(1) We eliminate in consolidation those patient service revenues earned by our health care facilities attributable to services provided to enrollees in our owned health plans and eliminate the corresponding medical claims expenses incurred by our health plans for those services.

(2) Segment EBITDA is defined as income (loss) from continuing operations before income taxes less interest expense (net of interest income), depreciation and amortization, equity method income or loss, stock compensation, gain or loss on disposal of assets, realized gains or losses on investments, monitoring fees and expenses, acquisition related expenses, debt extinguishment costs, impairment and restructuring charges and pension expense (credits). Management uses Segment EBITDA to measure the performance of our segments and develop strategic objectives and operating plans for those segments. Segment EBITDA eliminates the uneven effect of non-cash depreciation of tangible assets and amortization of intangible assets, much of which results from acquisitions accounted for under the purchase method of accounting. Segment EBITDA also eliminates the effects of changes in interest rates, which management believes relate to general trends in global capital markets, but are not necessarily indicative of the operating performance of our segments. Management believes that Segment EBITDA provides useful information to investors, lenders, financial analysts and rating agencies about the financial performance of our segments. Additionally, management believes that investors and lenders view Segment EBITDA as an important factor in making investment decisions concerning us. Segment EBITDA is not a substitute for net income (loss), operating cash flows or other cash flow statement data determined in accordance with accounting principles generally accepted in the United States. Segment EBITDA, as presented, may not be comparable to similar measures of other companies.
 
VANGUARD HEALTH SYSTEMS, INC.
Selected Operating Statistics
(Unaudited)
 
        Quarter ended    

CONSOLIDATED:
September 30,
2011     2012 % Change
Number of hospitals at end of period 28 28
Licensed beds at end of period 7,064 7,064
Discharges 68,161 71,481 4.9 %
Adjusted discharges 125,320 131,502 4.9
Average length of stay 4.34 4.41 1.6
Patient days 296,079 315,555 6.6
Adjusted patient days 544,366 580,521 6.6
Patient revenue per adjusted discharge $ 9,279 $ 9,403 1.3
Inpatient surgeries 16,077 16,592 3.2
Outpatient surgeries 29,976 31,131 3.9
Observation cases 16,357 19,228 17.6
Emergency room visits 292,839 315,035 7.6
Health plan member lives 245,000 235,800 (3.8 )
Health plan claims expense percentage 78.1 % 76.1 %
 

Uncompensated care as a percent of net patient revenues (prior to these uncompensated care adjustments)
17.9 % 21.8 %
 
Net patient revenue payer mix:
Medicare 26.6 % 27.5 %
Medicaid 14.7 13.5
Managed Medicare 10.2 11.3
Managed Medicaid 10.6 10.0
Managed care 35.1 34.2
Commercial 1.4 1.5
Self-pay   1.4     2.0  
Total   100.0 %   100.0 %
 
Discharges by payer:
Medicare 28.3 % 27.9 %
Medicaid 10.4 9.6
Managed Medicare 12.3 12.2
Managed Medicaid 17.8 18.6
Managed care 23.2 22.7
Commercial 0.5 0.5
Self-pay   7.5     8.5  
Total   100.0 %   100.0 %
 
 
VANGUARD HEALTH SYSTEMS, INC.
Selected Operating Statistics
(Unaudited) (continued)
 
        Quarter ended    

SAME STORE:
September 30,
2011     2012 % Change
Number of hospitals at end of period 26 26
Licensed beds at end of period 6,198 6,198
Total revenues, including health plan revenues (in millions) $ 1,404.0 $ 1,365.7 (2.7 )%
Net patient service revenues (in millions) $ 1,193.0 $ 1,200.0 0.6
Discharges 65,890 64,669 (1.9 )
Adjusted discharges 121,870 120,871 (0.8 )
Average length of stay 4.33 4.39 1.4
Patient days 285,479 283,825 (0.6 )
Adjusted patient days 528,021 530,488 0.5
Patient revenue per adjusted discharge $ 9,285 $ 9,471 2.0
Inpatient surgeries 15,415 14,583 (5.4 )
Outpatient surgeries 29,509 28,593 (3.1 )
Observation cases 15,792 17,416 10.3
Emergency room visits 286,126 293,163 2.5
Health plan member lives 245,000 225,300 (8.0 )
 

Uncompensated care as a percent of net patient revenues (prior to these uncompensated care adjustments)
17.9 % 20.8 %
 
Net patient revenue payer mix:
Medicare 26.3 % 26.0 %
Medicaid 13.9 13.3
Managed Medicare 10.4 11.6
Managed Medicaid 10.8 10.7
Managed care 35.6 35.1
Commercial 1.3 1.4
Self-pay   1.7     1.9  
Total   100.0 %   100.0 %
 
Discharges by payer:
Medicare 28.1 % 27.8 %
Medicaid 9.9 9.2
Managed Medicare 12.6 12.8
Managed Medicaid 18.3 18.2
Managed care 23.4 23.1
Commercial 0.6 0.5
Self-pay   7.1     8.4  
Total   100.0 %   100.0 %

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