HCA Healthcare (HCA) 22 Oct 212021 Q3 Earnings call transcript

Company Profile

Participants

Mark Kimbrough	VP, IR
Sam Hazen	CEO
Bill Rutherford	EVP and CFO
Kevin Fischbeck	Bank of America
Ann Hynes	Mizuho Securities
Brian Tanquilut	Jefferies
Justin Lake	Wolfe Research
Scott Fidel	Stephens
Ralph Giacobbe	Citi
Frank Morgan	RBC Capital Markets
Pito Chickering	Deutsche Bank
Whit Mayo	SVB Leerink
Lance Wilkes	Bernstein
Jamie Perse	Goldman Sachs
A.J. Rice	Credit Suisse
John Ransom	Raymond James
Joshua Raskin	Nephron Research
Gary Taylor	Cowen
Andrew Mok	UBS Financial

Call transcript

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Operator

Welcome to the HCA Healthcare Third Quarter 2021 Earnings Conference Call. Today's call is being recorded. At this time, for opening remarks and introductions, I would like to turn the call over to Vice President of Investor Relations, Mr. Mark Kimbrough. Please go ahead, sir.

Mark Kimbrough

right. All so you much. thank Chris, morning, to on call. welcome Good everyone today's and our this Hazen; me morning CEO, With is Rutherford. Sam Bill and CFO, and some will Sam provide and will we then prepared take remarks, questions. Bill

filings. remind a are adjusted reconciling over the net On such included and call other is risks, contain non-GAAP Sam let today’s Before that, measures I is management’s financial everyone statements, current reference replay over should income they attributable turn that a forward-looking materially uncertainties upon measure. statements later the EBITDA and Healthcare to Bill, and call morning’s from to providing More me factors today’s now these This call, based those I’ll recorded any this turn Numerous call on Sam. we HCA today. might to may cause A may in in is today. forward-looking information actual be be and and various listed which being as call adjusted call information are differ EBITDA, to on release in available and results table factors expressed press morning’s With Sam? will SEC of that today’s our release. supplemental the expectations.

Sam Hazen

thank for Good morning and you joining us.

was drove demand for significant yet The for The and surged us the period quarter most intense pandemic. our third variant with the Delta COVID services.

of level quarter total quarter, fourth and in This year. in to quarter XX% the in accounted last quarter, admissions. XX% for of the XX% first For the COVID patients X% compares second the

XX% Inpatient revenue XX%. grew which the the year. XX% and drove of levels record as Our revenue teams provided during care prior quarter, revenue to of compared outpatient grew growth inpatient

included $X.XX, was for margin over also Diluted exception inpatient used prior business. As prior effect of government early repay $X stimulus share of major may excluding the of decision notable dedication our received because mix or $X.XX sales you COVID our quarter per colleagues return Adjusted with was share, our which year better supported Surgery And on to billion I categories, resulted I payer across third as CARES others. per strong is and patients. year's the reversal a EBITDA by gains all great from year. that capacity earnings we growth delivered and to XX%. increase and service at the the surgery. work. commercial volumes for was for governmental and last them of of the income, recall, which from am assistance to constrained, our patients increased again, a Act. over considering treating This of facilities, XXXX, same-facility Even want thank proud Once communities. the for to were their compared physicians tremendously of their increased approximately volumes to

look again of remainder the we earnings XXXX, raised the we the have annual to of performance to As reflect company. strong our guidance

perspectives transition and let year. Now on general the some me to early upcoming

demand to in we environment give that the our are and analyze complete zone. historical time, continue fluid a more X% to uncertainties surge business. normal across environment, have of is we more environment, with with thoughts we obviously details growing our it to us, guidance most a some that a We of better very after return the which By few given more believe the in that are XXXX, like operating provide annual indicative preliminary to midst trends for to January, volumes Just pandemic. non-COVID makes a months categories Overall, a indication plan planning X% of that for providing hope in challenging, the will results you in of to with process XXXX. we exist our

we will to markets. total growth, supported We insurance growth that admissions this our throughout of enrollment be in will by a approximately business of X% COVID across COVID-related. As our believe job We and health be treat exchanges mix the patients good X% part stable of XXXX. a to estimate expect payer result as strong our

are We either year. amounts acuity high not at do levels. will patient assuming or continue also governmental expect pandemic-related significantly reimbursement continues reduced certain We but programs at next will continue

