HCA Healthcare (HCA) 29 Oct 192019 Q3 Earnings call transcript

Company Profile

Participants

Mark Kimbrough	Senior Vice President of Investor Relations
Sam Hazen	Chief Executive Officer
Bill Rutherford	Chief Financial Officer
A.J. Rice	Credit Suisse
Whit Mayo	UBS
Josh Raskin	Nephron Research
Pito Chickering	Deutsche Bank
Gary Taylor	JPMorgan
Justin Lake	Wolfe Research
Kevin Fischbeck	Bank of America
Ann Hynes	Mizuho Securities
Steve Tanal	Goldman Sachs
Frank Morgan	RBC Capital Markets
Steven Valiquette	Barclays
Scott Fidel	Stephens
Matt Borsch	BMO Capital Markets
Lance Wilkes	Sanford Bernstein
Peter Costa	Wells Fargo Securities
Brian Tanquilut	Jefferies
Matthew Gilmore	Baird
John Ransom	Raymond James

Call transcript

Due to licensing restrictions, you must log in to view earnings call transcripts.

Operator

[Call Starts Abruptly]

Mark Kimbrough

This morning's call is being recorded and a replay of the call will be available later today.

I will now turn the call over to Sam Hazen.

Sam Hazen

Good morning and thank you for joining us today.

Earlier today, we reported very solid results for the third quarter.

and were months to results of by revenue results the performance were quarter strong six management. first the growth third generally our comparable in driven The expense good year, the

revenue increased over increase driven facilities the quarters this growth past than the strongest we volume, the of was billion XX% XX by or Revenue in from more have acquisitions. quarter, in the combination our recent same $X.X seen and in

$XXX was million basis, based growth facilities revenue our domestic approximately XX had most grew same divisions. markets or X.X%. a broad or by volume service On We categories balanced with across growth XX and in it across

patient grew in patient admissions visits X.X%, in surgeries On a X.X%, now basis, X.X%, grew same X.X%. consecutive by X.X% grew we grew grew facilities quarters. Equivalent in by emergency admissions XX facilities room admissions grown outpatient and patient in surgeries have our same

we the to our capabilities our in care and facility. in quarter $X.X strategic into of The earnings facilities growth sales Healthcare X% of expand to converted clinical losses accessibility are are quality of revenue improve and business our for greater patient convenient on billion, per debt. networks in in creating the solid grew patients on with which investments gains to by EBITDA share retirement diluted high $X.XX excludes Adjusted the making approximately receive an earnings HCA

basis the high to in time patient We an available recently data XX showed XX.X%. growth most share points of company. The again good grew by market for all

communities to and capabilities Healthcare by we scale giving in a great tomorrow. and employees with use the the a our to people HCA serve delivering employees Finally, physicians physicians, thank our together I high of make in care quality patients their difference healthier work our to and unique for want

to call me let that, the turn Bill. over With

Bill Rutherford

Thank you, morning good and Sam, everyone.

quarter information to I the additional will cover third results. relating some

quarter the I provide statistics all our will virtually of mentioned, were Sam some solid additional operating for As information. and

admissions admissions facility the Same-facility the increased This third same prior equivalent During the both includes quarter, medicate to equivalent and Medicare. X.X% Medicare increased traditional compared admissions and year. increased X.X% in X.X% increased quarter third X.X%. and admissions managed

care quarter admission in increased third X.X% to year. admissions Same-facility the same-facility equivalent admissions and the increased the increased equivalent managed X.X% X.X% compared the increased X.X% and quarter prior year. compared Our self-pay to charity admissions third and for prior

in X.X% and increased our the emergency X Same-facility over level increased visits while quarter, X X.X% prior X X%, visits year. the room X level acuity increased to visits our higher

the domestic net In line the quarter emergency grew over range with year. guidance the addition, admission admissions to and prior growing room operation for equivalent per X.X% a prior the year Same-facility over the our increased for is X.X% X.X% in in year-to-date revenue year.

surgeries Same-facility outpatient grew X.X% the our over in X.X% and prior year. surgeries patient grew quarter in the

me move on quarter We of management. had let another Now, expenses. expense to operating solid

