MANAGEMENT S DISCUSSION AND ANALYSIS

Transcription

1 450 Brookline Avenue, Boston, MA TDD This document is dated as of June 11, 2018 SPECIAL NOTE CONCERNING FORWARD-LOOKING STATEMENTS. Certain of the discussions included in the following document may include certain forward-looking statements which involve known and unknown risks and uncertainties inherent in the operation of healthcare facilities. Actual actions or results may differ materially from those discussed below. Specific factors that might cause such differences include competition from other healthcare facilities in the service area of Dana-Farber Cancer Institute, federal and state regulations of healthcare providers, and reimbursement policies of the state and federal governments and managed care organizations. In particular, statements preceded by, followed by or that include the words believes, estimates, expects, anticipates, plans, intends, scheduled or other similar expressions are or may constitute forward-looking statements. MANAGEMENT S DISCUSSION AND ANALYSIS DANA-FARBER CANCER INSTITUTE, INC. AND SUBSIDIARIES* Second Quarter Ended March 31, 2018 Laurie H. Glimcher M.D., President and Chief Executive Officer Dorothy E. Puhy, Executive Vice President and Chief Operating Officer Michael L. Reney, Senior Vice President and Chief Financial Officer *Dana-Farber Cancer Institute, Inc. is the parent corporation of Dana-Farber, Inc., Dana- Farber Trust, Inc. and Dana-Farber Cancer Care Network, Inc. Results for the quarter ended March 31, 2018 are presented on a condensed, consolidated basis. The Obligated Group is Dana-Farber Cancer Institute, Inc. and Dana-Farber, Inc. A Teaching Affiliate of Harvard Medical School

2 Dana-Farber Cancer Institute, Inc. and Subsidiaries Management s Discussion and Analysis of Financial Condition and Operating Results Second Quarter Ended March 31, 2018 For the first six months of fiscal year ( FY ) 2018, Dana-Farber Cancer Institute, Inc. (DFCI) recorded an excess of revenues over expenses of $70.7 million, compared to $45.3 million for the first six months of FY Income from operations was $25.0 million, compared to $9.4 million for the first six months of FY Total operating revenue for the first six months of FY 2018 was $849.1 million, an increase of $86.5 million, or 11.3%, over the same period in FY Patient care revenue grew by $71.4 million, or 14.7% over the same period in FY Management attributes this increase largely to growth in patient volume as well as pharmacy revenue. Research revenues have increased by $7.2 million, or 3.4%, over the same period in FY Management attributes this to increases in funding from federal grants, clinical trials and affiliate billings. Unrestricted gifts increased by $3.1 million, or 6.0% over the same period in FY Management attributes this increase to growth in proceeds from the Pan Mass Challenge and various events. Operating expenses increased to $824.1 million, an increase of $70.8 million, or 9.4% over the same period in FY General, administrative and plant expenses increased by $13.6 million, or 8.2%. Management attributes this increase to consulting, legal and new rent obligations. Depreciation expense decreased by $0.9 million, or 1.9% and interest expense decreased by $2.2 million, or 18.4% compared to the prior fiscal year. Management attributes the decrease in depreciation and interest expense to the termination of the Longwood Research Space capital lease upon the purchase of the Longwood Research Space condominium in July Investment returns for the first six months of FY 2018 were $19.2 million compared to $20.8 million through the first six months of FY Investment returns include investment income and realized and unrealized gains or losses. DFCI s interest rate swap agreements increased in value by $6.1 million as compared to an increase of $17.7 million over the same period in FY DFCI s total assets decreased $16.5 million, or 0.6%, to $2.7 billion compared to the second quarter in FY Management attributes this decrease primarily due to the net impact of the termination of the Longwood Research Space capital lease upon the purchase of the Longwood Research Space condominium in July 2017 offset by growth in cash and investments and restricted fund raising. Compared with the second quarter of FY 2017, unrestricted net assets increased $62.6 million, or 8.8%, to $776.2 million. Temporarily restricted net assets increased $100.0 million, or 17.7%, to $664.3 million. 2

