HCA Healthcare (HCA) 10-Q 3 May 19 2019 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2019	Apr. 30, 2019
Document and Entity Information [Abstract]
Amendment Flag	false
Document Type	10-Q
Document Period End Date	Mar. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1
Trading Symbol	HCA
Entity Registrant Name	HCA Healthcare, Inc.
Entity Central Index Key	0000860730
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		342,307,400

Condensed Consolidated Income S

Condensed Consolidated Income Statements - USD ($) shares in Thousands, $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Income Statement [Abstract]
Revenues	$ 12,517	$ 11,423
Salaries and benefits	5,647	5,289
Supplies	2,041	1,915
Other operating expenses	2,299	2,110
Equity in earnings of affiliates	(11)	(9)
Depreciation and amortization	619	553
Interest expense	461	431
Losses (gains) on sales of facilities	1	(405)
Total expenses including equity in earnings of affiliates	11,057	9,884
Income before income taxes	1,460	1,539
Provision for income taxes	279	257
Net income	1,181	1,282
Net income attributable to noncontrolling interests	142	138
Net income attributable to HCA Healthcare, Inc.	$ 1,039	$ 1,144
Per share data:
Basic earnings	$ 3.03	$ 3.26
Diluted earnings	$ 2.97	$ 3.18
Shares used in earnings per share calculations (in millions):
Basic	342,876	350,850
Diluted	350,316	359,749

Condensed Consolidated Comprehe

Condensed Consolidated Comprehensive Income Statements - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Statement of Comprehensive Income [Abstract]
Net income	$ 1,181	$ 1,282
Other comprehensive income (loss) before taxes:
Foreign currency translation	20	54
Unrealized gains (losses) on available-for-salesecurities	8	(5)
Defined benefit plans	0
Pension costs included in salaries and benefits	3	5
Total defined benefit plans	3	5
Change in fair value of derivative financial instruments	(18)	35
Interest benefits included in interest expense	(5)	0
Total change in fair value of derivative financial instruments	(23)	35
Other comprehensive income before taxes	8	89
Income taxes related to other comprehensive income items	1	8
Other comprehensive income	7	81
Comprehensive income	1,188	1,363
Comprehensive income attributable to noncontrolling interests	142	138
Comprehensive income attributable to HCA Healthcare, Inc.	$ 1,046	$ 1,225

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Millions	Mar. 31, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 531	$ 502
Accounts receivable	7,420	6,789
Inventories	1,778	1,732
Other	1,379	1,190
Total current assets	11,108	10,213
Property and equipment, at cost	44,583	42,965
Accumulated depreciation	(23,455)	(23,208)
Property and equipment, net	21,128	19,757
Investments of insurance subsidiaries	338	362
Investments in and advances to affiliates	246	232
Goodwill and other intangible assets	8,159	7,953
Right-of-use operating lease assets	1,812
Other	588	690
Total assets	43,379	39,207
Current liabilities:
Accounts payable	2,693	2,577
Accrued salaries	1,424	1,580
Other accrued expenses	2,618	2,624
Long-term debt due within one year	3,796	788
Total current liabilities	10,531	7,569
Long-term debt, less net debt issuance costs of $170 and $157	31,019	32,033
Professional liability risks	1,313	1,275
Right-of-use operating lease obligations	1,494
Income taxes and other liabilities	1,277	1,248
Stockholders' deficit:
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 343,030,500 shares in 2019 and 342,895,200 shares in 2018	3	3
Accumulated other comprehensive loss	(374)	(381)
Retained deficit	(3,983)	(4,572)
Stockholders' deficit attributable to HCA Healthcare, Inc.	(4,354)	(4,950)
Noncontrolling interests	2,099	2,032
Total stockholders' deficit	(2,255)	(2,918)
Total liabilities and stockholders' deficit	$ 43,379	$ 39,207

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Mar. 31, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Debt issuance costs	$ 170	$ 157
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	1,800,000,000	1,800,000,000
Common stock, shares outstanding	343,030,500	342,895,200

Condensed Consolidated Statemen

Condensed Consolidated Statements of Stockholders' Deficit - USD ($) shares in Thousands, $ in Millions	Total	Common Stock [Member]	Capital in Excess of Par Value [Member]	Accumulated Other Comprehensive Loss [Member]	Retained Deficit [Member]	Equity Attributable to Noncontrolling Interests [Member]
Balances at Dec. 31, 2017	$ (4,995)	$ 4		$ (278)	$ (6,532)	$ 1,811
Balance, shares at Dec. 31, 2017		350,092
Comprehensive income (loss)	1,363			81	1,144	138
Repurchase of common stock	(423)		$ 114		(537)
Repurchase of common stock, shares		(4,370)
Share-based benefit plans	(114)		(114)
Share-based benefit plans, shares		5,265
Cash dividends declared	(126)				(126)
Distributions	(92)					(92)
Other	(47)					(47)
Balance at Mar. 31, 2018	(4,434)	$ 4		(197)	(6,051)	1,810
Balance, shares at Mar. 31, 2018		350,987
Comprehensive income (loss)	902			(64)	820	146
Repurchase of common stock	(470)	$ (1)	(93)		(376)
Repurchase of common stock, shares		(4,670)
Share-based benefit plans	96		96
Share-based benefit plans, shares		443
Cash dividends declared	(124)				(124)
Distributions	(93)					(93)
Other	(2)		(3)			1
Balance at Jun. 30, 2018	(4,125)	$ 3		(261)	(5,731)	1,864
Balance, shares at Jun. 30, 2018		346,760
Comprehensive income (loss)	891			(5)	759	137
Repurchase of common stock	(302)		(55)		(247)
Repurchase of common stock, shares		(2,518)
Share-based benefit plans	54		54
Share-based benefit plans, shares		844
Cash dividends declared	(123)				(123)
Distributions	(130)					(130)
Other	5		1			4
Balance at Sep. 30, 2018	(3,730)	$ 3		(266)	(5,342)	1,875
Balance, shares at Sep. 30, 2018		345,086
Comprehensive income (loss)	1,225			(20)	1,064	181
Repurchase of common stock	(335)		(69)		(266)
Repurchase of common stock, shares		(2,512)
Share-based benefit plans	79		79
Share-based benefit plans, shares		321
Cash dividends declared	(123)				(123)
Distributions	(126)					(126)
Reclassification of stranded tax effects				(95)	95
Other	92		(10)			102
Balance at Dec. 31, 2018	(2,918)	$ 3		(381)	(4,572)	2,032
Balance, shares at Dec. 31, 2018		342,895
Comprehensive income (loss)	1,188			7	1,039	142
Repurchase of common stock	$ (278)		32		(310)
Repurchase of common stock, shares	(2,106)	(2,106)
Share-based benefit plans	$ (29)		(29)
Share-based benefit plans, shares		2,242
Cash dividends declared	(140)				(140)
Distributions	(136)					(136)
Other	58		$ (3)			61
Balance at Mar. 31, 2019	$ (2,255)	$ 3		$ (374)	$ (3,983)	$ 2,099
Balance, shares at Mar. 31, 2019		343,031

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Deficit (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018
Statement of Stockholders' Equity [Abstract]
Cash dividends declared, per share	$ 0.40	$ 0.35	$ 0.35	$ 0.35	$ 0.35

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cash flows from operating activities:
Net income	$ 1,181	$ 1,282
Decrease in cash from operating assets and liabilities:
Accounts receivable	(369)	(4)
Inventories and other assets	(174)	(218)
Accounts payable and accrued expenses	(651)	(263)
Depreciation and amortization	619	553
Income taxes	269	246
Losses (gains) on sales of facilities	1	(405)
Amortization of debt issuance costs	8	8
Share-based compensation	62	60
Other	28	24
Net cash provided by (used in) operating activities	974	1,283
Cash flows from investing activities:
Purchase of property and equipment	(781)	(694)
Acquisition of hospitals and health care entities	(1,474)	(379)
Disposal of hospitals and health care entities	30	767
Change in investments	36	11
Other	24	(40)
Net cash used in investing activities	(2,165)	(335)
Cash flows from financing activities:
Issuances of long-term debt	1,500
Net change in revolving bank credit facilities	460	270
Repayment of long-term debt	(49)	(50)
Distributions to noncontrolling interests	(136)	(92)
Payment of debt issuance costs	(22)	(2)
Payment of cash dividends	(141)	(123)
Repurchases of common stock	(278)	(423)
Other	(118)	(191)
Net cash provided by (used in) financing activities	1,216	(611)
Effect of exchange rate changes on cash and cash equivalents	4	17
Change in cash and cash equivalents	29	354
Cash and cash equivalents at beginning of period	502	732
Cash and cash equivalents at end of period	531	1,086
Interest payments	580	549
Income tax payments, net	$ 10	$ 11

