $28.06 General & Administrative $ $ $ $ $ $ Total Operating Expenses $1, $ $ $1, $1, $2, per Case Employee Salary and Wages $ $ $ $ $ $ Taxes and Benefits $92.31 $68.99 $63.48 $81.61 $ $ Occupancy Costs $ $99.41 $64.91 $ $ $ Medical and Surgical $ $ $ $ $ $ Other Medical Costs $22.45 $31.88 $5.39 $12.11 $25.45 $41.99 Insurance $12.62 $9.41 $7.28 $10.74 $15.88 $21.17 General & Administrative $ $ $ $ $ $ Total Operating Expenses $1, $ $ $1, $1, $2,

50 MULTI-SPECIALTY ASC INTELLIMARKER acility Sta s cs $'s in thousands Standard Median Mean Dev. 25% 50% 75% 90% Gross PP&E per OR $1,033 $590 $642 $899 $1,303 $1,840 Gross PP&E per Sq Ft $283 $136 $190 $277 $370 $450 Gross PP&E plus WC per OR $1,352 $722 $917 $1,196 $1,646 $2,222 Gross PP&E plus WC per Sq Ft $375 $173 $267 $354 $471 $566 e a n s ed e s Square Feet per Facility 14,699 6,983 10,000 13,600 17,868 22,679 enta ate e t $29.16 $17.82 $21.58 $27.51 $33.78 $40.40 ent an st e t $32.88 $12.01 $26.68 $34.45 $39.17 $45.53 Aggregated Sta s cal Statistical Analysis 120 acility Si e re uency Distri u on of Fa i i es ,000 10,000 15,000 20,000 25,000 > $25,000 Square Feet per Facility 37 VMG Health, LLC 2012 Rights Reserved 1

51 MULTI-SPECIALTY ASC INTELLIMARKER Aggregated Statistical Analysis 4.28 Leverage Ratios $'s in thousands Standard Median Mean Dev. 25% 50% 75% 90% Total Debt $1,243 $1,590 $122 $608 $1,802 $3,376 Net Debt $1,730 $1,651 $374 $1,317 $2,383 $4,615 Total Debt / Assets 27.4 % 25.7 % 5.0 % 17.1 % 46.3 % 69.1 % Total Debt / Equity % % 7.1 % 26.9 % % % Total Debt / EBITDA 2.01x 8.51x 0.07x 0.23x 0.94x 2.32x Net Debt / Assets 35.8 % 24.4 % 14.7 % 30.8 % 55.6 % 68.5 % Net Debt / Equity % % 25.4 % 68.9 % % % Net Debt / EBITDA 3.77x 11.94x 0.20x 0.65x 1.45x 3.41x 38

52 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER 2012 SECTION 5 Regional Analysis Financial Statements Income Statement 5.1 Common Size Income Statement 5.2 Balance Sheet 5.3 Common Size Balance Sheet 5.4 Revenue Cycle Analysis Liquidity Analysis 5.5 Accounts Receivable Analysis 5.6 Revenue Analysis Case Volume Mix as a percent of Total Cases 5.7 Case Volume Summary 5.8 Payor Mix as a percent of Gross Charges 5.9 Revenue per Case - West 5.10 Revenue per Case - Southwest 5.11 Revenue per Case - Midwest 5.12 Revenue per Case - Southeast 5.13 Revenue per Case - Northeast 5.14 ENT Revenue per Case 5.15 GI/Endoscopy Revenue per Case 5.16 General Surgery Revenue per Case 5.17 OB/GYN Revenue per Case 5.18 Ophthalmology Revenue per Case 5.19 Oral Surgery Revenue per Case 5.20 Orthopedics Revenue per Case 5.21 Pain Management Revenue per Case Podiatry Revenue per Case 5.24 Urology Revenue per Case 5.25 EBITDA Margin Analysis 5.26 Sta ng Analysis Sta ng Summary 5.27 Hourly Salaries & Wages 5.28 Sta ours per Case 5.29 Expense Analysis Expense Analysis 5.30 Asset Analysis Liability Detail Regional Analysis VMG Health, LLC 2012 Rights Reserved

53 MULTI-SPECIALTY ASC INTELLIMARKER Regional Analysis 5.1 Income Statement $'s in thousands Patient Revenues Gross Charges Facilities $27,071 West $23,944 Southwest $30,001 Midwest $27,431 Southeast $24,656 Northeast $23,580 Adjustments ($18,441) ($16,562) ($22,310) ($16,997) ($17,427) ($14,822) Net Revenue $7,164 $6,246 $6,632 $8,064 $5,990 $8,045 Operating Expenses Employee Salary and Wages $1,507 $1,421 $1,453 $1,624 $1,422 $1,418 Taxes and Benefits $349 $341 $326 $439 $332 $329 Occupancy Costs $438 $473 $437 $470 $352 $510 Medical and Surgical $1,435 $1,270 $1,492 $1,522 $1,288 $1,267 Other Medical Costs $52 $46 $25 $104 $22 $80 Insurance $45 $47 $46 $40 $46 $40 Depreciation and Amortization $264 $250 $280 $248 $223 $329 General & Administrative Bad Debt $117 $89 $115 $159 $120 $82 Management Fees $320 $322 $367 $301 $256 $279 Other G & A $622 $609 $634 $635 $645 $484 Total G & A $930 $913 $967 $1,250 $913 $737 Total Operating Expenses $5,521 $4,740 $5,040 $5,777 $4,687 $4,749 Operating Income $1,571 $1,240 $1,611 $2,376 $717 $1,830 Other Income (Expense) $5 $3 $6 $11 $5 $12 Net Interest Expense $50 $41 $86 $26 $60 $47 Earnings Before Taxes $1,457 $1,230 $1,419 $2,372 $700 $1,816 EBITDA $1,886 $1,555 $1,807 $2,748 $1,061 $1,976 40

54 MULTI-SPECIALTY ASC INTELLIMARKER Common Size Income Statement Patient Revenues Facilities West Southwest Midwest Southeast Northeast Gross Charges % % % % % % Adjustments % % % % % % Net Revenue % % % % % % Regional Analysis Operating Expenses Employee Salary and Wages 23.0 % 26.2 % 21.2 % 18.6 % 24.5 % 23.1 % Taxes and Benefits 5.1 % 5.8 % 4.6 % 5.4 % 5.3 % 4.8 % Occupancy Costs 6.7 % 7.8 % 6.6 % 5.0 % 5.9 % 7.0 % Medical and Surgical 21.4 % 21.1 % 22.9 % 18.5 % 23.1 % 20.5 % Other Medical Costs 0.7 % 0.7 % 0.3 % 0.9 % 0.5 % 1.1 % Insurance 0.7 % 0.8 % 0.7 % 0.5 % 0.8 % 0.5 % Depreciation and Amortization 3.7 % 3.6 % 4.4 % 3.2 % 4.0 % 3.8 % General & Administrative Bad Debt 1.5 % 1.1 % 1.5 % 2.3 % 1.5 % 1.3 % Management Fees 5.0 % 5.0 % 5.6 % 3.5 % 5.0 % 5.2 % Other G & A 8.9 % 9.7 % 9.2 % 7.3 % 10.6 % 8.3 % Total G & A 14.3 % 15.3 % 14.6 % 12.3 % 13.2 % 15.0 % Total Operating Expenses 75.0 % 78.0 % 83.3 % 63.2 % 76.8 % 68.4 % Operating Income 20.0 % 17.2 % 21.7 % 31.9 % 16.8 % 20.0 % Other Income (Expense) 0.1 % 0.0 % 0.1 % 0.1 % 0.2 % 0.2 % Net Interest Expense 0.7 % 0.6 % 1.0 % 0.3 % 1.0 % 0.7 % Earnings Before Taxes 18.9 % 17.0 % 19.6 % 30.5 % 16.8 % 18.5 % EBITDA 25.5 % 21.8 % 26.0 % 34.9 % 19.8 % 27.5 % 41 VMG Health, LLC 2012 Rights Reserved 1

55 MULTI-SPECIALTY ASC INTELLIMARKER Regional Analysis 5.3 Balance Sheet $'s in thousands ASSETS Cash and Equivalents Facilities $510 West $595 Southwest $511 Midwest $686 Southeast $399 Northeast $344 Net Accounts Receivable $628 $769 $566 $765 $500 $607 Other Current Assets $174 $160 $191 $188 $247 $155 Current Assets $1,296 $1,411 $1,277 $1,663 $1,140 $1,033 Gross PP&E $3,389 $2,849 $4,043 $3,256 $3,961 $3,085 Accumulated Depreciation ($2,273) ($1,966) ($2,858) ($1,900) ($2,677) ($1,971) Net PP&E $972 $772 $1,112 $1,197 $1,026 $890 Other Assets $158 $345 $47 $251 $356 $202 Total Assets $2,886 $3,025 $2,778 $3,401 $2,824 $2,720 LIABILITIES Current Liabilities $373 $369 $476 $367 $276 $364 Current Portion of LTD $169 $183 $165 $221 $118 $205 Total Current Liabilities $449 $437 $519 $572 $324 $563 Total Long-Term Debt $417 $226 $615 $280 $492 $531 Other LT Liabilities $47 $113 $29 $99 $12 $219 Total Liabilities $949 $561 $1,278 $960 $767 $1,141 EQUITY Shareholders' Equity $1,570 $1,795 $1,296 $1,592 $1,812 $1,739 Total Liabilities & Equity $2,885 $3,025 $2,778 $3,401 $2,823 $2,720 42

56 MULTI-SPECIALTY ASC INTELLIMARKER Common Size Balance Sheet Facilities West Southwest Midwest Southeast Northeast ASSETS Cash and Equivalents 17.7 % 19.7 % 18.4 % 20.2 % 14.2 % 12.7 % Net Accounts Receivable 21.8 % 25.4 % 20.4 % 22.5 % 17.7 % 22.3 % Other Current Assets 6.0 % 5.3 % 6.9 % 5.6 % 8.8 % 5.7 % Current Assets 44.9 % 46.7 % 46.0 % 48.9 % 40.4 % 38.0 % Regional Analysis Gross PP&E % 94.2 % % 95.7 % % % Accumulated Depreciation % % % % % % Net PP&E 33.7 % 25.5 % 40.1 % 35.2 % 36.3 % 32.7 % Other Assets 5.5 % 11.4 % 1.7 % 7.4 % 12.6 % 7.4 % Total Assets % % % % % % LIABILITIES Current Liabilities 13.0 % 12.2 % 17.1 % 10.8 % 9.8 % 13.4 % Current Portion of LTD 5.9 % 6.1 % 5.9 % 6.5 % 4.2 % 7.6 % Total Current Liabilities 15.6 % 14.5 % 18.7 % 16.8 % 11.5 % 20.7 % Total Long-Term Debt 14.5 % 7.5 % 22.2 % 8.3 % 17.4 % 19.5 % Other LT Liabilities 1.6 % 3.8 % 1.0 % 2.9 % 0.5 % 8.1 % Total Liabilities 32.9 % 18.6 % 46.0 % 28.3 % 27.2 % 42.0 % EQUITY Shareholders' Equity 54.4 % 59.3 % 46.7 % 46.8 % 64.2 % 64.0 % Total Liabilities & Equity % % % % % % 43 VMG Health, LLC 2012 Rights Reserved 1

57 MULTI-SPECIALTY ASC ASC INTELLIMARKER Regional Analysis 5.5 Liquidity Analysis $'s in thousands Facili es West Southwest Midwest Southeast Northeast Cash $510 $595 $511 $686 $399 $344 % of Total Assets 17.0 % 18.6 % 16.6 % 20.7 % 15.9 % 14.1 % Net A/R $628 $769 $566 $765 $500 $607 % of Total Assets 22.1 % 27.1 % 20.3 % 18.6 % 20.2 % 21.8 % Working Capital $881 $1,114 $809 $1,174 $765 $476 % of Net Revenue 13.7 % 17.8 % 11.8 % 15.5 % 15.7 % 10.8 % ent a a s e a n x enses Liquidity Analysis 16% % of Net Revenue 12% 8% 4% 0% a es West Southwest Midwest Southeast Northeast Working Capital 44

58 MULTI-SPECIALTY ASC INTELLIMARKER Accounts Receivable Analysis $'s in thousands Facili es West Southwest Midwest Southeast Northeast Accounts Receivable - Gross $1,004 $1,004 $879 $1,353 $444 $803 Accounts Receivable - Net $628 $628 $566 $765 $500 $607 Regional Analysis A/R Turnover - Net A/R Days Outstanding - Net A/R Aging 0 to 30 days 55.8 % 55.8 % 60.4 % 55.4 % 58.8 % 58.3 % 31 to 60 days 16.5 % 16.5 % 13.3 % 18.0 % 14.5 % 17.8 % 61 to 90 days 7.5 % 7.5 % 6.4 % 8.9 % 7.1 % 7.1 % 91 to 120 days 5.1 % 5.1 % 4.7 % 5.3 % 5.2 % 4.0 % Over 120 days 12.7 % 12.7 % 14.1 % 9.8 % 12.8 % 11.5 % Accounts Receivable Aging a es West Southwest Midwest Southeast Northeast 0 to 30 days 31 to 60 days 61 to 90 days 91 to 120 days Over 120 days 45 VMG Health, LLC 2012 Rights Reserved 1

59 MULTI-SPECIALTY ASC ASC INTELLIMARKER Regional Analysis 5.7 Case Volume Mix as a percent of Total Cases Facili es West Southwest Midwest Southeast Northeast ENT 9 % 8 % 8 % 12 % 9 % 8 % GI / Endoscopy 27 % 18 % 25 % 27 % 30 % 32 % General Surgery 7 % 4 % 9 % 5 % 6 % 7 % OB/GYN 3 % 2 % 5 % 5 % 2 % 7 % Ophthalmology 17 % 18 % 21 % 8 % 17 % 13 % Oral Surgery 1 % 2 % 3 % 0 % 0 % 1 % Orthopedics 17 % 19 % 13 % 19 % 14 % 23 % Pain Management 13 % 11 % 11 % 16 % 15 % 17 % as 4 % 6 % 3 % 5 % 3 % 2 % Podiatry 3 % 3 % 3 % 3 % 2 % 3 % Urology 2 % 2 % 2 % 3 % 2 % 6 % Other 1 % 5 % 2 % 2 % 0 % 1 % 30% 24% 18% 12% 6% 0% ENT GI / Endoscopy General Surgery OB/GYN Ophthalmology Oral Surgery Orthopedics Pain Management Podiatry Urology Other West Southwest Midwest Southeast Northeast 46

60 MULTI-SPECIALTY ASC INTELLIMARKER Case Volume Summary Facili es West Southwest Midwest Southeast Northeast Total Cases per Center 4,204 4,097 4,004 4,411 4,556 3,931 Cases per Day a ases e e a n per Year per Day Regional Analysis n a ases e ed e per Year per Day ases e ed Top 2 Physicians 28 % 29 % 29 % 26 % 28 % 28 % Top 5 Physicians 52 % 54 % 53 % 47 % 51 % 53 % Top 10 Physicians 73 % 74 % 73 % 68 % 72 % 79 % Top Producing Physicians 80% % of Case Volume 60% 40% 20% 0% a es West Southwest Midwest Southeast Northeast Top 2 Physicians Top 5 Physicians Top 10 Physicians 47 VMG Health, LLC 2012 Rights Reserved 1

61 MULTI-SPECIALTY ASC ASC INTELLIMARKER Regional Analysis 5.9 Payor Mix as a Percent of Gross Charges Facili es West Southwest Midwest Southeast Northeast Medicare 24 % 21 % 27 % 15 % 31 % 25 % Medicaid 3 % 6 % 3 % 2 % 4 % 3 % Commercial 58 % 56 % 59 % 62 % 51 % 59 % Worker's Comp 4 % 5 % 2 % 4 % 3 % 5 % Self Pay 2 % 2 % 2 % 1 % 2 % 1 % Other Pay 4 % 9 % 4 % 6 % 2 % 6 % Medicare & Comercial as a % of Gross Charges 60% 40% 20% 0% a es West Southwest Midwest Southeast Northeast Medicare Commercial 48

62 MULTI-SPECIALTY ASC INTELLIMARKER Revenue per Case - West Specialty Gross Charges Net Revenue ENT $8,426 $1,740 GI / Endoscopy $3,665 $787 General Surgery $5,492 $1,455 OB/GYN $6,214 $1,918 Ophthalmology $5,951 $1,188 Oral Surgery $3,405 $1,161 Orthopedics $9,723 $2,640 Pain Management $3,765 $787 as $10,361 $1,500 Podiatry $7,867 $1,947 Urology $7,684 $1,475 Other $6,215 $1,582 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH Regional Analysis 0 $2000 $4000 $6000 $8000 $10000 Net Revenue Gross Charges 49 VMG Health, LLC 2012 Rights Reserved 1

63 MULTI-SPECIALTY ASC ASC INTELLIMARKER Regional Analysis 5.11 Revenue per Case - Southwest Specialty Gross Charges Net Revenue ENT $8,673 $2,071 GI / Endoscopy $3,737 $949 General Surgery $7,268 $1,994 OB/GYN $8,722 $2,555 Ophthalmology $7,209 $1,303 Oral Surgery $2,700 $871 Orthopedics $11,764 $2,725 Pain Management $5,645 $1,044 as $7,976 $1,808 Podiatry $9,679 $2,184 Urology $8,731 $2,205 Other $4,809 $1,329 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH 0 $2000 $4000 $6000 $8000 $10000 Net Revenue Gross Charges 5.12 Revenue per Case - Midwest Specialty Gross Charges Net Revenue ENT $7,710 $2,172 GI / Endoscopy $3,029 $820 General Surgery $5,949 $2,149 OB/GYN $5,993 $2,608 Ophthalmology $6,353 $1,328 Oral Surgery $3,690 $1,440 Orthopedics $9,475 $3,166 Pain Management $3,250 $833 as $8,174 $2,381 Podiatry $7,191 $2,277 Urology $5,974 $2,281 Other $6,480 $2,479 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH 0 $1500 $3000 $4500 $6000 $7500 Net Revenue Gross Charges 50