3 Management attributes this increase primarily to strong fund-raising activities throughout this past year. Permanently restricted net assets increased $8.5 million, or 4.4%, to $200.4 million. Cash and investments increased by $163.9 million, or 13.1%, compared to the second quarter in FY For the six-month period ended March 31, 2018, the endowment s investments experienced a return of 4.4%. Days cash on hand increased by 4 days to 232 days compared to the second quarter of FY Management attributes this increase to strong operating performance, positive investment returns and cash proceeds from DFCI s portion of the proceeds from the assignment by BCD of its agreement to acquire the MATEP power plant. Net patient accounts receivable decreased to $101.2 million from $123.4 million compared to the second quarter of FY 2017 due primarily to strong cash receipts during the quarter as well as the write-off of certain prior year patient accounts resulting from the 2015 implementation of a new electronic medical record and revenue cycle system. Days in accounts receivable decreased to 33 days as compared to 44 days in the second quarter of FY Assets whose use is limited decreased by $227.1 million compared to the second quarter of FY 2017 as a result of the purchase the Longwood Research Space condominium in July Prepaid expenses and other current assets increased by $12.7 million from the second quarter of FY 2017 as a result of an increase in prepayments related to pharmacy inventories. Contributions receivable increased by $6.9 million compared to the second quarter of FY 2017 as a result of new pledges. Amounts due to third-party payors decreased compared to the second quarter of FY 2017 as a result of settlements with certain payors as well as changes in estimates. Research advances have increased to $105.3 million from $73.7 million in the second quarter of FY 2017 due to growth in clinical trials and a change in accounting treatment for Royalty payments. These Royalty payments were recorded within Temporarily Restricted Net Assets and are now recorded in Research Advances prior to being expensed. Long-term debt decreased by $170.9 million compared to the second quarter of FY 2017 as a result of the termination of the Longwood Research Space capital lease. Other Developments: Effective March 30, 2018, BCD Hospital Energy Collaborative, LLC, assigned its purchase and sale agreement for the acquisition of the MATEP power 3

4 plant to Longwood Energy Partners, LLC. DFCI s portion of the proceeds ($22.5 million) was recorded as non-operating income. 4

5 Consolidated Balance Sheets March 31 September 30 (Dollars in thousands) ASSETS Current Assets Cash and cash equivalents $ 173,354 $ 145,143 $ 125,379 $ 136,127 Patient accounts receivable, net 101, ,398 99, ,877 Contributions receivable, current portion 5,333 6,851 14,969 16,325 Assets whose use is limited, current portion 5, ,319 9, ,318 Research receivables 35,025 31,015 34,712 22,144 Prepaid expenses and other current assets 74,924 62,217 61,324 54,530 Total Current Assets 394, , , ,321 Investments 1,237,675 1,101,953 1,174,119 1,034,466 Assets whose use is limited by indenture - agreement or other, less current portion 12,789 12,801 12,762 12,703 Property, plant and equipment, net 946, , , ,299 Contributions receivable, less current portion 39,184 30,795 29,504 28,824 Other assets 49,297 48,159 48,997 48,262 TOTAL ASSETS $ 2,680,763 $ 2,697,260 $ 2,576,386 $ 2,635,875 LIABILITIES AND NET ASSETS Current Liabilities Accounts payable and accrued expenses 123,579 $ 151,879 $ 142,827 $ 144,608 Amounts due to third party payors 33,558 39,340 42,716 43,044 Research advances 105,304 73,733 95,979 62,045 Current portion of long-term debt 4,915 12,094 5,422 14,722 Total Current Liabilities 267, , , ,419 Other Liabilities Long-term debt, less current portion 603, , , ,064 Other Liabilities 168, , , , , , , ,883 Net Assets Unrestricted 776, , , ,285 Temporarily restricted 664, , , ,317 Permanently restricted 200, , , ,971 Total Net Assets 1,640,893 1,469,901 1,508,635 1,393,573 TOTAL LIABILITIES AND NET ASSETS $ 2,680,763 $ 2,697,260 $ 2,576,386 $ 2,635,875 5

