Tenet Healthcare (THC) 8-K Results of Operations and Financial Condition

Trevor Fetter

President and Chief Executive Officer

January 11, 2011

Tenet Healthcare Corporation

Presentation To Investors

Exhibit 99.1

2

Forward-looking statements

Forward-looking statements

Certain

statements

contained

in

this

presentation

constitute

“forward-looking

statements”

within

the

meaning

of

Section

27A

of

the

Securities

Act

of

1933

and

Section

21E

of

the

Securities Exchange Act of 1934. Such forward-looking statements are based on management's current expectations and involve known and unknown risks, uncertainties and

other

factors

that

may

cause

the

Company’s

actual

results

to

be

materially

different

from

those

expressed

or

implied

by

such

forward-looking

statements.

Such

factors

include,

among others, the following: the passage of heath care reform legislation and the enactment of additional federal and state health care reform; other changes in federal, state, or

local laws and regulations affecting the health care industry; general economic and business conditions, both nationally and regionally; demographic changes; changes in, or the

failure to comply with, laws and governmental regulations; the ability to enter into managed care provider arrangements on acceptable terms; changes in Medicare and Medicaid

payments or reimbursement; liability and other claims asserted against the Company; competition, including the Company’s ability to attract patients to its hospitals; technological

and pharmaceutical improvements that increase the cost of providing, or reduce the demand for, health care; changes in business strategy or development plans; the ability to

attract and retain qualified personnel, including physicians, nurses and other health care professionals, and the impact on the Company’s labor expenses resulting from a shortage

of nurses or other health care professionals; the significant indebtedness of the Company; the Company's ability to integrate new businesses with its existing operations; the

availability and terms of capital to fund the expansion of the Company's business, including the acquisition of additional facilities; the creditworthiness of counterparties to the

Company’s business transactions; adverse fluctuations in interest rates and other risks related to interest rate swaps or any other hedging activities the Company undertakes; the

ability

to

continue

to

expand

and

realize

earnings

contributions

from

the

Company’s

Conifer

revenue

cycle

management

and

patient

communication

businesses;

and

its

ability

to

identify and execute on measures designed to save or control costs or streamline operations. Such factors also include the positive and negative effects of health reform legislation

on reimbursement and utilization and the future designs of provider networks and insurance plans, including pricing, provider participation, coverage and co-pays and deductibles,

all

of

which

contain

significant

uncertainty,

and

for

which

multiple

models

exist

which

may

differ

materially

from

the

Company's

expectations.

Certain

additional

risks

and

uncertainties

are

discussed

in

the

Company’s

filings

with

the

Securities

and

Exchange

Commission,

including

the

Company’s

annual

report

on

Form

10-K

and

quarterly

reports

on

Form 10-Q. The Company specifically disclaims any obligation to update any forward-looking statement, whether as a result of changes in underlying factors, new information,

future events or otherwise.

Non-GAAP Information

This

document

includes

certain

financial

measures

such

as

Adjusted

EBITDA,

which

are

not

calculated

in

accordancewith

generally

accepted

accounting

principles

(GAAP).

Management recommends that you focus on the GAAP numbers as the best indicator of financial performance.

These alternative measures are provided only as a supplement to aid in analysis of the Company.

Reconciliation

between

non-GAAP

measures

and

related

GAAP

measures

can

be

found

in

Appendix

D.

Additional Information

Tenet Healthcare Corporation ("Tenet") will file with the Securities and Exchange Commission ("SEC") a proxy statement in connection with its 2011 annual meeting of

stockholders.

Any

definitive

proxy

statement

will

be

mailed

to

stockholders

of

Tenet.

INVESTORS

AND

SECURITYHOLDERS

OF

TENET

ARE

URGED

TO

READ

THESE

AND

OTHER DOCUMENTS FILED WITH THE SEC CAREFULLY IN THEIR ENTIRETY WHEN THEY BECOME AVAILABLE BECAUSE THEY WILL CONTAIN IMPORTANT

INFORMATION.

Investors

and

securityholders

will

be

able

to

obtain

free

copies

of

these

documents

(when

available)

and

other

documents

filed

with

the

SEC

by

Tenet

through

the

website maintained by the SEC at http://www.sec.gov.

Certain Information Regarding Participants

Tenet and certain of its respective directors and executive officers are deemed to be participants under the rules of the SEC.  Information regarding these participants is contained in

a filing under Rule 14a-12 filed by Tenet with the SEC on January 7, 2011.  This filing and other documents can be obtained free of charge from the sources indicated above. 

Additional

information

regarding

the

interests

of

these

participants

in

any

proxy

solicitation

and

a

description

of

their

direct

and

indirect

interests,

by

security

holdings

or

otherwise,

will

also

be included in any proxy statement and other relevant materials to be filed with the SEC if and when they become available.

3

The hospital industry: a compelling investment

The hospital industry: a compelling investment

Strong demographic changes driving growth

The growth rate of the over 65 population will more than double to over 3.0% between 2010 and 2012

Per capita spending on healthcare nearly doubles between age 50 and age 65

Affordable Care Act

Expands insurance coverage to 32 million uninsured Americans (2014)

Insurance “reforms”

increase interim coverage (2010)

Newly covered population likely to utilize hospital services at increased rate

Recession has suppressed volume growth and increased bad debt expense

Returning to pre-recession levels expected to expand margins and growth rates

4

Tenet at a glance

Tenet at a glance

Acute Care Hospitals

(1)

Beds

(1)

Employees

US Coverage

(1)

Inpatient Admissions

(2)

Outpatient Visits

(2)

November 2010 EBITDA Outlook:

-

Including CA Provider Fee

-

Excluding CA Provider Fee

Current 2010 EBITDA Estimate

(5)

(Excluding CA Provider Fee)

2011 EBITDA Outlook Range

(5)

-

Represents an increase of $100mm -

$200m over

the 2010 estimate

___________________________

1.