64 MULTI-SPECIALTY ASC ASC INTELLIMARKER Revenue per Case - Southeast Specialty Gross Charges Net Revenue ENT $6,537 $1,369 GI / Endoscopy $3,722 $663 General Surgery $5,194 $1,472 OB/GYN $6,239 $1,381 Ophthalmology $5,162 $1,255 Oral Surgery $3,312 $947 Orthopedics $9,384 $2,154 Pain Management $3,193 $724 as $5,683 $1,213 Podiatry $6,946 $1,446 Urology $6,181 $1,301 Other $7,062 $1,621 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH Regional Analysis 0 $2000 $4000 $6000 $8000 $10000 Net Revenue Gross Charges 5.14 Revenue per Case - Northeast Specialty Gross Charges Net Revenue ENT $7,494 $2,009 GI / Endoscopy $3,104 $816 General Surgery $6,196 $1,372 OB/GYN $5,977 $1,871 Ophthalmology $5,839 $1,295 Oral Surgery $4,439 $1,099 Orthopedics $9,884 $2,310 Pain Management $4,453 $840 as $3,589 $1,402 Podiatry $8,017 $1,819 Urology $7,392 $1,520 Other $4,684 $1,643 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH 0 $1500 $3000 $4500 $6000 $7500 $9000 Net Revenue Gross Charges 51 VMG Health, LLC 2012 Rights Reserved 1

65 MULTI-SPECIALTY ASC INTELLIMARKER Regional Analysis 5.15 ENT Revenue per Case Facili es West Southwest Midwest Southeast Northeast Based on case volume of 111,232 19,701 31,463 26,787 21,641 11,640 Gross Charges per Case $7,847 $8,426 $8,673 $7,710 $6,537 $7,494 Net Revenue per Case $1,849 $1,740 $2,071 $2,172 $1,369 $2,009 Discount To Charges 76.2 % 79.4 % 76.1 % 71.8 % 79.1 % 73.2 % $9000 ENT Revenue per Case $6000 $3000 $0 a es West Southwest Midwest Southeast Northeast Net Revenue per Case Gross Charges per Case 52

66 VMG Health, LLC 2012 Rights Reserved 1 MULTI-SPECIALTY MULTI-SPECIALTY ASC ASC INTELLIMARKER INTELLIMARKER GI/Endoscopy Revenue per Case Facili es West Southwest Midwest Southeast Northeast Based on case volume of 236,713 34,814 83,863 39,506 45,353 33,177 Gross Charges per Case $3,610 $3,665 $3,737 $3,029 $3,722 $3,104 Net Revenue per Case $788 $787 $949 $820 $663 $816 Discount To Charges 75.1 % 78.5 % 74.6 % 72.9 % 82.2 % 73.7 % Regional Analysis $4000 GI/Endoscopy Revenue per Case $3000 $2000 $1000 $0 a es West Southwest Midwest Southeast Northeast Net Revenue per Case Gross Charges per Case 5.17 General Surgery Revenue per Case Facili es West Southwest Midwest Southeast Northeast Based on case volume of 87,591 12,179 31,834 15,941 14,752 12,885 Gross Charges per Case $6,152 $5,492 $7,268 $5,949 $5,194 $6,196 Net Revenue per Case $1,795 $1,455 $1,994 $2,149 $1,472 $1,372 Discount To Charges 69.4 % 73.5 % 72.6 % 63.9 % 71.7 % 77.9 % General Surgery Revenue per Case $6000 $4000 $2000 $0 a es West Southwest Midwest Southeast Northeast Net Revenue per Case Gross Charges per Case 53

67 Regional Analysis 5.18 OB/GYN Revenue per Case 5.18 OB/GYN Revenue per Case MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC ASC INTELLIMARKER Based on case volume of Facili es West Southwest Midwest Southeast Northeast Facili 47,585es West 4,069 Southwest 17,182 Midwest 11,264 Southeast 6,845 Northeast 8,225 Based on case volume of 47,585 4,069 17,182 11,264 6,845 8,225 Gross Charges per Case $7,001 $6,214 $8,722 $5,993 $6,239 $5,977 Gross Net Revenue Charges per per Case Case $2,081 $7,001 $6,214 $1,918 $8,722 $2,555 $5,993 $2,608 $6,239 $1,381 $5,977 $1,871 Net Discount Revenue To Charges per Case $2, % $1, % $2, % $2, % $1, % $1, % Discount To Charges 68.7 % 69.1 % 70.7 % 56.5 % 77.9 % 68.7 % $8000 $8000 $6000 $6000 $4000 $4000 OB/GYN Revenue per Case OB/GYN Revenue per Case $2000 $2000 $0 $0 a es West Southwest Midwest Southeast Northeast a es West Southwest Midwest Southeast Northeast Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case 5.19 Ophthalmology Revenue per Case 5.19 Ophthalmology Revenue per Case Based on case volume of Facili es West Southwest Midwest Southeast Northeast Facili 181,046es 24,072 West Southwest 75,054 Midwest 23,973 Southeast 32,988 Northeast 24,959 Based on case volume of 181,046 24,072 75,054 23,973 32,988 24,959 Gross Charges per Case $6,097 $5,951 $7,209 $6,353 $5,162 $5,839 Gross Net Revenue Charges per per Case Case $1,273 $6,097 $5,951 $1,188 $7,209 $1,303 $6,353 $1,328 $5,162 $1,255 $5,839 $1,295 Net Discount Revenue To Charges per Case $1, % $1, % $1, % $1, % $1, % $1, % Discount To Charges 77.5 % 80.0 % 81.9 % 79.1 % 75.7 % 77.8 % $6000 $6000 Opthalmology Revenue per Case Opthalmology Revenue per Case $4000 $4000 $2000 $2000 $0 $0 a es West Southwest Midwest Southeast Northeast a es West Southwest Midwest Southeast Northeast Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case 54 1 VMG Health, LLC 2012 Rights Reserved

68 5.20 Oral Surgery Revenue per Case 5.20 Oral Surgery Revenue per Case MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER Based on case volume of Facili es Facili 10,914es West West 2,595 Southwest Southwest 6,107 Midwest Midwest 867 Southeast Southeast 635 Northeast Northeast 710 Based on case volume of 10,914 2,595 6, Gross Charges per Case $3,194 $3,405 $2,700 $3,690 $3,312 $4,439 Gross Net Revenue Charges per per Case Case $1,026 $3,194 $3,405 $1,161 $2,700 $871 $3,690 $1,440 $3,312 $947 $4,439 $1,099 Net Discount Revenue To Charges per Case $1, % $1, % 67.7 $871 % $1, % 71.4 $947 % $1, % Discount To Charges 68.6 % 65.9 % 67.7 % 61.0 % 71.4 % 75.3 % Regional Analysis $6000 $6000 Oral Surgery Revenue per Case Oral Surgery Revenue per Case $4000 $4000 $2000 $2000 $0 $0 a es West Southwest Midwest Southeast Northeast a es West Southwest Midwest Southeast Northeast Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case 5.21 Orthopedics Revenue per Case 5.21 Orthopedics Revenue per Case Based on case volume of Facili es Facili 217,976es West 43,904 West Southwest Southwest 48,353 Midwest Midwest 57,703 Southeast Southeast 33,002 Northeast Northeast 35,014 Based on case volume of 217,976 43,904 48,353 57,703 33,002 35,014 Gross Charges per Case $9,874 $9,723 $11,764 $9,475 $9,384 $9,884 Gross Net Revenue Charges per per Case Case $2,618 $9,874 $9,723 $2,640 $11,764 $2,725 $9,475 $3,166 $9,384 $2,154 $9,884 $2,310 Net Discount Revenue To Charges per Case $2, % $2, % $2, % $3, % $2, % $2, % Discount To Charges 71.2 % 72.9 % 76.8 % 66.6 % 77.0 % 76.6 % $12000 $12000 $10000 $10000 $8000 $8000 $6000 $6000 $4000 $4000 $2000 $2000 $0 $0 Orthopedics Revenue per Case Orthopedics Revenue per Case a es West Southwest Midwest Southeast Northeast a es West Southwest Midwest Southeast Northeast Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case 55 VMG Health, LLC 2012 Rights Reserved 1

69 MULTI-SPECIALTY ASC INTELLIMARKER Regional Analysis 5.22 Pain Management Revenue per Case Facili es West Southwest Midwest Southeast Northeast Based on case volume of 200,316 33,941 42,729 43,344 51,071 29,231 Gross Charges per Case $4,106 $3,765 $5,645 $3,250 $3,193 $4,453 Net Revenue per Case $840 $787 $1,044 $833 $724 $840 Discount To Charges 76.2 % 79.1 % 81.5 % 74.4 % 77.3 % 81.1 % $6000 Pain Management Revenue per Case $4000 $2000 $0 a es West Southwest Midwest Southeast Northeast Net Revenue per Case Gross Charges per Case 5.23 Plas c Surgery Revenue per Case Facili es West Southwest Midwest Southeast Northeast Based on case volume of 44,421 10,789 10,816 13,150 8,068 1,598 Gross Charges per Case $7,419 $10,361 $7,976 $8,174 $5,683 $3,589 Net Revenue per Case $1,696 $1,500 $1,808 $2,381 $1,213 $1,402 Discount To Charges 77.6 % 85.5 % 77.3 % 70.9 % 78.7 % 60.9 % Plas c Surgery Revenue per Case $9000 $6000 $3000 $0 a es West Southwest Midwest Southeast Northeast Net Revenue per Case Gross Charges per Case 56

70 VMG Health, LLC 2012 Rights Reserved 1 MULTI-SPECIALTY MULTI-SPECIALTY ASC ASC ASC INTELLIMARKER INTELLIMARKER Podiatry Revenue per Case Facili Facili es es West West Southwest Southwest Midwest Midwest Southeast Southeast Northeast Northeast Based on case volume of 36,908 4,705 11,234 8,956 4,893 7,120 Based on case volume of 36,908 4,705 11,234 8,956 4,893 7,120 Gross Gross Charges Charges per per Case Case $7,969 $7,969 $7,867 $7,867 $9,679 $9,679 $7,191 $7,191 $6,946 $6,946 $8,017 $8,017 Net Net Revenue Revenue per per Case Case $1,893 $1,893 $1,947 $1,947 $2,184 $2,184 $2,277 $2,277 $1,446 $1,446 $1,819 $1,819 Discount Discount To To Charges Charges % % % % % % Regional Analysis $10000 $10000 Podiatry Podiatry Revenue Revenue per per Case Case $8000 $8000 $6000 $6000 $4000 $4000 $2000 $2000 $0 $0 a es es West West Southwest Southwest Midwest Midwest Southeast Southeast Northeast Northeast Net Revenue per Case Net Revenue per Case Gross Charges per Case Gross Charges per Case 5.25 Urology Revenue per Case Facili Facili es es West West Southwest Southwest Midwest Midwest Southeast Southeast Northeast Northeast Based on case volume of 52,258 6,043 13,547 8,052 10,155 14,461 Based on case volume of 52,258 6,043 13,547 8,052 10,155 14,461 Gross Gross Charges Charges per per Case Case $7,498 $7,498 $7,684 $7,684 $8,731 $8,731 $5,974 $5,974 $6,181 $6,181 $7,392 $7,392 Net Net Revenue Revenue per per Case Case $1,788 $1,788 $1,475 $1,475 $2,205 $2,205 $2,281 $2,281 $1,301 $1,301 $1,520 $1,520 Discount Discount To To Charges Charges % % % % % % Oral Oral Surgery Surgery Revenue Revenue per per Case Case $8000 $8000 $6000 $6000 $4000 $4000 $2000 $2000 $0 $0 a es es West West Southwest Southwest Midwest Midwest Southeast Southeast Northeast Northeast Net Revenue per Case Net Revenue per Case Gross Charges per Case Gross Charges per Case 57

71 MULTI-SPECIALTY ASC ASC INTELLIMARKER Regional Analysis 5.26 EBITDA Margin Analysis Net Revenue Facili es West Southwest Midwest Southeast Northeast Less than $3 mm 12.8 % NMF 3.0 % 27.9 % 12.8 % 11.8 % $3 mm to $4.9 mm 16.2 % 12.2 % 17.8 % 13.5 % 17.5 % 18.0 % $5 mm to $6.9 mm 24.5 % 30.7 % 25.8 % 21.9 % 19.8 % 43.3 % $7 mm to $8.9 mm 28.6 % 23.9 % 30.8 % 31.8 % 21.2 % 19.3 % Greater than $9 mm 37.3 % 25.3 % 33.4 % 47.4 % 31.7 % 35.5 % 80% 60% 40% 20% 0% Facili es West Southwest Midwest Southeast Northeast $5 mm to $6.9 mm Less than $3 mm $3 mm to $4.9 mm $7 mm to $8.9 mm Greater than 9 mm 58

72 MULTI-SPECIALTY ASC INTELLIMARKER Sta ng Summary Facili es West Southwest Midwest Southeast Northeast Nurse FTE Tech FTE Ad inist a e FT Administrator FTE Regional Analysis Total FTE Number Of FTEs Facili es West Southwest Midwest Southeast Northeast Nurse FTE Tech FTE Administrator FTE 59 VMG Health, LLC 2012 Rights Reserved 1

73 MULTI-SPECIALTY ASC ASC INTELLIMARKER Regional Analysis 5.28 Hourly Salaries & Wages Facili es West Southwest Midwest Southeast Northeast se ta $32.10 $36.67 $31.44 $29.77 $30.68 $33.86 Tec ta $21.18 $21.84 $21.37 $19.18 $19.24 $22.46 Ad inist a e ta $22.70 $23.20 $22.05 $22.03 $23.41 $24.06 Total Hourly $27.00 $28.45 $26.49 $25.98 $26.59 $29.05 Administrator - Salary $105,996 $109,475 $107,492 $104,372 $102,332 $109,268 Hourly Wages $36 $30 $24 $18 $12 $6 $0 Facili es West Southwest Midwest Southeast Northeast 60

74 MULTI-SPECIALTY ASC INTELLIMARKER Sta ours per Case Facili es West Southwest Midwest Southeast Northeast Nurse HPC Tech HPC Ad inist a e Administrator HPC Regional Analysis Total HPC Number of PC Facili es West Southwest Midwest Southeast Northeast 61 VMG Health, LLC 2012 Rights Reserved 1

75 MULTI-SPECIALTY ASC INTELLIMARKER Regional Analysis 5.30 Operating Expense Analysis as a % of Net Revenue Facilities West Southwest Midwest Southeast Northeast Employee Salary and Wages 23.0 % 26.2 % 21.2 % 18.6 % 24.5 % 23.1 % Taxes and Benefits 5.1 % 5.8 % 4.6 % 5.5 % 5.3 % 4.8 % Occupancy Costs 6.7 % 7.8 % 6.6 % 5.0 % 5.9 % 7.0 % Medical and Surgical 21.4 % 21.1 % 22.9 % 18.5 % 23.1 % 20.5 % Other Medical Costs 0.8 % 0.7 % 0.3 % 0.9 % 0.5 % 1.1 % Insurance 0.7 % 0.8 % 0.7 % 0.5 % 0.8 % 0.5 % General & Administrative 14.3 % 15.3 % 14.6 % 12.3 % 13.2 % 15.0 % Total Operating Expenses 75.0 % 78.0 % 83.3 % 63.2 % 76.8 % 68.4 % per Square Foot Employee Salary and Wages $ $ $ $ $97.51 $ Taxes and Benefits $25.69 $27.84 $23.05 $29.74 $21.99 $28.34 Occupancy Costs $34.54 $38.18 $32.51 $32.19 $30.99 $40.37 Medical and Surgical $ $96.26 $ $ $91.41 $ Other Medical Costs $3.62 $2.95 $1.42 $5.85 $1.38 $5.12 Insurance $3.22 $3.91 $3.38 $2.45 $3.17 $3.37 General & Administrative $75.90 $80.48 $79.84 $73.23 $70.21 $78.62 Total Operating Expenses $ $ $ $ $ $ per OR ($'s in thousands) Employee Salary and Wages $ $ $ $ $ $ Taxes and Benefits $92.98 $99.33 $83.21 $ $82.10 $ Occupancy Costs $ $ $ $ $92.27 $ Medical and Surgical $ $ $ $ $ $ Other Medical Costs $12.92 $10.75 $7.36 $24.81 $6.00 $30.79 Insurance $12.10 $15.16 $11.52 $9.43 $12.32 $12.73 General & Administrative $ $ $ $ $ $ Total Operating Expenses $1, $1, $1, $1, $1, $1, per Case Employee Salary and Wages $ $ $ $ $ $ Taxes and Benefits $81.61 $95.17 $75.30 $95.78 $72.80 $82.62 Occupancy Costs $ $ $ $ $66.95 $ Medical and Surgical $ $ $ $ $ $ Other Medical Costs $12.11 $12.23 $5.22 $23.00 $4.37 $20.05 Insurance $10.74 $11.84 $12.73 $9.02 $8.46 $10.59 General & Administrative $ $ $ $ $ $ Total Operating Expenses $1, $1, $1, $1, $ $1, Regional Analysis 62

76 MULTI-SPECIALTY ASC INTELLIMARKER Regional Analysis 5.31 Facility Sta s cs $'s in thousands Facili es West Southwest Midwest Southeast Northeast Gross PP&E per OR $899 $698 $969 $975 $1,035 $1,129 Gross PP&E per Sq Ft $277 $250 $285 $291 $330 $304 Gross PP&E plus WC per OR $1,196 $1,016 $1,155 $1,376 $1,266 $1,365 Gross PP&E plus WC per Sq Ft $354 $313 $354 $411 $417 $342 Regional Analysis Opera ng Rooms Procedure Rooms Square Feet per Facility 13,600 12,000 15,454 16,500 14,000 11,330 Rental Rate per Sq Ft $27.51 $34.46 $25.35 $27.25 $23.23 $29.20 Rent & Occupancy Cost per Sq Ft $34.45 $37.94 $32.54 $29.92 $28.17 $37.51 Average Facility Cost per Square Foot $36 $30 $24 $18 $12 $6 $0 Facili es West Southwest Midwest Southeast Northeast 63 1 VMG Health, LLC 2012 Rights Reserved