6 Consolidated Statement of Operations and Changes in Net Assets Quarter Ended Six Months Ended Year Ended March 31 March 31 September 30 (Dollars in thousands) Operating revenues: Patient service revenue, net of contractual $ 281,657 $ 253,773 $ 562,062 $ 491,382 $ 995,241 $ 938,141 allowances and discounts Provision for bad debts 812 4,249 4,777 5,493 4,432 12,813 Net Patient service revenues, less provision for bad debts 280, , , , , ,328 Research revenues 112, , , , , ,793 Unrestricted contributions and bequests 7,089 7,172 54,734 51,613 75,227 73,276 Other operating revenues 11,784 7,006 17,546 12,823 24,671 21,130 Total operating revenues 412, , , ,658 1,524,935 1,406,527 Operating expenses: Direct research 99,334 98, , , , ,901 Direct patient care 198, , , , , ,564 General, administrative and plant 93,299 86, , , , ,624 Depreciation and amortization 24,418 26,379 48,834 49,759 97,303 88,060 Interest 4,956 5,893 9,732 11,928 22,894 15,656 Total operating expenses 420, , , ,303 1,561,769 1,376,805 Operating income (loss) (8,784) (13,081) 25,035 9,355 (36,834) 29,722 Investment gains, net 5,678 16,436 19,249 20,788 46,916 26,280 Interest rate swap agreement: Net interest paid (1,023) (1,234) (2,129) (2,527) (4,830) (5,354) Change in fair value 6, ,091 17,719 15,997 (13,836) Assignment fee 22,489 22, EXCESS OF REVENUES OVER EXPENSES 24,620 2,412 70,735 45,335 21,249 36,812 Other Changes in Net Assets: Net unrealized gains (losses) on endowment (2) - (2) Net assets released from restriction for capital ,519 20,948 Pension adjustment ,757 (2,380) Other (400) - 2, Increase in unrestricted net assets 24,218 2,412 73,372 45,335 34,525 55,553 Increase in temporarily restricted net assets 14,822 4,287 51,459 24,026 72,522 23,410 Increase in permanently restricted net assets 1,583 1,631 7,427 6,967 8,015 10,151 Increase in Net Assets 40,623 8, ,258 76, ,062 89,114 Net Assets at Beginning of Period 1,600,270 1,461,571 1,508,635 1,393,573 1,393,573 1,304,459 NET ASSETS AT END OF PERIOD $ 1,640,893 $ 1,469,901 $ 1,640,893 $ 1,469,901 $ 1,508,635 $ 1,393,573 6

7 DANA-FARBER CANCER INSTITUTE, INC. Asset Allocation Summary March 31 September 30 (Dollars in Thousands) U.S. Government Money Market Fund $ 7,063 $ 2,607 $ 1,630 $ 3,864 U.S. Government Securities 92,747 81,297 81,689 70,172 U.S. Equity Securities 78,339 77,272 94,769 63,704 U.S. Equity Mutual Funds 144, , , ,556 International Equity Securities 45,481 61,770 81,508 52,303 International Equity Mutual Funds 273, , , ,929 Alternative Investments* 595, , , ,938 Total $ 1,237,675 $ 1,101,953 $ 1,174,119 $ 1,034,466 * Alternative investments include investments in private equity funds, partnerships, limited liability companies and other funds, which generally have reduced liquidity. Investment Performance Summary March 31 September Dana-Farber Portfolio 4.4% 5.7% 12.6% 8.4% Investment Committee Custom Benchmark* 4.0% 4.6% 11.4% 6.3% S&P % 10.1% 18.6% 15.4% * The custom benchmark is a weighted index return developed for the Institute at the request of the Investment Committee assuming Committee-determined target percentages in the different asset classes (e.g., U.S. equity, non-u.s. equity, fixed income, etc.) and the index return used for each asset class is a broad market benchmark selected by the Committee, (e.g. S&P 500 for U.S. Equities). The exact composition of the custom benchmark shifts over time as the Committee revises the target allocation percentages and selects different benchmarks for each asset class. It was adjusted in January 2015 and January

8 DANA-FARBER CANCER INSTITUTE, INC. Capitalization for the Obligated Group March 31 September 30 (Dollars in Thousands) Long-Term Debt Series K Bonds $ 75,159 $ 79,286 $ 79,198 $ 83,145 Series L Bonds 184, , , ,000 Series M Bonds 50,293 50,240 50,266 50,213 Series N Bonds 276, , , ,805 South Shore lease obligation 14,970 19,226 15,393 19,819 Milford lease obligation 7,845 8,194 7,921 8,461 Longwood Center lease obligation* - 167, ,343 Total Long-Term Debt 608, , , ,786 Unrestricted Net Assets 802, , , ,684 Total Capitalization $ 1,411,275 $ 1,518,419 $ 1,340,003 $ 1,479,470 Total Long-Term Debt as a Percent of Total Capitalization 43.1% 51.8% 45.8% 53.9% *The decrease in the Long-Term Debt as a Percent of Total Capitalization is the result of the termination of the Longwood Research Space capital lease upon the purchase of the Longwood Research Space condominium in July