Continuing operations as of December 31, 2010.

2.

LTM continuing operations as of December 31, 2010.

3.

Based on THC share price of $6.69 as of December 31, 2010.

4.

$3.7 billion equity value (includes mandatory convertible) plus $4.1 billion in debt less $0.4 billion in cash, as of September 30, 2010.

5.

Assumes

California

Provider

Fee

is

recognized

in

2011

as

opposed

to

2010.

Actual

2010

EBITDA

results

may

vary

when

2010

results

are

released

in

February.

2010E Revenue

(2)

Equity Market Value

(3)

Enterprise Value

(4)

Net Debt

$9.2 bn

$3.7 bn

$7.4 bn

$3.7 bn

Corporate Governance

Independent Chairman of the Board

9 out of 10 board members are independent

Diversified experience in public sector, healthcare,

accounting and finance, technology and

manufacturing

Substantial experience with major corporate actions

$1,050 -

$1,100 mm

$986 -

$1,036 mm

$1,050 mm

$1,150 -

$1,250 mm

49

13,430

57,000

11 states

513,000

3.9mm

Q4 2010 preliminary performance highlights and

EBITDA outlook

(1)

Q4 2010 preliminary performance highlights and

EBITDA outlook

(1)

Inpatient and outpatient year-over-year volume trends both improved relative to Q3

Inpatient admissions declined by 2.0% (compares to a 3.5% decline in Q3)

Outpatient visits increased by 2.9% (compares to a 2.0% decline in Q3)

Commercial volume trends improved compared to Q3 2010’s results, but statistic will no longer be

disclosed

Preliminary

EBITDA

(excluding

California

Provider

Fee)

of

$1.050

billion

exceeds

previous

outlook

Excluding $64 million California Provider Fee, previous outlook was for $986 million to $1.036 billion

Q4 Preliminary EBITDA is $281 million, previous outlook, excluding the California Provider Fee, was $217

million to $267 million

Requirements for California Provider Fee to be recognized in 2010 were not met by year end

Recognition is now expected in 2011

Expected amount remains $64 million

New EBITDA Outlook for 2011 established from $1.150 billion to $1.250 billion (including

California Provider Fee)

5

Solid results in 2010 and poised for further growth and value creation in 2011

___________________________

1.

Actual Q4 2010 volume trends and 2010 EBITDA may vary when 2010 results are released in February.

6

Our national hospital and outpatient

center footprint

Our national hospital and outpatient

center footprint

Acute Care Hospitals

Diagnostic Imaging Centers (DICs)

Ambulatory Surgery Centers (ASCs)

DIC in development

49 acute care hospitals

81 free-standing OP centers

$9.2 billion in revenues

Focus on high growth markets

Well-positioned in attractive growth markets

7

Tenet Healthcare: A compelling investment

Tenet Healthcare: A compelling investment

Continued Strong Organic Growth

Continued Strong Organic Growth

in Earnings

in Earnings

Operating Integrity, Growth and

Operating Integrity, Growth and

Infrastructure Investments Reduce Future Risks

Infrastructure Investments Reduce Future Risks

Consistent Strategy Driven by Innovative,

Consistent Strategy Driven by Innovative,

High Margin, Capital Efficient Initiatives

High Margin, Capital Efficient Initiatives

8

Significant positive momentum –

multiple

value drivers

Significant positive momentum –

multiple

value drivers

___________________________

1.

Data reflects the results of our existing 49 hospitals.

2.

Actual 2010 results may vary when 2010 results are released in February.

3.

Return on capital is defined as income from continuing operations excluding impairments and debt gains/losses, net of tax, plus after-tax interest expense net of investment income, and 1/3 of rent

expense after-tax divided by invested capital, which is defined as total debt including our former government settlement obligation less cash plus average equity over the most recent five quarters

excluding impairments in the period recorded plus 8 times rent expense.  The reversal of our deferred tax asset valuation allowance in 2010 has been excluded from the 2010 computation.

Return on Invested Capital

(1)(3)

De-levered Balance Sheet

Superior EBITDA Growth and Margin Expansion

(1)

($ millions)

Estimate

(2)

($ millions)

Estimate

(2)

Estimate

(2)

Strong Net Revenue Growth

(1)

($ millions)

Estimate

(2)

$7,669

$7,557

$7,676

$8,083

$8,585

$9,014

$9,200

2004

2005

2006

2007

2008

2009

2010

6.9%

9.2%

12.1%

12.0%

(3.3%)

2006

2007

2008

2009

2010

Return on Invested Capital

$422

$543

$631

$658

$739

$982

$1,050

2004

2005

2006

2007

2008

2009

2010

0%

2%

4%

6%

8%

10%

12%

14%

EBITDA

EBITDA Margin

$4,436

$4,803

$5,088

$5,039

$5,088

$4,950

$4,059

2004

2005

2006

2007

2008

2009

2010

Debt

DOJ Liability

1

6

8

8

3

4

6

6

3

9

Tenet has led same-hospital admissions growth over the

last 15 quarters

Tenet has led same-hospital admissions growth over the

last 15 quarters

Same-Hospital Admissions Growth

(1)

Ranking

(2)

Over Last 15 Quarters

___________________________

1.