77 MULTI-SPECIALTY ASC INTELLIMARKER Regional Analysis 5.32 Leverage Ratios $'s in thousands Facilities West Southwest Midwest Southeast Northeast Total Debt $608 $308 $709 $376 $805 $608 Net Debt $1,317 $530 $1,320 $2,260 $1,357 $1,485 Total Debt / Assets 17.1 % 5.3 % 22.8 % 11.0 % 18.9 % 25.4 % Total Debt / Equity 26.9 % 7.0 % 34.3 % 15.4 % 33.4 % 41.1 % Total Debt / EBITDA 0.23x 0.19x 0.40x 0.09x 0.22x 0.21x Regional Analysis Net Debt / Assets 30.8 % 15.9 % 33.5 % 41.0 % 28.9 % 43.9 % Net Debt / Equity 68.9 % 23.9 % 92.4 % % 64.4 % % Net Debt / EBITDA 0.65x 0.53x 0.49x 0.94x 1.04x 0.89x 64

78 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER 2012 SECTION 6 Financial Statements Income Statement 6.1 Common Size Income Statement 6.2 Balance Sheet 6.3 Common Size Balance Sheet 6.4 Revenue Cycle Analysis Liquidity Analysis 6.5 Accounts Receivable Analysis 6.6 Revenue Analysis Case Volume Mix as a percent of Total Cases 6.7 Case Volume Summary 6.8 Payor Mix as a percent of Gross Charges ENT Revenue per Case 6.13 GI/Endoscopy Revenue per Case 6.14 General Surgery Revenue per Case 6.15 OB/GYN Revenue per Case 6.16 Ophthalmology Revenue per Case 6.17 Oral Surgery Revenue per Case 6.18 Orthopedics Revenue per Case 6.19 Pain Management Revenue per Case Podiatry Revenue per Case 6.22 Urology Revenue per Case 6.23 EBITDA Margin Analysis 6.24 Sta ng Analysis Sta ng Summary 6.25 Hourly Salaries & Wages 6.26 Sta ours per Case 6.27 Expense Analysis Expense Analysis 6.28 Asset Analysis Liability Detail Facility Size by Operating Rooms VMG Health, LLC 2012 Rights Reserved

79 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size by Operating Rooms 6.1 Income Statement $'s in thousands Patient Revenues Gross Charges Facilities $27, ORs $15, ORs $24,709 > 4 ORs $45,049 Adjustments ($18,441) ($11,777) ($17,000) ($35,097) Net Revenue $7,164 $3,656 $6,631 $9,231 Operating Expenses Employee Salary and Wages $1,507 $902 $1,476 $2,134 Taxes and Benefits $349 $196 $346 $483 Occupancy Costs $438 $298 $460 $573 Medical and Surgical $1,435 $665 $1,320 $2,248 Other Medical Costs $52 $26 $58 $60 Insurance $45 $30 $43 $63 Depreciation and Amortization $264 $239 $231 $343 General & Administrative Bad Debt $117 $85 $112 $140 Management Fees $320 $173 $322 $366 Other G & A $622 $398 $586 $863 Total G & A $930 $599 $915 $1,145 Total Operating Expenses $5,521 $2,973 $5,052 $6,634 Operating Income $1,571 $539 $1,518 $2,060 Other Income (Expense) $5 $2 $4 $11 Net Interest Expense $50 $56 $38 $104 Earnings Before Taxes $1,457 $518 $1,450 $1,898 EBITDA $1,886 $726 $1,802 $2,500 66

80 MULTI-SPECIALTY ASC INTELLIMARKER Common Size Income Statement Patient Revenues Facilities 1-2 ORs 3-4 ORs > 4 ORs Gross Charges % % % % Adjustments % % % % Net Revenue % % % % Operating Expenses Employee Salary and Wages 23.0 % 24.6 % 23.3 % 22.4 % Taxes and Benefits 5.1 % 4.7 % 5.1 % 5.2 % Occupancy Costs 6.7 % 8.8 % 6.8 % 6.2 % Medical and Surgical 21.4 % 20.4 % 21.1 % 23.0 % Other Medical Costs 0.7 % 1.0 % 0.9 % 0.5 % Insurance 0.7 % 0.7 % 0.7 % 0.7 % Depreciation and Amortization 3.7 % 5.2 % 3.4 % 3.7 % General & Administrative Bad Debt 1.5 % 1.4 % 1.6 % 1.5 % Management Fees 5.0 % 5.6 % 5.0 % 4.4 % Other G & A 8.9 % 9.1 % 8.6 % 9.8 % Total G & A 14.3 % 14.9 % 13.4 % 14.6 % Facility Size by by Operating Rooms Total Operating Expenses 75.0 % 73.1 % 80.1 % 72.4 % Operating Income 20.0 % 15.5 % 20.0 % 20.1 % Other Income (Expense) 0.1 % 0.0 % 0.1 % 0.1 % Net Interest Expense 0.7 % 1.5 % 0.5 % 1.2 % Earnings Before Taxes 18.9 % 13.3 % 19.4 % 19.6 % EBITDA 25.5 % 20.3 % 26.1 % 25.0 % 67 VMG Health, LLC 2012 Rights Reserved 50

81 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size by Operating Rooms 6.3 Balance Sheet $'s in thousands ASSETS Cash and Equivalents Facilities $ ORs $ ORs $470 > 4 ORs $752 Net Accounts Receivable $628 $413 $568 $839 Other Current Assets $174 $105 $167 $292 Current Assets $1,296 $684 $1,224 $1,974 Gross PP&E $3,389 $2,017 $3,180 $5,330 Accumulated Depreciation ($2,273) ($1,218) ($2,061) ($3,589) Net PP&E $972 $610 $947 $1,295 Other Assets $158 $34 $97 $679 Total Assets $2,886 $1,643 $2,720 $4,906 LIABILITIES Current Liabilities $373 $280 $351 $522 Current Portion of LTD $169 $158 $118 $392 Total Current Liabilities $449 $332 $420 $633 Total Long-Term Debt $417 $145 $505 $615 Other LT Liabilities $47 $136 $22 $132 Total Liabilities $949 $407 $908 $1,710 EQUITY Shareholders' Equity $1,570 $962 $1,534 $2,005 Total Liabilities & Equity $2,885 $1,643 $2,720 $4,906 68

82 MULTI-SPECIALTY ASC INTELLIMARKER Common Size Balance Sheet Facilities 1-2 ORs 3-4 ORs > 4 ORs ASSETS Cash and Equivalents 17.7 % 14.1 % 17.3 % 15.3 % Net Accounts Receivable 21.8 % 25.2 % 20.9 % 17.1 % Other Current Assets 6.0 % 6.4 % 6.1 % 6.0 % Current Assets 44.9 % 41.7 % 45.0 % 40.2 % Gross PP&E % % % % Accumulated Depreciation % % % % Net PP&E 33.7 % 37.1 % 34.8 % 26.4 % Other Assets 5.5 % 2.1 % 3.6 % 13.9 % Total Assets % % % % LIABILITIES Current Liabilities 13.0 % 17.1 % 12.9 % 10.6 % Current Portion of LTD 5.9 % 9.6 % 4.4 % 8.0 % Total Current Liabilities 15.6 % 20.2 % 15.5 % 12.9 % Facility Size by by Operating Rooms Total Long-Term Debt 14.5 % 8.9 % 18.6 % 12.5 % Other LT Liabilities 1.6 % 8.3 % 0.8 % 2.7 % Total Liabilities 32.9 % 24.8 % 33.4 % 34.9 % EQUITY Shareholders' Equity 54.4 % 58.5 % 56.4 % 40.9 % Total Liabilities & Equity % % % % 69 VMG Health, LLC 2012 Rights Reserved 52

83 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size by Operating Rooms 6.5 Liquidity Analysis $'s in thousands Cash $510 $220 $499 $772 % of Total Assets 17.0 % 15.3 % 18.8 % 16.6 % Net A/R $628 $426 $602 $921 % of Total Assets 22.1 % 29.0 % 22.0 % 17.9 % Working Capital $881 $484 $912 $1,588 % of Net Revenue 13.7 % 11.3 % 14.5 % 14.0 % Liquidity Analysis % of Net Revenue 12% 8% 4% 0% 1-2 ORs 3-4 ORs > 4 ORs 70

84 MULTI-SPECIALTY ASC ASC INTELLIMARKER Accounts Receivable Analysis $'s in thousands Facili es 1-2 ORs 3-4 ORs > 4 ORs Accounts Receivable - Gross $1,004 $466 $908 $1,421 Accounts Receivable - Net $628 $413 $568 $839 A/R Turnover - Net A/R Days Outstanding - Net A/R Aging 0 to 30 days 55.8 % 48.8 % 57.8 % 54.9 % 31 to 60 days 16.5 % 17.4 % 16.2 % 15.6 % 61 to 90 days 7.5 % 8.1 % 7.4 % 8.0 % 91 to 120 days 5.1 % 5.8 % 4.8 % 5.3 % Over 120 days 12.7 % 19.3 % 11.2 % 14.4 % Facility Facility Size Size by by Operating Opera ng Rooms Accounts Receivable Aging 60% 40% 20% 0% Facili es 1-2 ORs 3-4 ORs > 4 ORs 0 to 30 days 31 to 60 days 61 to 90 days 91 to 120 days Over 120 days 71 VMG Health, LLC 2012 Rights Reserved 54

85 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size by Operating Rooms 6.7 Case olume Mix as a percent of Total Cases Facili es 1-2 ORs 3-4 ORs > 4 ORs ENT 9 % 8 % 9 % 9 % GI / Endoscopy 27 % 29 % 30 % 16 % General Surgery 7 % 5 % 7 % 7 % OB/GYN 3 % 2 % 3 % 4 % Ophthalmology 17 % 12 % 18 % 17 % Oral Surgery 1 % 0 % 1 % 1 % Orthopedics 17 % 17 % 18 % 13 % Pain Management 13 % 23 % 15 % 6 % Plas c 4 % 4 % 4 % 3 % Podiatry 3 % 3 % 3 % 3 % Urology 2 % 2 % 2 % 3 % Other 1 % 1 % 1 % 1 % 30% 24% 18% 12% 6% 0% ENT GI / Endoscopy General Surgery OB/GYN Ophthalmology Oral Surgery Orthopedics Pain Management Plastic Podiatry Urology Other 1-2 ORs 3-4 ORs > 4ORs 72

86 MULTI-SPECIALTY ASC INTELLIMARKER Case olume Summary Facili es 1-2 ORs 3-4 ORs > 4 ORs Total Cases per Center 4,204 2,711 3,955 6,117 Cases per Day Surgical Cases per Opera ng Room per Year per Day on Surgical Cases per Procedure Room per Year per Day o Cases Per ormed y Top 2 Physicians 28 % 31 % 29 % 24 % Top 5 Physicians 52 % 60 % 54 % 44 % Top 10 Physicians 73 % 84 % 74 % 64 % Facility Size by Operating Rooms Top Producing Physicians 80% % of Case Volume 60% 40% 0% Facili es ORs ORs ORs Top 2 Physicians Top 5 Physicians Top 10 Physicians 73 VMG Health, LLC 2012 Rights Reserved 1

87 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size by Opera ng Operating Rooms 6.9 Payor Mix as a Percent of ross Charges Facili es 1-2 ORs 3-4 ORs > 4 ORs Medicare 24 % 29 % 22 % 23 % Medicaid 3 % 4 % 3 % 4 % Commercial 58 % 54 % 59 % 62 % Worker's Comp 4 % 3 % 4 % 3 % Self Pay 2 % 1 % 2 % 2 % Other Pay 4 % 6 % 5 % 3 % 60% Medicare & Comercial as a % of ross Charges 40% 20% 0% Facili es 1-2 ORs 3-4 ORs > 4 ORs Medicare Commercial 74

88 MULTI-SPECIALTY ASC INTELLIMARKER Revenue per Case - Facili es with 1-2 ORs Specialty ross Charges Net Revenue ENT $7,457 $1,462 GI / Endoscopy $2,973 $668 General Surgery $5,426 $1,387 OB/GYN $5,748 $1,660 Ophthalmology $5,731 $1,167 Oral Surgery $2,594 $784 Orthopedics $8,424 $2,206 Pain Management $4,051 $857 Plas c $6,715 $1,455 Podiatry $7,883 $1,670 Urology $5,557 $1,410 Other $2,679 $830 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH $0 $2,000 $4,000 $6,000 $8,000 Facility Size Size by by Operating Opera ng Rooms Net Revenue Gross Charges 75 VMG Health, LLC 2012 Rights Reserved 58

89 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size by Opera ng Operating Rooms 6.11 Reveue per Case - Facili es with 3-4 ORs Specialty ross Charges Net Revenue ENT $7,380 $1,844 GI / Endoscopy $3,391 $790 General Surgery $5,722 $1,800 OB/GYN $6,894 $2,116 Ophthalmology $5,888 $1,264 Oral Surgery $3,115 $1,065 Orthopedics $9,697 $2,640 Pain Management $3,906 $819 Plas c $6,672 $1,789 Podiatry $7,612 $2,099 Urology $6,659 $1,636 Other $5,991 $1,770 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH $0 $2,000 $4,000 $6,000 $8,000 $10,000 Net Revenue Gross Charges 6.12 Revenue per Case - Facili es with > 4 ORs Specialty ross Charges Net Revenue ENT $8,792 $1,919 GI / Endoscopy $4,014 $872 General Surgery $7,260 $1,888 OB/GYN $8,068 $2,127 Ophthalmology $6,967 $1,380 Oral Surgery $4,605 $1,036 Orthopedics $11,051 $2,670 Pain Management $4,868 $955 Plas c $8,301 $1,704 Podiatry $8,183 $1,864 Urology $8,314 $2,087 Other $5,455 $1,357 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH $0 $2,000 $4,000 $6,000 Net Revenue $8,000 $10,000 Gross Charges 76

90 MULTI-SPECIALTY MULTI-SPECIALTY ASC ASC INTELLIMARKER ENT Revenue per Case Facilities 1-2 ORs 3-4 ORs > 4 ORs Based on case volume of 111,232 7,671 52,890 50,671 Gross Charges per Case $7,847 $7,457 $7,380 $8,792 Net Revenue per Case $1,849 $1,462 $1,844 $1,919 Discount To Charges 76.2 % 80.4 % 75.0 % 78.2 % 8,000 ENT Revenue per Case Facility Size Size by by Operating Rooms 6,000 4,000 2,000 0 Facilities 1-2 ORs 3-4 ORs > 4 ORs Net Revenue per Case Gross Charges per Case 77

91 Facility Facility Size Size by by Operating ng Rooms 6.14 I Endoscopy Revenue per Case 6.14 Endoscopy Revenue per Case MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC ASC INTELLIMARKER Based on case volume of Facili es Facili 234,285es 1-2 ORs 143,682-2 ORs 3-4 ORs 3125,829-4 ORs > 4 ORs > 64,7744 ORs Based on case volume of 234,285 43, ,829 64,774 Gross Charges per Case $3,610 $2,973 $3,391 $4,014 Gross Net Revenue Charges per per Case $3,610 $788 $2,973 $668 $3,391 $790 $4,014 $872 Discount Net Revenue To Charges per Case 75.1 $788 % 77.5 $668 % 76.7 $790 % 78.3 $872 % Discount To Charges 75.1 % 77.5 % 76.7 % 78.3 % I Endoscopy Revenue per Case I Endoscopy Revenue per Case $4,000 $4,000 $3,000 $3,000 $2,000 $2,000 $1,000 $1, Facili es 1-2 ORs 3-4 ORs > 4 ORs Facili es 1-2 ORs 3-4 ORs > 4 ORs Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case 6.15 eneral Surgery Revenue per Case 6.15 eneral Surgery Revenue per Case Based on case volume of Facili es Facili 87,591 es 1-2 ORs 1-5,234 2 ORs 3-4 ORs 3-44,0804 ORs > 4 ORs > 438,277 ORs Based on case volume of 87,591 5,234 44,080 38,277 Gross Charges per Case $6,152 $4,842 $6,313 $7,129 Net Gross Revenue Charges per per Case $1,795 $6,152 $1,351 $4,842 $1,894 $6,313 $1,932 $7,129 Net Discount Revenue To Charges per Case $1, % 72.1% $1,351 $1, % $1, % Discount To Charges 68.0% 72.1% 70.0 % 72.9 % eneral Surgery Revenue per Case eneral Surgery Revenue per Case $6,000 $6,000 $4,000 $4,000 $2,000 $2,000 $0 $0 Facili es 1-2 ORs 3-4 ORs > 4 ORs Facili es 1-2 ORs 3-4 ORs > 4 ORs Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case VMG Health, LLC 2012 Rights Reserved

92 MULTI-SPECIALTY ASC ASC INTELLIMARKER OB YN Revenue per Case Facili es 1-2 ORs 3-4 ORs > 4 ORs Based on case volume of 46,531 3,714 23,174 19,643 Gross Charges per Case $7,001 $5,748 $6,894 $8,068 Net Revenue per Case $2,081 $1,660 $2,116 $2,127 Discount To Charges 68.7 % 71.1 % 69.3 % 73.6 % $8,000 $6,000 OB YN Revenue per Case Facility Size by Operating Opera ng Rooms $4,000 $2,000 $0 Facili es 1-2 ORs 3-4 ORs > 4 ORs Net Revenue per Case Gross Charges per Case 6.17 Ophthalmology Revenue per Case Facili es 1-2 ORs 3-4 ORs > 4 ORs Based on case volume of 177,453 14,216 81,254 81,983 Gross Charges per Case $6,097 $5,731 $5,888 $6,967 Net Revenue per Case $1,273 $1,167 $1,264 $1,380 Discount To Charges 77.5 % 79.6 % 78.5 % 80.2 % Ophthalmology Revenue per Case $6,000 $4,000 $2,000 $0 Facili es 1-2 ORs 3-4 ORs > 4 ORs Net Revenue per Case Gross Charges per Case 79 VMG Health, LLC 2012 Rights Reserved 62