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	3 Months Ended
	Mar. 31, 2019
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, 2019, these affiliates owned and operated 185 hospitals, 124 freestanding surgery centers and provided extensive outpatient and ancillary services. HCA Healthcare, Inc.’s facilities are located in 21 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 S-X. 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 $86 million and $81 million for the quarters ended March 31, 2019 and 2018, respectively. Operating results for the quarter ended March 31, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K Revenues 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 Our performance obligations for outpatient services are generally satisfied over a period of less than one day fee-for-service Revenues (continued) 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 2019 Ratio 2018 Ratio Medicare $ 2,770 22.1 % $ 2,524 22.1 % Managed Medicare 1,589 12.7 1,399 12.3 Medicaid 347 2.8 281 2.5 Managed Medicaid 613 4.9 561 4.9 Managed care and insurers 6,426 51.4 6,062 53.1 International (managed care and insurers) 297 2.4 305 2.7 Other 475 3.7 291 2.4 Revenues $ 12,517 100.0 % $ 11,423 100.0 % 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, 2019 and 2018 follows (dollars in millions): 2019 2018 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 10,606 $ 9,867 Cost-to-charges ratio (patient care costs as percentage of gross patient charges) 11.8 % 12.4 % Total uncompensated care $ 7,085 $ 6,252 Multiply by the cost-to-charges ratio 11.8 % 12.4 % Estimated cost of total uncompensated care $ 836 $ 775 Total uncompensated care as a percentage of the sum of revenues and total uncompensated care was 36.1% and 35.4% for the quarters ended March 31, 2019 and 2018, respectively. The total uncompensated care amounts include charity care of $2.905 billion and $1.879 billion, and the related estimated costs of charity care were $343 million and $233 million for the quarters ended March 31, 2019 and 2018, respectively. 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, 2019
Business Combinations [Abstract]
Acquisitions and Dispositions	NOTE 2 — ACQUISITIONS AND DISPOSITIONS During the quarter ended March 31, 2019, we paid $1.398 billion to acquire a seven During the quarter ended March 31, 2019, we received proceeds of $25 million and recognized a net pretax loss of $ 1

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	NOTE 3 — INCOME TAXES Our provision for income taxes for the quarters ended March 31, 2019 and 2018 was $279 million and $257 million, respectively, and the effective tax rates were 21.2% and 18.4%, respectively. Our provision for income taxes included tax benefits related to the settlement of employee equity awards of $49 million and $92 million for the quarters ended March 31, 2019 and 2018, respectively. Our liability for unrecognized tax benefits was $457 million, including accrued interest of $53 million, as of March 31, 2019 ($435 million and $48 million, respectively, as of December 31, 2018). Unrecognized tax benefits of $143 million ($137 million as of December 31, 2018) would affect the effective rate, if recognized. The Internal Revenue Service began an examination of the Company’s 2016 and 2017 federal income tax returns during 2019. We are also subject to examination by 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, 2019
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, 2019 and 2018 (dollars and shares in millions, except per share amounts): 2019 2018 Net income attributable to HCA Healthcare, Inc. $ 1,039 $ 1,144 Weighted average common shares outstanding 342.876 350.850 Effect of dilutive incremental shares 7.440 8.899 Shares used for diluted earnings per share 350.316 359.749 Earnings per share: Basic earnings $ 3.03 $ 3.26 Diluted earnings $ 2.97 $ 3.18

Investments of Insurance Subsid

Investments of Insurance Subsidiaries	3 Months Ended
	Mar. 31, 2019
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, 2019 and December 31, 2018 follows (dollars in millions): March 31, 2019 Amortized Unrealized Fair Gains Losses Debt securities $ 336 $ 11 $ — $ 347 Money market funds and other 81 — — 81 $ 417 $ 11 $ — 428 Amounts classified as current assets (90 ) Investment carrying value $ 338 December 31, 2018 Amortized Cost Unrealized Amounts Fair Value Gains Losses Debt securities $ 338 $ 5 $ (2 ) $ 341 Money market funds and other 68 — — 68 $ 406 $ 5 $ (2 ) 409 Amounts classified as current assets (47 ) Investment carrying value $ 362 At March 31, 2019 and December 31, 2018, the investments of our insurance subsidiaries were classified as “available-for-sale.” Scheduled maturities of investments in debt securities at March 31, 2019 were as follows (dollars in millions): Amortized Cost Fair Value Due in one year or less $ 3 $ 3 Due after one year through five years 64 65 Due after five years through ten years 201 209 Due after ten years 68 70 $ 336 $ 347 The average expected maturity of the investments in debt securities at March 31, 2019 was 5.9

Financial Instruments

Financial Instruments	3 Months Ended
	Mar. 31, 2019
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 The following table sets forth our interest rate swap agreements, which have been designated as cash flow hedges, at March 31, 2019 (dollars in millions): Notional Amount Maturity Date Fair Value Pay-fixed interest rate swaps $ 2,000 December 2021 $ 38 Pay-fixed interest rate swaps 500 December 2022 2 During the next 12 months, we estimate $20 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, 2019 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Loss Location of Gain Amount of Gain Interest rate swaps $ 14 Interest expense $ 5

Assets and Liabilities Measured

Assets and Liabilities Measured at Fair Value	3 Months Ended
	Mar. 31, 2019
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, 2019 and December 31, 2018, 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, 2019 and December 31, 2018, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): March 31, 2019 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 347 $ — $ 347 $ — Money market funds and other 81 81 — — Investments of insurance subsidiaries 428 81 347 — Less amounts classified as current assets (90 ) (80 ) (10 ) — $ 338 1 $ 337 $ — Interest rate swaps (Other) $ 40 $ — $ 40 $ — December 31, 2018 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 341 $ — $ 341 $ — Money market funds and other 68 68 — — Investments of insurance subsidiaries 409 68 341 — Less amounts classified as current assets (47 ) (47 ) — — $ 362 $ 21 $ 341 $ — Interest rate swaps (Other) $ 63 $ — $ 63 $ — The estimated fair value of our long-term debt was $36.602 billion and $32.887 billion at March 31, 2019 and December 31, 2018, respectively, compared to carrying amounts, excluding net debt issuance costs, aggregating $34.985 billion and $32.978 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, 2019
Debt Disclosure [Abstract]
Long-Term Debt	NOTE 8 — LONG-TERM DEBT A summary of long-term debt at March 31, 2019 and December 31, 2018, including related interest rates at March 31, 2019, follows (dollars in millions): March 31, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 3.7%) $ 3,500 $ 3,040 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 3.7%) 3,776 3,801 Senior secured notes (effective interest rate of 5.6%) 13,800 13,800 Other senior secured debt (effective interest rate of 5.5%) 657 585 Senior secured debt 21,733 21,226 Senior unsecured notes (effective interest rate of 6.3%) 13,252 11,752 Net debt issuance costs (170 ) (157 ) Total debt (average life of 6.3 years, rates averaging 5.4%) 34,815 32,821 Less amounts due within one year 3,796 788 $ 31,019 $ 32,033 During January 2019, we issued $1.500 billion aggregate principal amount of senior unsecured notes comprised of $1.000 billion aggregate principal amount of 5.875% notes due 2029 and $500 million aggregate principal amount of 5.625% notes due 2028. We used the net proceeds to fund the purchase of a seven-hospital

Leases

Leases	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
Leases	NOTE 9 — LEASES We adopted ASU No. 2016-02, Leases (Topic 842) We lease property and equipment under finance and operating leases. For leases with terms greater than 12 months, we record the related right-of-use right-of-use Generally, we use our estimated incremental borrowing rate to discount the lease payments based on information available at lease commencement, as most of our leases do not provide a readily determinable implicit interest rate. The following table presents our lease-related assets and liabilities at March 31, 2019 (dollars in millions): Balance Sheet Classification March 31, 2019 Assets: Operating leases Right-of-use $ 1,812 Finance leases Property and equipment 590 Total lease assets $ 2,402 Liabilities: Current: Operating leases Other accrued expenses $ 310 Finance leases Long-term 39 Noncurrent: Operating leases Right-of-use 1,494 Finance leases Long-term debt 519 Total lease liabilities $ 2,362 Weighted-average remaining term: Operating leases 12.3 years Finance leases 9.2 years Weighted-average discount rate: Operating leases(1) 5.6 % Finance leases 5.4 % (1) Upon adoption of the new lease standard, discount rates used for existing leases were established at January 1, 2019. The following table presents certain information related to lease expense for finance and operating leases for the quarter ended March 31, 2019 (dollars in millions): 2019 Finance lease expense: Amortization of leased assets $ 17 Interest of lease liabilities 6 Operating leases(2) 94 Short-term lease expense(2) 78 Variable lease expense(2) 39 Total lease expense $ 234 (2) Expenses are included in “other operating expenses” in our condensed consolidated income statement. Other Information The following table presents supplemental cash flow information for the quarter ended March 31, 2019 (dollars in millions): 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 144 Operating cash flows for finance leases 6 Financing cash flows for finance leases 17 Maturities of Lease Liabilities The following table reconciles the undiscounted cash flows to the finance lease liabilities and operating lease liabilities recorded on the balance sheet at March 31, 2019 (dollars in millions): Operating Finance 2019 $ 294 $ 72 2020 370 92 2021 315 71 2022 254 62 2023 198 52 Thereafter 1,265 318 Total minimum lease payments 2,696 667 Less: amount of lease payments representing interest (892 ) (109 ) Present value of future minimum lease payments 1,804 558 Less: current obligations under leases (310 ) (39 ) Long-term lease obligations $ 1,494 $ 519

Contingencies

Contingencies	3 Months Ended
	Mar. 31, 2019
Commitments and Contingencies Disclosure [Abstract]
Contingencies	NOTE 10 — 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 (“FCA”), private parties have the right to bring qui tam conduct in these or future inquiries or investigations could be considered systemic, their resolution could have a material, adverse effect on our results of operations, financial position or liquidity. Texas operates a state Medicaid program pursuant to a waiver from CMS under Section 1115 of the Social Security Act (“Program”). The Program includes uncompensated-care pools; payments from these pools are intended to defray the uncompensated costs of services provided by our and other hospitals to Medicaid eligible or uninsured individuals. Separately, we and other hospitals provide charity care services in several communities in the state. The Civil Division of the U.S. Department of Justice and the U.S. Attorney’s Office for the Southern District of Texas have requested information about whether the Program as operated in Harris County complies with the laws and regulations applicable to provider related donations. The Company is cooperating with this request. We believe that our participation is and has been consistent with the requirements of the Program. However, at this time, we cannot predict what effect, if any, the request or resulting claims under the federal FCA, other statutes, regulations or laws, could have on the Company.