In with this a cost over providing show year's are a we these us challenges EBITDA for remarkable However, partially inflationary we and expectations, they we we be Again, anticipate estimated and certain COVID But are anticipate for the in pressures. operating The will environment, revenues been Healthcare. perspectives manage Clearly, we have incurred adjusted able to that some treating believe cost along early expect which being to at costs these point through to in by will in change. past reduction pressures. modest results. time, offset could challenging we period growth labor lead other two patients. sum, assumptions these cause of years HCA XXXX this

We Across of our at dimensions have true our level and while mission. many time, to high we demonstrated business, of resiliency staying same a resolve, improved. the have

the better improved for grow and which to stakeholders. should allow backside capabilities, and our provide operational us to quality I value our of our stronger believe will and positioned this to higher we have competitively financially We emerge also patients. event care organizational drive on

for We model, better turn network, and enterprise-level Thank an the competitive scale to With model believe operating We local over I'll you. with creates system aggressively at our this with supported and coupled a is call develop by system-level Bill. share stakeholders. and capabilities. market which comprehensive unique advantage, to are drives located our that, produces and outcomes investing conveniently gains

Bill Rutherford

I our allocation you, and our activity morning, cash Thank during review quarter guidance. and will Sam, Great. the then flow XXXX capital discuss everyone. good updated

capital compared the million $XXX taxes. from $X.X of billion quarter approximately approved that third of In scheduled had year, have of income We $X.X flow million. and billion XXXX. come Capital stimulus pipeline was is and spending deferred share over $XXX approximately the just repurchases the cash XXXX. And in Our million between we of was in the quarter to received payroll during billion quarter. to operations end as completed of online the now $X.XX $XXX $X.X prior billion the approximately we of for

our anticipate We remaining have $X of on full completing approximately And approximately share $X.X we billion XXXX. authorization. billion repurchases for year

available the years. the facilities debt-to-EBITDA health announced quarter, the X.XX billion quarter, the billion of at generate is end we recorded Our about was times investments. had $X.X anticipate, ratio been which end to related sale four hospitals in we will in during it $X.X entity $X after-tax at on divestitures. of quarter. proceeds approximately over We sale the We the and from of of has the other of third Also liquidity approximately of lowest gain care billion Georgia our XX

billion in to noted this now $XX.X range morning, between as We our $XX.X we follows. XXXX guidance expect As are revenues release billion. our updating full and year

adjusted expect full to We billion. between range $XX.X year EBITDA billion $XX.X and

earnings We range expect our approximately full And remains per diluted $XX.XX. $XX.XX capital at target share and to $X.X spending between year billion.

this XX navigated of has reflect The I HCA company, resiliency As have pandemic. I remarks, to conclude we condition Healthcare as it's on the past of financial during full of time. this months the financial been on display my the think important

times, low opportunities today and strong this below range evaluate generation, before emerged end of XXXX. positioned our our into our continued three available well we we cycle has cash our stated our planning capital ratio than organization stronger of With are entered as pandemic. Our allocation liquidity the we flow leverage for well heading

in stakeholders. of delivering and committed value to are with our year-end our information more sharing all our long-term We outlook We about for call. forward to focused look you

I'll Mark it So the to that, with Q&A. over call turn to up open for

Mark Kimbrough

queue please? into All Bill. on Thanks, questions, Sam. give right. instructions for would Thanks, you Chris, getting the

Operator

first Kevin is of America. Fischbeck Our question Instructions] from [Operator Bank with

Your line is open.

Kevin Fischbeck

Great.

to Did and and the that a across then be X% year. in - say I COVID down sounds or might total So quick for most like ask service volume It growth question. then next actually you main lines? volume X% clarification

main like So higher little It thought labor then was is than make margins And I quarter. may the we we really was like to right. thought. bit about be lower than hearing sure QX I But that costs. looks want seem does then just labor the this question a

Just a and there what labor today? you're on color you're kind seeing pressure managing of how little more

Sam Hazen

I what he couldn't said. hear

was? question first The

Bill Rutherford

The certain service the lines, across to volume. on lines? X% is Or volume. Was service X% it that all inclusive?

Kevin Fischbeck

Because COVID Yes. So... down, right? is

Bill Rutherford

Core business up.

Kevin Fischbeck

to and Pre-COVID up X% X% COVID down?

Sam Hazen

We expect COVID to be volumes down.

think, be are for we year. anticipating X% said, this to I I X%, next As about of year. admissions total It's our X% COVID-related will

for do expect some so that hope COVID that forth. happens our communities we decline we related, and So and in

XXXX and be it we're And zone we as XXXX particular expecting the really company is X% estimate over X% to. in across the this a point boils composite so time, to down to at up in when whole what over volumes

Bill Rutherford

Yes. Labor?