93 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER Facility Facility Size Size by by Operating ng Rooms 6.18 Oral Surgery Revenue per Case 6.18 Oral Surgery Revenue per Case Based on case volume of Facili es Facili 10,914es 1-2 ORs ORs 3-4 ORs 3-6,218 4 ORs > 4 ORs > 4,2234 ORs Based on case volume of 10, ,218 4,223 Gross Charges per Case $3,194 $2,594 $3,115 $4,605 Gross Net Revenue Charges per per Case $1,026 $3,194 $2,594 $784 $1,065 $3,115 $1,036 $4,605 Net Discount Revenue To Charges per Case $1, % 69.8 $784 % $1, % $1, % Discount To Charges 68.6 % 69.8 % 65.8 % 77.5 % Oral Surgery Revenue per Case Oral Surgery Revenue per Case $4,000 $4,000 $2,000 $2,000 $0 $0 Facili es 1-2 ORs 3-4 ORs > 4 ORs Facili es 1-2 ORs 3-4 ORs > 4 ORs Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case 6.19 Orthopedics Revenue per Case 6.19 Orthopedics Revenue per Case Based on case volume of Facili es Facili 217,976 es 1-2 ORs 1-22,000 2 ORs 3-4 ORs 3130,642-4 ORs > 4 ORs > 65,334 4 ORs Based on case volume of 217,976 22, ,642 65,334 Gross Charges per Case $9,874 $8,677 $9,911 $9,231 Net Gross Revenue Charges per per Case $2,618 $9,874 $2,499 $8,677 $2,815 $9,911 $2,428 $9,231 Net Discount Revenue To Charges per Case $2, % 71.2 $2,499 % 71.6 $2,815 % 73.7% $2,428 Discount To Charges 69.9% 71.2 % 71.6 % 73.7% $12,000 $12,000 Orthopedics Revenue per Case Orthopedics Revenue per Case $8,000 $8,000 $4,000 $4,000 $ 0 $ 0 Facili es 1-2 ORs 3-4 ORs > 4 ORs Facili es 1-2 ORs 3-4 ORs > 4 ORs Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case VMG Health, LLC 2012 Rights Reserved

94 MULTI-SPECIALTY ASC INTELLIMARKER Pain Management Revenue per Case Facili es 1-2 ORs 3-4 ORs > 4 ORs Based on case volume of 198,864 44, ,195 54,207 Gross Charges per Case $4,106 $4,051 $3,906 $4,868 Net Revenue per Case $840 $857 $819 $955 Discount To Charges 76.2 % 78.8 % 79.0 % 80.4 % $4,000 Pain Management Revenue per Case Facility Size Size by by Operating Opera ng Rooms $3,000 $2,000 $1,000 $0 Facili es 1-2 ORs 3-4 ORs > 4 ORs Net Revenue per Case Gross Charges per Case 6.21 Plas c Surgery Revenue per Case Facili es 1-2 ORs 3-4 ORs > 4 ORs Based on case volume of 44,178 3,955 17,883 22,340 Gross Charges per Case $7,419 $6,715 $6,672 $8,301 Net Revenue per Case $1,696 $1,455 $1,789 $1,704 Discount To Charges 77.6 % 78.3 % 73.2 % 79.5 % Plas c Surgery Revenue per Case $8,000 $6,000 $4,000 $2,000 $0 Facili es 1-2 ORs 3-4 ORs > 4 ORs Net Revenue per Case Gross Charges per Case 81 VMG Health, LLC 2012 Rights Reserved 64

95 Facility Facility Size Size by by Operating ng Rooms 6.22 Podiatry Revenue per Case 6.22 Podiatry Revenue per Case MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC ASC INTELLIMARKER Based on case volume of Facili es Facili 36,908 es 1-2 ORs 1-3,800 2 ORs 3-4 ORs 320,040-4 ORs > 4 ORs > 13,068 4 ORs Based on case volume of 36,908 3,800 20,040 13,068 Gross Charges per Case $7,969 $7,883 $7,612 $8,183 Gross Net Revenue Charges per per Case $1,893 $7,969 $7,883 $1,670 $7,612 $2,099 $8,183 $1,864 Net Discount Revenue To Charges per Case $1, % $1, % $2, % $1, % Discount To Charges 74.3 % 78.8 % 72.4 % 77.2 % Podiatry Revenue per Case Podiatry Revenue per Case $8,000 $8,000 $6,000 $6,000 $4,000 $4,000 $2,000 $2,000 $0 Facili es 1-2 ORs 3-4 ORs > 4 ORs $0 Facili es 1-2 ORs 3-4 ORs > 4 ORs Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case 6.23 Urology Revenue per Case 6.23 Urology Revenue per Case Based on case volume of Facili es Facili 52,258 es 1-2 ORs 13,577-2 ORs 3-4 ORs 330,455-4 ORs > 4 ORs > 18,226 4 ORs Based on case volume of 52,258 3,577 30,455 18,226 Gross Charges per Case $7,498 $4,525 $6,290 $7,868 Net Gross Revenue Charges per per Case $1,788 $7,498 $1,525 $4,525 $1,623 $6,290 $1,912 $7,868 Net Discount Revenue To Charges per Case $1, % $1, % $1, % $1, % Discount To Charges 70.7 % 66.3 % 74.2 % 75.7 % Urology Revenue per Case Urology Revenue per Case $8,000 $8,000 $6,000 $6,000 $4,000 $4,000 $2,000 $2,000 $0 $0 Facili es 1-2 ORs 3-4 ORs > 4 ORs Facili es 1-2 ORs 3-4 ORs > 4 ORs Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case VMG Health, LLC 2012 Rights Reserved

96 MULTI-SPECIALTY ASC INTELLIMARKER EBITDA Margin Analysis Net Revenue Facili es 1-2 ORs 3-4 ORs > 4 ORs Less than $3 mm 12.8 % 19.0 % 5.9 % 5.1 % $3 mm to $4.9 mm 16.2 % 17.7 % 14.0 % 17.8 % $5 mm to $6.9 mm 24.5 % 40.2 % 22.8 % 19.1 % $7 mm to $8.9 mm 28.6 % 39.2 % 31.2 % 23.5 % Greater than $9 mm 37.3 % 64.1 % 40.9 % 31.1 % 60% Facility Size Size by by Operating Opera ng Rooms 40% 20% 0% Facili es 1-2 ORs 3-4 ORs > 4 ORs Less than $3 mm $3 mm to $4.9 mm $5 mm to $6.9 mm $7 mm to $8.9 mm reater than $9 mm 83 VMG Health, LLC 2012 Rights Reserved 66

97 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size by Operating Opera ng Rooms 6.25 Sta ng Summary Facili es 1-2 ORs 3-4 ORs > 4 ORs Nurse FTE Tech FTE Administra e FTE Administrator FTE Total FTE Number Of FTEs Facili es 1-2 ORs 3-4 ORs > 4 ORs Nurse FTE Tech FTE Administrator FTE 84

98 MULTI-SPECIALTY ASC INTELLIMARKER ourly Salaries & Wages Facili es 1-2 ORs 3-4 ORs > 4 ORs urse Sta $32.10 $30.74 $32.14 $32.67 Tec Sta $21.18 $21.11 $20.54 $21.30 Administra e Sta $22.70 $23.50 $22.67 $22.07 Total Hourly Administrator - Salary $27.00 $105,996 ourly Wages $26.82 $26.73 $27.00 $91,621 $105,500 $110,698 Facility Size Size by by Operating Opera ng Rooms $30 $20 $10 $0 Facili es 1-2 ORs 3-4 ORs > 4 ORs Nurse Sta Tech Sta 85 VMG Health, LLC 2012 Rights Reserved 68

99 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size by Opera ng Operating Rooms 6.27 Sta ours per Case Facili es 1-2 ORs 3-4 ORs > 4 ORs Nurse HPC Tech HPC Administra e PC Administrator HPC Total HPC Number of PC Facili es 1-2 ORs 3-4 ORs > 4 ORs Nurse PC Tech PC Administrator PC 86

100 MULTI-SPECIALTY ASC ASC INTELLIMARKER as a % of Net Revenue Employee Salary and Wages 23.0 % 24.6 % 22.3 % 22.4 % 5.1 % 4.7 % 5.1 % 5.2 % 6.7 % 8.8 % 6.8 % 6.2 % Medical and Surgical 21.4 % 20.4 % 21.1 % 23.0 % 0.7 % 1.0 % 0.9 % 0.5 % Insurance 0.7 % 0.7 % 0.7 % 0.7 % 14.3 % 14.9 % 13.4 % 14.6 % 75.0 % 73.1 % 80.1 % 72.4 % per Square Foot Employee Salary and Wages $ $98.83 $ $ $25.69 $22.53 $23.48 $24.25 $34.54 $32.66 $35.55 $34.65 Medical and Surgical $ $64.58 $95.15 $ $3.62 $2.42 $5.62 $5.40 Insurance $3.22 $3.60 $2.91 $2.58 $75.90 $62.49 $71.38 $68.41 $ $ $ $ per OR ($'s in thousands) Employee Salary and Wages $ $ $ $ $92.98 $94.82 $90.78 $74.74 $ $ $ $ Medical and Surgical $ $ $ $ $12.92 $13.15 $18.71 $14.89 Insurance $12.10 $16.31 $11.21 $9.58 $ $ $ $ $1, $1, $1, $1, per Case Employee Salary and Wages $ $ $ $ $81.61 $55.12 $78.70 $80.85 $ $70.06 $ $ Medical and Surgical $ $ $ $ $12.11 $11.09 $17.03 $17.23 Insurance $10.74 $9.83 $10.29 $9.70 $ $ $ $ $1, $ $1, $1, Facility Size by Operating Rooms VMG Health, LLC Rights Reserved VMG Health, LLC 2011 Rights Reserved

101 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size by Operating Opera ng Rooms 6.29 Facility Sta s cs $'s in thousands Facili es 1-2 ORs 3-4 ORs > 4 ORs Gross PP&E per OR $899 $1,230 $894 $892 Gross PP&E per Sq Ft $277 $313 $269 $315 Gross PP&E plus WC per OR $1,196 $1,413 $1,211 $1,080 Gross PP&E plus WC per Sq Ft $354 $402 $334 $371 Opera ng Rooms Procedure Rooms Square Feet per Facility 13,600 7,566 12,975 18,651 Rental Rate per Sq Ft $27.51 $30.00 $26.93 $28.00 Rent & Occupancy Cost per Sq Ft $34.45 $38.49 $33.83 $34.44 Average Facility Costs per Square Foot $40 $30 $20 $10 $0 Facili es 1-2 ORs 3-4 ORs > 4 ORs Rent & Occupancy Cost per Sq Ft Rental Rate per Sq Ft 88

102 MULTI-SPECIALTY ASC INTELLIMARKER Leverage Ratios $'s in thousands Facilities 1-2 ORs 3-4 ORs > 4 ORs Total Debt $608 $608 $562 $1,076 Net Debt $1,317 $1,317 $1,269 $2,293 Total Debt / Assets 17.1 % 17.1 % 17.6 % 16.9 % Total Debt / Equity 26.9 % 26.9 % 28.4 % 27.0 % Total Debt / EBITDA 0.23x 0.23x 0.22x 0.45x Net Debt / Assets 30.8 % 30.8 % 40.9 % 34.7 % Net Debt / Equity 68.9 % 68.9 % % 91.2 % Net Debt / EBITDA 0.65x 0.65x 0.72x 0.69x Facility Size by by Operating Rooms 89 VMG Health, LLC 2012 Rights Reserved 72

103 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Facility Size by Operating Rooms 90

104 MULTI-SPECIALTY ASC INTELLIMARKER 2012 SECTION 7 Facility Size by Case Volume Financial Statements Income Statement 7.1 Common Size Income Statement 7.2 Balance Sheet 7.3 Common Size Balance Sheet 7.4 Revenue Cycle Analysis Liquidity Analysis 7.5 Accounts Receivable Analysis 7.6 Revenue Analysis Case Volume Mix as a percent of Total Cases 7.7 Case Volume Summary 7.8 Payor Mix as a percent of Gross Charges ENT Revenue per Case 7.13 GI/Endoscopy Revenue per Case 7.14 General Surgery Revenue per Case 7.15 OB/GYN Revenue per Case 7.16 Ophthalmology Revenue per Case 7.17 Oral Surgery Revenue per Case 7.18 Orthopedics Revenue per Case 7.19 Pain Management Revenue per Case Podiatry Revenue per Case 7.22 Urology Revenue per Case 7.23 EBITDA Margin Analysis 7.24 Sta ng Analysis Sta ng Summary 7.25 Hourly Salaries & Wages 7.26 Sta ours per Case 7.27 Expense Analysis Expense Analysis 7.28 Asset Analysis Liability Detail Facility Size by Case Volume 91

105 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size Size by by Case Case Volume Volume 7.1 Income Statement $'s in thousands Patient Revenues Gross Charges Facilities $27,071 < 3,000 $13,637 3,000-5,999 $25,937 > 5,999 $32,505 Adjustments ($18,441) ($9,365) ($18,891) ($22,388) Net Revenue $7,164 $3,687 $6,197 $9,011 Operating Expenses Employee Salary and Wages $1,507 $936 $1,354 $1,946 Taxes and Benefits $349 $209 $311 $470 Occupancy Costs $438 $395 $415 $491 Medical and Surgical $1,435 $867 $1,285 $2,016 Other Medical Costs $52 $27 $45 $70 Insurance $45 $27 $44 $57 Depreciation and Amortization $264 $262 $229 $290 General & Administrative Bad Debt $117 $50 $114 $146 Management Fees $320 $196 $300 $392 Other G & A $622 $442 $585 $743 Total G & A $930 $769 $776 $1,185 Total Operating Expenses $5,521 $3,653 $5,070 $6,766 Operating Income $1,571 $374 $1,117 $2,370 Other Income (Expense) $5 $8 $3 $11 Net Interest Expense $50 $85 $45 $53 Earnings Before Taxes $1,457 $235 $1,045 $2,230 EBITDA $1,886 $545 $1,414 $2,702 92

106 MULTI-SPECIALTY ASC INTELLIMARKER Common Size Income Statement Patient Revenues Facilities < 3,000 3,000-5,999 > 5,999 Gross Charges % % % % Adjustments % % % % Net Revenue % % % % Operating Expenses Employee Salary and Wages 23.0 % 24.2 % 23.7 % 22.1 % Taxes and Benefits 5.1 % 5.7 % 5.0 % 5.1 % Occupancy Costs 6.7 % 8.7 % 7.7 % 5.6 % Medical and Surgical 21.4 % 22.9 % 20.9 % 21.3 % Other Medical Costs 0.7 % 0.8 % 0.7 % 0.8 % Insurance 0.7 % 0.7 % 0.7 % 0.7 % Depreciation and Amortization 3.7 % 6.7 % 4.2 % 3.3 % General & Administrative Bad Debt 1.5 % 1.3 % 1.5 % 1.6 % Management Fees 5.0 % 5.3 % 5.2 % 4.5 % Other G & A 8.9 % 9.1 % 9.6 % 8.2 % Total G & A 14.3 % 17.9 % 18.6 % 14.6 % Facility Size Size by by Case Case Volume Volume Total Operating Expenses 75.0 % 81.6 % 74.7 % 63.6 % Operating Income 20.0 % 7.8 % 18.3 % 25.2 % Other Income (Expense) 0.1 % 0.3 % 0.0 % 0.1 % Net Interest Expense 0.7 % 1.9 % 0.7 % 0.7 % Earnings Before Taxes 18.9 % 5.1 % 17.2 % 23.7 % EBITDA 25.5 % 17.2 % 24.5 % 29.1 % 93 VMG Health, LLC 2012 Rights Reserved 74

107 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size Size by by Case Case Volume 7.3 Balance Sheet $'s in thousands ASSETS Cash and Equivalents Facilities $510 < 3,000 $328 3,000-5,999 $385 > 5,999 $752 Net Accounts Receivable $628 $426 $537 $849 Other Current Assets $174 $154 $157 $231 Current Assets $1,296 $869 $1,190 $1,935 Gross PP&E $3,389 $2,914 $3,321 $3,566 Accumulated Depreciation ($2,273) ($1,261) ($2,089) ($2,754) Net PP&E $972 $1,036 $776 $1,112 Other Assets $158 $43 $251 $224 Total Assets $2,886 $2,233 $2,644 $3,890 LIABILITIES Current Liabilities $373 $272 $342 $474 Current Portion of LTD $169 $158 $154 $244 Total Current Liabilities $449 $342 $420 $559 Total Long-Term Debt $417 $1,317 $406 $373 Other LT Liabilities $47 $101 $20 $99 Total Liabilities $949 $1,082 $825 $1,041 EQUITY Shareholders' Equity $1,570 $1,053 $1,272 $1,901 Total Liabilities & Equity $2,885 $2,233 $2,644 $3,890 94

108 MULTI-SPECIALTY ASC INTELLIMARKER Common Size Balance Sheet Facilities < 3,000 3,000-5,999 > 5,999 ASSETS Cash and Equivalents 17.7 % 14.7 % 14.6 % 19.3 % Net Accounts Receivable 21.8 % 19.1 % 20.3 % 21.8 % Other Current Assets 6.0 % 6.9 % 6.0 % 5.9 % Current Assets 44.9 % 38.9 % 45.0 % 49.7 % Gross PP&E % % % 91.7 % Accumulated Depreciation % % % % Net PP&E 33.7 % 46.4 % 29.4 % 28.6 % Other Assets 5.5 % 2.0 % 9.5 % 5.8 % Total Assets % % % % Facility Size Size by by Case Case Volume Volume LIABILITIES Current Liabilities 13.0 % 12.2 % 12.9 % 12.2 % Current Portion of LTD 5.9 % 7.1 % 5.8 % 6.3 % Total Current Liabilities 15.6 % 15.3 % 15.9 % 14.4 % Total Long-Term Debt 14.5 % 59.0 % 15.4 % 9.6 % Other LT Liabilities 1.6 % 4.6 % 0.8 % 2.6 % Total Liabilities 32.9 % 48.5 % 31.2 % 26.8 % EQUITY Shareholders' Equity 54.4 % 47.2 % 48.1 % 48.9 % Total Liabilities & Equity % % % % 95 VMG Health, LLC 2012 Rights Reserved 76

109 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size Size by by Case Case Volume Volume 7.5 Liquidity Analysis $'s in thousands Facili es < 3,000 3,000-5,999 > 5,999 Cash $510 $328 $385 $752 % of Total Assets 17.0 % 10.8 % 18.4 % 17.6 % Net A/R $628 $426 $537 $849 % of Total Assets 22.1 % 15.9 % 21.8 % 22.7 % Working Capital $881 $645 $803 $1,333 % of Net Revenue 13.7 % 15.3 % 13.5 % 14.0 % Current Ra o Days Opera ng Expenses Liquidity Analysis 16% % of Net Revenue 12% 8% 4% 0% Facili es < 3,000 3,000-5,999 > 5,999 Working Capital 96

