HCA Healthcare (HCA) 10-Q 8 May 18 2018 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2018	Apr. 30, 2018
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q1
Trading Symbol	HCA
Entity Registrant Name	HCA Healthcare, Inc.
Entity Central Index Key	860,730
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		349,299,200

Condensed Consolidated Income S

Condensed Consolidated Income Statements shares in Thousands, $ in Millions	3 Months Ended
	Mar. 31, 2018USD ($)$ / sharesshares
Income Statement [Abstract]
Revenues	$ 11,423
Salaries and benefits	5,289
Supplies	1,915
Other operating expenses	2,110
Equity in earnings of affiliates	(9)
Depreciation and amortization	553
Interest expense	431
Gains on sales of facilities	(405)
Total expenses including equity in earnings of affiliates	9,884
Income before income taxes	1,539
Provision for income taxes	257
Net income	1,282
Net income attributable to noncontrolling interests	138
Net income attributable to HCA Healthcare, Inc.	$ 1,144
Per share data:
Basic earnings per share | $ / shares	$ 3.26
Diluted earnings per share | $ / shares	3.18
Shares used in earnings per share calculations (in millions):
Cash dividends declared per share | $ / shares	$ 0.35
Basic | shares	350,850
Diluted | shares	359,749

Condensed Consolidated Comprehe

Condensed Consolidated Comprehensive Income Statements - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Statement of Comprehensive Income [Abstract]
Net income	$ 1,282	$ 777
Other comprehensive income (loss) before taxes:
Foreign currency translation	54	10
Unrealized gains (losses) on available-for-sale securities	(5)	3
Defined benefit plans	0	0
Pension costs included in salaries and benefits	5	5
Total defined benefit plans	5	5
Change in fair value of derivative financial instruments	35	3
Interest costs included in interest expense		7
Total change in fair value of derivative financial instruments	35	10
Other comprehensive income before taxes	89	28
Income taxes related to other comprehensive income items	8	10
Other comprehensive income	81	18
Comprehensive income	1,363	795
Comprehensive income attributable to noncontrolling interests	138	118
Comprehensive income attributable to HCA Healthcare, Inc.	$ 1,225	$ 677

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Millions	Mar. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 1,086	$ 732
Accounts receivable	6,332	6,501
Inventories	1,677	1,573
Other	1,296	1,171
Total current assets	10,391	9,977
Property and equipment, at cost	40,308	40,084
Accumulated depreciation	(22,184)	(22,189)
Property and equipment, net	18,124	17,895
Investments of insurance subsidiaries	417	418
Investments in and advances to affiliates	231	199
Goodwill and other intangible assets	7,471	7,394
Other	665	710
Total assets	37,299	36,593
Current liabilities:
Accounts payable	2,538	2,606
Accrued salaries	1,238	1,369
Other accrued expenses	2,005	1,983
Long-term debt due within one year	1,697	200
Total current liabilities	7,478	6,158
Long-term debt, less net debt issuance costs of $158 and $164	31,594	32,858
Professional liability risks	1,244	1,198
Income taxes and other liabilities	1,417	1,374
Stockholders' deficit:
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 350,987,500 shares in 2018 and 350,091,600 shares in 2017	4	4
Accumulated other comprehensive loss	(197)	(278)
Retained deficit	(6,051)	(6,532)
Stockholders' deficit attributable to HCA Healthcare, Inc.	(6,244)	(6,806)
Noncontrolling interests	1,810	1,811
Total stockholders' deficit	(4,434)	(4,995)
Total liabilities and stockholders' deficit	$ 37,299	$ 36,593

Condensed Consolidated Balance5

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Mar. 31, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Debt issuance cost	$ 158	$ 164
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	1,800,000,000	1,800,000,000
Common stock, shares outstanding	350,987,500	350,091,600

Condensed Consolidated Statemen

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Cash flows from operating activities:
Net income	$ 1,282	$ 777
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	(4)	168
Inventories and other assets	(218)	3
Accounts payable and accrued expenses	(246)	(591)
Depreciation and amortization	553	521
Income taxes	246	292
Gains on sales of facilities	(405)	(1)
Amortization of debt issuance costs	8	8
Share-based compensation	60	73
Other	24	30
Net cash provided by operating activities	1,300	1,280
Cash flows from investing activities:
Purchase of property and equipment	(694)	(571)
Acquisition of hospitals and health care entities	(379)	(90)
Disposal of hospitals and health care entities	767	4
Change in investments	11	(19)
Other	(40)	7
Net cash used in investing activities	(335)	(669)
Cash flows from financing activities:
Net change in revolving bank credit facilities	270	160
Repayment of long-term debt	(50)	(43)
Distributions to noncontrolling interests	(92)	(145)
Payment of debt issuance costs	(2)	(2)
Payment of cash dividends	(123)
Repurchases of common stock	(423)	(424)
Other	(191)	(50)
Net cash used in financing activities	(611)	(504)
Change in cash and cash equivalents	354	107
Cash and cash equivalents at beginning of period	732	646
Cash and cash equivalents at end of period	1,086	753
Interest payments	549	540
Income tax payments (refunds), net	$ 11	$ (3)

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	3 Months Ended
	Mar. 31, 2018
Accounting Policies [Abstract]
Basis of Presentation and Significant Accounting Policies	NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES Reporting Entity HCA Healthcare, Inc. is a holding company whose affiliates own and operate hospitals and related health care entities. The term “affiliates” includes direct and indirect subsidiaries of HCA Healthcare, Inc. and partnerships and joint ventures in which such subsidiaries are partners. At March 31, 2018, these affiliates owned and operated 178 hospitals, 120 freestanding surgery centers and provided extensive outpatient and ancillary services. HCA Healthcare, Inc.’s facilities are located in 20 states and England. The terms “Company,” “HCA,” “we,” “our” or “us,” as used herein and unless otherwise stated or indicated by context, refer to HCA Healthcare, Inc. and its affiliates. The terms “facilities” or “hospitals” refer to entities owned and operated by affiliates of HCA and the term “employees” refers to employees of affiliates of HCA. Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete consolidated financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included and are of a normal and recurring nature. The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $81 million and $82 million for the quarters ended March 31, 2018 and 2017, respectively. Operating results for the quarter ended March 31, 2018 are not necessarily indicative of the results that may be expected for the year ending December 31, 2018. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K for the year ended December 31, 2017. Revenues In May 2014, the Financial Accounting Standards Board (“FASB”) issued a new standard related to revenue recognition. We adopted the new standard effective January 1, 2018, using the full retrospective method. The adoption of the new standard did not have an impact on our recognition of net revenues for any periods prior to adoption. The most significant impact of adopting the new standard is to the presentation of our consolidated income statements, where we no longer present the “Provision for doubtful accounts” as a separate line item and our “Revenues” are presented net of estimated implicit price concession revenue deductions. We also have eliminated the related presentation of “allowances for doubtful accounts” on our consolidated balance sheets as a result of the adoption of the new standard. Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals. Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual allowances under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay revenues at the estimated amounts we expect to collect. Our revenues from third-party payers and others (including uninsured patients) for the quarters ended March 31, 2018 and 2017 are summarized in the following table (dollars in millions): 2018 Ratio 2017 Ratio Medicare $ 2,524 22.1 % $ 2,361 22.2 % Managed Medicare 1,399 12.3 1,183 11.1 Medicaid 281 2.5 294 2.8 Managed Medicaid 561 4.9 589 5.5 Managed care and insurers 6,062 53.1 5,623 52.9 International (managed care and insurers) 305 2.7 269 2.5 Other 291 2.4 304 3.0 Revenues $ 11,423 100.0 % $ 10,623 100.0 % Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility recorded estimates will change by a material amount. Estimated reimbursement amounts are adjusted in subsequent periods as cost reports are prepared and filed and as final settlements are determined (in relation to certain government programs, primarily Medicare, this is generally referred to as the “cost report” filing and settlement process). The Emergency Medical Treatment and Labor Act (“EMTALA”) requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital’s emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual’s ability to pay for treatment. Federal and state laws and regulations require, and our commitment to providing quality patient care encourages, us to provide services to patients who are financially unable to pay for the health care services they receive. Prior to November 2017, patients treated at hospitals for non-elective care, who have income at or below 200% of the federal poverty level, were eligible for charity care. During November 2017, we expanded our charity policy to include patients who have income above 200%, but at or below 400%, of the federal poverty level and we will limit the patient responsibility amounts for these patients to a percentage of their annual household income, computed on a sliding scale based upon their annual income and the applicable percentage of the federal poverty level. The federal poverty level is established by the federal government and is based on income and family size. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. We provide discounts to uninsured patients who do not qualify for Medicaid or charity care. In implementing the uninsured discount policy, we may first attempt to provide assistance to uninsured patients to help determine whether they may qualify for Medicaid, other federal or state assistance, or charity care. If an uninsured patient does not qualify for these programs, the uninsured discount is applied. The collection of outstanding receivables for Medicare, Medicaid, managed care payers, other third-party payers and patients is our primary source of cash and is critical to our operating performance. The primary collection risks relate to uninsured patient accounts, including patient accounts for which the primary insurance carrier has paid the amounts covered by the applicable agreement, but patient responsibility amounts (deductibles and copayments) remain outstanding. Implicit price concessions relate primarily to amounts due directly from patients. Estimated implicit price concessions are recorded for all uninsured accounts, regardless of the aging of those accounts. Accounts are written off when all reasonable internal and external collection efforts have been performed. The estimates for implicit price concessions are based upon management’s assessment of historical writeoffs and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. Management relies on the results of detailed reviews of historical writeoffs and collections at facilities that represent a majority of our revenues and accounts receivable (the “hindsight analysis”) as a primary source of information in estimating the collectability of our accounts receivable. We perform the hindsight analysis quarterly, utilizing rolling twelve-months accounts receivable collection and writeoff data. We believe our quarterly updates to the estimated implicit price concession amounts at each of our hospital facilities provide reasonable estimates of our revenues and valuations of our accounts receivable. These routine, quarterly changes in estimates have not resulted in material adjustments to the valuations of our accounts receivable or period-to-period comparisons of our results of operations. At March 31, 2018 and 2017, estimated implicit price concessions of $5.312 billion and $4.880 billion had been recorded as reductions to our revenues and accounts receivable balances to enable us to record our revenues and accounts receivable at the estimated amounts we expect to collect. To quantify the total impact of the trends related to uninsured accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. A summary of the estimated cost of total uncompensated care for the quarters ended March 31, 2018 and 2017 follows (dollars in millions): 2018 2017 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 9,867 $ 9,149 Cost-to-charges ratio (patient care costs as percentage of gross patient charges) 12.4 % 12.8 % Total uncompensated care $ 6,252 $ 5,327 Multiply by the cost-to-charges ratio 12.4 % 12.8 % Estimated cost of total uncompensated care $ 775 $ 682 Total uncompensated care as a percentage of the sum of revenues and total uncompensated care was 35.4% and 33.4% for the quarters ended March 31, 2018 and 2017, respectively. The total uncompensated care amounts include charity care of $1.879 billion and $1.086 billion, and the related estimated costs of charity care were $233 million and $139 million for the quarters ended March 31, 2018 and 2017, respectively. Recent Pronouncements In February 2016, the FASB issued Accounting Standards Update 2016-02, Leases Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.