9 DANA-FARBER CANCER INSTITUTE, INC. Days Cash on Hand for the Obligated Group March 31 September 30 (Dollars in Thousands) Total Unrestricted Cash Position 1 $ 960,351 $ 857,053 $ 879,509 $ 769,103 Average Daily Expenses 2 4,145 3,752 3,897 3,403 Days Cash On-Hand Unrestricted cash equivalents and marketable securities plus an amount equal to 200% of the donor restricted research funds that have been released from restriction and used for operating expenses during the relevant calculation period, plus temporarily restricted cash and marketable securities that are available for current use but excluding certain items permitted to be excluded under the Master Trust Indenture. 2 Total operating expenses less extraordinary items, infrequently occurring items or unusual items and the cumulative effect of changes in accounting principles, depreciation and amortization and other non-cash charges divided by the number of days in the period. Four Quarters Ended Year Ended Actual and Maximum Debt Service for the Obligated Group March 31 September 30 (Dollars in Thousands) Income Available for Debt Service 146, , , ,735 Actual Historical Annual Debt Service 32,534 42,265 39,515 30,844 Actual Historical Debt Service Coverage Ratio Income Available for Debt Service 146, , , ,735 Pro Forma Maximum Annual Debt Service 1 36,464 51,640 35,711 51,372 Pro Forma Maximum Debt Service Coverage Ratio The increase in both the historical and maximum annual debt service is the result of the Series N bond financing as well as the conversion of the Longwood Research Space lease to a capital lease. 1 Maximum Annual Debt Service represents the highest total debt service on all long-term indebtedness which is projected to occur in the fiscal year ending 9/30/2027. The debt service requirement for $150,000 of long-term indebtedness which is covered by interest rate swap agreements is calculated in accordance with the terms of Master Trust Indenture. The Assumed Rate used to calculate debt service for the Series L variable rate bonds is 1.62% and 1.28% for September 30, 2017 and 2016 and 1.93% and 1.40% for March 31, 2018 and 2017, respectively. The Assumed Rate used to calculate debt service for the variable rate capital lease which expires in 2030 is 3.49% and 3.040% for September 30, 2017 and 2016 and 4.48% and 2.70% for March 31, 2018 and 2017, respectively. 9

10 DANA-FARBER CANCER INSTITUTE, INC. Operational Statistics for the Obligated Group Quarter Ended Six Months Ended Year Ended March 31 March 31 September OUTPATIENT STATISTICS MD Clinic visits (1) 83,655 79, , , , ,900 Infusion visits (1) 42,575 40,874 84,937 82, , ,112 ANCILLARY STATISTICS (units of service) Laboratories 311, , , ,961 1,246,171 1,134,298 Blood Bank 16,502 16,955 33,888 33,746 67,889 64,431 Pharmacy (1)(2) 113,507,587 90,167, ,707, ,435, ,567, ,933,689 PET Scans 1, ,519 1,980 3,871 4,347 Diagnostic Radiology 4,544 4,227 9,385 8,796 18,412 12,110 Ultrasound ,406 1,164 Nuclear Medicine ,302 1,348 2,725 2,300 MRI 2,050 1,826 3,472 3,856 7,813 8,211 CT Scans 7,865 7,017 15,657 14,776 30,245 30,399 Radiation Therapy 9,389 9,583 19,917 19,220 38,358 42,160 Respiratory Therapy/EKG 6,251 5,268 11,344 10,294 21,263 23,357 (Treatments) INPATIENT STATISTICS Licensed Beds Total Admissions ,044 1,280 ALOS Total Patient Days 2,558 2,633 5,151 4,946 10,288 10,059 Occupancy Rate 94.7% 97.5% 94.3% 90.6% 93.7% 91.6% Source: Institute Records 1 Includes results of DFCCN 2 Cost of drugs administered 10