110 MULTI-SPECIALTY ASC INTELLIMARKER Accounts Receivable Analysis $'s in thousands Facili es < 3,000 3,000-5,999 > 5,999 Accounts Receivable - Gross $1,004 $422 $850 $1,387 Accounts Receivable - Net $628 $426 $537 $849 A/R Turnover - Net A/R Days Outstanding - Net A/R Aging 0 to 30 days 55.8 % 50.0 % 57.1 % 57.6 % 31 to 60 days 16.5 % 17.4 % 16.5 % 16.4 % 61 to 90 days 7.5 % 7.5 % 7.5 % 7.6 % 91 to 120 days 5.1 % 5.7 % 5.2 % 5.0 % Over 120 days 12.7 % 17.1 % 12.6 % 10.6 % Facility Size Size by by Case Case Volume Volume Accounts Receivable Aging 60% 40% 20% 0% Facili es < > to 30 days 31 to 60 days 61 to 90 days 91 to 120 days Over 120 days 97 VMG Health, LLC 2012 Rights Reserved 78

111 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size Size by by Case Case Volume 7.7 Case Volume Mix as a percent of Total Cases Facili es < 3,000 3,000-5,999 > 5,999 ENT 9 % 9 % 10 % 8 % GI / Endoscopy 27 % 24 % 24 % 29 % General Surgery 7 % 8 % 5 % 8 % OB/GYN 3 % 5 % 5 % 3 % Ophthalmology 17 % 13 % 18 % 17 % Oral Surgery 1 % 2 % 1 % 0 % Orthopedics 17 % 20 % 16 % 17 % Pain Management 13 % 17 % 12 % 13 % Plas c 4 % 4 % 4 % 3 % Podiatry 3 % 4 % 3 % 2 % Urology 2 % 6 % 4 % 2 % Other 1 % 1 % 1 % 1 % 30% 24% 18% 12% 6% 0% ENT GI / Endoscopy General Surgery OB/GYN Ophthalmology Oral Surgery Orthopedics Pain Management Podiatry Urology Other < 3,000 3,000-5,999 > 5,999 98

112 MULTI-SPECIALTY ASC INTELLIMARKER Case Volume Summary Facili es < 3,000 3,000-5,999 > 5,999 Total Cases per Center 4,204 2,246 3,891 6,128 Cases per Day Surgical Cases per Opera ng Room per Year per Day on Surgical Cases per Procedure Room per Year ,131 per Day o Cases Per ormed y Top 2 Physicians 28 % 29 % 27 % 28 % Top 5 Physicians 52 % 55 % 51 % 51 % Top 10 Physicians 73 % 75 % 73 % 72 % Facility Size Size by by Case Case Volume Volume Top Producing Physicians 80% % of Case Volume 60% 40% 20% 0% Facili es < 3,000 3,000-5,999 > 5,999 Top 2 Physicians Top 5 Physicians Top 10 Physicians 99 VMG Health, LLC 2012 Rights Reserved 80

113 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size Size by by Case Case Volume 7.9 Payor Mix as a Percent of Gross Charges Medicare Medicaid Commercial Worker's Comp Self Pay Other Pay Facili es < 3,000 3,000-5,999 > 5, % 3 % 58 % 4 % 2 % 4 % 26 % 3 % 55 % 3 % 1 % 6 % Medicare & Comercial as a % of Gross Charges 25 % 4 % 56 % 4 % 2 % 4 % 21 % 3 % 60 % 3 % 1 % 4 % 60% 40% 20% 0% Facili es < 3,000 3,000-5,999 > 5,999 Medicare Commercial 100

114 MULTI-SPECIALTY ASC INTELLIMARKER Revenue per Case - Facili es with < 3,000 Cases Specialty Gross Charges Net Revenue ENT $8,750 $2,050 GI / Endoscopy $3,809 $740 General Surgery $5,753 $1,497 OB/GYN $6,239 $2,028 Ophthalmology $5,773 $1,254 Oral Surgery $3,405 $1,161 Orthopedics $9,847 $2,640 Pain Management $3,511 $795 Plas c $6,119 $1,455 Podiatry $8,168 $1,890 Urology $6,005 $1,637 Other $10,507 $2,352 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH Facility Size Size by by Case Case Volume Volume $0 $3,000 $6,000 $9,000 Net Revenue Gross Charges 101 VMG Health, LLC 2012 Rights Reserved 82

115 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size Size by by Case Case Volume Volume 7.11 Revenue per Case - Facili es with 3,000-5,999 cases Specialty Gross Charges Net Revenue ENT $7,654 $1,764 GI / Endoscopy $3,347 $809 General Surgery $6,106 $1,632 OB/GYN $7,802 $2,149 Ophthalmology $6,531 $1,264 Oral Surgery $3,231 $962 Orthopedics $9,442 $2,565 Pain Management $4,706 $860 Plas c $7,670 $1,500 Podiatry $7,733 $1,904 Urology $8,476 $1,565 Other $7,617 $1,680 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH $0 $3,000 $6,000 $9,000 Net Revenue Gross Charges 7.12 Revenue per Case - Facili es with > 6,000 Specialty Gross Charges Net Revenue ENT $7,473 $1,855 GI / Endoscopy $3,670 $802 General Surgery $6,284 $1,870 OB/GYN $6,587 $2,060 Ophthalmology $6,084 $1,310 Oral Surgery $3,060 $1,179 Orthopedics $10,066 $2,681 Pain Management $4,099 $840 Plas c $7,722 $1,843 Podiatry $8,020 $1,812 Urology $7,245 $2,044 Other $4,714 $1,329 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH $0 $2,000 $4,000 $6,000 $8,000 Net Revenue Gross Charges 102

116 MULTI-SPECIALTY ASC INTELLIMARKER ENT Revenue per Case Facili es < 3,000 3,000-5,999 > 5,999 Based on case volume of 111,232 8,724 41,037 61,471 Gross Charges per Case $7,847 $8,750 $7,654 $7,473 Net Revenue per Case $1,849 $2,050 $1,764 $1,855 Discount To Charges 76.2 % 76.6 % 77.0 % 75.2 % $8,000 ENT Revenue per Case Facility Size Size by by Case Case Volume Volume $6,000 $4,000 $2,000 $0 Facili es < 3,000 3,000-5,999 > 5,999 Net Revenue per Case Gross Charges per Case 103 VMG Health, LLC 2012 Rights Reserved 84

117 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size Size by by Case Case Volume 7.14 GI/Endoscopy Revenue per Case 7.14 GI/Endoscopy Revenue per Case Facili es < 3,000 3,000-5,999 > 5,999 Based on case volume of Facili es 236,713 < 8,024 3,000 3,000 73,047-5, ,642 > 5,999 Based on case volume of 236,713 8,024 73, ,642 Gross Charges per Case $3,610 $3,809 $3,347 $3,670 Gross Net Revenue Charges per per Case Case $3,610 $788 $3,809 $740 $3,347 $809 $3,670 $802 Discount Net Revenue To Charges per Case 75.1 $788 % 80.6 $740 % 75.8 $809 % 78.2 $802 % Discount To Charges 75.1 % 80.6 % 75.8 % 78.2 % GI/Endoscopy Revenue per Case GI/Endoscopy Revenue per Case $4,000 $4,000 $3,000 $3,000 $2,000 $2,000 $1,000 $1,000 $0 $0 Facili es < 3,000 3,000-5,999 > 5,999 Facili es < 3,000 Net Revenue per Case 3,000-5,999 Gross Charges per Case > 5,999 Net Revenue per Case Gross Charges per Case 7.15 General Surgery Revenue per Case 7.15 General Surgery Revenue per Case Facili es < 3,000 3,000-5,999 > 5,999 Based on case volume of Facili es 87,591 < 7,596 3,000 3,000 24,164-5,999 > 55,831 5,999 Based on case volume of 87,591 7,596 24,164 55,831 Gross Charges per Case $6,152 $5,753 $6,106 $6,284 Gross Net Revenue Charges per per Case Case $6,152 $1,795 $5,753 $1,497 $6,106 $1,632 $6,284 $1,870 Discount Net Revenue To Charges per Case $1, % $1, % $1, % $1, % Discount To Charges 69.4 % 74.0 % 73.3 % 70.3 % General Surgery Revenue per Case General Surgery Revenue per Case $6,000 $6,000 $4,000 $4,000 $2,000 $2,000 $0 $0 Facili es < 3,000 3,000-5,999 > 5,999 Facili es < 3,000 3,000-5,999 > 5,999 Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case VMG Health, LLC 2012 Rights Reserved

118 MULTI-SPECIALTY ASC ASC INTELLIMARKER OB/GYN Revenue per Case Facili es < 3,000 3,000-5,999 > 5,999 Based on case volume of 47,585 3,742 15,534 28,309 Gross Charges per Case $7,001 $6,239 $7,802 $6,587 Net Revenue per Case $2,081 $2,028 $2,149 $2,060 Discount To Charges 68.7 % 67.5 % 72.5 % 68.7 % $8,000 OB/GYN Revenue per Case Facility Size by by Case Case Volume $6,000 $4,000 $2,000 $0 Facili es < 3,000 3,000-5,999 > 5,999 Net Revenue per Case Gross Charges per Case 7.17 Ophthalmology Revenue per Case Facili es < 3,000 3,000-5,999 > 5,999 Based on case volume of 181,046 10,336 54, ,291 Gross Charges per Case $6,097 $5,773 $6,531 $6,084 Net Revenue per Case $1,273 $1,254 $1,264 $1,310 Discount To Charges 77.5 % 78.3 % 80.7 % 78.5 % Ophthalmology Revenue per Case $6,000 $4,000 $2,000 $0 Facili es < 3,000 3,000-5,999 > 5,999 Net Revenue per Case Gross Charges per Case 105 VMG Health, LLC 2012 Rights Reserved 86

119 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size Size by by Case Case Volume 7.18 Oral Surgery Revenue per Case 7.18 Oral Surgery Revenue per Case Based on case volume of Facili es < 3,000 3,000-5,999 > 5,999 Facili es 10,914 < 1,478 3,000 3,0006,041-5,999 > 3,395 5,999 Based on case volume of 10,914 1,478 6,041 3,395 Gross Charges per Case $3,194 $3,405 $3,231 $3,060 Gross Net Revenue Charges per per Case Case $3,194 $1,026 $3,405 $1,161 $3,231 $962 $3,060 $1,179 Net Discount Revenue To Charges per Case $1, % $1, % 70.2 $962 % $1, % Discount To Charges 68.6 % 65.9 % 70.2 % 61.5 % Oral Surgery Revenue per Case Oral Surgery Revenue per Case $3,000 $3,000 $2,000 $2,000 $1,000 $1,000 $0 $0 Facili es < 3,000 3,000-5,999 > 5,999 Facili es < 3,000 Net Revenue per Case 3,000-5,999 Gross Charges per Case > 5,999 Net Revenue per Case Gross Charges per Case 7.19 Orthopedics Revenue per Case 7.19 Orthopedics Revenue per Case Based on case volume of Facili es < 3,000 3,000-5,999 > 5,999 Facili es 217,976 < 21,489 3,000 3,000 64,142-5, ,345 > 5,999 Based on case volume of 217,976 21,489 64, ,345 Gross Charges per Case $9,874 $9,847 $9,442 $10,066 Gross Net Revenue Charges per per Case Case $9,874 $2,618 $9,847 $2,640 $9,442 $2,565 $10,066 $2,681 Discount Net Revenue To Charges per Case $2, % $2, % $2, % $2, % Discount To Charges 71.2 % 73.2 % 72.8 % 73.4 % Orthopedics Revenue per Case Orthopedics Revenue per Case $10,000 $10,000 $8,000 $8,000 $6,000 $6,000 $4,000 $4,000 $2,000 $2,000 $0 $0 Facili es < 3,000 3,000-5,999 > 5,999 Facili es < 3,000 Net Revenue per Case 3,000-5,999 Gross Charges per Case > 5,999 Net Revenue per Case Gross Charges per Case VMG Health, LLC 2012 Rights Reserved

120 MULTI-SPECIALTY ASC INTELLIMARKER Pain Management Revenue per Case Facili es < 3,000 3,000-5,999 > 5,999 Based on case volume of 200,316 16,936 56, ,289 Gross Charges per Case $4,106 $3,511 $4,706 $4,099 Net Revenue per Case $840 $795 $860 $840 Discount To Charges 76.2 % 77.4 % 81.7 % 79.5 % Pain Management Revenue per Case Facility Size Size by by Case Case Volume Volume $4,000 $2,000 $0 Facili es < 3,000 3,000-5,999 > 5,999 Net Revenue per Case Gross Charges per Case 7.21 Plas c Surgery Revenue per Case Facili es < 3,000 3,000-5,999 > 5,999 Based on case volume of 44,421 5,567 14,593 24,261 Gross Charges per Case $7,419 $6,119 $7,670 $7,722 Net Revenue per Case $1,696 $1,455 $1,500 $1,843 Discount To Charges 77.6 % 76.2 % 80.4 % 76.1 % Plas c Surgery Revenue per Case $6,000 $4,000 $2,000 $0 Facili es < 3,000 3,000-5,999 > 5,999 Net Revenue per Case Gross Charges per Case 107 VMG Health, LLC 2012 Rights Reserved 88

121 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size Size by by Case Case Volume 7.22 Podiatry Revenue per Case 7.22 Podiatry Revenue per Case Facili es < 3,000 3,000-5,999 > 5,999 Based on case volume of Facili es 36,908 < 3,000 5,016 3,000 13,937-5,999 > 17,955 5,999 Based on case volume of 36,908 5,016 13,937 17,955 Gross Charges per Case $7,969 $8,168 $7,733 $8,020 Gross Net Revenue Charges per per Case Case $7,969 $1,893 $8,168 $1,890 $7,733 $1,904 $8,020 $1,812 Net Discount Revenue To Charges per Case $1, % $1, % $1, % $1, % Discount To Charges 74.3 % 76.9 % 75.4 % 77.4 % Podiatry Revenue per Case Podiatry Revenue per Case $8,000 $8,000 $6,000 $6,000 $4,000 $4,000 $2,000 $2,000 $0 Facili es < 3,000 3,000-5,999 > 5,999 $0 Facili es < 3,000 3,000-5,999 > 5,999 Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case 7.23 Urology Revenue per Case 7.23 Urology Revenue per Case Based on case volume of Facili es < 3,000 3,000-5,999 > 5,999 Facili es 52,258 < 3,000 2,650 3,000 16,582-5,999 > 33,026 5,999 Based on case volume of 52,258 2,650 16,582 33,026 Gross Charges per Case $7,498 $6,005 $8,476 $7,245 Gross Net Revenue Charges per per Case Case $7,498 $1,788 $6,005 $1,637 $8,476 $1,565 $7,245 $2,044 Net Discount Revenue To Charges per Case $1, % $1, % $1, % $2, % Discount To Charges 70.7 % 72.8 % 81.5 % 71.8 % Urology Revenue per Case Urology Revenue per Case $8,000 $8,000 $6,000 $6,000 $4,000 $4,000 $2,000 $2,000 $0 $0 Facili es < 3,000 3,000-5,999 > 5,999 Facili es < 3,000 3,000-5,999 > 5,999 Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case VMG Health, LLC 2012 Rights Reserved

122 VMG Health, LLC 2012 Rights Reserved 90 MULTI-SPECIALTY ASC INTELLIMARKER EBITDA Margin Analysis Net Revenue Facili es < 3,000 3,000-5,999 > 5,999 Less than $3 mm 12.8 % 5.8 % 15.7 % 21.5 % $3 mm to $4.9 mm 16.2 % 11.8 % 15.2 % 18.7 % $5 mm to $6.9 mm 24.5 % 31.0 % 27.0 % 20.9 % $7 mm to $8.9 mm 28.6 % 41.1 % 26.6 % 29.8 % Greater than $9 mm 37.3 % 32.3 % 39.4 % 35.9 % Facility Size Size by by Case Case Volume 40% 20% 0% Facili es < 3,000 3,000-5,999 > 5,999 Less than $3 mm $3 mm to $4.9 mm $5 mm to $6.9 mm $7 mm to $8.9 mm Greater than $9 mm 109

123 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size Size by by Case Case Volume Volume 7.25 Sta ng Summary Facili es < 3,000 3,000-5,999 > 5,999 Nurse FTE Tech FTE Administra e FTE Administrator FTE Total FTE Number Of FTEs Facili es < 3,000 3,000-5,999 > 5,999 Nurse FTE Tech FTE Administrator FTE 110

124 MULTI-SPECIALTY ASC ASC INTELLIMARKER Hourly Salaries & Wages Facili es < 3,000 3,000-5,999 > 5,999 urse Sta $32.10 $32.19 $31.56 $32.16 Tec Sta $21.18 $21.97 $19.70 $21.37 Administra e Sta $22.70 $24.58 $21.61 $22.75 Total Hourly Administrator - Salary $27.00 $105,996 $27.57 $25.99 $27.27 $100,000 $105,996 $110,812 Facility Facility Size Size by by Case Case Volume Volume Hourly Wages $30 $20 $10 $0 Facili es < 3,000 3,000-5,999 > 5, VMG Health, LLC 2012 Rights Reserved 92

125 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size Size by by Case Case Volume 7.27 Sta ours per Case Facili es < 3,000 3,000-5,999 > 5,999 Nurse HPC Tech HPC Administra e PC Administrator HPC Total HPC Number Of PC Facili es < 3,000 3,000-5,999 > 5,999 Nurse HPC Tech HPC Administrator HPC 112