Data for Tenet reflects the results of our existing 49 hospitals.

2.

Metric records number of quarters in which the Company ranked #1, #2 or #3 among the three companies in the 15 quarters from Q1’07 to Q3’10.

Ranked 1

st

Ranked 2

nd

Ranked 3

rd

10

Strong organic net revenue growth

(1)

Strong organic net revenue growth

(1)

($ millions)

Estimate

(2)

___________________________

1.

Data reflects the results of our existing 49 hospitals.

2.

Actual 2010 results may vary when they are released in February.

$7,669

$7,557

$7,676

$8,083

$8,585

$9,014

$9,200

2004

2005

2006

2007

2008

2009

2010

11

Consistent improvement of operating metrics has driven solid organic EBITDA growth

Tenet’s same-hospital EBITDA growth has outpaced

its largest peers in eight out of the last 15 quarters

Tenet’s same-hospital EBITDA growth has outpaced

its largest peers in eight out of the last 15 quarters

EBITDA Growth

(1)

Ranking

(2)

Over Last 15 Quarters

___________________________

1.

Data for Tenet reflects the results of our existing 49 hospitals.  Community’s same-store year-over-year EBITDA growth calculated using reported same-store income from operations, same-store

depreciation and amortization, and same-store minority interest in earnings for each quarter.  HCA year-over-year EBITDA growth based on reported consolidated EBITDA.

2.

Metric records number of quarters in which the Company ranked #1, #2 or #3 among the three companies in the 15 quarters from Q1’07 to Q3’10.

Ranked 1

st

Ranked 2

nd

Ranked 3

rd

4

5

6

3

7

5

8

3

4

12

Tenet’s EBITDA margins have expanded

590 basis points since 2004

(1)

Tenet’s EBITDA margins have expanded

590 basis points since 2004

(1)

($ millions)

Estimate

(2)

Cost control initiatives coupled with improved pricing has yielded significant margin expansion

___________________________

1.

Data reflects the results of our existing 49 hospitals.

2.

Actual 2010 EBITDA may vary when results are released in February.

$739

$982

$1,050

$658

$631

$543

$422

11.4%

10.9%

8.6%

8.1%

8.2%

7.2%

5.5%

2004

2005

2006

2007

2008

2009

2010

EBITDA

EBITDA Margin

13

Tenet’s consistent EBITDA improvement

relative to peers has narrowed the margin gap

Tenet’s consistent EBITDA improvement

relative to peers has narrowed the margin gap

Tenet is on track to exceed current industry average margins

___________________________

1.

Peer

Average

EBITDA

margin

of

Community

Health

Systems,

Hospital

Corporation

of

America,

Health

Management

Associates,

LifePoint,

Universal

Health

Services

and

Vanguard

Health

Systems.

Vanguard

2010

EBITDA

margin

reflects

last

twelve

months

financials

as

of

September

30,

2010

and

the

remaining

peers

reflect

2010E

Wall

Street

research

estimates.

Peer Avg:

(230bps)

Tenet:

590bps

2004–2010E

Change

10.8%

2.6%

THC EBITDA Margin

Peer

Average

Margin

(1)

0%

5%

10%

15%

20%

2004

2005

2006

2007

2008

2009

2010E

14

Tenet has one of the lowest leverage ratios

and longest maturity profiles in the industry

Tenet has one of the lowest leverage ratios

and longest maturity profiles in the industry

Active management of capital structure has significantly improved Tenet’s debt profile

___________________________

1.

As of September 30, 2010. Total Debt less Cash and Cash Equivalents/LTM EBITDA.

2.

Includes $1.525 billion issuance announced on November 9, 2010.

3.

Pro forma for Detroit Medical Center acquisition.  Assumes $120 million of EBITDA at Detroit Medical Center as per Wall Street research.

4.

Pro forma for announced acquisition of Psychiatric Solutions.

5.

$216 million due February 1, 2013.

6.

Borrowing availability under our revolving credit facility was $460 million at September 30, 2010. Becomes $500 million under the new agreement, as of September 30, 2010.

No

significant

debt

maturities

prior

to

2015

(5)

No

significant

maintenance

covenants

Ample

liquidity

with

$398

million

of

cash

as

of

9/30/2010;

$800

million

undrawn

credit

line

(6)

provides flexibility

Weighted Average Debt Maturity (years)

Leverage Ratio

(1)

Leverage Ratio

Years

(2)

(3)

(4)

4.0

4.0

5.0

5.0

6.0

6.0

8.0

HMA

Community

UHS

LifePoint

Vanguard

HCA

Tenet

4.8x

4.7x

4.3x

3.9x

3.8x

3.7x

2.7x

HCA

CommunityVanguard

UHS

HMA

Tenet

LifePoint

15

Well-defined growth strategy

Well-defined growth strategy

High margin businesses

Growth in EBITDA, cash flow,

ROIC

Organic growth

Outpatient

Capacity utilization & operating

leverage through physician

alignment

Revenue cycle business

Financial Objectives

Growth Drivers

Integrated clinical systems driving the capture of incentives, improved clinical

quality, provider integration and cost efficiencies

Greater than average benefit from new federal law

Operating Foundation

Current

HIT

investments

necessary

to

achieve

government’s

“meaningful

use”

will

capture

government

incentives

and

contribute

positive

benefit

to

earnings

beginning

in

2012,

while

also

improving

clinical

outcomes

and

operational

efficiency

16

Improve outpatient/inpatient mix

High growth/high margin revenue cycle management business focused on acute

care providers

Significant cost savings extracted from productivity and other efficiency initiatives

Outpatient

Conifer

MPI

(1)

Health IT

Significant reductions in uncompensated care and increased paying volumes due

to Affordable Care Act

Available capacity and increasing volumes position Company for substantial

margin expansion

Economic recovery and reduced unemployment expected to decrease bad debt

expense and drive margin expansion

Affordable

Care Act

Operating

Leverage

Bad Debt

Seven key drivers of a 16 –18% EBITDA margin

Seven key drivers of a 16 –18% EBITDA margin

Tenet-specific

Macroeconomic

Industry

___________________________

1.

