X0303 4 2010-05-19 0 0001472595 Accretive Health, Inc. AH 0001317191 Ascension Health 4600 EDMUNDSON ROAD ST. LOUIS MO 63134 0 0 1 0 Common Stock 2010-05-19 4 X 0 874532 4.43 A 8326385 D Common Stock 2010-05-19 4 J 0 322744 12.00 D 8003641 D Common Stock 2010-05-19 4 X 0 437268 10.25 A 8440909 D Common Stock 2010-05-19 4 J 0 373407 12.00 D 8067502 D Warrant (Right to Buy) 4.43 2010-05-19 4 X 0 874532 0.00 D Common Stock 874532 0 D Warrant (Right to Buy) 10.25 2010-05-19 4 X 0 437268 0.00 D Common Stock 437268 0 D The Reporting Person exercised this warrant on a cashless basis, simultaneous with the execution and delivery of the underwriting agreement related to the Issuer's initial public offering, based on the initial public offering price per share of $12.00, resulting in the issuance to the Reporting Person of 551,788 shares of Common Stock and cancellation of the warrant with respect to the balance of 322,744 shares of Common Stock. The Reporting Person exercised this warrant on a cashless basis, simultaneous with the execution and delivery of the underwriting agreement related to the Issuer's initial public offering, based on the initial public offering price per share of $12.00, resulting in the issuance to the Reporting Person of 63,861 shares of Common Stock and cancellation of the warrant with respect to the balance of 373,407 shares of Common Stock. The warrants to purchase 874,532 shares of Common Stock with an exercise price of $4.43 per share were immediately exercisable when issued in December 2007. The warrants expire upon the effective date of the Issuer's initial public offering. The warrants to purchase 437,268 shares of Common Stock with an exercise price of $10.25 per share were immediately exercisable when issued in March 2008. /s/ Anthony J. Speranzo 2010-05-21