Sam Hazen

a over question needed me and shift premium let care And intense COVID the We them the margins the our to and was needed speak third that facilities where still do at putting Obviously, dealing quarter, labor, of And and producing up on it good people. quarter levels think, our with used quarter. level labor. that not where we overtime moral imperative outcome had produced, we we to actually absolutely XX% company, a with in communities cost with that But we strain care of step lot so in record very to On us. we And very to. care patients. our I acuity appropriately. significant a what of and did as people take We Yes. we to. the was and on sick EBITDA in volume support third pay different for levels. We of, a labor surge, And had to take third used and a forth. very of us took labor of did to we with a bonuses required that to and were

nurses for the We of what forward, which labor of School years anticipate over of approximately a our pipeline produce nursing, to have going do of a It we multipronged expanding coming Nursing we out three with starts strategy is for great managing. company. Galen times graduates our compared of next to the few going graduate number think school today. the So, we

Obviously, opportunities of of And and the models have to manage have labor be how about to can very and more is combination levels retention. going thing can they as change care to support all create care. present care patients, of facing amount think we're we of where resources our can three non-nursing on the some And We've to that position of we're as tremendously technology environment we But with just doing do to to The is is on through work we're manage these a an we're where patients with their The need last added nurses successful to We're environment on responsibilities paradigm that and we our that with we're that to deliver discharging those themselves, company areas. and new right ultimately, tremendous time, they the there's working put can we've floors, think many trying they in care different an our recruitment through in the recruitment things position our accomplish environment. excited We pretty thing us and at a nursing through environment opposed same in way the and the our care unknowns. hospitals. we transformation. have productive benefits our confident where in advanced what and now. second And in working reasonable functions. our we're

Operator

from next question Mizuho with Ann The is Securities. Hynes

is line open. Your

Ann Hynes

are Medicare one just inpatient being XXXX it on Medicaid? comes to outperforming down. still Is want for how your by what about I comment mix? And surgeries payer when tracked mix? expectations just to and your And volume payer commercial know follow-up

they If you Thanks. happening XXXX. think were or the all the sequentially? that's chart COVID-related in XX.X% versus you is provided there Do you release, look press else at something down

Sam Hazen

All right Ann.

Bill Rutherford

the with start mix. me let payer Ann,

payer and to the Our remains probably others alluded prior Sam care with XX% mix, I favorable our growing comments, over managed to in his XX% think, as year.

were whether at very not at but we that growth, On showed Medicare. Medicare look X% level. to Our trends. X% We on quite similar XXXX,

favorable So, we going continue trends payer to mix expect forward.

Sam Hazen

as patient requirements. quarter, surgery respect with my third comments, we other of mentioned constrained to or the for in And labor - in care surgery out need I

at many surgical our So, Number space times across had to we used rooms physical our of patients facilities. our instances take in in care we use people. one, support recovery to COVID to staff

of volume that quarter that had in thing, will as And do we second the surgeries to of at We periods as instances. do transfers standpoint, so during some quarter, first recover our it's we elective the previous result typically reduce did that, from And where hospitals. in many think that an example. recovered we in many same care in sort reduced to quarter

that. So we in anticipate recovery

reopening our surgical company. from so the an fashion. we that across our And working see any are appropriate standpoint, don't in issues with really company surgery we And activity way through across the structural capacity

Operator

question is Brian next with The Jefferies. from Tanquilut

Your is line open.

Brian Tanquilut

as the morning. unusual sort congrats the midpoint of on QX, see guidance, to decline the to question, guess to which And it guidance. my Good it's the what's XXXX you is quarter. guys of for QX in EBITDA from I implied by to relates a sequential you

translate background? are XXXX to thinking growth we think to X% wondering you as just kind just then that's if like with well? in X% flat volume, trend the just expect how X% about the I to margins margin a So X% conservatism. about as EBITDA of rate And Should commentary, to labor

Sam Hazen

me this provides recognize start fourth the then manage We've guidance. - to at quarter range growth, again, continue of continue play. the But raise best project still We'll at company had variables previous I the think some we with our $XXX normal level. our let there's lot a million drive growth. midpoint, We can to Brian, of at is months to at few to the and to our range roughly level the compared midpoint we think Yes. we a It's guidance. very from. appropriate

it from how So, read right I think again, it's now. appropriate we

Mark Kimbrough

Margin.

the margins. I think about also asked he

Sam Hazen

of into for play margins lot variables to that there's Well, year. next be a going

our to to continue continue we to expectation history I those. think to talk do we we'll margins about have be reasonable But to As conclude further going forward, planning, drive a that's you that. to able our and