MPI = Medicare Performance Initiative.

1

2

3

4

6

5

7

17

Targeted acquisitions and organic growth will

drive meaningful EBITDA margin expansion

Targeted acquisitions and organic growth will

drive meaningful EBITDA margin expansion

___________________________

1.

Acquisitions closed in 2010. Full year impact reflected in 2011 metrics.

2.

Acquisitions expected to be negotiated and closed in 2011. Metrics represent partial year impacts (except for purchase price).

3.

Percentage growth based on 2010 Outlook of 3.9mm OP visits, which includes OP visits associated with newly acquired centers.

($ millions)

EBITDA Impact

Outpatient

1

Tenet physician alignment and targeted growth initiatives expected to drive further outpatient growth

Outpatient Acquisition Strategy

2010 Acquisitions

(1)

2011 Acquisitions

(2)

Total 2011 Impact

Centers Acquired

24

15–25

40–50

Purchase Price ($mm)

$65

$100

$165

2011 Outpatient Visits

(000s)

215

50–60

265–275

Impact on 2011 Visits

(3)

(% increase)

5%

1%–2%

6%–7%

2011

2012

2013

Run-Rate

2013

$65

$65

$55

$35

Total

20

20

10

--

2012

20

20

20

10

2011

$25

$25

$25

$25

2010

EBITDA contribution

from acquisitions

completed in:

$10

$10

$10

$25

$10

$65

2010 Acquisitions

2011 Acquisitions

2012 Acquisitions

2013 Run-Rate

18

Conifer ranks among revenue cycle

industry leaders

Conifer ranks among revenue cycle

industry leaders

___________________________

Source: Tenet and Accretive Health as of September 30, 2010 10-Q filing. Wall Street research.

Note: Market data as of December 31, 2010.

Conifer

2

Strong momentum with meaningful provider penetration and a substantial pipeline for continued growth

Conifer

Accretive

# Client Hospitals

79

64

Client Net Patient Revenue

$13.4bn

$14.0bn

# Employees

2,600

2,100

Solution Spans Entire Revenue Cycle

Value Proposition = Increasing Client Yield

Margin Expansion Inherent in Business Model

Provides Long-Term Contracts

2011E EBITDA Multiple

N/A

16.8x

Enterprise Value

N/A

$1.5bn

2011 Revenue

N/A

$885

2011 EBITDA

N/A

$88

Substantial embedded value within Tenet

19

Medicare Performance Initiative will continue to

deliver significant cost savings

Medicare Performance Initiative will continue to

deliver significant cost savings

MPI

3

MPI’s

Goal: Cost reduction captured through physician adoption of best practices

$30 million in 2010 cost savings achieved

$50

million

incremental

savings

in

2011

and

subsequent

years

as

MPI

is

rolled

out

to

more

hospitals and more DRGs; augmented by other supply and productivity initiatives

MPI

cost

savings

are

cumulative

2011

2012

2013

2014

2015

Run-Rate Savings

Incremental Savings

$100

$150

$200

$250

$50

$50

$50

$100

$50

$150

$50

$200

$50

($ millions)

2009

2010

(1)

2011

2012

2013

2014

2015

2016

Healthcare IT (HIT)

Program Expense

(2)

$12

$21

$50

$60

$40

$15

–

–

Federal HIT Incentives

–

–

$15

$70

$97

$81

$44

$13

EBITDA Impact

($12)

($21)

($35)

$10

$57

$66

$44

$13

HIT Capital Expenditures

$49

$69

$106

$115

$69

$14

–

–

Foundation Systems

(# Go-Live)

–

8

12

20

9

–

–

–

CPOE Systems

(# Go-Live)

–

–

9

17

14

9

–

–

20

HIT investments improve clinical outcomes and

operational efficiencies

HIT investments improve clinical outcomes and

operational efficiencies

___________________________

1.

Estimate pending final close.  Actual results may vary when results are released in February.

2.

Excludes recurring clinical support operating expenses and HIT benefits to operating performance.

Health IT

4

Federal HIT incentives contribute positive benefit to earnings starting in 2012

Clinical systems are critical to physician alignment and integration, reduction of medication

errors, standardization of clinical practice and reduction of cost

($ in millions)

Penalties avoided

by achieving

“Meaningful Use”

(Net present

value of $315mm)

21

Reduced bad debt expense expected to

contribute to EBITDA growth

Reduced bad debt expense expected to

contribute to EBITDA growth

___________________________

1.

Data reflects the results of our existing 49 hospitals.

2.

Collection rates from self-pay accounts. The increase in bad debt expense includes factors in addition to the decline in collection rates.

