R1 RCM : The Cowen 41st Annual Health Care Conference

Forward-Looking Statements and Non-GAAP Financial Measures

This presentation includes information that may constitute "forward-looking statements," made pursuant to the safe harbor provisions of the Private Securities Litigation

Reform Act of 1995. Forward-looking statements relate to future, not past, events and often address our expected future growth, plans and performance or forecasts. These forward-looking statements are often identified by the use of words such as "anticipate," "believe," "designed," "estimate," "expect," "forecast," "intend," "may," "plan," "predict," "project," "target," "will," or "would," and similar expressions or variations, although not all forward-looking statements contain these identifying words. These forward-looking statements include, among other things, statements about the potential impacts of the COVID-19 pandemic, our strategic initiatives, our capital plans, our costs, our ability to successfully deliver on our commitments to our customers, our ability to deploy new business as planned, our ability to successfully implement new technologies, our future financial performance and our liquidity, and the anticipated benefits of acquisitions, dispositions, and other strategic transactions. Such forward- looking statements are based on management's current expectations about future events as of the date hereof and involve many risks and uncertainties that could cause our actual results to differ materially from those expressed or implied in our forward-looking statements. Subsequent events and developments, including actual results or changes in our assumptions, may cause our views to change. We do not undertake to update our forward-looking statements except to the extent required by applicable law. Readers are cautioned not to place undue reliance on such forward-looking statements.

All forward-looking statements included herein are expressly qualified in their entirety by these cautionary statements. Our actual results and outcomes could differ materially from those included in these forward-looking statements as a result of various factors, including, but not limited to, the severity, magnitude and duration of the COVID-19 pandemic; responses to the pandemic by the government and healthcare providers and the direct and indirect impacts of the pandemic on our customers and personnel; the disruption of national, state and local economies as a result of the pandemic; the impact of the pandemic on our financial results, including possible lost revenue and increased expenses; risks that the expected benefits from acquisitions, dispositions, and other strategic transactions will not be realized or will not be realized within the expected time period; the risk that acquired businesses will not be integrated successfully; significant transaction costs; unknown or understated liabilities; and the factors discussed under the heading "Risk Factors" in our annual report on Form 10-K for the year ended December 31, 2020, our quarterly reports on Form 10-Q and any other periodic reports that the Company files with the Securities and Exchange Commission.

This presentation includes the following non-GAAP financial measure: Adjusted EBITDA. Please refer to the Appendix located at the end of this presentation for a reconciliation of the non-GAAP financial measure to the most directly comparable GAAP financial measure.

R1 Investment Highlights

Leading, technology-driven revenue cycle platform with a compelling financial model

Note: Adjusted EBITDA is a non-GAAP measure, please refer to the Appendix for a reconciliation of non-GAAP financial measures

Significant Improvements for Integrated Health Systems

NEED

VALUE ADD

RESULTS

Growing pressure to run revenue cycle more efficiently

We plug into health providers' existing IT systems

OPERATING MODEL

Proprietary	Experienced	Analytics	Global Shared	Proven
Technology	Talent	and Alerts	Services	Results

Comprehensive Revenue Cycle Capabilities for Providers

Care Settings

Solutions address the full spectrum of needs and operations

Physician

Acute

Post-Acute

Revenue Cycle Phases

Order to Intake

Care to Claim

Claim to Payment

Payment Models

Fee-for-service

Patient Self-pay

Value-based

Transforming revenue cycle performance across care settings and payment models

Leading Position to Extend Scale Advantage

Proven Ability to Deliver Scale Benefits Further Differentiates R1 Value Proposition

Financial Outlook

2021	Medium-Term2 Objectives
Revenue1	1,410 - 1,460	Annual growth in end-to-end NPR under management: 10-12%
Operating Income	135 - 155	Annual adjusted EBITDA Growth: 12-15%
Adjusted EBITDA	315 - 330	Adjusted EBITDA Margin: ~25%

$M

Note1: 2021 guidance assumes patient volumes at 90-95% pre-COVID levels Note2: Medium-term is defined as 3-5 years post-2021