XX expenses Our grew same-facility to the quarter admissions basis points the our X.X% year. quarter the increased in same-store per operating prior and margins in compared equivalent

grew the admission improvements. labor quarter, hourly X.X same-facility the grew rate adjusted quarter X.X% per cost in see productivity in and labor year same-facility Our to continue prior the we versus average

other the prior per over to prior compared grew admission equivalent the year per Same-facility cost supply admission Same-facility adjusted X.X% X.X% period. expenses increased year. operating

expense. million during assessment. quarter, quarter. a favorable actuarial last adjustment Also, our recognized professional based favorable based of updated This an reserve XX third third the During quarter, XX recognized year's compares the share million to the on company million liability recorded additional the in adjustment the XX company compensation

had outperforming quarter. in had on basis an consolidated our The expectations. the also quarter XX acquisitions margins recent impact approximately Our points acquisitions another solid unfavorable

to about flow spending for be cash me billion Capital quarter let a from year. totaled take versus last X.XX with X.XX the operations operations talk was expectations. third in continues to strong. of billion Cash Cash the from quarter moment So, billion flow. our X.XX line flow in

aggregate losses XXX amount million senior X.XX quarter. on principle secured of debt During redemptions during notes. totaling Pre-tax of the quarter, retirement for recorded redeemed were we billion the these

dividend and During we Also, our XX, quarter, repurchase as X.XXX million per paid declared Directors Board million to release the of XXX has mentioned of of remaining of our have share. September quarterly in morning, repurchase X.X billion a this shares XXXX. we authorization cash $X.XX as

per this on on EBITDA retirement year end Earnings the third revolving quarter, of on in facilities of facilities last versus was of had we was quarter including of debt billion the the the third our quarter ratio of adjusted gains debt year. $X.XX $X.XX sales X.X available At our to shares X.XXx. credit losses and on in

we XXXX The in compensation the based last Share equated some $X.XX hurricane professional accounted for adjustment versus reserve $X.XX expense tax EPS this also $X.XX of $X.XX to And due recorded year credits. liability last year. EPS this year $X.XX of and to year. to

And excess per versus tax based last this $X.XX year. $X.XX was year share finally, the benefit compensation

updated anticipate billion. noted EBITDA X.XX X.XX billion. and between guidance per approximate full release, $XX.XX ranged billion between projected share And we XXXX $XX.XX and capital range in our year to X.X As our spending to earnings we adjusted with to projected

and back remarks my over concludes turn let call me to the Sam. that So,

Sam Hazen

It's to the the markets believe want our some Before drivers thoughts overall fundamentals difficult give of always strong. of business. preliminary with components I various around XXXX. We and primary questions, predict in we remain to to growth our go certainty, you

believe, to networks acquired our our operational also this the of spending well improve as are We positioning competitive capital and positioned continue integrate our with to on hospitals. capitalize initiatives, we favorable environment execute we

grow long-term to usual believe operation near rate believe part slightly our have our long-term assumptions, we above should core push our acquisitions of growth expectations. As XXXX, organically result, growth mid the top a upper should growth the we to and in subject the expectations completed we our of

detailed in January. budgeting the process look to over our next guidance few wrapping sharing you we and be We up with months will our forward

Now, over let call Mark to turn for questions. the me

Mark Kimbrough

right. might Anna, give now you, All questions. Thank who ask to Sam. those like you instructions to

Operator

question Instructions] will Suisse. take now Rice from [Operator first our Credit Yes, sir. with And you. Thank A.J.

A.J. Rice

Hi, everybody. Thanks the question. for

to I of want Sam's off Just comments guess jump there.

growth want I contributing the will X%. would year there'll roughly X% that have I we been this year. to that, growth, be high-end, comment I'm core incremental is to look sure to talking about assume at to that I years. contribute to core guys target can assuming you of to acquisitions couple the verify grow year, just And in toward the contributing X% because acquisitions for that think trajectory permission X% the growth a moderate you But, on saying So, bigger are about I'm acquisition how pretty have been continue as those next to Savannah the of just you next

Sam Hazen

A.J. Thanks Bill?

Bill Rutherford

Hey A.J. This is Bill.

me Let take this. Yes.

X%. time acquisitions pretty been adjusted We're X% record high-end a me EBITDA least range is recently and the to to within mid profile. have we long-term a some contributing our range been Let confirm, think solid at track we've in at period where also our growth between range. We we growth said to of of performing that that

year. mentioned, we X% this X% to you As anticipated

turnaround same others. But as at We for as had to year to of year the the few rate we permission the you alluded as some performance of continue them likely first to continue this growth expect company. the to not and

some budget but you as commentary see performance to trying completed think comments of general some Sam where haven't a to solid specifics I our mentioned, we operating year-end early But direction So I call. and process, the provide on our our obviously year was with with our We'll this think lot range. we detail thoughts more little to provide XXXX. we on -- give long-term for want a company a related

A.J. Rice

right. All

Sam Hazen

Thank you. A.J.