Acquisitions and Dispositions

Acquisitions and Dispositions	3 Months Ended
	Mar. 31, 2018
Business Combinations [Abstract]
Acquisitions and Dispositions	NOTE 2 — ACQUISITIONS AND DISPOSITIONS During the quarter ended March 31, 2018, we paid $360 million to acquire a hospital facility and $19 million to acquire other nonhospital health care entities. During the quarter ended March 31, 2017, we paid $90 million to acquire other nonhospital health care entities. During the quarter ended March 31, 2018, we received proceeds of $758 million and recognized a net pretax gain of $376 million related to the sale of the two hospital facilities in our Oklahoma market. During the quarter ended March 31, 2018, we also received proceeds of $9 million and recognized a net pretax gain of $29 million related to sales of real estate and other investments. During the quarter ended March 31, 2017, we received proceeds of $4 million and recognized a net pretax gain of $1 million related to sales of real estate and other investments.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2018
Income Tax Disclosure [Abstract]
Income Taxes	NOTE 3 — INCOME TAXES Our provision for income taxes for the quarters ended March 31, 2018 and 2017, was $257 million and $289 million, respectively, and the effective tax rates were 18.4% and 30.4%, respectively. The reduction in the effective tax rate was primarily related to the estimated impact of tax rate changes under the 2017 Tax Cuts and Jobs Act (the “Tax Act”). Our provision for income taxes for the quarters ended March 31, 2018 and 2017 included tax benefits of $92 million and $67 million, respectively, related to the settlement of employee equity awards. The Tax Act was enacted on December 22, 2017, and it significantly revised U.S. corporate income taxes, including lowering the federal statutory corporate tax rate from 35% to 21% beginning in 2018. Due to the complexity and uncertainty regarding numerous provisions of the Tax Act, we have not completed our accounting for its effects. However, we have made reasonable estimates and recorded provisional amounts in our financial statements as of March 31, 2018. As we complete our analysis of the Tax Act, we may make adjustments to the provisional amounts and record additional amounts for those federal, state, and foreign tax assets and liabilities for which we were unable to make reasonable estimates as of March 31, 2018. Any adjustments or additional amounts recorded may materially impact our provision for income taxes and effective tax rate in the periods in which they are made. Our liability for unrecognized tax benefits was $446 million, including accrued interest of $48 million, as of March 31, 2018 ($439 million and $44 million, respectively, as of December 31, 2017). Unrecognized tax benefits of $152 million ($145 million as of December 31, 2017) would affect the effective rate, if recognized. We are subject to examination by federal, state and foreign taxing authorities. Depending on the resolution of any federal, state and foreign tax disputes, the completion of examinations by federal, state or foreign taxing authorities, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible that our liability for unrecognized tax benefits may significantly increase or decrease within the next 12 months. However, we are currently unable to estimate the range of any possible change.

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2018
Earnings Per Share [Abstract]
Earnings Per Share	NOTE 4 — EARNINGS PER SHARE We compute basic earnings per share using the weighted average number of common shares outstanding. We compute diluted earnings per share using the weighted average number of common shares outstanding, plus the dilutive effect of outstanding equity awards and potential shares, computed using the treasury stock method. The following table sets forth the computation of basic and diluted earnings per share for the quarters ended March 31, 2018 and 2017 (dollars and shares in millions, except per share amounts): 2018 2017 Net income attributable to HCA Healthcare, Inc. $ 1,144 $ 659 Weighted average common shares outstanding 350.850 370.289 Effect of dilutive incremental shares 8.899 9.691 Shares used for diluted earnings per share 359.749 379.980 Earnings per share: Basic earnings per share $ 3.26 $ 1.78 Diluted earnings per share $ 3.18 $ 1.74

Investments of Insurance Subsid

Investments of Insurance Subsidiaries	3 Months Ended
	Mar. 31, 2018
Investments, Debt and Equity Securities [Abstract]
Investments of Insurance Subsidiaries	NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES A summary of our insurance subsidiaries’ investments at March 31, 2018 and December 31, 2017 follows (dollars in millions): March 31, 2018 Amortized Unrealized Fair Gains Losses Debt securities $ 251 $ 5 $ — $ 256 Money market funds and other 205 — — 205 $ 456 $ 5 $ — 461 Amounts classified as current assets (44 ) Investment carrying value $ 417 December 31, 2017 Amortized Unrealized Fair Gains Losses Debt securities $ 361 $ 10 $ — $ 371 Money market funds and other 101 — — 101 $ 462 $ 10 $ — 472 Amounts classified as current assets (54 ) Investment carrying value $ 418 At March 31, 2018 and December 31, 2017, the investments of our insurance subsidiaries were classified as “available-for-sale.” Changes in temporary unrealized gains and losses are recorded as adjustments to other comprehensive income (loss). Scheduled maturities of investments in debt securities at March 31, 2018 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 29 $ 29 Due after one year through five years 34 35 Due after five years through ten years 166 170 Due after ten years 22 22 $ 251 $ 256 The average expected maturity of the investments in debt securities at March 31, 2018 was 4.8 years, compared to the average scheduled maturity of 6.4 years. Expected and scheduled maturities may differ because the issuers of certain securities have the right to call, prepay or otherwise redeem such obligations prior to their scheduled maturity date.

Financial Instruments

Financial Instruments	3 Months Ended
	Mar. 31, 2018
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Financial Instruments	NOTE 6 — FINANCIAL INSTRUMENTS Interest Rate Swap Agreements We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. These swap agreements involve the exchange of fixed and variable rate interest payments between two parties based on common notional principal amounts and maturity dates. Pay-fixed interest rate swaps effectively convert variable rate obligations to fixed interest rate obligations. The interest payments under these agreements are settled on a net basis. The net interest payments, based on the notional amounts in these agreements, generally match the timing of the related liabilities for the interest rate swap agreements which have been designated as cash flow hedges. The notional amounts of the swap agreements represent amounts used to calculate the exchange of cash flows and are not our assets or liabilities. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions. The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at March 31, 2018 (dollars in millions): Notional Maturity Date Fair Pay-fixed interest rate swaps $ 2,000 December 2021 $ 74 Pay-fixed interest rate swaps 500 December 2022 11 During the next 12 months, we estimate $14 million will be reclassified from other comprehensive income (“OCI”) and will reduce interest expense. Derivatives — Results of Operations The following table presents the effect of our interest rate swaps on our results of operations for the quarter ended March 31, 2018 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Gain Interest rate swaps $ 27

Assets and Liabilities Measured

Assets and Liabilities Measured at Fair Value	3 Months Ended
	Mar. 31, 2018
Fair Value Disclosures [Abstract]
Assets and Liabilities Measured at Fair Value	NOTE 7 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE Accounting Standards Codification 820, Fair Value Measurements and Disclosures Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment. Cash Traded Investments Our cash traded investments are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency. Derivative Financial Instruments We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. The valuation of these instruments is determined using widely accepted valuation techniques, including discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves and implied volatilities. We incorporate credit valuation adjustments to reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements of these instruments. Although we determined the majority of the inputs used to value our derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with our derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by us and our counterparties. We assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions, and at March 31, 2018 and December 31, 2017, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives. The following tables summarize our assets measured at fair value on a recurring basis as of March 31, 2018 and December 31, 2017, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): March 31, 2018 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 256 $ — $ 256 $ — Money market funds and other 205 205 — — Investments of insurance subsidiaries 461 205 256 — Less amounts classified as current assets (44 ) (44 ) — — $ 417 161 $ 256 $ — Interest rate swaps (Other) $ 85 $ — $ 85 $ — December 31, 2017 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 371 $ — $ 371 $ — Money market funds and other 101 101 — — Investments of insurance subsidiaries 472 101 371 — Less amounts classified as current assets (54 ) (54 ) — — $ 418 $ 47 $ 371 $ — Interest rate swaps (Other) $ 50 $ — $ 50 $ — The estimated fair value of our long-term debt was $34.084 billion and $34.689 billion at March 31, 2018 and December 31, 2017, respectively, compared to carrying amounts, excluding net debt issuance costs, aggregating $33.449 billion and $33.222 billion, respectively. The estimates of fair value are generally based upon the quoted market prices or quoted market prices for similar issues of long-term debt with the same maturities.

Long-Term Debt

Long-Term Debt	3 Months Ended
	Mar. 31, 2018
Debt Disclosure [Abstract]
Long-Term Debt	NOTE 8 — LONG-TERM DEBT A summary of long-term debt at March 31, 2018 and December 31, 2017, including related interest rates at March 31, 2018, follows (dollars in millions): March 31, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 3.3%) $ 3,750 $ 3,680 Senior secured revolving credit facility (effective interest rate of 3.4%) 200 — Senior secured term loan facilities (effective interest rate of 3.5%) 3,873 3,891 Senior secured notes (effective interest rate of 5.4%) 15,300 15,300 Other senior secured debt (effective interest rate of 5.8%) 574 599 Senior secured debt 23,697 23,470 Senior unsecured notes (effective interest rate of 6.4%) 9,752 9,752 Net debt issuance costs (158 ) (164 ) Total debt (average life of 6.6 years, rates averaging 5.2%) 33,291 33,058 Less amounts due within one year 1,697 200 $ 31,594 $ 32,858

Contingencies

Contingencies	3 Months Ended
	Mar. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Contingencies	NOTE 9 — CONTINGENCIES We operate in a highly regulated and litigious industry. As a result, various lawsuits, claims and legal and regulatory proceedings have been and can be expected to be instituted or asserted against us. We are also subject to claims and suits arising in the ordinary course of business, including claims for personal injuries or wrongful restriction of, or interference with, physicians’ staff privileges. In certain of these actions the claimants may seek punitive damages against us which may not be covered by insurance. We are also subject to claims by various taxing authorities for additional taxes and related interest and penalties. The resolution of any such lawsuits, claims or legal and regulatory proceedings could have a material, adverse effect on our results of operations, financial position or liquidity. Health care companies are subject to numerous investigations by various governmental agencies. Under the federal False Claims Act, private parties have the right to bring qui tam

Capital Structure

Capital Structure	3 Months Ended
	Mar. 31, 2018
Text Block [Abstract]
Capital Structure	NOTE 10 — CAPITAL STRUCTURE The changes in stockholders’ deficit, including changes in stockholders’ deficit attributable to HCA Healthcare, Inc. and changes in equity attributable to noncontrolling interests, are as follows (dollars and shares in millions): Equity (Deficit) Attributable to HCA Healthcare, Inc. Equity Total Common Stock Capital in Accumulated Retained Shares Par Value Balances at December 31, 2017 350.092 $ 4 $ — $ (278 ) $ (6,532 ) $ 1,811 $ (4,995 ) Comprehensive income — — — 81 1,144 138 1,363 Repurchase of common stock (4.370 ) — — — (423 ) — (423 ) Dividends and distributions — — — — (126 ) (92 ) (218 ) Share-based benefit plans 5.265 — — — (114 ) — (114 ) Dispositions of entities with noncontrolling interests — — — — — (53 ) (53 ) Other — — — — — 6 6 Balances at March 31, 2018 350.987 $ 4 $ — $ (197 ) $ (6,051 ) $ 1,810 $ (4,434 ) During the quarter ended March 31, 2018, we repurchased 4.370 million shares of our common stock at an average price of $96.80 per share through market purchases pursuant to the $2.0 billion share repurchase program authorized during October 2017. At March 31, 2018, we had $1.379 billion of repurchase authorization available under the October 2017 authorization. On January 30, 2018, our Board of Directors initiated and declared a quarterly dividend of $0.35 per share on our common stock. Dividends were paid on March 30, 2018 to stockholders of record on March 1, 2018. The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized Foreign Defined Change Total Balances at December 31, 2017 $ 7 $ (149 ) $ (168 ) $ 32 $ (278 ) Unrealized losses on available-for-sale securities, net of $1 income tax benefit (4 ) — — — (4 ) Foreign currency translation adjustments — 54 — — 54 Change in fair value of derivative instruments, net of $8 of income taxes — — — 27 27 Expense reclassified into operations from other comprehensive income, net of $1 income tax benefit — — 4 — 4 Balances at March 31, 2018 $ 3 $ (95 ) $ (164 ) $ 59 $ (197 )

