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1. Accretive Health Revenue Cycle Management
Driving Growth Through Measured Results
DECEMBER 3, 2012

2. Safe Harbor
Certain statements contained in this presentation may be considered forward-looking as
defined by the Private Securities Litigation Reform Act of 1995. In particular, any statements
made about Accretive Health’s expectations for future financial and operational performance,
expected growth, new services, profitability or business outlook are forward-looking
statements. Investors are cautioned not to place undue reliance on such forward-looking
statements. There is no assurance that the matters contained in such statements will occur
since these statements involve various risks and uncertainties that could cause actual
results to differ materially from those expressed in such forward-looking statements. These
risks and uncertainties include those listed under the heading Risk Factors in the company’s
Quarterly Report on Form 10-Q for the quarter ended September 30, 2012, which is available
on the SEC’s website as well as in the investor relations portion of Accretive Health’s website
at www.accretivehealth.com. The forward-looking statements made in this presentation are
based on the company’s beliefs and expectations as of December 3, 2012 only and should
not be relied upon as representing the company’s views as of any subsequent date. While the
company may elect to update these forward-looking statements at some point in the future,
Accretive Health specifically disclaims any obligation to do so, even if its views change.
Driving Growth Through Measured Results 2

3. Use of Non-GAAP Financial Measures
In order to provide stockholders with greater insight and to We believe adjusted EBITDA is useful to stockholders in evaluating our
allow for better understanding of how our management and operating performance for the following reasons:
board of directors analyze our financial performance and
• these and similar non-GAAP measures are widely used by investors to
make operational decisions, we supplement our condensed measure a company’s operating performance without regard to items that
consolidated financial statements presented on a GAAP can vary substantially from company to company depending upon financing
basis with the adjusted EB ITDA and adjusted net income and accounting methods, book values of assets, capital structures and the
measures *. methods by which assets were acquired;
Adjusted EBITDA measure has limitations, as noted below, • securities analysts often use adjusted EBITDA and similar non-GAAP
and should not be considered in isolation or in substitute for measures as supplemental measures to evaluate the o verall operating
analysis of our results as reported under GAAP. performance of companies; and
• by comparing our adjusted EBITDA in different historical periods, our
Our management uses adjusted EBITDA:
stockholders can evaluate our operating results without the additional
• as a measure of operating performance, because it does not variations of interest income (expense), income tax expense (benefit),
include the impact of items that we do not consider indicative depreciation and amortization expense and share-based compensation
of our core operating performance; expense.
• for planning purposes, including the preparation of our
We understand that, although measures similar to adjusted EBITDA are
annual operating budget;
frequently used by investors and securities analysts in their evaluation of
• to allocate resources to enhance the financial performance companies, these measures have limitations as analytical tools, and you
of our business;
should not consider it in isolation or as a substitute for analysis of our
• to evaluate the effectiveness of our business strategies; and results of operations as reported under GAAP. To properly and prudently
• in communications with our board of directors and investors evaluate our business, we encourage you to review the GAAP financial
concerning our financial performance. statements included elsewhere in our regulatory filings, including the
Preliminary Prospectus, Form 8-K, and Form 10-K, and not to rely on any
single financial measure to evaluate our business.
*Reconciliations of non-GAAP measures to their most directly comparable GAAP measures are presented, where possible in the Appendix, as well as in the
Company’s financial press releases and related Form 8-K filings with the Securities and Exchange Commission. This information can be accessed for free in
the Investor Relations section of the Company’s website at www.accretivehealth.com
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4. ACCRETIVE HEALTH OVERVIEW
Driving Growth Through Measured Results

5. Our Guiding Principles
• Our primary goal is to help our healthcare clients strengthen their financial
stability and deliver better care to the communities they serve
• We use technology to drive best practices and best outcomes
• We work collaboratively with clients to create solutions to existing challenges
• We promote an entrepreneurial culture to encourage innovation and
continuously upgrade our functionality with a focus on value creation
Driving Growth Through Measured Results 5