11 DANA-FARBER CANCER INSTITUTE, INC. Operational Statistics for the Obligated Group Quarter Ended March 31 Inpatient Outpatient Percentage Gross Revenues Medicare 44% 29% 42% 38% Medicaid 11% 7% 7% 7% Other 28% 40% 28% 30% Blue Cross 16% 21% 22% 23% Self-Pay 1% 3% 1% 2% Total 100% 100% 100% 100% Six Months Ended March 31 Inpatient Outpatient Percentage Gross Revenues Medicare 37% 26% 42% 39% Medicaid 14% 10% 7% 7% Other 28% 39% 28% 30% Blue Cross 20% 23% 22% 23% Self-Pay 1% 2% 1% 1% Total 100% 100% 100% 100% Year Ended September 30 Inpatient Outpatient Percentage Gross Revenues Medicare 31% 30% 40% 37% Medicaid 9% 11% 7% 8% Other 36% 32% 28% 30% Blue Cross 23% 26% 23% 23% Self-Pay 1% 1% 2% 2% Total 100% 100% 100% 100% 11

12 Fund-Raising Contributions Quarter Ended Six Months Ended Year Ended (Dollars in thousands) March 31 March 31 September Fundraising Contributions Unrestricted contributions and bequests $ 7,089 $ 7,172 $ 54,734 $ 51,613 $ 75,227 $ 73,276 Gifts for current use $ (95) 703 4,953 4,947 8,098 7,711 Temporarily restricted $ 36,168 16,610 76,361 49, ,832 83,365 Permanently restricted 1,583 1,631 7,427 7,067 9,815 10,151 Subtotal 44,745 26, , , , ,503 Non-government Grants $ 8,557 7,664 17,550 15,497 46,391 39,132 Total Fundraising Contributions $ 53,302 $ 33,780 $ 161,025 $ 129,067 $ 256,363 $ 213,635 Direct Fundraising Expenses $ 7,230 $ 7,805 $ 13,875 $ 14,358 $ 30,168 $ 28,459 Direct Fundraising Expenses as Percent of 14% 23% 9% 11% 12% 13% Total Fundraising Contributions Notes Unrestricted contributions and restricted contributions, used on a current basis, are recorded as operating revenues. Other restricted contributions are recorded as additions to temporarily restricted or permanently restricted assets. Contributions include those received and pledged. Contributions pledged are reported at net present value. 12

13 Supplementary Information See Annual Report filings for comparative annual consolidating financial statements contained in the Supplementary Information section of Audited Financial Statements. 13

14 Consolidating Balance Sheet March 31, 2018 (Dollars in thousands) ASSETS Obligated Group Dana-Farber Cancer Care Network, Inc. Eliminations and Reclassifications Consolidated Current Assets Cash and cash equivalents $ 173,023 $ 331 $ 173,354 Patient accounts receivable, net 98,841 2, ,149 Contributions receivable, less current portion 5,333 5,333 Assets whose use is limited, current portion 5,196 5,196 Research receivables 35,025 35,025 Prepaid expenses and other current assets 103,853 1,428 $ (30,357) 74,924 Total Current Assets 421,271 4,067 (30,357) 394,981 Investments 1,237,675 1,237,675 Assets whose use is limited by indenture agreement or other, less current portion 12,789 12,789 Property, plant and equipment, net 945,670 1, ,837 Contributions receivable, less current portion 39,184 39,184 Other assets 49,297 49,297 TOTAL ASSETS $ 2,705,886 $ 5,234 $ (30,357) $ 2,680,763 LIABILITIES AND NET ASSETS Current Liabilities Accounts payable and accrued expenses $ 122,652 $ 31,284 $ (30,357) $ 123,579 Amounts due to third party payors 33,558 33,558 Research advances 105, ,304 Current portion of long-term debt 4,915 4,915 Total Current Liabilities 266,429 31,284 (30,357) 267,356 Other Liabilities Long-term debt, less current portion 603, ,993 Other Liabilities 168, , , ,514 Net Assets Unrestricted 802,367 (26,184) 776,183 Temporarily restricted 664, ,298 Permanently restricted 200, ,412 Total Net Assets 1,666,943 (26,050) - 1,640,893 TOTAL LIABILITIES AND NET ASSETS $ 2,705,886 $ 5,234 $ (30,357) $ 2,680,763 14