Key Takeaways

Recession Has Driven Increase in Bad Debt Expense

Bad Debt

5

Economic recovery expected to moderate bad debt expense and drive EBITDA margin expansion

Prior to the recession, Conifer drove self-

pay collections from 32% to 36%

Tenet has executed its plan throughout the

recession

AR days declined from 54 days in Q1’08 to 46

days in Q3’10

Point of service collections increased from

34.5% in 2008 to 39.4% YTD 2010

Billing cycle times reduced by 19% from Q1’08

Right Care, Right Place initiative

53% increase in Medicaid qualifications in

2010 compared to 2008

Expense reductions expected from

improved collections in the future

2007 collection rate of 36% declined to 29% in

2010

(2)

Economic recovery alone expected to 

improve collections back to 36%

Conifer expected to drive improved collections

beyond 36%

(1)

Pre-Recession

Recession

7.2%

6.3%

6.9%

7.3%

7.7%

8.0%

2005

2006

2007

2008

2009

2010

YTD

Sept

Bad Debt as % of Net Revenue

22

Increase in capacity utilization provides

significant upside opportunity

Increase in capacity utilization provides

significant upside opportunity

___________________________

1.

Utilization defined as daily census divided by number of licensed beds.

2.

Actual 2010 utilization may vary when results are released in February.

Utilization of Licensed Beds

(1)

Operating Leverage

6

Adjusted fixed expenses to right-size cost structure during economic downturn while also

maintaining capacity to increase volumes in near term

$40

million

incremental

EBITDA

for

every

one

percent

increase

in

total

volumes,

assuming

current mix

$80 million incremental EBITDA from a one percent increase in capacity utilization

No significant near-term capacity constraints

(2)

54%

50%

52%

Tenet 5-Yr High Utilization

Tenet 2010E Utilization

Tenet Projected 2015 Utilization

23

Affordable Care Act expected to increase

volumes

Affordable Care Act expected to increase

volumes

___________________________

Assumptions: Conversions of uninsured to Medicaid and exchanges use Congressional Budget Office assumptions (57% conversion) evenly split between Medicaid and exchanges.

Existing volumes  convert at existing case

mix. Exchange pricing is slightly lower than projected commercial pricing.

Note:

Volume

growth

estimate

assumes

the

same

market

share

of

newly

insured

as

Tenet

presently

has

of

Medicaid

and

commercial

patients

and

that

utilization

of

hospital

services

are

consistent

with

current

Medicaid

and

commercial

populations.

Ultimate

outcomes

of

the

new

law

will

vary,

potentially

significantly,

depending

on

actual

pricing

of

the

exchanges,

migration

of

lives

(including

to

Medicaid

and

exchanges

from

commercial

coverage),

case

mix

and

utilization

of

hospital

and

outpatient

services

by

the

newly

insured,

exchange

copays

and

deductibles

and

other variables.

Affordable Care Act

7

The Affordable Care Act is expected to be negative to earnings through 2013 due to Market

Basket reductions (reducing positive annual market basket adjustments)

However, expected to be positive in 2014 and 2015 due to:

Migration of existing charity care to an insured status (revenue, bad debt and income increase)

Migration

of

uninsured

volumes

to

an

insured

status

(revenue

and

bad

debt

decrease,

income

increases)

Increased utilization of healthcare by the newly insured (revenue, bad debt and income increase)

Expected to result in 7.5% inpatient and 5.0% outpatient volume growth

Our 2015 estimated EBITDA range provides for substantial variation

Tenet is positioned to benefit more from coverage of the newly insured due to our concentration in areas of high uninsured populations

24

EBITDA outlook for 2010 and 2011

EBITDA outlook for 2010 and 2011

EBITDA

Guidance Range

Commentary

2010

Estimate

(1)

$1,050mm

$64 million California provider fee extracted from 2010 and moved

to 2011

Cash balance at December 31, 2010 is approximately $400 million

with favorable EBITDA performance offset by higher capital

spending (approximately $460 million), the deferral of the

California Provider Fee, and working capital and other liability

changes

2011

$1,150mm–

$1,250mm

Conservative macroeconomic assumptions

Admissions decline of 1% to flat

Adverse payer mix shift of $25 million

Bad debt remains an elevated 7.4% to 8.4%

HIT expense, net of incentives, expected to increase $14 million

to

$35 million

$50 million in MPI and other cost savings

Outpatient acquisitions adding $30 to $40 million

Follow-on provider fees of $40 million expected, guidance range

allows for variability

___________________________

1.

Actual 2010 EBITDA results may vary when 2010 results are released in February.

25

Tenet has exceeded initial annual outlook

in 2009 and 2010

Tenet has exceeded initial annual outlook

in 2009 and 2010

1.  

Actual 2010 EBITDA may vary when results are released in February.

26

Long-term outlook: 2010–2015

Long-term outlook: 2010–2015

Guidance Range

Drivers

Revenue Growth

4%–6% CAGR

Continued

pricing

improvement

balanced

by

modest

volume

growth

(1)

Government pricing pressure as measures from the “Affordable Care Act”

are implemented

Improving outpatient mix

36% of net patient revenue

Flat to positive admissions growth

Strong growth from Conifer and outpatient acquisitions

EBITDA Growth

11%–16% CAGR

Reduction in bad debt expense

Economic recovery

Affordable Care Act

Growth in high margin business

Conifer

Outpatient services

Increased operating leverage

MPI

Health IT incentives

EBITDA Target Margin

16%–18% by end of 2015

Capital Expenditures

$450mm–$550mm per annum

Seismic requirements met as of Q4 2010

EPS Growth

37%–50% CAGR

Continued trend of deleveraging and improving the capital structure

NOL

$2 billion NOL (December 2010)

Expected to be fully realized by 2014 or 2015

NPV of $550mm–$600mm

___________________________

1.

Commercial pricing negotiated; 90% of 2011, 60% of 2012, at contractual price increases consistent with 2010.