Segment and Geographic Informat

Segment and Geographic Information	3 Months Ended
	Mar. 31, 2018
Segment Reporting [Abstract]
Segment and Geographic Information	NOTE 11 — SEGMENT AND GEOGRAPHIC INFORMATION We operate in one line of business, which is operating hospitals and related health care entities. We operate in two geographically organized groups: the National and American Groups. The National Group includes 88 hospitals located in Alaska, California, Florida, southern Georgia, Idaho, Indiana, northern Kentucky, Nevada, New Hampshire, South Carolina, Utah and Virginia, and the American Group includes 84 hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Mississippi, Missouri, Tennessee and Texas. We also operate six hospitals in England, and these facilities are included in the Corporate and other group. Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, gains on sales of facilities, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters ended March 31, 2018 and 2017 are summarized in the following table (dollars in millions): 2018 2017 Revenues: National Group $ 5,568 $ 5,148 American Group 5,327 4,995 Corporate and other 528 480 $ 11,423 $ 10,623 Equity in earnings of affiliates: National Group $ (2 ) $ (5 ) American Group (9 ) (8 ) Corporate and other 2 3 $ (9 ) $ (10 ) Adjusted segment EBITDA: National Group $ 1,182 $ 1,131 American Group 1,031 1,007 Corporate and other (95 ) (133 ) $ 2,118 $ 2,005 Depreciation and amortization: National Group $ 225 $ 214 American Group 252 238 Corporate and other 76 69 $ 553 $ 521 Adjusted segment EBITDA $ 2,118 $ 2,005 Depreciation and amortization 553 521 Interest expense 431 419 Gains on sales of facilities (405 ) (1 ) Income before income taxes $ 1,539 $ 1,066

Supplemental Condensed Consolid

Supplemental Condensed Consolidating Financial Information	3 Months Ended
	Mar. 31, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Supplemental Condensed Consolidating Financial Information	NOTE 12 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION During December 2012, HCA Healthcare, Inc. issued $1.000 billion aggregate principal amount of 6.250% senior unsecured notes due 2021. These notes are senior unsecured obligations and are not guaranteed by any of our subsidiaries. HCA Inc., a direct wholly-owned subsidiary of HCA Healthcare, Inc., is the obligor under a significant portion of our other indebtedness, including our senior secured credit facilities, senior secured notes and senior unsecured notes (other than the senior unsecured notes issued by HCA Healthcare, Inc.). The senior secured notes and senior unsecured notes issued by HCA Inc. are fully and unconditionally guaranteed by HCA Healthcare, Inc. The senior secured credit facilities and senior secured notes are fully and unconditionally guaranteed by substantially all existing and future, direct and indirect, 100% owned material domestic subsidiaries that are “Unrestricted Subsidiaries” under our Indenture dated December 16, 1993 (except for certain special purpose subsidiaries that only guarantee and pledge their assets under our senior secured asset-based revolving credit facility). Our summarized condensed consolidating comprehensive income statements for the quarters ended March 31, 2018 and 2017, condensed consolidating balance sheets at March 31, 2018 and December 31, 2017 and condensed consolidating statements of cash flows for the quarters ended March 31, 2018 and 2017, segregating HCA Healthcare, Inc. issuer, HCA Inc. issuer, the subsidiary guarantors, the subsidiary non-guarantors and eliminations, follow: HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED MARCH 31, 2018 (Dollars in millions) HCA Healthcare, Inc. Issuer HCA Inc. Issuer Subsidiary Guarantors Subsidiary Non- Guarantors Eliminations Condensed Consolidated Revenues $ — $ — $ 6,776 $ 4,647 $ — $ 11,423 Salaries and benefits — — 3,069 2,220 — 5,289 Supplies — — 1,141 774 — 1,915 Other operating expenses 1 — 1,128 981 — 2,110 Equity in earnings of affiliates (1,090 ) — (2 ) (7 ) 1,090 (9 ) Depreciation and amortization — — 323 230 — 553 Interest expense 16 837 (367 ) (55 ) — 431 Gains on sales of facilities — — (395 ) (10 ) — (405 ) Management fees — — (158 ) 158 — — (1,073 ) 837 4,739 4,291 1,090 9,884 Income (loss) before income taxes 1,073 (837 ) 2,037 356 (1,090 ) 1,539 Provision (benefit) for income taxes (71 ) (195 ) 467 56 — 257 Net income (loss) 1,144 (642 ) 1,570 300 (1,090 ) 1,282 Net income attributable to noncontrolling interests — — 28 110 — 138 Net income (loss) attributable to HCA Healthcare, Inc. $ 1,144 $ (642 ) $ 1,542 $ 190 $ (1,090 ) $ 1,144 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 1,225 $ (615 ) $ 1,546 $ 240 $ (1,171 ) $ 1,225 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED MARCH 31, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary (as adjusted) Subsidiary (as adjusted) Eliminations Condensed Revenues $ — $ — $ 6,336 $ 4,287 $ — $ 10,623 Salaries and benefits — — 2,904 1,997 — 4,901 Supplies — — 1,075 722 — 1,797 Other operating expenses 1 — 1,050 879 — 1,930 Equity in earnings of affiliates (608 ) — (2 ) (8 ) 608 (10 ) Depreciation and amortization — — 310 211 — 521 Interest expense 16 733 (290 ) (40 ) — 419 Losses (gains) on sales of facilities — — 1 (2 ) — (1 ) Management fees — — (160 ) 160 — — (591 ) 733 4,888 3,919 608 9,557 Income (loss) before income taxes 591 (733 ) 1,448 368 (608 ) 1,066 Provision (benefit) for income taxes (68 ) (270 ) 526 101 — 289 Net income (loss) 659 (463 ) 922 267 (608 ) 777 Net income attributable to noncontrolling interests — — 23 95 — 118 Net income (loss) attributable to HCA Healthcare, Inc. $ 659 $ (463 ) $ 899 $ 172 $ (608 ) $ 659 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 677 $ (456 ) $ 902 $ 180 $ (626 ) $ 677 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET MARCH 31, 2018 (Dollars in millions) HCA Healthcare, Inc. Issuer HCA Inc. Issuer Subsidiary Guarantors Subsidiary Non- Guarantors Eliminations Condensed Consolidated ASSETS Current assets: Cash and cash equivalents $ — $ — $ 304 $ 782 $ — $ 1,086 Accounts receivable — — 3,747 2,585 — 6,332 Inventories — — 1,143 534 — 1,677 Other — — 728 568 — 1,296 — — 5,922 4,469 — 10,391 Property and equipment, net — — 11,632 6,492 — 18,124 Investments of insurance subsidiaries — — — 417 — 417 Investments in and advances to affiliates 30,752 — 31 200 (30,752 ) 231 Goodwill and other intangible assets — — 5,438 2,033 — 7,471 Other 437 85 30 113 — 665 $ 31,189 $ 85 $ 23,053 $ 13,724 $ (30,752 ) $ 37,299 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,776 $ 762 $ — $ 2,538 Accrued salaries — — 779 459 — 1,238 Other accrued expenses 190 281 545 989 — 2,005 Long-term debt due within one year — 1,597 63 37 — 1,697 190 1,878 3,163 2,247 — 7,478 Long-term debt, net 995 30,125 293 181 — 31,594 Intercompany balances 35,687 (9,253 ) (25,158 ) (1,276 ) — — Professional liability risks — — — 1,244 — 1,244 Income taxes and other liabilities 561 — 379 477 — 1,417 37,433 22,750 (21,323) 2,873 — 41,733 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (6,244 ) (22,665 ) 44,301 9,116 (30,752 ) (6,244 ) Noncontrolling interests — — 75 1,735 — 1,810 (6,244 ) (22,665 ) 44,376 10,851 (30,752 ) (4,434 ) $ 31,189 $ 85 $ 23,053 $ 13,724 $ (30,752 ) $ 37,299 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ 1 $ — $ 112 $ 619 $ — $ 732 Accounts receivable — — 3,693 2,808 — 6,501 Inventories — — 1,030 543 — 1,573 Other — — 663 508 — 1,171 1 — 5,498 4,478 — 9,977 Property and equipment, net — — 11,110 6,785 — 17,895 Investments of insurance subsidiaries — — — 418 — 418 Investments in and advances to affiliates 29,581 — 22 177 (29,581 ) 199 Goodwill and other intangible assets — — 4,893 2,501 — 7,394 Other 510 50 47 103 — 710 $ 30,092 $ 50 $ 21,570 $ 14,462 $ (29,581 ) $ 36,593 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,793 $ 813 $ — $ 2,606 Accrued salaries — — 862 507 — 1,369 Other accrued expenses 29 378 536 1,040 — 1,983 Long-term debt due within one year — 97 64 39 — 200 29 475 3,255 2,399 — 6,158 Long-term debt, net 995 31,367 307 189 — 32,858 Intercompany balances 35,322 (9,742 ) (25,228 ) (352 ) — — Professional liability risks — — — 1,198 — 1,198 Income taxes and other liabilities 552 — 357 465 — 1,374 36,898 22,100 (21,309 ) 3,899 — 41,588 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (6,806 ) (22,050 ) 42,755 8,876 (29,581 ) (6,806 ) Noncontrolling interests — — 124 1,687 — 1,811 (6,806 ) (22,050 ) 42,879 10,563 (29,581 ) (4,995 ) $ 30,092 $ 50 $ 21,570 $ 14,462 $ (29,581 ) $ 36,593 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE QUARTER ENDED MARCH 31, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 1,144 $ (642 ) $ 1,570 $ 300 $ (1,090 ) $ 1,282 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (99 ) (347 ) (7 ) — (468 ) Depreciation and amortization — — 323 230 — 553 Income taxes 246 — — — — 246 Gains on sales of facilities — — (395 ) (10 ) — (405 ) Amortization of debt issuance costs — 8 — — — 8 Share-based compensation — — 60 — — 60 Equity in earnings of affiliates (1,090 ) — — — 1,090 — Other 21 — — 3 — 24 Net cash provided by (used in) operating activities 306 (733 ) 1,211 516 — 1,300 Cash flows from investing activities: Purchase of property and equipment — — (413 ) (281 ) — (694 ) Acquisition of hospitals and health care entities — — (373 ) (6 ) — (379 ) Disposition of hospitals and health care entities — — 767 — — 767 Change in investments — — 13 (2 ) — 11 Other — — (48 ) 8 — (40 ) Net cash used in investing activities — — (54 ) (281 ) — (335 ) Cash flows from financing activities: Net change in revolving credit facilities — 270 — — — 270 Repayment of long-term debt — (18 ) (22 ) (10 ) — (50 ) Distributions to noncontrolling interests — — (24 ) (68 ) — (92 ) Payment of debt issuance costs — (2) — — — (2 ) Payment of cash dividends (123 ) — — — — (123 ) Repurchases of common stock (423 ) — — — — (423 ) Changes in intercompany balances with affiliates, net 434 483 (919 ) 2 — — Other (195 ) — — 4 — (191 ) Net cash (used in) provided by financing activities (307 ) 733 (965 ) (72 ) — (611 ) Change in cash and cash equivalents (1 ) — 192 163 — 354 Cash and cash equivalents at beginning of period 1 — 112 619 — 732 Cash and cash equivalents at end of period $ — $ — $ 304 $ 782 $ — $ 1,086 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE QUARTER ENDED MARCH 31, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary (as adjusted) Subsidiary (as adjusted) Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 659 $ (463 ) $ 922 $ 267 $ (608 ) $ 777 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (295 ) (199 ) 89 — (420 ) Depreciation and amortization — — 310 211 — 521 Income taxes 292 — — — — 292 Losses (gains) on sales of facilities — — 1 (2 ) — (1 ) Amortization of debt issuance costs — 8 — — — 8 Share-based compensation — — 73 — — 73 Equity in earnings of affiliates (608 ) — — — 608 — Other 19 — 1 10 — 30 Net cash provided by (used in) operating activities 347 (750 ) 1,108 575 — 1,280 Cash flows from investing activities: Purchase of property and equipment — — (312 ) (259 ) — (571 ) Acquisition of hospitals and health care entities — — (5 ) (85 ) — (90 ) Disposition of hospitals and health care entities — — 4 — — 4 Change in investments — — 2 (21 ) — (19 ) Other — — 1 6 — 7 Net cash used in investing activities — — (310 ) (359 ) — (669 ) Cash flows from financing activities: Net change in revolving credit facilities — 160 — — — 160 Repayment of long-term debt — (18 ) (13 ) (12 ) — (43 ) Distributions to noncontrolling interests — — (57 ) (88 ) — (145 ) Payment of debt issuance costs — (2 ) — — — (2 ) Repurchases of common stock (424 ) — — — — (424 ) Changes in intercompany balances with affiliates, net 134 610 (656 ) (88 ) — — Other (57 ) — — 7 — (50 ) Net cash (used in) provided by financing activities (347 ) 750 (726 ) (181 ) — (504 ) Change in cash and cash equivalents — — 72 35 — 107 Cash and cash equivalents at beginning of period — — 113 533 — 646 Cash and cash equivalents at end of period $ — $ — $ 185 $ 568 $ — $ 753 The above supplemental condensed consolidating financial information for the quarter ended March 31, 2017 has been adjusted to properly record the impact of certain subsidiaries that were non-guarantors becoming guarantors, primarily related to the Company acquiring previous noncontrolling interests of non-guarantor subsidiaries that then became guarantor subsidiaries. The impact of these adjustments was immaterial as they had no impact to our consolidated income statements, balance sheets or statements of cash flows, had no impact on any liquidity measures of the Company, nor did they impact any financial ratios based on our consolidated balance sheets or income statements. There was also no impact to our loan covenant reporting or compliance. The impact of the adjustments was limited to reclassifications between the Subsidiary Guarantors and Subsidiary Non-Guarantors columns of the condensed consolidating financial statements. The application of these adjustments to the consolidating information for the quarter ended March 31, 2017 is summarized as follows (dollars in millions): As Adjustment As Adjusted Quarter ended March 31, 2017 Net income (loss) attributable to HCA Healthcare, Inc.: HCA Healthcare, Inc. Issuer $ 659 $ — $ 659 HCA Inc. Issuer (463 ) — (463 ) Subsidiary Guarantors 818 81 899 Subsidiary Non-Guarantors 253 (81 ) 172 Eliminations (608 ) — (608 ) Condensed Consolidated $ 659 $ — $ 659 As Adjustment As Adjusted Quarter ended March 31, 2017 Net cash provided (used in) operating activities: HCA Healthcare, Inc. Issuer $ 347 $ — $ 347 HCA Inc. Issuer (750 ) — (750 ) Subsidiary Guarantors 983 125 1,108 Subsidiary Non-Guarantors 700 (125 ) 575 Eliminations — — — Condensed Consolidated $ 1,280 $ — $ 1,280