15 Consolidating Statement of Operations and Changes in Net Assets Six Months Ended March 31, 2018 (Dollars in thousands) Obligated Group Dana-Farber Cancer Care Network, Inc. Eliminations and Reclassifications Consolidated Operating revenues: Patient service revenues, net of contractual $ 544,019 $ 18,043 $ 562,062 allowances and discounts Provision for bad debts 4,777 4,777 Net patient service revenue, less provision for bad debts 539,242 18, ,285 Research revenues 219, ,574 Unrestricted contributions and bequests 54,734 54,734 Other operating revenues 17,546 17,546 Total operating revenues 831,081 18, ,139 Operating expenses: Direct research 192, ,327 Direct patient care 372,403 20, ,699 General, administrative and plant 179, ,512 Depreciation and amortization 48, ,834 Interest 9,732 9,732 Total operating expenses 802,902 21, ,104 Operating income 28,179 (3,144) - 25,035 Investment gains, net 19,249 19,249 Interest rate swap agreement: Net interest paid (2,129) (2,129) Change in fair value 6,091 6,091 Assignment fee 22,489 22,489 EXCESS OF REVENUES OVER EXPENSES 73,879 (3,144) - 70,735 Other Changes in Net Assets: Net unrealized loss on endowment (2) (2) Net assets released from restriction for capital - - Pension adjustment - Other 2,639 2,639 Increase in unrestricted net assets 76,516 (3,144) - 73,372 Increase in temporarily restricted net assets 51,470 (11) 51,459 Increase in permanently restricted net assets 7,427 7,427 Increase in Net Assets 135,413 (3,155) - 132,258 Net Assets at Beginning of Period 1,531,530 (22,895) 1,508,635 NET ASSETS AT END OF PERIOD $ 1,666,943 $ (26,050) - $ 1,640,893 15

16 Consolidating Statement of Operations and Changes in Net Assets Quarter Ended March 31, 2018 (Dollars in thousands) Obligated Group Dana-Farber Cancer Care Network, Inc. Eliminations and Reclassifications Consolidated Operating revenues: Patient service revenues, net of contractual $ 272,655 $ 9,002 $ 281,657 allowances and discounts Provision for bad debts Net patient service revenue, less provision for bad debts 271,843 9, ,845 Research revenues 112, ,462 Unrestricted contributions and bequests 7,089-7,089 Other operating revenues 11,784-11,784 Total operating revenues 403,169 9, ,180 Operating expenses: Direct research 99, ,334 Direct patient care 188,882 10, ,957 General, administrative and plant 92, ,299 Depreciation and amortization 24, ,418 Interest 4,956-4,956 Total operating expenses 410,457 10, ,964 Operating income (7,288) (1,496) - (8,784) Investment gains, net 5,678-5,678 Interest rate swap agreement: Net interest paid (1,023) - (1,023) Change in fair value 6,260-6,260 Transfer fee 22,489-22,489 EXCESS OF REVENUES OVER EXPENSES 26,116 (1,496) - 24,620 Other Changes in Net Assets: Net unrealized loss on endowment (2) - (2) Change in fair value of interest swaps Net assets released from restriction for capital Pension adjustment Other (400) - (400) Increase in unrestricted net assets 25,714 (1,496) - 24,618 Increase in temporarily restricted net assets 14,830 (8) 14,822 Increase in permanently restricted net assets 1,583-1,583 Increase in Net Assets 41,727 (1,504) - 40,623 Net Assets at Beginning of Period 1,624,816 (24,546) 1,600,270 NET ASSETS AT END OF PERIOD $ 1,666,543 $ (26,050) $ - $ 1,640,893 16

17 Consolidating Balance Sheets March 31, 2017 (Dollars in thousands) ASSETS Obligated Group Dana-Farber Cancer Care Network, Inc. Eliminations and Reclassifications Consolidated Current Assets Cash and cash equivalents $ 144,996 $ 147 $ 145,143 Patient accounts receivable, net 120,700 2, ,398 Contributions receivable, current portion 6,851 6,851 Assets whose use is limited, current portion 232, ,319 Research receivables 31,015 31,015 Prepaid expenses and other current assets 84, $ (22,847) 62,217 Total Current Assets 620,084 3,706 (22,847) 600,943 Investments 1,101,953 1,101,953 Assets whose use is limited by indenture agreement or other, less current portion 12,801 12,801 Property, plant and equipment, net 900,919 1, ,609 Contributions receivable, less current portion 30,795 30,795 Other assets 48,159 48,159 TOTAL ASSETS $ 2,714,711 $ 5,396 $ (22,847) $ 2,697,260 LIABILITIES AND NET ASSETS Current Liabilities Accounts payable and accrued expenses $ 151,635 $ 23,091 $ (22,847) $ 151,879 Amounts due to third party payors 39,340 39,340 Research advances 73,733 73,733 Current portion of long-term debt 12,094 12,094 Total Current Liabilities 276,802 23,091 (22,847) 277,046 Other Liabilities Long-term debt, less current portion 774, ,861 Other Liabilities 175, , , ,313 Net Assets Unrestricted 731,464 (17,847) 713,617 Temporarily restricted 564, ,346 Permanently restricted 191, ,938 Total Net Assets 1,487,596 (17,695) - 1,469,901 TOTAL LIABILITIES AND NET ASSETS $ 2,714,711 $ 5,396 $ (22,847) $ 2,697,260 17