Share Repurchases Transactions

Share Repurchases Transactions and Other Comprehensive Loss	3 Months Ended
	Mar. 31, 2019
Federal Home Loan Banks [Abstract]
Share Repurchases Transactions and Other Comprehensive Loss	NOTE 11 — SHARE REPURCHASES TRANSACTIONS AND OTHER COMPREHENSIVE LOSS During January 2019, our Board of Directors authorized a share repurchase program for up to $2 billion of our outstanding common stock. During the quarter ended March 31, 2019, we repurchased 2.106 million shares of our common stock at an average price of $131.92 per share through market purchases pursuant to the $2.0 billion share repurchase program authorized during October 2017 (which was completed during the first quarter of 2019) and the $2.0 billion share repurchase program authorized during January 2019. At March 31, 2019, we had $1.995 billion of repurchase authorization available under the January 2019 authorization. The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized for-Sale Foreign Defined Change Total Balances at December 31, 2018 $ 3 $ (283 ) $ (148 ) $ 47 $ (381 ) Unrealized gains on available-for-sale 6 — — — 6 Foreign currency translation adjustments, net of $3 of income taxes — 17 — — 17 Change in fair value of derivative instruments, net of $4 income tax benefits — — — (14 ) (14 ) Expense (income) reclassified into operations from other comprehensive income, net of $1 income tax benefits and $1 of income taxes, respectively — — 2 (4 ) (2 ) Balances at March 31, 2019 $ 9 $ (266 ) $ (146 ) $ 29 $ (374 )

Segment and Geographic Informat

Segment and Geographic Information	3 Months Ended
	Mar. 31, 2019
Segment Reporting [Abstract]
Segment and Geographic Information	NOTE 12 — SEGMENT AND GEOGRAPHIC INFORMATION We operate in one line of business, which is operating hospitals and related health care entities. We operate in two hospitals located in Colorado, northern Georgia, Kansas, southern Kentucky, Louisiana, Mississippi, Missouri, Tennessee and Texas. We also operate six Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses (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, 2019 and 2018 are summarized in the following table (dollars in millions): 2019 2018 Revenues: National Group $ 6,317 $ 5,568 American Group 5,595 5,327 Corporate and other 605 528 $ 12,517 $ 11,423 Equity in earnings of affiliates: National Group $ (2 ) $ (2 ) American Group (11 ) (9 ) Corporate and other 2 2 $ (11 ) $ (9 ) Adjusted segment EBITDA: National Group $ 1,454 $ 1,182 American Group 1,141 1,031 Corporate and other (54 ) (95 ) $ 2,541 $ 2,118 Depreciation and amortization: National Group $ 265 $ 225 American Group 281 252 Corporate and other 73 76 $ 619 $ 553 Adjusted segment EBITDA $ 2,541 $ 2,118 Depreciation and amortization 619 553 Interest expense 461 431 Losses (gains) on sales of facilities 1 (405 ) Income before income taxes $ 1,460 $ 1,539

Supplemental Condensed Consolid

Supplemental Condensed Consolidating Financial Information	3 Months Ended
	Mar. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Supplemental Condensed Consolidating Financial Information And Other Collateral-related Information	NOTE 13 — SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION HCA Healthcare, Inc. has $1.000 billion aggregate principal amount of 6.250% senior unsecured notes due 2021 outstanding. 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, 2019 and 2018, condensed consolidating balance sheets at March 31, 2019 and December 31, 2018 and condensed consolidating statements of cash flows for the quarters ended March 31, 2019 and 2018, segregating HCA Healthcare, Inc. issuer, HCA Inc. issuer, the subsidiary guarantors, the subsidiary non-guarantors HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED MARCH 31, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues $ — $ — $ 7,224 $ 5,293 $ — $ 12,517 Salaries and benefits — — 3,137 2,510 — 5,647 Supplies — — 1,177 864 — 2,041 Other operating expenses 2 — 1,146 1,151 — 2,299 Equity in earnings of affiliates (1,026 ) — (2 ) (9 ) 1,026 (11 ) Depreciation and amortization — — 355 264 — 619 Interest expense (income) 16 995 (473 ) (77 ) — 461 Losses on sales of facilities — — 1 — — 1 Management fees — — (171 ) 171 — — (1,008 ) 995 5,170 4,874 1,026 11,057 Income (loss) before income taxes 1,008 (995 ) 2,054 419 (1,026 ) 1,460 Provision (benefit) for income taxes (31 ) (231 ) 472 69 — 279 Net income (loss) 1,039 (764 ) 1,582 350 (1,026 ) 1,181 Net income attributable to noncontrolling interests — — 20 122 — 142 Net income (loss) attributable to HCA Healthcare, Inc. $ 1,039 $ (764 ) $ 1,562 $ 228 $ (1,026 ) $ 1,039 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 1,046 $ (782 ) $ 1,564 $ 251 $ (1,033 ) $ 1,046 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED MARCH 31, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed 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 BALANCE SHEET MARCH 31, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 139 $ 392 $ — $ 531 Accounts receivable — — 4,200 3,220 — 7,420 Inventories — — 1,149 629 — 1,778 Other — — 699 680 — 1,379 — — 6,187 4,921 — 11,108 Property and equipment, net — — 12,587 8,541 — 21,128 Investments of insurance subsidiaries — — — 338 — 338 Investments in and advances to affiliates 34,199 — 29 217 (34,199 ) 246 Goodwill and other intangible assets — — 5,725 2,434 — 8,159 Right-of-use operating lease assets — — 438 1,374 — 1,812 Other 404 40 32 112 — 588 $ 34,603 $ 40 $ 24,998 $ 17,937 $ (34,199 ) $ 43,379 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,767 $ 926 $ — $ 2,693 Accrued salaries — — 851 573 — 1,424 Other accrued expenses 300 302 736 1,280 — 2,618 Long-term debt due within one year — 3,697 54 45 — 3,796 300 3,999 3,408 2,824 — 10,531 Long-term debt, net 997 29,464 231 327 — 31,019 Intercompany balances 37,135 (7,851 ) (29,293 ) 9 — — Professional liability risks — — — 1,313 — 1,313 Right-of-use operating lease obligations — — 336 1,158 — 1,494 Income taxes and other liabilities 525 — 233 519 — 1,277 38,957 25,612 (25,085 ) 6,150 — 45,634 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (4,354 ) (25,572 ) 50,001 9,770 (34,199 ) (4,354 ) Noncontrolling interests — — 82 2,017 — 2,099 (4,354 ) (25,572 ) 50,083 11,787 (34,199 ) (2,255 ) $ 34,603 $ 40 $ 24,998 $ 17,937 $ (34,199 ) $ 43,379 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 174 $ 328 $ — $ 502 Accounts receivable, net — — 3,964 2,825 — 6,789 Inventories — — 1,178 554 — 1,732 Other — — 669 521 — 1,190 — — 5,985 4,228 — 10,213 Property and equipment, net — — 12,450 7,307 — 19,757 Investments of insurance subsidiaries — — — 362 — 362 Investments in and advances to affiliates 33,166 — 29 203 (33,166 ) 232 Goodwill and other intangible assets — — 5,724 2,229 — 7,953 Other 478 64 35 113 — 690 $ 33,644 $ 64 $ 24,223 $ 14,442 $ (33,166 ) $ 39,207 LIABILITIES AND Current liabilities: Accounts payable $ — $ — $ 1,721 $ 856 $ — $ 2,577 Accrued salaries — — 998 582 — 1,580 Other accrued expenses 142 403 905 1,174 — 2,624 Long-term debt due within one year — 696 55 37 — 788 142 1,099 3,679 2,649 — 7,569 Long-term debt, net 996 30,544 212 281 — 32,033 Intercompany balances 36,951 (6,789 ) (28,415 ) (1,747 ) — — Professional liability risks — — — 1,275 — 1,275 Income taxes and other liabilities 505 — 223 520 — 1,248 38,594 24,854 (24,301 ) 2,978 — 42,125 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (4,950 ) (24,790 ) 48,437 9,519 (33,166 ) (4,950 ) Noncontrolling interests — — 87 1,945 — 2,032 (4,950 ) (24,790 ) 48,524 11,464 (33,166 ) (2,918 ) $ 33,644 $ 64 $ 24,223 $ 14,442 $ (33,166 ) $ 39,207 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE QUARTER ENDED MARCH 31, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 1,039 $ (764 ) $ 1,582 $ 350 $ (1,026 ) $ 1,181 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (101 ) (600 ) (478 ) — (1,194 ) Depreciation and amortization — — 355 264 — 619 Income taxes 269 — — — — 269 Losses on sales of facilities — — 1 — — 1 Amortization of debt issuance costs — 8 — — — 8 Share-based compensation — — 62 — — 62 Equity in earnings of affiliates (1,026 ) — — — 1,026 — Other 25 — 5 (2 ) — 28 Net cash provided by (used in) operating activities 292 (857 ) 1,405 134 — 974 Cash flows from investing activities: Purchase of property and equipment — — (471 ) (310 ) — (781 ) Acquisition of hospitals and health care entities — — (12 ) (1,462 ) — (1,474 ) Disposition of hospitals and health care entities — — 30 — — 30 Change in investments — — — 36 — 36 Other — — (5 ) 29 — 24 Net cash used in investing activities — — (458 ) (1,707 ) — (2,165 ) Cash flows from financing activities: Issuance of long-term debt — 1,500 — — — 1,500 Net change in revolving credit facilities — 460 — — — 460 Repayment of long-term debt — (23 ) (16 ) (10 ) — (49 ) Distributions to noncontrolling interests — — (25 ) (111 ) — (136 ) Payment of debt issuance costs — (22 ) — — — (22 ) Payment of cash dividends (141 ) — — — — (141 ) Repurchases of common stock (278 ) — — — — (278 ) Changes in intercompany balances with affiliates, net 243 (1,058 ) (941 ) 1,756 — — Other (116 ) — — (2 ) — (118 ) Net cash (used in) provided by financing activities (292 ) 857 (982 ) 1,633 — 1,216 Effect on exchange rate changes on cash and cash equivalents — — — 4 — 4 Change in cash and cash equivalents — — (35 ) 64 — 29 Cash and cash equivalents at beginning of period — — 174 328 — 502 Cash and cash equivalents at end of period $ — $ — $ 139 $ 392 $ — $ 531 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 ) (24 ) — (485 ) 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 ) 1,211 499 — 1,283 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 ) Effect on exchange rate changes on cash and cash equivalents — — — 17 — 17 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