Operator

Whit next our from Mayo take UBS. question with We'll

Whit Mayo

final thanks. patient -- the Bill, and Medicare got rule. dish rates pending XXXX We've Hey dish you've got the outpatient set. in

improved how are the as next sort your just high-end Just around you of growth about of internally guys comment guide, is long-term be thinking sort shaping Medicare you any of would helpful. views pricing help the year environment how at on your rates curious

Bill Rutherford

Bill. Yes. This is

update rate year comparable So, X.X% this again year rate a to update. pretty in we what variable likely to X% seeing we're are anticipating this Medicare

not But relative into the being in force factor environment that to next only our to to and XXXX. favorable continue factor year. do generally pricing a Medicare it will we combined see our we So, guidance,

Whit Mayo

Okay. Thanks.

Sam Hazen

Thanks Whit.

Operator

Our next question comes from with Nephron Josh Research. Raskin

Josh Raskin

in sort recent running CapEx higher CapEx. sort return the about Hi. even that of are of XX% getting, year and you you've have CapEx years. know morning. three kind around guys Question of like to than feels the past obviously spoken of in And Thanks. are we're acceleration in you on impact to XX% in Good that sort I it recent of be years this this going

is recent in markets of how drivers of the we're is I'm to improved a projects there that rate kind serious way guys of in terms specific you've of So, you of some and that growth up track seeing and growth one put dollars curious in sort really this it. years where line

working? the sort how and that's just generally So, of around CapEx

Sam Hazen

Sam. This is

our It's our hospital we difficult a or we growth capital adding pinpoint Clearly, total and of and clinical key our look our our individual capital clearly specifically of agenda. whether performance of to score at achieved the the geared that capacity, an in our company. physicians, on value ambulatory can think the technology capital. and component is I increasing not expenditures expectations that's plan spending for network really toward out building

lot But, a mind purposes. long not our capital for just It's a short for keep run. in of is run

because really some so a building the of project, the toward And geared of our run. complexity of much longer it's projects

while to So payoff get on that. it full a a us takes

don't But, performance we have in the expectations. had globally speaking, we modeled of And accomplish much few we company it's that to performance outperformed so, better our company sort and returns of that Generally putting most aggregate financial hoped. all obviously contributing projects. competitive when a what our a had we position. We've the on believe the you of our monitor against we our

of the running XX% of on in today hit that's the occupancy lot year. levels are that's and company this We a capital spite of at inpatient approximately

beds the in did over online we XXXX, we're in I as anticipating we're in think XXXX. And think previous adding this amount the year I coming course more a we of year. similar than had

So, physician it's agenda network. we that's relationship mean robust to just our have me to hard physicians value adding I continue add to a point for that. as to

yielding quality network we our value outpatient is grow. our And as agenda think continue continues clinical performance. our to improve to then excellence ultimately I

centers the surgery performance over company. almost XXX the will to XXX volume XXX overall care hospitals up all that connected physician XXX urgent rooms our and freestanding clinics of be think roughly emergency We I of centers to to and are roughly XXXX ambulatory is connected that

were flat as broadest years. flat performance were to The I've as alluded admissions outpatient behavioral positive almost and two from was in based our Bill metrics centers health three far this. standpoint an up. had were that volume areas only We the surgery seen that modestly

our hospital surgeries strong volumes. based was outpatient Our what very overall that's drove outpatient and

had we think forward. look we has broad based that that had to growth I think as company is speaks really the overall appropriate the volume comprehensive we growth years. And So, for agenda

Josh Raskin

Thanks. Perfect.

Mark Kimbrough

right. Thanks All Josh.

Operator

question will Bank. Our Deutsche next Pito Chickering come from with

Pito Chickering

Good morning Nice guys. quarter.

follow-up actually of a outpatient inpatient topic that on Just surgeries. and

strong Third of versus very sort half quite the of and sort comps. was challenging strong quarter year, first of the

half. of so what continuing guess the strengthen [indiscernible], strength docs next conviction it a what bit that and gives or more the year and you that And inpatient, to led talk I outpatient ORs, both over which expansion of could a was caused around about expansion hiring

Sam Hazen

question so This in spoken trends. our is indicated to Pito. us And to the think bit processes to initiative we and surgical expected as invest continue suite. Robotics then, number to we the tailwind. contribute Sam. be that volume that over improve calendar in of stronger did respond given years a example quarter is you continue performance. a procedure technology performance our have solid did a surgical an third think capabilities to some Well, little of we to our has obviously in when deeper some cardiovascular past we we slight that But we've surgical to adding forth is we company. growth That's care our operating physicians driving need. And for it as I room the And modestly been tailwind the score the our for of overall one within continue that we what as because

strong Our on very cardiovascular X.X% inpatient was up. the surgery almost

in had volume orthopedic up joints X%. were our We robotics total, performance. Our total strong

performance. was surgery vascular Our

it's this It's of adding that some we're our but So, our is and clinical initiatives. program also supply physician our Ors, improvement clearly strategy, strategy. It's performance our strategy. more

to very about our and mentioned what best understand very marketplace their I in we in our pay really performances move physicians success us quarter And future. that's as broadly. we we so believe share practices very is and it as one monitor our the as prospects. we time. the needs best and a And And foundation to the those formula this performance We company this of detail across growth the the think not of into surgical previously All successful sort but think then yielding we that's company just carefully, will for dividends we continue for detail over carefully. we are

Mark Kimbrough

Thanks Pito. Right.