Operator

question next from Our with Wolfe is Justin Lake Research.

open. is line Your

Justin Lake

of A here. things Thanks. couple

labor And mid-single point the kind single-digits there any labor, when you One, gets company clarify, great are travel Can typical percentage the on say the percentage wanted it's is then things? as kind well. of can on it’s I in of labor. on to your of kind labor cost question you help maybe is X:X? you I through given run of year costs digits, us revenue high of for is I dollar a running? of just side, or lower know because would as to growth of that terms and quarterly, when my not your that a how walk the color us little on the it repriced given their say you're kind the kind should fair historically, maybe - such then, of - modest, what the you it labor Just the know XXXX? give all to - jump-off EBITDA side the amount in cost, temporary of increases be two through kind Thanks. And get take

Mark Kimbrough

You - snuck but... one three questions call in on

Bill Rutherford

this is Bill. Justin,

to was the have throughout commentary, to into XXXX. going for for full But not have benefit of to on forward. ready course provide received process. We contribute those intention the programs We our They about we've well these for as payments, with details. the assessment to from We could million, - some to $XXX what some start $XXX payments, lot the really we of go we've expecting as reach into line really a DRG hope don't some we're to they million now, XXXX. of not million These full now as sequestration mentioned cuts. the sight me Let close delay of kind uninsured, HRSA add-on of we going year. year-to-date. payments to these know clear COVID support planning programs, COBRA the But for as $XXX of broad complete expect year, continue

to have costs this costs, and also expect alike. that some cost we COVID-related going supply-related of year However, don't we screeners forward; continue

of historical basis. X% -- thinking an And we netting year-over-year broad growth our the growth that will amounts. as-reported So after to reasonably these is rate what expect generate is our to on able some in now modest result be to out result X% should

now. commentary of that intention was to planning in see still we going our So we thinking But go broad our firm was XXXX. kind forward growth show that some up that that cycle. the through right our We'll as of

Sam Hazen

And used of again, care was with take Delta labor to respect find variant record could we that to whatever labor, surge. the company with the we census experiencing

we COVID to our we So of we And for it premium the of we census. year, obviously that We've whatever being contract as took fourth that have pattern that bonuses the full-time the patient XX% staff staff, less pattern down And in last quarter to load pay this naturally XX% labor used of quarter over those a time. resulted Again, categories. that That to in trends first FTEs expect about our had. had to continue. in year.

As the we it that in quarter. vary relates changes the to -- quarter mostly third the company. second the speaking, and they're wage rates in Generally have, and they across

effectively managed that's did And think that the quarter third reboot, transition part But to then and a a effective company in really a produce in margins. seasonality and in got. judge second can very quarter, manage of very of we that labor that part the we proven the in the has Bill through have So we've this, quarter. the have fourth we fourth move the our thing, don't typically, baseline and We natural we activity that inside quarter that through in third of trend more One have course in year. the the as alluding generates of than we it solid quarter right now, challenge was that's seasonality see I surge like a costs to way.

and that a hopefully, reboot part of third produces the and mode will into company. next anticipate navigate into year, quarter back a able teams the ultimately for fully to be in the quarter, way that fourth I on our success the So through

Operator

from The Fidel next question with is Scott Stephens.

Your line open. is

Scott Fidel

what volumes. could even much of talk it suspension seeing continued seems And though redetermination. Interested about to trend are of in just if overall the up bit Medicaid like relatively terms the because you you're Medicaid mix interesting low of in too, just volumes so Medicaid the a been have enrollments

what in aspect, the that you're So Medicaid increases in of perspective on enrollment vaults your around interested Medicaid in Thanks. growth. lower just thinking relative to the terms

Sam Hazen

Thanks, Great. Scott.

Bill Rutherford

look of done growth our has enrollment XXXX Yes, did Scott. see versus at X%, at try. what in I my have I We fingertips Medicaid XXXX I'll when Medicaid states. don't almost

relative have have Medicaid growth I don't So tracking X%. about least. in that as a we're Year-to-date, we But base. quarter seen this at at

So perhaps that does as track with going enrollment forward well.

Operator

is question next from Ralph Giacobbe. The

line Your is open.