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2019
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 S-X. 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 $86 million and $81 million for the quarters ended March 31, 2019 and 2018, respectively. Operating results for the quarter ended March 31, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K
Revenues	Revenues 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 Our performance obligations for outpatient services are generally satisfied over a period of less than one day fee-for-service Revenues (continued) 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 2019 Ratio 2018 Ratio Medicare $ 2,770 22.1 % $ 2,524 22.1 % Managed Medicare 1,589 12.7 1,399 12.3 Medicaid 347 2.8 281 2.5 Managed Medicaid 613 4.9 561 4.9 Managed care and insurers 6,426 51.4 6,062 53.1 International (managed care and insurers) 297 2.4 305 2.7 Other 475 3.7 291 2.4 Revenues $ 12,517 100.0 % $ 11,423 100.0 % 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, 2019 and 2018 follows (dollars in millions): 2019 2018 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 10,606 $ 9,867 Cost-to-charges ratio (patient care costs as percentage of gross patient charges) 11.8 % 12.4 % Total uncompensated care $ 7,085 $ 6,252 Multiply by the cost-to-charges ratio 11.8 % 12.4 % Estimated cost of total uncompensated care $ 836 $ 775 Total uncompensated care as a percentage of the sum of revenues and total uncompensated care was 36.1% and 35.4% for the quarters ended March 31, 2019 and 2018, respectively. The total uncompensated care amounts include charity care of $2.905 billion and $1.879 billion, and the related estimated costs of charity care were $343 million and $233 million for the quarters ended March 31, 2019 and 2018, respectively.
Reclassifications	Reclassifications Certain prior year amounts have been reclassified to conform to the current year presentation.

Basis of Presentation and Sig_3

Basis of Presentation and Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2019
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, 2019 and 2018 are summarized in the following table (dollars in millions): 2019 Ratio 2018 Ratio Medicare $ 2,770 22.1 % $ 2,524 22.1 % Managed Medicare 1,589 12.7 1,399 12.3 Medicaid 347 2.8 281 2.5 Managed Medicaid 613 4.9 561 4.9 Managed care and insurers 6,426 51.4 6,062 53.1 International (managed care and insurers) 297 2.4 305 2.7 Other 475 3.7 291 2.4 Revenues $ 12,517 100.0 % $ 11,423 100.0 %
Schedule of Estimated Cost of Uncompensated Care	A summary of the estimated cost of total uncompensated care for the quarters ended March 31, 2019 and 2018 follows (dollars in millions): 2019 2018 Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 10,606 $ 9,867 Cost-to-charges ratio (patient care costs as percentage of gross patient charges) 11.8 % 12.4 % Total uncompensated care $ 7,085 $ 6,252 Multiply by the cost-to-charges ratio 11.8 % 12.4 % Estimated cost of total uncompensated care $ 836 $ 775

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2019
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, 2019 and 2018 (dollars and shares in millions, except per share amounts): 2019 2018 Net income attributable to HCA Healthcare, Inc. $ 1,039 $ 1,144 Weighted average common shares outstanding 342.876 350.850 Effect of dilutive incremental shares 7.440 8.899 Shares used for diluted earnings per share 350.316 359.749 Earnings per share: Basic earnings $ 3.03 $ 3.26 Diluted earnings $ 2.97 $ 3.18

Investments of Insurance Subs_2

Investments of Insurance Subsidiaries (Tables)	3 Months Ended
	Mar. 31, 2019
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	A summary of our insurance subsidiaries’ investments at March 31, 2019 and December 31, 2018 follows (dollars in millions): March 31, 2019 Amortized Unrealized Fair Gains Losses Debt securities $ 336 $ 11 $ — $ 347 Money market funds and other 81 — — 81 $ 417 $ 11 $ — 428 Amounts classified as current assets (90 ) Investment carrying value $ 338 December 31, 2018 Amortized Cost Unrealized Amounts Fair Value Gains Losses Debt securities $ 338 $ 5 $ (2 ) $ 341 Money market funds and other 68 — — 68 $ 406 $ 5 $ (2 ) 409 Amounts classified as current assets (47 ) Investment carrying value $ 362
Schedule of Maturities of Investments	Scheduled maturities of investments in debt securities at March 31, 2019 were as follows (dollars in millions): Amortized Cost Fair Value Due in one year or less $ 3 $ 3 Due after one year through five years 64 65 Due after five years through ten years 201 209 Due after ten years 68 70 $ 336 $ 347

Financial Instruments (Tables)

Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2019
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, 2019 (dollars in millions): Notional Amount Maturity Date Fair Value Pay-fixed interest rate swaps $ 2,000 December 2021 $ 38 Pay-fixed interest rate swaps 500 December 2022 2
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, 2019 (dollars in millions): Derivatives in Cash Flow Hedging Relationships Amount of Loss Location of Gain Amount of Gain Interest rate swaps $ 14 Interest expense $ 5

Assets and Liabilities Measur_2

Assets and Liabilities Measured at Fair Value (Tables)	3 Months Ended
	Mar. 31, 2019
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, 2019 and December 31, 2018, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions): March 31, 2019 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 347 $ — $ 347 $ — Money market funds and other 81 81 — — Investments of insurance subsidiaries 428 81 347 — Less amounts classified as current assets (90 ) (80 ) (10 ) — $ 338 1 $ 337 $ — Interest rate swaps (Other) $ 40 $ — $ 40 $ — December 31, 2018 Fair Value Measurements Using Fair Value Quoted Prices in Significant Other Significant Assets: Investments of insurance subsidiaries: Debt securities $ 341 $ — $ 341 $ — Money market funds and other 68 68 — — Investments of insurance subsidiaries 409 68 341 — Less amounts classified as current assets (47 ) (47 ) — — $ 362 $ 21 $ 341 $ — Interest rate swaps (Other) $ 63 $ — $ 63 $ —

Long-Term Debt (Tables)

Long-Term Debt (Tables)	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
Schedule of Long-Term Debt	A summary of long-term debt at March 31, 2019 and December 31, 2018, including related interest rates at March 31, 2019, follows (dollars in millions): March 31, December 31, Senior secured asset-based revolving credit facility (effective interest rate of 3.7%) $ 3,500 $ 3,040 Senior secured revolving credit facility — — Senior secured term loan facilities (effective interest rate of 3.7%) 3,776 3,801 Senior secured notes (effective interest rate of 5.6%) 13,800 13,800 Other senior secured debt (effective interest rate of 5.5%) 657 585 Senior secured debt 21,733 21,226 Senior unsecured notes (effective interest rate of 6.3%) 13,252 11,752 Net debt issuance costs (170 ) (157 ) Total debt (average life of 6.3 years, rates averaging 5.4%) 34,815 32,821 Less amounts due within one year 3,796 788 $ 31,019 $ 32,033

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
Schedule of lease-related assets and liabilities	The following table presents our lease-related assets and liabilities at March 31, 2019 (dollars in millions): Balance Sheet Classification March 31, 2019 Assets: Operating leases Right-of-use $ 1,812 Finance leases Property and equipment 590 Total lease assets $ 2,402 Liabilities: Current: Operating leases Other accrued expenses $ 310 Finance leases Long-term 39 Noncurrent: Operating leases Right-of-use 1,494 Finance leases Long-term debt 519 Total lease liabilities $ 2,362 Weighted-average remaining term: Operating leases 12.3 years Finance leases 9.2 years Weighted-average discount rate: Operating leases(1) 5.6 % Finance leases 5.4 % (1) Upon adoption of the new lease standard, discount rates used for existing leases were established at January 1, 2019.
Schedule of lease expense for finance and operating leases	The following table presents certain information related to lease expense for finance and operating leases for the quarter ended March 31, 2019 (dollars in millions): 2019 Finance lease expense: Amortization of leased assets $ 17 Interest of lease liabilities 6 Operating leases(2) 94 Short-term lease expense(2) 78 Variable lease expense(2) 39 Total lease expense $ 234 (2) Expenses are included in “other operating expenses” in our condensed consolidated income statement.
Schedule of supplemental cash flow information	The following table presents supplemental cash flow information for the quarter ended March 31, 2019 (dollars in millions): 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 144 Operating cash flows for finance leases 6 Financing cash flows for finance leases 17
Schedule of undiscounted cash flows to the finance lease liabilities and operating lease liabilities recorded on balance sheet	The following table reconciles the undiscounted cash flows to the finance lease liabilities and operating lease liabilities recorded on the balance sheet at March 31, 2019 (dollars in millions): Operating Finance 2019 $ 294 $ 72 2020 370 92 2021 315 71 2022 254 62 2023 198 52 Thereafter 1,265 318 Total minimum lease payments 2,696 667 Less: amount of lease payments representing interest (892 ) (109 ) Present value of future minimum lease payments 1,804 558 Less: current obligations under leases (310 ) (39 ) Long-term lease obligations $ 1,494 $ 519