Expect to add $4B in new end-to-end NPR under management in 2021

Note: Adjusted EBITDA is a non-GAAP measure, please refer to the Appendix for a reconciliation of non-GAAP financial measures

Technology Drives Long-Term Operational Model

Costs as % of R1 revenue

2020E

Future

Technology costs

Labor and related costs

SG&A costs

Adjusted EBITDA margin

Digitization Expected to Drive Significant Margin Expansion

R1 Investment Highlights

Market Dynamics Play to Our Strengths

Best value proposition

•  Transformed patient experience

•  Revenue improvement

•  Cost reduction

•  Faster collections

Large, Growing and Underpenetrated RCM Market

$110B Market1

External Spend Growing >2x Market2

R1 Growing Faster

Acute-Care $70B

Physician $40B

Total TAM $110B

Internal 5%

External Spend

12%

Annual spend CAGR projected through 2027

R1 Revenue CAGR

(2018-2021E)

Market dynamics support strong incremental growth

Note1: CMS NHE Projections and R1 estimates

Note2: Research and Markets Global Forecast to 2027, published March 2020

R1 Investment Highlights

Extensive Capabilities Across the Revenue Cycle

VISIBILITY + ACTIONABLE INTELLIGENCE + PERFORMANCE MANAGEMENT

DEPLOYMENT + CENTRALIZED OPERATIONS + TALENT + GLOBAL NETWORK

NORMALIZING TECHNOLOGY + AUTOMATION SOLUTIONS + SECURITY

PROVEN METHODS + STANDARDIZATION + OPERATING RHYTHM + COMPLIANCE

Broadest Portfolio of Technology Tools

Patient Access & IntakeYield & Denial Mitigation

Order Management

Scheduling

Financial Clearance

Price Estimation

Digital Check-In

Financial Counseling

Scoring and Personalization

Integrated Bill Pay

Documentation Management

Simple and Complex Coding

Revenue Capture and Integrity

Claim Status Triage

Denial Detection and Triage

Clinical and Technical Appeals

Yield-Based Follow-Up

Analytics

Actionable Performance MonitoringPredictive Analytics

Automation

Robotic Process Automation

(RPA)

Digital Self-Service

Omni-Channel Communications

Natural Language Processing

Cognitive Automation

Web Service Integration

R1 Proprietary Technology

PATIENT EXPERIENCELINK

ACCESS

CONTACTINSIGHTPASCHART MGRDECISIONPOSTANALYTICS

PROVIDER AWARENESSAUTOMATE

Patient Experience Solution: Facilitating a Great Experience

Reliable availability

1. Find

Consumer friendly scheduler presents only real, clinically appropriate appointments onlineComprehensive pre-check instills patient confidence, limits surprises and improves performance

3. Arrive

Smooth check-in improves satisfaction and returns patient and provider focus to high-quality care

• - No waiting on hold

  • - Rules engine = accuracy

    • - White glove or fully digital

• - No confusing paper orders

  • - Price transparency

    • - Smooth payment

• - Confirm time instantly

  • - Automated onboarding forms

    • - Satisfying experience

• - Full digital self-service

• - Automated underlying RCM

• - Encourages return visit

R1, SCI, and Tonic combined to create the most comprehensive patient and provider-centric platform for care coordination

Most Advanced Patient Experience Solution on Market

Platform Components

Key R1 Intellectual Property

Capabilities Enabled

R1addressessignificant gapsinthemarket

User Interface	▪ Tonic for Health, DPX ▪ R1 Unity (SCI) Provider Portal	▪ Self-service search & schedule ▪ Self-service intake
Data Management	▪ Top 3 EHR API partnerships ▪ R1 proprietary APIs	▪ Data travels w/ patient ▪ Plug & Play ▪ Enterprise configurability
Rules Engines & Work Drivers	▪ R1 Access financial clearance ▪ R1 Insight price calculation ▪ R1 Unity (SCI) orders & booking rules	▪ Comprehensive Demographics ▪ Full Price Transparancy ▪ Eligiblity & Authorization Rules ▪ Financial Clearance & Payment
Analytics & Operating System	▪ R1 PX operating playbook ▪ Dedicated deployment & standardization team	▪ Digital adoption ▪ Process fool-proofing ▪ Operational enablement