126 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER Operating Expense Analysis as a % of Net Revenue Facilities < 3,000 3,000-5,999 > 5,999 Employee Salary and Wages 23.0 % 24.2 % 23.7 % 22.1 % Taxes and Benefits 5.1 % 5.7 % 5.0 % 5.1 % Occupancy Costs 6.7 % 8.7 % 7.7 % 5.6 % Medical and Surgical 21.4 % 22.9 % 20.9 % 21.3 % Other Medical Costs 0.8 % 0.8 % 0.7 % 0.8 % Insurance 0.7 % 0.7 % 0.7 % 0.7 % General & Administrative 14.3 % 17.9 % 18.6 % 14.6 % Total Operating Expenses 75.0 % 81.6 % 74.7 % 63.6 % per Square Foot Employee Salary and Wages $ $84.46 $ $ Taxes and Benefits $25.69 $21.86 $22.27 $30.51 Occupancy Costs $34.54 $31.51 $35.42 $34.63 Medical and Surgical $ $75.74 $93.85 $ Other Medical Costs $3.62 $2.25 $3.09 $4.28 Insurance $3.22 $2.30 $3.32 $3.73 General & Administrative $75.90 $54.84 $74.29 $83.73 Total Operating Expenses $ $ $ $ per OR ($'s in thousands) Employee Salary and Wages $ $ $ $ Taxes and Benefits $92.98 $85.16 $82.18 $ Occupancy Costs $ $ $ $ Medical and Surgical $ $ $ $ Other Medical Costs $12.92 $9.18 $11.14 $17.60 Insurance $12.10 $9.13 $12.27 $13.02 General & Administrative $ $ $ $ Total Operating Expenses $1, $1, $1, $1, per Case Employee Salary and Wages $ $ $ $ Taxes and Benefits $81.61 $ $81.61 $75.51 Occupancy Costs $ $ $ $85.57 Medical and Surgical $ $ $ $ Other Medical Costs $12.11 $11.31 $11.60 $13.29 Insurance $10.74 $13.39 $10.72 $9.40 General & Administrative $ $ $ $ Total Operating Expenses $1, $1, $1, $1, Facility Facility Size Size by by Case Case Volume Volume 113

127 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size Size by by Case Case Volume 7.29 Facility Sta s cs $'s in thousands Facili es < 3,000 3,000-5,999 > 5,999 Gross PP&E per OR $899 $862 $923 $898 Gross PP&E per Sq Ft $277 $281 $271 $290 Gross PP&E plus WC per OR $1,196 $1,092 $1,241 $1,199 Gross PP&E plus WC per Sq Ft $354 $344 $334 $390 Opera ng Rooms Procedure Rooms Square Feet per Facility 13,600 12,148 13,192 14,891 Rental Rate per Sq Ft $27.51 $26.93 $26.52 $28.37 Rent & Occupancy Cost per Sq Ft $34.45 $32.02 $34.87 $34.64 Average Facility Costs per Square Foot $30 $20 $10 $0 Facili es < 3,000 3,000-5,999 > 5,

128 MULTI-SPECIALTY ASC INTELLIMARKER Leverage Ratios $'s in thousands Facilities < 3,000 3,000-5,999 > 5,999 Total Debt $608 $1,238 $548 $652 Net Debt $1,317 $1,796 $941 $1,298 Total Debt / Assets 17.1 % 27.0 % 16.0 % 14.9 % Total Debt / Equity 26.9 % 48.4 % 25.8 % 24.9 % Total Debt / EBITDA 0.23x 0.69x 0.22x 0.21x Net Debt / Assets 30.8 % 60.4 % 19.6 % 29.9 % Net Debt / Equity 68.9 % % 51.7 % 65.7 % Net Debt / EBITDA 0.65x 2.13x 0.60x 0.33x Facility Size Size by by Case Case Volume Volume 115 VMG Health, LLC 2012 Rights Reserved 96

129 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Facility Size by Case Volume 116

130 MULTI-SPECIALTY ASC INTELLIMARKER SECTION 8 Facility Size by Net Revenue Financial Statements Income Statement 8.1 Common Size Income Statement 8.2 Balance Sheet 8.3 Common Size Balance Sheet 8.4 Revenue Cycle Analysis Liquidity Analysis 8.5 Accounts Receivable Analysis 8.6 Revenue Analysis Case Volume Mix as a percent of Total Cases 8.7 Case Volume Summary 8.8 Payor Mix as a percent of Gross Charges ENT Revenue per Case 8.13 GI/Endoscopy Revenue per Case 8.14 General Surgery Revenue per Case 8.15 OB/GYN Revenue per Case 8.16 Ophthalmology Revenue per Case 8.17 Oral Surgery Revenue per Case 8.18 Orthopedics Revenue per Case 8.19 Pain Management Revenue per Case Podiatry Revenue per Case 8.22 Urology Revenue per Case 8.23 Sta ng Analysis Sta ng Summary 8.24 Hourly Salaries & Wages 8.25 Sta ours per Case 8.26 Expense Analysis Expense Analysis 8.27 Asset Analysis Liability Detail Facility Size by Net Revenue 117

131 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size by Net Revenue 8.1 Income Statement 4,500,000 - $'s in thousands Patient Revenues Gross Charges Facilities $27,071 < 4,500,000 $12,489 6,999,999 $21,878 > 6,999,999 $37,880 Adjustments ($18,441) ($8,824) ($16,038) ($27,755) Net Revenue $7,164 $3,351 $5,846 $10,034 Operating Expenses Employee Salary and Wages $1,507 $928 $1,351 $2,015 Taxes and Benefits $349 $196 $274 $481 Occupancy Costs $438 $323 $432 $556 Medical and Surgical $1,435 $694 $1,209 $2,139 Other Medical Costs $52 $20 $41 $75 Insurance $45 $28 $46 $58 Depreciation and Amortization $264 $200 $203 $316 General & Administrative Bad Debt $117 $70 $82 $151 Management Fees $320 $172 $287 $449 Other G & A $622 $420 $536 $775 Total G & A $930 $641 $718 $1,378 Facility Size by Net Revenue Total Operating Expenses $5,521 $2,907 $4,477 $6,967 Operating Income $1,571 $210 $1,042 $2,724 Other Income (Expense) $5 $4 $5 $5 Net Interest Expense $50 $45 $34 $54 Earnings Before Taxes $1,457 $201 $943 $2,620 EBITDA $1,886 $473 $1,266 $3,

132 MULTI-SPECIALTY ASC ASC INTELLIMARKER Common Size Income Statement 4,500,000 - < 4,500,000 6,999,999 > 6,999,999 Gross Charges % % % % Adjustments % % % % Net Revenue % % % % Employee Salary and Wages 23.0 % 28.6 % 22.7 % 20.3 % 5.1 % 6.0 % 4.7 % 5.0 % Occupancy Costs 6.7 % 9.6 % 7.4 % 5.6 % Medical and Surgical 21.4 % 20.4 % 20.7 % 22.2 % Other Medical Costs 0.7 % 0.6 % 0.7 % 0.9 % Insurance 0.7 % 0.9 % 0.8 % 0.6 % 3.7 % 6.6 % 3.4 % 3.2 % Facility Size by Net Revenue Bad Debt 1.5 % 2.0 % 1.4 % 1.7 % Management Fees 5.0 % 5.1 % 4.8 % 4.4 % Other G & A 8.9 % 12.1 % 8.9 % 8.1 % Total G & A 14.3 % 18.4 % 13.1 % 13.7 % 75.0 % 86.9 % 80.2 % 72.6 % 20.0 % 4.5 % 23.1 % 27.1 % Other Income (Expense) 0.1 % 0.1 % 0.1 % 0.0 % Net Interest Expense 0.7 % 1.3 % 0.6 % 0.6 % 18.9 % 5.5 % 16.1 % 25.5 % 25.5 % 14.2 % 21.7 % 30.8 % VMG Health, LLC Rights Reserved VMG Health, LLC 2011 Rights Reserved

133 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Facility Size by by Net Net Revenue 8.3 Balance Sheet 4,500,000 - $'s in thousands ASSETS Cash and Equivalents Facilities $510 < 4,500,000 $218 6,999,999 $430 > 6,999,999 $780 Net Accounts Receivable $628 $363 $502 $903 Other Current Assets $174 $142 $126 $259 Current Assets $1,296 $702 $1,183 $1,989 Gross PP&E $3,389 $2,581 $2,917 $4,330 Accumulated Depreciation ($2,273) ($1,614) ($2,028) ($3,020) Net PP&E $972 $642 $788 $1,206 Other Assets $158 $24 $356 $217 Total Assets $2,886 $1,451 $2,515 $4,575 LIABILITIES Current Liabilities $373 $235 $315 $522 Current Portion of LTD $169 $118 $109 $283 Total Current Liabilities $449 $267 $386 $617 Total Long-Term Debt $417 $270 $169 $531 Other LT Liabilities $47 $49 $29 $37 Total Liabilities $949 $374 $587 $1,282 EQUITY Shareholders' Equity $1,570 $838 $1,544 $2,351 Total Liabilities & Equity $2,885 $1,451 $2,515 $4,

134 MULTI-SPECIALTY ASC INTELLIMARKER Common Size Balance Sheet 4,500,000 - Facilities < 4,500,000 6,999,999 > 6,999,999 ASSETS Cash and Equivalents 16.5 % 15.1 % 17.1 % 17.1 % Net Accounts Receivable 21.2 % 25.0 % 20.0 % 19.8 % Other Current Assets 5.7 % 9.8 % 5.1 % 5.7 % Current Assets 42.8 % 48.4 % 47.1 % 43.5 % Gross PP&E % % % 94.6 % Accumulated Depreciation % % % % Net PP&E 36.5 % 44.3 % 31.4 % 26.4 % Other Assets 2.4 % 1.7 % 14.2 % 4.8 % Total Assets % % % % Facility Size Size by by Net Net Revenue LIABILITIES Current Liabilities 11.6 % 16.3 % 12.5 % 11.4 % Current Portion of LTD 6.9 % 8.1 % 4.4 % 6.2 % Total Current Liabilities 16.2 % 18.4 % 15.4 % 13.5 % Total Long-Term Debt 24.5 % 18.6 % 6.7 % 11.6 % Other LT Liabilities 1.0 % 3.4 % 1.2 % 0.8 % Total Liabilities 40.6 % 25.8 % 23.3 % 28.0 % EQUITY Shareholders' Equity 46.1 % 57.7 % 61.4 % 51.4 % Total Liabilities & Equity % % % % 121 VMG Health, LLC 2012 Rights Reserved 1

135 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size Size by by Net Net Revenue 8.5 Liquidity Analysis $'s in thousands 4,500,000 - Facili es < 4,500,000 6,999,999 > 6,999,999 C ash $510 $215 $416 $770 % of Total Assets 17.0 % 16.5 % 18.3 % 17.8 % N et A/R $628 $359 $502 $895 % of Total Assets 22.1 % 23.5 % 25.1 % 21.2 % Working Capital $881 $453 $803 $1,457 % of Net Revenue 13.7 % 12.8 % 14.1 % 13.7 % Current Ra o Days Opera ng Expenses Working Capital % of Net Revenue 12% 8% 4% 0% Facili es < 4,499,999 4,500,000-6,999,999 > 6,999,

136 MULTI-SPECIALTY ASC INTELLIMARKER Accounts Receivable Analysis $'s in thousands 4,500,000 - Facili es < 4,500,000 6,999,999 > 6,999,999 Accounts Receivable - Gross $1,004 $444 $569 $1,376 Accounts Receivable - Net $628 $359 $502 $895 A/R Turnover - Net A/R Days Outstanding - Net A/R Aging 0 to 30 days 55.8 % 51.6 % 59.7 % 56.9 % Facility Size Size by by Net Net Revenue 31 to 60 days 16.5 % 15.5 % 15.5 % 16.7 % 61 to 90 days 7.5 % 8.4 % 6.6 % 8.3 % 91 to 120 days 5.1 % 6.7 % 4.0 % 5.1 % Over 120 days 12.7 % 17.6 % 12.3 % 10.9 % Accounts Receivable Aging 60% 40% 20% 0% Facili es < 4,499,999 4,500,000-6,999,999 0 to 30 days 31 to 60 days > 6,999, to 90 days 91 to 120 days Over 120 days 123 VMG Health, LLC 2012 Rights Reserved 102

137 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size Size by by Net Net Revenue 8.7 Case Volume Mix as a percent of Total Cases 4,500,000 - Facili es < 4,500,000 6,999,999 > 6,999,999 ENT 9 % 8 % 12 % 8 % GI / Endoscopy 27 % 29 % 23 % 24 % General Surgery 7 % 6 % 4 % 8 % OB/GYN 3 % 2 % 2 % 5 % Ophthalmology 17 % 21 % 18 % 17 % Oral Surgery 1 % 2 % 1 % 0 % Orthopedics 17 % 13 % 19 % 19 % Pain Management 13 % 21 % 22 % 12 % Plas c 4 % 4 % 4 % 3 % Podiatry 3 % 3 % 3 % 3 % Urology 2 % 4 % 1 % 2 % Other 1 % 1 % 1 % 1 % 30% 24% 18% 12% 6% 0% ENT GI / Endoscopy General Surgery OB/GYN Ophthalmology Oral Surgery Orthopedics Pain Management Plastic Podiatry Urology Other < 4,500,000 4,500,00-6,999,999 > 6,999,

138 MULTI-SPECIALTY ASC INTELLIMARKER Case Volume Summary 4,500,000 - Facili es < 4,500,000 6,999,999 > 6,999,999 Total Cases per Center 4,204 2,900 3,891 5,373 Cases per Day Surgical Cases per Opera ng Room per Year per Day on Surgical Cases per Procedure Room per Year per Day o Cases Per ormed y Top 2 Physicians 28 % 33 % 28 % 24 % Top 5 Physicians 52 % 63 % 53 % 46 % Top 10 Physicians 73 % 83 % 74 % 68 % Facility Size Size by by Net Net Revenue Revenue 90% Top Producing Physicians % of Case Volume 60% 30% 0% Facili es < 4,499,999 4,500,000-6,999,999 > 6,999,999 Top 2 Physicians Top 5 Physicians Top 10 Physicians 125 VMG Health, LLC 2012 Rights Reserved 1

139 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size Size by by Net Net Revenue 8.9 Payor Mix as a Percent of Gross Charges 4,500,000 - Facili es < 4,500,000 6,999,999 > 6,999,999 Medicare 24 % 32 % 22 % 20 % Medicaid 3 % 4 % 4 % 3 % Commercial 58 % 52 % 58 % 62 % Worker's Comp 4 % 4 % 3 % 4 % Self Pay 2 % 2 % 2 % 1 % Other Pay 4 % 4 % 3 % 4 % Medicare & Commercial as a % of Gross Charges 60% 40% 20% 0% Facili es < 4,499,999 4,500,000-6,999,999 > 6,999,999 Medicare Commercial 126

140 MULTI-SPECIALTY ASC INTELLIMARKER Revenue per Case - Facili es with less than $4.5 Million in Net Revenue Specialty ross Charges Net Revenue ENT $6,769 $1,365 GI / Endoscopy $3,066 $674 General Surgery $5,321 $1,387 OB/GYN $5,960 $1,613 Ophthalmology $5,150 $1,148 Oral Surgery $2,910 $784 Orthopedics $8,564 $2,153 Pain Management $2,950 $690 Plas c $5,558 $1,283 Podiatry $7,054 $1,514 Urology $5,931 $1,475 Other $6,752 $1,757 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH Facility Size Size by by Net Net Revenue Revenue $0 $1500 $3000 $4500 $6000 $7500 Net Revenue Gross Charges 127 VMG Health, LLC 2012 Rights Reserved 106

141 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size Size by by Net Net Revenue 8.11 Revenue per Case - Facili es with $4.5 - $7 Million in Net Revenue Specialty ross Charges Net Revenue ENT $7,380 $1,543 GI / Endoscopy $3,035 $750 General Surgery $5,722 $1,531 OB/GYN $6,276 $1,766 Ophthalmology $6,148 $1,242 Oral Surgery $3,158 $984 Orthopedics $8,726 $2,253 Pain Management $3,406 $743 Plas c $8,406 $1,489 Podiatry $7,424 $1,676 Urology $6,025 $1,423 Other $4,853 $1,731 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH $0 $1500 $3000 $4500 $6000 $7500 $9000 Net Revenue Gross Charges 8.12 Revenue per Case - Facili es with > $7 Million in Net Revenue Specialty ross Charges Net Revenue ENT $8,321 $2,133 GI / Endoscopy $4,036 $962 General Surgery $7,085 $2,068 OB/GYN $8,080 $2,358 Ophthalmology $6,414 $1,359 Oral Surgery $3,613 $1,209 Orthopedics $10,407 $2,969 Pain Management $4,952 $1,139 Plas c $8,047 $2,002 Podiatry $8,890 $2,323 Urology $8,290 $2,200 Other $5,455 $1,473 ENT GI GEN GYN OPH ORA ORT PM PLS POD URO OTH $0 $2500 $5000 $7500 $10000 Net Revenue Gross Charges 128

142 MULTI-SPECIALTY MULTI-SPECIALTY ASC ASC INTELLIMARKER INTELLIMARKER ENT Revenue per Case 4,500,000 - < 4,500,000 6,999,999 > 6,999,999 Based on case volume of 111,232 18,606 27,230 65,395 Gross Charges per Case $7,847 $6,769 $7,380 $8,321 Net Revenue per Case $1,849 $1,365 $1,543 $2,133 Discount To Charges 76.2 % 79.8 % 79.1 % 74.4 % $8000 ENT Revenue per Case Facility Facility Size Size by by Net Net Revenue Revenue $6000 $4000 $2000 $0 < 4,499,999 4,500,000-6,999,999 > 6,999,999 Net Revenue per Case Gross Charges per Case 129