Operator

next Taylor Our question with from comes Gary JPMorgan.

Gary Taylor

Hi, a had good I of morning. couple questions.

of if on of settle a physician have employment, physician is physician and recruiting, to acquisitions. renewed us on degree any some see of think little up of your to employment this one. equity, change sort a or wanted just of to and how others I private be strategy give outright you're are rolling you making Could in to to I'll acquisition the pace going update approaching acquisitions activity physicians space seems terms

Sam Hazen

a I in thank per our see This strategy a se. is don't see Sam I change. change don't again. you. Gary,

been employment. have about been we about We have recruiting

of and those other program leadership alignment continue to yield clinical about been have for relationship methods a and We success development with and us.

spoke that are of And making, medical to. staffs the the in the across growing are through facilities all I physicians. that of our investments in development of initiatives physician channels, X% We quality alluded folks year. to. momentum because attracting that per coming the to are some just about at portfolio those nursing company's issues it's that making. gaining we're it's overall we're believe are seeing of improvements and We X.X% face these you that And It's

practice physicians who X,XXX We HCA about facilities. have We of XX,XXX at employ those.

our at We X% growing probably XX% ranks per to are employment year.

for within tactic as not strategy a common ranks, future. is look but to more it physician we a it's us So, our sole the

Gary Taylor

Thank you.

Mark Kimbrough

right. Gary. All Thanks

Operator

Wolfe Our next Research. question comes from Justin Lake with

Justin Lake

come guys. Appreciate like on to guide, of A out morning. at implied commentary to sheet. looks should the XXXX range you'd of do year, you're just the the out kind math on Good like low the end Came some X.XX%. debt Thanks. question -- the I about it balance going If say on with at I your be of EBITDA X.X%. of more at here

the have get to to $X $X So X.X%. It yes, like I room mid is know billion point. target looks your of X.X% long-term billion, just you'd back to

cetera. as curious share kind opportunity how going think you're of to XXXX, that just would thinking M&A about into So, the pipeline Thanks. repurchase opportunity, et

Bill Rutherford

for thanks Bill. the Justin, question. This is

at range optionality very the to right, think We continues this You're ratios we a the obviously the lot our flexibility leverage low company into end are future. that. and give and of with our of pleased

as our cycle. to longer range. continue as but making a term the time, of we'll we're it. you know, evaluate to and Obviously, our far will thought changes some Not any to As planning give into at lot going this range

that balance important well likely have the physician, a the to attribute our sheet. for a company. approach and as through balance We of capital policies. We fund time obviously to we've the is the towards dividends the capital We'll couple balanced think continue for to we sheet hopefully We We've the do end an investments as got think allocation of disciplined close repurchase share pretty some stated strength cash of evaluate capital our year. managing from and flow our we'll to that. smaller acquisitions

very So, I we're with again, result. the think pleased

where capability high as the to into on to of continues I give fold. acquisitions execute flexibility value We've think got a we continue to the right those. the see are level we potentially us now lot come

Mark Kimbrough

Thanks Justin. right. All

Justin Lake

the color. for Thanks

Operator

Bank Kevin with Fischbeck of America. from Our next question comes

Kevin Fischbeck

surprising seemed I guess revenue I Thanks. you weak. up. to volumes a want of people and little guys QX kind guess follow was I it I bit a just to -- Great. issue it like being in particular guess was and commercial it called

kind maybe your it's end of view This say pricing. quarter you could if I on looks better, still the lower towards wonder long-term but of

on getting are be to to if and want in that there's and it now. where seems better just QX see why we what any So, on happened post-mortem

Sam Hazen

Bill.