Ralph Giacobbe

acuity gave the and sort you X% guess, stat on volume sense developing us mix, X%. Is quarter you XXXX? to next what sense then see to specifically, or strong either of give any another exclude can out I COVID to sort give Thanks. you full of some year? off -- you obviously the year-over-year But way on relative Hoping on I gave first, is, want the how of know guidance. And hold pricing and you up there. just a to there that us

Sam Hazen

Thanks. Hi I Sam. is into Rob. We this acuity do be that as we move levels -- strong forward will Well, said as anticipate XXXX.

levels our -- for to COVID up have compared been acuity the non-COVID XXXX. year Our

we're part is And is is of just And in, natural believe. some outpatient. so strategic. into seen that of lift Part the have of we environment that that we acuity. Part sort of in a migration that

look in if we anticipate particular for our at as the a know will point it metric a at this levels is assigned acuity that to that it remain don't compared activity you to strong. we've up But non-COVID year time. whole, So XXXX. I

anticipate into we at continuing particular juncture, that, XXXX. And this so

Operator

Frank is Morgan Our RBC with Capital next Markets. from question

is open. Your line

Frank Morgan

the you provide the COVID? outpatient and for Just a surgery to regional and curious additional side. biggest you on Thanks. color between saw Any surgical us volumes on impact basis could freestanding and in where

Sam Hazen

we comments as mentioned down for because for used necessary were that COVID only lot surgeries that Well, a in my I again, the the And patients. were our inpatient space of quarter. the that's was metric,

of ASCs up was both It at up. but then than more was was up again, It And our standpoint. COVID we was a X%. against when growth, is inpatients we freight. the hospitals, correlation both And that, from in surgery activity capacity think, direct inpatient bed exception needed outpatient the in a I our had that our for it in look XXXX, and up. to were that manage with staffing freestanding fact you order space Our it again, to

Frank Morgan

from you just the outpatient Thanks. outpatient Texas a markets, say, the And of an did of say, on just in an and the because any Florida standpoint, effect side, notice -- in, more COVID? geographic

Sam Hazen

don't for all Obviously, me. I very of Delta variant. us have Texas were front it geographies the intense and in of with Florida

than that did that's pressure reasonable it's question, so we And my But to the parts country. other assume more to those we where reaction be that of that would Frank. in had in markets

Operator

Chickering with next Our Pito Deutsche question is Bank. from

open. is line Your

Pito Chickering

Thanks my for taking questions.

For your Kai the XXXX revenue commentary, -- you talked continuing. procedures acuity about

I your of Thanks through noise so are still you fueling from it COVID, growth question recovering, laid think 'XX just beyond, and as cardio that? Just out once sort for And of get much. of the is in long-term XXXX noise these past, What the what Is and XXXX? you you, curious a EBITDA the levels does over from once then get you've that continue of areas about orthopedics, driving etcetera? sort that? it does

Sam Hazen

Thanks.

for not continue can out and And have a and Our we look market belief of to be is so growth, where underneath it's pattern And we will that where X.X% that and we differentiated the gains. we better to the today for competitively you to has we is model existent. yield of so economies broader But more growth is job our pattern continue to embedded intermediate we're forth still factors. these still so we as And And for were into particular XXXX, relates guidance we think we've networks, are it X% HCA, as we And we can think heading think where we've years. think with forth. in then growth our run still positioning we and of approach at shareholders. outcomes differentiated any share improved we had We model. into And portfolio, clinical to this strong return resource services this markets. health physicians, strong. give have the out that care company's look think And going it demand when because forth. portfolio successful versus ready overall do our population think

Operator

The next SVB is from question with Whit Leerink. Mayo

is line open. Your

Whit Mayo

last back As to ago, guess, I sort reflect certain medical you I commentary to comes Sam, a on it year I closer sort of of ability call referenced think a growth lot pop-up to opportunities. It we'll align of groups emerging mind. the just months. hear the these evolved how in some or But have this would opportunities to just of high-level shifts, the share any be thoughts observations helpful? Thanks. maybe I etcetera. context over mean market might be And of helpful XX

Sam Hazen

year, year, have, XXXX market last market Whit. year. remember share with first don't or up that data at the is a we period, what in picked us our fact of you, recent Well, shows happened this in Thank let just sort at high of watermark. We that I most late the share which when me that I XXXX look part start exact

So, with start I'll that.

added our we have Additionally, to networks.

on physician opened the hospitals or some out here round it's a added, whether had have few center some and acquisitions cases, to then of months. a emergency whether We And rooms, urgent the freestanding have platform of in new in added number surgery. ambulatory hospitals that platform, it's particular, over reasonable new new we've our small offering. network we've facilities, added there, new XX But hospitals last we've side, to outpatient care our

to existing practice has our of which practices also offerings. that communities, new acquisitions have added but development of in been Some our

is facility end X,XXX. our capability just XXXX, X,XXX a the of little it up At facilities. I to of north about think outpatient outpatient was

patients, continue network convenience communities. these to capabilities for a add our broader we again, in creating offering and So

We acquisitions. have done some

And as our our online it our acquisitions to with as Our connected of that that then strong a as to facilities relates is pipeline platform. outpatient is Bill XXXX platform new outpatient strong. fueled will indicated, and robust, we hospital projects well come investment. are both and pipeline we outpatient pipeline XXXX of development Also, that in have as

see, produce shareholders. deliver we patients will, to HCA model, So, and value value results to you flywheel, our solid again, the continuing and to if of the our

Operator

The is Bernstein. Wilkes Lance from question next with

Your line is open.