18 Consolidating Statement of Operations and Changes in Net Assets Six Months Ended March 31, 2017 (Dollars in thousands) Obligated Group Dana-Farber Cancer Care Network, Inc. Eliminations and Reclassifications Consolidated Operating revenues: Patient service revenues, net of contractual $ 473,821 $ 17,561 $ 491,382 allowances and discounts Provision for bad debts 5,493 5,493 Net patient service revenue, less provision for bad debts 468,328 17, ,889 Research revenues 212, ,333 Unrestricted contributions and bequests 51,613 51,613 Other operating revenues 12,823 12,823 Total operating revenues 745,092 17, ,658 Operating expenses: Direct research 186, ,723 Direct patient care 318,708 19, ,028 General, administrative and plant 165,436 1, ,865 Depreciation and amortization 49, ,759 Interest 11,928 11,928 Total operating expenses 732,293 21, ,303 Operating income 12,799 (3,444) - 9,355 Investment gains, net 20,788 20,788 Interest rate swap agreement: Net interest paid (2,527) (2,527) Change in fair value 17,719 17,719 Other EXCESS OF REVENUES OVER EXPENSES 48,779 (3,444) - 45,335 Other Changes in Net Assets: Net unrealized gain/(loss) on endowment - - Net assets released from restriction for capital - - Pension adjustment - Other - Increase in unrestricted net assets 48,779 (3,444) - 45,335 Increase in temporarily restricted net assets 24, ,026 Increase in permanently restricted net assets 6,967 6,967 Increase in Net Assets 79,766 (3,438) - 76,328 Net Assets at Beginning of Period 1,407,830 (14,257) 1,393,573 NET ASSETS AT END OF PERIOD $ 1,487,596 $ (17,695) - $ 1,469,901 18

19 Consolidating Statement of Operations and Changes in Net Assets Quarter Ended March 31, 2017 (Dollars in thousands) Obligated Group Dana-Farber Cancer Care Network, Inc. Eliminations and Reclassifications Consolidated Operating revenues: Patient service revenues, net of contractual $ 245,122 $ 8,651 $ 253,773 allowances and discounts Provision for bad debts 4,249-4,249 Net patient service revenue, less provision for bad debts 240,873 8, ,524 Research revenues 111, ,784 Unrestricted contributions and bequests 7,172 7,172 Other operating revenues 7,006 7,006 Total operating revenues 366,831 8, ,486 Operating expenses: Direct research 98, ,636 Direct patient care 161,840 9, ,229 General, administrative and plant 85, ,430 Depreciation and amortization 26, ,379 Interest 5,893 5,893 Total operating expenses 378,343 10, ,567 Operating loss (11,512) (1,569) - (13,081) Investment gains, net 16,436 16,436 Interest rate swap agreement: Net interest paid (1,234) (1,234) Change in fair value Other EXCESS OF REVENUES OVER EXPENSES 3,981 (1,569) - 2,412 Other Changes in Net Assets: Net unrealized gain/(loss) on endowment - - Net assets released from restriction for capital - - Pension adjustment - - Other - - Increase in unrestricted net assets 3,981 (1,569) - 2,412 Increase in temporarily restricted net assets 4,295 (8) 4,287 Increase in permanently restricted net assets 1,631 1,631 Increase in Net Assets 9,907 (1,577) - 8,330 Net Assets at Beginning of Period 1,477,689 (16,118) 1,461,571 NET ASSETS AT END OF PERIOD $ 1,487,596 $ (17,695) - $ 1,469,901 19