Basis of Presentation and Sig19

Basis of Presentation and Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2018
Basis of Presentation	Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete consolidated financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included and are of a normal and recurring nature. The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $81 million and $82 million for the quarters ended March 31, 2018 and 2017, respectively. Operating results for the quarter ended March 31, 2018 are not necessarily indicative of the results that may be expected for the year ending December 31, 2018. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K for the year ended December 31, 2017.
Revenues	Revenues In May 2014, the Financial Accounting Standards Board (“FASB”) issued a new standard related to revenue recognition. We adopted the new standard effective January 1, 2018, using the full retrospective method. The adoption of the new standard did not have an impact on our recognition of net revenues for any periods prior to adoption. The most significant impact of adopting the new standard is to the presentation of our consolidated income statements, where we no longer present the “Provision for doubtful accounts” as a separate line item and our “Revenues” are presented net of estimated implicit price concession revenue deductions. We also have eliminated the related presentation of “allowances for doubtful accounts” on our consolidated balance sheets as a result of the adoption of the new standard. Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals. Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual allowances under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay revenues at the estimated amounts we expect to collect. Our revenues from third-party payers and others (including uninsured patients) for the quarters ended March 31, 2018 and 2017 are summarized in the following table (dollars in millions): 2018 Ratio 2017 Ratio Medicare $ 2,524 22.1 % $ 2,361 22.2 % Managed Medicare 1,399 12.3 1,183 11.1 Medicaid 281 2.5 294 2.8 Managed Medicaid 561 4.9 589 5.5 Managed care and insurers 6,062 53.1 5,623 52.9 International (managed care and insurers) 305 2.7 269 2.5 Other 291 2.4 304 3.0 Revenues $ 11,423 100.0 % $ 10,623 100.0 % Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility recorded estimates will change by a material amount. Estimated reimbursement amounts are adjusted in subsequent periods as cost reports are prepared and filed and as final settlements are determined (in relation to certain government programs, primarily Medicare, this is generally referred to as the “cost report” filing and settlement process). The Emergency Medical Treatment and Labor Act (“EMTALA”) requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital’s emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual’s ability to pay for treatment. Federal and state laws and regulations require, and our commitment to providing quality patient care encourages, us to provide services to patients who are financially unable to pay for the health care services they receive. Prior to November 2017, patients treated at hospitals for non-elective care, who have income at or below 200% of the federal poverty level, were eligible for charity care. During November 2017, we expanded our charity policy to include patients who have income above 200%, but at or below 400%, of the federal poverty level and we will limit the patient responsibility amounts for these patients to a percentage of their annual household income, computed on a sliding scale based upon their annual income and the applicable percentage of the federal poverty level. The federal poverty level is established by the federal government and is based on income and family size. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. We provide discounts to uninsured patients who do not qualify for Medicaid or charity care. In implementing the uninsured discount policy, we may first attempt to provide assistance to uninsured patients to help determine whether they may qualify for Medicaid, other federal or state assistance, or charity care. If an uninsured patient does not qualify for these programs, the uninsured discount is applied. The collection of outstanding receivables for Medicare, Medicaid, managed care payers, other third-party payers and patients is our primary source of cash and is critical to our operating performance. The primary collection risks relate to uninsured patient accounts, including patient accounts for which the primary insurance carrier has paid the amounts covered by the applicable agreement, but patient responsibility amounts (deductibles and copayments) remain outstanding. Implicit price concessions relate primarily to amounts due directly from patients. Estimated implicit price concessions are recorded for all uninsured accounts, regardless of the aging of those accounts. Accounts are written off when all reasonable internal and external collection efforts have been performed. The estimates for implicit price concessions are based upon management’s assessment of historical writeoffs and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. Management relies on the results of detailed reviews of historical writeoffs and collections at facilities that represent a majority of our revenues and accounts receivable (the “hindsight analysis”) as a primary source of information in estimating the collectability of our accounts receivable. We perform the hindsight analysis quarterly, utilizing rolling twelve-months accounts receivable collection and writeoff data. We believe our quarterly updates to the estimated implicit price concession amounts at each of our hospital facilities provide reasonable estimates of our revenues and valuations of our accounts receivable. These routine, quarterly changes in estimates have not resulted in material adjustments to the valuations of our accounts receivable or period-to-period comparisons of our results of operations. At March 31, 2018 and 2017, estimated implicit price concessions of $5.312 billion and $4.880 billion had been recorded as reductions to our revenues and accounts receivable balances to enable us to record our revenues and accounts receivable at the estimated amounts we expect to collect. To quantify the total impact of the trends related to uninsured accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. A summary of the estimated cost of total uncompensated care for the quarters ended March 31, 2018 and 2017 follows (dollars in millions): 2018 2017 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 9,867 $ 9,149 Cost-to-charges ratio (patient care costs as percentage of gross patient charges) 12.4 % 12.8 % Total uncompensated care $ 6,252 $ 5,327 Multiply by the cost-to-charges ratio 12.4 % 12.8 % Estimated cost of total uncompensated care $ 775 $ 682 Total uncompensated care as a percentage of the sum of revenues and total uncompensated care was 35.4% and 33.4% for the quarters ended March 31, 2018 and 2017, respectively. The total uncompensated care amounts include charity care of $1.879 billion and $1.086 billion, and the related estimated costs of charity care were $233 million and $139 million for the quarters ended March 31, 2018 and 2017, respectively.
Recent Pronouncements	Recent Pronouncements In February 2016, the FASB issued Accounting Standards Update 2016-02, Leases
Reclassifications	Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.
Earning Per Share	We compute basic earnings per share using the weighted average number of common shares outstanding. We compute diluted earnings per share using the weighted average number of common shares outstanding, plus the dilutive effect of outstanding equity awards and potential shares, computed using the treasury stock method.
Fair Value Measurements and Disclosures	Accounting Standards Codification 820, Fair Value Measurements and Disclosures Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment.
Cash Traded Investments	Cash Traded Investments Our cash traded investments are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency.
Derivative Financial Instruments	Derivative Financial Instruments We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. The valuation of these instruments is determined using widely accepted valuation techniques, including discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves and implied volatilities. We incorporate credit valuation adjustments to reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements of these instruments. Although we determined the majority of the inputs used to value our derivatives fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with our derivatives utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by us and our counterparties. We assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions, and at March 31, 2018 and December 31, 2017, we determined the credit valuation adjustments were not significant to the overall valuation of our derivatives.
Interest Rate Swaps [Member]
Interest Rate Swap Agreements	Interest Rate Swap Agreements We have entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. These swap agreements involve the exchange of fixed and variable rate interest payments between two parties based on common notional principal amounts and maturity dates. Pay-fixed interest rate swaps effectively convert variable rate obligations to fixed interest rate obligations. The interest payments under these agreements are settled on a net basis. The net interest payments, based on the notional amounts in these agreements, generally match the timing of the related liabilities for the interest rate swap agreements which have been designated as cash flow hedges. The notional amounts of the swap agreements represent amounts used to calculate the exchange of cash flows and are not our assets or liabilities. Our credit risk related to these agreements is considered low because the swap agreements are with creditworthy financial institutions.