Lance Wilkes

you to talking deployment Yes, looking as follow the enterprise And talk sit about the earlier a on at you the up what And could wanted assets I markets. just in you're particular, as the were little if bit flywheel capital theme. far about in atop local that year, looking there's at just it. focused might that going and or on virtual thought assets there if sorts other assets of digital if to and into what and concept or But then be feed you're had any Thanks. interesting progress as you on any evolution reports to that?

Sam Hazen

our see digital capabilities use complementary more company. All you, opportunities in effectively do We Lance. right. to Thank

on our capabilities our tremendous opportunity is improve support advancing technology care, in and environment. physicians well nurses to safe organization I've more as as a decision-making calls, previous As mentioned a with

can produce and more through it. go that consistency we with more believe see transparency, efficiencies also as We which we

that number a to connected got that. are initiatives we've So, of

we telemedicine component, meet inside on that support inside that telemedicine to with capabilities And by our of then are nurses to and better our from patient where come outreach them really hospitals. want care and extended of addition our physicians can patients for preserve walls to population, see and facilities we the our be. our to goes to In support using opportunities they what for our helping telemedicine

that one care, the instances. showing about excited our value physicians led potentially are of more when areas what forth. with so care they early being better efficient connect is of very our then and of some form So, in his care signs They're and progressing. team, those which And by transformation yields we're in agenda,

we're a what So, number company of But we're underway. do what because studying are about excited not approaches. still implemented pretty organization. best They're agenda we this across have the initiatives our completely can the for

Operator

is The with Perse next question Goldman Jamie Sachs. from

open. is line Your

Jamie Perse

you how that couple you you Good some the with are base question. pressures offset you're in those Early And phases the wage opportunities tracking? optimize? And there? thanks and those different guys. structure incremental the were outlined to are morning thinking out more of dealing pandemic, the of cost cost can much about. How pressures of inflationary a enough for other of

Bill Rutherford

Bill. is for This question. Thanks Yes. the

have Those talked started we efforts we last year. about have efforts As resiliency underway. We continue. before,

we might the of have are implementation and implemented We benefits still the some provide terms to And be of consolidate those around benefit may changes the help going we in those we're that the future. efforts offset some that field-based areas to in we These They're how also support structural stages inflationary where scale, functions that the some to ability our our realizing of We early at some will increases now. operations. see. efforts of and are of right standardize some have that of centered expect are we those distributed now. do have looking utilizing efforts

have we number underway. So a efforts of

the completion Some and of benefits stage, are speak. realized the them being at are we as

will them some in And forward. stages that are going benefit early of the still provide

activity important of part an our level right now. it's So

timely. place sure we focused governance they teams a have certain a that of And to get have make on executed variety We efforts. structure in

continue they forward. So will going

Operator

A.J. with The next question Suisse. from is Credit Rice

open. is line Your

A.J. Rice

I did this we’re $X don’t further. Hi And just if capital retirement I deployment you Thanks. your billion. ask congratulations you know a to wishes. Obviously, going and year, have the want to so everybody. little say, call, fourth the on quarter Mark about best would I on

you know of of deal. is going about Salt deployment – the reasonable repurchases. pace $X you've kind do what announced think on forward, When billion City you And capital I for that? think already You're done you've Lake share

significant Salt about comments, might of be incorporating I'm Bill, that with not more the assets your made EBITDA. growth, of that you until to talk specifically deal assets understanding about hospital can or $XX you on So that the Lake, out million of $XXX next My other side when closes, year's million it's about commentary. in assuming, you're your pipeline? that pandemic, And available, coming

Bill Rutherford

Yes. are A.J., you correct.