Share Repurchases Transaction_2

Share Repurchases Transactions and Other Comprehensive Loss (Tables)	3 Months Ended
	Mar. 31, 2019
Federal Home Loan Banks [Abstract]
Components of Accumulated Other Comprehensive Loss	The components of accumulated other comprehensive loss are as follows (dollars in millions): Unrealized for-Sale Foreign Defined Change Total Balances at December 31, 2018 $ 3 $ (283 ) $ (148 ) $ 47 $ (381 ) Unrealized gains on available-for-sale 6 — — — 6 Foreign currency translation adjustments, net of $3 of income taxes — 17 — — 17 Change in fair value of derivative instruments, net of $4 income tax benefits — — — (14 ) (14 ) Expense (income) reclassified into operations from other comprehensive income, net of $1 income tax benefits and $1 of income taxes, respectively — — 2 (4 ) (2 ) Balances at March 31, 2019 $ 9 $ (266 ) $ (146 ) $ 29 $ (374 )

Segment and Geographic Inform_2

Segment and Geographic Information (Tables)	3 Months Ended
	Mar. 31, 2019
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, 2019 and 2018 are summarized in the following table (dollars in millions): 2019 2018 Revenues: National Group $ 6,317 $ 5,568 American Group 5,595 5,327 Corporate and other 605 528 $ 12,517 $ 11,423 Equity in earnings of affiliates: National Group $ (2 ) $ (2 ) American Group (11 ) (9 ) Corporate and other 2 2 $ (11 ) $ (9 ) Adjusted segment EBITDA: National Group $ 1,454 $ 1,182 American Group 1,141 1,031 Corporate and other (54 ) (95 ) $ 2,541 $ 2,118 Depreciation and amortization: National Group $ 265 $ 225 American Group 281 252 Corporate and other 73 76 $ 619 $ 553 Adjusted segment EBITDA $ 2,541 $ 2,118 Depreciation and amortization 619 553 Interest expense 461 431 Losses (gains) on sales of facilities 1 (405 ) Income before income taxes $ 1,460 $ 1,539

Supplemental Condensed Consol_2

Supplemental Condensed Consolidating Financial Information (Tables)	3 Months Ended
	Mar. 31, 2019
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, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Revenues $ — $ — $ 7,224 $ 5,293 $ — $ 12,517 Salaries and benefits — — 3,137 2,510 — 5,647 Supplies — — 1,177 864 — 2,041 Other operating expenses 2 — 1,146 1,151 — 2,299 Equity in earnings of affiliates (1,026 ) — (2 ) (9 ) 1,026 (11 ) Depreciation and amortization — — 355 264 — 619 Interest expense (income) 16 995 (473 ) (77 ) — 461 Losses on sales of facilities — — 1 — — 1 Management fees — — (171 ) 171 — — (1,008 ) 995 5,170 4,874 1,026 11,057 Income (loss) before income taxes 1,008 (995 ) 2,054 419 (1,026 ) 1,460 Provision (benefit) for income taxes (31 ) (231 ) 472 69 — 279 Net income (loss) 1,039 (764 ) 1,582 350 (1,026 ) 1,181 Net income attributable to noncontrolling interests — — 20 122 — 142 Net income (loss) attributable to HCA Healthcare, Inc. $ 1,039 $ (764 ) $ 1,562 $ 228 $ (1,026 ) $ 1,039 Comprehensive income (loss) attributable to HCA Healthcare, Inc. $ 1,046 $ (782 ) $ 1,564 $ 251 $ (1,033 ) $ 1,046 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING COMPREHENSIVE INCOME STATEMENT FOR THE QUARTER ENDED MARCH 31, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed 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
Schedule of Condensed Consolidating Balance Sheet	HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET MARCH 31, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 139 $ 392 $ — $ 531 Accounts receivable — — 4,200 3,220 — 7,420 Inventories — — 1,149 629 — 1,778 Other — — 699 680 — 1,379 — — 6,187 4,921 — 11,108 Property and equipment, net — — 12,587 8,541 — 21,128 Investments of insurance subsidiaries — — — 338 — 338 Investments in and advances to affiliates 34,199 — 29 217 (34,199 ) 246 Goodwill and other intangible assets — — 5,725 2,434 — 8,159 Right-of-use operating lease assets — — 438 1,374 — 1,812 Other 404 40 32 112 — 588 $ 34,603 $ 40 $ 24,998 $ 17,937 $ (34,199 ) $ 43,379 LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY Current liabilities: Accounts payable $ — $ — $ 1,767 $ 926 $ — $ 2,693 Accrued salaries — — 851 573 — 1,424 Other accrued expenses 300 302 736 1,280 — 2,618 Long-term debt due within one year — 3,697 54 45 — 3,796 300 3,999 3,408 2,824 — 10,531 Long-term debt, net 997 29,464 231 327 — 31,019 Intercompany balances 37,135 (7,851 ) (29,293 ) 9 — — Professional liability risks — — — 1,313 — 1,313 Right-of-use operating lease obligations — — 336 1,158 — 1,494 Income taxes and other liabilities 525 — 233 519 — 1,277 38,957 25,612 (25,085 ) 6,150 — 45,634 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (4,354 ) (25,572 ) 50,001 9,770 (34,199 ) (4,354 ) Noncontrolling interests — — 82 2,017 — 2,099 (4,354 ) (25,572 ) 50,083 11,787 (34,199 ) (2,255 ) $ 34,603 $ 40 $ 24,998 $ 17,937 $ (34,199 ) $ 43,379 HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING BALANCE SHEET DECEMBER 31, 2018 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed ASSETS Current assets: Cash and cash equivalents $ — $ — $ 174 $ 328 $ — $ 502 Accounts receivable, net — — 3,964 2,825 — 6,789 Inventories — — 1,178 554 — 1,732 Other — — 669 521 — 1,190 — — 5,985 4,228 — 10,213 Property and equipment, net — — 12,450 7,307 — 19,757 Investments of insurance subsidiaries — — — 362 — 362 Investments in and advances to affiliates 33,166 — 29 203 (33,166 ) 232 Goodwill and other intangible assets — — 5,724 2,229 — 7,953 Other 478 64 35 113 — 690 $ 33,644 $ 64 $ 24,223 $ 14,442 $ (33,166 ) $ 39,207 LIABILITIES AND Current liabilities: Accounts payable $ — $ — $ 1,721 $ 856 $ — $ 2,577 Accrued salaries — — 998 582 — 1,580 Other accrued expenses 142 403 905 1,174 — 2,624 Long-term debt due within one year — 696 55 37 — 788 142 1,099 3,679 2,649 — 7,569 Long-term debt, net 996 30,544 212 281 — 32,033 Intercompany balances 36,951 (6,789 ) (28,415 ) (1,747 ) — — Professional liability risks — — — 1,275 — 1,275 Income taxes and other liabilities 505 — 223 520 — 1,248 38,594 24,854 (24,301 ) 2,978 — 42,125 Stockholders’ (deficit) equity attributable to HCA Healthcare, Inc. (4,950 ) (24,790 ) 48,437 9,519 (33,166 ) (4,950 ) Noncontrolling interests — — 87 1,945 — 2,032 (4,950 ) (24,790 ) 48,524 11,464 (33,166 ) (2,918 ) $ 33,644 $ 64 $ 24,223 $ 14,442 $ (33,166 ) $ 39,207
Schedule of Condensed Consolidating Statement of Cash Flows	HCA HEALTHCARE, INC. CONDENSED CONSOLIDATING STATEMENT OF CASH FLOWS FOR THE QUARTER ENDED MARCH 31, 2019 (Dollars in millions) HCA HCA Inc. Subsidiary Subsidiary Eliminations Condensed Cash flows from operating activities: Net income (loss) $ 1,039 $ (764 ) $ 1,582 $ 350 $ (1,026 ) $ 1,181 Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Changes in operating assets and liabilities (15 ) (101 ) (600 ) (478 ) — (1,194 ) Depreciation and amortization — — 355 264 — 619 Income taxes 269 — — — — 269 Losses on sales of facilities — — 1 — — 1 Amortization of debt issuance costs — 8 — — — 8 Share-based compensation — — 62 — — 62 Equity in earnings of affiliates (1,026 ) — — — 1,026 — Other 25 — 5 (2 ) — 28 Net cash provided by (used in) operating activities 292 (857 ) 1,405 134 — 974 Cash flows from investing activities: Purchase of property and equipment — — (471 ) (310 ) — (781 ) Acquisition of hospitals and health care entities — — (12 ) (1,462 ) — (1,474 ) Disposition of hospitals and health care entities — — 30 — — 30 Change in investments — — — 36 — 36 Other — — (5 ) 29 — 24 Net cash used in investing activities — — (458 ) (1,707 ) — (2,165 ) Cash flows from financing activities: Issuance of long-term debt — 1,500 — — — 1,500 Net change in revolving credit facilities — 460 — — — 460 Repayment of long-term debt — (23 ) (16 ) (10 ) — (49 ) Distributions to noncontrolling interests — — (25 ) (111 ) — (136 ) Payment of debt issuance costs — (22 ) — — — (22 ) Payment of cash dividends (141 ) — — — — (141 ) Repurchases of common stock (278 ) — — — — (278 ) Changes in intercompany balances with affiliates, net 243 (1,058 ) (941 ) 1,756 — — Other (116 ) — — (2 ) — (118 ) Net cash (used in) provided by financing activities (292 ) 857 (982 ) 1,633 — 1,216 Effect on exchange rate changes on cash and cash equivalents — — — 4 — 4 Change in cash and cash equivalents — — (35 ) 64 — 29 Cash and cash equivalents at beginning of period — — 174 328 — 502 Cash and cash equivalents at end of period $ — $ — $ 139 $ 392 $ — $ 531 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 ) (24 ) — (485 ) 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 ) 1,211 499 — 1,283 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 ) Effect on exchange rate changes on cash and cash equivalents — — — 17 — 17 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