Basis of Presentation and Sig20

Basis of Presentation and Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2018
Accounting Policies [Abstract]
Schedule of Revenues from Third Party Payers, Uninsured and Other Payers	Our revenues from third-party payers and others (including uninsured patients) for the quarters ended March 31, 2018 and 2017 are summarized in the following table (dollars in millions): 2018 Ratio 2017 Ratio Medicare $ 2,524 22.1 % $ 2,361 22.2 % Managed Medicare 1,399 12.3 1,183 11.1 Medicaid 281 2.5 294 2.8 Managed Medicaid 561 4.9 589 5.5 Managed care and insurers 6,062 53.1 5,623 52.9 International (managed care and insurers) 305 2.7 269 2.5 Other 291 2.4 304 3.0 Revenues $ 11,423 100.0 % $ 10,623 100.0 %
Schedule of Estimated Cost of Uncompensated Care	A summary of the estimated cost of total uncompensated care for the quarters ended March 31, 2018 and 2017 follows (dollars in millions): 2018 2017 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 9,867 $ 9,149 Cost-to-charges ratio (patient care costs as percentage of gross patient charges) 12.4 % 12.8 % Total uncompensated care $ 6,252 $ 5,327 Multiply by the cost-to-charges ratio 12.4 % 12.8 % Estimated cost of total uncompensated care $ 775 $ 682

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2018
Earnings Per Share [Abstract]
Schedule of Computations of Basic and Diluted Earnings Per Share	The following table sets forth the computation of basic and diluted earnings per share for the quarters ended March 31, 2018 and 2017 (dollars and shares in millions, except per share amounts): 2018 2017 Net income attributable to HCA Healthcare, Inc. $ 1,144 $ 659 Weighted average common shares outstanding 350.850 370.289 Effect of dilutive incremental shares 8.899 9.691 Shares used for diluted earnings per share 359.749 379.980 Earnings per share: Basic earnings per share $ 3.26 $ 1.78 Diluted earnings per share $ 3.18 $ 1.74

Investments of Insurance Subs22

Investments of Insurance Subsidiaries (Tables)	3 Months Ended
	Mar. 31, 2018
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	A summary of our insurance subsidiaries’ investments at March 31, 2018 and December 31, 2017 follows (dollars in millions): March 31, 2018 Amortized Unrealized Fair Gains Losses Debt securities $ 251 $ 5 $ — $ 256 Money market funds and other 205 — — 205 $ 456 $ 5 $ — 461 Amounts classified as current assets (44 ) Investment carrying value $ 417 December 31, 2017 Amortized Unrealized Fair Gains Losses Debt securities $ 361 $ 10 $ — $ 371 Money market funds and other 101 — — 101 $ 462 $ 10 $ — 472 Amounts classified as current assets (54 ) Investment carrying value $ 418
Schedule of Maturities of Investments	Scheduled maturities of investments in debt securities at March 31, 2018 were as follows (dollars in millions): Amortized Fair Due in one year or less $ 29 $ 29 Due after one year through five years 34 35 Due after five years through ten years 166 170 Due after ten years 22 22 $ 251 $ 256

Financial Instruments (Tables)

Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2018
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges	The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at March 31, 2018 (dollars in millions): Notional Maturity Date Fair Pay-fixed interest rate swaps $ 2,000 December 2021 $ 74 Pay-fixed interest rate swaps 500 December 2022 11
Effect of Interest Rate on Results of Operations	The following table presents the effect of our interest rate swaps on our results of operations for the quarter ended March 31, 2018 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Gain Interest rate swaps $ 27

Assets and Liabilities Measur24

Assets and Liabilities Measured at Fair Value (Tables)	3 Months Ended
	Mar. 31, 2018
Fair Value Disclosures [Abstract]
Schedule of Assets Measured at Fair Value on Recurring Basis	The following tables summarize our assets measured at fair value on a recurring basis as of March 31, 2018 and December 31, 2017, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): March 31, 2018 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 256 $ — $ 256 $ — Money market funds and other 205 205 — — Investments of insurance subsidiaries 461 205 256 — Less amounts classified as current assets (44 ) (44 ) — — $ 417 161 $ 256 $ — Interest rate swaps (Other) $ 85 $ — $ 85 $ — December 31, 2017 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 371 $ — $ 371 $ — Money market funds and other 101 101 — — Investments of insurance subsidiaries 472 101 371 — Less amounts classified as current assets (54 ) (54 ) — — $ 418 $ 47 $ 371 $ — Interest rate swaps (Other) $ 50 $ — $ 50 $ —

Long-Term Debt (Tables)

Long-Term Debt (Tables)	3 Months Ended
	Mar. 31, 2018
Debt Disclosure [Abstract]
Schedule of Long-Term Debt	A summary of long-term debt at March 31, 2018 and December 31, 2017, including related interest rates at March 31, 2018, follows (dollars in millions): March 31, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 3.3%) $ 3,750 $ 3,680 Senior secured revolving credit facility (effective interest rate of 3.4%) 200 — Senior secured term loan facilities (effective interest rate of 3.5%) 3,873 3,891 Senior secured notes (effective interest rate of 5.4%) 15,300 15,300 Other senior secured debt (effective interest rate of 5.8%) 574 599 Senior secured debt 23,697 23,470 Senior unsecured notes (effective interest rate of 6.4%) 9,752 9,752 Net debt issuance costs (158 ) (164 ) Total debt (average life of 6.6 years, rates averaging 5.2%) 33,291 33,058 Less amounts due within one year 1,697 200 $ 31,594 $ 32,858

Capital Structure (Tables)

Capital Structure (Tables)	3 Months Ended
	Mar. 31, 2018
Text Block [Abstract]
Schedule of Changes in Stockholders' Deficit and Equity	The changes in stockholders’ deficit, including changes in stockholders’ deficit attributable to HCA Healthcare, Inc. and changes in equity attributable to noncontrolling interests, are as follows (dollars and shares in millions): Equity (Deficit) Attributable to HCA Healthcare, Inc. Equity Total Common Stock Capital in Accumulated Retained Shares Par Value Balances at December 31, 2017 350.092 $ 4 $ — $ (278 ) $ (6,532 ) $ 1,811 $ (4,995 ) Comprehensive income — — — 81 1,144 138 1,363 Repurchase of common stock (4.370 ) — — — (423 ) — (423 ) Dividends and distributions — — — — (126 ) (92 ) (218 ) Share-based benefit plans 5.265 — — — (114 ) — (114 ) Dispositions of entities with noncontrolling interests — — — — — (53 ) (53 ) Other — — — — — 6 6 Balances at March 31, 2018 350.987 $ 4 $ — $ (197 ) $ (6,051 ) $ 1,810 $ (4,434 )
Components of Accumulated Other Comprehensive Loss	The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized Foreign Defined Change Total Balances at December 31, 2017 $ 7 $ (149 ) $ (168 ) $ 32 $ (278 ) Unrealized losses on available-for-sale securities, net of $1 income tax benefit (4 ) — — — (4 ) Foreign currency translation adjustments — 54 — — 54 Change in fair value of derivative instruments, net of $8 of income taxes — — — 27 27 Expense reclassified into operations from other comprehensive income, net of $1 income tax benefit — — 4 — 4 Balances at March 31, 2018 $ 3 $ (95 ) $ (164 ) $ 59 $ (197 )

Segment and Geographic Inform27

Segment and Geographic Information (Tables)	3 Months Ended
	Mar. 31, 2018
Segment Reporting [Abstract]
Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA and Depreciation and Amortization	The geographic distributions of our revenues, equity in earnings of affiliates, adjusted segment EBITDA and depreciation and amortization for the quarters ended March 31, 2018 and 2017 are summarized in the following table (dollars in millions): 2018 2017 Revenues: National Group $ 5,568 $ 5,148 American Group 5,327 4,995 Corporate and other 528 480 $ 11,423 $ 10,623 Equity in earnings of affiliates: National Group $ (2 ) $ (5 ) American Group (9 ) (8 ) Corporate and other 2 3 $ (9 ) $ (10 ) Adjusted segment EBITDA: National Group $ 1,182 $ 1,131 American Group 1,031 1,007 Corporate and other (95 ) (133 ) $ 2,118 $ 2,005 Depreciation and amortization: National Group $ 225 $ 214 American Group 252 238 Corporate and other 76 69 $ 553 $ 521 Adjusted segment EBITDA $ 2,118 $ 2,005 Depreciation and amortization 553 521 Interest expense 431 419 Gains on sales of facilities (405 ) (1 ) Income before income taxes $ 1,539 $ 1,066