Bill Rutherford

is This thanks. Kevin, Yes. Bill.

issues So Year-to-date few QX mix, a little range. good with see we X.X payer attributed you in soft. it was had is were bounce midpoint We We commercial if yes, very some and isolated we're markets. of to as up. Obviously, the mentioned, back volume mix our some case pleased we a X.X, at that which growth. the will, range right

continue So our we have again, contracts, and will great I into think visibility visibility with our our contracts. commercial to

softness that some pleased we year-to-date. We the higher are continue, in rebounded quarter and here a our with us in think post third some invest And just I as of in services well. for Sam quarter second acuity where mentioned, as

Mark Kimbrough

Kevin. Thanks,

Operator

take question Ann will We Securities. from with next our Hynes Mizuho

Ann Hynes

acquisitions, of profile. good merger on you I acquisitions the the XXXX on more just I Late what you color are us know well? Can love billion profile you some early revenue. right those mission color some and gave Hi, know of morning. margin X Thanks. let and acquired but now the XXXX, as

Sam Hazen

As portfolio say we're each we anticipated, those now. them to story performance very margin in recover, Savannah are us acquisitions pleased we high time have single the year. I'd that with We the first digit running of Memorial take a And some of different if a the them. stands. little to will, that's and knew would where where knew you of Mission, right bit obviously,

us. this contribute mentioned, The performance they'll year So, next contributing is digit. and knew I to those the think of high to for the be we continue think those growth growth we've year multi-year margin to we I acquisitions single characterize process would as

digits how would high characterize now. right single I that's So margins, the

Ann Hynes

Thanks.

Mark Kimbrough

Ann. Thanks

Operator

Tanal question of from Goldman Steve next Sachs. comes Our

Steve Tanal

Mark. I morning. question. quick Hey, one Thanks guess guys. Good

really tough. strong particularly a growth compare year looked Just the ago was care managed and adjusted admissions

thinking of that, just but macro really of to kind are I commercial's your solid growing admins bit thoughts than a faster get on Medicaid Obviously, the through adjusted commercial, So wanted absolutes. environment. kind still and

thinking are there. mix a index. Thanks to And all that payer headwind so or you about great is mind any the in mix? commentary that good? the be how Are guys. And mean, dynamics you have number would I acuity pretty these your if

Sam Hazen

the think Well, I read is still positive. very environment we

a solid running markets. had We growth continue commercial our range. X% to basis. numbers. year-to-date indicators anticipated We in X% on economic Good in that see to employment We're

But characterize think for the So, to to with second the would at overall, commercial are economic when we're trends any the very is I our market at look for in pleased period the the or the access good contracts. they subject think indicators, one that's HCA. some We looking favorable we know quarter. employment still We us. still overall in we environment pretty indicators, a look is volume at here trends there,

factors Relative to quarter. We to was intensity, are for that our case flat the think contributing there some mix are that. basically

to ventilator we see are end continue We of life. reducing patients, our critical sepsis, as paying improvement days improving initiatives dividends that see clinical for reducing care

these to initiatives value a brings case on patients. our but lot All of impact mix have obviously clinical do metrics, some our of

line So, we the think that there's in in some but we very service think revenue areas, again, strong -- and clearance probably quarter with a our few was expectations. the line other I had

Mark Kimbrough

Steve. Thanks

Operator

with a take now Markets. from Frank Capital will We RBC question Morgan

Frank Morgan

Good morning.

terms You end year that smaller of of deployment. referenced couple up you a of in wrap the before may acquisitions capital the

systems accounts the of Thanks. on did curious I'm some seeing suggest in I'm but opportunity change with curious, Mission those for with some likely. that seen more more might opportunities like are I've press the those, there kinds and any then some larger Savannah. of maybe landscape you think you just of I about

Sam Hazen

It's that se know Sam. landscape don't Frank, this the changing. per I is

organizational as and is size discussions. those works whether think materialize indicated, We we we or will, or some yet systems, for you to determined. capability take have not into with We Bill decent is if that us think transaction think I'll any sheet absorb a say more. for chassis of a more balance on acquisitions. to discussions to the built our that be seller works is positioned are I having

necessarily we're we're the be but surface Obviously, a the run. are and so looking, will my board most decision beyond looks or we that the anything forward out decision don't do there. generally talking, to thinking strategic marketplace few makes know transaction next for not-for-profits we And will short good estimation to us that as sort through go it want And is if with of years. a a in of the

that So, what we've We're we to excited acquisitions see those discussions how go? have about the done.

We're opportunities internally for Bill for a seeing see we we're improvement we And part. what most them. modeling performance. in indicated, still the in As with anticipated had our progression accomplishing

us gives that acquisitions our getting in confidence organization are So, that better. assimilating capability the in

to present opportunities And we'll so take those. able themselves we're that be of hopeful as advantage

Mark Kimbrough

Thanks, Frank.

Frank Morgan

you. Thank

Operator

Our with next Valiquette question comes from Steven Barclays.