Basis of Presentation and Sig_4

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)HospitalSurgery_CenterState	Mar. 31, 2018USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of owned and operated hospitals | Hospital	185
Number of freestanding surgery centers | Surgery_Center	124
Number of facilities locations | State	21
General and administrative expense	$ 86	$ 81
Percentage of sum of revenues and uncompensated care	36.10%	35.40%
Charity care amount	$ 2,905	$ 1,879
Estimated costs of charity care	$ 343	$ 233
Inpatient Services [Member]
Summary Of Significant Accounting Policies [Line Items]
Performance obligations for inpatient/ outpatient services satisfied period	Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days
Out of Network Services [Member]
Summary Of Significant Accounting Policies [Line Items]
Revenues	$ 86
Maximum [Member] | Outpatient Services [Member]
Summary Of Significant Accounting Policies [Line Items]
Performance obligations for inpatient/ outpatient services satisfied period	Our performance obligations for outpatient services are generally satisfied over a period of less than one day

Basis of Presentation and Sig_5

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, 2019	Mar. 31, 2018
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 12,517	$ 11,423
Revenues ratio from third party payers	100.00%	100.00%
Medicare [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 2,770	$ 2,524
Revenues from third party payers, Ratio	22.10%	22.10%
Managed Medicare [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 1,589	$ 1,399
Revenues from third party payers, Ratio	12.70%	12.30%
Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 347	$ 281
Revenues from third party payers, Ratio	2.80%	2.50%
Managed Medicaid [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 613	$ 561
Revenues from third party payers, Ratio	4.90%	4.90%
Managed Care and Other Insurers [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 6,426	$ 6,062
Revenues from third party payers, Ratio	51.40%	53.10%
International (Managed Care and Other Insurers) [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 297	$ 305
Revenues from third party payers, Ratio	2.40%	2.70%
Product and Service, Other [Member]
Revenues From Third Party Payers [Line Items]
Revenues from third party payers	$ 475	$ 291
Other, Ratio	3.70%	2.40%

Basis of Presentation and Sig_6

Basis of Presentation and Significant Accounting Policies - Schedule of Estimated Cost of Uncompensated Care (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Accounting Policies [Abstract]
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization)	$ 10,606	$ 9,867
Cost-to-charges ratio (patient care costs as percentage of gross patient charges)	11.80%	12.40%
Total uncompensated care	$ 7,085	$ 6,252
Multiply by the cost-to-charges ratio	11.80%	12.40%
Estimated cost of total uncompensated care	$ 836	$ 775

Acquisitions and Dispositions -

Acquisitions and Dispositions - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)Hospital	Mar. 31, 2018USD ($)
Business Acquisition [Line Items]
Number of hospitals purchased | Hospital	7
Proceeds from sale of business	$ 30	$ 767
Real Estate and Other Investments [Member]
Business Acquisition [Line Items]
Proceeds from sale of business	5	9
Pretax gain (loss) on sales of business		29
Real Estate and Other Investments [Member] | Louisiana Markets [Member]
Business Acquisition [Line Items]
Pretax gain (loss) on sales of business	1
Discontinued Operations, Disposed of by Sale [Member] | Louisiana Markets [Member]
Business Acquisition [Line Items]
Proceeds from sale of business	25
Discontinued Operations, Disposed of by Sale [Member] | Oklahoma [Member]
Business Acquisition [Line Items]
Proceeds from sale of business		758
Pretax gain (loss) on sales of business		376
Hospitals [Member]
Business Acquisition [Line Items]
Aggregate purchase price	1,398	360
Non hospital Health Care [Member]
Business Acquisition [Line Items]
Aggregate purchase price	76	$ 19
Other [Member]
Business Acquisition [Line Items]
Goodwill	$ 207

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Income Tax Contingency [Line Items]
Effective tax rate	21.20%	18.40%
Provision for tax benefits related to settlement of employee awards	$ 49	$ 92
Liability for unrecognized tax benefits	457		$ 435
Unrecognized tax benefits, accrued interest	53		48
Unrecognized tax benefits that would impact effective tax rate	143		$ 137
Provision for income taxes	$ 279	$ 257

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, 2019	Mar. 31, 2018
Earnings Per Share [Abstract]
Net income attributable to HCA Healthcare, Inc.	$ 1,039	$ 1,144
Weighted average common shares outstanding	342,876	350,850
Effect of dilutive incremental shares	7,440	8,899
Shares used for diluted earnings per share	350,316	359,749
Basic earnings per share	$ 3.03	$ 3.26
Diluted earnings per share	$ 2.97	$ 3.18

Investments of Insurance Subs_3

Investments of Insurance Subsidiaries - Schedule of Investments (Detail) - USD ($) $ in Millions	Mar. 31, 2019	Dec. 31, 2018
Debt Securities, Available-for-sale [Line Items]
Amounts classified as current assets	$ (90)	$ (47)
Investment carrying value	338	362
Amortized Cost	417	406
Unrealized Amounts, Gains	11	5
Unrealized Amounts, Losses		(2)
Fair Value	428	409
Money Market Funds and Other [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	81	68
Fair Value	81	68
Debt Securities [Member] | States and Municipalities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	336	338
Unrealized Amounts, Gains	11	5
Unrealized Amounts, Losses		(2)
Fair Value	$ 347	$ 341

Investments of Insurance Subs_4

Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail) $ in Millions	Mar. 31, 2019USD ($)
Investments, Debt and Equity Securities [Abstract]
Due in one year or less, Amortized Cost	$ 3
Due after one year through five years, Amortized Cost	64
Due after five years through ten years, Amortized Cost	201
Due after ten years, Amortized Cost	68
Amortized Cost, Total	336
Due in one year or less, Fair Value	3
Due after one year through five years, Fair Value	65
Due after five years through ten years, Fair Value	209
Due after ten years, Fair Value	70
Fair Value, Total	$ 347

Investments of Insurance Subs_5

Investments of Insurance Subsidiaries - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2019
Investments, Debt and Equity Securities [Abstract]
Available for sale securities expected maturity of debt securities	5 years 10 months 24 days
Available for sale securities average scheduled maturity	10 years 2 months 12 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, 2019USD ($)
Maturity Date, 2021 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 2,000
Fair Value	$ 38
Maturity Date	Dec. 31, 2021
Maturity Date, 2022 [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Notional Amount	$ 500
Fair Value	$ 2
Maturity Date	Dec. 31, 2022

Financial Instruments - Additio

Financial Instruments - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Estimated amount reclassified from other comprehensive income and reduce interest expense	$ 20

Financial Instruments - Effect

Financial Instruments - Effect of Interest Rate Swaps on Results of Operations (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain Recognized in OCI on Derivatives, Net of Tax	$ (14)
Interest Rate Swaps [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain Recognized in OCI on Derivatives, Net of Tax	14
Interest Rate Swaps [Member] | Reclassification out of Accumulated Other Comprehensive Income [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Interest rate swaps	$ 5

Assets and Liabilities Measur_3

Assets and Liabilities Measured at Fair Value - Schedule of Assets Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Millions	Mar. 31, 2019	Dec. 31, 2018
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	$ 428	$ 409
Less amounts classified as current assets	(90)	(47)
Investments of insurance subsidiaries, noncurrent	338	362
Interest Rate Swaps [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Derivative Asset	40	63
Money Market Funds and Other [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	81	68
Debt Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Debt Securities, Available-for-sale Securities	347	341
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Assets, Fair Value Disclosure	81	68
Less amounts classified as current assets	(80)	(47)
Investments of insurance subsidiaries, noncurrent	1	21
Quoted Prices in Active Markets for Identical Assets and Liabilities (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 Disclosure	81	68
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 Disclosure	347	341
Less amounts classified as current assets	(10)
Investments of insurance subsidiaries, noncurrent	337	341
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]
Derivative Asset	40	63
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Debt Securities, Available-for-sale Securities	$ 347	$ 341

Assets and Liabilities Measur_4

Assets and Liabilities Measured at Fair Value - Additional Information (Detail) - USD ($) $ in Millions	Mar. 31, 2019	Dec. 31, 2018
Fair Value Disclosures [Abstract]
Estimated fair value of long-term debt	$ 36,602	$ 32,887
Carrying amounts of long-term debt	$ 34,985	$ 32,978

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-Term Debt (Detail) - USD ($) $ in Millions	Mar. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Senior secured debt	$ 21,733	$ 21,226
Net debt issuance costs	(170)	(157)
Total debt (average life of 6.4 years, rates averaging 5.5%)	34,815	32,821
Less amounts due within one year	3,796	788
Long-term debt	31,019	32,033
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term line of credit	3,500	3,040
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Senior secured debt	3,776	3,801
Senior Secured Notes [Member]
Debt Instrument [Line Items]
Senior secured debt	13,800	13,800
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Other senior secured debt	657	585
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes	$ 13,252	$ 11,752

Long-Term Debt - Schedule of _2

Long-Term Debt - Schedule of Long-Term Debt (Parenthetical) (Detail)	3 Months Ended
	Mar. 31, 2019
Debt Instrument [Line Items]
Total debt average term	6 years 3 months 18 days
Total debt average rate	5.40%
Senior Secured Asset-Based Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Effective interest rate	3.70%
Senior Secured Term Loan Facilities [Member]
Debt Instrument [Line Items]
Effective interest rate	3.70%
Senior Secured Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	5.60%
Other Senior Secured Debt [Member]
Debt Instrument [Line Items]
Effective interest rate	5.50%
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Effective interest rate	6.30%

Long-Term Debt - Additional Inf

Long-Term Debt - Additional Information (Detail) $ in Millions	Jan. 31, 2019USD ($)
5.625% Senior Notes Due 2028 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount	$ 500
Debt instrument, stated interest	5.625%
5.875% Senior Notes Due 2029 [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount	$ 1,000
Debt instrument, stated interest	5.875%
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Debt instrument, principal amount	$ 1,500

Leases - Schedule Of Lease-Rel

Leases - Schedule Of Lease-Related Assets And Liabilities (Detail) $ in Millions	Mar. 31, 2019USD ($)
Assets:
Operating leases	$ 1,812
Finance leases	590
Total lease assets	2,402
Liabilities
Operating leases	310
Finance leases	39
Operating leases	1,494
Finance leases	519
Total lease liabilities	$ 2,362
Weighted-average remaining term:
Operating leases	12 years 3 months 18 days
Finance leases	9 years 2 months 12 days
Weighted-average discount rate:
Operating leases	5.60%	[1]
Finance leases	5.40%
[1]	Upon adoption of the new lease standard, discount rates used for existing leases were established at January 1, 2019.