R1 uniquely positioned to bring critical pieces together, delivering comprehensive platform for patients and

providers

Unique IP advantage in key process areas drives step-change digital adoption

Leading Automation of the Revenue Cycle

Transformative Technology for R1; Built-for-Purpose Ecosystem

• ▪ Platform of expert rules, machine learning, OCR/NLP, RPA, and workflow orchestration expands automation opportunities

• ▪ Strategic business partnerships with leading RPA platforms enables efficient scaling and hardens security

• 3 Applications Architecturally Built for Scale Support R1's Strategic Growth Plan

• ▪ Differentiated capability automating 30M+ tasks and the work of 1,200+ FTEs annually

• ▪ $20M+ annual EBITDA contribution from current production routines demonstrates value

• ▪ Able to rapidly scale across R1's captive operational footprint

R1's automation ecosystem expands beyond RPA to transform end-to-end RCM operations

R1 Investment Highlights

Multiple Growth and Profit Drivers

1. Onboard and Optimize Contracted End-to-End Business

2019

2020

2021

2022

Penn State Health, LifePoint Health ($5B NPR)

Quorum Health, Physician Group1, and RUSH ($4B NPR)

AMITA and Ascension Medical Group ($6B NPR)

Intermountain Health ($6B NPR)

Ascension Phase-2 and Wisconsin ($5B NPR)

Ascension Pre-2016 and Phase-1 ($9B NPR)

Note1: $700M NPR End-to-End Operating Partner Physician Group signed in Q3 2019

2. Drive Digitization and Automation

3 Proven Levers…

…Driving Significant EBITDA…

…with Runway to Expand

Transformation Measures

2020E

2022E

125MAssessed

~500M Manual Tasks

30M in Production

3. New Commercial Wins

2021 Commercial Focus Areas

Continued Sales Execution to Convert End-to-End Pipeline

Sizeable Cross-Sell Opportunity

NPR Cross-Sell Opportunity into Non-E2E Base:

PAS Installed Base $92B

Aggressive Market Launch of PX Offering following 2020 Commercial Wins

Cross Sell into Installed Base via expanded commercial leadership roles

SCI Installed Base $88B

Cerner Partnership $77B

$28B

Expect 10-12% Growth in End-to-End NPR Under Management Over the Next 3-5 Years

4. Committed to Capital Deployment via Targeted M&A

Proven M&A Track Record

and

Strong Balance Sheet	Scaled Platform for
Position	Synergy Realization
Net Debt1: $380M
Operational Control
of $40B in NPR
2021 Adj. EBITDA: $315-330M	Creates Opportunity
Jan 2020
for Outsized
Net Leverage1: <2x	Synergies
June 2020

Feb 2018

Targeted M&A is a Core Component of R1's Growth Strategy

Note1: Data as of 12/31/20. Net debt is defined as gross debt less cash and cash equivalents. Net leverage is defined as Net debt divided by annual adjusted EBITDA.

R1 Investment Highlights

Track Record of High Recurring Revenue and Margin Expansion

Revenue ($M)

Adj. EBITDA ($M)

EBITDA Margin1

2018

2019

2021E

2018

2019

2021E

2018

2019

2021E

Note1: Based on midpoints of 2021 revenue and adjusted EBITDA guidance

Financial Outlook

2021	Medium-Term2 Objectives
Revenue1	1,410 - 1,460	Annual growth in end-to-end NPR under management: 10-12%
Operating Income	135 - 155	Annual adjusted EBITDA Growth: 12-15%
Adjusted EBITDA	315 - 330	Adjusted EBITDA Margin: ~25%

$M

Note1: 2021 assumes patient volumes at 90-95% pre-COVID levels Note2: Medium-term is defined as 3-5 years post-2021