143 Facility Facility Size Size by by by Net Net Net Revenue 8.14 GI/Endoscopy Revenue per Case 8.14 GI/Endoscopy Revenue per Case MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER ,500,000 - < 4,500,000 4,500,000 6,999,999 - > 6,999,999 Based on case volume of 236,713 46,298 68, ,006 < 4,500,000 6,999,999 > 6,999,999 Based on case volume of 236,713 46,298 68, ,006 Gross Charges per Case $3,610 $3,066 $3,035 $4,036 Net Gross Revenue Charges per per Case Case $3,610 $788 $3,066 $674 $3,035 $750 $4,036 $962 Discount Net Revenue To Charges per Case 75.1 $788 % 78.0 $674 % 75.3 $750 % 76.2 $962 % Discount To Charges 75.1 % 78.0 % 75.3 % 76.2 % $4000 $4000 $3000 $3000 $2000 $2000 $1000 $1000 $0 $0 GI/Endoscopy Revenue per Case GI/Endoscopy Revenue per Case < 4,499,999 4,500,000 - < 4,499,999 4,500,000 6,999,999-6,999,999 Net Revenue per Case Net Revenue per Case Gross Charges per Case Gross Charges per Case > 6,999,999 > 6,999, General Surgery Revenue per Case 8.15 General Surgery Revenue per Case 4,500,000 - < 4,500,000 4,500,000 6,999,999 - > 6,999,999 Based on case volume of 87,591 12,889 14,489 60,213 < 4,500,000 6,999,999 > 6,999,999 Based on case volume of 87,591 12,889 14,489 60,213 Gross Charges per Case $6,152 $5,321 $5,722 $7,085 Net Gross Revenue Charges per per Case Case $1,795 $6,152 $1,387 $5,321 $1,531 $5,722 $2,068 $7,085 Discount Net Revenue To Charges per Case $1, % $1, % $1, % $2, % Discount To Charges 69.4 % 73.9 % 73.2 % 70.8 % General Surgery Revenue per Case General Surgery Revenue per Case $6000 $6000 $4000 $4000 $2000 $ $0 $0 < 4,499,999 4,500,000 - < 4,499,999 4,500,000 6,999,999-6,999,999 Net Revenue per Case Net Revenue per Case Gross Charges per Case VMG Health, LLC 2012 Rights Reserved Gross Charges per Case > 6,999,999 > 6,999,999

144 MULTI-SPECIALTY ASC ASC INTELLIMARKER OB/GYN Revenue per Case 4,500,000 - < 4,500,000 6,999,999 > 6,999,999 Based on case volume of 47,585 6,444 6,695 34,445 Gross Charges per Case $7,001 $5,960 $6,276 $8,080 Net Revenue per Case $2,081 $1,613 $1,766 $2,358 Discount To Charges 68.7 % 72.9 % 71.9 % 70.8 % $8000 OB/GYN Revenue per Case Facility Size Size by by Net Net Revenue Revenue $6000 $4000 $2000 $0 < 4,499,999 4,500,000-6,999,999 > 6,999,999 Net Revenue per Case Gross Charges per Case 8.17 Ophthalmology Revenue per Case 4,500,000 - < 4,500,000 6,999,999 > 6,999,999 Based on case volume of 181,046 28,760 26, ,464 Gross Charges per Case $6,097 $5,150 $6,148 $6,414 Net Revenue per Case $1,273 $1,148 $1,242 $1,359 Discount To Charges 77.5 % 77.7 % 79.8 % 78.8 % Ophthalmology Revenue per Case $6000 $4000 $2000 $0 < 4,499,999 4,500,000-6,999,999 Net Revenue per Case Gross Charges per Case > 6,999, VMG Health, LLC 2012 Rights Reserved 110

145 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Facility Size Size by by by Net Revenue 8.18 Oral Surgery Revenue per Case 8.18 Oral Surgery Revenue per Case 4,500,000 - < 4,500,000 4,500,000 6,999,999 - > 6,999,999 Based on case volume of 10,914 2,477 4,012 4,425 < 4,500,000 6,999,999 > 6,999,999 Based on case volume of 10,914 2,477 4,012 4,425 Gross Charges per Case $3,194 $2,910 $3,158 $3,613 Net Gross Revenue Charges per per Case Case $1,026 $3,194 $2,910 $784 $3,158 $984 $1,209 $3,613 Discount Net Revenue To Charges per Case $1, % 73.1 $784 % 68.8 $984 % $1, % Discount To Charges 68.6 % 73.1 % 68.8 % 66.5 % Oral Surgery Revenue per Case Oral Surgery Revenue per Case $3000 $3000 $2000 $2000 $1000 $1000 $0 $0 < 4,499,999 4,500,000 - < 4,499,999 4,500,000 6,999,999-6,999,999 Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case > 6,999,999 > 6,999, Orthopedics Revenue per Case 8.19 Orthopedics Revenue per Case 4,500,000 - < 4,500,000 4,500,000 6,999,999 - > 6,999,999 Based on case volume of 217,976 29,942 45, ,647 < 4,500,000 6,999,999 > 6,999,999 Based on case volume of 217,976 29,942 45, ,647 Gross Charges per Case $9,874 $8,564 $8,726 $10,407 Net Gross Revenue Charges per per Case Case $2,618 $9,874 $8,564 $2,153 $8,726 $2,253 $10,407 $2,969 Net Discount Revenue To Charges per Case $2, % $2, % $2, % $2, % Discount To Charges 71.2 % 74.9 % 74.2 % 71.5 % Orthopedics Revenue per Case Orthopedics Revenue per Case $10000 $10000 $8000 $8000 $6000 $6000 $4000 $4000 $2000 $2000 $0 $0 < 4,499,999 4,500,000 - < 4,499,999 4,500,000 6,999,999-6,999,999 Net Revenue per Case Gross Charges per Case Net Revenue per Case Gross Charges per Case > 6,999,999 > 6,999, VMG Health, LLC 2012 Rights Reserved

146 MULTI-SPECIALTY ASC ASC INTELLIMARKER Pain Management Revenue per Case 4,500,000 - < 4,500,000 6,999,999 > 6,999,999 Based on case volume of 200,316 44,015 55, ,809 Gross Charges per Case $4,106 $2,950 $3,406 $4,952 Net Revenue per Case $840 $690 $743 $1,139 Discount To Charges 76.2 % 76.6 % 78.2 % 77.0 % $5000 Pain Management Revenue per Case Facility Size Size by by Net Net Revenue $4000 $3000 $2000 $1000 $0 < 4,499,999 4,500,000-6,999,999 Net Revenue per Case Gross Charges per Case > 6,999,999 4,500,000 - < 4,500,000 6,999,999 > 6,999,999 Based on case volume of 44,421 6,755 10,069 27,597 Gross Charges per Case $7,419 $5,558 $8,406 $8,047 Net Revenue per Case $1,696 $1,283 $1,489 $2,002 Discount To Charges 77.6 % 76.9 % 82.3 % 75.1 % $8000 $6000 $4000 $2000 $0 < 4,499,999 4,500,000-6,999,999 > 6,999,999 Net Revenue per Case Gross Charges per Case 133 VMG Health, LLC 2012 Rights Reserved 112

147 MULTI-SPECIALTY MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size by Net Revenue 8.22 Podiatry Revenue per Case 4,500,000 - < 4,500,000 6,999,999 > 6,999,999 Based Based on on case case volume volume of of 36,908 36,908 5,868 5,868 7,690 7,690 23,351 23,351 Gross Charges per Case $7,969 $7,054 $7,424 $8,890 Net Revenue per Case $1,893 $1,514 $1,676 $2,323 Discount To Charges 74.3 % 78.5 % 77.4 % 73.9 % Podiatry Revenue per Case $8000 $6000 $4000 $2000 $0 $0 < 4,499,999 4,500,000-6,999,999 Net Net Revenue Revenue per per Case Case Gross Gross Charges Charges per per Case Case > 6,999, Urology Revenue per Case 4,500,000 - < 4,500,000 6,999,999 > 6,999,999 Based Based on on case case volume volume of of 52,258 52,258 7,999 7,999 7,886 7,886 36,373 36,373 Gross Charges per Case $7,498 $5,931 $6,025 $8,290 Net Revenue per Case $1,788 $1,475 $1,423 $2,200 Discount To Charges 70.7 % 75.1 % 76.4 % 73.5 % Urology Revenue per Case $8000 $6000 $4000 $2000 $0 $0 < 4,499,999 4,500,000-6,999,999 Net Net Revenue Revenue per per Case Case Gross Gross Charges Charges per per Case Case > 6,999, VMG Health, LLC 2012 Rights Reserved

148 MULTI-SPECIALTY ASC ASC INTELLIMARKER Sta ng Summary 4,500,000 - Facili es < 4,500,000 6,999,999 > 6,999,999 Nurse FTE Tech FTE Administra e FTE Administrator FTE Total FTE Number Of FTEs Facility Size Size by by Net Net Revenue Facili es < 4,499,999 4,500,000-6,999,999 > 6,999,999 Nurse FTE Tech FTE Administrator FTE 135 VMG Health, LLC 2012 Rights Reserved 114

149 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Size by by Net Net Revenue 8.25 Hourly Salaries & Wages 4,500,000 - Facili es < 4,500,000 6,999,999 > 6,999,999 urse Sta $32.10 $30.74 $31.58 $32.46 Tec Sta $21.18 $21.18 $19.62 $21.47 Administra e Sta $22.70 $22.91 $22.28 $22.67 Total Hourly Administrator - Salary $27.00 $105,996 $25.80 $26.73 $27.31 $96,500 $105,020 $114,605 Hourly Wages $30 $20 $10 $0 Facili es < 4,499,999 4,500,000-6,999,999 > 6,999,

150 MULTI-SPECIALTY ASC INTELLIMARKER Sta ours per Case 4,500,000 - Facili es < 4,500,000 6,999,999 > 6,999,999 Nurse HPC Tech HPC Administra e PC Administrator HPC Total HPC Number Of PC Facility Size Size by by Net Net Revenue Facili es < 4,499,999 4,500,000-6,999,999 > 6,999,999 Nurse HPC Tech HPC Administrator HPC 137 VMG Health, LLC 2012 Rights Reserved 116

151 MULTI-SPECIALTY ASC INTELLIMARKER 2012 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Facility Size by by Net Net Revenue 8.27 Operating Expense Analysis 4,500,000 - as a % of Net Revenue Facilities < 4,500,000 6,999,999 > 6,999,999 Employee Salary and Wages 22.1 % 27.2 % 23.8 % 18.7 % Taxes and Benefits 5.0 % 5.8 % 5.4 % 4.4 % Occupancy Costs 6.7 % 9.6 % 7.5 % 5.3 % Medical and Surgical 21.3 % 21.9 % 23.1 % 19.1 % Other Medical Costs 1.0 % 1.1 % 1.0 % 0.9 % Insurance 0.7 % 0.9 % 0.8 % 0.5 % General & Administrative 22.8 % 24.3 % 14.5 % 13.9 % Total Operating Expenses 75.0 % 87.6 % 74.6 % 61.6 % per Square Foot Employee Salary and Wages $ $84.09 $ $ Taxes and Benefits $25.69 $17.90 $22.48 $29.79 Occupancy Costs $34.54 $33.97 $34.53 $34.76 Medical and Surgical $ $64.74 $92.02 $ Other Medical Costs $3.62 $2.14 $3.29 $4.59 Insurance $3.22 $2.97 $3.36 $3.38 General & Administrative $75.90 $59.82 $72.65 $86.82 Total Operating Expenses $ $ $ $ per OR ($'s in thousands) Employee Salary and Wages $ $ $ $ Taxes and Benefits $92.98 $65.27 $81.97 $ Occupancy Costs $ $ $ $ Medical and Surgical $ $ $ $ Other Medical Costs $12.92 $10.16 $10.75 $18.56 Insurance $12.10 $10.52 $11.47 $12.81 General & Administrative $ $ $ $ Total Operating Expenses $1, $1, $1, $1, per Case Employee Salary and Wages $ $ $ $ Taxes and Benefits $81.61 $73.47 $73.76 $86.27 Occupancy Costs $ $ $ $ Medical and Surgical $ $ $ $ Other Medical Costs $12.11 $11.31 $9.67 $13.34 Insurance $10.74 $10.71 $10.49 $10.98 General & Administrative $ $ $ $ Total Operating Expenses $1, $1, $1, $1,

152 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facility Sta s cs $'s in thousands 4,500,000 - Facili es < 4,500,000 6,999,999 > 6,999,999 Gross PP&E per OR $899 $803 $740 $988 Gross PP&E per Sq Ft $277 $239 $276 $313 Gross PP&E plus WC per OR $1,196 $942 $1,032 $1,387 Gross PP&E plus WC per Sq Ft $354 $294 $365 $401 Opera ng Rooms Procedure Rooms Square Feet per Facility 13,600 9,755 12,000 16,252 Rental Rate per Sq Ft $27.51 $26.74 $27.80 $27.40 Rent & Occupancy Cost per Sq Ft $34.45 $34.97 $32.53 $34.63 Facility Size Size by by Net Net Revenue $30 $20 $10 $0 Facili es < 4,499,999 4,500,000-6,999,999 > 6,999, VMG Health, LLC 2012 Rights Reserved 118

153 MULTI-SPECIALTY ASC INTELLIMARKER Facility Size Size by by Net Net Revenue 8.29 Leverage Ratios $'s in thousands 4,500,000 - Facilities < 4,500,000 6,999,999 > 6,999,999 Total Debt $608 $384 $216 $707 Net Debt $1,317 $1,317 $1,103 $1,392 Total Debt / Assets 17.1 % 23.8 % 12.9 % 17.3 % Total Debt / Equity 26.9 % 39.3 % 18.5 % 25.2 % Total Debt / EBITDA 0.23x 0.44x 0.22x 0.21x Net Debt / Assets 30.8 % 55.1 % 36.9 % 28.4 % Net Debt / Equity 68.9 % % % 55.2 % Net Debt / EBITDA 0.65x 1.79x 0.93x 0.33x 140

154 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Financial Statements Income Statement Common Size Income Statement Balance Sheet Common Size Balance Sheet Revenue Cycle Analysis Liquidity Analysis Accounts Receivable Analysis Revenue Analysis Sta SECTION Case Volume Summary 9.7 Payor Mix as a percent of Gross Charges 9.8 O rthopedics Revenue per Case 9.9 ng Analysis Sta ng Summary 9.10 Hourly Salaries & Wages 9.11 Sta ours per Case 9.12 Expense Analysis Asset Analysis Expense Analysis Facilities with Greater than 50% in Orthopedics 141

155 MULTI-SPECIALTY ASC INTELLIMARKER Facilities with Greater than 50% in in Orthopedics 9.1 Income Statement $'s in thousands Patient Revenues Standard Median Mean Dev. 25% 50% 75% 90% Gross Charges $27,477 $15,995 $14,511 $28,106 $32,501 $52,522 Adjustments ($18,161) ($12,639) ($8,657) ($16,316) ($19,551) ($41,276) Net Revenue $9,316 $4,590 $5,647 $11,068 $12,270 $14,591 Operating Expenses Employee Salary and Wages $1,793 $795 $1,214 $1,803 $2,049 $3,086 Taxes and Benefits $404 $196 $272 $368 $608 $665 Occupancy Costs $675 $388 $405 $607 $843 $1,200 Medical and Surgical $2,003 $1,313 $1,494 $1,769 $2,331 $2,841 Other Medical Costs $80 $45 $50 $103 $106 $118 Insurance $33 $16 $22 $28 $42 $49 Depreciation and Amortization $394 $360 $168 $238 $465 $784 General & Administrative Bad Debt $207 $157 $107 $134 $277 $456 Management Fees $253 $89 $176 $257 $285 $350 Other G & A $749 $380 $442 $685 $1,034 $1,244 Total G & A $995 $494 $664 $1,055 $1,270 $1,617 Total Operating Expenses $5,921 $2,822 $4,375 $6,312 $7,610 $8,661 Operating Income $3,023 $2,385 $1,021 $2,937 $4,514 $6,392 Other Income (Expense) $11 $13 $1 $3 $18 $28 Net Interest Expense $96 $163 $5 $17 $101 $336 Earnings Before Taxes $2,940 $2,446 $1,019 $2,736 $4,460 $6,392 EBITDA $3,395 $2,424 $1,072 $3,801 $4,767 $6,

156 MULTI-SPECIALTY ASC INTELLIMARKER Common Size Income Statement Patient Revenues Standard Median Mean Dev. 25% 50% 75% 90% Gross Charges % % % % % % Adjustments % % % % % % Net Revenue % 0.0 % % % % % Operating Expenses Employee Salary and Wages 21.2 % 7.2 % 16.9 % 18.9 % 25.0 % 32.7 % Taxes and Benefits 4.7 % 1.7 % 3.7 % 4.3 % 5.7 % 6.3 % Occupancy Costs 8.2 % 5.0 % 3.8 % 7.4 % 10.7 % 13.3 % Medical and Surgical 21.8 % 6.2 % 18.0 % 21.1 % 25.1 % 29.1 % Other Medical Costs 0.7 % 0.2 % 0.7 % 0.8 % 0.9 % 0.9 % Insurance 0.4 % 0.2 % 0.2 % 0.4 % 0.5 % 0.8 % Depreciation and Amortization 4.9 % 7.8 % 2.1 % 2.8 % 3.6 % 6.4 % General & Administrative Bad Debt 1.8 % 0.9 % 1.0 % 1.4 % 2.3 % 3.1 % Management Fees 3.2 % 1.4 % 2.2 % 2.9 % 3.6 % 4.2 % Other G & A 8.7 % 3.7 % 6.3 % 7.5 % 9.0 % 14.8 % Total G & A 11.4 % 4.3 % 8.4 % 11.7 % 13.6 % 16.2 % Total Operating Expenses 67.9 % 18.2 % 53.7 % 67.9 % 72.6 % 91.2 % Operating Income 27.4 % 24.1 % 24.0 % 30.6 % 43.3 % 49.6 % Other Income (Expense) 0.1 % 0.1 % 0.0 % 0.0 % 0.2 % 0.2 % Net Interest Expense 1.7 % 4.4 % 0.1 % 0.2 % 0.9 % 2.2 % Facilities with with Greater than 50% in Orthopedics Earnings Before Taxes 26.0 % 27.8 % 23.2 % 29.9 % 43.2 % 49.5 % EBITDA 32.1 % 18.2 % 27.4 % 32.9 % 46.3 % 51.8 % 143 VMG Health, LLC 2012 Rights Reserved 1