Steven Valiquette

Sorry. Good Thanks. morning.

the quarter. trends the strong a of snapback on but about bit this in have bit, that in admission XQ a to up little revenue same-store quarters So, quarter. that from X.X% to quite the certainly And six didn't softened operating with the for per obviously the posted this slightly results. touched company little metric But row trends improved lots a XQ was last X.X% before adjusted

I'm curious obviously a So if the to mean, near getting a glide if in just term -- path I things commercial additional of I variables that bit. there based is back little progressing hitting kind the now. you any anything right else color to And are just on hidden potential on see how surgeries, but touched do guess, improvements X% there, are that around Thanks. you just that curious there's

Bill Rutherford

This is Thanks. Bill.

X% RAA. So, we right that. X% the is of year-to-date in performance anticipate we've our in said said to middle We've

so X.X%, solid saw we with second that from the that coupled to growth. revenue growth. the look really at confident quarter outpatient our quarter. And per third admission improvement inpatient are We our revenue inpatient We grew

-- influence service performance. we complexity major variables mix where or any factors major changes a and of I don't revenue, and see that lot between tell of a But, I'll year-to-date or again, so forth. there see don't acuity with on structural are And impact we're structural changes materially. that, characterize, really our pleased are think impact the really should I we that that you, with any that I

Steven Valiquette

Okay. All right. Appreciate the extra color. Thanks.

Operator

with take now Scott a question will We Stephens. Fidel from

Scott Fidel

Thanks. -- admits just from versus payers bit of of some Question being denials about aggressive talked reported terms XQ your more in observation. that that peers of had inpatient the one a posture on in

to like it it that on look you any just doesn't fundamentals some that any whether, you wanting they seen see see and the commercial from pricing, of Just dynamic of that but similar recorded to markets and case? been want your not in have volumes of has recently or the

Bill Rutherford

bill. is This

amount that those to status. HCA country our overcome case that time material driver with and think appealing the that. with in can the We we we of denials got a for that always around denials. advance status is observation for factors I effort activity well well as resources and the a a those amount patient and effort considerable that think we of strong utilizing a for have spent we a we But, positioned and We've the in to seen deal adjudication us challenge us. and But, case. characterize spend increase. that as And we deal Denials and indicators out I in industry operating we do time, deal to it factor the kind we with. that So, observation claims making have it's have that we continues industry is as considerable when of clinical don't the in see terms the observation and patient of of of called cycle health. are administration past that

Sam Hazen

add to Bill. me Let that

a answer patients. a I not their our them major their free a and size, that yield for number patients that us technology, that sort confusion processes the think friendly have our members to of the centers some of organizations the to environment and patient that efforts move to member. major these we more their technology, some capability underway both toward the and optimistic our better going take size have with more advantage both the are our create payers billing around of and of of And I'm for technology a for for for and payers friction

what into do our capabilities some appropriately And of part with claims of Parallon so the integrate big payers attempting that's to shops these that that we're have. and

So transaction much it's organizations. more environment both a efficient, low for cost that

Mark Kimbrough

Scott. Thanks,

Operator

will now Markets. Matt to We move with Borsch Capital BMO

Matt Borsch

which the yet instituting me a where was all that of different is, rule we've largest but heard cited that stick on that theme Let hospital payers one is -- a Scott about, different procedures are slightly area through of fourth to and I'm sort. have impact you go you're outpatient your on whether going if think to screen have curious radar in if quarter. something will that some the that's -- pre-certification asking

Sam Hazen

Well, this quarter referencing. is from anticipate Sam. I don't that you're that policy impact particular any fourth

the We that have being provisions the inside function, will ambulatory network of to facilities hospital most our of how facilities. contracts our speak network inpatient or outpatient facilities our and

the that's have the patient, continue location our dealt for protect It's they outcome ultimately on that. the to a selection significant that appropriate and get with work physicians. site right the clinical payer business we find forth. we'll in and the price point not in change they result want. the the and at a sort to of of and the appropriate as lot of way these in we so with any composition anticipating procedures a patient is those speaking, the and that payers so of for typically we're our around so past network And policies And And

Matt Borsch

you. Thank

Mark Kimbrough

Thanks, Matt.