6. Accretive Health Snapshot
Founded in 2003, headquartered in Chicago
Win – Win Proposition with our Client Partners
• We are paid based on our results; no upfront costs for Quality or Revenue Cycle Services
• We have partnered with some of the most well-respected health systems in the U.S.
We Drive Measured Results for our Partners
• Since inception we have delivered $1.5 billion in cash benefits to clients
Innovation and Operational Excellence is at the Core of What We Do
• Success of our RCM offering is driven by applying technology and innovative process
improvements to drive measurable results
• Seeded Physician Advisory Services in 2009, now a $60 million run-rate business
• Developed unique offerings to improve care quality at lower costs – Intra-Stay Quality and
Population Health Management Infrastructure
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7. Three Distinct Offerings
Revenue Quality and Physician
Cycle Management Care Coordination Advisory Services
Proven end-to-end Utilize physician-driven Compliance services
solution that lowers best practices to that maintain detailed
collection costs and improve care quality at audit trails for claims
reduces yield a lower cost
leakage
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8. Multiple Growth Drivers in Each Business
Revenue Cycle Management
• Large market opportunity, low current penetration
• Proven end-to-end solution with a win-win proposition
• Margin expansion by driving further efficiency and reducing reimbursement leakage
Quality and Care Coordination
• Population Health Management is developing as the next frontier of healthcare
• Lack of provider infrastructure for population health management
• Intra-Stay Quality has broad appeal and could create beachhead into new hospitals
Physician Advisory Services
• Increasing frequency of audits
• Opportunity for continued market share gains
• Expansion into compliance and workflow advisory services
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9. Providers are Getting Squeezed
• Value-based payment models
Health
Reform • Medicaid expansion/State
budget constraints
• Insurance exchanges
• Declining
reimbursement
• Rising bad debt Economic
• Rising costs • ICD-10
from medical Compliance
• RAC Audits
innovation
• Capital constraints • Patient satisfaction scores
Insufficient
• Significant variance Resources • Higher out-of-pocket costs
in provision and Patients
quality of care • Aging population
• Personalized medicine
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10. Market Opportunity
RCM Quality PAS
Market Size $1.0 Trillion $1.6 Trillion $ 710 billion
% to AH 5.0% 6.25% 0.12%
Revenue
Revenue $50 $100 $850
Opportunity Billion Billion Million
Sources: CMS National Healthcare Expenditures, September 2011 and Definitive Healthcare
RCM market scope includes net patient revenue at all hospitals based on CMS 2014 projected expenditures
Quality market scope includes all hospital and physician expenditures
PAS market scope includes all hospitals with >$250 million in net patient revenue
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11. Value Proposition
Revenue Cycle and Quality Require No Upfront Investment from Clients
• Accretive Health is compensated based on Measured Value delivered to clients
Our End-to-End Solution Delivers Superior Results by Combining People,
Process and Technology
• People: Well-trained professionals who work directly with the client
• Process: Market-leading best practices to allow seamless workflow at all stages of the
revenue collection process
• Technology: Comprehensive tools to measure and improve efficiency for clinical and financial
outcomes
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12. A Differentiated Offering
Accretive Health
Operating Partnership
NOT
 Pay for measured results
a consulting firm
 Unparalleled form of
collaboration
NOT
 End-to-end scope
an outsourcing model
 AH makes significant
investment of resources
NOT  Pay for results not input
a software provider
We create operating partnerships that result in distinctly
different outcomes than other models
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13. End-to-End RCM Solution Provides Competitive Advantages
Value
Patient Patient Lost Payor
Compliance Proposition
Advocacy Share Charges Follow-Up
(% revenue lift)
4-6%
(Measured)
SaaS /
Est. 0.5-1%
Technology- (Not Measured)
Supported RCM
Est. 0.5-1%
Consulting (Measured)
IT Outsourcing / Est. 0.5-1.5%
Non-HC BPO (Not Measured)
Note: Based on Accretive Health’s estimates
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14. Partnering with Innovative Leaders
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15. REVENUE CYCLE MANAGEMENT
Driving Growth Through Measured Results

16. Market Drivers for RCM Solutions
Financial Increasing Obsolete Investment
Pressures Complexity Technology Risk
• Declining • ICD-10 • Old-generation • No upfront
reimbursement financial systems investment
• Health
still in use with Accretive
• Increasing Reform
Health
patient • Fragmented
responsibility solutions
• Poor collection
rates
We compete with numerous vendors who approach the
market with incomplete solutions
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17. Collection Yield: Uncovering Hidden Leakage
Opacity in the revenue cycle process hides leakage
Typical hospital Calculation after
calculation AH analysis
Gross charges $1,000 $1,000
Less: Accurate contractual adjustments - 500 - 500
Less: Hidden leakage disguised as - 35 0
contractual adjustments
Gross charges less contractuals (collectable cash) $465 $500
Less: Payor write-offs -5 -5
Less: Bad debt -25 -25
Less: Hidden leakage 0 -35
Areas for AH
Cash collected $435 $435 to drive
improvement
$435 $435
Yield (cash collected/collectable cash): $465 = 94% $500 = 87%
We uncover hidden leakage to derive a real picture of collection yield
Driving Growth Through Measured Results 17