about that let our in allocation, capital into We are commentary little a not incorporating talk this Relating step point anything the me broadly time. into back and that. to at

very a given balance our we cash carrying. position next allocation the in flow my sheet liquidity in mentioned and approach as strong are I our capital position As decisions year we're comments, for generation, we

past, what to deploy capital to as with our I opportunity our is internal program. As through first capture approach balanced on focused the in our growth in we've evaluating described described we're capital markets capital, really to a priority

range haven’t we'll would finalized anticipate yet, on We that it the commensurate but with I opportunity. increase

guidance, little to the billion. were So should pandemic, somewhere to be it maybe Prior we billion our billion $X.X we below at $X.X in this mentioned a that. $X year, around

it's think process. settle And be an that important so our After continuing matter that growth. will the year. we utilize overall to for we're to we cash allocation of capital our A a free best evaluating But to where our continue and of be to value. drive part program, next that, should how dividend repurchase of expect important share program flow an part

balanced our to capacity part be portfolio We would give have to ample consideration haven't due finalized them forward. that. both going capital And those of capital expect we But of programs. of I to

Operator

The Ransom Raymond question is with next John James. from

line is Your open.

John Ransom

I'd add morning. my best Mr. wishes to Kimbrough. Good

Sam Hazen

while, yet. got for He's but… little not a We leaving him still

Mark Kimbrough

Yeah. for get here be I to… the year-end. I'll

John Ransom

thinking spelunking ballroom I'm of or something. dancing

I hobby. eccentric think take need to you an

Mark Kimbrough

That's right.

John Ransom

Just think hanging get in, the X%, at say, range labor less comes peak we we quarters. from to COVID – August? of costs, some three $XXX and talked mean, a to acute a about saw thinking relative you just of about labor from bit XX% they sequentially what million off, for in fourth wave in at that pressure breather the think lot, conjunction that your reasonable up If with but guidance, I jumped let's costs drops after about X%, by dropped kind about say your in, the fourth Delta quarter, a it pressure it quarter the so the isn't little of

Bill Rutherford

Yeah, John. Bill. This is

looking we whether well we earlier as during support we I think the these the we mentioned as his that labor to had we And subside, contract at differentials implemented and at that subside. some utilization the seeing. of commentary, quarter bonus overtime any way pay. volume to programs premium of to quarter be And the gaining this it shift then labor, affected expect having those does by as the Sam the in was were as – we COVID could

we quarter. come that But in expect to to had pressure third where relative do in still we market. understand So labor we down there's the

out fourth have that the to see So settles for quarter. we'll where just

John Ransom

just I as So mean, follow-up. a

pressure imply sequentially, I going flat acute think that and wouldn't So if less up EBITDA about flat? revenue sequential from labor not being

Bill Rutherford

Yes. I that question. understand

end As us at that. seasonality grow the think for the to before, range top our opportunity historically, know we We the said we will see seasonality. what some be. of We provides change don't

think again, what seeing, given at environment just the and in range, we're that's going our with point. we're this we're prudent So I

Operator

Joshua from Nephron is question with Raskin next Research. The

Your line is open.

Joshua Raskin

so I'm the hold days the And another one felt hospital level. then From point? is of the employers in operator movement? of feel guess, XQ. the going providers my to conversation there's for a around is HCA get do facility Mark, contracts? hospital HCA country, largest country, that for I about for know think care in of I how value-based question do this morning. you there the My at base? the ton you on largest look opportunities then value-based side them to comments Good Thanks. perspective enabling on care. till on much physicians the for at to it your the you we are being this at think doesn't it's And do Because like benefit opportunities physician But from XX

Sam Hazen

facility as in, in physician our continue, little That of market to care. the contracts, value-based value-based obviously, care in and Well, the opportunities see a methodologies. commercial to some structures? value-based platform Is In further Again, other part from think, we do we to and our value-based aspects it we our of accelerating particular continue of on They of payer one markets. demographics No. those Inside bit dynamics in in into of company, care. our push reimbursement. that depending have vary aspects platform, circumstances our future. the certain will of Medicare have the reimbursement embedded component have we aspects I into care

see it on XX% environment, contracted But across payer very already do going lot a the and work XX% we on They terms for side, our as So they're growing about organization with in you more think I we in I strong. place. contracted that evolve, We're pull that's we would relationships XXXX in the XX%, if in XXXX. the than up, the continue what's for platform look structure you submit. physician both at for We're on of And renew organizations. the the marketplace. facility

And well. We Medicare most just relationships where contracts market, every do most commercial in as Advantage business. in we in about are

of offer then, So price why for payer. our those each offerings, And situation key with in comprehensive, part system And solutions And each markets to a it's that's adjust we that payers, important approach. the to creating the model different can both having the outpatient for of patients. within a but ultimately that's our be for full fit points the solutions. convenient

some value And that, of again, be based. can

can approach it other of balance think Some right the a we're how reimbursement that. as terms. be striking different we we But to in approach

Operator

next Our Taylor Cowen. Gary from with question is

line open. Your is

Gary Taylor

The maybe for due. one manage enough And given, Street a very the guys. immediately morning it's was not is the through. on it credit data difficult to point, know Congrats Good always looking quarter. next when I

I quarter, the ask,… to on job wanted good So

Bill Rutherford

Thank you Gary.