Tenet’s EBITDA growth

Tenet’s EBITDA growth

($ millions)

Projected EBITDA growth is more modest than historical growth rates

$1,250

$1,535

$2,250

27

___________________________

1.

2010 –

2015 CAGR based on mid-point of projected range.

2.

Actual 2010 EBITDA may vary when results are released in February.

Estimate

(2)

$422

$1,050

$1,150

$1,335

$1,750

$0

$500

$1,000

$1,500

$2,000

$2,500

2004

2010

2011

2013

2015

Lower End of EBITDA Range

Upper End of EBITDA Range

EBITDA walk forward (2010–2013)

EBITDA walk forward (2010–2013)

Key Drivers

Initial benefits from Medicare Performance Initiative

Run-rate impact of near-term outpatient acquisitions

Return on Health IT investments through incentives

Moderate reduction in bad debt expense as a result of

economic recovery

$1,535

$1,050

___________________________

1.

Operating Leverage is driven by the combination of assumptions on volumes, pricing and cost drivers.

$100mm

cushion

$100mm

upside opportunity

(1)

28

2013

EBITDA

2013

EBITDA

Margin

$1,535

14-15%

$1,435

13-14%

$1,335

12-13%

$65

$35

$150

$80

$40

$80

$25

($90)

2010

Outpatient

Conifer

MPI

Health IT

Medicaid

Funding

Bad Debt

Expense

Operating

Leverage

Affordable

Care Act

2013

$1,335

EBITDA walk forward (2013–2015)

EBITDA walk forward (2013–2015)

Key Drivers

$1,535

$2,250

Improvement in capacity utilization from new federal

law, demographics and other factors drive operating

leverage

Full impact of Medicare Performance Initiative

Additional third party revenues and benefits from

utilization of Conifer’s capabilities

Affordable Care Act

Recovery of

Losses

Through ‘13

Gains

During

’14-’15

29

(1)

___________________________

1.

Operating Leverage is driven by the combination of assumptions on volumes, pricing and cost drivers.

$250mm

cushion

$250mm

upside opportunity

2015

EBITDA

2015

EBITDA

Margin

$2,250

18-19%

$2,000

16-18%

$1,750

15-16%

$50

$100

$5

$190

$90

($10)

$140

$1,750

$1,335

2013

Conifer

MPI

Health IT

Bad Debt

Expense

Operating

Leverage

2015

$1,435

30

Tenet Healthcare: a compelling investment

Tenet Healthcare: a compelling investment

Positive Industry Trends

Strong demographic changes driving growth

Growth

rate

of

Americans

over

65

will

more

than

double

from

2010

to

2012

Recession has suppressed volume growth and increased bad debt expense

New federal law expands insurance coverage to 32 million uninsured Americans (2014)

Delivering Consistent Performance

Superior EBITDA growth and margin expansion

Accelerated Adjusted Free Cash Flow

De-levered balance sheet

Same-hospital admission and EBITDA growth has outpaced peer group

Positioned to Outperform

Continued strong organic growth in earnings and cash flow

Consistent strategy driven by innovative, high margin, capital efficient initiatives

Operating integrity, past growth and infrastructure investments reduce future risks

Appendix A:

Selected Q4’10 Disclosures

31

32

Selected Q4’10 Disclosures

Selected Q4’10 Disclosures

0.1

99,513

99,645

Uninsured + Charity

OP Visits

0.0

8,392

8,394

Uninsured + Charity

Admissions

(3.1)

628,438

608,890

Patient days

3.2

872,228

900,182

Paying OP Visits

2.9

971,741

999,827

OP Visits

(2.2)

121,239

118,583

Paying Admissions

129,631

Q4’09

Q4’10E

(1)

Change (%)

Admissions

126,977

(2.0)

___________________________

1.

Actual Q4’10 results may vary when Q4’10 results are released in February.

Appendix B:

Medicare Performance Initiative

33

34

Medicare Performance Initiative (MPI)

Overview

What is MPI?

MPI is a program with the goal of creating a sustained, standardized approach following

nationally recognized best practices to improve clinical outcomes and reduce variable costs

This program is built on a unique foundation of information system capabilities and allows us to

improve the way we treat disease and perform procedures on Medicare patients

Any

benefits

of

the

initiative

should

also

have

a

“halo”

effect

on

other

payers

This is critical given the direction of health care reform to a more “value based purchasing

model”

involving the delivery of higher quality at lower pricing near Medicare payment levels

MPI encompasses many different initiatives:

1)

Physician behavior change

2)

Labor management

3)

Supply chain initiatives

4)

Case management program

MPI initiatives are identified, tracked, measured and shared

35

1. Physician Behavior Change

How are savings achieved through different methods of treating disease

and performing procedures?

An analysis is performed on 5 MS-DRG groups at each hospital where total costs exceed

revenues to identify variable costs that can be reduced

Physician champions are enlisted to support the changes in behavior that will reduce the

variability of how different physicians treat the same disease

Customized prescriptive work plans are developed to reduce the variable costs using local,

national, and acceptable best practices for standards of care

Repeatable

process

is

hardwired

to

address

more

MS-DRGs

in

the

future

What’s in it for the physician?

High cost/ low quality physicians are already being excluded by health plans in certain

markets

Hospital

and

physician

incentives

will

be

more

aligned,

creating

greater

opportunity

for

success under health reform based payment models

Improving profitability and quality enhances the hospital’s ability to attract the best

employees and fund investments in capital equipment and facilities

36

Physicians championing behavior change

have led to reduced ALOS and variable cost

5%

2%

1%

1%

Average Length of Stay

3%

9%

Variable Cost per Case

(unadjusted for inflation)

5%

7%

4%

6%

___________________________

Note: Data includes first 16 Wave 1 MPI hospitals, and each hospital’s unique base period represents the six months proceeding the formal launch of Wave 1 of MPI.