Operator

Sanford We'll now to move Wilkes Lance Bernstein. with

Lance Wilkes

sorts maybe how of that opposed your the Yes. other taking strategies, of end networks I for with talk payer owned that in and about to much directed you and share physician or is market changes can maybe the as physicians bit quarter, wondering and little a steerage affiliated strategies? was things like

Sam Hazen

back the consistent and years been we the with Sam we it with our growth the I that resonates marketplace is It it about resonates and think find has payer. how growth us That for to model. physician patient. over this model resonates think in I and if comments model you that about the made the go our the -- with

the yielding of of combination the share think sustained time. so components is market we our have those And we gains over that model

most our market markets we information. we that gained gained in XX% information share lines we service get XX and where XX monitor or In of our we share recent in

growth believe the basic of payers. and yielding believe; appropriately teams for detailed, value model, what resourced the it's well and we our value our executed patients, of So, value elements value to this model. think for growth the for employees Again, it's inside appropriately our by our physicians; and our really we ultimately it's we be is

company item driving sort what's to And of the so it, aggregate an of this hard market company depending the aggregate, that bit think a the performance pull the to little approach, time. the if to we when our it, HCA of that you to But it's one and because sustain of say ultimately from it is of it kind up deconstruct takes we've other been drive strategy the on to sort able will, the flywheel, all this we one varies circumstances. growth of extended for periods point components item of to start to consistent

Mark Kimbrough

Lance. you, Thank

Operator

James a take question Jaffray. Piper now from Sarah with We'll

Sarah James

and that you temp guys T any across you is left much the much you on How quarter quarter. How Thank broadly efforts do push supply is pressure mentioned thinking Thanks. expense board last cycle can control, on temporary on these I more the are be and management. on further now to Did you using load? staff you. about usage sit Volumes savings achieved? for how revenue expense initiatives? Then were and ongoing chain savings pretty staff? your how strong impactful Where that put

Bill Rutherford

Thanks Bill. Sarah. This Yes, Sarah. is

good Obviously, So, the with cost some and performance. we we company. to leverage operating be with of pleased structure our fixed when get performance the can cost of continue pleased volume we the

have, the supply to from costs and throughout all you to know, company in improvements continuing itself third as that other I labor probably manage operating aspects think and initiatives We of the cost showed to quarter. yielded

very we're do our company. pleased cost of the with terms very of structure the in of to manage So, proud they what the performance, teams

reduced you year right we that Tell of our reduced that pretty saw labor, we it, out whole that's labor, was use an the turnover year really over our within as do on we past, have improvement manage and line. the temporary sometimes when half temporary we stabilized the year-to-date. it labor call volume labor. now peaks, it good Regarding but call context contract have operators we our to that area us to and a we some Pleased,

think we're us. where I X% So year-to-date to stand for solid again, range. That's to and we for with we number pleased a continue quarter the manage that X%

Mark Kimbrough

Sarah. Thanks

Sarah James

Thank you.

Operator

to move Fargo now Wells Peter We'll Costa Securities. with

Peter Costa

these delays Washington morning, early to lot quarter. you in of like of are any gives healthcare Looks an a it focus Good guys hurt do sort some and like Things the dish. kicked have way others is or just in you year. than going time could of more issues next billing of any surprise think of Are more being delays? nice in you the that on impact more those to the given should we of And that there repair? into one something terms

Sam Hazen

think I this Well, is again. Sam

democratic Washington to healthcare Obviously, primary the out a Washington sure legislation the some pocket patient, bill healthcare process think, protecting surprise a that the about that in around in. policy costs. seeing legislative discussions or I And the even within we're making states discussions patient in having obviously, has whether area. supportive we the within on we're are the lot some as the of and then are of engage from defined this going we DC currently within that that's in transparency a said patient before, of their protects there

of So, elements. we're supportive those

that don't and we beyond concerns to to elements, moving what the accomplish think going patient. those around need they I than do they're have accomplish more we believe

those the again, the neither necessary information, transparency, us. present of we're those challenges the pieces of getting being surprise patient it relates for billing protected any to So unusual two supportive as the and and legislation,

future it's we it think will the As that you there. or areas, if those could they just about here in of some some we think challenges create if overreach,

on on dish, I our As the we're move significant the impact as revenues it relates outcome think to but waiting having we for that don't still into anticipate Medicare XXXX. a the that, final very we

Peter Costa

Thanks.

Mark Kimbrough

then, Pete. off. close going right. to take three we more All and it going we Thanks Diana, are to are

Operator

Okay. We'll from sir. with Perfect. Brian Tanquilut take Thank you, now question a Jefferies.

Brian Tanquilut

quarter. morning good great on guys. Congratulations a Hey,

Just for me. and really question quick simple

I'm what outlook, incremental And expansion? hospitals should comments then made about we already expectation So, over the thinking what's into factoring the be XXXX. XXXX I what qualitative on there obviously you that views well, about margin the percentage as about how Thanks. or the M&A your from in acquired announced? think is as in baked improvement been