Supplemental Condensed Consol28

Supplemental Condensed Consolidating Financial Information (Tables)	3 Months Ended
	Mar. 31, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Condensed Consolidating Comprehensive Income Statement	HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED MARCH 31, 2018 (Dollars in millions) HCA Healthcare, Inc. Issuer HCA Inc. Issuer Subsidiary Guarantors Subsidiary Non- Guarantors Eliminations Condensed Consolidated Revenues $ — $ — $ 6,776 $ 4,647 $ — $ 11,423 Salaries and benefits — — 3,069 2,220 — 5,289 Supplies — — 1,141 774 — 1,915 Other operating expenses 1 — 1,128 981 — 2,110 Equity in earnings of affiliates (1,090 ) — (2 ) (7 ) 1,090 (9 ) Depreciation and amortization — — 323 230 — 553 Interest expense 16 837 (367 ) (55 ) — 431 Gains on sales of facilities — — (395 ) (10 ) — (405 ) Management fees — — (158 ) 158 — — (1,073 ) 837 4,739 4,291 1,090 9,884 Income (loss) before income taxes 1,073 (837 ) 2,037 356 (1,090 ) 1,539 Provision (benefit) for income taxes (71 ) (195 ) 467 56 — 257 Net income (loss) 1,144 (642 ) 1,570 300 (1,090 ) 1,282 Net income attributable to noncontrolling interests — — 28 110 — 138 Net income (loss) attributable to HCA Healthcare, Inc. $ 1,144 $ (642 ) $ 1,542 $ 190 $ (1,090 ) $ 1,144 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 1,225 $ (615 ) $ 1,546 $ 240 $ (1,171 ) $ 1,225 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED MARCH 31, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary (as adjusted) Subsidiary (as adjusted) Eliminations Condensed Revenues $ — $ — $ 6,336 $ 4,287 $ — $ 10,623 Salaries and benefits — — 2,904 1,997 — 4,901 Supplies — — 1,075 722 — 1,797 Other operating expenses 1 — 1,050 879 — 1,930 Equity in earnings of affiliates (608 ) — (2 ) (8 ) 608 (10 ) Depreciation and amortization — — 310 211 — 521 Interest expense 16 733 (290 ) (40 ) — 419 Losses (gains) on sales of facilities — — 1 (2 ) — (1 ) Management fees — — (160 ) 160 — — (591 ) 733 4,888 3,919 608 9,557 Income (loss) before income taxes 591 (733 ) 1,448 368 (608 ) 1,066 Provision (benefit) for income taxes (68 ) (270 ) 526 101 — 289 Net income (loss) 659 (463 ) 922 267 (608 ) 777 Net income attributable to noncontrolling interests — — 23 95 — 118 Net income (loss) attributable to HCA Healthcare, Inc. $ 659 $ (463 ) $ 899 $ 172 $ (608 ) $ 659 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 677 $ (456 ) $ 902 $ 180 $ (626 ) $ 677
Schedule of Condensed Consolidating Balance Sheet	HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET MARCH 31, 2018 (Dollars in millions) HCA Healthcare, Inc. Issuer HCA Inc. Issuer Subsidiary Guarantors Subsidiary Non- Guarantors Eliminations Condensed Consolidated ASSETS Current assets: Cash and cash equivalents $ — $ — $ 304 $ 782 $ — $ 1,086 Accounts receivable — — 3,747 2,585 — 6,332 Inventories — — 1,143 534 — 1,677 Other — — 728 568 — 1,296 — — 5,922 4,469 — 10,391 Property and equipment, net — — 11,632 6,492 — 18,124 Investments of insurance subsidiaries — — — 417 — 417 Investments in and advances to affiliates 30,752 — 31 200 (30,752 ) 231 Goodwill and other intangible assets — — 5,438 2,033 — 7,471 Other 437 85 30 113 — 665 $ 31,189 $ 85 $ 23,053 $ 13,724 $ (30,752 ) $ 37,299 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,776 $ 762 $ — $ 2,538 Accrued salaries — — 779 459 — 1,238 Other accrued expenses 190 281 545 989 — 2,005 Long-term debt due within one year — 1,597 63 37 — 1,697 190 1,878 3,163 2,247 — 7,478 Long-term debt, net 995 30,125 293 181 — 31,594 Intercompany balances 35,687 (9,253 ) (25,158 ) (1,276 ) — — Professional liability risks — — — 1,244 — 1,244 Income taxes and other liabilities 561 — 379 477 — 1,417 37,433 22,750 (21,323) 2,873 — 41,733 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (6,244 ) (22,665 ) 44,301 9,116 (30,752 ) (6,244 ) Noncontrolling interests — — 75 1,735 — 1,810 (6,244 ) (22,665 ) 44,376 10,851 (30,752 ) (4,434 ) $ 31,189 $ 85 $ 23,053 $ 13,724 $ (30,752 ) $ 37,299 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ 1 $ — $ 112 $ 619 $ — $ 732 Accounts receivable — — 3,693 2,808 — 6,501 Inventories — — 1,030 543 — 1,573 Other — — 663 508 — 1,171 1 — 5,498 4,478 — 9,977 Property and equipment, net — — 11,110 6,785 — 17,895 Investments of insurance subsidiaries — — — 418 — 418 Investments in and advances to affiliates 29,581 — 22 177 (29,581 ) 199 Goodwill and other intangible assets — — 4,893 2,501 — 7,394 Other 510 50 47 103 — 710 $ 30,092 $ 50 $ 21,570 $ 14,462 $ (29,581 ) $ 36,593 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,793 $ 813 $ — $ 2,606 Accrued salaries — — 862 507 — 1,369 Other accrued expenses 29 378 536 1,040 — 1,983 Long-term debt due within one year — 97 64 39 — 200 29 475 3,255 2,399 — 6,158 Long-term debt, net 995 31,367 307 189 — 32,858 Intercompany balances 35,322 (9,742 ) (25,228 ) (352 ) — — Professional liability risks — — — 1,198 — 1,198 Income taxes and other liabilities 552 — 357 465 — 1,374 36,898 22,100 (21,309 ) 3,899 — 41,588 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (6,806 ) (22,050 ) 42,755 8,876 (29,581 ) (6,806 ) Noncontrolling interests — — 124 1,687 — 1,811 (6,806 ) (22,050 ) 42,879 10,563 (29,581 ) (4,995 ) $ 30,092 $ 50 $ 21,570 $ 14,462 $ (29,581 ) $ 36,593
Schedule of Condensed Consolidating Statement of Cash Flows	HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE QUARTER ENDED MARCH 31, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 1,144 $ (642 ) $ 1,570 $ 300 $ (1,090 ) $ 1,282 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (99 ) (347 ) (7 ) — (468 ) Depreciation and amortization — — 323 230 — 553 Income taxes 246 — — — — 246 Gains on sales of facilities — — (395 ) (10 ) — (405 ) Amortization of debt issuance costs — 8 — — — 8 Share-based compensation — — 60 — — 60 Equity in earnings of affiliates (1,090 ) — — — 1,090 — Other 21 — — 3 — 24 Net cash provided by (used in) operating activities 306 (733 ) 1,211 516 — 1,300 Cash flows from investing activities: Purchase of property and equipment — — (413 ) (281 ) — (694 ) Acquisition of hospitals and health care entities — — (373 ) (6 ) — (379 ) Disposition of hospitals and health care entities — — 767 — — 767 Change in investments — — 13 (2 ) — 11 Other — — (48 ) 8 — (40 ) Net cash used in investing activities — — (54 ) (281 ) — (335 ) Cash flows from financing activities: Net change in revolving credit facilities — 270 — — — 270 Repayment of long-term debt — (18 ) (22 ) (10 ) — (50 ) Distributions to noncontrolling interests — — (24 ) (68 ) — (92 ) Payment of debt issuance costs — (2) — — — (2 ) Payment of cash dividends (123 ) — — — — (123 ) Repurchases of common stock (423 ) — — — — (423 ) Changes in intercompany balances with affiliates, net 434 483 (919 ) 2 — — Other (195 ) — — 4 — (191 ) Net cash (used in) provided by financing activities (307 ) 733 (965 ) (72 ) — (611 ) Change in cash and cash equivalents (1 ) — 192 163 — 354 Cash and cash equivalents at beginning of period 1 — 112 619 — 732 Cash and cash equivalents at end of period $ — $ — $ 304 $ 782 $ — $ 1,086 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE QUARTER ENDED MARCH 31, 2017 (Dollars in millions) HCA HCA Inc. Subsidiary (as adjusted) Subsidiary (as adjusted) Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 659 $ (463 ) $ 922 $ 267 $ (608 ) $ 777 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (295 ) (199 ) 89 — (420 ) Depreciation and amortization — — 310 211 — 521 Income taxes 292 — — — — 292 Losses (gains) on sales of facilities — — 1 (2 ) — (1 ) Amortization of debt issuance costs — 8 — — — 8 Share-based compensation — — 73 — — 73 Equity in earnings of affiliates (608 ) — — — 608 — Other 19 — 1 10 — 30 Net cash provided by (used in) operating activities 347 (750 ) 1,108 575 — 1,280 Cash flows from investing activities: Purchase of property and equipment — — (312 ) (259 ) — (571 ) Acquisition of hospitals and health care entities — — (5 ) (85 ) — (90 ) Disposition of hospitals and health care entities — — 4 — — 4 Change in investments — — 2 (21 ) — (19 ) Other — — 1 6 — 7 Net cash used in investing activities — — (310 ) (359 ) — (669 ) Cash flows from financing activities: Net change in revolving credit facilities — 160 — — — 160 Repayment of long-term debt — (18 ) (13 ) (12 ) — (43 ) Distributions to noncontrolling interests — — (57 ) (88 ) — (145 ) Payment of debt issuance costs — (2 ) — — — (2 ) Repurchases of common stock (424 ) — — — — (424 ) Changes in intercompany balances with affiliates, net 134 610 (656 ) (88 ) — — Other (57 ) — — 7 — (50 ) Net cash (used in) provided by financing activities (347 ) 750 (726 ) (181 ) — (504 ) Change in cash and cash equivalents — — 72 35 — 107 Cash and cash equivalents at beginning of period — — 113 533 — 646 Cash and cash equivalents at end of period $ — $ — $ 185 $ 568 $ — $ 753
Summary of Restatement Adjustments to Financial Statements	The application of these adjustments to the consolidating information for the quarter ended March 31, 2017 is summarized as follows (dollars in millions): As Adjustment As Adjusted Quarter ended March 31, 2017 Net income (loss) attributable to HCA Healthcare, Inc.: HCA Healthcare, Inc. Issuer $ 659 $ — $ 659 HCA Inc. Issuer (463 ) — (463 ) Subsidiary Guarantors 818 81 899 Subsidiary Non-Guarantors 253 (81 ) 172 Eliminations (608 ) — (608 ) Condensed Consolidated $ 659 $ — $ 659 As Adjustment As Adjusted Quarter ended March 31, 2017 Net cash provided (used in) operating activities: HCA Healthcare, Inc. Issuer $ 347 $ — $ 347 HCA Inc. Issuer (750 ) — (750 ) Subsidiary Guarantors 983 125 1,108 Subsidiary Non-Guarantors 700 (125 ) 575 Eliminations — — — Condensed Consolidated $ 1,280 $ — $ 1,280

Basis of Presentation and Sig29

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) $ in Millions	Oct. 31, 2017	Nov. 30, 2017	Mar. 31, 2018USD ($)StateHospitalSurgery_Center	Mar. 31, 2017USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of owned and operated hospitals | Hospital			178
Number of freestanding surgery centers | Surgery_Center			120
Number of facilities locations | State			20
General and administrative expense			$ 81	$ 82
Estimated implicit price concessions recorded as reductions to revenues and accounts receivable			$ 5,312	$ 4,880
Percentage of sum of revenues and uncompensated care			35.40%	33.40%
Charity care amount			$ 1,879	$ 1,086
Estimated costs of charity care			$ 775	$ 682
Inpatient Services [Member]
Summary Of Significant Accounting Policies [Line Items]
Performance obligations for inpatient/ outpatient services satisfied period			5 days
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Percentage of income of federal poverty level eligible for charity care	200.00%	400.00%
Maximum [Member] | Outpatient Services [Member]
Summary Of Significant Accounting Policies [Line Items]
Performance obligations for inpatient/ outpatient services satisfied period			1 day
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Percentage of income of federal poverty level eligible for charity care		200.00%

Basis of Presentation and Sig30

Basis of Presentation and Significant Accounting Policies - Schedule of Revenues from Third Party Payers, Uninsured and Other Payers (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Revenues From Third Party Payers [Line Items]
Other	$ 291	$ 304
Revenues	$ 11,423	$ 10,623
Other, Ratio	2.40%	3.00%
Revenues ratio from third party payers	100.00%	100.00%
Medicare [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 2,524	$ 2,361
Revenues from third party payers, Ratio	22.10%	22.20%
Managed Medicare [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 1,399	$ 1,183
Revenues from third party payers, Ratio	12.30%	11.10%
Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 281	$ 294
Revenues from third party payers, Ratio	2.50%	2.80%
Managed Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 561	$ 589
Revenues from third party payers, Ratio	4.90%	5.50%
Managed Care and Insurers [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 6,062	$ 5,623
Revenues from third party payers, Ratio	53.10%	52.90%
International (Managed Care and Other Insurers) [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 305	$ 269
Revenues from third party payers, Ratio	2.70%	2.50%

Basis of Presentation and Sig31

Basis of Presentation and Significant Accounting Policies - Schedule of Estimated Cost of Uncompensated Care (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Accounting Policies [Abstract]
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)	$ 9,867	$ 9,149
Cost-to-charges ratio (patient care costs as percentage of gross patient charges)	12.40%	12.80%
Total uncompensated care	$ 6,252	$ 5,327
Multiply by the cost-to-charges ratio	12.40%	12.80%
Estimated cost of total uncompensated care	$ 775	$ 682

Acquisitions and Dispositions -

Acquisitions and Dispositions - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2018USD ($)Hospital	Mar. 31, 2017USD ($)
Business Acquisition [Line Items]
Proceeds from sale of business	$ 767	$ 4
Real Estate and Other Investments [Member]
Business Acquisition [Line Items]
Pretax gain (loss) on sales of business	29	1
Proceeds from sale of business	9	4
Discontinued Operations, Disposed of by Sale [Member] | Oklahoma [Member]
Business Acquisition [Line Items]
Pretax gain (loss) on sales of business	376
Proceeds from sale of business	$ 758
Number of hospitals sold | Hospital	2
Hospitals [Member]
Business Acquisition [Line Items]
Aggregate purchase price	$ 360
Nonhospital Health Care [Member]
Business Acquisition [Line Items]
Aggregate purchase price	$ 19	$ 90

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		12 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Provision for income taxes	$ 257	$ 289
Effective tax rates	18.40%	30.40%
Provision for tax benefits related to settlement of employee awards	$ 92	$ 67
Effective tax rate	21.00%		35.00%
Liability for unrecognized tax benefits	$ 446		$ 439
Unrecognized tax benefits, accrued interest	48		44
Unrecognized tax benefits that would impact effective tax rate	$ 152		$ 145

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Computations of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Earnings Per Share [Abstract]
Net income attributable to HCA Healthcare, Inc.	$ 1,144	$ 659
Weighted average common shares outstanding	350,850	370,289
Effect of dilutive incremental shares	8,899	9,691
Shares used for diluted earnings per share	359,749	379,980
Basic earnings per share	$ 3.26	$ 1.78
Diluted earnings per share	$ 3.18	$ 1.74

Investments of Insurance Subs35

Investments of Insurance Subsidiaries - Schedule of Investments (Detail) - USD ($) $ in Millions	Mar. 31, 2018	Dec. 31, 2017
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	$ 456	$ 462
Unrealized Amounts, Gains	5	10
Unrealized Amounts, Losses	0	0
Fair Value	461	472
Amounts classified as current assets	(44)	(54)
Investment carrying value	417	418
Money Market Funds and Other [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	205	101
Unrealized Amounts, Losses	0	0
Fair Value	205	101
Debt Securities [Member] | States and Municipalities [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	251	361
Unrealized Amounts, Gains	5	10
Unrealized Amounts, Losses	0	0
Fair Value	$ 256	$ 371

Investments of Insurance Subs36

Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail) $ in Millions	Mar. 31, 2018USD ($)
Investments, Debt and Equity Securities [Abstract]
Due in one year or less, Amortized Cost	$ 29
Due after one year through five years, Amortized Cost	34
Due after five years through ten years, Amortized Cost	166
Due after ten years, Amortized Cost	22
Amortized Cost, Total	251
Due in one year or less, Fair Value	29
Due after one year through five years, Fair Value	35
Due after five years through ten years, Fair Value	170
Due after ten years, Fair Value	22
Fair Value, Total	$ 256