Gary Taylor

margins ago, higher primarily to this margins When about points, hundred ask, factors beyond, to like to et thoughts the few structure. your now driving at XXXX take the years the pre-pandemic, some understand investors Or some for wanted back inherently cost the as the higher in it. guidance despite you you assumes, despite year your real to margins feel labor COVID I I sustain efficiencies there of head occupancy, next Bill, should cost, But year sort come the up we opportunities can costs, sort back look to a that that of or the go get I talk that have …I cetera. some right ultimately trending good where think goes been to your out think the degree. of basis And were wanted permanent better did a structurally so a think reasons to Bill. of we and And acuity, middle? couple low-XXs? just into maybe somewhere are just The mix, all think we

Bill Rutherford

very Gary, thanks. a Well, It good one, is question.

can we are efficiency throughout the on Assure, driving focused organization. as as much we

think track that. I a record pretty we have of good doing

You're right.

If were a be quarters go We've pre-pandemic, that. are of There margins. we step changed couple we'd XX% in XX%. hovering you

is to mix due the Some of and that there. acuity on

to continue be margins. drive will focus Our to

scale should about. continue account We We is have organization drive we those, those once the to of supported programs by and maintain plans find we efficiencies, fully day-to-day resiliency of support been a anticipate couple management, our some and COVID spoke I the benefits. for to utilize that that bring

see that a margins compare do believe post-COVID of I normalized there. we get into some we to So elevation in surge where pre-pandemic, and environment once they our current kind were you'll

Mark Kimbrough

you, Thank Gary.

Gary Taylor

Yeah. Thanks.

SamHazen

the I XX% -- the you words, average times Yeah, at of In So when in clearance. almost, quarter you this XXXX at EBITDA look is When XXXX our two margins were of what XXXX, what look Sam. we against Gary, other call, cleared margin the in third XXXX. was

Bill same of a potential it. implications pieces some out profitability as those compared alluding we inflation able mitigate Obviously, that we possibly gains structural we're as that there's and of think that But to we the been And And do it's obviously, some the of And company. to period then see of what figure strategies was significant to sustain to are. the exactly our have so to. can. reposition pushing try much we will that have we to

Operator

The Andrew with is from question UBS next Mok Financial.

is line Your open.

Andrew Mok

morning. Good

you base expect aid. If to sounds First, my X%. off XXXX, in I one to growth you the X% compared clarification, Is long-term accelerating then, X% said Bill, growth target core the earnings I'll of question. get that ex-government it EBITDA think actually of like to growth so, fair? X% to earlier,

Bill Rutherford

to we Well, long-term have X%. had X%

be at our more we'd think X% in you actual historical, if X%. look I to that

intent you the And was commentary stages. on some early in give there. broad we're again, to specifics So versus

was was structured. the commentary how that So

Andrew Mok

novo just de follow-up then the And on deployment. a

XX the surgery I come those of next months? think to de rehab. and ramp you facilities of least cadence you between expected novos when the and have underway over us at sense give ambulatory inpatient XX for those a online the profit facilities XX Can

Sam Hazen

through I or of that a novo or acquisition XXXX, I -- I in is mean XXXX care have development. urgent don't have pipeline coming we online again know de

maybe or XX surgery We ambulatory XX have centers.

in which with so, And quarter, -- fourth come in another the then maybe of categories -- come component. other online that XX XXXX online some most facilities of in or XXXX, so XXXX. and have particular in outpatient that Some come online some those or XX we

the So different we in addition X,XXX categories lot a outpatient our continued of online. that's part And facilities. have to coming

or well. We composite are those -- I ramp in of so have do And complementary. for as each them And a natural a prospects most around And bullish on development. but And active part, on have we them the we're those facilities. earnings pretty total. expectations there's all outpatient a the in don't those -- really for the

Operator

any further time. to remarks. no this at for Kimbrough are I'll questions the over closing Mr. turn There call

Mark Kimbrough

answer I'm you around All right. this hope questions today. any much so you thank a for help your care. call. afternoon, Chris, I I Thanks, our weekend. wonderful Take might can have. you additional for everyone, joining have if

Operator

Ladies now Thank and this disconnect. you you for conference gentlemen, participating, and may call. concludes today's

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