Leases - Schedule Of Lease Expe

Leases - Schedule Of Lease Expense For Finance And Operating Leases (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)
Finance lease expense:
Amortization of leased assets	$ 17
Interest of lease liabilities	6
Operating leases	94	[1]
Short-term lease expense	78	[1]
Variable lease expense	39	[1]
Total lease expense	$ 234
[1]	Expenses are included in “other operating expenses” in our condensed consolidated income statement.

Leases - Schedule Of Supplement

Leases - Schedule Of Supplemental Cash Flow Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)
Cash Paid For Amounts Included In Measurement Of Lease Liabilities [Abstract]
Operating cash flows for operating leases	$ 144
Operating cash flows for finance leases	6
Financing cash flows for finance leases	$ 17

Leases - Schedule of undiscount

Leases - Schedule of undiscounted cash flows to the finance lease liabilities and operating lease liabilities (Detail) $ in Millions	Mar. 31, 2019USD ($)
Operating Lease Liabilities, Payments Due [Abstract]
2019	$ 294
2020	370
2021	315
2022	254
2023	198
Thereafter	1,265
Total minimum lease payments	2,696
Less: amount of lease payments representing interest	(892)
Present value of future minimum lease payments	1,804
Less: current obligations under leases	(310)
Long-term lease obligations	1,494
Finance Lease Liabilities, Payments, Due [Abstract]
2019	72
2020	92
2021	71
2022	62
2023	52
Thereafter	318
Total minimum lease payments	667
Less: amount of lease payments representing interest	(109)
Present value of future minimum lease payments	558
Less: current obligations under leases	(39)
Long-term lease obligations	$ 519

Share Repurchases Transaction_3

Share Repurchases Transactions and Other Comprehensive Loss - Additional Information (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended
	Mar. 31, 2019	Jan. 31, 2019	Oct. 31, 2017
Repurchase of common stock, shares	2,106
Repurchase price of common stock, per share	$ 131.92
Share repurchase program, remaining authorized repurchase amount	$ 1,995
Share repurchase program authorized amount		$ 2,000	$ 2,000
Board of Directors Chairman [Member]
Share repurchase program, remaining authorized repurchase amount		$ 2,000

Share Repurchases Transaction_4

Share Repurchases Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)
Equity [Abstract]
Unrealized gains on available-for-sale securities, beginning balances	$ 3
Unrealized gains on available-for-sale securities, net of income tax benefit	6
Unrealized gains on available-for-sale securities, ending balances	9
Foreign currency translation adjustments, beginning balances	(283)
Foreign currency translation adjustments	17
Foreign currency translation adjustments, ending balances	(266)
Defined benefit plans, beginning balances	(148)
Defined benefit plans, (income) expense reclassified into operations from other comprehensive income	2
Defined benefit plans, ending balances	(146)
Change in fair value of derivative instruments, beginning balances	47
Change in fair value of derivative instruments	(14)
Change in fair value of derivative instruments, (income) expense reclassified into operations from other comprehensive income	(4)
Change in fair value of derivative instruments, ending balances	29
Accumulated other comprehensive income (loss), net of tax, beginning balances	(381)
Unrealized losses on available-for-sale securities, net of income taxes	6
Foreign currency translation adjustments	17
Change in fair value of derivative instruments	(14)
Expense (income) reclassified into operations from other comprehensive income, Total	(2)
Accumulated other comprehensive income (loss), net of tax, ending balances	$ (374)

Share Repurchases Transaction_5

Share Repurchases Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)
Equity [Abstract]
Unrealized losses on available-for-sale securities, tax benefit portion	$ 2
Foreign currency translation adjustments, income tax benefit	3
Change in fair value of derivative instruments, income tax expense (benefit)	4
Defined benefit plans, Expense reclassified into operations from other comprehensive income, Income tax benefits	1
Change in fair value of derivative instruments, Expense reclassified into operations from other comprehensive income, Income tax benefits	$ 1

Segment and Geographic Inform_3

Segment and Geographic Information - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2019Hospital
Segment Reporting Information [Line Items]
Number of geographically organized groups	2
Number of owned and operated hospitals	185
Reorganization Group [Member] | National Group [Member]
Segment Reporting Information [Line Items]
Number of owned and operated hospitals	95
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 Inform_4

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, 2019	Mar. 31, 2018
Segment Reporting Information [Line Items]
Revenues	$ 12,517	$ 11,423
Equity in earnings of affiliates	(11)	(9)
Adjusted segment EBITDA	2,541	2,118
Depreciation and amortization	619	553
Interest expense	461	431
Gains on sales of facilities	1	(405)
Income before income taxes	1,460	1,539
National Group [Member]
Segment Reporting Information [Line Items]
Revenues	6,317	5,568
Equity in earnings of affiliates	(2)	(2)
Adjusted segment EBITDA	1,454	1,182
Depreciation and amortization	265	225
American Group [Member]
Segment Reporting Information [Line Items]
Revenues	5,595	5,327
Equity in earnings of affiliates	(11)	(9)
Adjusted segment EBITDA	1,141	1,031
Depreciation and amortization	281	252
Corporate and Other [Member]
Segment Reporting Information [Line Items]
Revenues	605	528
Equity in earnings of affiliates	2	2
Adjusted segment EBITDA	(54)	(95)
Depreciation and amortization	$ 73	$ 76

Supplemental Condensed Consol_3

Supplemental Condensed Consolidating Financial Information - Additional Information (Detail)	Mar. 31, 2019USD ($)
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 Consol_4

Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Comprehensive Income Statement (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Condensed Statement of Income Captions [Line Items]
Revenues	$ 12,517	$ 11,423
Salaries and benefits	5,647	5,289
Supplies	2,041	1,915
Other operating expenses	2,299	2,110
Equity in earnings of affiliates	(11)	(9)
Depreciation and amortization	619	553
Interest expense (income)	461	431
Losses (gains) on sales of facilities	1	(405)
Total expenses including equity in earnings of affiliates	11,057	9,884
Income (loss) before income taxes	1,460	1,539
Provision (benefit) for income taxes	279	257
Net income (loss)	1,181	1,282
Net income attributable to noncontrolling interests	142	138
Net income (loss) attributable to HCA Healthcare, Inc.	1,039	1,144
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	1,046	1,225
HCA Healthcare, Inc. Issuer [Member]
Condensed Statement of Income Captions [Line Items]
Other operating expenses	2	1
Equity in earnings of affiliates	(1,026)	(1,090)
Interest expense (income)	16	16
Total expenses including equity in earnings of affiliates	(1,008)	(1,073)
Income (loss) before income taxes	1,008	1,073
Provision (benefit) for income taxes	(31)	(71)
Net income (loss)	1,039	1,144
Net income (loss) attributable to HCA Healthcare, Inc.	1,039	1,144
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	1,046	1,225
HCA Inc. Issuer [Member]
Condensed Statement of Income Captions [Line Items]
Interest expense (income)	995	837
Total expenses including equity in earnings of affiliates	995	837
Income (loss) before income taxes	(995)	(837)
Provision (benefit) for income taxes	(231)	(195)
Net income (loss)	(764)	(642)
Net income (loss) attributable to HCA Healthcare, Inc.	(764)	(642)
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	(782)	(615)
Subsidiary Guarantors [Member]
Condensed Statement of Income Captions [Line Items]
Revenues	7,224	6,776
Salaries and benefits	3,137	3,069
Supplies	1,177	1,141
Other operating expenses	1,146	1,128
Equity in earnings of affiliates	(2)	(2)
Depreciation and amortization	355	323
Interest expense (income)	(473)	(367)
Losses (gains) on sales of facilities	1	(395)
Management fees	(171)	(158)
Total expenses including equity in earnings of affiliates	5,170	4,739
Income (loss) before income taxes	2,054	2,037
Provision (benefit) for income taxes	472	467
Net income (loss)	1,582	1,570
Net income attributable to noncontrolling interests	20	28
Net income (loss) attributable to HCA Healthcare, Inc.	1,562	1,542
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	1,564	1,546
Subsidiary Non-Guarantors [Member]
Condensed Statement of Income Captions [Line Items]
Revenues	5,293	4,647
Salaries and benefits	2,510	2,220
Supplies	864	774
Other operating expenses	1,151	981
Equity in earnings of affiliates	(9)	(7)
Depreciation and amortization	264	230
Interest expense (income)	(77)	(55)
Losses (gains) on sales of facilities		(10)
Management fees	171	158
Total expenses including equity in earnings of affiliates	4,874	4,291
Income (loss) before income taxes	419	356
Provision (benefit) for income taxes	69	56
Net income (loss)	350	300
Net income attributable to noncontrolling interests	122	110
Net income (loss) attributable to HCA Healthcare, Inc.	228	190
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	251	240
Eliminations [Member]
Condensed Statement of Income Captions [Line Items]
Equity in earnings of affiliates	1,026	1,090
Total expenses including equity in earnings of affiliates	1,026	1,090
Income (loss) before income taxes	(1,026)	(1,090)
Net income (loss)	(1,026)	(1,090)
Net income (loss) attributable to HCA Healthcare, Inc.	(1,026)	(1,090)
Comprehensive income (loss) attributable to HCA Healthcare, Inc.	$ (1,033)	$ (1,171)