157 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facilities Facili es with Greater than 50% in Orthopedics 9.3 Balance Sheet $'s in thousands ASSETS Standard Median Mean Dev. 25% 50% 75% 90% Cash and Equivalents $955 $682 $362 $787 $1,349 $1,513 Net Accounts Receivable $943 $358 $844 $948 $1,156 $1,270 Other Current Assets $317 $138 $215 $259 $390 $515 Current Assets $1,902 $1,148 $1,151 $1,511 $2,839 $3,169 Gross PP&E $3,189 $1,696 $2,261 $2,811 $3,547 $4,436 Accumulated Deprecia on ($2,085) $887 ($2,183) ($1,942) ($1,491) ($1,217) Net PP&E $1,103 $921 $478 $849 $1,361 $1,697 Other Assets $1,526 $1,935 $76 $698 $1,958 $4,808 Total Assets $4,022 $2,934 $2,247 $3,017 $5,402 $8,366 LIABILITIES Current ia ili es $355 $199 $323 $364 $442 $572 Current Por on o TD $117 $76 $67 $128 $135 $200 Total Current ia ili es $409 $221 $354 $449 $572 $633 Total Long-Term Debt $526 $719 $122 $226 $672 $875 Ot er T ia ili es $309 $352 $3 $189 $495 $714 Total ia ili es $960 $740 $526 $858 $1,224 $1,483 EQUITY Shareholders' Equity $3,062 $3,000 $673 $1,835 $4,256 $7,961 Total Liabili es & Equity $4,022 $2,934 $2,247 $3,017 $5,402 $8,

158 MULTI-SPECIALTY ASC INTELLIMARKER Common Size Balance Sheet Standard Median Mean Dev. 25% 50% 75% 90% ASSETS Cash and Equivalents 23.8 % 23.3 % 16.1 % 26.1 % 25.0 % 18.1 % Net Accounts Receivable 23.4 % 12.2 % 37.6 % 31.4 % 21.4 % 15.2 % Other Current Assets 7.9 % 4.7 % 9.6 % 8.6 % 7.2 % 6.2 % Current Assets 47.3 % 39.1 % 51.2 % 50.1 % 52.6 % 37.9 % Gross PP&E 79.3 % 57.8 % % 93.2 % 65.7 % 53.0 % Accumulated Depreciation % 30.2 % % % % % Net PP&E 27.4 % 31.4 % 21.3 % 28.2 % 25.2 % 20.3 % Other Assets 38.0 % 66.0 % 3.4 % 23.2 % 36.3 % 57.5 % Total Assets % % % % % % LIABILITIES Current Liabilities 8.8 % 6.8 % 14.4 % 12.1 % 8.2 % 6.8 % Current Portion of LTD 2.9 % 2.6 % 3.0 % 4.3 % 2.5 % 2.4 % Total Current Liabilities 10.2 % 7.6 % 15.8 % 14.9 % 10.6 % 7.6 % Total Long-Term Debt 13.1 % 24.5 % 5.5 % 7.5 % 12.5 % 10.5 % Other LT Liabilities 7.7 % 12.0 % 0.2 % 6.3 % 9.2 % 8.5 % Total Liabilities 23.9 % 25.2 % 23.4 % 28.5 % 22.7 % 17.7 % EQUITY Shareholders' Equity 76.1 % % 30.0 % 60.8 % 78.8 % 95.2 % Facilities Facilities with with Greater than 50% in Orthopedics Total Liabilities & Equity % % % % % % 145 VMG Health, LLC 2012 Rights Reserved 1

159 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facilities es with Greater than 50% in Orthopedics 9.5 Liquidity Analysis $'s in thousands Standard Median Mean Dev. 25% 50% 75% 90% C ash $955 $682 $362 $787 $1,349 $1,513 % of Total Assets 23.8 % 23.3 % 16.1 % 26.1 % 25.0 % 18.1 % N et A/R $943 $358 $844 $948 $1,156 $1,270 % of Total Assets 23.4 % 12.2 % 37.6 % 31.4 % 21.4 % 15.2 % Working Capital $1,874 $934 $927 $1,387 $2,439 $2,529 % of Net Revenue 18.9 % 4.6 % 15.0 % 19.3 % 21.4 % 23.2 % Current Ra o Days Opera ng Expenses $'s in thousands $1,400 $1,200 $1,000 $800 $600 $400 $200 Wor ing Capital Components $0 Cash Net A/R Working Capital (W/C) 146

160 MULTI-SPECIALTY ASC INTELLIMARKER Accounts Receivable Analysis $'s in thousands Standard Median Mean Dev. 25% 50% 75% 90% Accounts Receivable - Gross $1,081 $577 $817 $1,355 $1,483 $1,560 Accounts Receivable - Net $943 $358 $844 $948 $1,157 $1,270 A/R Turnover - Net A/R Days Outstanding - Net A/R Aging 0 to 30 days 53.2 % 13.0 % 47.0 % 55.3 % 59.7 % 63.0 % 31 to 60 days 17.5 % 4.8 % 13.8 % 16.1 % 20.3 % 23.1 % 61 to 90 days 8.6 % 3.4 % 7.5 % 9.2 % 11.1 % 12.0 % 91 to 120 days 5.7 % 1.6 % 5.1 % 6.2 % 6.8 % 7.6 % Over 120 days 15.0 % 8.3 % 6.2 % 15.5 % 20.8 % 25.0 % 60% 50% 40% Median Accounts Receivable Aging Facilities Facili es with with Greater than 50% in Orthopedics 30% 20% 10% 0% 0 to 30 days 31 to 60 days 61 to 90 days 91 to 120 days Over 210 Days 147 VMG Health, LLC 2012 Rights Reserved 1

161 MULTI-SPECIALTY ASC INTELLIMARKER Facilities es with Greater than 50% in Orthopedics 9.7 Case Volume Summary Total Cases per Center Cases per Day Surgical Cases per Opera ng Room per Year per Day on Surgical Cases per Procedure Room per Year per Day o Cases Per ormed y Top 2 Physicians Top 5 Physicians Top 10 Physicians 80% % of Case Volume 60% 40% 20% Standard Median Mean Dev. 25% 50% 75% 90% 3,760 1,962 2,544 3,349 4,717 7, , , % 12 % 22 % 30 % 39 % 48 % 59 % 15 % 48 % 57 % 61 % 78 % 80 % 9 % 75 % 80 % 85 % 87 % Top Producing Physicians 0% Top 2 Physicians Top 5 Physicians Top 10 Physicians 148

162 MULTI-SPECIALTY ASC INTELLIMARKER Payor Mix as a Percent of Gross Charges Standard Median Mean Dev. 25% 50% 75% 90% Medicare 17 % 11 % 7 % 18 % 21 % 34 % Medicaid 4 % 3 % 0 % 3 % 6 % 7 % Commercial 62 % 10 % 54 % 61 % 65 % 71 % Worker's Comp 11 % 12 % 4 % 6 % 11 % 34 % Self Pay 2 % 2 % 1 % 1 % 2 % 2 % Other Pay 8 % 7 % 2 % 9 % 12 % 14 % 60% 40% 20% Average Payor Mix Facilities Facili es with with Greater than 50% in Orthopedics 0% Medicare Medicaid Commercial Workers's Comp Self Pay Other Pay Mean Standard Dev. 149 VMG Health, LLC 2012 Rights Reserved 1

163 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facilities Facili es with Greater than 50% in Orthopedics 9.9 Orthopedics Revenue per Case Standard Median Mean Dev. 25% 50% 75% 90% Based on case volume of 46,682 Gross Charges per Case $9,289 $3,073 $7,659 $9,781 $11,097 $12,487 Net Revenue per Case $3,190 $1,059 $2,335 $2,938 $4,048 $4,803 Discount To Charges 62.8 % 12.9 % 55.9 % 59.7 % 73.9 % 77.7 % of Fa i i es Orthopedics Frequency Distribu on $1,000 $1,800 $2,600 $3,400 $4,200 $5,000 Net Revenue per Case 150

164 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facili es with Facili Greater es with than Greater 50% in than Orthopedics 50% in Orthopedics 9.10 Sta ng Summary 9.11 Sta ng Summary MULTI-SPECIALTY Standard ASC INTELLIMARKER Median 2012 Mean Dev. 25% 50% 75% 90% Nurse FTE Tech FTE Administra e FTE Administrator FTE Standard Median Total FTE Mean 28.2 Dev % % % % Nurse FTE Tech FTE Administra e FTE Administrator 20 FTE Total FTE Mean Mean Standard De Standard De 25% 50% 75% 90% Nurse FTE Tech FTE Administrator FTE 25% 50% 75% 90% Facilities with Greater than 50% in Orthopedics Nurse FTE Tech FTE Administrator FTE 151

165 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facilities with Greater than 50% in Orthopedics 9.11 ourly Salaries & Wages Standard Median Mean Dev. 25% 50% 75% 90% urse Sta $32.71 $6.55 $28.18 $33.33 $35.52 $36.69 Tec Sta $21.40 $2.99 $20.27 $20.54 $22.20 $26.04 Administra e Sta $24.50 $3.62 $23.18 $24.84 $26.30 $28.84 Total Hourly $27.79 $3.98 $25.28 $26.73 $29.93 $31.60 Administrator - Salary $126,965 $19,397 $113,538 $132,136 $137,432 $146,376 of Fa i i es Administrator Salary Frequency Distribu on Facili es with Greater than 50% in Orthopedics 0 $50,000 $70,000 $90,000 $111,000 $130,000 >$130,000 Annual Salary 152

166 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facili es with Greater than 50% in Orthopedics 9.12 Sta ours per Case Standard Median Mean Dev. 25% 50% 75% 90% Nurse HPC Tech HPC Administra e PC Administrator HPC Total HPC Facilities with Greater than 50% in Orthopedics 153

167 MULTI-SPECIALTY ASC ASC INTELLIMARKER Facilities with Greater than 50% in Orthopedics 9.13 Standard Median as a % of Net Revenue Mean Dev. 25% 50% 75% 90% Employee Salary and Wages 21.2 % 7.2 % 16.9 % 18.9 % 25.0 % 32.6 % Taxes and Benefits 4.7 % 1.7 % 3.7 % 4.3 % 5.7 % 6.3 % Occupancy Costs 8.2 % 5.0 % 3.8 % 7.4 % 10.7 % 13.3 % Medical and Surgical 21.8 % 6.2 % 18.0 % 21.1 % 25.1 % 29.1 % Other Medical Costs 0.7 % 0.2 % 0.7 % 0.8 % 0.9 % 0.9 % Insurance 0.4 % 0.2 % 0.2 % 0.4 % 0.5 % 0.8 % 11.4 % 4.3 % 8.4 % 10.1 % 13.6 % 16.2 % 67.9 % 18.2 % 53.7 % 67.9 % 72.6 % 91.2 % per Square Foot Employee Salary and Wages $ $47.52 $95.33 $99.73 $ $ Taxes and Benefits $25.58 $9.67 $20.01 $22.67 $28.10 $37.82 Occupancy Costs $41.63 $15.01 $32.54 $42.41 $49.80 $60.21 Medical and Surgical $ $51.97 $93.37 $ $ $ Other Medical Costs $4.34 $2.80 $2.40 $3.88 $6.37 $7.90 Insurance $2.24 $1.52 $1.04 $1.82 $2.66 $3.53 $13.43 $10.61 $6.30 $8.56 $17.00 $30.60 $ $ $ $ $ $ per OR ($'s in thousands) Employee Salary and Wages $ $ $ $ $ $ Taxes and Benefits $ $38.78 $80.96 $93.89 $ $ Occupancy Costs $ $82.12 $ $ $ $ Medical and Surgical $ $ $ $ $ $ Other Medical Costs $20.12 $10.93 $12.39 $25.74 $26.61 $29.43 Insurance $8.81 $4.45 $6.30 $7.87 $10.62 $14.21 $53.75 $38.23 $27.95 $39.35 $69.26 $ $1, $ $1, $1, $1, $1, per Case Employee Salary and Wages $ $ $ $ $ $ Taxes and Benefits $ $48.16 $89.02 $96.39 $ $ Occupancy Costs $ $ $ $ $ $ Medical and Surgical $ $ $ $ $ $ Other Medical Costs $18.67 $12.64 $10.56 $13.57 $27.40 $35.68 Insurance $9.32 $4.38 $6.44 $8.47 $11.58 $15.10 $62.20 $46.21 $33.01 $38.86 $72.48 $ $1, $ $1, $1, $1, $2,

168 MULTI-SPECIALTY MULTI-SPECIALTY ASC ASC INTELLIMARKER INTELLIMARKER Facili es with Greater than 50% in Orthopedics 9.14 Facility Sta s cs $'s in thousands Standard Median Mean Dev. 25% 50% 75% 90% Gross PP&E per OR $931 $598 $626 $721 $1,011 $1,181 Gross PP&E per Sq Ft $219 $129 $118 $201 $266 $315 Gross PP&E plus WC per OR $1,448 $772 $960 $1,278 $1,670 $1,938 Gross PP&E plus WC per Sq Ft $344 $173 $226 $283 $395 $559 Opera ng Rooms Procedure Rooms Square Feet per Facility 16,157 5,727 12,471 15,643 18,000 25,662 Rental Rate per Sq Ft $32.14 $12.71 $24.83 $30.99 $37.96 $44.98 Rent & Occupancy Cost per Sq Ft $41.63 $15.01 $32.54 $42.41 $49.80 $ Facilities with Greater than 50% in Orthopedics $6,000 $8,500 $10,000 $12,000 $15,000 >$15,

169 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Facilities with Greater than 50% in Orthopedics 156

170 MULTI-SPECIALTY ASC INTELLIMARKER 2012 Key Definitions Amounts owed for goods and services purchased, but not yet paid for. Outstanding amounts owed by customers for products or services. The average number of days to collect on Accounts Receivable. A/R Days is calculated by dividing Accounts Receivable by Total Net Revenue times the number of days in the period (365 for an annual calculation). The average number of times that accounts receivable are created and paid in a year. Turnover is calculated by dividing Total Net Revenue by Accounts Receivable. The sum of all Depreciation expenses incurred from prior accounting periods for property listed as an asset on the balance sheet of any center. A non-cash expense representing a decrease in value of intangible assets resulting from the passage of time. Balance sheet accounts detailing the owned properties, both tangible and intangible, of any business entity. Assets may include Cash, Stock, Inventories, Property, Equipment, and intangibles. A balance sheet that displays all items as percentages of total assets. In the normal balance sheet, account values are expressed in dollar terms, while in the common size one, each value is listed as a percentage of total assets. An income statement that displays all items as percentages of Net Revenue. In the normal income statement, account values are expressed in dollar terms, while in the common size one, each value is listed as a percentage of total assets. Contractual Adjustments represent the difference between billed charges and the contractually obligated payment amounts negotiated with various government or other third-party payors. Represents the value of all assets that are reasonably expected to be converted into cash within one year in the normal course of business. Current assets include cash, accounts receivable, inventory, marketable securities, prepaid expenses and other liquid assets that can be readily converted to cash. Debt incurred as part of normal operations and is expected to be repaid during the following 12 months. Liabilities include Accounts Payable, obligations for borrowed money, etc. Current Assets divided by the Current Liabilities. A non-cash expense representing a decrease in value of Fixed Assets, or Property, Plant and Equipment, resulting from age, wear or other market conditions. 157

171 MULTI-SPECIALTY ASC INTELLIMARKER 2012 A metric used to show a company s operating profitability before taking into account leverage, capital, or tax expenses and used as a convenient, accrual-based estimate for cash flow. The number of times an event occurs within a set of numerical data. Reflects the outstanding amounts from the charges generated from the provider s established fee rate, regardless of collection amounts, contractual adjustments or other adjustments. Represents the total amount charged in connection with a surgery or procedure. Gross PP&E represents the original acquisition cost of a company s tangible fixed assets. Includes items such as but not limited to leasehold improvements and equipment. Amounts owed against loans or other financial obligations lasting over one year. The mean is the average value of a set of numbers in a data set. To compute a mean, add up all the numbers in a data set and divide by the size of the data set. half are greater. The middle value in a data set where half of the responses are lower and other Net PP&E represents the Gross PP&E less the Accumulated Depreciation expenses. Also known as the book value of the PP&E. The total Accounts Receivable minus Bad Debts. It represents the Gross Charges less adjustments made for contractual or other predetermined reimbursement rates that are less than the billed amount. Net Revenue represents the amount of revenue available for collections. A normal distribution of data means that most of the data points in a set of data are close to the Mean while relatively few data points tend to one extreme or the other. In a normal distribution, approximately 68 percent of the data in the set falls within one Standard Deviation from the mean. Approximately 95 percent of the data in the set would fall within two Standard Deviations from the mean. Non-surgical Cases include GI and Pain Management Cases. Operating margin is a measurement of the earnings of a business before non-operating related income. The revenue remaining after paying for all normal business related operating expenses and is expressed as a percent of net revenue. This is a catch-all category for a variety of assets not already classified in one of the other asset line items. Represents assets not related to the Cash, A/R, inventory and PP&E. 158

172 MULTI-SPECIALTY ASC INTELLIMARKER 2012 A percentile is a measure that tells us what percent of the total frequency scored at or below that measure. For example, the 90 th percentile provides the value in a data set where ninety percent (90%) of the responses are lower and the remaining ten percent (10%) are greater. The value in a data set where one quarter (25%) of the responses are lower and the remainder three quarters (75%) are greater. The value where three quarters (75 %) of the responses are lower and the remainder quarter (25 %) is greater. There are three quartiles. The first or lower quartile (LQ) of a list is a number such that at least 25% of the numbers in the list are no larger than it, and at least 75% of the numbers in the list are no smaller than it. The second quartile is the Median. The third or upper quartile (UQ) is a number such that at least 75% of the entries in the list are no larger than it, and at least 25% of the numbers in the list are no smaller than it. within one year. The portion of amounts owed against loans or other financial obligations that are due A firm s Total Assets minus its Total Liabilities. A measure of how tightly all the data points are clustered around the mean in a set of data. If the data points are all close to the mean, then the standard deviation is low. If many data points are very different from the mean, then the standard deviation is high. Surgical Cases include all specialties with the exception of GI and Pain Management. A measure of the average distance between each of a set of data points and their mean value. The amount by which Current Assets exceeds Current Liabilities. Working capital is a measure of the amount of capital required to fund the operating expenses of the center. 159

173 MULTI-SPECIALTY ASC INTELLIMARKER

174 Chateau Plaza 2515 McKinney Avenue Suite 1500 Dallas, TX ph: fx: The Pinnacle Building 150 3rd Avenue South Suite 2120 Nashville, TN ph: fx: Multi-Specialty Ambulatory Surgical Centers Financial & Operational Benchmarking Study 2012