Sam Hazen

increase revenue is towards think to we've comes which revenue our X% be the volume believe X% to being of things past before our that the of all we Obviously, quarters. be guidance, what is on our this operating it to able if can unit or our Sam. operating We in side over We whether had said This stores same we enough generally high we the margin seven that's grow volumes keep our growth, kind high should margin growth, and able with revenue grow should where we on combination. or six we equal. price to in

belief with of As that the margins it respect is able range, same relates portfolio. our to the to to maintain our end be thereabouts low stores should we

be As have spoke And for of to the we will able the that belief overall margin lot models think of have much them to in affects our it how acquisitions ago, to our as make appropriate a revenue company's same we efficient I They time. adjust be in performance, margins large we company as the performance. Bill a those should a range, we in our These upper that improvements a steady we color over side improvement incrementally our connected our don't to is of store's to of grow generate we but anticipate a and have them how environment. institutions. all do as more margin are to people minute as margins improvement. the if can the adjustments,

think I X.Xx that's margin. quarter, metric our our a EBITDA us. revenue roughly was average this good a in And for to clearance

that the growth, our to about at margin heading average a revenue X.Xx that's same into clear at able revenue X.X% so And we stores were quarter.

So that's and our it. but be and a takes from and There the pretty that approach time good one sort they of be thinking. our microcosm of next, to have how that would about considered over we quarter to puts are to think

Mark Kimbrough

you, Brian. Thank

Operator

Baird. We'll with Gilmore now move to Matthew

Matthew Gilmore

color I call self question. some even growth Hey, The or a new mean pay fluctuation pretty seemed lower stronger volume that's growth moderate quarter moderate normal ER on you to quarter-to-quarter that? and out to the could with just that helping thanks get drove for self-pay what visit number, this anything was that

Sam Hazen

year. one with Medicaid say the out been that we've is Virginia call Well, I pleased would expanded this thing performance,

as that's we pay into So that self of conversions some see from impacting Medicaid.

mid expansion. So that's that, impact expectations Even the that having on a self-pay digit if this, within for Virginia are positive I what it's single outside higher Medicaid growth even trend. to you we tell within our normalize still

Matthew Gilmore

Got much. very it. Thanks

Mark Kimbrough

care. Take All right.

Operator

Yes, sir. That Raymond will with John Ransom be James. from

John Ransom

Pretty Hey, morning. range XQ that see we'll procedures Do your think implied XQ more your so, factor into you continue to guidance? wide if did how good in and seasonality into for guide. you elective

Bill Rutherford

Yes, John. This is Bill.

look a strong well. adjust of X% year really at for basis. we're year with us consolidated guidance, that do running what everyone a numbers to remind you fourth things, line in on last As quarter our as I for quarter few Once close a much our pretty in full was generally

I'll out that our now, terms always seen level be the seasonality, hasn't a over thinking. you bit, been little major We've several in tends right that to past As there of factor tell a years.

our throughout continued been of the changing through performances. our we've what stand now, our with quarter year with that. we've we guidance the each as it much and pretty the to looks progression So, quarter be we've where to the and fourth consistent right guidance quarters year-to-date is at improving Obviously, look gone just year

we So, a that's stand XXXX. where for

John Ransom

but growth want 'XX. high bps your follow-up The and patient just And engagement to survey fiscal I at all copay just in question. this showed for kind just of about, of is continued really Mercer How financing out with thinking XXX know as a of Mark's are a strategies patient this that, you guys another plan growth if interesting off, relentless to cut me pocket?

Bill Rutherford

teams that that fro Yes. to it cycle I'll John, our we've from our over headlines. the from Parallon view, we our I accelerating dramatically revenue as seen change very our address think we of view, a several what tell But, if that. as you and reasonably well. I haven't We're past with handle those years. see some don't I pleased know much seen

revenue of just it's the we that within our clearance managed context total So through.

Sam Hazen

and them way built explain ones probably of -- I them for. to ensure that's to burdens their very work And get hit policies fair and Bill and challenges deductible the some instances, friendly come Sam, understand the that in that with with we these up But system then don't the most to is our exist the our and And patient industry I helps they is they've through understand our fully help with with to done them a patients in policies. think that to plans. patient have engagement protection that in deal that protection plans high industry what forth. patients one thing, team signed comprehensive many the the patient create think, to his so one we've some have this a is leading And them of of with understanding policy the

John Ransom

much. so Thanks Great.

Mark Kimbrough

Thanks, John.

Operator

over today. back our I'd for presentation like question-and-answer or That the presenters turn for session our closing any additional remarks. does to conclude to

Mark Kimbrough

the right. to want All us call. I for everyone thank joining on today

if questions I'm always, free But thanks available you that you additional have or feel me clarifications call. need, give to just As again. anyway, a would

Operator

does And thank once your and all today's that again, we conference you participation. conclude for

You may now disconnect.

We use cookies on this site to provide a more responsive and personalized service. Continuing to browse, clicking I Agree, or closing this banner indicates agreement. See our Cookie Policy for more information.