Supplemental Condensed Consol_5

Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Balance Sheet (Detail) - USD ($) $ in Millions	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 531	$ 502
Accounts receivable, net	7,420	6,789
Inventories	1,778	1,732
Other	1,379	1,190
Total current assets	11,108	10,213
Property and equipment, net	21,128	19,757
Investments of insurance subsidiaries	338	362
Investments in and advances to affiliates	246	232
Goodwill and other intangible assets	8,159	7,953
Right-of-use operating lease assets	1,812
Other	588	690
Total assets	43,379	39,207
Current liabilities:
Accounts payable	2,693	2,577
Accrued salaries	1,424	1,580
Other accrued expenses	2,618	2,624
Long-term debt due within one year	3,796	788
Total current liabilities	10,531	7,569
Long-term debt, net	31,019	32,033
Professional liability risks	1,313	1,275
Right-of-use operating lease obligations	1,494
Income taxes and other liabilities	1,277	1,248
Total liabilities	45,634	42,125
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(4,354)	(4,950)
Noncontrolling interests	2,099	2,032
Total stockholders' deficit	(2,255)	(2,918)	$ (3,730)	$ (4,125)	$ (4,434)	$ (4,995)
Total liabilities and stockholders' deficit	43,379	39,207
HCA Healthcare, Inc. Issuer [Member]
Current assets:
Investments in and advances to affiliates	34,199	33,166
Other	404	478
Total assets	34,603	33,644
Current liabilities:
Other accrued expenses	300	142
Total current liabilities	300	142
Long-term debt, net	997	996
Intercompany balances	37,135	36,951
Income taxes and other liabilities	525	505
Total liabilities	38,957	38,594
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(4,354)	(4,950)
Total stockholders' deficit	(4,354)	(4,950)
Total liabilities and stockholders' deficit	34,603	33,644
HCA Inc. Issuer [Member]
Current assets:
Other	40	64
Total assets	40	64
Current liabilities:
Other accrued expenses	302	403
Long-term debt due within one year	3,697	696
Total current liabilities	3,999	1,099
Long-term debt, net	29,464	30,544
Intercompany balances	(7,851)	(6,789)
Total liabilities	25,612	24,854
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(25,572)	(24,790)
Total stockholders' deficit	(25,572)	(24,790)
Total liabilities and stockholders' deficit	40	64
Subsidiary Guarantors [Member]
Current assets:
Cash and cash equivalents	139	174
Accounts receivable, net	4,200	3,964
Inventories	1,149	1,178
Other	699	669
Total current assets	6,187	5,985
Property and equipment, net	12,587	12,450
Investments in and advances to affiliates	29	29
Goodwill and other intangible assets	5,725	5,724
Right-of-use operating lease assets	438
Other	32	35
Total assets	24,998	24,223
Current liabilities:
Accounts payable	1,767	1,721
Accrued salaries	851	998
Other accrued expenses	736	905
Long-term debt due within one year	54	55
Total current liabilities	3,408	3,679
Long-term debt, net	231	212
Intercompany balances	(29,293)	(28,415)
Right-of-use operating lease obligations	336
Income taxes and other liabilities	233	223
Total liabilities	(25,085)	(24,301)
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	50,001	48,437
Noncontrolling interests	82	87
Total stockholders' deficit	50,083	48,524
Total liabilities and stockholders' deficit	24,998	24,223
Subsidiary Non-Guarantors [Member]
Current assets:
Cash and cash equivalents	392	328
Accounts receivable, net	3,220	2,825
Inventories	629	554
Other	680	521
Total current assets	4,921	4,228
Property and equipment, net	8,541	7,307
Investments of insurance subsidiaries	338	362
Investments in and advances to affiliates	217	203
Goodwill and other intangible assets	2,434	2,229
Right-of-use operating lease assets	1,374
Other	112	113
Total assets	17,937	14,442
Current liabilities:
Accounts payable	926	856
Accrued salaries	573	582
Other accrued expenses	1,280	1,174
Long-term debt due within one year	45	37
Total current liabilities	2,824	2,649
Long-term debt, net	327	281
Intercompany balances	9	(1,747)
Professional liability risks	1,313	1,275
Right-of-use operating lease obligations	1,158
Income taxes and other liabilities	519	520
Total liabilities	6,150	2,978
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	9,770	9,519
Noncontrolling interests	2,017	1,945
Total stockholders' deficit	11,787	11,464
Total liabilities and stockholders' deficit	17,937	14,442
Eliminations [Member]
Current assets:
Investments in and advances to affiliates	(34,199)	(33,166)
Total assets	(34,199)	(33,166)
Current liabilities:
Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.	(34,199)	(33,166)
Total stockholders' deficit	(34,199)	(33,166)
Total liabilities and stockholders' deficit	$ (34,199)	$ (33,166)

Supplemental Condensed Consol_6

Supplemental Condensed Consolidating Financial Information - Schedule of Condensed Consolidating Statement of Cash Flows (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cash flows from operating activities:
Net income (loss)	$ 1,181	$ 1,282
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(1,194)	(485)
Depreciation and amortization	619	553
Income taxes	269	246
Losses (gains) on sales of facilities	1	(405)
Amortization of debt issuance costs	8	8
Share-based compensation	62	60
Other	28	24
Net cash provided by (used in) operating activities	974	1,283
Cash flows from investing activities:
Purchase of property and equipment	(781)	(694)
Acquisition of hospitals and health care entities	(1,474)	(379)
Disposition of hospitals and health care entities	30	767
Change in investments	36	11
Other	24	(40)
Net cash used in investing activities	(2,165)	(335)
Cash flows from financing activities:
Issuance of long-term debt	1,500
Net change in revolving credit facilities	460	270
Repayment of long-term debt	(49)	(50)
Distributions to noncontrolling interests	(136)	(92)
Payment of debt issuance costs	(22)	(2)
Payment of cash dividends	(141)	(123)
Repurchases of common stock	(278)	(423)
Other	(118)	(191)
Net cash provided by (used in) financing activities	1,216	(611)
Effect on exchange rate changes on cash and cash equivalents	4	17
Change in cash and cash equivalents	29	354
Cash and cash equivalents at beginning of period	502	732
Cash and cash equivalents at end of period	531	1,086
HCA Healthcare, Inc. Issuer [Member]
Cash flows from operating activities:
Net income (loss)	1,039	1,144
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	269	246
Equity in earnings of affiliates	(1,026)	(1,090)
Other	25	21
Net cash provided by (used in) operating activities	292	306
Cash flows from financing activities:
Payment of cash dividends	(141)	(123)
Repurchases of common stock	(278)	(423)
Changes in intercompany balances with affiliates, net	243	434
Other	(116)	(195)
Net cash provided by (used in) financing activities	(292)	(307)
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)	(764)	(642)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(101)	(99)
Amortization of debt issuance costs	8	8
Net cash provided by (used in) operating activities	(857)	(733)
Cash flows from financing activities:
Issuance of long-term debt	1,500
Net change in revolving credit facilities	460	270
Repayment of long-term debt	(23)	(18)
Payment of debt issuance costs	(22)	(2)
Changes in intercompany balances with affiliates, net	(1,058)	483
Net cash provided by (used in) financing activities	857	733
Subsidiary Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	1,582	1,570
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(600)	(347)
Depreciation and amortization	355	323
Losses (gains) on sales of facilities	1	(395)
Share-based compensation	62	60
Other	5
Net cash provided by (used in) operating activities	1,405	1,211
Cash flows from investing activities:
Purchase of property and equipment	(471)	(413)
Acquisition of hospitals and health care entities	(12)	(373)
Disposition of hospitals and health care entities	30	767
Change in investments		13
Other	(5)	(48)
Net cash used in investing activities	(458)	(54)
Cash flows from financing activities:
Repayment of long-term debt	(16)	(22)
Distributions to noncontrolling interests	(25)	(24)
Changes in intercompany balances with affiliates, net	(941)	(919)
Net cash provided by (used in) financing activities	(982)	(965)
Change in cash and cash equivalents	(35)	192
Cash and cash equivalents at beginning of period	174	112
Cash and cash equivalents at end of period	139	304
Subsidiary Non-Guarantors [Member]
Cash flows from operating activities:
Net income (loss)	350	300
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Changes in operating assets and liabilities	(478)	(24)
Depreciation and amortization	264	230
Losses (gains) on sales of facilities		(10)
Other	(2)	3
Net cash provided by (used in) operating activities	134	499
Cash flows from investing activities:
Purchase of property and equipment	(310)	(281)
Acquisition of hospitals and health care entities	(1,462)	(6)
Change in investments	36	(2)
Other	29	8
Net cash used in investing activities	(1,707)	(281)
Cash flows from financing activities:
Repayment of long-term debt	(10)	(10)
Distributions to noncontrolling interests	(111)	(68)
Changes in intercompany balances with affiliates, net	1,756	2
Other	(2)	4
Net cash provided by (used in) financing activities	1,633	(72)
Effect on exchange rate changes on cash and cash equivalents	4	17
Change in cash and cash equivalents	64	163
Cash and cash equivalents at beginning of period	328	619
Cash and cash equivalents at end of period	392	782
Eliminations [Member]
Cash flows from operating activities:
Net income (loss)	(1,026)	(1,090)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Equity in earnings of affiliates	$ 1,026	$ 1,090