Expect to add $4B in new end-to-end NPR under management in 2021

Note: Adjusted EBITDA is a non-GAAP measure, please refer to the Appendix for a reconciliation of non-GAAP financial measures

Appendix

Contract Economics by Engagement Model

Illustrative Revenue and EBITDA Contribution Based on Typical $3B NPR

Revenue contribution

EBITDA contribution (pre-SG&A)

Financial Model for Operating Partner Model

Illustrative Contribution from $3B NPR Customer

Launch

0-12 Months

Growth

12-36 Months

Steady State

36+ Months

• • Deploy transition resources

• • Perform financial assessment

• • Invest in infrastructure

• • Implement technology

• • Finalize employee transitions

• • Transfers to Shared Services

• • Complete standardization

• • Steady state org structure

• • Continuous optimization:

  • - KPI metric improvement

  • - Technology advancement

  • - Productivity improvement

Financial Impact - $MMid-Point of Range

Revenue	75
Adj. EBITDA contribution	(12)
Adj. EBITDA contribution %	(16%)

Financial Impact - $MMid-Point of Range

Revenue	120
Adj. EBITDA contribution	20
Adj. EBITDA contribution %	17%

Financial Impact - $MMid-Point of Range

Revenue	135
Adj. EBITDA contribution	40
Adj. EBITDA contribution %	30%

Financial Model for Co-Managed Partner Model

Illustrative Contribution from $3B NPR Customer

Launch

0-12 Months

Growth

12-36 Months

Steady State

36+ Months

• • Deploy transition resources

• • Perform financial assessment

• • Invest in infrastructure

• • Implement technology

• • Complete standardization

• • Workflow optimization

• • Rationalize third-party vendors

• • Continuous optimization:

  • - KPI metric improvement

  • - Technology advancement

  • - Productivity improvement

Financial Impact - $MMid-Point of Range

Revenue	10
Adj. EBITDA contribution	(2)
Adj. EBITDA contribution %	(20%)

Financial Impact - $MMid-Point of Range

Revenue	25
Adj. EBITDA contribution	7
Adj. EBITDA contribution %	28%

Financial Impact - $MMid-Point of Range

Revenue	40
Adj. EBITDA contribution	18
Adj. EBITDA contribution %	45%

Use of Non-GAAP Financial Measures

• ▪ In order to provide a more comprehensive understanding of the information used by R1's management team in financial and operational decision making, the Company supplements its GAAP consolidated financial statements with certain non-GAAP financial performance measures, including adjusted EBITDA. Adjusted EBITDA is defined as GAAP net income before net interest income/expense, income tax provision/benefit, depreciation and amortization expense, share-based compensation expense, expense arising from debt extinguishment, strategic initiatives costs, transitioned employee restructuring expense, and certain other items.

• ▪ Our board of directors and management team use adjusted EBITDA as (i) one of the primary methods for planning and forecasting overall expectations and for evaluating actual results against such expectations and (ii) a performance evaluation metric in determining achievement of certain executive incentive compensation programs, as well as for incentive compensation programs for employees.

• ▪ A reconciliation of GAAP net income to Adjusted EBITDA and GAAP operating income guidance to non-GAAP adjusted EBITDA guidance is provided below. Adjusted EBITDA should be considered in addition to, but not as a substitute for, the information presented in accordance with GAAP.

Reconciliation of GAAP Net Income to Adjusted EBITDA

$ in millions

Year Ended 12/31/2020

Net Income 117.1

Net interest expense 17.3

Income tax provision (benefit) 1.3

D&A expense 68.7

Share-based compensation expense 24.0

Gain on business disposition (55.7)

Other 67.3

Adjusted EBITDA

$240.0

Reconciliation of GAAP Operating Income Guidance to Non-GAAP Adjusted EBITDA Guidance

$ in millions

2021

GAAP Operating Income Guidance $135-155 Plus:

Depreciation and amortization expense $70-80

Share-based compensation expense $55-60

Strategic initiatives, severance and other costs $50-55

Adjusted EBITDA Guidance

$315-330