Investments of Insurance Subs37

Investments of Insurance Subsidiaries - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2018
Investments, Debt and Equity Securities [Abstract]
Available for sale securities expected maturity of debt securities	4 years 9 months 18 days
Available for sale securities average scheduled maturity	6 years 4 months 24 days

Financial Instruments - Schedul

Financial Instruments - Schedule of Interest Rate Swap Agreements Designated as Cash Flow Hedges (Detail) - Pay-Fixed Interest Rate Swaps [Member]	3 Months Ended
	Mar. 31, 2018USD ($)
Maturity Date, 2021 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 2,000,000,000
Fair Value	$ 74,000,000
Maturity Date	Dec. 31, 2021
Maturity Date, 2022 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 500,000,000
Fair Value	$ 11,000,000
Maturity Date	Dec. 31, 2022

Financial Instruments - Additio

Financial Instruments - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2018USD ($)
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Estimated amount reclassified from other comprehensive income and reduce interest expense	$ 14

Financial Instruments - Effect

Financial Instruments - Effect of Interest Rate Swaps on Results of Operations (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2018USD ($)
Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain Recognized in OCI on Derivatives, Net of Tax	$ 27

Assets and Liabilities Measur41

Assets and Liabilities Measured at Fair Value - Schedule of Assets Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Millions	Mar. 31, 2018	Dec. 31, 2017
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	$ 461	$ 472
Less amounts classified as current assets	(44)	(54)
Investments of insurance subsidiaries, noncurrent	417	418
Interest Rate Swaps [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Interest rate swaps (Other)	85	50
Money Market Funds and Other [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	205	101
Debt Securities [Member] | States and Municipalities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	256	371
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	205	101
Less amounts classified as current assets	(44)	(54)
Investments of insurance subsidiaries, noncurrent	161	47
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member] | Money Market Funds and Other [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	205	101
Significant Other Observable Inputs (Level 2) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	256	371
Investments of insurance subsidiaries, noncurrent	256	371
Significant Other Observable Inputs (Level 2) [Member] | Interest Rate Swaps [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Interest rate swaps (Other)	85	50
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member] | States and Municipalities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value	$ 256	$ 371

Assets and Liabilities Measur42

Assets and Liabilities Measured at Fair Value - Additional Information (Detail) - USD ($) $ in Millions	Mar. 31, 2018	Dec. 31, 2017
Fair Value Disclosures [Abstract]
Estimated fair value of long-term debt	$ 34,084	$ 34,689
Carrying amounts of long-term debt	$ 33,449	$ 33,222

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-Term Debt (Detail) - USD ($) $ in Millions	Mar. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Senior secured debt	$ 23,697	$ 23,470
Net debt issuance costs	(158)	(164)
Total debt (average life of 6.6 years, rates averaging 5.2%)	33,291	33,058
Less amounts due within one year	1,697	200
Long-term debt	31,594	32,858
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term line of credit	3,750	3,680
Senior Secured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term line of credit	200
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Senior secured debt	3,873	3,891
Senior Secured Notes [Member]
Debt Instrument [Line Items]
Senior secured debt	15,300	15,300
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Other senior secured debt	574	599
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes	$ 9,752	$ 9,752

Long-Term Debt - Schedule of 44

Long-Term Debt - Schedule of Long-Term Debt (Parenthetical) (Detail)	3 Months Ended
	Mar. 31, 2018
Debt Instrument [Line Items]
Total debt average term	6 years 7 months 6 days
Total debt average rate	5.20%
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Effective interest rate	3.30%
Senior Secured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Effective interest rate	3.40%
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Effective interest rate	3.50%
Senior Secured Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	5.40%
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Effective interest rate	5.80%
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	6.40%

Capital Structure - Schedule of

Capital Structure - Schedule of Changes in Stockholders' Deficit and Equity (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Capital Structure [Line Items]
Beginning Balances	$ (4,995)
Comprehensive income	1,363	$ 795
Repurchase of common stock	(423)
Dividends and distributions	(218)
Share-based benefit plans	(114)
Dispositions of entities with noncontrolling interests	(53)
Other	6
Ending Balances	(4,434)
Common Stock [Member]
Capital Structure [Line Items]
Beginning Balances	4
Ending Balances	$ 4
Beginning Balances, Shares	350,092,000
Repurchase of common stock, shares	(4,370,000)
Share-based benefit plans, Shares	5,265,000
Ending Balances, Shares	350,987,000
Accumulated Other Comprehensive Loss [Member]
Capital Structure [Line Items]
Beginning Balances	$ (278)
Comprehensive income	81
Ending Balances	(197)
Retained Deficit [Member]
Capital Structure [Line Items]
Beginning Balances	(6,532)
Comprehensive income	1,144
Repurchase of common stock	(423)
Dividends and distributions	(126)
Share-based benefit plans	(114)
Ending Balances	(6,051)
Equity Attributable to Noncontrolling Interests [Member]
Capital Structure [Line Items]
Beginning Balances	1,811
Comprehensive income	138
Dividends and distributions	(92)
Dispositions of entities with noncontrolling interests	(53)
Other	6
Ending Balances	$ 1,810

Capital Structure - Additional

Capital Structure - Additional Information (Detail) - Common Stock [Member] - USD ($)	Jan. 30, 2018	Mar. 31, 2018	Oct. 31, 2017
Capital Structure [Line Items]
Repurchase of common stock, shares		4,370,000
Repurchase price of common stock, per share		$ 96.80
Share repurchase program, remaining authorized repurchase amount		$ 1,379,000
Share repurchase program authorized amount			$ 2,000,000,000
Dividends declared date	Jan. 30, 2018
Dividends per share	$ 0.35
Dividends record date	Mar. 1, 2018
Dividends payment date	2018-03

Capital Structure - Components

Capital Structure - Components of Accumulated Other Comprehensive Loss (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2018USD ($)
Equity [Abstract]
Unrealized gains on available-for-sale securities, beginning balances	$ 7
Unrealized losses on available-for-sale securities, net of income tax benefit	(4)
Unrealized gains on available-for-sale securities, ending balances	3
Foreign currency translation adjustments, beginning balances	(149)
Foreign currency translation adjustments	54
Foreign currency translation adjustments, ending balances	(95)
Defined benefit plans, beginning balances	(168)
Defined benefit plans, (income) expense reclassified into operations from other comprehensive income	4
Defined benefit plans, ending balances	(164)
Change in fair value of derivative instruments, beginning balances	32
Change in fair value of derivative instruments net of income taxes	27
Change in fair value of derivative instruments, ending balances	59
Accumulated other comprehensive income, net of tax, beginning balances	(278)
Unrealized losses on available-for-sale securities, net of income tax benefit	(4)
Foreign currency translation adjustments	54
Change in fair value of derivative instruments	27
Expense reclassified into operations from other comprehensive income, Total	4
Accumulated other comprehensive income (loss), net of tax, ending balances	$ (197)

Capital Structure - Component48

Capital Structure - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2018USD ($)
Equity [Abstract]
Unrealized losses on available-for-sale securities, tax benefit portion	$ 1
Defined benefit plans, Expense reclassified into operations from other comprehensive income, Income tax benefit	1
Change in fair value of derivative instruments, change in fair value of derivative instruments, income taxes	$ 8

Segment and Geographic Inform49

Segment and Geographic Information - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2018Hospital
Segment Reporting Information [Line Items]
Number of geographically organized groups	2
Number of owned and operated hospitals	178
Reorganization Group [Member] | National Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	88
Reorganization Group [Member] | American Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	84
Reorganization Group [Member] | Corporate and Other [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	6

Segment and Geographic Inform50

Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization and Assets (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Segment Reporting Information [Line Items]
Revenues	$ 11,423	$ 10,623
Equity in earnings of affiliates	9	10
Adjusted segment EBITDA	2,118	2,005
Depreciation and amortization	553	521
Interest expense	431	419
Gains on sales of facilities	(405)	(1)
Income before income taxes	1,539	1,066
National Group [Member]
Segment Reporting Information [Line Items]
Revenues	5,568	5,148
Equity in earnings of affiliates	(2)	(5)
Adjusted segment EBITDA	1,182	1,131
Depreciation and amortization	225	214
American Group [Member]
Segment Reporting Information [Line Items]
Revenues	5,327	4,995
Equity in earnings of affiliates	(9)	(8)
Adjusted segment EBITDA	1,031	1,007
Depreciation and amortization	252	238
Corporate and Other [Member]
Segment Reporting Information [Line Items]
Revenues	528	480
Equity in earnings of affiliates	2	3
Adjusted segment EBITDA	(95)	(133)
Depreciation and amortization	$ 76	$ 69

Supplemental Condensed Consol51

Supplemental Condensed Consolidating Financial Information and Other Collateral-Related Information - Additional Information (Detail) - USD ($)	Mar. 31, 2018	Dec. 31, 2012
Supplemental Condensed Consolidating Financial Information [Line Items]
Ownership percentage held by parent	100.00%
Senior Unsecured Notes Due 2021 [Member]
Supplemental Condensed Consolidating Financial Information [Line Items]
Debt instrument, principal amount		$ 1,000,000,000
Debt instrument, stated interest		6.25%

Supplemental Condensed Consol52

Supplemental Condensed Consolidating Financial Information and Other Collateral-Related Information - Schedule of Condensed Consolidating Comprehensive Income Statement (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Condensed Statement of Income Captions [Line Items]
Revenues	$ 11,423	$ 10,623
Salaries and benefits	5,289	4,901
Supplies	1,915	1,797
Other operating expenses	2,110	1,930
Equity in earnings of affiliates	(9)	(10)
Depreciation and amortization	553	521
Interest expense	431	419
Losses (gains) on sales of facilities	(405)	(1)
Total expenses including equity in earnings of affiliates	9,884	9,557
Income (loss) before income taxes	1,539	1,066
Provision (benefit) for income taxes	257	289
Net income (loss)	1,282	777
Net income attributable to noncontrolling interests	138	118
Net income (loss) attributable to HCA Healthcare, Inc.	1,144	659
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	1,225	677
HCA Healthcare, Inc. Issuer [Member]
Condensed Statement of Income Captions [Line Items]
Other operating expenses	1	1
Equity in earnings of affiliates	(1,090)	(608)
Interest expense	16	16
Total expenses including equity in earnings of affiliates	(1,073)	(591)
Income (loss) before income taxes	1,073	591
Provision (benefit) for income taxes	(71)	(68)
Net income (loss)	1,144	659
Net income (loss) attributable to HCA Healthcare, Inc.	1,144	659
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	1,225	677
HCA Inc. Issuer [Member]
Condensed Statement of Income Captions [Line Items]
Interest expense	837	733
Total expenses including equity in earnings of affiliates	837	733
Income (loss) before income taxes	(837)	(733)
Provision (benefit) for income taxes	(195)	(270)
Net income (loss)	(642)	(463)
Net income (loss) attributable to HCA Healthcare, Inc.	(642)	(463)
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	(615)	(456)
Subsidiary Guarantors [Member]
Condensed Statement of Income Captions [Line Items]
Revenues	6,776	6,336
Salaries and benefits	3,069	2,904
Supplies	1,141	1,075
Other operating expenses	1,128	1,050
Equity in earnings of affiliates	(2)	(2)
Depreciation and amortization	323	310
Interest expense	(367)	(290)
Losses (gains) on sales of facilities	(395)	1
Management fees	(158)	(160)
Total expenses including equity in earnings of affiliates	4,739	4,888
Income (loss) before income taxes	2,037	1,448
Provision (benefit) for income taxes	467	526
Net income (loss)	1,570	922
Net income attributable to noncontrolling interests	28	23
Net income (loss) attributable to HCA Healthcare, Inc.	1,542	899
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	1,546	902
Subsidiary Non-Guarantors [Member]
Condensed Statement of Income Captions [Line Items]
Revenues	4,647	4,287
Salaries and benefits	2,220	1,997
Supplies	774	722
Other operating expenses	981	879
Equity in earnings of affiliates	(7)	(8)
Depreciation and amortization	230	211
Interest expense	(55)	(40)
Losses (gains) on sales of facilities	(10)	(2)
Management fees	158	160
Total expenses including equity in earnings of affiliates	4,291	3,919
Income (loss) before income taxes	356	368
Provision (benefit) for income taxes	56	101
Net income (loss)	300	267
Net income attributable to noncontrolling interests	110	95
Net income (loss) attributable to HCA Healthcare, Inc.	190	172
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	240	180
Eliminations [Member]
Condensed Statement of Income Captions [Line Items]
Equity in earnings of affiliates	1,090	608
Total expenses including equity in earnings of affiliates	1,090	608
Income (loss) before income taxes	(1,090)	(608)
Net income (loss)	(1,090)	(608)
Net income (loss) attributable to HCA Healthcare, Inc.	(1,090)	(608)
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	$ (1,171)	$ (626)