18. How do we Uncover Hidden Leakage?
Our proprietary AHtoContract tool is vital in calculating Best Possible revenue
12-month period
All contracts
All patient visits and charge information
AHtoContract Tool
Best Possible Revenue
Driving Growth Through Measured Results 18

19. Understanding Leakage: Illustrative Example
Revenue Mix
100% 4.1%
7.7%
% of
Yield
Total
75%
Uninsured 5% 0.2% 4.1% x 5.0% = 0.2%
Insured patient
responsibility 30% 2.3% 7.7% x 30% = 2.3%
50%
88.2% Payors 95.8% 84.5% 88.2% x 95.8% = 84.5%
25% Overall Collection Rate: 87.0%
Uninsured patients
Insured patients residual responsibility
0% Payor reimbursement
In an industry where operating margins average ~2%,
13% revenue leakage is significant
Note: Based on Accretive Health’s estimates
Driving Growth Through Measured Results 19

20. RCM Win-Win Proposition I: Improved Revenue Lift
5% • Pre-registration
• Automated insurance verification
Payor yield: 2% • Automated plan code correction
• Prior authorizations
4% • Continuous denials review/fix
• Automated denial resolution
• Automated underpayment trolling
• Proper contractualization of receivables
3% • Specialized physicians to appeal denials
Insured • Real-time patient responsibility estimation
patient yield: 1% • Simplified billing statements
• Prior balance visibility
2% • Patient education
Patient self-pay • Alternate sources of coverage
conversion: 1% • Expeditious charity care application
• Manage secondary coverage as backup
1%
Increase to • Identification of missing or unbilled charges
• Pricing initiatives
“Best Possible”: 1% • Post-coding, pre-bill quality review
0%
We retain a portion of the revenue lift as our Incentive Fee
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21. Reducing Collection Costs: Methodology
We help our clients reduce costs through:
• Process efficiency – eliminate • Vendor cost management
redundant effort • Demand-driven staffing and scheduling
• Technology-driven productivity • Use of Shared Service Centers to drive
improvements – automation economies of scale
What services are included?
Front-End Middle Back-End
Scheduling Transcription Billing
Pre–registration Coding Claim follow–up
Registration Case coordination Cash posting
Eligibility Records storage Pre-collect
Insurance verification Clinical documentation Underpayments
Pre–authorization Release of information Denial management
Financial counseling Medical records Contract compliance
Admitting Charge capture
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22. RCM Win-Win Proposition II: Reducing Collection Costs
Cost Baseline: Hospitals spend about 4.0-4.5% of NPR on their collection effort
• This baseline serves as the initial basis of our Base Fee
$120
$100 Cost Baseline
15-30% expense
$80
reduction after
engaging with AH
$60
$40
$20
$0
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
Reducing collection costs:
• Accretive Health aims to reduce cost to collect by 15-20%, or 20-30% if services are migrated to Shared
Service Centers
• Cost savings are shared with clients, providing a mutual incentive
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23. Shared Service Centers
We operate 10 Shared Service Centers domestically and offshore
89% of revenue cycle management customers utilize at least one shared
service; 55% of customers utilize at least three shared services
Shared services deliver enhanced benefits – more cost savings than
processing on-site
Services delivered via Shared Service Centers:
• Financial Clearance
• Customer Service
• Pre-collect
• Medicaid Eligibility
• Patient Financial Services
• Underpayments
• Transcription
• Coding
Driving Growth Through Measured Results 23

24. Why Our End-to-End Solution is Better
Superior results through complete oversight of the revenue cycle
• Fragmented solutions are sub-optimal, with no complete view of data
• Competitors with limited scope can only deliver limited value
• Root cause analysis shows significant problems are caused by poor inputs
• Garbage in…garbage out!
• Effective revenue cycle must capture all inputs and outputs at the front, middle
and back end
Accretive Health Oversight
Patient Cash
Information FRONT MIDDLE BACK Collected
(input) (output)
Competitors with
limited scope
Driving Growth Through Measured Results 24