Source: Internal company data.

Pre-MPI             Post-MPI

Pre-MPI             Post-MPI

9%

0

2

4

6

8

All Payer -

Combined

Medicare -

Combined

All Payer -

Procedural

Medicare -

Procedural

All Payer -

Medical

Medicare -

Medical

$0

$5,000

$10,000

$15,000

All Payer -

Combined

Medicare -

Combined

All Payer -

Procedural

Medicare -

Procedural

All Payer -

Medical

Medicare -

Medical

37

2.  Labor Management

Labor Management Specialists are assigned to each Region

Each hospital is provided an array of labor productivity tools –

Position

Control, Staffing Grids, Visionware

Labor Management Specialists make site visits to work with hospital teams

to improve use of tools and understanding of program

New Labor Management Reporting System (LMRS) has been developed

Replaces previous bi-weekly labor reports

Reflects both paid and productive FTEs and dollars

Departmental drill downs available

Future enhancements to include more meaningful department-level drill down

38

Better labor management has resulted in lower

labor expense

Paid FTEs per AADC

Contract Labor per APD

___________________________

Source:   Internal company data.

1.

2010E based on November YTD results plus December forecast.  Core hospitals only.

Estimate

(1)

Estimate

(1)

$41

$44

$37

$20

$16

2006

2007

2008

2009

2010

4.31

4.32

4.26

4.18

4.12

2006

2007

2008

2009

2010

39

CMI-adjusted Supply Cost per Adjusted Patient Day

(1)

3.  Supply Chain Initiatives

3.  Supply Chain Initiatives

Numerous supply chain initiatives

have been identified and

implemented

These require significant work with

physicians and staff to change

behavior, but can result in significant

savings

Supply chain initiatives that have been most effective

include:

High cost drugs –

medication utilization management

Cardiac Rhythm Management (CRM) devices

Drug eluting stents

Ortho and spine implants

High cost supplies –

custom procedure tray utilization

Purchased services –

Food and Nutritional Services and

Environmental Services

Blood product sourcing and improved utilization

___________________________

1.

Core hospital supply cost only.

2.8%

2.6%

3.5%

3.5%

3.2%

2.4%

1.2%

3.2%

1.6%

(0.1%)

(1%)

0%

1%

2%

3%

4%

5%

Q3 2009

Q4 2009

Q1 2010

Q2 2010

Q3 2010

Percent Change -

MedSurg PPI

Percent Change -

Supply Expense per CMI-Adjusted Patient Day

Cumulative Cardiac Rhythm Management

Contracting Savings:  2009 –

2011

(2)

40

Many supply chain initiatives have controlled or

decreased supply expense

Many supply chain initiatives have controlled or

decreased supply expense

Pharmacy Spend Per

Adjusted Patient Admission

(1)

Estimate

___________________________

1.

Source: Internal company data.

2.

Source:

Internal

company

data.

Savings

for

2009

through

2011

on

this

initiative

projected

to

be

in

excess

of

$20

million.

Region

Impact %

California

(28.8%)

Central

(28.3%)

Florida

(24.7%)

Philadelphia

(24.1%)

Southern States

(19.6%)

Total

(25.2%)

$397

$397

$401

$411

2007

2008

2009

2010

41

4.  Case Management Program

4.  Case Management Program

Case Management Specialists are assigned to each Region and perform

on-site visits to hospitals

Medical Necessity screening is performed using Interqual

guidelines

prior to, or as soon as possible after, bed placement

Clinical rationale for decision is clearly documented

Goals of an effective case management program are:

Correct use of observation status

Ensure length of stay is appropriate

Reduce managed care denials

Tactics used to reach these goals are:

All clinical departments, nursing departments, and the Utilization Management (UM)

committee share in ownership

Implement multidisciplinary patient care conferences

Adequate & effective Physician Advisor coverage with UM knowledge

Physician education and support

42

Hospitals have direct access to

MPI-level variable cost

analytics, updated on a

monthly basis

MPI analytics and reporting now on intranet

Best Practices are shared regularly

throughout the company

It is expected that every hospital

management team is implementing

those applicable Quick Wins

43

MPI Summary

MPI is a program that delivers higher quality at lower costs and

positions Tenet well

for the country’s move to value based purchasing

MPI is sustainable:  $30mm in savings were captured in 2010 and $50mm in

savings are targeted for 2011 and beyond

2011

2012

2013

2014

2015

Run-Rate Savings

Incremental Savings

$100

$150

$200

$250

$50

$50

$50

$100

$50

$150

$50

$200

$50

($ millions)

Appendix C:

Tenet Board of Directors

44

45

Tenet’s Board of Directors is aligned with

shareholder interests

Tenet’s Board of Directors is aligned with

shareholder interests

Substantial Wealth

of Directorship

Knowledge

Executive

Leadership

Experience

Independent Board

of Directors

Independent Chairman of the Board

Separation of Chairman and CEO roles

9 out of 10 independent board members

No two directors can serve on another public company board together (prevents interlocking directorates)

Each of the directors has served in a leadership role within a large, complex organization

Diversified experience with leaders in public sector, healthcare, accounting and finance, technology and

manufacturing

1 former Chairman and CEO of an S&P 500 corporation

2 former CEOs and/or Presidents of a major business unit of S&P 500 corporations

1 former Chairman and CEO of an international public accounting firm

2 former Governors of U.S. States, of which one was a former member of the U.S. Senate and former President

of a major university

Healthcare:

Allscripts,

Athersys,

CorMatrix

Cardiovascular,

Eclipsys*,

EndoGastric

Solutions,

IMS

Health*,

Intuitive Surgical, MAKO Surgical

Selected

Corporations:

Deloitte*,

Electronic

Data

Systems*,

GreenPoint

Financial*,

Hovnanian,

Intuit,

North Fork Bancorp*, Office Depot, Prudential Financial, Qwest Communications, Unisys*, United

Technologies

Other: Allina Hospitals and Clinics*, The Cleveland Clinic Foundation*

Board members have experience with major corporate actions: Eclipsys*, Electronic Data Systems*, IMS

Health*, North Fork Bancorp*

* -

Indicates prior Directorship affiliation

46

Tenet’s Board of Directors is aligned with

shareholder interests (cont’d)

Tenet’s Board of Directors is aligned with

shareholder interests (cont’d)

Government Experience

Provider Experience

Operating and Financial Expertise

Edward

A.

Kangas,

Non-Executive

Chairman

Global

Chairman

and

CEO,

Deloitte

Touche

(1989-2000)

Member

of

Tenet

Board

since

2003

Other

Directorships:

Allscripts

Healthcare

Solutions,

Hovnanian Enterprises, Intuit, United Technologies, Eclipsys*,

EDS*

Governor Jeb Bush

Governor of Florida (1999-2007)

Member of Tenet Board since 2007

Other Directorships: Rayonier, Swisher International, Angelica

Trevor

Fetter,

President

and

CEO

(Since

2003)

President, Tenet (2002-2003)

CEO, Broadlane

(2000-2002)

CFO, Tenet (1995-1999)

Other Directorships: Hartford Financial Services Group

Karen Garrison

President, Pitney Bowes Business Services (1999-2004)

Member of Tenet Board since 2005

Other Directorships: Kaman Corporation, Standard Parking,

North Fork Bancorp*

Floyd D. Loop, M.D.

Chairman and CEO, The Cleveland Clinic Foundation (1989-

2004)

Member of Tenet Board since 1999

Other Directorships: Athersys, Intuitive Surgical

Ronald A. Rittenmeyer

Chairman, President and CEO, Electronic Data Systems

Corporation (2005-2008)

Member of Tenet Board since 2010

Other Directorships: AIG, Electronic Data Systems*, R.H.

Donnelley*, Safety-Kleen Systems*, RailTex*

Brenda Gaines

President and CEO, Diners Club North America (2002-2004)

Member of Tenet Board since 2005

Other Directorships: Fannie Mae, NICOR, Office Depot, CNA

Financial Corp*

Senator J. Robert Kerrey

President, New School University (2001-2010)

Former U.S. Senator (1989-2000)

Former Governor (1982-1987)

Member of Tenet Board since 2001

Other Directorships: Genworth

Financial, Jones Apparel

Group, Scientific Games Corporation

Richard R. Pettingill

President and CEO, Allina Hospitals and Clinics (2002-2009)

VP and COO, Kaiser Foundation Health Plans and Hospitals

(1996-2002)

Member of Tenet Board since 2004

Other

Directorships:

Mako

Surgical

James A. Unruh

Chairman and CEO, Unisys (1990-1997)

Member of Tenet Board since 2004

Other Directorships: Prudential Financial, Qwest

Communications, CSG Systems International

* -

Indicates prior Directorship affiliation

Appendix D:

Adjusted EBITDA Reconciliation

47

Reconciliation of EBITDA

Reconciliation of EBITDA

Adjusted EBITDA, a non-GAAP term, is defined by the Company as net income (loss) attributable to Tenet Healthcare Corporation common

shareholders

before

(1)

cumulative

effect

of

changes

in

accounting

principle,

net

of

tax,

(2)

net

income

attributable

to

noncontrolling

interests,

(3)

preferred stock dividends, (4) income (loss) from discontinued operations, net of tax, (5) income tax (expense) benefit, (6) investment earnings (loss),

(7) gain (loss) from early extinguishment of debt, (8) net gain (loss) on sales of investments, (9) interest expense, (10) litigation and investigation

(costs) benefit, net of insurance recoveries, (11) hurricane insurance recoveries, net of costs, (12) impairment of long-lived assets and goodwill and

restructuring charges, net of insurance recoveries, and (13) depreciation and amortization. The Company’s Adjusted EBITDA may not be comparable

to EBITDA reported by other companies.

The Company provides this information as a supplement to GAAP information to assist itself and investors in understanding the impact of various

items on its financial statements, some of which are recurring or involve cash payments. The Company uses this information in its analysis of the

performance of its business excluding items that it does not consider as relevant in the performance of its hospitals in continuing operations. Adjusted

EBITDA is not a measure of liquidity, but is a measure of operating performance that management uses in its business as an alternative to net income

(loss) attributable to Tenet Healthcare Corporation common shareholders. Because Adjusted EBITDA excludes many items that are included in our

financial

statements,

it

does

not

provide

a

complete

measure

of

our

operating

performance.

Accordingly,

investors

are

encouraged

to

use

GAAP

measures when evaluating the Company’s financial performance.

Future period high range estimates assume excess cash is used to

early retire debt. Actual use of cash may vary and therefore interest expense and

other elements of earnings may vary significantly. The reconciliation of net income (loss) attributable to Tenet Healthcare Corporation common

shareholders, the most comparable GAAP term, to Adjusted EBITDA,

is set forth below.

48