Supplemental Condensed Consol53

Supplemental Condensed Consolidating Financial Information and Other Collateral-Related Information - Schedule of Condensed Consolidating Balance Sheet (Detail) - USD ($) $ in Millions	Mar. 31, 2018	Dec. 31, 2017	Mar. 31, 2017	Dec. 31, 2016
Current assets:
Cash and cash equivalents	$ 1,086	$ 732	$ 753	$ 646
Accounts receivable	6,332	6,501
Inventories	1,677	1,573
Other	1,296	1,171
Total current assets	10,391	9,977
Property and equipment, net	18,124	17,895
Investments of insurance subsidiaries	417	418
Investments in and advances to affiliates	231	199
Goodwill and other intangible assets	7,471	7,394
Other	665	710
Total assets	37,299	36,593
Current liabilities:
Accounts payable	2,538	2,606
Accrued salaries	1,238	1,369
Other accrued expenses	2,005	1,983
Long-term debt due within one year	1,697	200
Total current liabilities	7,478	6,158
Long-term debt, net	31,594	32,858
Professional liability risks	1,244	1,198
Income taxes and other liabilities	1,417	1,374
Total liabilities	41,733	41,588
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(6,244)	(6,806)
Noncontrolling interests	1,810	1,811
Total stockholders' deficit	(4,434)	(4,995)
Total liabilities and stockholders' deficit	37,299	36,593
HCA Healthcare, Inc. Issuer [Member]
Current assets:
Cash and cash equivalents		1
Total current assets		1
Investments in and advances to affiliates	30,752	29,581
Other	437	510
Total assets	31,189	30,092
Current liabilities:
Other accrued expenses	190	29
Total current liabilities	190	29
Long-term debt, net	995	995
Intercompany balances	35,687	35,322
Income taxes and other liabilities	561	552
Total liabilities	37,433	36,898
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(6,244)	(6,806)
Total stockholders' deficit	(6,244)	(6,806)
Total liabilities and stockholders' deficit	31,189	30,092
HCA Inc. Issuer [Member]
Current assets:
Other	85	50
Total assets	85	50
Current liabilities:
Other accrued expenses	281	378
Long-term debt due within one year	1,597	97
Total current liabilities	1,878	475
Long-term debt, net	30,125	31,367
Intercompany balances	(9,253)	(9,742)
Total liabilities	22,750	22,100
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(22,665)	(22,050)
Total stockholders' deficit	(22,665)	(22,050)
Total liabilities and stockholders' deficit	85	50
Subsidiary Guarantors [Member]
Current assets:
Cash and cash equivalents	304	112	185	113
Accounts receivable	3,747	3,693
Inventories	1,143	1,030
Other	728	663
Total current assets	5,922	5,498
Property and equipment, net	11,632	11,110
Investments in and advances to affiliates	31	22
Goodwill and other intangible assets	5,438	4,893
Other	30	47
Total assets	23,053	21,570
Current liabilities:
Accounts payable	1,776	1,793
Accrued salaries	779	862
Other accrued expenses	545	536
Long-term debt due within one year	63	64
Total current liabilities	3,163	3,255
Long-term debt, net	293	307
Intercompany balances	(25,158)	(25,228)
Income taxes and other liabilities	379	357
Total liabilities	(21,323)	(21,309)
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	44,301	42,755
Noncontrolling interests	75	124
Total stockholders' deficit	44,376	42,879
Total liabilities and stockholders' deficit	23,053	21,570
Subsidiary Non-Guarantors [Member]
Current assets:
Cash and cash equivalents	782	619	$ 568	$ 533
Accounts receivable	2,585	2,808
Inventories	534	543
Other	568	508
Total current assets	4,469	4,478
Property and equipment, net	6,492	6,785
Investments of insurance subsidiaries	417	418
Investments in and advances to affiliates	200	177
Goodwill and other intangible assets	2,033	2,501
Other	113	103
Total assets	13,724	14,462
Current liabilities:
Accounts payable	762	813
Accrued salaries	459	507
Other accrued expenses	989	1,040
Long-term debt due within one year	37	39
Total current liabilities	2,247	2,399
Long-term debt, net	181	189
Intercompany balances	(1,276)	(352)
Professional liability risks	1,244	1,198
Income taxes and other liabilities	477	465
Total liabilities	2,873	3,899
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	9,116	8,876
Noncontrolling interests	1,735	1,687
Total stockholders' deficit	10,851	10,563
Total liabilities and stockholders' deficit	13,724	14,462
Eliminations [Member]
Current assets:
Investments in and advances to affiliates	(30,752)	(29,581)
Total assets	(30,752)	(29,581)
Current liabilities:
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(30,752)	(29,581)
Total stockholders' deficit	(30,752)	(29,581)
Total liabilities and stockholders' deficit	$ (30,752)	$ (29,581)

Supplemental Condensed Consol54

Supplemental Condensed Consolidating Financial Information and Other Collateral-Related Information - Schedule of Condensed Consolidating Statement of Cash Flows (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Cash flows from operating activities:
Net income (loss)	$ 1,282	$ 777
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(468)	(420)
Depreciation and amortization	553	521
Income taxes	246	292
Losses (gains) on sales of facilities	(405)	(1)
Amortization of debt issuance costs	8	8
Share-based compensation	60	73
Other	24	30
Net cash provided by operating activities	1,300	1,280
Cash flows from investing activities:
Purchase of property and equipment	(694)	(571)
Acquisition of hospitals and health care entities	(379)	(90)
Disposition of hospitals and health care entities	767	4
Change in investments	11	(19)
Other	(40)	7
Net cash used in investing activities	(335)	(669)
Cash flows from financing activities:
Net change in revolving bank credit facilities	270	160
Repayment of long-term debt	(50)	(43)
Distributions to noncontrolling interests	(92)	(145)
Payment of debt issuance costs	(2)	(2)
Payment of cash dividends	(123)
Repurchases of common stock	(423)	(424)
Other	(191)	(50)
Net cash used in financing activities	(611)	(504)
Change in cash and cash equivalents	354	107
Cash and cash equivalents at beginning of period	732	646
Cash and cash equivalents at end of period	1,086	753
Eliminations [Member]
Cash flows from operating activities:
Net income (loss)	(1,090)	(608)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Equity in earnings of affiliates	1,090	608
HCA Healthcare, Inc. Issuer [Member]
Cash flows from operating activities:
Net income (loss)	1,144	659
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(15)	(15)
Income taxes	246	292
Equity in earnings of affiliates	(1,090)	(608)
Other	21	19
Net cash provided by operating activities	306	347
Cash flows from financing activities:
Payment of cash dividends	(123)
Repurchases of common stock	(423)	(424)
Changes in intercompany balances with affiliates, net	434	134
Other	(195)	(57)
Net cash used in financing activities	(307)	(347)
Change in cash and cash equivalents	(1)
Cash and cash equivalents at beginning of period	1
HCA Inc. Issuer [Member]
Cash flows from operating activities:
Net income (loss)	(642)	(463)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(99)	(295)
Amortization of debt issuance costs	8	8
Net cash provided by operating activities	(733)	(750)
Cash flows from financing activities:
Net change in revolving bank credit facilities	270	160
Repayment of long-term debt	(18)	(18)
Payment of debt issuance costs	(2)	(2)
Changes in intercompany balances with affiliates, net	483	610
Net cash used in financing activities	733	750
Subsidiary Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	1,570	922
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(347)	(199)
Depreciation and amortization	323	310
Losses (gains) on sales of facilities	(395)	1
Share-based compensation	60	73
Other		1
Net cash provided by operating activities	1,211	1,108
Cash flows from investing activities:
Purchase of property and equipment	(413)	(312)
Acquisition of hospitals and health care entities	(373)	(5)
Disposition of hospitals and health care entities	767	4
Change in investments	13	2
Other	(48)	1
Net cash used in investing activities	(54)	(310)
Cash flows from financing activities:
Repayment of long-term debt	(22)	(13)
Distributions to noncontrolling interests	(24)	(57)
Changes in intercompany balances with affiliates, net	(919)	(656)
Net cash used in financing activities	(965)	(726)
Change in cash and cash equivalents	192	72
Cash and cash equivalents at beginning of period	112	113
Cash and cash equivalents at end of period	304	185
Subsidiary Non-Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	300	267
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(7)	89
Depreciation and amortization	230	211
Losses (gains) on sales of facilities	(10)	(2)
Other	3	10
Net cash provided by operating activities	516	575
Cash flows from investing activities:
Purchase of property and equipment	(281)	(259)
Acquisition of hospitals and health care entities	(6)	(85)
Change in investments	(2)	(21)
Other	8	6
Net cash used in investing activities	(281)	(359)
Cash flows from financing activities:
Repayment of long-term debt	(10)	(12)
Distributions to noncontrolling interests	(68)	(88)
Changes in intercompany balances with affiliates, net	2	(88)
Other	4	7
Net cash used in financing activities	(72)	(181)
Change in cash and cash equivalents	163	35
Cash and cash equivalents at beginning of period	619	533
Cash and cash equivalents at end of period	$ 782	$ 568

Supplemental Condensed Consol55

Supplemental Condensed Consolidating Financial Information and Other Collateral-Related Information - Summary of Restatement Adjustments to Financial Statements (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	$ 1,144	$ 659
Net cash provided by operating activities	1,300	1,280
HCA Healthcare, Inc. Issuer [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	1,144	659
Net cash provided by operating activities	306	347
HCA Inc. Issuer [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	(642)	(463)
Net cash provided by operating activities	(733)	(750)
Subsidiary Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	1,542	899
Net cash provided by operating activities	1,211	1,108
Subsidiary Non-Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	190	172
Net cash provided by operating activities	516	575
Eliminations [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.	$ (1,090)	(608)
As Previously Reported [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		659
Net cash provided by operating activities		1,280
As Previously Reported [Member] | HCA Healthcare, Inc. Issuer [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		659
Net cash provided by operating activities		347
As Previously Reported [Member] | HCA Inc. Issuer [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		(463)
Net cash provided by operating activities		(750)
As Previously Reported [Member] | Subsidiary Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		818
Net cash provided by operating activities		983
As Previously Reported [Member] | Subsidiary Non-Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		253
Net cash provided by operating activities		700
As Previously Reported [Member] | Eliminations [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		(608)
Adjustment [Member] | Subsidiary Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		81
Net cash provided by operating activities		125
Adjustment [Member] | Subsidiary Non-Guarantors [Member]
Adjustments or Reclassifications [Line Items]
Net income attributable to HCA Healthcare, Inc.		(81)
Net cash provided by operating activities		$ (125)