25. Our Technology is a Critical Piece of our Offering
Accretive Health technology integrates with client patient accounting,
scheduling, and electronic health record systems
• Existing patient accounting system remains
“System of Truth”
• Industry-standard protocols (HL7, EDI, etc)
• Seamless interfacing, NOT a system conversion
• Experienced implementation teams
• No local hardware or software installation
• Hosted in world-class SAS-70 compliant data center
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26. Technology Model
Our technology…
Detects accounts that have financial risk
Streamlines the Execution of resolving the risk
Measures the efficiency and effectiveness of our process and outcomes
Driving Growth Through Measured Results 26

27. Core Revenue Cycle Technology
AHtoContract™
Best Possible calculation, contract modeling, insurance payer follow up
payment
AHtoAccess™
Patient pre-registration and registration, insurance eligibility checking
AHtoCharge™
Charge integrity and compliance
Yield-Based Follow Up™
Follow-Up™
Follow-up
Follow up for un-billed and billed claims with payors
AHtoAnalytics™
Operational reporting and analytics with drill-through to account level detail
Driving Growth Through Measured Results 27
Proprietary & Confidential

28. Eliminating Leakage Drives Returns
Potential Sources of Leakage Throughout End-to-End Process
Actual Leakage
FRONT-END MIDDLE BACK-END Realized
Registration and Health Information Uncompensated Care
Billing and Follow-up
Financial Clearance Management • Bad debt
• Charity care
• Denial write-offs
• Incomplete patient data • Insufficient or • Insufficient follow up
• Incomplete insurance incomplete with payer/patient
verification documentation • Failure to appeal Hidden Leakage in
• Coding errors denial • Contractuals
• Incorrect payor code (Underpayments,
• Failure to obtain • Missed charges • Billing errors misclassified denials)
pre-authorization • Discharge not final
• Incorrect residual billed (DNFB)
Hidden Leakage Due to
estimate • Cash posting errors
• Missing charges
• Failure to discuss patient • Failure to bill • Documentation and
share/ prior balance secondary coding errors
• Failure to find • Delays in timely filing
secondary insurance • Third-party take
• Coordination of benefits backs
Driving Growth Through Measured Results 28

29. AHtoCharge
Metrics Manual Internal Audit* AHtoCharge
Total Registered Visits 1,000,000 1,000,000
Reviewed Accounts 1,000 1,000,000
% Reviewed 0.1% 100%
Worked Accounts 1,000 30,000
Reconciled Revenue Leakage (# of accounts) 100 8,000
Gross $'s Reconciled $50,000 $4,000,000
*Based on Accretive Health’s estimates
Driving Growth Through Measured Results 29

30. Lifecycle of a Claim
Thorough analysis of claims
Balance (BAL) Compare to:
REI $4642.01 Aug.15,2012 – Nov 13, 2012 Charges
BAL $0 CHR $9423.75 PMT $4642.01 ADJ $4781.74
L Payments
Patient Payments
Discharged Insurance Payments
8000.00
8/22/2012 Adjustments
Exp Reimbursement
6000.00
Admitted Patient Payment
8/18/2012 11/7/2012
4000.00
Contractual
Allowance
Insurance 11/7/2012 Insurance
Payment adjustment
2000.00 S 10/11/2012 Insurance
R payment
P R
E C U Y
LL A U T B 2 8 C Z Y 8 2 8 $ B 2 8 $ $
0
Pre-Registration
Aug 20 Aug 27 Sep Sep 20 Sep 17 Sep 24 Oct Oct 8 Oct 15 Oct 22 Oct 29 Nov
8/15/2012 Insurance
plan info added
Driving Growth Through Measured Results 30

31. Yield-Based Follow-up
The Yield-Based Follow-up Tool utilizes proprietary algorithms and business
logic to assign accounts to appropriate risk categories.
Initial Prioritization based on factors including:
• Payor type and plan code • Days from discharge
• Current insurance balance • Days before filing appeals deadline
• Expected reimbursement • Most recent activity on the account
• Denial type (if any) • Recommended follow-up date
Advanced Prioritization Algorithms
• Customizable business rules engine utilizing 30+ • Insights from predictive models based on analysis of
variables for each account historical data
Workflow Management
• Grouping of accounts into risk levels • Campaigns focused on specific claim types
Prioritized claims for each follow-up representative
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32. Factors that Contribute to Long-Term Client Partnerships
• Technology is integrated into all key steps in the revenue cycle process
• Industry knowledge, reporting, and analytics capabilities are integrated into
management of the operations
• Embedded management teams are integral to execution of revenue
cycle processes
• Utilization of Shared Service Centers delivers additional cost savings
• Operational excellence and a focus on continuous improvement, combined
with consistent financial results, generates loyalty
Driving Growth Through Measured Results 32